Therapy and epidemiology of autism-clostridial spores as key elements
Therapy and epidemiology of autism-clostridial spores as key elements
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DOI：
10.1016/j.mehy.2007.07.019
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发表时间：
2008-01-01
影响因子：
4.7
通讯作者：
Finegold, Sydney M.
中科院分区：
文献类型：
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作者：
Finegold, Sydney M.
这篇手稿回顾了肠道细菌，特别是梭菌，可能在某些自闭症病例中发挥作用的证据，并假设梭菌孢子（对抗菌剂和常用杀菌剂具有显著抗性）涉及：（1）在对药物如口服万古霉素有反应后，在药物停用后，自闭症受试者复发，（2）近年来孤独症发病率的不明原因增加;（3）同一家庭中多个病例的不明原因增加。假设（1），如果成立，将刺激研究找到耐受性良好和安全的药物，可以与万古霉素（或其他适当的抗菌剂）一起使用，以消除孢子;这将彻底改变治疗方法。假设（2）和（3）与抗菌药物的广泛使用、自闭症幼儿的卫生条件差以及难以从家庭环境中清除孢子有关。这两个假设对这种重要而令人痛苦的疾病的流行病学有重大影响，并将鼓励研究从家庭和其他环境中消除梭菌孢子的方法。(c)2007爱思唯尔有限公司保留所有权利。
This manuscript reviews evidence indicating that intestinal, bacteria, specifically clostridia, may play a role in certain cases of autism and hypothesizes that the clostridial spores (which are notably resistant to antimicrobial agents and commonly used germicides) are involved in: (1) relapse in the autistic subject after a response to an agent such as oral vancomycin, after the drug is discontinued, (2) the unexplained increased incidence of autism in recent years, and (3) the unexplained increase in numbers of multiple cases in the same family. Hypothesis (1), if established as valid, would spur research to find well-tolerated and safe agents that could be given together with vancomycin (or other appropriate antimicrobial agent) to eliminate spores; this would revolutionize the therapeutic approach. Hypotheses (2) and (3) relate to widespread use of antimicrobial agents, poor hygiene in young autistic children, and difficulty in removing spores from the home environment. These tatter two hypotheses have major implications with regard to the epidemiology of this important and distressing disease and would encourage research into methods to eliminate clostridial spores from the home and other environments. (c) 2007 Elsevier Ltd. All rights reserved.