Click below for access to the paper.
References will be provided in a later Substack.
A groundbreaking study led by researchers from the Chinese University of Hong Kong has firmly established a link between autism spectrum disorder (ASD) and the composition of the gut microbiome in children. This comprehensive analysis went beyond just examining gut bacteria, also investigating fungi, archaea, and viruses residing in the digestive tract.
The researchers developed a robust assay that revealed a correlation between changes in the entire gut microbiome composition and ASD diagnosis. They identified 14 archaea, 51 bacteria, 7 fungi, 18 viruses, 27 microbial genes, and 12 metabolic pathways that differed between neurotypical children and those with ASD.
Using machine learning, they found that combining data from multiple microbial kingdoms, including 31 markers, yielded a diagnostic accuracy rate of 79.5 to 88.6 percent, depending on the age group. This multi-kingdom approach significantly outperformed using any single microbial kingdom alone.
The study, one of the broadest and most comprehensive of its kind, not only affirms the gut-autism association but also paves the way for further research into the mechanisms behind ASD and the development of relatively straightforward, non-invasive diagnostic tests for children. As neuroscientist Bhismadev Chakrabarti noted, this research opens up possibilities for investigating specific biochemical pathways and their impact on different autistic features.
While the exact reason for the gut-autism link remains unclear, this study significantly broadens our understanding of the role of the gut microbiome in ASD[1]. It suggests that multi-kingdom microbial markers could potentially aid in autism diagnosis in the future.
Several potential therapeutic interventions for autism spectrum disorder (ASD) based on gut microbiome research have been identified.
Studies have shown that probiotic interventions using specific strains like Lactobacillus plantarum, Lactobacillus reuteri, and Bacteroides fragilis can help alleviate gastrointestinal symptoms and improve behavioural characteristics in children with ASD. Prebiotics, which are non-digestible food ingredients that promote the growth of beneficial gut bacteria, and plant-based diets are often recommended for individuals with ASD to support a healthy gut microbiome.
Faecal microbiota transplantation (FMT) or microbiota transfer therapy (MTT) is another effective intervention. FMT involves transferring gut microbes from healthy individuals to those with ASD. Studies have shown that MTT can lead to long-term improvements in gut health and reductions in both gastrointestinal and ASD symptoms.
Treatment with specific antibiotics like anti-Clostridium antibiotics has been shown to significantly reduce abnormal behaviour in some children with ASD, suggesting that targeting certain bacterial populations in the gut may be beneficial.
While these interventions show promise, it is important to note that the gut-brain axis and the role of the microbiome in ASD are complex and not yet fully understood. More research is needed to elucidate the specific mechanisms involved and to develop targeted, effective therapies. However, the growing body of evidence linking the gut microbiome to ASD provides a promising avenue for future therapeutic interventions.
Based on the latest research, prebiotics and probiotics show promise as complementary treatments for autism spectrum disorder (ASD) by targeting the gut-brain axis:
1. Improving gastrointestinal symptoms: Many individuals with ASD suffer from GI issues like constipation, diarrhea, and abdominal pain. Probiotics, especially strains like Lactobacillus reuteri and Bifidobacterium, can help alleviate these symptoms by restoring balance to the gut microbiome. Prebiotics support the growth of beneficial gut bacteria.
2. Reducing autism-related behaviours: Studies in both animal models and humans suggest that probiotic and prebiotic supplementation may improve core ASD symptoms like social deficits, repetitive behaviours, and communication difficulties. This is likely due to the influence of the gut microbiome on neurotransmitter production and brain function via the gut-brain axis.
3. Restoring gut microbiome composition: Children with ASD often have altered gut microbiota, with higher levels of potentially harmful bacteria like Clostridia and lower levels of beneficial strains like Faecalibacterium prausnitzii. Probiotics can help restore a healthier balance of gut bacteria, while prebiotics provide food for the growth of good bacteria.
