Abstract
In recent years, there has been an emerging interest in the possible role of the gut microbiota as a co-factor in the development of autism spectrum disorders (ASDs), as many studies have highlighted the bidirectional communication between the gut and brain (the so-called “gut-brain axis”). Accumulating evidence has shown a link between alterations in the composition of the gut microbiota and both gastrointestinal and neurobehavioural symptoms in children with ASD. The aim of this narrative review was to analyse the current knowledge about dysbiosis and gastrointestinal (GI) disorders in ASD and assess the current evidence for the role of probiotics and other non-pharmacological approaches in the treatment of children with ASD. Analysis of the literature showed that gut dysbiosis in ASD has been widely demonstrated; however, there is no single distinctive profile of the composition of the microbiota in people with ASD. Gut dysbiosis could contribute to the low-grade systemic inflammatory state reported in patients with GI comorbidities. The administration of probiotics (mostly a mixture of Bifidobacteria, Streptococci and Lactobacilli) is the most promising treatment for neurobehavioural symptoms and bowel dysfunction, but clinical trials are still limited and heterogeneous. Well-designed, randomized, placebo-controlled clinical trials are required to validate the effectiveness of probiotics in the treatment of ASD and to identify the appropriate strains, dose, and timing of treatment.
Highlights
Autism spectrum disorder (ASD) is a complex group of developmental disorders characterized by impaired social interactions and communication together with repetitive and restrictive behaviours.Among autism spectrum disorders (ASDs), autism represents the primary type
We review evidence of dysbiosis in ASD, focusing on the possible link between gastrointestinal disorders, inflammation and neurobehavioural symptoms in autistic children
They developed a lymphoblastoid cell line (LCL) model of ASD with a subset of LCLs presenting mitochondrial dysfunction and demonstrated that butyric acid (BA) has a positive effect on cells from both healthy and ASD children that are under physiological stress
Summary
Autism spectrum disorder (ASD) is a complex group of developmental disorders characterized by impaired social interactions and communication together with repetitive and restrictive behaviours. Recent studies have suggested that alterations in the gut microbiota composition (i.e., dysbiosis) in children with ASD may contribute to both gastrointestinal and CNS symptoms [19,20]. The gut microbiota and the related metabolites play a crucial role in the so-called “gut-brain axis” [26,27,28,29], a physiological bidirectional complex network of communication between the brain and the gut [27,30,31]: The disruption of neural, endocrine and metabolic mechanisms that are involved in gut-CNS signalling seems to be involved in neuropsychiatric disorders, including autism and ASDs [22]. Those published in English and that investigated overall neurological disorders, autism spectrum disorders, were included in the evaluation
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