Dalton Neil, Chandler Susie, Turner Charles, Charman Tony, Pickles Andrew, Loucas Tom, Simonoff Emily, Sullivan Peter, Baird Gillian
WellChild Laboratory, Evelina Children's Hospital & King's College London, London.
Autism Res. 2014 Jun;7(3):305-13. doi: 10.1002/aur.1350. Epub 2013 Dec 12.
To test whether gut permeability is increased in autism spectrum disorders (ASD) by evaluating gut permeability in a population-derived cohort of children with ASD compared with age- and intelligence quotient-matched controls without ASD but with special educational needs (SEN).
One hundred thirty-three children aged 10-14 years, 103 with ASD and 30 with SEN, were given an oral test dose of mannitol and lactulose and urine collected for 6 hr. Gut permeability was assessed by measuring the urine lactulose/mannitol (L/M) recovery ratio by electrospray mass spectrometry-mass spectrometry. The ASD group was subcategorized for comparison into those without (n = 83) and with (n = 20) regression.
There was no significant difference in L/M recovery ratio (mean (95% confidence interval)) between the groups with ASD: 0.015 (0.013-0.018), and SEN: 0.014 (0.009-0.019), nor in lactulose, mannitol, or creatinine recovery. No significant differences were observed in any parameter for the regressed versus non-regressed ASD groups. Results were consistent with previously published normal ranges. Eleven children (9/103 = 8.7% ASD and 2/30 = 6.7% SEN) had L/M recovery ratio > 0.03 (the accepted normal range cut-off), of whom two (one ASD and one SEN) had more definitely pathological L/M recovery ratios > 0.04.
There is no statistically significant group difference in small intestine permeability in a population cohort-derived group of children with ASD compared with a control group with SEN. Of the two children (one ASD and one SEN) with an L/M recovery ratio of > 0.04, one had undiagnosed asymptomatic celiac disease (ASD) and the other (SEN) past extensive surgery for gastroschisis.
通过评估一组来自普通人群的自闭症谱系障碍（ASD）儿童的肠道通透性，并与年龄和智商匹配但无ASD但有特殊教育需求（SEN）的对照组进行比较，来测试ASD患儿的肠道通透性是否增加。
133名10 - 14岁儿童，其中103名患有ASD，30名患有SEN，口服甘露醇和乳果糖测试剂量，并收集6小时尿液。通过电喷雾质谱 - 质谱法测量尿液中乳果糖/甘露醇（L/M）回收率来评估肠道通透性。将ASD组进一步分为无（n = 83）和有（n = 20）发育倒退的亚组进行比较。
ASD组（均值（95%置信区间））与SEN组的L/M回收率无显著差异：分别为0.015（0.013 - 0.018）和0.014（0.009 - 0.019），乳果糖、甘露醇或肌酐回收率也无显著差异。在发育倒退与未发育倒退的ASD组的任何参数中均未观察到显著差异。结果与先前公布的正常范围一致。11名儿童（ASD组9/103 = 8.7%，SEN组2/30 = 6.7%）的L/M回收率> 0.03（公认的正常范围临界值），其中两名（一名ASD和一名SEN）的L/M回收率更明确地高于病理范围> 0.04。
与有SEN的对照组相比，在一组来自普通人群队列的ASD儿童中，小肠通透性在统计学上无显著组间差异。在两名L/M回收率> 0.04的儿童（一名ASD和一名SEN）中，一名患有未诊断出的无症状乳糜泻（ASD），另一名（SEN）曾因腹裂接受过广泛手术。
