肠道微生物干预在孤独症谱系障碍中的应用展望

赵英欣; 何凡; 郑毅

doi:10.11852/zgetbjzz2021-1702

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中国儿童保健杂志 ›› 2023, Vol. 31 ›› Issue (3) : 279-283. DOI: 10.11852/zgetbjzz2021-1702

综述

肠道微生物干预在孤独症谱系障碍中的应用展望

赵英欣^1,2, 何凡^1,2, 郑毅^1,2

作者信息 +

Application of gut microbiom intervention in autism spectrum disorder

ZHAO Yingxin^1,2, HE Fan^1,2, ZHENG Yi^1,2

Author information +

文章历史 +

摘要

孤独症谱系障碍(ASD)患病率不断攀升,已成为现代医学面临的主要挑战之一。除了社交互动的持续损害和局限的、重复的兴趣、活动或行为模式这些核心症状之外,还会伴随如胃肠道症状、易怒和攻击行为、情绪问题、多动症状、睡眠问题等,给照料者带来沉重精神和经济负担。目前ASD病因尚不明确,治疗主要以行为改善为主,尚无有效药物可以治疗其核心症状。近年来,肠道微生物作为ASD患者危险因素的潜在中介作用受到越来越多的关注。临床研究表明:改变肠道微生物生态环境失调不仅可改善ASD的胃肠症状,还可改善其适应不良行为。未来需要更多的研究探索肠道微生物对ASD症状的影响,以期为临床提供更多有力的证据。

Abstract

The prevalence of autism spectrum disorder(ASD) is rising, which has become one of the main challenges of modern medicine. In addition to the core symptoms such as continuous damage to social interaction and limited and repeated interests, activities or behavior patterns, it will also be accompanied by gastrointestinal symptoms, irritability and aggressive behavior, emotional problems, hyperactivity symptoms, sleep problems, etc., which will bring heavy mental and economic burden to caregivers. At present, the etiology of ASD is not clear.The main treatment of ASD is behavioral therapy, and there is no effective drug to treat its core symptoms. In recent years, more and more attention has been paid to the potential mediating role of gut microbiom as risk factors in patients with ASD. Several clinical studies have shown that changes of gut microbiom can not only improve the gastrointestinal symptoms of ASD, but also improve its maladaptive behavior. Further studies are warranted to explore the effect of gut microbiom on ASD symptoms so as to provide more powerful evidence for clinical practice.

导出引用

赵英欣, 何凡, 郑毅. 肠道微生物干预在孤独症谱系障碍中的应用展望[J]. 中国儿童保健杂志. 2023, 31(3): 279-283 https://doi.org/10.11852/zgetbjzz2021-1702

ZHAO Yingxin, HE Fan, ZHENG Yi. Application of gut microbiom intervention in autism spectrum disorder[J]. Chinese Journal of Child Health Care. 2023, 31(3): 279-283 https://doi.org/10.11852/zgetbjzz2021-1702

