Correlation Analysis Of The Severity Of Autism Spectrum Disorders And Peripheral Blood NF-κB And A20 MRNA Expression Levels

ObjectiveThe Nuclear Factor-kappa B(NF-κB)signaling pathway plays an important role in the development of Autism Spectrum Disorder(ASD)and is involved in the inflammatory process by regulating the expression of various genes such as cytokines and immune-related factors.Serum zinc(Zinc,Zn)inhibits NF-κB signaling pathway and the secretion of related inflammatory factors by stimulating the expression of Zinc Finger Protein A20(A20).In this study,we investigated the relationship between these indicators and the severity of ASD by measuring the m RNA expression levels of NF-κB and it’s inhibitory factor Zinc Finger Protein A20 in peripheral blood,serum zinc,and calculating the Neutrophil/Lymphocyte Ratio(NLR),which is an indicator of inflammation,in order to provide a clinical basis for the treatment of ASD from a neuroimmune perspective.MethodsFrom September 2021 to November 2022,123 confirmed cases of ASD(aged2-15 years)were prospectively selected from the psychology department of shenyang Children’s hospital as the case group.The children with ASD were grouped according to the degree of their disease by the grouping method of Nadeem A et al.and the Child Autism Rating Scale(CARS),including 53 children with mild-moderate ASD and 70 children with severe ASD.At the same time,68 children aged 2 to 15 years were randomly selected from the healthy children according to gender in the ratio of male to female is 4 to 1 as the normal children group by stratified random sampling method.The expression levels of NF-κB and A20 m RNA in peripheral blood were detected by reverse transcription quantitative real-time polymerase chain reaction(RT-q PCR),and their serum zinc and inflammation index NLR levels were obtained by collecting clinical data.Results1.The peripheral blood NF-κB and A20 m RNA expression levels in the AS D children group were significantly higher than those in the normal children gro up,and the differences were statistically significant between the two groups(Z1=4.453,P<0.001.Z2=9.009,P<0.001).The peripheral blood NF-κB and A20 m RNA e xpression levels in the mild-moderate ASD group were significantly lower than t hose in the severe ASD group,and the differences were statistically significant between the two groups The differences were statistically significant(Z1=2.379,P=0.017.Z2=3.565,P<0.001).2.The serum zinc level in the ASD children group was significantly lower than that in the normal children group,and the difference between the two gro ups was statistically significant(Z=2.371,P=0.018).The difference between the se rum zinc level in the mild-moderate ASD group and the severe ASD group was not statistically significant(Z=1.190,P=0.234).3.No statistically significant differences were found between the NLR level s of the ASD children group at three age groups(<4 years,4-6 years,and >6years)compared with the normal children group(Z1=1.189,P=0.235.Z2=1.107,P=0.268.Z3=0.069,P=0.945),and the differences of NLR levels between the mild-mod erate ASD children group and the group of children with severe ASD were not statistically significant in the three age groups(Z1=1.101,P=0.271.Z2=1.316,P=0.188.Z3=1.256,P=0.209).4.The levels of peripheral blood NF-κB and A20 m RNA expression in the ASD children group were positively correlated with the degree of disease in A SD children(r1=0.229,P=0.028.r2=0.329,P=0.001),and the levels of NLR in the ASD group at the three age levels(<4 years,4-6 years,and >6 years)were not correlated with the degree of disease in ASD children(r1=0.161,P=0.241.r2=-0.374,P=0.095.r3=0.129,P=0.496),and there was no correlation between serum zinc a nd severity of ASD in the ASD group(r=0.047,P=0.628).Conclusions1.NF-κB and A20 are involved in the development of ASD disease,and NF-κB and A20 are closely related to the severity of ASD disease.2.Children with ASD have lower serum zinc than normal children,and attention should be paid to zinc supplementation during the treatment of children with ASD.3.Serum zinc and NLR were not significantly correlated with the severity of ASD and cannot be used as reference indicators for the assessment of ASD.