Validation of plasma protein glycation and oxidation biomarkers for the diagnosis of autism

<p dir="ltr">Autism Spectrum Disorder (ASD) is a common neurodevelopmental disorder in children. It is currently diagnosed by behaviour-based assessments made by observation and interview. In 2018 we reported a discovery study of a blood biomarker diagnostic test for ASD based on a c...

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Main Author: Aisha Nasser J. M. Al-Saei (17885957) (author)
Other Authors: Wared Nour-Eldine (13904298) (author), Kashif Rajpoot (781020) (author), Noman Arshad (17122805) (author), Abeer R. Al-Shammari (11405339) (author), Madeeha Kamal (16535217) (author), Ammira Al-Shabeeb Akil (15143925) (author), Khalid A. Fakhro (3158862) (author), Paul J. Thornalley (291723) (author), Naila Rabbani (291722) (author)
Published: 2023
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author Aisha Nasser J. M. Al-Saei (17885957)
author2 Wared Nour-Eldine (13904298)
Kashif Rajpoot (781020)
Noman Arshad (17122805)
Abeer R. Al-Shammari (11405339)
Madeeha Kamal (16535217)
Ammira Al-Shabeeb Akil (15143925)
Khalid A. Fakhro (3158862)
Paul J. Thornalley (291723)
Naila Rabbani (291722)
author2_role author
author
author
author
author
author
author
author
author
author_facet Aisha Nasser J. M. Al-Saei (17885957)
Wared Nour-Eldine (13904298)
Kashif Rajpoot (781020)
Noman Arshad (17122805)
Abeer R. Al-Shammari (11405339)
Madeeha Kamal (16535217)
Ammira Al-Shabeeb Akil (15143925)
Khalid A. Fakhro (3158862)
Paul J. Thornalley (291723)
Naila Rabbani (291722)
author_role author
dc.creator.none.fl_str_mv Aisha Nasser J. M. Al-Saei (17885957)
Wared Nour-Eldine (13904298)
Kashif Rajpoot (781020)
Noman Arshad (17122805)
Abeer R. Al-Shammari (11405339)
Madeeha Kamal (16535217)
Ammira Al-Shabeeb Akil (15143925)
Khalid A. Fakhro (3158862)
Paul J. Thornalley (291723)
Naila Rabbani (291722)
dc.date.none.fl_str_mv 2023-12-22T03:00:00Z
dc.identifier.none.fl_str_mv 10.1038/s41380-023-02357-9
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Validation_of_plasma_protein_glycation_and_oxidation_biomarkers_for_the_diagnosis_of_autism/25124969
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Medical biochemistry and metabolomics
Neurosciences
Psychology
Clinical and health psychology
Cognitive and computational psychology
plasma protein
glycation and oxidation
biomarkers
autism
Autism Spectrum Disorder (ASD)
dc.title.none.fl_str_mv Validation of plasma protein glycation and oxidation biomarkers for the diagnosis of autism
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <p dir="ltr">Autism Spectrum Disorder (ASD) is a common neurodevelopmental disorder in children. It is currently diagnosed by behaviour-based assessments made by observation and interview. In 2018 we reported a discovery study of a blood biomarker diagnostic test for ASD based on a combination of four plasma protein glycation and oxidation adducts. The test had 88% accuracy in children 5–12 years old. Herein, we present an international multicenter clinical validation study (N = 478) with application of similar biomarkers to a wider age range of 1.5–12 years old children. Three hundred and eleven children with ASD (247 male, 64 female; age 5.2 ± 3.0 years) and 167 children with typical development (94 male, 73 female; 4.9 ± 2.4 years) were recruited for this study at Sidra Medicine and Hamad Medical Corporation hospitals, Qatar, and Hospital Regional Universitario de Málaga, Spain. For subjects 5–12 years old, the diagnostic algorithm with features, advanced glycation endproducts (AGEs)—Nε-carboxymethyl-lysine (CML), Nω-carboxymethylarginine (CMA) and 3-deoxyglucosone-derived hydroimidazolone (3DG-H), and oxidative damage marker, o,o’-dityrosine (DT), age and gender had accuracy 83% (CI 79 – 89%), sensitivity 94% (CI 90–98%), specificity 67% (CI 57–76%) and area-under-the-curve of receiver operating characteristic plot (AUROC) 0.87 (CI 0.84–0.90). Inclusion of additional plasma protein glycation and oxidation adducts increased the specificity to 74%. An algorithm with 12 plasma protein glycation and oxidation adduct features was optimum for children of 1.5–12 years old: accuracy 74% (CI 70–79%), sensitivity 75% (CI 63–87%), specificity 74% (CI 58–90%) and AUROC 0.79 (CI 0.74–0.84). We conclude that ASD diagnosis may be supported using an algorithm with features of plasma protein CML, CMA, 3DG-H and DT in 5–12 years-old children, and an algorithm with additional features applicable for ASD screening in younger children. ASD severity, as assessed by ADOS-2 score, correlated positively with plasma protein glycation adducts derived from methylglyoxal, hydroimidazolone MG-H1 and Nε(1-carboxyethyl)lysine (CEL). The successful validation herein may indicate that the algorithm modifiable features are mechanistic risk markers linking ASD to increased lipid peroxidation, neuronal plasticity and proteotoxic stress.</p><h2>Other Information</h2><p dir="ltr">Published in: Molecular Psychiatry<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1038/s41380-023-02357-9" target="_blank">https://dx.doi.org/10.1038/s41380-023-02357-9</a></p>
