The microbiome of autism spectrum disorder: the implications on co-morbid symptomatology and the role in therapeutics
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Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairment in social communication and repetitive behavior. The etiology of ASD is believed to be multifactorial, yet much about causation remains unknown. There is a growing interest in the role of the intestinal microbiome, how it may differ in the ASD population and how the intestinal microbiota may impact central nervous system (CNS) function. This process involves bidirectional communication between the gut and the CNS and is referred to as the gut-brain axis or the microbiome-gut-brain axis. The gut-brain axis comprises the autonomic and enteric nervous systems, the vagus nerve, and the hypothalamic-pituitary-adrenal axis. While the exact mechanism of this pathway is currently unknown, there is growing evidence to suggest that gut microbiota plays an essential role in the brain, behavior, and cognitive development.
When comparing the microbiome in ASD to that observed in neurotypical individuals, there is a good deal of variability. Research has shown that distinct bacteria are associated with GI symptoms, Autism severity, and other systemic repercussions on the host’s health. However, because of the inconsistency in microbiome composition, there is not a signature biomarker of ASD.
It is still unknown if the diagnosis of ASD causes the gut biome dysbiosis or if the disruption in the biome worsens and contributes to the ASD core symptomology. Individuals with ASD are five times more likely to exhibit atypical eating patterns and six to eight times more likely to have gastrointestinal problems, including diarrhea, constipation, bloating, and gastroesophageal reflux disease when compared with neurotypical subjects. These GI disorders have been reported to be associated with anxiety problems, somatic complaints, sleep abnormalities, and externalizing problems in many ASD individuals. The microbiome in ASD is believed to be atypical and these atypicalities may contribute to some of the brain, behavior and cognitive features associated with ASD. This paper will review what is known about the microbiome in ASD and possible implications for treatment and interventions.
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