Neuropediatric Service, Hospital Miguel Pérez-Carreño, Caracas, Venezuela.
Pediatric Service, Hospital Felipe Guevara Rojas, El Tigre, Anzoátegui, Venezuela.
Curr Rev Clin Exp Pharmacol. 2022;17(3):166-173. doi: 10.2174/2772432816666210805141257.
Autism Spectrum Disorders (ASDs) are a group of prevalent neuropsychiatric disorders. They present a complex and unknown etiology, which in most cases includes significant peripheral alterations outside the brain such as in the composition of gut microbiota. Because the gut microbiota is involved in modulating the gut-brain axis, several studies have suggested that the microbiome in the gut can modify metabolites which are able to cross the blood-brain barrier and modulate brain function.
We reviewed the current evidence regarding microbiota alterations in patients with ASD and the effects of the administration of probiotics and prebiotics in these patients, both in terms of gastrointestinal and behavioural symptoms.
Administration of a probiotic formulation containing different strains of Lactobacillus (L. acidophilus, L. rhamnosus, and others) and Bifidobacteria had beneficial effects upon these aforementioned symptoms and their use is recommended in a subgroup of ASD patients that present gastrointestinal disturbances. Nonetheless, the types of gastrointestinal disturbances that most benefit from such interventions remain to be elucidated in order to personalize the medical approaches.
Recent clinical studies have shown that probiotic treatments can regulate the gut microbiota and may result in improvements in some behavioral abnormalities associated with ASD. Trials using prebiotic fibers or synbiotics preparations are still lacking and necessary in order to deep in such therapeutic strategies in ASD with comorbid gastrointestinal disrturbances.
自闭症谱系障碍(ASD)是一组常见的神经精神疾病。它们具有复杂且未知的病因,在大多数情况下,包括大脑以外的显著外周改变,如肠道微生物群的组成。由于肠道微生物群参与调节肠道-大脑轴,因此一些研究表明,肠道中的微生物组可以改变能够穿过血脑屏障并调节大脑功能的代谢物。
我们回顾了目前关于 ASD 患者肠道微生物群改变的证据,以及在这些患者中使用益生菌和益生元的效果,包括胃肠道和行为症状。
含有不同菌株的益生菌制剂(嗜酸乳杆菌、鼠李糖乳杆菌等)和双歧杆菌的给药对上述胃肠道和行为症状有有益的影响,并且建议在存在胃肠道紊乱的 ASD 患者亚组中使用。然而,最能从这些干预中受益的胃肠道紊乱类型仍有待阐明,以便对医疗方法进行个体化。
最近的临床研究表明,益生菌治疗可以调节肠道微生物群,并可能导致与 ASD 相关的一些行为异常的改善。使用益生元纤维或合生制剂的试验仍然缺乏,对于在伴有胃肠道紊乱的 ASD 中深入研究这种治疗策略是必要的。