مقاله : Behavioral Benefits of Camel Milk in Subjects with Autism Spectrum Disorder
جهت استفاده متخصصین: مقاله را از لینک زیر دانلود بفرمایید.
Behavioral Benefits of Camel Milk in Subjects with Autism Spectrum Disorder
ORIGINAL ARTICLE
Behavioral Benefits of Camel Milk in Subjects with Autism Spectrum Disorder
Laila Y. Al-Ayadhi1, Dost Muhammad Halepoto2, Abdul M. AL-Dress1, Yasmine Mitwali2 and Rana Zainah2
Abstract
Objective: To investigate the possible therapeutic effects of camel milk on behavioral characteristics as an interventional strategy in autistic children.
Study Design: Double-blind, Randomized Clinical Trial (RCT).
Place and Duration of Study: Autism Research and Treatment Center, Al-Amodi Autism Research Chair, Department of Physiology, Faculty of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia, from October 2012 to May 2013.
Methodology: Changes in behavioral characteristics in 65 (boys=60, girls=5) children with autism (aged from 2 to 12 years) were assessed. The behavioral symptoms were evaluated by Childhood Autism Rating Scale (CARS), Social Responsiveness Scale (SRS), and Autism Treatment Evaluation Checklist (ATEC) before and after the 2 weeks of camel milk therapy.
Results: Significant differences were detected on Autism Spectrum Disorder (ASD) by CARS, SRS and ATEC scales, following 2 weeks of camel milk consumption, but not in the placebo group.
Conclusion: The present study demonstrates that camel milk could be very promising therapeutic intervention in ASD. Further wide scale studies are strongly recommended.
Key Words: Autism spectrum disorder (ASD). Camel milk. Behavioral symptoms.
INTRODUCTIONAutism Spectrum Disorders (ASDs) are a wide range of neurodevelopmental conditions that demonstrate considerable phenotypic heterogeneity, both in terms of presentation at any one age and across development. The current classification systems include three domains of difficulties: reciprocal social interaction, abnormalities in communication, and patterns of nonfunctional restricted, repetitive and stereotyped behaviors.1 Although there is no known unique cause of autism, there is growing evidence that autism can be caused by a variety of factors including autoimmunity2 originated by dairy food allergy. While several intervention methods for ASDs have been used to treat children with autism spectrum disorders, very few have been subjected to careful scientific investigation. Autoimmunity to CNS was also documented by several research groups, through the presence of brain specific auto-antibodies in the brains of some autistic children.3 The reason behind the formation of some brain autoantibodies in some patients with autism is not fully Department of Physiology1 / Autism Research and Treatment Center2, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia. Correspondence: Dr. Dost Muhammad Halepoto, KSU-Autism Research and Treatment Center (99), King Saud University, P O. Box 2925, Riyadh-11461, Saudi Arabia. E-mail: dr_m_halepota@yahoo.com Received: June 13, 2014; Accepted: September 04, 2015. |
understood. It is speculated that an autoimmune reaction to neurons might be triggered by some crossreacting antigens in the environment resulting in the release of neuronal antigens. These neuronal antigens may result in induction of autoimmune reactions through the activation of the inflammatory cells in genetically susceptible individuals. The environmental antigens may include food allergies to certain peptides such as gliadin, cow’s milk protein and soy.4
Camel milk has emerged to have potential therapeutic effects in diseases such as diabetes,5 and hepatitis B,6 as well as cow milk allergy in children.4 Children with severe food allergies improved rapidly with camel milk.7 It contains various ‘protective proteins’ (Lysozymes, Immunoglobulins, Lactoferrin, Lactoperoxidase, Peptidoglycan Recognition Protein (PGRP) and N-acetyl-§-glucosaminidase (NAGase); mainly enzymes which have antiviral, antibacterial and immunological properties.7 Recently, Bashir and Al-Ayadhi investigated8 the role of the effectiveness of camel milk (raw and boiled) on Thymus and Activation-Regulated Chemokine (TARC) serum levels and CARS score in subjects with autism and compared to placebo group (cow milk). The results suggested that camel milk therapy over the course of two weeks, significantly decreases the serum levels of TARC among the study subjects and also improve clinical measurements of ASD severity (CARS score). The above findings initiated the authors’ interest to test the effectiveness of camel milk on behavioral changes in subjects with Autism Spectrum Disorders. The hypothesis tested in the present study was that autism can be caused by food allergy.9 It has been believed that normal diary food is harmful to the immune system, brain and bodies of children with ASD10 and have a significant impact on behavior, cognition, socialization, and health/physical traits associated with an ASD diagnosis. The present prospective, double-blind, placebo controlled trial has evaluated whether a standardized treatment of camel milk administered to patients diagnosed with ASD on a daily basis for 2 weeks would result in improved behavior, cognition, socialization, and health/physical traits associated with an ASD diagnosis. |
