Decreased cortical Nrf2 gene expression in autism and its relationship to thiol and cobalamin status

Biochimie. 2022 Jan:192:1-12. doi: 10.1016/j.biochi.2021.09.006. Epub 2021 Sep 10.


Nuclear factor erythroid 2-related factor 2 (Nrf2) promotes expression of a large number of antioxidant genes and multiple studies have described oxidative stress and impaired methylation in autism spectrum disorder (ASD), including decreased brain levels of methylcobalamin(III) (MeCbl). Here we report decreased expression of the Nrf2 gene (NFE2L2) in frontal cortex of ASD subjects, as well as differences in other genes involved in redox homeostasis. In pooled control and ASD correlation analyses, hydroxocobalamin(III) (OHCbl) was inversely correlated with NFE2L2 expression, while MeCbl and total cobalamin abundance were positively correlated with NFE2L2 expression. Levels of methionine, S-adenosylmethionine (SAM), S-adenosylhomocysteine (SAH) and cystathionine were positively correlated with NFE2L2 expression, while homocysteine (HCY) was negatively correlated. The relationship between Nrf2 activity and cobalamin was further supported by a bioinformatics-based comparison of cobalamin levels in different tissues with expression of a panel of 40 Nrf2-regulated genes, which yielded a strong correlation. Lastly, Nrf2-regulated gene expression was also correlated with expression of intracellular cobalamin trafficking and processing genes, such as MMADHC and MTRR. These findings highlight a previously unrecognized relationship between the antioxidant-promoting role of Nrf2 and cobalamin status, which is dysfunctional in ASD.

Keywords: Autism spectrum disorder; Cobalamin; Glutathione; Methionine synthase; Methylation; Nrf2; Oxidative stress; Vitamin B12.

MeSH terms

  • Autistic Disorder / genetics
  • Autistic Disorder / metabolism*
  • Frontal Lobe / metabolism*
  • Gene Expression Regulation*
  • Humans
  • NF-E2-Related Factor 2 / genetics
  • NF-E2-Related Factor 2 / metabolism*
  • Vitamin B 12 / genetics
  • Vitamin B 12 / metabolism*


  • NF-E2-Related Factor 2
  • NFE2L2 protein, human
  • Vitamin B 12