Improved core manifestations and language skills in autism following new vitamin D3 nanoemulsion supplement

Children with autism spectrum disorder (ASD) exhibit communication difficulties, which could not be confined to social communication but could also include receptive and expressive language abilities. Most of these children further manifest delays in adaptive performance. The adaptive abilities development of these children is influenced by executive functions and fine motor development.  The male and female differences in children with ASD differed among studies. Some reported no differences, and some reported more prominent restrictive repetitive behaviors in males. Many of these children manifest nutritional deficiencies, especially vitamin deficiencies. This could be related to their selective feeding behavior. Furthermore, the therapeutic diet restriction, which they may be subjected to, and the gastrointestinal disorders they manifest were suggested to be involved in their nutritional inadequacy. Previous reports have emphasized the deficiency of vitamin D3 in individuals with ASD. Vitamin D3 levels of children from lower-latitude areas showed huge differences, suggesting that increasing sun exposure in individuals with ASD did not result in elevating its levels.

Vitamin D3 (cholecalciferol) is one of the fat-soluble micronutrients that plays an essential role in brain development, especially neuronal differentiation. It shares in neuronal and glial protection and in reducing apoptosis in the hippocampus, which is involved in language and memory processing. It has two forms: 25- hydroxycholecalciferol and 1, 25- dihydroxycholecalciferol. The first hydroxylation of vitamin D3 (cholecalciferol) occurs in the liver to produce the 25-hydroxyvitamin D3 form, which is the main circulating form. The second hydroxylation takes place in the kidneys mainly, yielding the 1, 25-dihydroxyvitamin D3 form, which serves both paracrine and autocrine functions. Normally, the blood level of the 25-hydroxyvitamin D3 is higher than the 1, 25 type. Vitamin D3 supplementation in children with ASD revealed variable results in previous studies. It was reported to have no influence on irritability or core ASD symptoms, yet it has a beneficial effect on hyperactivity.  On the other hand, some studies reported improved core symptoms after supplementation with the marketed vitamin D3. The influence of its intake on receptive and expressive language performance has not been adequately investigated. Furthermore, the use of vitamin D3-loaded nanoemulsion and its benefits compared to the usual form of oral vitamin D3 have not been investigated in children with ASD. Nanotechnology has emerged as an answer to absorption and bioavailability concerns related to vitamin D3, allowing users to take advantage of its favorable effect while overcoming some disadvantages associated with its oral intake. Nanoparticles provide protection for vitamin D3 from external situations, and they increase the stability and solubility of this molecule.

This study was to investigate the influence of vitamin D3-loaded nanoemulsion supplementation on adaptive behavior and language performance in a group of children with ASD compared to the influence of the marketed product of vitamin D3. Correlations between the levels of the two forms of vitamin D3 and their abilities before and after the supplementation were investigated.