Since recent reports demonstrated higher oxidative stress statues in ASD subjects compared to normally developing controls17, it makes camel milk an ideal antioxidant food. Furthermore, camel milk can certainly play important role in the prevention of diary food allergies and has been used to treat children with autism.7 However, to date; few studies reported some improvements in symptom scores in children who were treated with camel milk.18–19
A significant therapeutic effect of raw camel milk is decreased on boiling even on pasteurization.20 Camel milk has good bacterial and anti-viral activity thus if is used raw, there are less chances of transmission of infection. This concept is consistent with the historic belief that natural substances play an important role in preventative and therapeutic treatment.20 Milk protein casein plays important role in the food allergies related disorders and cause autism.18 Many children with autism may have gastrointestinal difficulties that make it hard for them to digest milk protein properly. There are different possibilities for ways in which this could affect children with autism. This could be through the unique immunological properties of camel milk immunoglobulins (Igs) including unique subclasses IgG2 and IgG3, contribute to camel milk’s incredible infection fighting and eradication capacity. Camel Igs being so small are able to penetrate into tissues and cells to completely neutralize the enzyme activity of an infectious agent such as a bacteria or virus whereas, human antibodies Igs cannot.21 Second possibility, is through the strong antioxidant properties of camel milk.22 Bioactive peptides derived from camel milk protein showed higher functionality including antioxidant activity, anti-hypertension effect and antimicrobial activity comparing to bioactive peptides from bovine milk proteins.23 Last but not the least, it is a fact that camel milk does not contain allergens like beta-lactoglobulin and a “new” beta-casein which are present in cow milk and thus makes the camel milk attractive for children suffering from milk allergies.7 Another relevant fact is that the components of camel milk include immunoglobulins similar to those in mothers’ milk, which reduce children’s allergic reactions and strengthen their future response to foods. The beta-casein in camel milk is completely a different protein due to the amphipathic structure; so it has a strong inherent tendency to selfassociate into micelles of 15 – 60 molecules. Association and conformational changes can have a major influence on the function of beta-caseins.24 Casein molecules are actually micelles and camel milk micelles have been found to be larger in size (15 nm) than those of cow milk or human milk. Camel milk has a lower pH than other milk, so upon entering the stomach the casein micelles do not breakdown into casein and, therefore, do not break into casomorphins. Casomorphin creation from cow milk consumption is a common problem in autism that increases autistic symptoms.25 |
Further studies are needed by other investigators to confirm these findings; however, in the light of the positive results of this study and those of several previous studies,18,19 the use of camel milk appears to be a promising treatment for children with autism. Camel milk therapy was safe and well-tolerated. None worsened and no side effects were reported.
