Altering the gut microbiome to potentially modulate behavioral manifestations in autism spectrum disorders: A systematic review

Davies, Camron; Mishra, Dibyanshi; Eshraghi, Rebecca S.; Mittal, Jeenu; Sinha, Rahul; Bulut, Erdoğan; Mittal, Rahul; Eshraghi, Adrien A.

doi:10.1016/j.neubiorev.2021.07.001

Cited by 39 publications

(29 citation statements)

References 62 publications

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“…Increasing reports have identified gut microbiota as an important regulator of brain development, function, and behavior, it is identified to be involved in ASD ( Fung et al, 2017 ). Animal models have shown that transplantation of fecal microbiota from patients with neurological disorders would lead to typical disorder symptoms in germ-free mice ( Davies et al, 2021 ), clinical evidence also indicated that interactions exist between gut microbiota and ASD behavior. A large number of studies have shown that patients with ASD have various gastrointestinal symptoms, such as distension, abdominal pain, diarrhea, and constipation, and that these symptoms are closely related to the severity of ASD ( Vargason et al, 2019 ; Davies et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Fecal Microbiota Transplantation Relieves Gastrointestinal and Autism Symptoms by Improving the Gut Microbiota in an Open-Label Study

Chen²,

Cheng

et al. 2021

Front. Cell. Infect. Microbiol.

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Autism spectrum disorder (ASD) is a severe brain development disorder that is characterized by deficits in social communication and restricted, repetitive and stereotyped behaviors. Accumulating evidence has suggested that gut microbiota disorders play important roles in gastrointestinal symptoms and neurodevelopmental dysfunction in ASD patients. Manipulation of the gut microbiota by fecal microbiota transplantation (FMT) was recently shown to be a promising therapy for the treatment of various diseases. Here, we performed a clinical trial to evaluate the effect of FMT on gastrointestinal (GI) and ASD symptoms and gut microbiota alterations in children with ASD. We found that there was a large difference in baseline characteristics of behavior, GI symptoms, and gut microbiota between children with ASD and typically developing (TD) control children. FMT could improve GI symptoms and ASD symptoms without inducing any severe complications. Similarly, FMT significantly changed the serum levels of neurotransmitters. We further observed that FMT could promote the colonization of donor microbes and shift the bacterial community of children with ASD toward that of TD controls. The abundance of Eubacterium coprostanoligenes pre-FMT was positively correlated with high GSRS scores, whereas a decrease in Eubacterium coprostanoligenes abundance induced by FMT was associated with the FMT response. Our data suggest that FMT might be a promising therapeutic strategy to improve the GI and behavioral symptoms of patients with ASD, possibly due to its ability to alter gut microbiota and highlight a specific microbiota intervention that targets Eubacterium coprostanoligenes that can enhance the FMT response. This trial was registered at the Chinese Clinical Trial Registry (www.chictr.org.cn) (trial registration number ChiCTR1800014745).

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Section: Introductionmentioning

confidence: 99%

Fecal Microbiota Transplantation Relieves Gastrointestinal and Autism Symptoms by Improving the Gut Microbiota in an Open-Label Study

Chen²,

Cheng

et al. 2021

Front. Cell. Infect. Microbiol.

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“…We should also consider the possible involvement of the brain-gut axis (GBA) in the pathophysiological mechanism of CV, as we observed associated neurodevelopmental diseases in more than half of cases (54.4%). The link between dysbiosis and central nervous system disorders has been proven in clinical practice [30,31]. The complexity of GBA interactions encompasses immune overactivation, intestinal permeability, enteric reflexes and entero-endocrine signaling.…”

Section: Discussionmentioning

confidence: 99%

“…The complexity of GBA interactions encompasses immune overactivation, intestinal permeability, enteric reflexes and entero-endocrine signaling. GBA influences and modulates peripheral intestinal functions [30,31].…”