4. Reducing inflammation: Dysbiosis in the gut can lead to increased intestinal permeability and systemic inflammation, which may exacerbate ASD symptoms. Probiotics and prebiotics can help strengthen the gut barrier and modulate the immune response to reduce inflammation.
5. Influencing metabolic and neuronal signaling pathways: Beneficial bacteria produce short-chain fatty acids and other metabolites that can influence brain function via the vagus nerve and other pathways. Probiotics may help regulate the production of neurotransmitters like serotonin and GABA, which are often imbalanced in ASD.
Prebiotics and probiotics are definitely worth considering as an adjunct to standard behavioural and educational therapies for ASD, especially in children with significant gastrointestinal symptoms. Consulting with a healthcare provider experienced in integrative approaches to ASD is advisable when incorporating these treatments.
Based on the information provided in the search results, probiotics appear to regulate the gut-brain axis in autism through several key mechanisms:
1. Modulating the immune system and reducing inflammation:
- Probiotics can help restore balance to the gut microbiome, reducing levels of potentially harmful bacteria like Clostridia that are elevated in ASD. This helps decrease gut inflammation.
- Probiotic strains like Lactobacillus and Bifidobacterium support the growth of beneficial bacteria, strengthening the gut barrier and reducing systemic inflammation that can impact brain function.
2. Influencing neurotransmitter production:
- Beneficial gut bacteria produce neurotransmitters like GABA, serotonin, and acetylcholine that directly impact brain function and behavior.
- Studies show probiotics can increase levels of serotonin and decrease hyperactivity of the serotonin system seen in ASD. They also improve dopamine metabolism.
3. Producing beneficial metabolites:
- Probiotics increase production of short-chain fatty acids (SCFAs) like butyrate and acetate in the gut. SCFAs have a protective effect on the brain.
- In children with ASD, probiotics elevated levels of SCFAs that were abnormally low before treatment. This correlated with improved symptoms.
4. Strengthening the intestinal barrier:
- Probiotics help maintain a healthy gut lining, preventing "leaky gut" and the transfer of inflammatory compounds into the bloodstream that can negatively impact the brain.
- Reducing gut permeability decreases neuroinflammation, oxidative stress, and neuronal degeneration that may exacerbate ASD symptoms.
5. Promoting the growth of beneficial bacteria:
- Probiotics shift the gut microbiome composition, increasing bacteria like Bifidobacteriales that are reduced in ASD while suppressing potentially pathogenic Clostridium strains.
- This microbial rebalancing is associated with improvement in both gastrointestinal and behavioral symptoms of ASD.
In summary, probiotics appear to regulate the gut-brain axis in ASD by modulating the immune system, neurotransmitter production, SCFA levels, and gut barrier integrity to reduce inflammation and promote a microbial balance more conducive to healthy brain function. However, while promising, more clinical trials are needed to fully elucidate the mechanisms and establish the efficacy of probiotic interventions for ASD.
In addition to the microbiome, the following pathways have been identified as potential contributors to ASD features. Further research is needed to elucidate the specific roles of these pathways and to develop targeted interventions. However, these findings provide promising avenues for future research and potential therapeutic targets.
Clinically, attention to the manipulation of the following pathways is important and can be performed by doctors specialising in Nutritional Medicine.
1. Purine metabolic network: A study has found that the purine metabolic network was the most altered out of 50 biochemical pathways analysed in newborns who later developed ASD and 5-year-old children with ASD. In typically developing children, the purine network undergoes a 17-fold reversal between birth and age 5, which does not occur in ASD. This failed reversal may underlie excitatory-inhibitory imbalance in ASD.
2. Mitochondrial dysfunction and oxidative stress pathways: Mitochondrial dysfunction and oxidative stress have been proposed as key biochemical mechanisms in ASD. Abnormalities in these pathways can lead to impaired methylation capacity and other metabolic issues.
3. Glutamatergic and GABAergic neurotransmitter system imbalances. Imbalances between the excitatory neurotransmitter glutamate and the inhibitory neurotransmitter GABA have been implicated in ASD. Dysfunction in these systems affects neuronal migration, differentiation, synaptogenesis and brain development.
