Findings from a small study appear to show promise in changing the gut microbiome and improve GI and behavioural symptoms of autism.
Subjects’ improvements persisted for at least eight weeks after treatment ended, suggesting a long-term impact.
This link between the gut and the brain, also known as the gut-brain axis, has become an avenue of extreme interest for researchers.
By targeting this area to treat or alleviate the symptoms of mental disorders, the possibility of probiotic preparations or transplants could potentially prove an effective therapy.
Around 70% of people with autism have reported GI problems. The condition is often diagnosed at around the time the gut flora becomes established.
Researchers from Ohio State University enrolled 18 children with Autism Spectrum Disorder (ASD) aged 7–16 years, who also had moderate to severe gastrointestinal problems.
Each child participated in the study for 18 weeks in total, consisting of a 10-week Microbiota Transfer Therapy (MTT) treatment and an 8-week follow-up observation period after the treatment stopped.
As a control group, 20 age- and gender-matched children without GI disorders or ASD characteristics were recruited. They were monitored for 18 weeks but not treated.
For faecal microbiota transplant (FMT) treatment, two routes of administration were compared, oral versus rectal, for the initial dose, followed by a lower maintenance dosage given orally for 7–8 weeks.
Results revealed around an 80% reduction of GI symptoms at the end of treatment, including significant improvements in symptoms of constipation, diarrhoea, indigestion and abdominal pain. Improvements persisted eight weeks after treatment.
Similarly, clinical assessments showed that behavioural ASD symptoms improved significantly and remained improved eight weeks after treatment ended.
“Bacterial analyses revealed successful partial engraftment of donor microbiota and beneficial changes in the gut environment,” the study revealed.
“Specifically, overall bacterial diversity and the abundance of Bifidobacterium, Prevotella, and Desulfovibrio among other taxa increased following MTT and these changes persisted after treatment stopped (followed for 8 weeks).”
FMT join diet, antibiotics, probiotics and prebiotics as treatments to rebalance human gut microbiota to treat disease.
The diverse range of bacteria present in faecal matter is an advantage in stark contrast to the few bacterial species contained in milk cultures.
This may give greater promise in treating chronic inflammatory diseases, insulin sensitivity and recurrent Clostridium difficile infection.
“Scientists are trying to work out the cellular-level details of why patients who undergo faecal transplants for various conditions, such as C. diff infection, see improvement,” said Ann Gregory, study co-lead author and a microbiology graduate student at The Ohio State University.
“Doctors know it works, just not how.”
While the results are encouraging, the limitations of the study caused the team to take a step back.
Its small sample size and the subjects’ knowledge of the type of treatment they were receiving do open possibilities for false perceived benefits.
A matter dividing opinion
The sample matter is perhaps the biggest hurdle in FMT’s progress as a mainstream treatment.
Faecal matter is undeniably an unpleasant medium to be working with. It can spread pathogens and has largely unidentified populations of microbes, viruses, and other constituents despite recent progress.
Variability in these communities also result in great challenges for regulators, who remain stumped on how faecal matter, which is essentially a human waste product that changes every time it is produced, can be approved as a viable treatment.
In August last year, Seres Therapeutics, a start-up based on Cambridge, Massachusetts, had to pause work into its lead product—SER-109, after patients receiving this capsule were just as likely to suffer another bout of C-diff as those who got the placebo.
SER-109 contained 100 million spores from 50 species of gut microbes, purified from the stools of healthy human donors.
More closer to home, OpenBiome, a US non-profit stool bank are collaborating with the APC Microbiome Institute in Cork, Ireland to make its microbiota preparations for faecal microbiota transplantation (FMT) available to patients across Europe suffering from recurrent C. difficile infections.
Source: Biomed Central
Published online ahead of print: DOI: 10.1186/s40168-016-0225-7
“Microbiota Transfer Therapy alters gut ecosystem and improves gastrointestinal and autism symptoms: an open-label study.”
Authors: Dae-Wook Kang, James B. Adams, Ann C. Gregory et al.
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