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Does constipation affect the effectiveness of washed microbiota transplantation in treating autism spectrum
Zihao Pan1, Zheng Gao1, Junyi Chen1
1Department of Gastroenterology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China.
Purpose:
Washed microbiota transplantation (WMT) has been shown to improve the symptoms of Autism Spectrum Disorder (ASD). It's currently unclear whether the presence of constipation affects the efficacy of WMT in children with ASD. This study aims to investigate whether constipation affects the efficacy of WMT in children with ASD.
Patients And Methods:
To investigate the efficacy of WMT for ASD, we conducted a retrospective analysis of changes in ASD-related symptoms, sleep disturbances, gastrointestinal manifestations, intestinal barrier integrity, and gut microbiota composition in 103 ASD patients undergoing WMT. They were divided into two groups according to whether constipation was present or not before treatment.
Results:
1. Aberrant Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Sleep Disturbance Scale for Children (SDSC) scores in the non-constipation and constipation groups decreased with an increase in the number of WMT treatments. 2. Comparison of two groups: ABC scores in the non-constipation group decreased more after the first WMT course, whereas ABC scores in the constipation group decreased more after two WMT courses. 3. Intestinal Barrier Function: D-lactate levels decreased more in the constipation group after the first two courses. In general, WMT treatment had no significant effect on intestinal barrier function in patients with ASD. 4. Effect of WMT on constipation: As the number of WMT courses increased, Bristol Stool Form Scale (BSFS) scores in constipation group gradually approached 4. 5. Constipation group had lower microbial diversity than non-constipation group at baseline. After one course of WMT, constipation group showed an obvious increase in microbial diversity and a significant increase in the relative abundance of Bifidobacteria compared to non-constipation group.
Conclusion:
Post WMT, core symptoms and sleep disorders were significantly improved in both groups. Feces returned to normal shape in the constipation group. A difference in efficacy between the two groups was observed in early stages, but after multiple courses of WMT no difference in efficacy was noted. Although in the short-term, children with ASD and comorbid constipation showed a significant increase in microbial diversity after receiving WMT, mid-term outcomes indicate that constipation does not affect the efficacy of WMT in treating ASD.
Insights
Washed microbiota transplantation (WMT) effectively treats Autism Spectrum Disorder (ASD) symptoms, and comorbid constipation does not impact its long-term efficacy. Children with ASD and constipation showed improved gut health and microbial diversity post-WMT.
Area of Science:
- Microbiome research
- Neurodevelopmental disorders
- Gastroenterology
Background:
- Washed microbiota transplantation (WMT) has demonstrated efficacy in improving Autism Spectrum Disorder (ASD) symptoms.
- The influence of constipation on WMT effectiveness in ASD patients remains unclear.
- Understanding this interaction is crucial for optimizing treatment strategies.
Purpose of the Study:
- To investigate whether the presence of constipation affects the efficacy of WMT in children diagnosed with ASD.
- To compare treatment outcomes between ASD patients with and without pre-existing constipation.
Main Methods:
- Retrospective analysis of 103 ASD patients undergoing WMT.
- Patients were categorized into two groups: with and without constipation.
- Evaluated changes in ASD symptoms, sleep, gastrointestinal function, intestinal barrier integrity, and gut microbiota composition.
Main Results:
- Both groups showed improvements in ASD symptoms and sleep disturbances post-WMT.
- Constipation resolved in the affected group, with stool form normalizing.
- While initial efficacy varied, WMT demonstrated comparable long-term effectiveness regardless of constipation status; constipation group showed increased microbial diversity and Bifidobacteria.
Conclusions:
- WMT significantly improves core ASD symptoms and sleep disorders in both constipation and non-constipation groups.
- Constipation in ASD patients does not hinder the overall efficacy of WMT in the mid-term.
- WMT positively impacts gut microbiota diversity and composition, particularly in children with ASD and constipation.
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