4. Serotonergic system is a neurotransmitter system involved in mood, social behavior, sleep, and anxiety. Genetic studies have linked polymorphisms in serotonin-related genes to ASD.
5. Dopaminergic pathways regulate dopamine which is involved in reward-motivated behaviour and motor control. Genetic variations in dopamine-related genes have been associated with ASD.
6. Cell danger response pathways regulated by ATP signalling. Pathways linked to the cell danger response, which is regulated by ATP signalling, account for 80% of the metabolic impact in ASD. Failure of safeguards to deactivate this response may lead to heightened sensitivity to stimuli in ASD.
Vitamin D-related pathways are also involved. Vitamin D is associated with ASD at several levels, as it is related to ASD genes and the oxidative stress environment. Vitamin D is involved in bone development and calcium-dependent signalling, as well as immune function and hypersensitivity.
Abnormalities in folate, methylation, and one-carbon metabolism pathways, these interconnected pathways, have been associated with ASD. Folate (vitamin B9) is involved in methyl donor generation and one-carbon metabolism. Deficiencies in folate and vitamin B12, which is related to folate regeneration, can negatively impact cognitive function and brain development.
Continued research into these pathways may enable development of biomarkers and more novel targeted therapies for patients with ASD.
However, enough is known to enable much better management of ASD sufferers. Treating children with autism spectrum disorder (ASD) is complex and challenging due to the heterogeneous nature of the condition. A wide range of therapies and interventions are used, with varying levels of effectiveness. The main categories of treatments include:
Behavioral therapies: These are considered first-line treatments and have the most evidence supporting their efficacy. Examples include Applied Behavior Analysis (ABA), Early Intensive Behavioral Intervention (EIBI), and Pivotal Response Treatment (PRT). These therapies aim to teach new skills and behaviours using specialised, structured techniques. More effective if the biological therapies are applied early.
Developmental therapies: These focus on building social communication skills and relationships. While research suggests they are helpful, the evidence base is not as strong as for behavioural therapies. Examples include Floortime and Relationship Development Intervention.
Educational therapies: Children receive these at school to support academic and social development. They are tailored to the child's individual needs.
Allied health therapies: Speech therapy, occupational therapy, and physical therapy target specific challenges in communication, daily living skills, sensory processing, and movement. They are commonly used to complement other therapies.
Medical interventions: There are no orthodox medications to treat core ASD symptoms. However, drugs may be prescribed to manage co-occurring issues like irritability, aggression, ADHD, anxiety, or depression. Careful monitoring is required to balance benefits and risks and there are superior natural remedies.
Many families turn to Integrative and Nutritional Medicine (IM and NM). Most of these treatments have excellent scientifically-based evidence supporting their use for the health of patients with ASD.
The most common IM and NM therapies used for autism spectrum disorder (ASD) include:
1. Dietary interventions and supplements:
- Gluten-free/casein-free diets
- Allergen free diets
- Omega-3 fatty acids
- Vitamin B6 and magnesium
- Melatonin for sleep issues
- Probiotics and digestive enzymes
2. Mind-body practices:
- Music therapy
- Yoga and meditation
- Massage therapy
- Animal-assisted therapy
3. Manipulative and body-based practices:
- Chiropractic care
- Occupational therapy incorporating sensory integration
4. Biologically-based practices:
- Herbal remedies like ginkgo biloba
- Medicinal cannabis
5. Energy medicine:
- Acupuncture or acupressure
- Pulsating Electro Magnetic Field therapy
6. Other therapies:
- Hyperbaric oxygen therapy (HBOT)
- Chelation therapy
- Stem Cell Therapy
Usage statistics vary, but some studies report that 28-95% of children with ASD have used complementary therapies, with biological therapies and manipulative/body-based practices being the most common. Families should consult with qualified, trained and experienced doctors and healthcare providers to determine the best management plan using IM and NM therapies.