中图分类号： R749.94

参考文献

[1] Maenner MJ, Shaw KA, Bakian AV, et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years - autism and developmental disabilities monitoring network, 11 sites, United States[J]. MMWR Surveill Summ, 2021, 70(11):1-16.
[2] 张霆.益生菌在儿童生长发育中的作用[J].中国儿童保健杂志,2018,26(8):816-818.
Zhang T. Role of probiotics in the growth and development of children[J]. Chin J Child Health Care, 2018, 26(8): 816-818.
[3] Wang M, Wan J, Rong H, et al. Alterations in gut glutamate metabolism associated with changes in gut microbiota composition in children with autism spectrum disorder[J]. mSystems, 2019, 4(1):e00321-18.
[4] Liu Z, Mao X, Dan Z, et al. Gene variations in autism spectrum disorder are associated with alteration of gut microbiota, metabolites and cytokines[J]. Gut Microbes, 2021, 13(1):1-16.
[5] Dan Z, Mao X, Liu Q, et al. Altered gut microbial profile is associated with abnormal metabolism activity of autism spectrum disorder[J]. Gut Microbes, 2020, 11(5):1246-1267.
[6] Wan Y, Zuo T, Xu Z, et al. Underdevelopment of the gut microbiota and bacteria species as non-invasive markers of prediction in children with autism spectrum disorder[J]. Gut, 2021, 26:1-7.
[7] 赵英欣,张旭静,郑毅.肠道微生物-大脑轴与孤独症谱系障碍[J].中华精神科杂志,2019,52(3):224-227.
Zhao YX,Zhang XJ,Zheng Y. The microbiome-gut-brain axis and autism spectrum disorders[J]. Chinese Journal of Psychiatry,2019,52 (3): 224-227.
[8] Ray K. Gut microbiota: microbial metabolites feed into the gut-brain-gut circuit during host metabolism[J]. Nat Rev Gastroenterol Hepatol, 2014,11(2):76.
[9] Hsiao A, Ahmed AM, Subramanian S, et al. Members of the human gut microbiota involved in recovery from vibrio cholerae infection[J]. Nature, 2014,515(7527):423-426.
[10] Umbrello G, Esposito S. Microbiota and neurologic diseases:Potential effects of probiotics[J]. J Transl Med, 2016, 14(1):298.
[11] Needham BD, Adame MD, Serena G, et al. Plasma and fecal metabolite profiles in autism spectrum disorder[J]. Biol Psychiatry, 2021, 89(5):451-462.
[12] Olsen I, Hicks SD. Oral microbiota and autism spectrum disorder(ASD)[J]. J Oral Microbiol, 2019, 12(1):1702806.
[13] Fiorentino M, Sapone A, Senger S, et al. Blood-brain barrier and intestinal epithelial barrier alterations in autism spectrum disorders[J]. Mol Autism, 2016, 29;7:49.
[14] Santocchi E, Guiducci L, Prosperi M, et al. Effects of probiotic supplementation on gastrointestinal, sensory and core symptoms in autism spectrum disorders: A randomized controlled trial[J]. Front Psychiatry, 2020,11:550593.
[15] Niu M, Li Q, Zhang J, et al. Characterization of intestinal microbiota and probiotics treatment in children with autism spectrum disorders in China[J]. Front Neurol, 2019,5(10):1084.
[16] Yap CX, Henders AK, Alvares GA, et al. Autism-related dietary preferences mediate autism-gut microbiome associations[J]. Cell, 2021, 184: 1-16.
[17] Wang Y, Li N, Yang JJ, et al. Probiotics and fructo-oligosaccharide intervention modulate the microbiota-gut brain axis to improve autism spectrum reducing also the hyper-serotonergic state and the dopamine metabolism disorder[J]. Pharmacol Res, 2020, 157:104784.
[18] Grimaldi R, Gibson GR, Vulevic J, et al. A prebiotic intervention study in children with autism spectrum disorders(ASDs)[J]. Microbiome, 2018, 6(1):133.
[19] Benton D, Williams C, Brown A. Impact of consuminga milk drink containing a probiotic on mood and cognition[J]. Eur J Clin Nutr, 2007, 61(3):355-361.
[20] Wang X, Yang J, Zhang H, et al. Oral probiotic administration during pregnancy prevents autism-related behaviors in offspring induced by maternal immune activation via anti-inflammation in mice[J]. Autism Res, 2019, 12:576-588.
[21] Chen K, Fu Y, Wang Y, et al. Therapeutic effects of the in vitro cultured human gut microbiota as transplants on altering gut microbiota and improving symptoms associated with autism spectrum disorder[J]. Microb Ecol, 2020, 80(2):475-486.
[22] El-Ansary A, Bacha AB, Bjørklund G, et al. Probiotic treatment reduces the autistic-like excitation/inhibition imbalance in juvenile hamsters induced by orally administered propionic acid and clindamycin[J]. Metab Brain Dis, 2018, 33(4):1155-1164.
[23] Hsiao EY, McBride SW, Hsien S, et al. Microbiota modulate behavioral and physiological abnormalities associated with neurodevelopmental disorders[J]. Cell, 2013,155(7):1451-1463.
[24] Buffington SA, Dooling SW,Sgritta M, et al. Dissecting the contribution of host genetics and the microbiome in complex behaviors[J]. Cell, 2021, 184(7):1740-1756.e16.
[25] Tomova A, Husarova V, Lakatosova S, et al. Gastrointestinal microbiota in children with autism in Slovakia[J]. Physiol Behav, 2015, 138: 179-187.
[26] Kaluzna-Czaplinska J, Blaszczyk S. The level of arabinitol in autistic children after probiotic therapy[J]. Nutrition, 2012, 28(2):124-126.
[27] Shaaban SY, El Gendy YG, Mehanna NS, et al. The role of probiotics in children with autism spectrum disorder: A prospective, open-label study[J]. Nutr Neurosci, 2018,21(9):676-681.
[28] Kong XJ, Liu J, Liu K, et al. Probiotic and oxytocin combination therapy in patients with autism spectrum disorder: A randomized, double-blinded, placebo-controlled pilot trial[J]. Nutrients, 2021,13(5):1552.
[29] Kang DW, Adams JB, Gregory AC, et al. Microbiota transfer therapy alters gut ecosystem and improves gastrointestinal and autism symptoms: An open-label study[J]. Microbiome, 2017, 23;5(1):10.
[30] Kang DW, Adams JB, Coleman DM, et al. Long-term benefit of microbiota transfer therapy on autism symptoms and gut microbiota[J]. Sci Rep, 2019, 9(1):5821.
[31] Sanctuary MR, Kain JN, Chen SY, et al. Pilot study of probiotic/colostrum supplementation on gut function in children with autism and gastrointestinal symptoms[J]. PLoS One, 2019, 14(1):e0210064.
[32] Arnold LE, Luna RA, Williams K, et al. Probiotics for gastrointestinal symptoms and quality of life in autism:A placebo-controlled pilot trial[J]. J Child Adolesc Psychopharmacol, 2019, 29(9):659-669.