Generic placeholder image

Current Reviews in Clinical and Experimental Pharmacology


ISSN (Print): 2772-4328
ISSN (Online): 2772-4336

Review Article

The Effects of Probiotics and Prebiotics on Gastrointestinal and Behavioural Symptoms in Autism Spectrum Disorder

Author(s): José Guevara-Gonzaléz, José Guevara-Campos, Lucía González and Omar Cauli *

Volume 17, Issue 3, 2022

Published on: 05 August, 2021

Page: [166 - 173] Pages: 8

DOI: 10.2174/2772432816666210805141257

Price: $65


Background: Autism Spectrum Disorders (ASDs) are a group of prevalent neuropsychiatric disorders. They present a complex and unknown etiology, which in most cases includes significant peripheral alterations outside the brain such as in the composition of gut microbiota. Because the gut microbiota is involved in modulating the gut-brain axis, several studies have suggested that the microbiome in the gut can modify metabolites which are able to cross the blood-brain barrier and modulate brain function.

Methods: We reviewed the current evidence regarding microbiota alterations in patients with ASD and the effects of the administration of probiotics and prebiotics in these patients, both in terms of gastrointestinal and behavioural symptoms.

Results: Administration of a probiotic formulation containing different strains of Lactobacillus (L. acidophilus, L. rhamnosus, and others) and Bifidobacteria had beneficial effects upon these aforementioned symptoms and their use is recommended in a subgroup of ASD patients that present gastrointestinal disturbances. Nonetheless, the types of gastrointestinal disturbances that most benefit from such interventions remain to be elucidated in order to personalize the medical approaches.

Conclusion: Recent clinical studies have shown that probiotic treatments can regulate the gut microbiota and may result in improvements in some behavioral abnormalities associated with ASD. Trials using prebiotic fibers or synbiotics preparations are still lacking and necessary in order to deep in such therapeutic strategies in ASD with comorbid gastrointestinal disrturbances.

Keywords: Nutraceuticals, behavior, constipation, probiotic, fungi, gut-brain axis, prebiotic, bifidobacteria.

