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In the first published example showing that the intestine could play a role in autism, scientists discovered that a "stool transplant" dramatically improved behavior and gastrointestinal health -intestinal in children with neurodevelopmental disorder.
The research involved a very small number of children – 18 – with autism and also with severe gastrointestinal problems. Researchers at the Biodesign Institute of Arizona State University have hypothesized that by restarting the intestinal "microbiome" of children, the flora that inhabits the intestine, they could improve the symptoms of l & # 39; autism. To their surprise, the rebalancing of intestinal bacteria had a lasting effect two years after treatment for most participants, all of whom were under 18 years of age.
Rosa Krajmalnik-Brown, lead author of the research conducted in the State of Arizona, noted that the results of the analysis strengthen the theory of the axis of the intestine and the brain in autism, which means that bacteria in the intestine influence brain function.
Krajmalnik-Brown pointed out that it was better to leave professionals with fecal transplants. "We do not want people to try this at home," she said.
The transplants were not feces but "good" highly purified bacteria, extracted from faeces and administered to children in what Krajmalnik-Brown had described as a "chocolate drink".
Fecal grafts rebalance the microbial flora of the gut – the gut microbiome – by providing recipients with bacteria from the stool of a healthy donor. The introduction of new bacteria – which replicate themselves – diversifies the thriving bacterial communities in the intestine. After the transplant, there was a particular abundance of two beneficial bacterial species – bifidobacteria and Prevotella – the study found.
Similar transplants have saved adult patients from Clostridium difficile – C. diff – infections. Approximately 500,000 people are affected each year by C. diff in the United States and 30,000 die from it.
Fecal grafts are also promising to restart the microbiome in other serious gastrointestinal disorders, such as colitis and Crohn's disease.
One of the biggest battles in the field of medicine is the quarrel between doctors and pharmaceutical companies over whether human excreta should be considered a drug or a regulated treatment that doctors can administer as they please.
All of the children involved in Krajmalnik-Brown's research had a history of stomach pain, frequent constipation and diarrhea, issues that have long been reported by parents including children with autism. It is thought that up to 50% of children with autism have serious gastrointestinal problems.
Fecal grafts in Arizona, which Krajmalnik-Brown called "faecal transfers," received daily doses for eight weeks. The results were published in the journal Scientific Reports.
"First, they received two weeks of vancomycin," she said about the potent antibiotic, "to get rid of bacteria in the gut. Then they received a high-dose treatment and then the 'maintenance doses', namely the eight weeks of daily bacterial cocktails in a chocolate drink.
At the beginning of the initial 18 weeks During the research period, 83% of the children had what Krajmalnik-Brown described as severe autism. Two years later, only 17% could have severe symptoms and 39% had mild or moderate symptoms. Along with improving gastrointestinal health, behavior problems have decreased for most children, she said.
The Centers for Disease Control and Prevention estimates that one in every 59 children in the United States has an autism spectrum disorder.
"What was so exciting was the lasting effect," Krajmalnik-Brown said, citing symptom improvement two years after treatment.
Doctors not involved in the research said the results are promising but require additional data.
"Although researchers have long suspected that there is a relationship between the gut and the brain in children with autism, this study provides somewhat flawed support for this idea," he said. Dr. Andrew Adesman, Head of Developmental and Behavioral Pediatrics at Cohen. Children's Medical Center in New Hyde Park.
"The fecal transplant was the novel and the main presumed reason for the observed clinical improvement," said Adesman, pointing out that it was possible that "other elements of the initial regimen, such as Child who received an antibiotic for two weeks, actually altered the intestines. " bacteria. "
Adesman said he also feared there would be no placebo in Arizona research that would allow a comparison of observed benefits.
Krajmalnik-Brown said additional research was planned, including a placebo-controlled study. However, the next fecal transplant project, she said, will involve adults with autism.
"We do not have all the answers at this stage," she said, adding that she and her team were only hypothesizing why the children's behavior was improved after stool grafting. Perhaps because the gastrointestinal discomfort was relieved, said Krajmalnik-Brown, the children simply felt better.
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