Gastrointestinal flora and gastrointestinal status in children with autism--comparisons to typical children and correlation with autism severity.
Gastrointestinal flora and gastrointestinal status in children with autism--comparisons to typical children and correlation with autism severity.
复制标题
自闭症儿童的胃肠道菌群和胃肠道状态 - 与典型儿童相关，并与自闭症的严重程度相关。
DOI：
10.1186/1471-230x-11-22
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发表时间：
2011-03-16
影响因子：
2.4
通讯作者：
Rubin RA
中科院分区：
文献类型：
--
作者：
Adams JB;Johansen LJ;Powell LD;Quig D;Rubin RA
据报道，自闭症儿童经常出现胃肠道问题，这些问题比普通儿童更常见、更严重。研究人员对 58 名自闭症谱系障碍 (ASD) 儿童和 39 名年龄相仿的健康典型儿童的粪便样本进行了胃肠道菌群和胃肠道状态评估。粪便检测包括细菌和酵母培养物检测、溶菌酶、乳铁蛋白、分泌型 IgA、弹性蛋白酶、消化标记物、短链脂肪酸 (SCFA)、pH 值和血液存在情况。使用改良的六项胃肠道严重指数（6-GSI）问卷评估胃肠道症状，并使用自闭症治疗评估清单（ATEC）评估自闭症症状。胃肠道症状（由 6-GSI 评估）与自闭症的严重程度（由 ATEC 评估）密切相关（r = 0.59，p < 0.001）。 6-GSI 分数高于 3 的儿童的 ATEC 总分数比 6-GSI 分数为 3 或更低的儿童高得多（81.5 +/- 28 与 49.0 +/- 21，p = 0.00002）。自闭症儿童的总短链脂肪酸水平要低得多（-27%，p = 0.00002），包括较低水平的乙酸盐、丙酸盐和戊酸盐；这种差异在服用益生菌的自闭症儿童中更大，但在不服用益生菌的儿童中也很显着。自闭症儿童的双歧杆菌种类水平较低（-43%，p = 0.002），乳酸菌种类水平较高（+100%，p = 0.00002），但使用基于标准培养生长技术的其他细菌和酵母的水平相似。自闭症儿童的溶菌酶含量较低（-27%，p = 0.04），可能与益生菌的使用有关。两组消化功能的其他标志物相似。胃肠道症状与自闭症严重程度的强相关性表明，自闭症较严重的儿童可能有更严重的胃肠道症状，反之亦然。自闭症症状可能会加剧，甚至部分是由于潜在的胃肠道问题造成的。 SCFA 水平低部分与益生菌使用增加有关，部分原因可能是产量较低（有益细菌的解糖发酵较少和/或可溶性纤维摄入量较低）和/或体内吸收较多（由于转运时间较长和/或肠道通透性增加）。
Children with autism have often been reported to have gastrointestinal problems that are more frequent and more severe than in children from the general population. Gastrointestinal flora and gastrointestinal status were assessed from stool samples of 58 children with Autism Spectrum Disorders (ASD) and 39 healthy typical children of similar ages. Stool testing included bacterial and yeast culture tests, lysozyme, lactoferrin, secretory IgA, elastase, digestion markers, short chain fatty acids (SCFA's), pH, and blood presence. Gastrointestinal symptoms were assessed with a modified six-item GI Severity Index (6-GSI) questionnaire, and autistic symptoms were assessed with the Autism Treatment Evaluation Checklist (ATEC). Gastrointestinal symptoms (assessed by the 6-GSI) were strongly correlated with the severity of autism (assessed by the ATEC), (r = 0.59, p < 0.001). Children with 6-GSI scores above 3 had much higher ATEC Total scores than those with 6-GSI-scores of 3 or lower (81.5 +/- 28 vs. 49.0 +/- 21, p = 0.00002). Children with autism had much lower levels of total short chain fatty acids (-27%, p = 0.00002), including lower levels of acetate, proprionate, and valerate; this difference was greater in the children with autism taking probiotics, but also significant in those not taking probiotics. Children with autism had lower levels of species of Bifidobacter (-43%, p = 0.002) and higher levels of species of Lactobacillus (+100%, p = 0.00002), but similar levels of other bacteria and yeast using standard culture growth-based techniques. Lysozyme was somewhat lower in children with autism (-27%, p = 0.04), possibly associated with probiotic usage. Other markers of digestive function were similar in both groups. The strong correlation of gastrointestinal symptoms with autism severity indicates that children with more severe autism are likely to have more severe gastrointestinal symptoms and vice versa. It is possible that autism symptoms are exacerbated or even partially due to the underlying gastrointestinal problems. The low level of SCFA's was partly associated with increased probiotic use, and probably partly due to either lower production (less sacchrolytic fermentation by beneficial bacteria and/or lower intake of soluble fiber) and/or greater absorption into the body (due to longer transit time and/or increased gut permeability).