Whiteley Paul
ESPA Research,2A Hylton Park,Hylton Park Road,Sunderland SR5 3HD,UK.
Proc Nutr Soc. 2015 Aug;74(3):202-7. doi: 10.1017/S0029665114001475. Epub 2014 Oct 14.
Autism spectrum disorders represent a diverse and heterogeneous array of conditions unified by the variable presence of specific behaviours impacting social and communicative functions (social affect) alongside other presentation. Common overt characteristics may come about as a consequence of several different genetic and biological processes differentially manifesting across different people or groups. The concept of plural 'autisms' is evolving, strengthened by an increasingly important evidence base detailing different developmental trajectories across the autism spectrum and the appearance of comorbidity variably interacting with core symptoms and onwards influencing quality of life. Reports that dietary intervention, specifically the removal of foods containing gluten and/or casein from the diet, may impact on the presentation of autism for some, complement this plural view of autism. Evidence suggestive of differing responses to the use of a gluten- and casein-free diet, defined as best- and non-response, has combined with some progress on determining the underlying genetic and biological correlates potentially related to such dietary elements. The preliminary suggestion of a possible diet-related autism phenotype is the result. This review will highlight several pertinent aspects onwards to an effect of food in some cases of autism including research on the pharmacological activity of food metabolites, immune response, issues with gut barrier function and some contribution from the gut microbiota. These represent promising areas in need of far greater research inspection in order to potentially define such a diet-related subgroup on the autism spectrum.
自闭症谱系障碍是一系列多样且异质性的病症，其统一特征是存在影响社交和沟通功能（社交情感）的特定行为以及其他表现形式。常见的明显特征可能是由几种不同的遗传和生物学过程导致的，这些过程在不同的人或群体中表现各异。“多种自闭症”的概念正在不断演变，越来越多重要的证据表明，自闭症谱系中存在不同的发展轨迹，并且共病现象与核心症状相互作用，进而影响生活质量，这进一步强化了这一概念。有报告称，饮食干预，特别是从饮食中去除含麸质和/或酪蛋白的食物，可能会对一些自闭症患者的症状产生影响，这补充了对自闭症的这种多元观点。有证据表明，对于采用无麸质和无酪蛋白饮食（定义为最佳反应和无反应）的反应存在差异，同时在确定可能与此类饮食元素相关的潜在遗传和生物学关联方面也取得了一些进展。由此得出了可能存在与饮食相关的自闭症表型的初步建议。本综述将重点介绍食物在某些自闭症病例中的作用的几个相关方面，包括对食物代谢产物的药理活性、免疫反应、肠道屏障功能问题以及肠道微生物群的一些作用的研究。这些都是很有前景的领域，需要进行更深入的研究，以便有可能在自闭症谱系中确定这样一个与饮食相关的亚组。