Based on the latest research findings, several vitamins and minerals have shown promise in supporting individuals with autism spectrum disorder (ASD):
1. Vitamin D: Studies suggest that vitamin D supplementation may have a positive impact on behavioral measures in children with ASD. A randomized controlled trial found that vitamin D supplementation significantly increased mean 25(OH)D levels and showed improvements in behavior. However, more research is needed to determine optimal dosage and long-term effects.
2. Vitamin B9 (Folinic Acid): A randomized double-blind placebo-controlled trial on 48 children with ASD and language impairment found that folinic acid supplementation significantly improved verbal communication and core symptoms of ASD. Folinic acid may help prevent behavioral deficits by passing through the blood-brain barrier even in the presence of folate receptor autoantibodies, which are often found in excess concentrations in children with ASD.
3. Vitamin B12 (Methyl B12): Methyl B12 supplementation has been shown to improve symptoms of ASD, with children in the supplementation group demonstrating better scores on the Clinical Global Impression Scale of Improvement (CGI-I) compared to the placebo group. Oral low-dose folic acid administered with subcutaneously injected methyl-cobalamin increased blood plasma levels of glutathione and may lead to increased antioxidant capacity and reduced oxidative stress.
4. Vitamin B6 and Magnesium: Some studies suggest that supplementation with vitamin B6 in combination with magnesium might help improve behavior and communication skills in individuals with ASD. However, more research is needed to establish the effectiveness and safety of this combination therapy.
5. Vitamin A: A clinical trial investigating vitamin A supplementation in children with ASD found that it significantly alleviated symptoms. The study compared two supplement programs, with the higher dose (3000 IU/day for 11 weeks) showing increased serum retinol levels and significantly decreased Social Responsiveness Scale (SRS) scores.
While these findings are promising, it is crucial to note that optimal dosages and durations of vitamin and mineral supplementation in individuals with ASD are highly individual. The effectiveness of supplementation will vary on a case-by-case basis, and it is essential to consult with healthcare professionals before starting any supplementation regimen.
In summary, while many therapies are available for autistic children, selecting and delivering the right interventions is an ongoing challenge. A comprehensive approach involving behavioral, developmental, educational, and medical supports is considered best practice. However, access barriers and the complexities of the disorder mean that fine-tuning treatment to each child's evolving needs is a difficult process for families and providers alike. More research is needed on effective interventions, especially for older children and those with severe impairments.
FUNDAMENTAL RULES:
NO SUGAR OR WHITE FLOUR PRODUCTS IN THE DIET WHATSOEVER.
VITAMIN C IS YOUR BEST FRIEND
Ian Brighthope
Trouble is with these sorts of research they will simply push taking probiotics and prebiotics in a tablet synthetic form. Many parents of Autistic kids are still feeding them junk food and they do not eat properly. I know of one family two little kids one diagnosed austistic the other similar, they love chocolate and playing xbox, they are pale and have anger bursts, but don't eat properly or get outside much. One at aged 7 is still wearting nappies and does not like wearing clothes so the mother accomodates that with turning the heater up. And they both still suck on a bottle daily with milk formula. Formula is very questionable too. I have suggested reading the Brain Saver book by Anthony Williams but nothing seems to change. So is it partly the parents fault and they look for something else or someone else to blame? They get NDIS help too. If you have a mental issue it is easy to get but if you have a physical issue NDIS is very hard to get. Very sad that there is so many kids that are malnourished and full of heavy metals in their brains causing so many problems for themselves, their parents and carers and society in general who have to work around them.
Natural Health practitioners have comprehended this connection for a great many years.
Good to see that contemporary medicine is catching up with us.
Perhaps, someday, orthodox medicine will take note and remove many illnesses simply by fixing the gut microbiota... In the meantime, orthodox medicine is run and controlled by those who are openly wanting to eliminate a great many of us people, because of 'a narrative' that 'the overlords' cooked up sometime in the past.