Autism spectrum disorder (ASD) has been associated with disruptions in tryptophan (TRP) metabolism, affecting the production of key neuroactive metabolites. Investigating these metabolic pathways could yield valuable biomarkers for ASD severity and progression. We included 44 children with ASD and 44 healthy children, members of the same family. The average age in the ASD group was 10.7 years, while the average age in the control group was 9.4 years. Urinary tryptophan metabolites were quantified via liquid chromatography-mass spectrometry operating multiple reaction monitoring (MRM). Urinary creatinine was analyzed on an Advia 2400 analyzer using the Jaffe reaction. Statistical comparisons were made between ASD subgroups based on CARS scores. Our findings indicate that children with ASD have higher TRP concentrations (19.94 vs. 16.91; p = 0.04) than their siblings. Kynurenine (KYN) was found at higher levels in children with ASD compared to children in the control group (82.34 vs. 71.20; p = 0.86), although this difference was not statistically significant. The ASD group showed trends of higher KYN/TRP ratios and altered TRP/ indole-3-acetic acid (IAA) and TRP/5-hydroxyindoleacetic acid (5-HIAA) ratios, correlating with symptom severity. Although the numbers of the two groups were different, our findings suggest that mild and severe illnesses involve separate mechanisms. However, further comprehensive studies are needed to validate these ratios as diagnostic tools for ASD.

Center for Autism Unit of Child Psychiatry University Children's Hospital University Medical Centre Ljubljana 1000 Ljubljana Slovenia

Department of Microbiology Biotechnical Faculty University of Ljubljana 1230 Domžale Slovenia

Environmental Exposure Assessment Research Infrastructure Czech Republic 60200 Brno Czech Republic

Faculty of Mathematics Natural Sciences and Information Technologies University of Ljubljana 6000 Koper Slovenia

Faculty of Pharmacy University of Ljubljana 1000 Ljubljana Slovenia

Institute of Clinical Chemistry and Biochemistry University Medical Centre Ljubljana 1000 Ljubljana Slovenia

RECETOX Faculty of Science Masaryk University 61137 Brno Czech Republic

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