author_facet Walker, Stephen J.
Langefeld, Carl D.
Zimmerman, Kip
Schwartz, Marshall Z.
Krigsman, Arthur
Walker, Stephen J.
Langefeld, Carl D.
Zimmerman, Kip
Schwartz, Marshall Z.
Krigsman, Arthur
author Walker, Stephen J.
Langefeld, Carl D.
Zimmerman, Kip
Schwartz, Marshall Z.
Krigsman, Arthur
spellingShingle Walker, Stephen J.
Langefeld, Carl D.
Zimmerman, Kip
Schwartz, Marshall Z.
Krigsman, Arthur
Scientific Reports
A molecular biomarker for prediction of clinical outcome in children with ASD, constipation, and intestinal inflammation
Multidisciplinary
author_sort walker, stephen j.
spelling Walker, Stephen J. Langefeld, Carl D. Zimmerman, Kip Schwartz, Marshall Z. Krigsman, Arthur 2045-2322 Springer Science and Business Media LLC Multidisciplinary http://dx.doi.org/10.1038/s41598-019-42568-1 <jats:title>Abstract</jats:title><jats:p>In children with autism spectrum disorder (ASD) who present to the gastroenterologist with chronic constipation on a background of colonic inflammation, we have identified two distinct clinical subtypes: (1) patients who experience a sustained state of GI symptomatic remission while on maintenance anti-inflammatory therapy (<jats:italic>fast responders</jats:italic>) and, (2) those with recurrent right-sided fecal loading requiring regular colon cleanouts during treatment for enterocolitis (<jats:italic>slow responders</jats:italic>). We hypothesized that a detailed molecular analysis of tissue from the affected region of the colon would provide mechanistic insights regarding the fast versus slow response to anti-inflammatory therapy. To test this, ascending colon biopsy tissues from 35 children with ASD (20 <jats:italic>slow responders</jats:italic> and 15 <jats:italic>fast responders</jats:italic>) were analyzed by RNAseq. Hierarchical cluster analysis was performed to assign samples to clusters and gene expression analysis was performed to identify differentially expressed transcripts (DETs) between samples within the clusters. Significant differences were found between the two clusters with <jats:italic>fast responder</jats:italic>-predominant cluster showing an upregulation of transcripts involved in the activation of immune and inflammatory response and the <jats:italic>slow responder</jats:italic>-predominant cluster showing significant over-representation of pathways impacting colonic motility (e.g. genes involved in tryptophan and serotonin degradation and mitochondrial dysfunction). Regression analysis identified a single long non-coding RNA that could predict cluster assignment with a high specificity (0.88), sensitivity (0.89) and accuracy (0.89). Comparison of gene expression profiles in the ascending colon from a subset of patients with ASD, chronic right-sided fecal loading constipation and a slow versus fast response to therapy has identified molecular mechanisms that likely contribute to this differential response following the primary therapeutic intervention (i.e. treatment for colonic inflammation with brief induction immunosuppression followed by maintenance non-steroidal anti-inflammatory therapy). Importantly, we have identified a transcript that, if validated, may provide a biomarker that can predict from the outset which patients will be slow responders who would benefit from an alternate therapeutic strategy in treating their constipation.</jats:p> A molecular biomarker for prediction of clinical outcome in children with ASD, constipation, and intestinal inflammation Scientific Reports
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title A molecular biomarker for prediction of clinical outcome in children with ASD, constipation, and intestinal inflammation
title_unstemmed A molecular biomarker for prediction of clinical outcome in children with ASD, constipation, and intestinal inflammation
title_full A molecular biomarker for prediction of clinical outcome in children with ASD, constipation, and intestinal inflammation
title_fullStr A molecular biomarker for prediction of clinical outcome in children with ASD, constipation, and intestinal inflammation
title_full_unstemmed A molecular biomarker for prediction of clinical outcome in children with ASD, constipation, and intestinal inflammation
title_short A molecular biomarker for prediction of clinical outcome in children with ASD, constipation, and intestinal inflammation
title_sort a molecular biomarker for prediction of clinical outcome in children with asd, constipation, and intestinal inflammation
topic Multidisciplinary
url http://dx.doi.org/10.1038/s41598-019-42568-1
publishDate 2019
physical
