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The microbiome — the collection of organisms that live in the human gut, including bacteria, archaea, fungi, and viruses — has been shown to play an important role in brain function. Wildpixel / iStock
Ethan was diagnosed with moderate to severe autism at a young age. By age seven, despite the best efforts of her family and rehabilitation professionals, her vocabulary, diet, and social interactions were severely limited. He wasn’t even potty trained.
Autism And Gut Bacteria
Then one morning, four weeks into the special clinical trial, Ethan’s mom, Dana, woke him up with a smiley face: “Good morning mom.” The transformation was amazing, a face his son had never seen before, and he cried with joy.
Research On Gut Microbiota And Autism
It was a miraculous feces. Not the raw material in the toilet, but cultured gut microbial organisms from a rigorously screened donor that Ethan mixed into his drinks as part of the test.
“There’s a very high correlation between [gastrointestinal] severity and autism severity — language, social interaction, behavior, all of the core characteristics of autism,” says Jim Adams, an Arizona State University professor and autism researcher. saw this connection firsthand when her daughter was diagnosed with ASD. “The question is, is it because of the pain and discomfort of the GI issues, or is it more than that?”
When Adams reviewed the scientific literature, he found that dysbiosis, or disruption of the normal ecosystem of bacteria and other organisms in the gut, can affect ASD and GI symptoms. Treatment with vancomycin, a powerful antibiotic that does not enter the bloodstream but remains in the gut, may provide temporary relief. But the antibiotic can only be used for a short time before the bacteria become resistant to it.
More than a decade ago, the theory of the gut-brain connection emerged, in which dysfunction in the gut can also affect brain activity. “Seventy percent of the nerves that enter the central nervous system go to the gut. Why is that?” asks Sarkis Mazmanyan, a medical researcher at the California Institute of Technology. Mazmanian notes that compared to normal animals, germ-free mice, which don’t have bacteria in their gut, “have changes like anxiety, exercise, depression, and even the brain development”.
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In 2013, Mazmanian and a team of researchers demonstrated a gut-brain connection in a mouse model of autism. Three years later, the team did the same for Parkinson’s disease. They recently showed that transplanting an autistic person’s feces into germ-free mice produced many of the symptoms of ASD in the animals.
After transferring microbiome samples from individuals with ASD to germ-free mice, the mice displayed behavioral signs of autism. In addition, the mice showed increased communication after the manipulation of the microbiome. Gil Sharon et al. / Cell 2019.05.004
A healthy gut ecosystem contains around a thousand different bacteria, as well as archaea, fungi, and viruses, although the exact organisms and their numbers can vary from person to person. In contrast, the diversity of bacteria found in people with ASD is about 25 percent lower than in healthy people. Your gut lacks hundreds of different bacteria, most of which are important for fermentation and the production of short-chain fatty acids with health benefits.
Adams attempted to bring all of these disparate lines of research together by conducting a study on the effectiveness of stool transplants in children with ASD. Her team at ASU, the Autism/Asperger’s Research Program, includes gut bacteria expert Rosa Krymalnik-Brown, also known as Dr. rosie Little was known about stool transplants in children at the time the study was presented, so the FDA initially requested a small, preliminary safety study limited to children over the age of seven.
How The Gut Microbiome Could Provide A New Tool To Treat Autism
The study included 18 children aged 7 to 18 years with a diagnosis of ASD and significant GI problems. The cure was demanding, but relatively child-friendly. First, the antibiotic vancomycin was used to destroy the number of microbes in her gut. The children were then given daily doses of microbes cleaned from the guts of healthy donors, suspended in liquid and mixed with drinks, along with an antacid to reduce stomach acid, which can destroy the microbes before they reach the gut. The bowel treatment lasted ten weeks.
ASU researchers didn’t see much of an answer at first. The initial dysbiosis may have damaged some of the intestinal cells, as is the case in patients with irritable bowel syndrome (IBS), and it took some time for these wounds to recover sufficiently to support colonization by the donor bacteria. But halfway through the cycle, most participants showed signs of improvement.
Only two participants had a minimal response, with their GI symptoms improving by about 30 percent, and this didn’t last long after treatment was stopped. But 16 children had at least a 70 percent improvement in their GI symptoms, and most importantly, they showed improvement in the behavioral symptoms of autism. The paper was published in January 2017 and so impressed the Pentagon that the Department of Defense agreed to fund a study of microbial transplants in adults with autism, which began enrolling patients in early 2018.
Adams was surprised to hear that parents continued to show improvement in their children’s ASD-related behavior long after the study ended. The team decided to do a two-year follow-up to see what happened.
Clues About Autism May Come From The Gut
An independent professional evaluator using the Childhood Autism Rating Scale (CARS) found 23 percent fewer symptoms at the end of treatment than at the start; two years later it improved to 47 percent. At baseline, 83 percent of participants were classified at the severe end of the ASD scale, but after two years of follow-up, that number dropped to 17 percent, and 44 percent improved below the diagnostic threshold for ASD. .
Measures using the Parent Social Responsiveness Scale (SRS) assessment showed parallel improvements, according to a follow-up paper published in April this year. It appears that the gut microbiome could represent a new tool for treating ASD.
After follow-up, the participants still showed a diversity of healthy microbiomes, but the bacterial population in their gut was individualized and no longer resembled the donor. Variations reflect diet, environmental influences, the immune system, and individual genetics.
“If you have a company with a great work environment, good people will come and want to work for that company,” says Krajmalnik-Brown. “In the gut, if you have a good environment, you have good microbes, and other good microbes want to come and be there.”
Most Common Gut Health Issues In Autistic People
The team doesn’t claim that all of the improvements are due to treating the gut bacteria. Adams believes that restoring a healthy gut microbiome benefits the distorted gut-brain axis in ASD, and that treating the pain and anxiety of a dysbiotic gut can help children concentrate, focus, and manage language, behavior, and other government and society offered treatments improve service organizations methods.
“Unfortunately, these GI symptoms are often ignored, even when parents of children with autism say that treating these symptoms improves their child’s behavior,” says Paul Ashwood, a microbiologist who studies ASD at the University of California, Davis. He acknowledges the limitations of the Adams and Krymalnik-Brown studies, such as B. small sample sizes and the influence of outliers, but says: “The data are very interesting and should be followed up.”
As with any new approach to treating a condition, initial success raises more questions than answers. Will this approach benefit a broader population of ASD patients, including those without significant gastrointestinal symptoms? Is vancomycin necessary to disrupt the existing microbial ecosystem before healthy gut bacteria flood in? What is the best treatment duration? Answering these questions will take time and more research, but Adams is optimistic that an approved microbial treatment for ASD will be available in a few years.
Meanwhile, the ASU team is preparing another test for children. Their partners have developed a pill form of microbial transplant that they believe will bypass the stomach acid problem and deliver a more consistent product to the gut. The pill is already being used in other studies, and Adams believes the change will yield more consistent results than the first study.
The Gut Microbiome’s Role In Autism Gets Murkier
For her part, Dana is thrilled with the “amazing progress” Ethan, now 12, is making. He has achieved all of the goals set by his speech and occupational therapists and continues to work on social and life skills, such as: B. Learning to understand one’s own emotions and those of others and to express one’s feelings. If medical researchers like the ASU team can continue to develop microbiome treatments for ASD, many more children could benefit from the multifaceted value of a healthy gut. bacterial flora
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