Pan Zihao, Gao Zheng, Chen Junyi, Quan Yongxi, Xu Jiating, Liang Xiaofeng, Xie Wenrui, He Xingxiang, Wu Lihao
Department of Gastroenterology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China.
Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, Guangzhou, China.
Front Neurosci. 2025 Jul 23;19:1602681. doi: 10.3389/fnins.2025.1602681. eCollection 2025.
PURPOSE: Washed microbiota transplantation (WMT) has been shown to improve the symptoms of Autism Spectrum Disorder (ASD). It's currently unclear whether the presence of constipation affects the efficacy of WMT in children with ASD. This study aims to investigate whether constipation affects the efficacy of WMT in children with ASD. PATIENTS AND METHODS: To investigate the efficacy of WMT for ASD, we conducted a retrospective analysis of changes in ASD-related symptoms, sleep disturbances, gastrointestinal manifestations, intestinal barrier integrity, and gut microbiota composition in 103 ASD patients undergoing WMT. They were divided into two groups according to whether constipation was present or not before treatment. RESULTS: 1. Aberrant Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Sleep Disturbance Scale for Children (SDSC) scores in the non-constipation and constipation groups decreased with an increase in the number of WMT treatments. 2. Comparison of two groups: ABC scores in the non-constipation group decreased more after the first WMT course, whereas ABC scores in the constipation group decreased more after two WMT courses. 3. Intestinal Barrier Function: D-lactate levels decreased more in the constipation group after the first two courses. In general, WMT treatment had no significant effect on intestinal barrier function in patients with ASD. 4. Effect of WMT on constipation: As the number of WMT courses increased, Bristol Stool Form Scale (BSFS) scores in constipation group gradually approached 4. 5. Constipation group had lower microbial diversity than non-constipation group at baseline. After one course of WMT, constipation group showed an obvious increase in microbial diversity and a significant increase in the relative abundance of Bifidobacteria compared to non-constipation group. CONCLUSION: Post WMT, core symptoms and sleep disorders were significantly improved in both groups. Feces returned to normal shape in the constipation group. A difference in efficacy between the two groups was observed in early stages, but after multiple courses of WMT no difference in efficacy was noted. Although in the short-term, children with ASD and comorbid constipation showed a significant increase in microbial diversity after receiving WMT, mid-term outcomes indicate that constipation does not affect the efficacy of WMT in treating ASD.
目的：已证明洗肠菌群移植（WMT）可改善自闭症谱系障碍（ASD）的症状。目前尚不清楚便秘的存在是否会影响WMT对ASD儿童的疗效。本研究旨在调查便秘是否会影响WMT对ASD儿童的疗效。 患者与方法：为研究WMT对ASD的疗效，我们对103例接受WMT的ASD患者的ASD相关症状、睡眠障碍、胃肠道表现、肠道屏障完整性和肠道菌群组成的变化进行了回顾性分析。根据治疗前是否存在便秘将他们分为两组。 结果：1. 非便秘组和便秘组的异常行为检查表（ABC）、儿童自闭症评定量表（CARS）和儿童睡眠障碍量表（SDSC）评分随WMT治疗次数的增加而降低。2. 两组比较：非便秘组在第一个WMT疗程后ABC评分下降更多，而便秘组在两个WMT疗程后ABC评分下降更多。3. 肠道屏障功能：在前两个疗程后，便秘组的D-乳酸水平下降更多。总体而言，WMT治疗对ASD患者的肠道屏障功能无显著影响。4. WMT对便秘的影响：随着WMT疗程数的增加，便秘组的布里斯托大便形态量表（BSFS）评分逐渐接近4。5. 便秘组在基线时的微生物多样性低于非便秘组。经过一个疗程的WMT后，与非便秘组相比，便秘组的微生物多样性明显增加，双歧杆菌的相对丰度显著增加。 结论：WMT后，两组的核心症状和睡眠障碍均有显著改善。便秘组的粪便恢复正常形状。两组在早期观察到疗效差异，但在多个疗程的WMT后未发现疗效差异。虽然短期内，患有ASD并伴有便秘的儿童在接受WMT后微生物多样性显著增加，但中期结果表明便秘不影响WMT治疗ASD的疗效。
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