Department of Genomics, Central University of Kerala, Kasaragod, Kerala, India.
Division of Biology, Kansas State University, Manhattan, KS, USA.
Adv Exp Med Biol. 2019;1118:253-269. doi: 10.1007/978-3-030-05542-4_13.
Autism spectrum disorder (ASD) is a severe neurodevelopmental or neuropsychiatric disorder with elusive etiology and obscure pathophysiology. Cognitive inabilities, impaired communication, repetitive behavior pattern, and restricted social interaction and communication lead to a debilitating situation in autism. The pattern of co-occurrence of medical comorbidities is most intriguing in autism, compared to any other neurodevelopmental disorders. They have an elevated comorbidity burden among which most frequently are seizures, psychiatric illness, and gastrointestinal disorders. The gut microbiota is believed to play a pivotal role in human health and disease through involvement in physiological homoeostasis, immunological development, glutathione metabolism, amino acid metabolism, etc., which in a reasonable way explain the role of gut-brain axis in autism. Branded as a neurodevelopmental disorder with psychiatric impairment and often misclassified as a mental disorder, many experts in the field think that a therapeutic solution to autism is unlikely to emerge. As the pathophysiology is still elusive, taking into account of the various symptoms that are concurrent in autism is important. Gastrointestinal problems that are seen associated with most of the autism cases suggest that it is not just a psychiatric disorder as many claim but have a physiological base, and alleviating the gastrointestinal problems could help alleviating the symptoms by bringing out the much needed overall improvement in the affected victims. A gut disorder akin to Crohn's disease is, sometimes, reported in autistic children, an extremely painful gastrointestinal disease which is named as autistic enterocolitis. This disturbed situation hypothesized to be initiated by dysbiosis or microbial imbalance could in turn perturb the coordination of microbiota-gut-brain axis which is important in human mental health as goes the popular dictum: "fix your gut, fix your brain."
自闭症谱系障碍（ASD）是一种严重的神经发育或神经精神疾病，其病因和病理生理学尚不清楚。认知能力障碍、沟通障碍、重复行为模式以及社交互动和沟通受限，导致自闭症患者身体虚弱。与其他神经发育障碍相比，自闭症患者的合并症模式最为有趣。他们的合并症负担较高，其中最常见的是癫痫、精神疾病和胃肠道疾病。肠道微生物群被认为通过参与生理动态平衡、免疫发育、谷胱甘肽代谢、氨基酸代谢等，在人类健康和疾病中发挥着关键作用，这合理地解释了肠道-大脑轴在自闭症中的作用。自闭症被认为是一种神经发育障碍，伴有精神损害，并且经常被错误地归类为精神障碍，该领域的许多专家认为，自闭症不太可能出现治疗方法。由于其病理生理学仍不清楚，考虑到自闭症中同时存在的各种症状非常重要。与大多数自闭症病例相关的胃肠道问题表明，它不仅仅是许多人声称的精神障碍，而是有生理基础，缓解胃肠道问题可以通过为受影响的患者带来急需的整体改善来帮助缓解症状。在自闭症儿童中，有时会报告类似于克罗恩病的肠道疾病，这是一种非常痛苦的胃肠道疾病，被称为自闭症性结肠炎。这种紊乱情况假设是由菌群失调或微生物失衡引起的，反过来又会扰乱对人类心理健康非常重要的微生物群-肠道-大脑轴的协调，正如流行的说法：“修复肠道，修复大脑。”
