The Role of Nutrition, Oxidative Stress, and Trace Elements in the Pathophysiology of Autism Spectrum Disorders

Abstract

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by deficits in social communication and interaction, alongside repetitive behaviors, and atypical sensory-motor patterns. The growing prevalence of ASD has driven substantial advancements in research aimed at understanding its etiology, preventing its onset, and mitigating its impact. This ongoing effort necessitates continuous updates to the body of knowledge and the identification of previously unexplored factors. The present study addresses this need by examining the roles of nutrition, oxidative stress, and trace elements in the pathophysiology of ASD. In this review, an overview is provided of the key dietary recommendations for individuals with ASD, including gluten-free and casein-free (GFCF) diets, ketogenic diets (KDs), and other nutritional interventions. Furthermore, it explores the involvement of oxidative stress in ASD and highlights the significance of trace elements in maintaining neuropsychiatric health. The impact of these factors on molecular and cellular mechanisms was discussed, alongside therapeutic strategies and their efficacy in managing ASD.

Keywords: autism spectrum disorder (ASD); gluten-free and casein-free (GFCF) diet; ketogenic diet (KD); nutritional interventions; oxidative stress; trace elements.

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Literature search strategy.

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(A). Relationships between trace elements, antioxidants, and ROS in relation to ASD. Abbreviations: aryl hydrocarbon receptor (AhR); catalase (CAT); cytochrome P450 (CYP1A1); deoxyribonucleic acid (DNA); glutathione peroxidase (GPx); hydrogen peroxide (H₂O₂); magnesium (Mg); nicotinamide adenine dinucleotide phosphate (NADPH); nuclear factor erythroid 2-related factor 2 (Nrf2); peroxisome proliferator-activated receptor gamma (PPARγ); reactive oxygen species (ROS); selenium (Se); superoxide anion (O₂•⁻); superoxide dismutase (SOD); zinc (Zn). The arrow ending with a perpendicular beam indicates inhibition. (B). Oxidative stress mechanisms relevant to ASD. Abbreviations: catalase (CAT); deoxyribonucleic acid (DNA); reduced glutathione (GSH), oxidized glutathione (GSSG), glutathione peroxidase (GPx); glutathione reductase (GR); hydrogen peroxide (H₂O₂); reactive oxygen species (ROS); reactive nitrogen species (RNS); superoxide anion (O₂•⁻); superoxide dismutase (SOD).