Probiotic Therapy for Treating Behavioral and Gastrointestinal Symptoms in Autism Spectrum Disorder: A Systematic Review of Clinical Trials

Liu, Jun; Wan, Guo bing; Huang, Ming shi; Agyapong, George; Zou, Tian le; Zhang, Xueying; Liu, Yen Wenn; Song, Yiqing; Tsai, Yao‐Chou; Kong, Xue jun

doi:10.1007/s11596-019-2016-4

Cited by 31 publications

(23 citation statements)

References 26 publications

(58 reference statements)

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“…The effectiveness of probiotic therapy is limited due to the use of bacterial strains known for their medicinal properties and omission of unknown and probably significant factors. However, probiotic supplementation is well tolerated and the serious adverse effects are infrequent, yet rarely evaluated (Liu et al, 2019b). After knowing the microbiota composition of an individual, it may be easier to choose pro-or prebiotic preparations or modify their composition in relation to patient's needs.…”

Section: Discussionmentioning

confidence: 99%

“…Administration of probiotics aiming to restore gut microbial balance also seems to be promising (Saurman et al, 2020). The recent data on the therapeutic use of probiotics in ASDs revealed suggestive evidence and improvement trend in the behavioral and GI symptoms after the administration of these supplements (Liu et al, 2019b;Martıńez-Gonzaĺez and Andreo-Martıńez, 2020).…”

Section: Microbial-mediated Therapeutic Approaches In Asd With Comorbid Gimentioning

confidence: 99%

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Future Directions in Reducing Gastrointestinal Disorders in Children With ASD Using Fecal Microbiota Transplantation

Żebrowska

Łaczmańska

Łaczmański

2021

Front. Cell. Infect. Microbiol.

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Research on the use of fecal microbiota transplantation (FMT) in the treatment of disorders related to digestive system ailments in children with autism spectrum disorders (ASDs) is a new attempt in a therapeutic approach. There are very little scientific evidences available on this emerging alternative method. However, it appears to be interesting not only because of its primary outcome, relieving the gastrointestinal (GI) symptoms, but also secondary therapeutic effect of alleviating autistic behavioral symptoms. FMT seems to be also promising method in the treatment of another group of pediatric patients, children with inflammatory bowel disease (IBD). The aim of this study is to discuss the potential use of FMT and modified protocols (MTT, microbiota transfer therapy) in the treatment of GI disorders in ASD children supported by reports on another disease, IBD concerning pediatric patients. Due to the few reports of the use of FMT in the treatment of children, these two patients groups were selected, although suffering from distant health conditions: neurodevelopmental disorder and gastrointestinal tract diseases, because of the the fact that they seem related in aspects of the presence of GI symptoms, disturbed intestinal microbiota, unexplained etiology of the condition and age range of patients. Although the outcomes for all are promising, this type of therapy is still an under-researched topic, studies in the group of pediatric patients are sparse, also there is a high risk of transmission of infectious and noninfectious elements during the procedure and no long-term effects on global health are known. For those reasons all obtained results should be taken with a great caution. However, in the context of future therapeutic directions for GI observed in neurodevelopmental disorders and neurodegenerative diseases, the topic seems worthy of attention.

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Section: Discussionmentioning

confidence: 99%

Section: Microbial-mediated Therapeutic Approaches In Asd With Comorbid Gimentioning

confidence: 99%

Future Directions in Reducing Gastrointestinal Disorders in Children With ASD Using Fecal Microbiota Transplantation

Żebrowska

Łaczmańska

Łaczmański

2021

Front. Cell. Infect. Microbiol.

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“…In the first stage (12 weeks), all the patients will be randomly assigned to two groups: group A (30 subjects) receives oral L. reuteri probiotics while group B (30 subjects) receives oral as a placebo. We decided on a 12-week timeline because according to the most recent systematic review of probiotics therapy in ASD, the average duration of clinical trials is 3 months [19]. In the second stage, subjects in group A and group B will continue their respective oral L. reuteri probiotics or placebo administration as in stage 1.…”

Section: Study Proceduresmentioning

confidence: 99%

Probiotics and oxytocin nasal spray as neuro-social-behavioral interventions for patients with autism spectrum disorders: a pilot randomized controlled trial protocol

