Department of Experimental Medicine, SUN-Second University of Naples, Naples, Italy.
Department of Mental Health and Public Medicine, SUN-Second University of Naples, Naples, Italy.
Mycopathologia. 2017 Apr;182(3-4):349-363. doi: 10.1007/s11046-016-0068-6. Epub 2016 Sep 21.
High frequency of gastrointestinal yeast presence in ASD subjects was shown through a simple cultural approach (Candida spp. in 57.5 % of ASDs and no controls); the identification of aggressive form (pseudo-hyphae presenting) of Candida spp. at light microscope means that adhesion to intestinal mucosa is facilitated. Dysbiosis appears sustained by lowered Lactobacillus spp. and decreased number of Clostridium spp. Absence of C. difficilis and its toxins in both ASDs and controls is also shown. Low-mild gut inflammation and augmented intestinal permeability were demonstrated together with the presence of GI symptoms. Significant linear correlation was found between disease severity (CARs score) and calprotectin and Clostridium spp. presence. Also GI symptoms, such as constipation and alternating bowel, did correlate (multivariate analyses) with the increased permeability to lactulose. The present data provide rationale basis to a possible specific therapeutic intervention in restoring gut homeostasis in ASDs.
通过简单的培养方法（57.5%的 ASD 患儿和对照组均为假丝酵母菌属）发现 ASD 患儿胃肠道酵母菌存在的高频率；假菌丝的出现意味着假丝酵母菌属更容易黏附于肠黏膜，这表明其具有侵袭性。双歧杆菌属数量减少和梭菌属数量减少使得肠道菌群失调得以维持。在 ASD 患儿和对照组中均未发现艰难梭菌及其毒素。同时存在肠道低中度炎症和肠道通透性增加以及胃肠道症状。疾病严重程度（CARS 评分）与钙卫蛋白和梭菌属的存在呈显著线性相关。胃肠道症状（如便秘和交替性腹泻）也与乳果糖通透性增加相关（多元分析）。目前的数据为恢复 ASD 患儿肠道内稳态的可能的特定治疗干预提供了合理的依据。
