Campion Daniela, Ponzo Paola, Alessandria Carlo, Saracco Giorgio M, Balzola Federico
Division of Gastroenterology, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy.
Division of Gastroenterology, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy -
Minerva Gastroenterol Dietol. 2018 Dec;64(4):333-350. doi: 10.23736/S1121-421X.18.02493-5. Epub 2018 Mar 30.
Autism spectrum disorder (ASD) defines a set of neurodevelopmental disorders characterized by persistent deficits in social communication and interaction, along with repetitive patterns of behavior. Symptoms generally appear in the early developmental period and cause significant impairment in individual and social functioning. In recent years the increased prevalence of ASD, along with the evidence of a significant link between autism and gastrointestinal (GI) disturbances, raised a special interest in exploring the reciprocal influences between gut and brain. Investigators highlighted the existence of a so-called "gut-brain axis," empowering the hypothesis that GI abnormalities could trigger neuropsychiatric symptoms in ASD. Intestinal microbiota is thought to play a pivotal role in gut and systemic homeostasis, in central nervous system development, as well as in behavioral modulation and recurrent microbial imbalances have been shown in gut microbiota of autistic people. In this review we analyze current knowledge about intestinal microbiota and the relevance and role of dysbiosis in ASD. The most accredited theories about gut-brain interaction will be reviewed, along with current scientific evidence supporting the relationship between microbial imbalances and impairment of neurodevelopment. Finally, we will focus on the results of different therapeutic approaches in this context: administration of pre- and probiotics, antibiotics, fecal microbiota transplantation and special diets and dietary supplements.
自闭症谱系障碍(ASD)是一组神经发育障碍,其特征是社交沟通和互动持续存在缺陷,以及行为模式重复。症状通常在发育早期出现,并对个体和社会功能造成严重损害。近年来,ASD患病率上升,以及自闭症与胃肠道(GI)紊乱之间存在显著联系的证据,引发了人们对探索肠道与大脑之间相互影响的特别兴趣。研究人员强调了所谓“肠-脑轴”的存在,支持了GI异常可能引发ASD神经精神症状的假说。肠道微生物群被认为在肠道和全身稳态、中枢神经系统发育以及行为调节中起关键作用,并且自闭症患者的肠道微生物群中已显示出反复出现的微生物失衡。在这篇综述中,我们分析了关于肠道微生物群的现有知识以及菌群失调在ASD中的相关性和作用。我们将回顾关于肠-脑相互作用的最认可的理论,以及支持微生物失衡与神经发育受损之间关系的当前科学证据。最后,我们将关注在这种情况下不同治疗方法的结果:益生元和益生菌的施用、抗生素、粪便微生物群移植以及特殊饮食和膳食补充剂。