Faecal transplant may ease kids’ autism symptoms, small study suggests

By Will Chu

- Last updated on GMT

Many children with ASD often undergo increased oral antibiotic treatment during the first 3 years of life, which is thought to destabilise their gut microbiota. ©iStock/iculig
Many children with ASD often undergo increased oral antibiotic treatment during the first 3 years of life, which is thought to destabilise their gut microbiota. ©iStock/iculig

Related tags: Clostridium difficile

Children with autism may be helped by faecal transplants as work further underlines the importance of gastrointestinal (GI) health in neurodevelopmental disorders.

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.

Faecal findings

bowel gut diarrhea constipation
Results revealed around an 80% reduction of GI symptoms at the end of treatment, including improvements in symptoms of constipation, diarrhoea, indigestion and abdominal pain.©iStock

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

bacteria_green_closeup_iStock_Free
OpenBiome, along with the APC Microbiome Institute in Cork, Ireland will make its microbiota preparations for faecal microbiota transplantation (FMT) available to European patients suffering from C. difficile infections. ©iStock

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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2 comments

Protect & Nurture the Microbiome

Posted by Dr. Mark JS Miller,

We are slowly but surely moving on with fecal transplants from the initial days of last option treatment of Clostridium difficile. Now we are appreciating the importance and value of a healthy gut microbiome for many, many conditions. Having said that it is far from mainstream thinking and routine therapeutics - BUT IT WILL BECOME ROUTINE

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Whaaaat?!!!

Posted by Nancy Martinez,

I have NEVER even heard of this type of procedure until now. When I actually googled it, I was in shock and apparently has several other GI related therapy uses. Let me tell you, this FMT procedure definitely needs to get more info. out there. I know if my doctor ever proposed this to me, I would have to think twice about how he got his license. But the science and results make sense! Thanks for the unsettling bit of education I got today, but for sure, something that needs more testing and published research for so many that suffer from GI Issues.

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