Graphical Abstract
Christensen DL, Baio J, Van Naarden BK, et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years-autism and developmental disabilities monitoring network, 11 sites, United States, 2012. MMWR Surveill Summ 2016; 65(3): 1-23.
[] [PMID: 27031587]
Sandin S, Lichtenstein P, Kuja-Halkola R, Hultman C, Larsson H, Reichenberg A. The heritability of autism spectrum disorder. JAMA 2017; 318(12): 1182-4.
[] [PMID: 28973605]
Bai D, Yip BHK, Windham GC, et al. Association of genetic and environmental factors with autism in a 5-country cohort. JAMA Psychiatry 2019; 76(10): 1035-43.
[] [PMID: 31314057]
Srikantha P, Mohajeri MH. The possible role of the microbiota-gut-brain-axis in autism spectrum disorder. Int J Mol Sci 2019; 20(9): 2115.
[] [PMID: 31035684]
Martínez-González AE, Andreo-Martínez P. The role of gut microbiota in gastrointestinal symptoms of children with ASD. Medicina (Kaunas) 2019; 55(8): 408.
[] [PMID: 31357482]
Chandler S, Carcani-Rathwell I, Charman T, et al. Parent-reported gastro-intestinal symptoms in children with autism spectrum disorders. J Autism Dev Disord 2013; 43(12): 2737-47.
[] [PMID: 23371507]
Liu F, Li J, Wu F, Zheng H, Peng Q, Zhou H. Altered composition and function of intestinal microbiota in autism spectrum disorders: A systematic review. Transl Psychiatry 2019; 9(1): 43.
[] [PMID: 30696816]
Strati F, Cavalieri D, Albanese D, et al. New evidences on the altered gut microbiota in autism spectrum disorders. Microbiome 2017; 5(1): 24.
[] [PMID: 28222761]
Markowiak P, Śliżewska K. Effects of probiotics, prebiotics, and synbiotics on human health. Nutrients 2017; 9(9): 1021.
[] [PMID: 28914794]
Wilkins T, Sequoia J. Probiotics for gastrointestinal conditions: A summary of the evidence. Am Fam Physician 2017; 96(3): 170-8.
[PMID: 28762696]
Li J, Jia H, Cai X, et al. An integrated catalog of reference genes in the human gut microbiome. Nat Biotechnol 2014; 32(8): 834-41.
[] [PMID: 24997786]
Jiménez E, Marín ML, Martín R, et al. Is meconium from healthy newborns actually sterile? Res Microbiol 2008; 159(3): 187-93.
[] [PMID: 18281199]
Martín R, Makino H, Cetinyurek Yavuz A. Early-life events, including mode of delivery and type of feeding, sibling and gender, shape the developing gut microbiota. PLoS One 2016; 11(6): 158498.
Domínguez-Bello MG, Costello EK, Contreras M, et al. Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. Proc Natl Acad Sci USA 2010; 107(26): 11971-5.
[] [PMID: 20566857]
Bokulich NA, Chung J, Battaglia T, et al. Antibiotics, birth mode, and diet shape microbiome maturation during early life. Sci Transl Med 2016; 8(343): 343ra82.
[] [PMID: 27306664]
Asagaard K, Ma J, Antony KM, Ganu R, Petrosino J, Versalovic J. Ihe placenta harbors a unique microbiome. Sci Transl Med 2014; 6: 237-65.
Tamburini S, Shen N, Wu HC, Clemente JC. The microbiome in early life: Implications for health outcomes. Nat Med 2016; 22(7): 713-22.
[] [PMID: 27387886]
Ma J, Prince AL, Bader D, et al. High-fat maternal diet during pregnancy persistently alters the offspring microbiome in a primate model. Nat Commun 2014; 5: 3889-4889.
[] [PMID: 24846660]
Chu DM, Antony KM, Ma J, et al. The early infant gut microbiome varies in association with a material high-fat diet. Genome Med 2016; 8: 77.
Connolly N, Anixt J, Manning P, Ping-I Lin D, Marsolo KA, Bowers K. Maternal metabolic risk factors for autism spectrum disorder-An analysis of electronic medical records and linked birth data. Autism Res 2016; 9(8): 829-37.
[] [PMID: 26824581]
Bulffington SA, Di. Prisco GV, Auchtung T A, Ajami NJ, Petrosino J F, Costa-Mattioli M. Microbal reconstitution revers maternal diet induced social and synaptic deficits in offspring. Cells 2016; 165: 1762-75.
