Authors’ reply: “Autism in 2016: additional discovery”
Journal Title: Jornal de Pediatria - Year 2017, Vol 93, Issue 3
Abstract
Dear Editor, Fluegge in his letter1 commented on our review about autism spectrum disorder (ASD) etiopathogenesis, underscoring the possible role of one air pollutant and greenhouse gas, nitrous oxide (N2O), well known as the laughing gas used in surgery for its analgesic and anesthetic properties.2 In 2006 Cohen considered the hypothesis of an involvement of N2O in ASD etiopathogenesis, observing that high amounts of N2O in the blood could explain the uncontrollable laughter and high pain threshold detected in some subjects with ASD.2 For some years this hypothesis was passed over in silence, while, especially in the United States (USA), many studies have been performed to investigate the possible association between various air pollutants and an increased risk of ASD. Data from these studies suggest the involvement of early exposure to several air pollutants (including ozone, nitric oxide, nitrogen dioxide, carbon monoxide, sulfur dioxide, diesel particulates, some heavy metals, aromatic solvents) in ASD etiopathogenesis. Recently, Fluegge has frequently mentioned the theory that the early exposure to N2O may increase the risk for neurodevelopmental disorders, including ASDs, and in one review he described in detail several possible etiopathogenetic mechanisms through which N2O may lead to neurodevelopmental disorders, including: dopaminergic dysregulation; N-methyl-D-aspartate (NMDA) receptor antagonism; kappa-opioid receptor (KOR) activation; and α7 cholinergic inhibition.3
Authors and Affiliations
Annio Posar
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