Metabolic Brain Disease

, Volume 33, Issue 4, pp 1141–1153 | Cite as

Impaired lipid metabolism markers to assess the risk of neuroinflammation in autism spectrum disorder

  • Hanan Qasem
  • Laila Al-Ayadhi
  • Geir Bjørklund
  • Salvatore Chirumbolo
  • Afaf El-AnsaryEmail author
Original Article


Autism spectrum disorder (ASD) is a multifactorial disorder caused by an interaction between environmental risk factors and a genetic background. It is characterized by impairment in communication, social interaction, repetitive behavior, and sensory processing. The etiology of ASD is still not fully understood, and the role of neuroinflammation in autism behaviors needs to be further investigated. The aim of the present study was to test the possible association between prostaglandin E2 (PGE2), cyclooxygenase-2 (COX-2), microsomal prostaglandin E synthase-1 (mPGES-1), prostaglandin PGE2 EP2 receptors and nuclear kappa B (NF-κB) and the severity of cognitive disorders, social impairment, and sensory dysfunction. PGE2, COX-2, mPGES-1, PGE2-EP2 receptors and NF-κB as biochemical parameters related to neuroinflammation were determined in the plasma of 47 Saudi male patients with ASD, categorized as mild to moderate and severe as indicated by the Childhood Autism Rating Scale (CARS) or the Social Responsiveness Scale (SRS) or the Short Sensory Profile (SSP) and compared to 46 neurotypical controls. The data indicated that ASD patients have remarkably higher levels of the measured parameters compared to neurotypical controls, except for EP2 receptors that showed an opposite trend. While the measured parameter did not correlate with the severity of social and cognitive dysfunction, PGE2, COX-2, and mPGES-1 were remarkably associated with the dysfunction in sensory processing. NF-κB was significantly increased in relation to age. Based on the discussed data, the positive correlation between PGE2, COX-2, and mPGES-1 confirm the role of PGE2 pathway and neuroinflammation in the etiology of ASD, and the possibility of using PGE2, COX-2 and mPGES-1 as biomarkers of autism severity. NF-κB as inflammatory inducer showed an elevated level in plasma of ASD individuals. Receiver operating characteristic analysis together with predictiveness diagrams proved that the measured parameters could be used as predictive biomarkers of biochemical correlates to ASD.


Autism Childhood autism rating scale Cyclooxygenase-2, microsomal prostaglandin E synthase-1, neuroinflammation NF-κB: Nuclear factor kappa B, PGE2: prostaglandin E 2, short sensory profile Social responsiveness scale 



Arachidonic acid


Autism spectrum disorder


Childhood autism rating scale




Cytosolic phospholipase A2




Interferon gamma




Microsomal prostaglandin E synthase-1


Nuclear factor kappa B




Prostaglandin E2


Prostaglandin E2 EP2 receptors


Polyunsaturated fatty acids


Receiver operating characteristics curve


Reactive oxygen species


Social responsiveness scale


Short sensory profile


Tumor necrosis factor alpha



This research project was supported by a grant from the Research Center of the Center for Female Scientific and Medical Colleges at King Saud University, Riyadh, Saudi Arabia.

Compliance with ethical standards

Conflict of interest

The authors declare no potential conflicts of interest with respect to the authorship, and/or publication of this article.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee, and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


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Authors and Affiliations

  • Hanan Qasem
    • 1
  • Laila Al-Ayadhi
    • 2
    • 3
    • 4
  • Geir Bjørklund
    • 5
  • Salvatore Chirumbolo
    • 6
  • Afaf El-Ansary
    • 2
    • 3
    • 7
    • 8
    Email author
  1. 1.Biochemistry Department, Science CollegeKing Saud UniversityRiyadhSaudi Arabia
  2. 2.Autism Research and Treatment CenterRiyadhSaudi Arabia
  3. 3.Shaik AL-Amodi Autism Research ChairKing Saud UniversityRiyadhSaudi Arabia
  4. 4.Physiology Department, College of MedicineKing Saud UniversityRiyadhSaudi Arabia
  5. 5.Council for Nutritional and Environmental MedicineMo i RanaNorway
  6. 6.Department of Neurological and Movement SciencesUniversity of VeronaVeronaItaly
  7. 7.Central laboratory, Female Centre for Scientific and Medical StudiesKing Saud UniversityRiyadhSaudi Arabia
  8. 8.Therapeutic Chemistry DepartmentNational Research CenterGuizaEgypt

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