Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Miller School of Medicine, University of Miami, Miami, FL, United States.
Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, FL, United States.
Neurosci Biobehav Rev. 2021 Sep;128:549-557. doi: 10.1016/j.neubiorev.2021.07.001. Epub 2021 Jul 13.
There is a potential association between gastrointestinal (GI) symptoms and the severity of autism spectrum disorder (ASD). Given this correlation, the possible impact of probiotics and prebiotics have been explored in research studies to modify the gut microbiome and ameliorate behavioral manifestations of ASD via modulating the gut-brain-microbiome axis. This systematic review focuses on the interplay between these factors in altering the behavioral manifestations of ASD. Probiotic supplementation tended to mitigate some of the behavioral manifestations of ASD, with less of a discernible trend on the microbiome level. Studies supplementing multiple probiotic species, such as microbiota transfer therapy, or including prebiotics performed better than single strain supplementation. Our analysis suggests that gut dysbiosis may increase intestinal permeability, leading to more severe GI symptoms and a systemic inflammatory response, which can alter permeability across the blood-brain barrier and synaptogenesis in the brain. Future studies are warranted to understand the precise contribution of altering gut microbiome on clinical manifestations of ASD that will open up avenues to develop preventive and treatment modalities.
胃肠道（GI）症状与自闭症谱系障碍（ASD）的严重程度之间存在潜在关联。鉴于这种相关性，研究探索了益生菌和益生元的可能影响，以通过调节肠道-大脑-微生物组轴来改变肠道微生物组并改善 ASD 的行为表现。本系统综述重点关注这些因素在改变 ASD 行为表现方面的相互作用。益生菌补充剂倾向于减轻 ASD 的一些行为表现，但在微生物组水平上没有明显的趋势。补充多种益生菌物种的研究，例如微生物群转移治疗，或包括益生元的研究，比单一菌株补充效果更好。我们的分析表明，肠道菌群失调可能会增加肠道通透性，导致更严重的胃肠道症状和全身炎症反应，从而改变大脑中血脑屏障和突触发生的通透性。需要进一步的研究来了解改变肠道微生物组对 ASD 临床表现的确切贡献，这将为开发预防和治疗方法开辟途径。
