Wang Lihong, Yu Lianhu, Liu Zhiyue, Che Chao, Wang Yu, Zhao Yongheng, Zhu Mengna, Yang Guang, Cao Aihua
Department of Pediatrics, Shandong University Qilu Hospital, Shandong, Jinan, China.
Department of Pediatrics, Chinese PLA General Hospital, Beijing, China.
Front Med (Lausanne). 2024 Oct 18;11:1411089. doi: 10.3389/fmed.2024.1411089. eCollection 2024.
Autism spectrum disorder (ASD) is often linked to gastrointestinal issues and altered serotonin metabolism. Emerging evidence suggests gut microbiota influence both, with fecal microbiota transplantation (FMT) offering a potential therapeutic approach. However, its impact on serotonin metabolism and ASD symptoms is not well understood. In this study, we aimed to evaluate the clinical effects of FMT and examine changes in specific urinary metabolites in children with ASD.
A randomized double-blind controlled trial was performed to evaluate the clinical effects of FMT on GI and ASD-related symptoms. Gastrointestinal symptoms were assessed using the Gastrointestinal Symptom Rating Scale (GSRS), and the ASD-related symptoms were assessed using the Childhood Autism Rating Scale (CARS), Aberrant Behavior Checklist (ABC), and Social Responsiveness Scale (SRS) scores. Urinary metabolites were analyzed by homogeneous enzyme immunoassay using commercially available kits.
Significant improvements in GI and core ASD symptoms were observed following FMT intervention. The average GSRS scores decreased from 30.17 (before) to 19 (after; < 0.0001), CARS scores decreased from 36.22 to 33.33 ( < 0.0001), SRS scores decreased from 151.17 to 137.5 ( = 0.0002), and the ABC scores decreased 76.39 to 53.17 ( < 0.0001) in the FMT group. However, in the placebo group, GSRS, CARS, and SRS scores showed no significant changes, while ABC scores decreased from 72 to 58.75 ( = 0.034). The FMT group also showed a significant reduction in urinary 5-hydroxyindoleacetic acid (5-HIAA) levels from 8.6 to 7.32 mg/L ( = 0.022), while other metabolites showed no significant changes.
FMT is a safe and effective treatment for improving GI and core symptoms in children with ASD, with 5-HIAA showing potential as a urinary biomarker for treatment response.
自闭症谱系障碍（ASD）常与胃肠道问题及血清素代谢改变有关。新出现的证据表明肠道微生物群对二者均有影响，粪便微生物群移植（FMT）提供了一种潜在的治疗方法。然而，其对血清素代谢和ASD症状的影响尚不清楚。在本研究中，我们旨在评估FMT对ASD患儿的临床效果，并检测特定尿液代谢物的变化。
进行一项随机双盲对照试验，以评估FMT对胃肠道及ASD相关症状的临床效果。使用胃肠道症状评定量表（GSRS）评估胃肠道症状，使用儿童自闭症评定量表（CARS）、异常行为检查表（ABC）和社会反应量表（SRS）评分评估ASD相关症状。使用市售试剂盒通过均相酶免疫测定法分析尿液代谢物。
FMT干预后，胃肠道及ASD核心症状有显著改善。FMT组中，GSRS平均评分从30.17（干预前）降至19（干预后；<0.0001），CARS评分从36.22降至33.33（<0.0001），SRS评分从151.17降至137.5（=0.0002），ABC评分从76.39降至53.17（<0.0001）。然而，在安慰剂组中，GSRS、CARS和SRS评分无显著变化，而ABC评分从72降至58.75（=0.034）。FMT组尿液中5-羟吲哚乙酸（5-HIAA）水平也显著降低，从8.6降至7.32mg/L（=0.022），而其他代谢物无显著变化。
FMT是改善ASD患儿胃肠道及核心症状的一种安全有效的治疗方法，5-HIAA显示出作为治疗反应尿液生物标志物的潜力。
