Supplementation with antioxidants and folinic acid for children with Down’s syndrome: randomised controlled trial

Ellis, Jill; Tan, Hooi Kuan; Gilbert, Ruth; Muller, D. P. R.; Henley, William; Moy, Robert; Pumphrey, Rachel; Ani, Cornelius; Davies, Stefan M.K.; Edwards, Vanessa; Green, Heather; Salt, Alison; Logan, Stuart

doi:10.1136/bmj.39465.544028.ae

Cited by 85 publications

(80 citation statements)

References 31 publications

(27 reference statements)

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“…Individuals with DS have a higher concentration of the enzyme cystathionine β -synthase which leads to the so-called ' folate trap ' and a functional folate defi ciency (see Ellis et al, 2008 ). As folate plays a role in transmethylation reactions, which are crucial for the formation of neurotransmitters (e.g., 5-HT), low folate levels can lead to impaired metabolism of neurotransmitters.…”

Section: Results Of Clinical Trials In Individuals With Down Syndromementioning

confidence: 99%

“…In view of these biochemical defects, antioxidants are potential tools to reduce brain oxidative stress and supplementation with folate may be envisaged as a means to correct neuronal function. A recent study (Ellis et al, 2008 ) reports the results of a clinical trial in which infants with DS aged under seven months (n = 156) received a daily oral supplementation with antioxidants (selenium 10 µ g, zinc 5 mg, vitamin A 0.9 mg, vitamin E 100 mg, and vitamin C 50 mg), folinic acid (0.1 mg), antioxidants and folinic acid combined, or a placebo. Children were tested 18 months after the start of supplementation with Griffi ths mental developmental scales.…”

Section: Results Of Clinical Trials In Individuals With Down Syndromementioning

confidence: 99%

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Is it possible to improve neurodevelopmental abnormalities in Down syndrome?

Bartesaghi

Guidi²,

Ciani³

2011

Revneuro

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Down syndrome (DS) is a genetic pathology caused by the triplication of human chromosome 21. Although individuals with DS have various medical problems, intellectual disability is the most invalidating aspect of the pathology. Despite numerous efforts, the mechanisms whereby gene triplication leads to the DS phenotype have not been elucidated and there are, at present, no therapies to rescue brain developmental alterations and mental disability in individuals with DS. In this review, we focused on the major defects of the DS brain, comparing data regarding humans with DS and mouse models for DS, and therapeutic interventions attempted on animal DS models. Based on the promising results of pharmacotherapies in these models, we believe that it is possible to conclude that tools to improve brain development in DS are now almost at hand. We now know that it is possible to rescue and/or improve neurogenesis, neuron maturation, connectivity, neurodegeneration and behavior. We believe that the knowledge gained in DS mouse models provides a rational basis to start new clinical trials in infants, children and adults with DS, exploiting drugs that have proved able to rescue various facets of the DS neurologic phenotype. It is not unreasonable to consider that the results of these trials may provide a positive answer to the question: 'Is it possible to improve brain development in DS?'.

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Section: Results Of Clinical Trials In Individuals With Down Syndromementioning

confidence: 99%

Section: Results Of Clinical Trials In Individuals With Down Syndromementioning

confidence: 99%

Is it possible to improve neurodevelopmental abnormalities in Down syndrome?

Bartesaghi

Guidi²,

Ciani³

2011

Revneuro

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“…High intake of Zn supplement has been used in order to improve these patients' health [9,10]. However, some studies were not able to find such benefit in supplementation [11,12]. Regarding clinic repercussion of Zn deficiency, the present study was aimed to evaluate nutritional status of Zn in children with DS, assessing metabolic alterations caused by this disease.…”

Section: Introductionmentioning

confidence: 99%

Nutritional Status of Zinc in Children with Down Syndrome

Lima

Cardoso

Cozzolino

2009

Biol Trace Elem Res

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Experimental and clinical studies have established that zinc metabolism is altered in individuals with Down syndrome (DS). The present study intends to evaluate the nutritional status of zinc in children with DS by determining their biochemical and dietary parameters. The investigation was carried out on a group of children with DS (n = 35) and compared with a control group (n = 33), both aging between 4 and 11 years. Weight-for-age, height-for-age, and weight-for-height indexes and diet were evaluated by using a 3-day dietary record. Zinc was evaluated in plasma, erythrocytes, and 24-h urine collection by using the method of atomic absorption spectroscopy. The frequency of short stature was higher in children with DS. Both groups presented high protein content, adequate concentrations of lipids and carbohydrates, and deficit in calories. Adequate zinc intake was observed in 40% of children with DS and in 67% of the control group. Zinc concentrations were significantly lower in plasma and urine and higher in erythrocytes of children with DS. The results allowed us to conclude that the altered zinc nutritional status of individuals with Down syndrome contributes to clinical disturbances that usually appear with aging in these patients.

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“…Estudos preliminares apontam prevalência de obesidade variando de 7% a 21,9% (17)(18)(19) , especialmente devido a altas taxas de comportamento sedentário (20) como também a falta de conhecimento sobre comportamentos de vida saudável, limitadas escolhas nutricionais e baixos níveis de atividade física (4) .…”

Section: Discussionunclassified