To the Editor I read with interest with the meta-analysis conducted by Qin et al1 on the association between peripheral blood levels of brain-derived neurotrophic factor (BDNF) and autism spectrum disorder in children. The authors included 19 studies in their meta-analysis and concluded that children with autism spectrum disorder had significantly higher peripheral BDNF blood levels than did healthy control children. I have made the novel proposition elsewhere that exposure to the pervasive and understudied air pollutant nitrous oxide (N2O) may be a principal etiologic factor in neurodevelopmental disorders.2 A review of the biologic targets of N2O thought to be relevant to neurodevelopment impairment has revealed that low-dose exposure may modulate central opioidergic, glutamatergic, and cholinergic functioning.2
Fluegge K. Brain-Derived Neurotrophic Factor in Autism Spectrum Disorder. JAMA Pediatr. 2017;171(5):492–493. doi:10.1001/jamapediatrics.2017.0113
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