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Risk and Protective Environmental Factors Associated with Autism Spectrum Disorder: Evidence-Based Principles and Recommendations

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Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy
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Child Neurology and Psychiatry Unit, Systems Medicine Department, Tor Vergata University of Rome, 00133 Rome, Italy
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Division of Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA 02114, USA
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Hospital General Universitario Gregorio Marañón. 28009 Madrid, Spain
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Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, 3584 Utrecht, The Netherlands
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Child Neurology Unit, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
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Braun School of Public Health and Community Medicine, Hebrew University, Hadassah 99875, Israel
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Child and Adolescent Neuropsychiatry, Federico II University, 80133 Naples, Italy
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Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy
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The Autism Center/ALUT, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 69978 Tel Aviv, Israel
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DIMES, Bologna University, 40126 Bologna, Italy and IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(2), 217; https://doi.org/10.3390/jcm8020217
Received: 8 January 2019 / Revised: 3 February 2019 / Accepted: 5 February 2019 / Published: 8 February 2019
(This article belongs to the Special Issue Advances in Autism Spectrum Disorders)
Autism Spectrum Disorder (ASD) is a complex condition with early childhood onset, characterized by a set of common behavioral features. The etiology of ASD is not yet fully understood; however, it reflects the interaction between genetics and environment. While genetics is now a well-established risk factor, several data support a contribution of the environment as well. This paper summarizes the conclusions of a consensus conference focused on the potential pathogenetic role of environmental factors and on their interactions with genetics. Several environmental factors have been discussed in terms of ASD risk, namely advanced parental age, assisted reproductive technologies, nutritional factors, maternal infections and diseases, environmental chemicals and toxicants, and medications, as well as some other conditions. The analysis focused on their specific impact on three biologically relevant time windows for brain development: the periconception, prenatal, and early postnatal periods. Possible protective factors that might prevent or modify an ASD trajectory have been explored as well. Recommendations for clinicians to reduce ASD risk or its severity have been proposed. Developments in molecular biology and big data approaches, which are able to assess a large number of coexisting factors, are offering new opportunities to disentangle the gene–environment interplay that can lead to the development of ASD. View Full-Text
Keywords: Autism Spectrum Disorder; risk factors; protective factors; environment; genetics; medications; toxicants; recommendations Autism Spectrum Disorder; risk factors; protective factors; environment; genetics; medications; toxicants; recommendations
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Emberti Gialloreti, L.; Mazzone, L.; Benvenuto, A.; Fasano, A.; Garcia Alcon, A.; Kraneveld, A.; Moavero, R.; Raz, R.; Riccio, M.P.; Siracusano, M.; Zachor, D.A.; Marini, M.; Curatolo, P. Risk and Protective Environmental Factors Associated with Autism Spectrum Disorder: Evidence-Based Principles and Recommendations. J. Clin. Med. 2019, 8, 217.

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