Schultz ST, Klonoff-Cohen HS, Wingard DL, et al. Breastfeeding, infant formula supplementation, and Autistic disorder: the results of a parent survey. Int Breastfeed J 2006; 1: 16.
[] [PMID: 16978397]
Li Q, Ying H, Angel Belle C Dy, Randi JHagerman. The gut microbiota and autism spectrum disorders. Cell Neurosci 2017; 11: 120.
Santocchi E, Guiducci L, Fulceri F, et al. Gut to brain interaction in Autism Spectrum Disorders: a randomized controlled trial on the role of probiotics on clinical, biochemical and neurophysiological parameters. BMC Psychiatry 2016; 16: 183.
[] [PMID: 27260271]
Grossi E, Melli S, Dunca D, Terruzzi V. Unexpected improvement in core autism spectrum disorder symptoms after long-term treatment with probiotics. SAGE Open Med Case Rep 2016; 4: X16666231.
[] [PMID: 27621806]
Afaf El-Ansary, Naima Zayed. On the effectivenesses of probiotic as treatment strategy of autism. Nutr Food Sci 2018; 1: 1031031.
Wang LW, Tancredi DJ, Thomas DW. The prevalence of gastrointestinal problems in children across the United States with autism spectrum disorders from families with multiple affected members. J Dev Behav Pediatr 2011; 32(5): 351-60.
[] [PMID: 21555957]
de Magistris L, Familiari V, Pascotto A, et al. Alterations of the intestinal barrier in patients with autism spectrum disorders and in their first-degree relatives. J Pediatr Gastroenterol Nutr 2010; 51(4): 418-24.
[] [PMID: 20683204]
De Angelis M, Francavilla R, Piccolo M, De Giacomo A, Gobbetti M. Autism spectrum disorders and intestinal microbiota. Gut Microbes 2015; 6(3): 207-13.
[] [PMID: 25835343]
Li X, Chauhan A, Sheikh AM, et al. Elevated immune response in the brain of autistic patients. J Neuroimmunol 2009; 207(1-2): 111-6.
[] [PMID: 19157572]
Finegold SM. Desulfovibrio species are potentially important in regressive autism. Med Hypotheses 2011; 77(2): 270-4.
[] [PMID: 21592674]
Finegold SM, Dowd SE, Gontcharova V, et al. Pyrosequencing study of fecal microflora of autistic and control children. Anaerobe 2010; 16(4): 444-53.
[] [PMID: 20603222]
Rogers GB, Keating DJ, Young RL, Wong ML, Licinio J, Wesselingh S. From gut dysbiosis to altered brain function and mental illness: Mechanisms and pathways. Mol Psychiatry 2016; 21(6): 738-48.
[] [PMID: 27090305]
Sharon G, Sampson TR, Geschwind DH, Mazmanian SK. The central nervous system and the gut microbiome. Cell 2016; 167(4): 915-32.
[] [PMID: 27814521]
McElhanon BO, McCracken C, Karpen S, Sharp WG. Gastrointestinal symptoms in autism spectrum disorder: A meta-analysis. Pediatrics 2014; 133(5): 872-83.
[] [PMID: 24777214]
Braak H, Rüb U, Gai WP, Del Tredici K. Idiopathic Parkinson’s disease: Possible routes by which vulnerable neuronal types may be subject to neuroinvasion by an unknown pathogen. J Neural Transm (Vienna) 2003; 110(5): 517-36.
[] [PMID: 12721813]
McCarthy M, AddingtomHall J, Altmann D. The experience of dying with dementia: A restrospective study. Int J Geriatr Psychiatry 1977; 12: 404-9.
[<404::AID-GPS529>3.0.CO;2-2] [PMID: 9152728]
Hallmayer J, Cleveland S, Torres A, et al. Genetic heritability and shared environmental factors among twin pairs with autism. Arch Gen Psychiatry 2011; 68(11): 1095-102.
[] [PMID: 21727249]
Grimaldi R, Sela D, Swann JR, et al. In vitro fermentation of B-GOS: impact on fecal bacterial population and metabolic activity in autistic and non-autistic children FEMS. Microb Ecol 2017; 93(2): fiw233.
Bravo JA, Forsythe P, Chew MV, et al. Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. Proc Natl Acad Sci USA 2011; 108(38): 16050-5.
[] [PMID: 21876150]
Gomez-Euguilaz M, Ramón TJL, Pérez-Martínez L, Blanco JR. The microbiota-gut-brain axis and its large projections. Rev Neurol 2019; 68: 11-117.
Carabotti M, Scirocco A, Maselli MA, Severi C. The gut-brain axis: Interactions between enteric microbiota, central and enteric nervous systems. Ann Gastroenterol 2015; 28(2): 203-9.