CONCLUSIONAutism is a severe, lifelong disorder with serious emotional and financial consequences. Its incidence is rapidly increasing, and its etiology is still unclear. The present study demonstrates that camel milk could be very promising therapeutic intervention in ASD. Further wide-scale studies are strongly recommended. Acknowledgements: We thank Autism Research and Treatment Centre, Shaik Al-Amodi Autism Research Chair, King Abdul Aziz City for Science and Technology (KACST), and National Plan for Science and Technology (NPST), at Kind Saud University for sponsorship and financial support. REFERENCES1. American Psychiatric Association: Diagnostic and statistical manual of mental disorders, text revision. Washington, American Psychiatric Association, 2000. 2. Enstrom AM, Van de Water JA, Ashwood P. Autoimmunity in autism. Curr Opin Investing Drugs 2009; 10:463-73. 3. Mostafa GA, Al-Ayadhi LY. The relationship between the increased frequency of serum antineuronal antibodies and the severity of autism in children. Eur J Paediatr Neurol 2012; 16: 464-8. 4. Jyonouchi H, Sun S, Itokazu N. Innate immunity associated with inflammatory responses and cytokine production against common dietary proteins in patients with autism spectrum disorders. Neuropsychobiology 2002; 46:76-84. 5. Agrawal RP, Jain S, Shah S, Chopra A, Agarwal V. Effect of camel milk on glycemic control and insulin requirement in patients with type 1 diabetes: 2-years randomized controlled trial. Eur J Clin Nutr 2011; 65:1048-52. 6. Saltanat H, Li H, Xu Y, Wang J, Liu F, Geng XH. The influences of camel milk on the immune response of chronic hepatitis B patients. Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi 2009; 25: 431 -3. 7. Shabo Y, Barzel R, Margoulis M, Yagil R. Camel milk for food allergies in children. Immunol Allergies 2005; 7:796-8. 8. Bashir S, Al-Ayadhi LY. Effect of camel milk on thymus and activation-regulated chemokine in autistic children: doubleblind study. Pediatr Res 2014; 75:559-63. 9. Millward C, Ferriter M, Calver S, Connell-Jones G. Gluten and casein-free diets for autistic spectrum disorder. Cochrane Database Syst Rev 2008; 2:CD003498. 10. Sun Z, Cade RJ, Fregly MJ, Privette MR. U-Casomorphin induces fos-like immunoreactivity in discrete brain regions relevant to schizophrenia and autism. Autism 1999; 3:67-83. |
11. Rellini E, Tortolani D, Trillo S, Carbone S, Montecchi, F. Childhood autism rating scale (CARS) and autism behavior checklist (ABC) correspondence and conflicts with DSM-IV criteria in diagnosis of autism. J Autism Dev Disord 2004; 34: 703-8.
12. Constantino JN, Davis SA, Todd RD, Schindler MK, Gross MM, Brophy SL. Validation of a brief quantitative measure of autistic traits: comparison of the social responsiveness scale with the autism diagnostic interview-revised. J Autism Dev Disord 2003; 33:427-33. 13. Rimland B, Edelson M. The Autism Treatment Evaluation Checklist (ATEC). Autism Research Institute, San Diego, CA, 2000. Available at: http://www.autism.com. 14. Eberlein V. Hygienic status of camel milk in Dubai (United Arab Emirates) under two different milking management systems. Ph.D Thesis; Veterinary Faculty Ludwig-Maximilians-Universitat Munchen. 2007. 15. Elagamy I. Effect of heat treatment on camel milk proteins with respect to antimicrobial factors: a comparison with cows’ and buffalo milk proteins. Food Chemistry 2000; 68:227-32. 16. Al-Ayadhi LY, Mostafa GA. A lack of association between elevated serum levels of S100B protein and autoimmunity in autistic children. J Neuroinflammation 2012; 9:54. 17. Rose S, Melnyk S, Pavliv O, Bai S, Nick TG, Frye RE, et al. Evidence of oxidative damage and inflammation associated with low glutathione redox status in the autism brain. Transl Psychiatry 2012; 10; 2:e134. |
18. Shabo Y, Yagil R. Etiology of autism and camel milk as therapy. Int J Disabil Hum Dev 2005; 4:67-70.
19. Shabo Y, Yagil R. Behavioral improvement of autistic children following drinking camel milk, treating persons with brain damage. 4th National Conference TelAviv 2005. 20. Agrawal RP, Sahani MS, Tuteja FC. Hypoglycemic activity of camel milk in chemically pancreatectomized rates: an experimental study. Int J Diab Dev Countries 2005; 25:75-9. 21. Martin F, Volpari C, Steinkuhler C, Dimasi N, Brunetti M, Biasiol G, et al. Affinity selection of a camelized V (H) domain antibody inhibitor of hepatitis C virus NS3 protease. Protein Engineering 1997; 10:607-14. 22. AL-Ayadhi LY, Elamin NE. Camel milk as a potential therapy as an antioxidant in autism spectrum disorder (ASD). Evid Based Complement Alternat Med 2013; 602834. 23. Salami M, Moosavi-Movahedi F, Ehsani MR, Yousefi R, Niasari-Naslaji A, Moosavi-Movahedi AA. Functional properties of bioactive peptides produced from camel milk. Camel and Biomolecular Sciences, Tehran, Iran 2010. 24. Sharifizadeh A, Saboury AA, Moosavi-Movehedi AA. The role of temperature on self-association of beta-caseins from camel and bovine milk. Camel and Biomolecular Sciences, Tehran, Iran 2010. 25. Kappeler S, Farah Z, Puhan, Z. Sequence analysis of camelus dromedarius milk caseins. J Dairy Res 1998; 65:209-22. |
Journal of the College of Physicians and Surgeons Pakistan 2015, Vol. 25 (11): 819-823 823
MerC Kheyli Khoob Bod