自闭症谱系障碍与胃肠道健康:筛查环境因素对胃肠道问题的影响。

Autism Spectrum and gastrointestinal health: Screening on the influence of environmental factors on gastrointestinal problems.

作者信息

Brito Anita, Tocantins Fernando Ribeiro, Brentani Helena, Fujita André, Taddei Carla Romano, Beltrão-Braga Patricia Cristina Baleeiro

机构信息

Department of Microbiology, Institute of Biomedical Sciences (ICB-USP), University of São Paulo, São Paulo, SP, Brazil.

Institut Pasteur de São Paulo, São Paulo, SP, Brazil.

出版信息

Autism Res. 2024 Dec;17(12):2535-2546. doi: 10.1002/aur.3263. Epub 2024 Nov 17.

Abstract

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that combines genetic and environmental factors. The human microbiota is colonized by permanent or transitory microorganisms, depending on the host and the external factors controlling their permanence. The composition of the gut microbiota (GM) in ASD individuals is notably different from that in controls, which may contribute to the clinical conditions observed in these individuals. This study aimed to indirectly investigate the influence of GM on the gut-brain axis in individuals with ASD and controls by analyzing environmental factors that contribute to the microbiota composition. Two questionnaires were designed to collect data, one for the ASD Group (ASDG) and the other one for the Control Group (CG). The raw data from both questionnaires were collected from 2772 respondents. After triage, answers from 1687 ASD individuals, along with 466 respondents from the CG, were analyzed, resulting in a total of 2237 respondents. Our results showed that gastrointestinal problems (GP) escalate as individuals age and become more prominent in ASD individuals. In contrast, feeding problems (FP) did not appear to escalate in either group as individuals aged, even though the FP decreased in the CG. ANOVA revealed significant differences in breastfeeding status compared to GPs among preterm control individuals born via cesarean section (p-value = 0.027). The mean values of GP for breastfed and nonbreastfed individuals, for ASDG (0.257; 0.268) and CG (0.105; 0.248), highlighted the differences in breastfeeding effects on GP for the study groups. The use of antibiotics during pregnancy seemed to be significant for GPs in the ASDG only for breastfed individuals (p-value <0.001), but not in the CG group. In conclusion, variables such as mode of delivery, FPs, type of birth, and length of breastfeeding do not seem to be determining factors for GP in the ASDG but are relevant for the CG. However, for ASDG individuals whose mothers took antibiotics during pregnancy, breastfeeding may act as a protective factor, as maternal antibiotic administration during pregnancy seems to aggravate GP-values across the ages of the participants. Considering GP as a proxy for GM and recognizing the importance of GM composition for central nervous system (CNS) function, it appears that in individuals with ASD, GM seems to be more dependent on other factors, which might be linked to the genetic background of each one. These findings suggest that future studies of the gut-brain axis in individuals with ASD might consider the individual's genetic background, environmental factors, and GM.

摘要

自闭症谱系障碍(ASD)是一种由遗传和环境因素共同作用导致的复杂神经发育疾病。人类微生物群由永久或暂时的微生物群落定殖,这取决于宿主以及控制它们持久性的外部因素。ASD个体的肠道微生物群(GM)组成与对照组显著不同,这可能导致了这些个体所观察到的临床症状。本研究旨在通过分析影响微生物群组成的环境因素,间接探究GM对ASD个体和对照组中肠-脑轴的影响。设计了两份问卷来收集数据,一份针对ASD组(ASDG),另一份针对对照组(CG)。两份问卷的原始数据来自2772名受访者。经过筛选后,分析了1687名ASD个体以及CG组中466名受访者的回答,最终共有2237名受访者。我们的结果表明,胃肠道问题(GP)会随着个体年龄增长而加剧,并且在ASD个体中更为突出。相比之下,喂养问题(FP)在两组中均未随着个体年龄增长而加剧,尽管在CG组中FP有所下降。方差分析显示,剖宫产出生的早产对照个体中,与GP相比,母乳喂养状况存在显著差异(p值 = 0.027)。母乳喂养和非母乳喂养个体的GP平均值,ASDG组为(0.257;0.268),CG组为(0.105;0.248),突出了母乳喂养对研究组中GP影响的差异。孕期使用抗生素似乎仅对ASDG组中母乳喂养个体的GP有显著影响(p值 < 0.001),而对CG组无影响。总之,分娩方式、FP、出生类型和母乳喂养时长等变量似乎不是ASDG组中GP的决定性因素,但对CG组相关。然而,对于母亲在孕期使用抗生素的ASDG个体,母乳喂养可能起到保护作用,因为孕期母亲使用抗生素似乎会加重各年龄段参与者的GP值。将GP视为GM的替代指标,并认识到GM组成对中枢神经系统(CNS)功能的重要性,似乎在ASD个体中,GM似乎更依赖于其他因素,这可能与每个个体的遗传背景有关。这些发现表明,未来对ASD个体肠-脑轴的研究可能需要考虑个体的遗传背景、环境因素和GM。

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