[PMID: 25830558]
Spiller R, Major G. IBS and IBD - Separate entities or on a spectrum? Nat Rev Gastroenterol Hepatol 2016; 13(10): 613-21.
[] [PMID: 27667579]
Mulder EJ, Anderson GM, Kema IP, et al. Platelet serotonin levels in pervasive developmental disorders and mental retardation: Diagnostic group differences, within-group distribution, and behavioral correlates. J Am Acad Child Adolesc Psychiatry 2004; 43(4): 491-9.
[] [PMID: 15187810]
Marler S, Ferguson BJ, Lee EB, et al. Brief report: Whole blood serotomin levels and gasrttrointestinal symptoms in autism spectroum disorder. J Autism Dev Disord 2016; 46(3): 1124-30.
[] [PMID: 26527110]
Hata T, Asano Y, Yoshihara K, et al. Regulation of gut luminal serotonin by commensal microbiota in mice. PLoS One 2017; 12(7): e0180745.
[] [PMID: 28683093]
Forsythe P, Bienenstock J, Kunze WA. Vagal pathways for microbiome-brain-gut axis communication. Adv Exp Med Biol 2014; 817: 115-33.
[] [PMID: 24997031]
Wang L, Christophersen CT, Sorich MJ, Gerber JP, Angley MT, Conlon MA. Elevated fecal short chain fatty acid and ammonia concentrations in children with autism spectrum disorder. Dig Dis Sci 2012; 57(8): 2096-102.
[] [PMID: 22535281]
Ashood P, Krakowiak P, Hertz Picciotto L, Hansen R, Pessah I, Van de Water I. Elevated plasma cytokine in autism spectrum disorders provide evidence of immune dysfunction and are associated with impaired behavioral outcome. Brain Behav Immun 2011; 25: 10-45.
Garibay EV, Verde ER. Pediatric nutrition in Latin America. Nestle Nutrition Institute Workshop LATAM. 1: 414.
Alvarez Calatayuc G, Azpiroz F. Use of probiotics and prebiotics in primary care. Nutr Hosp 2015; 31: 59-63.
Sanctuary MR, Kain JN, Chen SY, et al. Pilot study of probiotic/colostrum supplementation on gut function in children with autism and gastrointestinal symptoms. PLoS One 2019; 14(1): e0210064.
[] [PMID: 30625189]
Chidambaram SB, Tuladhar S, Bhat A, et al. Autism and gut brain axis: Role of probiotics. Adv Neurobiol 2020; 24: 587-600.
[] [PMID: 32006375]
Shaaban SY, El Gendy YG, Mehanna NS, et al. The role of probiotics in children with autism spectrum disorder: A prospective, open-label study. Nutr Neurosci 2018; 21(9): 676-81.
[] [PMID: 28686541]
West R, Roberts E, Sichel L. Improvement in gastrointestinal symptoms among children with autism spectrum disorder receiving the Delpro® Probiotic and inmunomododulator formulations. J Prob Health 2013; 1: 102.
Kałużna-Czaplińska J, Błaszczyk S. The level of arabinitol in autistic children after probiotic therapy. Nutrition 2012; 28(2): 124-6.
[] [PMID: 22079796]
Arnold LE, Luna RA, Williams K, et al. Probiotics for gastrointestinal symptoms and quality of life in Autism: A placebo-controlled piloy trial. J Child Adolesc Psychopharmacol 2019; 29(9): 659-69.
[] [PMID: 31478755]
Severance EG, Gressitt KL, Stallings CR, et al. Probiotic normalization of Candida albicans in schizophrenia: A randomized, placebo-controlled, longitudinal pilot study. Brain Behav Immun 2017; 62: 41-5.
[] [PMID: 27871802]
Kang W, Adams J, Gregory A, et al. Microbiota transfer therapy alters gut ecosystem and improves gastrointestinal and autism symptoms: An open-label study. Microbiome 2017; 5: 10.
Kang W, Adams J, Coleman D, Pollard E, Maldonado J, Mc.Donough-Means S. Long-term benefit of microbiota transfer therapy on autism symptoms and gut microbiota. Sci Rep 2019; 9: 6821.
Skott E, Yang LL, Stiernborg M, et al. Effects of a synbiotic on symptoms, and daily functioning in attention deficit hyperactivity disorder - A double-blind randomized controlled trial. Brain Behav Immun 2020; 89: 9-19.
[] [PMID: 32497779]

Rights & Permissions Print Export Cite as
© 2023 Bentham Science Publishers | Privacy Policy