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Evaluation of Intestinal Function in Children With Autism and Gastrointestinal Symptoms
Rafail I Kushak1, Timothy M Buie, Katherine F Murray
1*Department of Pediatrics, Mass General Hospital for Children, Harvard Medical School, Boston †Department of Biology, Boston College, Chestnut Hill, MA.
Insights
Children with autism and gastrointestinal issues show similar gut findings to those without autism. Objective tests do not reveal autism-specific gut pathology, but can help identify atypical symptoms.
Area of Science:
- Gastroenterology
- Neurodevelopmental Disorders
- Pediatric Health
Background:
- Autism Spectrum Disorder (ASD) is often associated with gastrointestinal (GI) dysfunction, commonly referred to as "leaky gut."
- Understanding the specific GI alterations in children with ASD is crucial for diagnosis and management.
Purpose of the Study:
- To investigate disaccharidase activity, intestinal inflammation, and intestinal permeability in children with autism spectrum disorder (ASD) and gastrointestinal symptoms.
- To compare these findings with non-autistic children presenting with similar gastrointestinal complaints.
Main Methods:
- Duodenal biopsies were analyzed for disaccharidase activity (lactase, sucrase, maltase, palatinase).
- Intestinal permeability was assessed using the rhamnose/lactulose test with liquid chromatography-mass spectrometry.
- Intestinal inflammation markers, fecal calprotectin and lactoferrin, were measured via ELISA and histology.
Main Results:
- No significant differences in disaccharidase activity were observed between children with and without autism.
- Fecal calprotectin and lactoferrin levels were comparable between the two groups.
- Intestinal permeability, measured by the lactulose/rhamnose ratio, did not differ statistically between autistic and non-autistic children.
Conclusions:
- Objective gastrointestinal findings in children with autism and GI symptoms are similar to those in children without autism.
- Current noninvasive and endoscopic methods do not identify gastrointestinal pathology specific to autism.
- These assessments may, however, aid in identifying autistic children with atypical gastrointestinal symptoms.
Objective:
Alterations in intestinal function, often characterized as a "leaky gut," have been attributed to children who are on the autism spectrum. Disaccharidase activity, intestinal inflammation, and permeability were analyzed in 61 children with autism and 50 nonautistic individuals with gastrointestinal symptoms.
Methods:
All patients had duodenal biopsies assayed for lactase, sucrase, maltase, and palatinase activity. Intestinal permeability was evaluated by rhamnose/lactulose test and measured by high-performance liquid chromatography-mass spectrometry. Intestinal inflammation was evaluated by fecal calprotectin and lactoferrin levels using enzyme-linked immunosorbent assay and histology.
Results:
Some children with autism had mild levels of mucosal inflammation on intestinal biopsy. Disaccharidase activity was not different in autistic and nonautistic individuals. Fecal calprotectin and lactoferrin were similar in both groups. Differences between lactulose and rhamnose recovery and lactulose/rhamnose ratio in urine were not statistically different in patients with and without autism.
Conclusions:
The present study supports the observation that children with autism who have symptoms of gastrointestinal disorders have objective findings similar to children without autism. Neither noninvasive testing nor endoscopic findings identify gastrointestinal pathology specific to autism, but may be of benefit in identifying children with autism who have atypical symptoms.
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