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spelling Validation of plasma protein glycation and oxidation biomarkers for the diagnosis of autismAisha Nasser J. M. Al-Saei (17885957)Wared Nour-Eldine (13904298)Kashif Rajpoot (781020)Noman Arshad (17122805)Abeer R. Al-Shammari (11405339)Madeeha Kamal (16535217)Ammira Al-Shabeeb Akil (15143925)Khalid A. Fakhro (3158862)Paul J. Thornalley (291723)Naila Rabbani (291722)Biomedical and clinical sciencesClinical sciencesMedical biochemistry and metabolomicsNeurosciencesPsychologyClinical and health psychologyCognitive and computational psychologyplasma proteinglycation and oxidationbiomarkersautismAutism Spectrum Disorder (ASD)<p dir="ltr">Autism Spectrum Disorder (ASD) is a common neurodevelopmental disorder in children. It is currently diagnosed by behaviour-based assessments made by observation and interview. In 2018 we reported a discovery study of a blood biomarker diagnostic test for ASD based on a combination of four plasma protein glycation and oxidation adducts. The test had 88% accuracy in children 5–12 years old. Herein, we present an international multicenter clinical validation study (N = 478) with application of similar biomarkers to a wider age range of 1.5–12 years old children. Three hundred and eleven children with ASD (247 male, 64 female; age 5.2 ± 3.0 years) and 167 children with typical development (94 male, 73 female; 4.9 ± 2.4 years) were recruited for this study at Sidra Medicine and Hamad Medical Corporation hospitals, Qatar, and Hospital Regional Universitario de Málaga, Spain. For subjects 5–12 years old, the diagnostic algorithm with features, advanced glycation endproducts (AGEs)—Nε-carboxymethyl-lysine (CML), Nω-carboxymethylarginine (CMA) and 3-deoxyglucosone-derived hydroimidazolone (3DG-H), and oxidative damage marker, o,o’-dityrosine (DT), age and gender had accuracy 83% (CI 79 – 89%), sensitivity 94% (CI 90–98%), specificity 67% (CI 57–76%) and area-under-the-curve of receiver operating characteristic plot (AUROC) 0.87 (CI 0.84–0.90). Inclusion of additional plasma protein glycation and oxidation adducts increased the specificity to 74%. An algorithm with 12 plasma protein glycation and oxidation adduct features was optimum for children of 1.5–12 years old: accuracy 74% (CI 70–79%), sensitivity 75% (CI 63–87%), specificity 74% (CI 58–90%) and AUROC 0.79 (CI 0.74–0.84). We conclude that ASD diagnosis may be supported using an algorithm with features of plasma protein CML, CMA, 3DG-H and DT in 5–12 years-old children, and an algorithm with additional features applicable for ASD screening in younger children. ASD severity, as assessed by ADOS-2 score, correlated positively with plasma protein glycation adducts derived from methylglyoxal, hydroimidazolone MG-H1 and Nε(1-carboxyethyl)lysine (CEL). The successful validation herein may indicate that the algorithm modifiable features are mechanistic risk markers linking ASD to increased lipid peroxidation, neuronal plasticity and proteotoxic stress.</p><h2>Other Information</h2><p dir="ltr">Published in: Molecular Psychiatry<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1038/s41380-023-02357-9" target="_blank">https://dx.doi.org/10.1038/s41380-023-02357-9</a></p>2023-12-22T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1038/s41380-023-02357-9https://figshare.com/articles/journal_contribution/Validation_of_plasma_protein_glycation_and_oxidation_biomarkers_for_the_diagnosis_of_autism/25124969CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/251249692023-12-22T03:00:00Z
spellingShingle Validation of plasma protein glycation and oxidation biomarkers for the diagnosis of autism
Aisha Nasser J. M. Al-Saei (17885957)
Biomedical and clinical sciences
Clinical sciences
Medical biochemistry and metabolomics
Neurosciences
Psychology
Clinical and health psychology
Cognitive and computational psychology
plasma protein
glycation and oxidation
biomarkers
autism
Autism Spectrum Disorder (ASD)
status_str publishedVersion
title Validation of plasma protein glycation and oxidation biomarkers for the diagnosis of autism
title_full Validation of plasma protein glycation and oxidation biomarkers for the diagnosis of autism
title_fullStr Validation of plasma protein glycation and oxidation biomarkers for the diagnosis of autism
title_full_unstemmed Validation of plasma protein glycation and oxidation biomarkers for the diagnosis of autism
title_short Validation of plasma protein glycation and oxidation biomarkers for the diagnosis of autism
title_sort Validation of plasma protein glycation and oxidation biomarkers for the diagnosis of autism
topic Biomedical and clinical sciences
Clinical sciences
Medical biochemistry and metabolomics
Neurosciences
Psychology
Clinical and health psychology
Cognitive and computational psychology
plasma protein
glycation and oxidation
biomarkers
autism
Autism Spectrum Disorder (ASD)