Department of Molecular Pathobiology, College of Dentistry, New York University, New York, NY, USA.
Department of Cell Biology, NYU Grossman School of Medicine and Langone Medical Center, New York, NY, USA.
Nat Rev Gastroenterol Hepatol. 2024 Mar;21(3):142-163. doi: 10.1038/s41575-023-00857-1. Epub 2023 Dec 19.
Autism spectrum disorders (ASDs) are recognized as central neurodevelopmental disorders diagnosed by impairments in social interactions, communication and repetitive behaviours. The recognition of ASD as a central nervous system (CNS)-mediated neurobehavioural disorder has led most of the research in ASD to be focused on the CNS. However, gastrointestinal function is also likely to be affected owing to the neural mechanistic nature of ASD and the nervous system in the gastrointestinal tract (enteric nervous system). Thus, it is unsurprising that gastrointestinal disorders, particularly constipation, diarrhoea and abdominal pain, are highly comorbid in individuals with ASD. Gastrointestinal problems have also been repeatedly associated with increased severity of the core symptoms diagnostic of ASD and other centrally mediated comorbid conditions, including psychiatric issues, irritability, rigid-compulsive behaviours and aggression. Despite the high prevalence of gastrointestinal dysfunction in ASD and its associated behavioural comorbidities, the specific links between these two conditions have not been clearly delineated, and current data linking ASD to gastrointestinal dysfunction have not been extensively reviewed. This Review outlines the established and emerging clinical and preclinical evidence that emphasizes the gut as a novel mechanistic and potential therapeutic target for individuals with ASD.
自闭症谱系障碍(ASD)被认为是一种中枢神经发育障碍,其特征是社交互动、沟通和重复行为方面的障碍。将 ASD 识别为中枢神经系统(CNS)介导的神经行为障碍,使得大多数 ASD 研究都集中在 CNS 上。然而,由于 ASD 的神经机制性质和胃肠道中的神经系统(肠神经系统),胃肠道功能也可能受到影响。因此,自闭症患者高度合并胃肠道疾病,特别是便秘、腹泻和腹痛,这并不奇怪。胃肠道问题也与 ASD 的核心症状诊断的严重程度增加以及其他中枢介导的合并症(包括精神问题、易怒、刻板强迫行为和攻击行为)反复相关。尽管 ASD 中胃肠道功能障碍及其相关行为合并症的患病率很高,但这两种情况之间的具体联系尚未明确划定,目前将 ASD 与胃肠道功能障碍联系起来的数据也没有得到广泛审查。这篇综述概述了已确立和新兴的临床和临床前证据,强调了肠道作为 ASD 个体的一个新的机制和潜在治疗靶点。
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