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肠道-脑轴假说下的自闭症蠕虫治疗。

Helminth therapy for autism under gut-brain axis- hypothesis.

机构信息

Department of Pathology and Laboratory Medicine, UC Davis School of Medicine; Institute for Pediatric Regenerative Medicine and Shriners Hospitals for Children of Northern California, United States.

出版信息

Med Hypotheses. 2019 Apr;125:110-118. doi: 10.1016/j.mehy.2019.02.042. Epub 2019 Feb 19.

Abstract

Autism is a neurodevelopmental disease included within Autism Syndrome Disorder (ASD) spectrum. ASD has been linked to a series of genes that play a role in immune response function and patients with autism, commonly suffer from immune-related comorbidities. Despite the complex pathophysiology of autism, Gut-brain axis is gaining strength in the understanding of several neurological disorders. In addition, recent publications have shown the correlation between immune dysfunctions, gut microbiota and brain with the behavioral alterations and comorbid symptoms found in autism. Gut-brain axis acts as the "second brain", in a communication network established between neural, endocrine and the immunological systems. On the other hand, Hygiene Hypothesis suggests that the increase in the incidence of autoimmune diseases in the modern world can be attributed to the decrease of exposure to infectious agents, as parasitic nematodes. Helminths induce modulatory and protective effects against several inflammatory disorders, maintaining gastrointestinal homeostasis and modulating brain functions. Helminthic therapy has been previously performed in diseases such as ulcerative colitis, Crohn's disease, diabetes, multiple sclerosis, asthma, rheumatoid arthritis, and food allergies. Considering gut-brain axis, Hygiene Hypothesis, and the modulatory effects of helminths I hypothesized that a treatment with Trichuris suis soluble products represents a feasible holistic treatment for autism, and the key for the development of novel treatments. Preclinical studies are required to test this hypothesis.

摘要

自闭症是一种神经发育疾病,属于自闭症谱系障碍(ASD)。ASD 与一系列在免疫反应功能中起作用的基因有关,自闭症患者通常患有与免疫相关的合并症。尽管自闭症的病理生理学复杂,但肠道-大脑轴在理解几种神经紊乱方面的作用越来越重要。此外,最近的出版物表明,免疫功能紊乱、肠道微生物群和大脑与自闭症中发现的行为改变和合并症状之间存在相关性。肠道-大脑轴作为“第二大脑”,在神经、内分泌和免疫系统之间建立了一个通讯网络。另一方面,卫生假说表明,现代世界自身免疫性疾病发病率的增加可以归因于寄生虫线虫等传染性病原体暴露的减少。蠕虫诱导针对多种炎症性疾病的调节和保护作用,维持胃肠道内环境平衡并调节大脑功能。蠕虫疗法以前曾用于溃疡性结肠炎、克罗恩病、糖尿病、多发性硬化症、哮喘、类风湿性关节炎和食物过敏等疾病。考虑到肠道-大脑轴、卫生假说以及蠕虫的调节作用,我假设用猪鞭虫可溶性产物进行治疗代表了自闭症整体治疗的一种可行方法,也是开发新疗法的关键。需要进行临床前研究来验证这一假设。

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