Alterations of the Intestinal Barrier in Patients With Autism Spectrum Disorders and in Their First-degree Relatives
Alterations of the Intestinal Barrier in Patients With Autism Spectrum Disorders and in Their First-degree Relatives
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DOI：
10.1097/mpg.0b013e3181dcc4a5
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发表时间：
2010-10-01
影响因子：
2.9
通讯作者：
Bravaccio, Carmela
中科院分区：
文献类型：
--
作者：
de Magistris, Laura;Familiari, Valeria;Bravaccio, Carmela
目的：研究自闭症患者及其一级亲属的肠通透性(IPT)，探讨肠漏假说。对有或无胃肠道症状的自闭症患者及其一级亲属的粪便钙保护素(Fc)进行测定。患者和方法：用乳果糖/甘露醇试验评估IPT结果，并与成人和儿童对照组及FC值进行比较。结果：自闭症患者及其亲属的IPT异常率(36.7%)高于正常对照组(4.8%)。与不限制饮食的自闭症患者和对照组相比，报告的无麸质酪蛋白饮食的自闭症患者的IPT值显著降低。46.7%的自闭症儿童出现胃肠道症状：便秘(45.5%)、腹泻(34.1%)和其他(腹泻/便秘、腹痛等交替出现：15.9%)。24.4%的自闭症患者Fc升高，11.6%的自闭症患者亲属Fc升高，但与IPT值异常无关。结论：本研究结果支持肠道渗漏假说，提示测定IPT有助于识别可从无麸质饮食中获益的自闭症患者亚群。在一级亲属中发现的IPT改变表明自闭症患者家庭中存在肠道(紧密连接)遗传因素。
Objectives: Intestinal permeability (IPT) was investigated in patients with autism as well as in their first-degree relatives to investigate leaky gut hypothesis. Faecal calprotectin (FC) was also measured in patients with autism, either with or without gastrointestinal symptoms, and in their first-degree relatives.Patients and Methods: IPT results, assessed by means of the lactulose/mannitol test, were compared with adult and child controls and with FC values.Results: A high percentage of abnormal IPT values were found among patients with autism (36.7%) and their relatives (21.2%) compared with normal subjects (4.8%). Patients with autism on a reported gluten-casein-free diet had significantly lower IPT values compared with those who were on an unrestricted diet and controls. Gastrointestinal symptoms were present in 46.7% of children with autism: constipation (45.5%), diarrhoea (34.1%), and others (alternating diarrhoea/constipation, abdominal pain, etc: 15.9%). FC was elevated in 24.4% of patients with autism and in 11.6% of their relatives; it was not, however, correlated with abnormal IPT values.Conclusions: The results obtained support the leaky gut hypothesis and indicate that measuring IPT could help to identify a subgroup of patients with autism who could benefit from a gluten-free diet. The IPT alterations found in first-degree relatives suggest the presence of an intestinal (tight-junction linked) hereditary factor in the families of subjects with autism.