Case-ControlMolecular autism2016

Urinary metabolomics of young Italian autistic children supports abnormal tryptophan and purine metabolism.

Federica Gevi, Lello Zolla, Stefano Gabriele and 1 others

PMID 27904735

WHAT IT FOUND

Urine metabolic profiles differed between young autistic children and matched controls, mainly in tryptophan and purine pathways.

These are laboratory findings, not therapy outcomes, and do not tell clinicians how to diagnose or treat autism.

Key findings

01A panel of 25 urine metabolites separated autistic children from controls, with an AUC of 0.893 (95% CI 0.72–0.96).

02Tryptophan pathway metabolites differed: higher xanthurenic acid and quinolinic acid, lower kynurenic acid, lower melatonin-related compounds, and higher bacterial indole derivatives.

03Purine metabolites were higher in autistic children, including inosine, hypoxanthine, and xanthosine.

STILL TO COME

How it was doneWhat they found

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What it does not show

The study measured urine metabolites, not therapy outcomes, so it cannot tell therapists whether to change assessment or treatment. Single metabolite comparisons were not corrected for multiple testing. The authors say the abnormalities may apply only to young children and need replication in older groups. The study did not measure cerebrospinal fluid, so it cannot show that urine changes reflect brain metabolism. The paper did not test whether these metabolites can diagnose autism or guide treatment.

Declared interests

Funders named: Italian Ministry for University, Scientific Research and Technology; Italian Ministry of Health; Fondazione Gaetano e Mafalda Luce; Autism Research Institute; Innovative Medicines Initiative Joint Undertaking; Interuniversity Consortium for Biotechnologies.

The easy way to misread this

Do not treat these urine metabolites as a clinical test for autism or as a reason to change therapy. The study found group differences in young children, did not test diagnostic or treatment use, did not measure brain metabolites, and did not correct single metabolite tests for multiple comparisons.

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The study

Participants
30 children with ASD and 30 typically developing controls
Certainty of evidence
Low

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    Cite

    Federica Gevi, Lello Zolla, Stefano Gabriele, et al. Urinary metabolomics of young Italian autistic children supports abnormal tryptophan and purine metabolism. Molecular autism. 2016.

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