description <jats:title>Abstract</jats:title><jats:p>In children with autism spectrum disorder (ASD) who present to the gastroenterologist with chronic constipation on a background of colonic inflammation, we have identified two distinct clinical subtypes: (1) patients who experience a sustained state of GI symptomatic remission while on maintenance anti-inflammatory therapy (<jats:italic>fast responders</jats:italic>) and, (2) those with recurrent right-sided fecal loading requiring regular colon cleanouts during treatment for enterocolitis (<jats:italic>slow responders</jats:italic>). We hypothesized that a detailed molecular analysis of tissue from the affected region of the colon would provide mechanistic insights regarding the fast versus slow response to anti-inflammatory therapy. To test this, ascending colon biopsy tissues from 35 children with ASD (20 <jats:italic>slow responders</jats:italic> and 15 <jats:italic>fast responders</jats:italic>) were analyzed by RNAseq. Hierarchical cluster analysis was performed to assign samples to clusters and gene expression analysis was performed to identify differentially expressed transcripts (DETs) between samples within the clusters. Significant differences were found between the two clusters with <jats:italic>fast responder</jats:italic>-predominant cluster showing an upregulation of transcripts involved in the activation of immune and inflammatory response and the <jats:italic>slow responder</jats:italic>-predominant cluster showing significant over-representation of pathways impacting colonic motility (e.g. genes involved in tryptophan and serotonin degradation and mitochondrial dysfunction). Regression analysis identified a single long non-coding RNA that could predict cluster assignment with a high specificity (0.88), sensitivity (0.89) and accuracy (0.89). Comparison of gene expression profiles in the ascending colon from a subset of patients with ASD, chronic right-sided fecal loading constipation and a slow versus fast response to therapy has identified molecular mechanisms that likely contribute to this differential response following the primary therapeutic intervention (i.e. treatment for colonic inflammation with brief induction immunosuppression followed by maintenance non-steroidal anti-inflammatory therapy). Importantly, we have identified a transcript that, if validated, may provide a biomarker that can predict from the outset which patients will be slow responders who would benefit from an alternate therapeutic strategy in treating their constipation.</jats:p>
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author Walker, Stephen J., Langefeld, Carl D., Zimmerman, Kip, Schwartz, Marshall Z., Krigsman, Arthur
author_facet Walker, Stephen J., Langefeld, Carl D., Zimmerman, Kip, Schwartz, Marshall Z., Krigsman, Arthur, Walker, Stephen J., Langefeld, Carl D., Zimmerman, Kip, Schwartz, Marshall Z., Krigsman, Arthur
author_sort walker, stephen j.
container_issue 1
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description <jats:title>Abstract</jats:title><jats:p>In children with autism spectrum disorder (ASD) who present to the gastroenterologist with chronic constipation on a background of colonic inflammation, we have identified two distinct clinical subtypes: (1) patients who experience a sustained state of GI symptomatic remission while on maintenance anti-inflammatory therapy (<jats:italic>fast responders</jats:italic>) and, (2) those with recurrent right-sided fecal loading requiring regular colon cleanouts during treatment for enterocolitis (<jats:italic>slow responders</jats:italic>). We hypothesized that a detailed molecular analysis of tissue from the affected region of the colon would provide mechanistic insights regarding the fast versus slow response to anti-inflammatory therapy. To test this, ascending colon biopsy tissues from 35 children with ASD (20 <jats:italic>slow responders</jats:italic> and 15 <jats:italic>fast responders</jats:italic>) were analyzed by RNAseq. Hierarchical cluster analysis was performed to assign samples to clusters and gene expression analysis was performed to identify differentially expressed transcripts (DETs) between samples within the clusters. Significant differences were found between the two clusters with <jats:italic>fast responder</jats:italic>-predominant cluster showing an upregulation of transcripts involved in the activation of immune and inflammatory response and the <jats:italic>slow responder</jats:italic>-predominant cluster showing significant over-representation of pathways impacting colonic motility (e.g. genes involved in tryptophan and serotonin degradation and mitochondrial dysfunction). Regression analysis identified a single long non-coding RNA that could predict cluster assignment with a high specificity (0.88), sensitivity (0.89) and accuracy (0.89). Comparison of gene expression profiles in the ascending colon from a subset of patients with ASD, chronic right-sided fecal loading constipation and a slow versus fast response to therapy has identified molecular mechanisms that likely contribute to this differential response following the primary therapeutic intervention (i.e. treatment for colonic inflammation with brief induction immunosuppression followed by maintenance non-steroidal anti-inflammatory therapy). Importantly, we have identified a transcript that, if validated, may provide a biomarker that can predict from the outset which patients will be slow responders who would benefit from an alternate therapeutic strategy in treating their constipation.</jats:p>
