Autism Spectrum Disorder Clinical Trial
Official title:
Exosomal MicroRNA Expression in Children With Autism Spectrum Disorder
There is accumulating evidence that genetic expression plays a role in autism spectrum
disorder, but the regulation of such genes is poorly understood. Small RNA particles, called
microRNA (miRNA), have the ability to alter gene expression. These particles can be packaged
and released from brain cells into the blood. Changes in miRNA may contribute to the
patterns observed in autism spectrum disorder.
The purpose of this study is to identify small RNA particles that regulate gene expression
in autism spectrum disorder. The goal is to identify miRNA expression patterns which may
improve our understanding and diagnosis of autism spectrum disorder.
This study will recruit 20 children with idiopathic ASD (defined by DSM-IV criteria) and 20
age- and gender-matched controls with typical neuropsychological developmental patterns. The
number of subjects necessary for this study was determined by power analysis. Using a two
sample t-test model with 15 ASD and 15 control subjects in each group would have 80% power
to detect changes in expression equal to twice the standard deviation of the group mean with
Bonferonni corrected level (p<0.0001) based on expectations of measuring 500 miRNA in each
sample (Lenth, 2006).
Parental consent and patient assent forms will be distributed to potential subjects at the
University Pediatric and Adolescent Center and the Center for Development Behavior and
Genetics. To explain the study, children will be told, "The doctors are doing a study about
a disease called autism. If you want to be in this study a small amount of blood will be
taken from your arm with a needle. The needle will hurt but will go away after a little
while. The doctors will ask you to answer some questions about how you feel. You do not have
to be in the study. No one will be mad at you if you don't want to do this."
ASD subjects will be assessed using current methods in autism diagnosis: the Autism
Diagnostic Observation Schedule (ADOS) and the Checklist for Autism in Toddlers (CHAT). The
Vineland Behavior Scales will also be administered. All medical information collected will
be coded and de-identified according to standard protocols.
Venipuncture will be employed to collect 2ml of blood from each subject into an EDTA-free
vacutainer tube. Samples will be left for 1 hour at 37˚C to allow clotting before storage at
4˚C overnight. The sample will then be centrifuged at 4000 rpm for 20 minutes at 4˚C. Serum
will be removed from the clot by pipetting and stored at -80˚C until miRNA extraction is
performed.
The decision to measure exosomal miRNA from serum is supported by a study of miRNA in 12
human body fluids. Weber and colleagues (2010) determined that the median total
concentration of RNA in plasma (308 ug/L) was greater than that of cerebrospinal fluid (111
ug/L). Furthermore, the authors found the number of detectable miRNAs in plasma (349) to be
greater than cerebrospinal fluid (212). The miRNA content of plasma and cerebrospinal fluid
has some intriguing similarities. Of the twenty most abundant miRNAs found in cerebrospinal
fluid and plasma, 9 overlap. We have previously examined the expression of exosomal miRNA in
the serum of human alcoholic subjects. Intriguingly, we characterized the expression levels
of brain-specific miRNAs in serum samples from over 30% of those tested. This finding
demonstrates that exosomal miRNAs from the central nervous system can be detected and
quantified in human blood samples.
Serum miRNA will be extracted using a Qiagen RNeasy Mini Kit according to manufacturer
protocol. RNA will be processed with the Genisphere FlashTag HSR RNA labeling kit. RNA Spike
Control Oligos, and poly(A) tails will be added to each RNA sample and a biotinylated
signaling molecule will be ligated to the RNA. The labeled RNA samples will be added to a
hybridization cocktail, incubated, and injected into Affymetrix miRNA 2.0 arrays. After 16
hours of hybridization, the arrays will be washed and stained on an Affymetrix fluidics
station 450 using protocol FS450_0003. Arrays will be scanned on an Affymetrix GeneChip
Scanner 7G Plus. The cel files will be analyzed using miRNA QC Tool version 1.1.1.0.
A 3-way ANOVA assessing the impact of ASD, age, and gender on miRNA expression will be
employed along with a Mann Whitney Test. Targets with a P-value < 0.05 will be selected for
further analysis after multiple testing correction with Bonferroni analysis. Significantly
altered miRNAs will be queried on Mirbase.org for known mRNA targets. The target list will
then be examined using DAVID bioinformatics functional annotation tool for enriched gene
ontology categories. Correlations between miRNA expression and medical/neuropsychological
characteristics will be calculated using Pearson Correlation statistics, filtering for
miRNAs with p-value<0.05 and r>0.5.
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Observational Model: Case Control, Time Perspective: Prospective
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