Koc University, Istanbul, Turkey.
Neuroscience. 2018 Mar 15;374:271-286. doi: 10.1016/j.neuroscience.2018.01.060. Epub 2018 Feb 8.
Recent evidence implicates immune alterations and gut microbiota dysbiosis in at least some subpopulations of individuals with autism spectrum disorder (ASD). Immune and gut alterations in ASD have mostly been studied separately, and the reviews and theoretical models up to now have mainly considered the immune system as one of the routes for gut-brain communication. We take a different perspective and consider possible common mechanisms of action for the gut microbiota and inflammation on the neural basis of ASD. We propose these to be their effects on ASD-susceptibility genes, neurodevelopment, and intestinal and blood-brain barrier integrity. We then use these common mechanisms to offer pathways for potentially beneficial effects of early-life probiotics on the neural development in ASD. This new perspective yields a conceptual framework for creating effective preventions for mothers at risk of giving birth to children with ASD. Such a framework may also inform effective interventions targeting these common mechanisms of action, which may be shared in many ASD cases regardless of their different etiological profiles. Probiotics may be one example of such preventions and interventions. Finally, the common mechanisms offered by this perspective can be useful in the search of comprehensive theories that can account for the complete neurobiological and behavioral symptoms of ASD.
最近的证据表明，免疫改变和肠道微生物失调至少存在于自闭症谱系障碍（ASD）的某些亚群中。ASD 中的免疫和肠道改变大多是分开研究的，迄今为止的综述和理论模型主要将免疫系统视为肠道-大脑通讯的途径之一。我们采取不同的视角，考虑肠道微生物和炎症对 ASD 神经基础可能具有共同的作用机制。我们提出这些机制是它们对 ASD 易感基因、神经发育以及肠道和血脑屏障完整性的影响。然后，我们利用这些共同的作用机制为生命早期益生菌对 ASD 神经发育的潜在有益影响提供途径。这种新的视角为处于生育 ASD 儿童风险中的母亲提供了有效的预防措施，创造了一个概念框架。这种框架也可以为针对这些共同作用机制的有效干预措施提供信息，这些机制可能在许多 ASD 病例中共享，而不论其不同的病因谱如何。益生菌可能是这种预防和干预措施的一个例子。最后，这种观点提供的共同作用机制可用于寻找能够解释 ASD 完整神经生物学和行为症状的综合理论。