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spelling Walker, Stephen J. Langefeld, Carl D. Zimmerman, Kip Schwartz, Marshall Z. Krigsman, Arthur 2045-2322 Springer Science and Business Media LLC Multidisciplinary http://dx.doi.org/10.1038/s41598-019-42568-1 <jats:title>Abstract</jats:title><jats:p>In children with autism spectrum disorder (ASD) who present to the gastroenterologist with chronic constipation on a background of colonic inflammation, we have identified two distinct clinical subtypes: (1) patients who experience a sustained state of GI symptomatic remission while on maintenance anti-inflammatory therapy (<jats:italic>fast responders</jats:italic>) and, (2) those with recurrent right-sided fecal loading requiring regular colon cleanouts during treatment for enterocolitis (<jats:italic>slow responders</jats:italic>). We hypothesized that a detailed molecular analysis of tissue from the affected region of the colon would provide mechanistic insights regarding the fast versus slow response to anti-inflammatory therapy. To test this, ascending colon biopsy tissues from 35 children with ASD (20 <jats:italic>slow responders</jats:italic> and 15 <jats:italic>fast responders</jats:italic>) were analyzed by RNAseq. Hierarchical cluster analysis was performed to assign samples to clusters and gene expression analysis was performed to identify differentially expressed transcripts (DETs) between samples within the clusters. Significant differences were found between the two clusters with <jats:italic>fast responder</jats:italic>-predominant cluster showing an upregulation of transcripts involved in the activation of immune and inflammatory response and the <jats:italic>slow responder</jats:italic>-predominant cluster showing significant over-representation of pathways impacting colonic motility (e.g. genes involved in tryptophan and serotonin degradation and mitochondrial dysfunction). Regression analysis identified a single long non-coding RNA that could predict cluster assignment with a high specificity (0.88), sensitivity (0.89) and accuracy (0.89). Comparison of gene expression profiles in the ascending colon from a subset of patients with ASD, chronic right-sided fecal loading constipation and a slow versus fast response to therapy has identified molecular mechanisms that likely contribute to this differential response following the primary therapeutic intervention (i.e. treatment for colonic inflammation with brief induction immunosuppression followed by maintenance non-steroidal anti-inflammatory therapy). Importantly, we have identified a transcript that, if validated, may provide a biomarker that can predict from the outset which patients will be slow responders who would benefit from an alternate therapeutic strategy in treating their constipation.</jats:p> A molecular biomarker for prediction of clinical outcome in children with ASD, constipation, and intestinal inflammation Scientific Reports
spellingShingle Walker, Stephen J., Langefeld, Carl D., Zimmerman, Kip, Schwartz, Marshall Z., Krigsman, Arthur, Scientific Reports, A molecular biomarker for prediction of clinical outcome in children with ASD, constipation, and intestinal inflammation, Multidisciplinary
title A molecular biomarker for prediction of clinical outcome in children with ASD, constipation, and intestinal inflammation
title_full A molecular biomarker for prediction of clinical outcome in children with ASD, constipation, and intestinal inflammation
title_fullStr A molecular biomarker for prediction of clinical outcome in children with ASD, constipation, and intestinal inflammation
title_full_unstemmed A molecular biomarker for prediction of clinical outcome in children with ASD, constipation, and intestinal inflammation
title_short A molecular biomarker for prediction of clinical outcome in children with ASD, constipation, and intestinal inflammation
title_sort a molecular biomarker for prediction of clinical outcome in children with asd, constipation, and intestinal inflammation
title_unstemmed A molecular biomarker for prediction of clinical outcome in children with ASD, constipation, and intestinal inflammation
topic Multidisciplinary
url http://dx.doi.org/10.1038/s41598-019-42568-1