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      Prenatal levonorgestrel exposure induces autism-like behavior in offspring through ERβ suppression in the amygdala

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          Abstract

          Background

          Autism spectrum disorder (ASD) is characterized by impairments in social communication and restricted or repetitive behaviors or interests. ASD is now diagnosed in more than one out of 100 children and is biased towards males by a ratio of at least 4:1. Many possible explanations and potential causative factors have been reported, such as genetics, sex, and environmental factors, although the detailed mechanisms of ASD remain unclear.

          Methods

          The dams were exposed through oral contraceptives to either vehicle control (VEH) alone, levonorgestrel (LNG) alone, ethinyl estradiol (EE) alone, or a combination of LNG/EE for 21 days during their pregnancy. The subsequent 10-week-old offspring were used for autism-like behavior testing, and the limbic tissues were isolated for analysis. In another experimental group, 8-week-old male offspring were treated by infusion of ERβ overexpression/knockdown lentivirus in the amygdala, and the offspring were analyzed after 2 weeks.

          Results

          We show that prenatal exposure of either LNG alone or a LNG/EE combination, but not EE alone, results in suppression of ERβ (estrogen receptor β) and its target genes in the amygdala with autism-like behavior in male offspring, while there is a much smaller effect on female offspring. However, we find that there is no effect on the hippocampus and hypothalamus. Further investigation shows that ERβ suppression is due to LNG-mediated altered methylation on the ERβ promoter and results in tissue damage with oxidative stress and the dysfunction of mitochondria and fatty acid metabolism, which subsequently triggers autism-like behavior. Overexpression of ERβ in the amygdala completely restores LNG-induced ERβ suppression and autism-like behaviors in offspring, while ERβ knockdown mimics this effect, indicating that ERβ expression in the amygdala plays an important role in autism-like behavior development.

          Conclusions

          We conclude that prenatal levonorgestrel exposure induces autism-like behavior in offspring through ERβ suppression in the amygdala. To our knowledge, this is the first time the potential effect of oral contraceptives on the contribution of autism-like behavior in offspring has been discovered.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s13229-017-0159-3) contains supplementary material, which is available to authorized users.

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          Most cited references46

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          Advances in autism genetics: on the threshold of a new neurobiology.

          Autism is a heterogeneous syndrome defined by impairments in three core domains: social interaction, language and range of interests. Recent work has led to the identification of several autism susceptibility genes and an increased appreciation of the contribution of de novo and inherited copy number variation. Promising strategies are also being applied to identify common genetic risk variants. Systems biology approaches, including array-based expression profiling, are poised to provide additional insights into this group of disorders, in which heterogeneity, both genetic and phenotypic, is emerging as a dominant theme.
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            Sex differences in the brain: implications for explaining autism.

            Empathizing is the capacity to predict and to respond to the behavior of agents (usually people) by inferring their mental states and responding to these with an appropriate emotion. Systemizing is the capacity to predict and to respond to the behavior of nonagentive deterministic systems by analyzing input-operation-output relations and inferring the rules that govern such systems. At a population level, females are stronger empathizers and males are stronger systemizers. The "extreme male brain" theory posits that autism represents an extreme of the male pattern (impaired empathizing and enhanced systemizing). Here we suggest that specific aspects of autistic neuroanatomy may also be extremes of typical male neuroanatomy.
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              The amygdala is enlarged in children but not adolescents with autism; the hippocampus is enlarged at all ages.

              Autism is a neurodevelopmental disorder characterized by impairments in reciprocal social interaction, deficits in verbal and nonverbal communication, and a restricted repertoire of activities or interests. We performed a magnetic resonance imaging study to better define the neuropathology of autistic spectrum disorders. Here we report findings on the amygdala and the hippocampal formation. Borders of the amygdala, hippocampus, and cerebrum were defined, and their volumes were measured in male children (7.5-18.5 years of age) in four diagnostic groups: autism with mental retardation, autism without mental retardation, Asperger syndrome, and age-matched typically developing controls. Although there were no differences between groups in terms of total cerebral volume, children with autism (7.5-12.5 years of age) had larger right and left amygdala volumes than control children. There were no differences in amygdala volume between the adolescent groups (12.75-18.5 years of age). Interestingly, the amygdala in typically developing children increases substantially in volume from 7.5 to 18.5 years of age. Thus, the amygdala in children with autism is initially larger, but does not undergo the age-related increase observed in typically developing children. Children with autism, with and without mental retardation, also had a larger right hippocampal volume than typically developing controls, even after controlling for total cerebral volume. Children with autism but without mental retardation also had a larger left hippocampal volume relative to controls. These cross-sectional findings indicate an abnormal program of early amygdala development in autism and an abnormal pattern of hippocampal development that persists through adolescence. The cause of amygdala and hippocampal abnormalities in autism is currently unknown.
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                Author and article information

                Contributors
                yuanlinzou@126.com
                qiaomeilu@126.com
                zhengdan@mails.tjmu.edu.cn
                chuzhg@hotmail.com
                zhaoyuliu_33@hotmail.com
                chenhaijia@saliai.com
                qf_ruan@126.com
                gexiaohu@saliai.com
                201726244@qq.com
                wangxiaoyan@saliai.com
                louwentinglaura@163.com
                yjhuang003@163.com
                twang-yf@163.com
                13886190549@139.com
                zxliu_tjmu@yahoo.com
                +86-18071085225 , wgxie@hotmail.com
                +86-13871002482 , zhouyk@mails.tjmu.edu.cn
                +86-13049687987 , vasilis112@yahoo.com
                Journal
                Mol Autism
                Mol Autism
                Molecular Autism
                BioMed Central (London )
                2040-2392
                17 August 2017
                17 August 2017
                2017
                : 8
                : 46
                Affiliations
                [1 ]ISNI 0000 0004 0368 7223, GRID grid.33199.31, Internal Medicine of Tongji Hospital, Tongji Medical College, , Huazhong University of Science and Technology, ; Wuhan, 430030 People’s Republic of China
                [2 ]ISNI 0000 0004 0368 7223, GRID grid.33199.31, Tongji Wenchang Hospital, , Huazhong University of Science and Technology, ; Wenchang, 571321 People’s Republic of China
                [3 ]ISNI 0000 0004 0368 7223, GRID grid.33199.31, Institute of Environmental Medicine, Tongji Medical College, , Huazhong University of Science and Technology, ; Wuhan, 430030 People’s Republic of China
                [4 ]ISNI 0000 0001 2331 6153, GRID grid.49470.3e, Institute of Burns, , Tongren Hospital of Wuhan University, ; Wuhan, 430060 People’s Republic of China
                [5 ]SALIAI Stem Cell Institute of Guangdong, Guangzhou SALIAI Stem Cell Science and Technology Co. LTD, Guangzhou, 510055 People’s Republic of China
                Author information
                http://orcid.org/0000-0001-9407-0779
                Article
                159
                10.1186/s13229-017-0159-3
                5561609
                28824796
                36455232-86d9-466b-ba31-e5d8c9c22ef9
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 21 March 2017
                : 13 July 2017
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                Neurosciences
                amygdala,autism-like behavior,estrogen receptor β,oral contraceptives,oxidative stress

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