The Role of the Gut Microbiome in Autism Becomes Murkier

The study “confirms a lot of what people think,” according to Calliope Holingue, a psychiatric epidemiologist at the Center for Autism and Related Disorders at the Kennedy Krieger Institute in Maryland, if the connection between autism and the microbiome may be in part due to food. “As such, I don’t think it completely eliminates the possibility that the microbiome plays a role in autism itself.”

One criticism, he says, is that the study looks at a snapshot of time, rather than a long period of time. “Even if the authors did not see that autism itself was associated with gut microbiome composition or variability, that does not mean that the microbiome was not included at some point, prior to the study, for example,” Holingue said. Yap recognizes that in order to assess causality, longitudinal studies are essential.

While there has been no study so far conclusively shown this, the first signs of a relationship between gut and autism seed hope for a treatment. For example, a research group was published at Arizona State University study in 2017 who took 18 children on the autism spectrum who also suffered from gastrointestinal problems, and managed them for a fecal transplant. In 2019, the team published a two-year follow-up, and reported a nearly 50 percent improvement in autism-related symptoms. But the study was not randomized, had no control group, was not compared to placebo, and had a small sample size.

Arizona State University studies have been a source of controversy within the field, Holingue said. “Some people are big fans of them. And I think some of the other people are very worried that they will do more harm than good, and it’s probably not clear what the purpose is,” he said. A real one source of controversy among autistic people and their families is that the ultimate goal of research should be to search for treatments. ”Many in the autistic community say they don’t want the research to go away. focus on medications for autism or treatments for autism, but the conditions and factors that support them, ”Holingue said.

Despite the lack of concrete evidence to support efficacy, initial research urges clinics to offer treatments for autistic people, including interventions such as probiotics, prebiotics, and fecal microbiota. transplants, or FMTs (or, less commonly, “transpoosion”). Fecal transplants — in which germs from the feces of a healthy person are administered to the patient either anally or orally — have been shown to benefit certain conditions: in particular, in Treatment of Clostridioides difficile colitis, a often debilitating, sometimes fatal, condition resulting from excessive use of antibiotics, which upset the balance of intestinal bacteria. This success has become hype in trying to treat more conditions — including autism.

“When people are autistic or [their] Families receive the news that someone with autism, they no longer have effective support, ”said James Cusack, CEO of Autistica, a UK autism research charity, which is on the spectrum. “And that can be a traumatic experience for families and for autistic people.” It also means that a parent may feel compelled to find alternative ways to ensure that their child develops in the same way as their peers. (A 2015 study surveyed parents and found that nearly nine in 10 were looking for complementary and alternative treatments for autism in their children.) These parents may be more likely to try things that are in fact not based on evidence, Cusack said. said. “And it’s really sad that people are in this position. What we need to try to do is try and understand the reasons people make these decisions and try to support them to do it differently.

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