Intranasal Oxytocin for Patients With Autism Spectrum Disorder: A Comprehensive Meta-Analysis of Preclinical and Clinical Studies

IF 2.9 3区心理学 Q2 PSYCHOLOGY, DEVELOPMENTAL Review Journal of Autism and Developmental Disorders Pub Date : 2024-02-10 DOI:10.1007/s40489-024-00428-3

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Abstract

The neuropeptide oxytocin (OXT) has been identified as a potential therapeutic intervention for ASD due to its involvement in social bonding and affiliative behaviors. The present study aimed to assess the effectiveness and safety of intranasal administration of OXT in preclinical and clinical investigations related to ASD. The random-effects meta-analysis method evaluated the combined effect sizes, heterogeneity, and publication bias. Additionally, subgroup analyses were conducted to investigate potential moderators. We confirmed 54 preclinical, animal model, and clinical trials on 2593 cases with ASD through systematic search in PubMed, Web of Science, CNKI, Scopus, and Cochrane library databases from 1980 to 2023. The least-squares mean change of ABC-mSW was significantly lower in the OXT group than in Placebo (SMD, −1.45; 95% CI, −2.24, −0.66; P = 0.0003; I2 = 93%). The analysis showed significantly low OXT plasma concentration after intranasal OXT compared with placebo (SMD, 0.94; 95% CI, 0.48, 1.40; P < 0.0001; I2 = 82%). Our analysis showed only CGI improvement was significantly seen in patients with ASD receiving intranasal OXT compared with placebo (SMD, 0.07; 95% CI, 0.00, 0.14; P = 0.04; I2 = 0%). The meta-analysis suggests that the administration of intranasal OXT may have a positive impact on the behavior of individuals with ASD, particularly in terms of enhancing social and communicative abilities. Nevertheless, turning preclinical research discoveries into clinical applications poses a significant hurdle. Additional research is necessary to ascertain the most effective dose, delivery techniques, and long-term consequences to optimize the treatment efficacy and safety for individuals with ASD. Future research endeavors should aim to investigate the heterogeneity of ASD and the variability in responsiveness to interventions involving intranasal OXT.

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治疗自闭症谱系障碍患者的鼻内催产素：临床前和临床研究的综合荟萃分析

摘要神经肽催产素（OXT）被认为是治疗自闭症的潜在干预措施，因为它参与了社会联系和附属行为。本研究旨在评估在与 ASD 相关的临床前和临床研究中鼻内注射 OXT 的有效性和安全性。随机效应荟萃分析法评估了综合效应大小、异质性和发表偏倚。此外，我们还进行了亚组分析，以研究潜在的调节因素。通过在PubMed、Web of Science、CNKI、Scopus和Cochrane图书馆数据库中进行系统检索，我们确认了从1980年到2023年对2593例ASD患者进行的54项临床前、动物模型和临床试验。OXT组ABC-mSW的最小二乘平均变化显著低于安慰剂组（SMD，-1.45；95% CI，-2.24，-0.66；P = 0.0003；I2 = 93%）。分析显示，与安慰剂相比，鼻内注射 OXT 后的 OXT 血浆浓度明显偏低（SMD，0.94；95% CI，0.48，1.40；P <；0.0001；I2 = 82%）。我们的分析显示，与安慰剂相比，只有CGI改善在接受鼻内OXT治疗的ASD患者中明显可见（SMD，0.07；95% CI，0.00，0.14；P = 0.04；I2 = 0%）。荟萃分析表明，鼻内注射 OXT 可能会对 ASD 患者的行为产生积极影响，尤其是在提高社交和沟通能力方面。然而，将临床前研究发现转化为临床应用还面临着巨大的障碍。有必要开展更多研究，以确定最有效的剂量、给药技术和长期后果，从而优化对 ASD 患者的治疗效果和安全性。未来的研究工作应致力于调查 ASD 的异质性以及对鼻内 OXT 干预反应的差异性。

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来源期刊

Review Journal of Autism and Developmental Disorders PSYCHOLOGY, DEVELOPMENTAL-

CiteScore

8.40

自引率

0.00%

发文量

期刊介绍： The Review Journal of Autism and Developmental Disorders publishes original articles that provide critical reviews of topics across the broad interdisciplinary research fields of autism spectrum disorders. Topics range from basic to applied and include but are not limited to genetics, neuroscience, diagnosis, applied behavior analysis, psychopharmacology, incidence, prevalence, etiology, differential diagnosis, treatment, measurement of treatment effects, education, perception and cognition. Topics across the life span are appropriate. In addition, given the high rates of comorbid conditions, the interface of sleep disorders, feeding problems, motor difficulties, ADHD, anxiety, depression and other disorders with autism spectrum disorders are appropriate. The Journal aims for an international audience as reflected in the editorial board.