High KEAP1, NRF2 and Low HO-1 Serum Levels in Children with Autism.

Introduction: The purpose of our study was to investigate heme oxygenase-1 (HO-1), nuclear factor erythroid-2-related factor 2 (NRF2), and kelch-like ECH-associated protein 1 (KEAP1) levels in children with autism spectrum disorder (ASD) and to reveal their association with the severity of autism.

Methods: This study measured serum HO-1, KEAP1, and NRF2 levels in 43 patients with ASD (aged 3-12 years) and in 41 age- and gender-matched healthy controls. ASD severity was rated using the Childhood Autism Rating Scale (CARS). HO-1, KEAP1, and NRF2 levels were determined in the biochemistry laboratory using the ELISA technique.

Results: HO-1 levels were significantly lower in patients aged 3-12 years compared to controls aged 3-12, while KEAP1 and NRF2 levels were significantly higher (=0.020, <0.001, and =0.017, respectively). No correlation was determined between ASD severity on the basis of total CARS scores and HO-1, KEAP1 or NRF2 (>0.05).

Conclusion: This study suggests that oxidative stress is higher in children with ASD and that HO-1 levels are insufficient to achieve oxidative balance.