Department of Pediatrics, Columbia University Medical Center, 620 West 168th Street, New York, NY, 10032, USA.
Department of Pathology and Immunology, Texas Children's Microbiome Center, Baylor College of Medicine, Texas Children's Hospital, Feigin Tower, 1102 Bates Avenue, Suite 955, Houston, TX, 77030, USA.
Dig Dis Sci. 2020 Mar;65(3):818-828. doi: 10.1007/s10620-020-06133-5.
While there are numerous medical comorbidities associated with ASD, gastrointestinal (GI) issues have a significant impact on quality of life for these individuals. Recent findings continue to support the relationship between the gut microbiome and both GI symptoms and behavior, but the heterogeneity within the autism spectrum requires in-depth clinical characterization of these clinical cohorts. Large, diverse, well-controlled studies in this area of research are still needed. Although there is still much to discover about the brain-gut-microbiome axis in ASD, microbially mediated therapies, specifically probiotics and fecal microbiota transplantation have shown promise in the treatment of GI symptoms in ASD, with potential benefit to the core behavioral symptoms of ASD as well. Future research and clinical trials must increasingly consider complex phenotypes in ASD in stratification of large datasets as well as in design of inclusion criteria for individual therapeutic interventions.
虽然 ASD 与许多医学合并症相关,但胃肠道 (GI) 问题对这些人的生活质量有重大影响。最近的研究结果持续支持肠道微生物组与 GI 症状和行为之间的关系,但自闭症谱系内的异质性需要对这些临床队列进行深入的临床特征描述。在这一研究领域中,仍需要进行大型、多样、精心控制的研究。尽管在 ASD 的脑-肠-微生物组轴方面仍有许多有待发现,但微生物介导的治疗方法,特别是益生菌和粪便微生物移植,已显示出在治疗 ASD 的 GI 症状方面有希望,并且对 ASD 的核心行为症状也可能有好处。未来的研究和临床试验必须越来越多地考虑 ASD 中的复杂表型,在对大型数据集进行分层以及为个体治疗干预确定纳入标准时都要考虑这些表型。