Blom Johanna Maria Catharina, Ruggerini Ciro, Caroli Franco, Ferreri Carla, Masi Annalisa, Rivi Veronica, Sarti Pierfrancesco, Rebecchi Mauro, Arletti Chiara
Dept. of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Association for the Inclusion of People with Severe Disabilities, Modena, Italy.
Front Psychiatry. 2025 Aug 19;16:1608033. doi: 10.3389/fpsyt.2025.1608033. eCollection 2025.
Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition often accompanied by chronic inflammation and metabolic dysfunction, which are increasingly recognized as key contributors to symptom severity and behavioral challenges. Despite these insights, targeted nutritional interventions in adults with severe ASD remain understudied.
This pilot study investigated whether a precision, biomarker-guided dietary intervention could improve both behavioral symptoms and underlying biological dysregulations in adults with Level 3 ASD.
Seven adults with severe ASD residing at the ASP Charitas residential facility in Modena (Italy) participated in a 12-month dietary intervention aimed at reducing inflammation, optimizing fatty acid profiles, and supporting metabolic health. Behavioral assessments-including CARS-2-ST, DASH-II, ABC, and SSP-and biological markers such as IL-6, fecal calprotectin, vitamin D, HbA1c, and erythrocyte lipid profiles were collected at baseline, 6 months, and 12 months.
Baseline assessments confirmed severe ASD symptoms, psychiatric comorbidities, sensory processing abnormalities, systemic and intestinal inflammation, metabolic impairment, and a pro-inflammatory lipid profile. Following the intervention, significant reductions were observed in core autism symptoms (CARS-2-ST, ABC), alongside decreased frequency and severity of behavioral symptoms (DASH-II). Sensory processing (SSP) stabilized or modestly improved. Biochemical markers shifted toward normalization, including increased vitamin D, improved insulin sensitivity (HbA1c), and reduced inflammatory markers (IL-6, fecal calprotectin). Lipidomic profiling revealed elevated anti-inflammatory omega-3 fatty acids (DHA, EPA) and a decreased omega-6/omega-3 ratio. Correlational analyses linked these biological changes to behavioral improvements, suggesting a mechanistic connection.
This pilot study suggests that a targeted dietary intervention, based on biological markers reflective of neurobiological dysfunctions, may offer a promising complementary approach to managing ASD symptoms in adults. The findings indicate that dietary modifications can lead to improvements in both biological and behavioral markers, but further research is needed to refine personalized nutritional strategies for individuals with ASD.
自闭症谱系障碍（ASD）是一种复杂的神经发育疾病，常伴有慢性炎症和代谢功能障碍，这些因素日益被认为是导致症状严重程度和行为挑战的关键因素。尽管有这些认识，但针对重度ASD成人的靶向营养干预研究仍较少。
这项试点研究调查了一种精准的、基于生物标志物的饮食干预是否能改善3级ASD成人的行为症状和潜在的生物失调。
7名居住在意大利摩德纳慈善机构ASP住宅设施中的重度ASD成人参与了一项为期12个月的饮食干预，旨在减轻炎症、优化脂肪酸谱并支持代谢健康。在基线、6个月和12个月时收集行为评估（包括CARS-2-ST、DASH-II、ABC和SSP）以及生物标志物，如IL-6、粪便钙卫蛋白、维生素D、糖化血红蛋白（HbA1c）和红细胞脂质谱。
基线评估证实了严重的ASD症状、精神共病、感觉处理异常、全身和肠道炎症、代谢损害以及促炎脂质谱。干预后，核心自闭症症状（CARS-2-ST、ABC）显著减轻，行为症状（DASH-II）的频率和严重程度也有所降低。感觉处理（SSP）稳定或略有改善。生化标志物趋向正常化，包括维生素D增加、胰岛素敏感性改善（HbA1c）以及炎症标志物减少（IL-6、粪便钙卫蛋白）。脂质组学分析显示抗炎性ω-3脂肪酸（DHA、EPA）升高，ω-6/ω-3比值降低。相关性分析将这些生物学变化与行为改善联系起来，表明存在机制上的关联。
这项试点研究表明，基于反映神经生物学功能障碍的生物标志物的靶向饮食干预，可能为管理成人ASD症状提供一种有前景的补充方法。研究结果表明，饮食调整可导致生物学和行为标志物的改善，但需要进一步研究以完善针对ASD个体的个性化营养策略。