Kong

et al. 2020

Pilot Feasibility Stud

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Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder characterized by impairments in social interaction and communication. Oxytocin (OXT), as a neuropeptide, plays a role in emotional and social behaviors. Lactobacillus reuteri (L. reuteri) supplementation led to an OXT-dependent behavioral improvement in ASD mouse models. Despite some promising results from animal studies, little is known about the efficacy of supplementation with L. reuteri, alone or with exogenous OXT therapy, on social-behavioral functions in ASD patients. This paper presents a protocol for a pilot randomized controlled trial to evaluate the feasibility of conducting a full trial comparing oral supplementation of L. reuteri probiotics and intranasal OXT spray to placebo on the effect of social and behavioral functions in ASD patients. The study will also capture preliminary estimates of the efficacy of the proposed interventions in ASD patients. Methods: This pilot trial is a two-staged, randomized, double-blind, placebo-controlled, parallel-group study. Throughout the study (0-24 weeks), 60 patients with ASD will be randomly assigned to receive either oral L. reuteri probiotics or placebo. In the second study stage (13-24 weeks), all participants will receive intranasal OXT spray. As primary outcomes, serum OXT levels will be assayed and social behaviors will be assessed via the Autism Behavior Checklist and the Social Responsiveness Scale which are validated questionnaires, an objective emotional facial matching test, and a new video-based eye-tracking test. Secondary outcomes include the GI-severity-index and Bristol Stool Chart to assess GI function and gut microbiome/short-chain fatty acids. All the outcomes will be assessed at baseline and weeks 12 and 24. Discussion: This pilot study will provide important information on the feasibility of recruitment, blinding and concealment, treatment administration, tolerability and adherence, specimen collection, outcome assessment, potential adverse effects, and the preliminary efficacy on both primary and secondary outcomes. If successful, this pilot study will inform a larger randomized controlled trial fully powered to examine the efficacies of oral L. reuteri probiotics and/or intranasal OXT spray on social-behavioral improvement in ASD patients. Trial registration: ClinicalTrials.gov, NCT03337035. Registered 8 November 2017.

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“…Multiple studies have reported effects of probiotic treatments on microbiota composition and GI symptoms in ASD children. Although many of these studies did not analyze the behavior of the children, or did not see any improvement after probiotic administration [26,[119][120][121], other studies did report behavioral improvement [122][123][124][125]. In Shaaban et al (2017) [123], 30 children with ASD were given a 3-month, daily treatment with a patented probiotic mixture (composed of strains of the species L. acidophilus, L. rhamnosus and B. longum) which induced an improvement in communication, sociability and cognitive awareness, characterized by a decrease in the ATEC (autism treatment evaluation checklist) score.…”

Section: Clinical Studiesmentioning

confidence: 99%

Role of the Gut Microbiota in the Pathophysiology of Autism Spectrum Disorder: Clinical and Preclinical Evidence

et al. 2020

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting 1 in 160 people in the world. Although there is a strong genetic heritability to ASD, it is now accepted that environmental factors can play a role in its onset. As the prevalence of gastrointestinal (GI) symptoms is four-times higher in ASD patients, the potential implication of the gut microbiota in this disorder is being increasingly studied. A disturbed microbiota composition has been demonstrated in ASD patients, accompanied by altered production of bacterial metabolites. Clinical studies as well as preclinical studies conducted in rodents have started to investigate the physiological functions that gut microbiota might disturb and thus underlie the pathophysiology of ASD. The first data support an involvement of the immune system and tryptophan metabolism, both in the gut and central nervous system. In addition, a few clinical studies and a larger number of preclinical studies found that modulation of the microbiota through antibiotic and probiotic treatments, or fecal microbiota transplantation, could improve behavior. Although the understanding of the role of the gut microbiota in the physiopathology of ASD is only in its early stages, the data gathered in this review highlight that this role should be taken in consideration.

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Probiotic Therapy for Treating Behavioral and Gastrointestinal Symptoms in Autism Spectrum Disorder: A Systematic Review of Clinical Trials

Cited by 31 publications

References 26 publications

Future Directions in Reducing Gastrointestinal Disorders in Children With ASD Using Fecal Microbiota Transplantation

Future Directions in Reducing Gastrointestinal Disorders in Children With ASD Using Fecal Microbiota Transplantation

Probiotics and oxytocin nasal spray as neuro-social-behavioral interventions for patients with autism spectrum disorders: a pilot randomized controlled trial protocol

Role of the Gut Microbiota in the Pathophysiology of Autism Spectrum Disorder: Clinical and Preclinical Evidence

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