Section: Discussionmentioning

confidence: 99%

Colonic Volvulus in Children: Surgical Management of a Challenging Condition

et al. 2021

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Colonic volvulus (CV) is a rare but potentially life-threatening condition with unclear etiopathogenesis. To date, less than 80 pediatric cases have been described. Hirschsprung’s disease (HD) is associated with CV in 17% of cases, representing a significant risk factor. Non-HD CV is an even more complex entity. The aim of this study is to describe a series of patients with CV to accentuate some peculiar aspects of this disease. We performed a retrospective study (period: 2012–2021) collecting information of patients with CV. Data analyzed included: demographics, medical history, presenting symptoms and radiological and surgical details. Eleven patients (12.5 ± 2.8 years; 7F/4M) had CV (eight sigmoid, two transverse colon, one total colon). Five patients had associated anomalies and three had HD. A two-step approach with volvulus endoscopic/radiological detorsion followed by intestinal resection was attempted in eight cases (one endoscopic approach failed). Three patients required surgery at admission. At follow-up, two patients developed recurrent intestinal obstruction, one of whom also had anastomotic stenosis. Colonic volvulus is a challenging condition that requires prompt patient care. A missed diagnosis could lead to severe complications. The evaluation of the patient should include a careful histological examination (searching for HD and alpha-actin deficiency), immunologic and metabolic screening, neurological tests and detection of chronic intestinal pseudo-obstruction (CIPO). Lifelong follow-up is mandatory for the early recognition and treatment of progressive diseases involving the proximal gastrointestinal tract.

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“…Unlike other reviews on this topic [ 45 , 46 , 47 ], the most appropriate tools to judge each paper were chosen, differentiating how to estimate biases of RCT from those of nonrandomized trials. Applying the tools adopted to specifically evaluate the risk of bias in RCT also in nonrandomized studies could represent a mistake [ 48 ], e.g., randomization protects against biases that arise before the start of intervention [ 24 ], then this phase has to be considered as a possible source of biases in not-randomized trials only.…”

Section: Study Qualitymentioning

confidence: 99%

Interventions on Microbiota: Where Do We Stand on a Gut–Brain Link in Autism? A Systematic Review

et al. 2022

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The alteration of the microbiota–gut–brain axis has been recently recognized as a critical modulator of neuropsychiatric health and a possible factor in the etiopathogenesis of autism spectrum disorders (ASD). This systematic review offers practitioners an overview of the potential therapeutic options to modify dysbiosis, GI symptoms, and ASD severity by modulating the microbiota–gut–brain axis in ASD, taking into consideration limits and benefits from current findings. Comprehensive searches of PubMed, Scopus, the Web of Science Core Collection, and EMBASE were performed from 2000 to 2021, crossing terms referred to ASD and treatments acting on the microbiota–gut–brain axis. A total of 1769 publications were identified, of which 19 articles met the inclusion criteria. Data were extracted independently by two reviewers using a preconstructed form. Despite the encouraging findings, considering the variability of the treatments, the samples size, the duration of treatment, and the tools used to evaluate the outcome of the examined trials, these results are still partial. They do not allow to establish a conclusive beneficial effect of probiotics and other interventions on the symptoms of ASD. In particular, the optimal species, subspecies, and dosages have yet to be identified. Considering the heterogeneity of ASD, double-blind, randomized, controlled trials and treatment tailored to ASD characteristics and host-microbiota are recommended.

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Altering the gut microbiome to potentially modulate behavioral manifestations in autism spectrum disorders: A systematic review

Cited by 39 publications

References 62 publications

Fecal Microbiota Transplantation Relieves Gastrointestinal and Autism Symptoms by Improving the Gut Microbiota in an Open-Label Study

Fecal Microbiota Transplantation Relieves Gastrointestinal and Autism Symptoms by Improving the Gut Microbiota in an Open-Label Study

Colonic Volvulus in Children: Surgical Management of a Challenging Condition

Interventions on Microbiota: Where Do We Stand on a Gut–Brain Link in Autism? A Systematic Review

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