Metabolic Brain Disease

, Volume 31, Issue 2, pp 273–278 | Cite as

Acid glycosaminoglycan (aGAG) excretion is increased in children with autism spectrum disorder, and it can be controlled by diet

  • Ildikó Endreffy
  • Geir Bjørklund
  • Ferenc Dicső
  • Mauricio A. Urbina
  • Emőke Endreffy
Original Article


Autism research continues to receive considerable attention as the options for successful management are limited. The understanding of the autism spectrum disorder (ASD) etiology has now progressed to encompass genetic, epigenetic, neurological, hormonal, and environmental factors that affect outcomes for patients with ASD. Glycosaminoglycans (GAGs) are a family of linear, sulfated polysaccharides that are associated with central nervous system (CNS) development, maintenance, and disorders. Proteoglycans (PG) regulate diverse functions in the central nervous system. Heparan sulfate (HS) and chondroitin sulfate (CS) are two major GAGs present in the PGs of the CNS. As neuroscience advances, biochemical treatments to correct brain chemistry become better defined. Nutrient therapy can be very potent and has minimal to no side effects, since no molecules foreign to the body are needed. Given GAGs are involved in several neurological functions, and that its level can be somewhat modulated by the diet, the present study aimed to evaluate the role of GAGs levels in ASD symptoms. Both tGAG and its different fractions were evaluated in the urine of ASD and healthy control childrens. As levels differed between groups, a second trial was conduted evaluating if diet could reduce tGAG levels and if this in turn decrease ASD symptoms. The present study found that tGAG concentration was significantly higher in the urine of children with ASD compared to healthy control children and this was also evident in all GAG fractions. Within groups (controls and ASD), no gender differences in GAG excretion were found. The use of a 90 days elimination diet (casein-free, special carbohydrates, multivitamin/mineral supplement), had major effects in reducing urinary tGAG excretion in children with ASD.


Autism Glycosaminoglycans Proteoglycans Neurodevelopment disorders Epigenetics Nutrition 



The authors thank the children with ASD and their parents for their consensus, collaboration, and hard work as participants in this research study. Further, the physicians Denes Kovendi and Eva Satorhegyi are thanked for help with diagnosis.

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 in studies involving human participants 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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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of PediatricsJósa András County HospitalNyíregyházaHungary
  2. 2.Council for Nutritional and Environmental MedicineMo i RanaNorway
  3. 3.Department of Biosciences, College of Life and Environmental SciencesUniversity of ExeterExeterUK
  4. 4.Departamento de Zoología, Facultad de Ciencias Naturales y OceanográficasUniversidad de ConcepciónConcepciónChile
  5. 5.Department of Pediatrics and Pediatric Health Care Center, Faculty of MedicineUniversity of SzegedSzegedHungary

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