Biodesign Swette Center for Environmental Biotechnology, Arizona State University, Tempe, AZ, 85287, USA.
Biodesign Center for Fundamental and Applied Microbiomics, Arizona State University, Tempe, AZ, 85287, USA.
Sci Rep. 2019 Apr 9;9(1):5821. doi: 10.1038/s41598-019-42183-0.
Many studies have reported abnormal gut microbiota in individuals with Autism Spectrum Disorders (ASD), suggesting a link between gut microbiome and autism-like behaviors. Modifying the gut microbiome is a potential route to improve gastrointestinal (GI) and behavioral symptoms in children with ASD, and fecal microbiota transplant could transform the dysbiotic gut microbiome toward a healthy one by delivering a large number of commensal microbes from a healthy donor. We previously performed an open-label trial of Microbiota Transfer Therapy (MTT) that combined antibiotics, a bowel cleanse, a stomach-acid suppressant, and fecal microbiota transplant, and observed significant improvements in GI symptoms, autism-related symptoms, and gut microbiota. Here, we report on a follow-up with the same 18 participants two years after treatment was completed. Notably, most improvements in GI symptoms were maintained, and autism-related symptoms improved even more after the end of treatment. Important changes in gut microbiota at the end of treatment remained at follow-up, including significant increases in bacterial diversity and relative abundances of Bifidobacteria and Prevotella. Our observations demonstrate the long-term safety and efficacy of MTT as a potential therapy to treat children with ASD who have GI problems, and warrant a double-blind, placebo-controlled trial in the future.
许多研究报告称自闭症谱系障碍（ASD）患者的肠道微生物群存在异常，这表明肠道微生物组与类似自闭症的行为之间存在关联。改变肠道微生物组是改善 ASD 儿童胃肠道（GI）和行为症状的潜在途径，粪便微生物群移植可以通过从健康供体中输送大量共生微生物来使失调的肠道微生物组向健康转变。我们之前进行了一项开放性的粪便微生物群移植治疗（MTT）试验，该试验联合使用了抗生素、肠道清洁、胃酸抑制剂和粪便微生物群移植，观察到 GI 症状、自闭症相关症状和肠道微生物组都有显著改善。在这里，我们报告了在治疗完成两年后对相同的 18 名参与者进行的随访。值得注意的是，大多数 GI 症状的改善得以维持，并且在治疗结束后自闭症相关症状甚至有了更大的改善。治疗结束时肠道微生物组的重要变化在随访中仍然存在，包括细菌多样性和双歧杆菌和普雷沃氏菌相对丰度的显著增加。我们的观察结果表明，MTT 作为一种治疗有 GI 问题的 ASD 儿童的潜在疗法具有长期的安全性和有效性，因此未来有必要进行双盲、安慰剂对照试验。
