Tharika Arunkumar - Department of Pediatrics
Autism spectrum disorder (ASD) is a common neurodevelopmental condition in children characterized by challenges with communication, social interactions, and repetitive behaviors. Many children with ASD also frequently experience gastrointestinal (GI) symptoms such as constipation, diarrhea, and abdominal pain. The underlying causes of ASD are still being investigated, but the gut microbiome has emerged as a potential factor in both the behavioral and GI symptoms. An imbalance in the gut microbiota is hypothesized to disrupt the gut-brain axis, which allows bidirectional communication between the GI system and the central nervous system. Fecal microbiota transplantation (FMT) is a novel therapy that aims to restore a healthy balance of microbes in the gut by transferring fecal material from a healthy donor into the GI tract of a recipient. By repopulating the gut with a diverse community of microbes, FMT may modulate the gut environment and gut-brain interactions in a way that improves both GI and behavioral symptoms.
This systematic review evaluated four studies that administered FMT to pediatric patients with ASD and measured outcomes on behavioral and GI symptoms. The results across all four studies found statistically significant improvements in ASD behavioral rating scales, including the Aberrant Behavior Checklist (ABC) and the Child Autism Rating Scale (CARS), following FMT treatment. The studies also demonstrated substantial improvements in GI symptoms using the Bristol Stool Form Scale and Gastrointestinal Symptom Rating Scale. These findings suggest that FMT could be a promising intervention for both the behavioral and GI issues associated with ASD in children. However, there are limitations due to the small sample sizes, differences in study protocols, lack of control groups, and short follow-up times. More rigorous research is still needed, including randomized controlled trials and long-term follow-up studies, to further evaluate the efficacy and safety of FMT for ASD. But the results so far indicate microbiome-modulating therapies like FMT warrant further investigation as potential treatments for this complex neurodevelopmental disorder.
References:
Dossaji, Z., Khattak, A., Tun, K. M., Hsu, M., Batra, K., & Hong, A. S. (2023). Efficacy of fecal microbiota transplant on behavioral and gastrointestinal symptoms in pediatric autism: A systematic review. Microorganisms, 11(3), 806. https://doi.org/10.3390/microorganisms11030806
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