Autism Therapy Could Lie in Fecal Microbial Transplant

Highlights

• A research team from Arizona State University has found that autism symptoms could be improved by fecal microbial transplant.
• The study was found to be effective in increasing the number of good bacteria, especially Prevotella, which is normally found to be low in children with autism.
• There was an 80% improvement in gastrointestinal symptoms and up to 25% improvement in social skills and sleep.

Autism has always been treated as a condition with treatment that targeted the mind, but a new study has found that the solution may also lie in the gut. A research team from Arizona State University (ASU) is using a novel approach in autism treatment that is effective and that involves using fecal microbial transplants to improve the gut microbiome (microorganisms in the gut).

The initial findings of the study holds promise and was published in the journal Microbiome, but there are further studies that are required before the therapy is approved by the UnitedStates Food and Drug Administration (USFDA).

The research team includes scientists from the University of Minnesota, the Northern Arizona University and Ohio State University and the study was conducted on 18 study participants who had autism spectrum disorders and were between 7 to 16 years old.

Autism

Autism spectrum disorder (ASD) is a neurological as well as a developmental disorder that begins in early childhood but lasts for a lifetime. The affected person finds it difficult to interact with people and there are difficulties in communication and learning.  This is called a spectrum disorder as people exhibit a range of symptoms. People with autism may repeat things or may seem like they are in their own world.

Studies have shown that there is a gene and environment interaction associated with the cause of autism but there are currently no standard treatment methods. Behavioral therapies like speech language therapy are known to improve the condition over a period of time.

Fecal Transplant for People with Autism:

The current 10-week study conducted on 18 children with autism involved

• treatment with  antibiotics
• bowel cleanse
• daily fecal microbial transplants for 8 weeks

This study was based on earlier studies conducted by ASU that showed an association between symptoms of autism and the gut microbiome.

The findings of the study were

• 80 % improvement on average of gastrointestinal symptoms that are associated with autism spectrum disorders.
• 20-25 % improvement in symptoms of autism which include improved social behavior and sleep.

Team leader, Dr. James Adams, professor of Materials Sciences said that the results of the study were very encouraging and that they had completed the phase 1 trial demonstrating the safety associated with this treatment program. However, phase 2 and phase 3 trials need to be undertaken before this method is available for people. He further added "We look forward to continuing research on this treatment method with a larger, placebo-controlled trial in the future."

Fecal Microbial Transplant:

In Fecal Microbiota Transplant (FMT) the stool sample or fecal matter is collected from a donor and mixed with a saline solution, filtered and then introduced into a patient via enema, endoscopy, colonoscopy, or sigmoidoscopy.

Benefits of Fecal Microbial Transplant

• It replaces good bacteria that have been suppressed or killed due to the use of antibiotics.
• There are 1,000 different species of gut bacteria which are transferred from the donor to the patient, acting like a broad-spectrum probiotic treatment which restores the normal gut bacteria of the patients.
• It is currently used to lower the risk of infection by bacteria, especially Clostridium difficile (C. diff) that causes a debilitating form of diarrhea.
• It is also used for many other digestive or auto-immune diseases, including ulcerative colitis,  Crohn's disease or irritable bowel syndrome (IBS).

The first documented fecal transplant was conducted in the 4th century in China, in a technique known as "yellow soup".

• The technique has been in use in veterinary medicine for over 100 years in the treatment of C. diff.
• In some parts of the world, it is customary for the mother's stool to be given in small amounts to a newborn infant. This was done to provide good bacteria immediately for better immunity and digestion. 
• In the U.S, fecal transplant has been used sporadically from the 1950′s; however, without much regulation. It has gained popularity over the past few years.
• FDA announced classified fecal matter as an Investigational New Drug (IND) as well as a biologic.
• FDA announced that qualified physicians could perform fecal transplant for recurrent C. diff after obtaining a signed consent from the patient and using the stool sample from a tested donor.

After using fecal microbial transplant for patients with autism, the scientists stated that they saw a considerable increase in the microbe diversity and an increase in Prevotella, which was found to be low in children with autism spectrum disorders. The microbes that were transferred using fecal transplant were persistent even after the treatment was stopped. The transplant not only resulted in providing good bacteria to the recipient but it also aided in altering the gut environment, making it conducive for the growth of beneficial microbes.

The transfer of 'good' bacteria to a recipient was found to be effective using the methods followed in the current study, however, a placebo trial would aid in evaluating the effectiveness of this treatment.

The methodology followed in the study may seem simple and may encourage use by family members. However, the scientists in the study caution that improper transplant could lead to gastro-intestinal infections. The extent of benefit obtained among patients with autism offers a good use for use of fecal transplant as a potential form of therapy in the near future.

References:

1. What is FMT? - (http://thefecaltransplantfoundation.org/what-is-fecal-transplant/)
2. Autism Spectrum Disorder - (https://medlineplus.gov/autismspectrumdisorder.html)

Source: Medindia