摘要
Background: Autism spectrum disorder (ASD) is a complex developmental condition typically characterized by deficits in social and communicative behaviors as well as repetitive patterns of behaviors. Despite its prevalence (affecting 0.1% to 1.8% of the global population), the pathogenesis of ASD remains incompletely understood. Patients with ASD are reported to have more frequent gastrointestinal (GI) complaints. There is some anecdotal evidence that probiotics are able to alleviate GI symptoms as well as improve behavioral issues in children with ASD. However, systematic reviews of the effect of prebiotics/probiotics on ASD and its associated symptoms are lacking. Methods: Using the keywords (prebiotics OR probiotics OR microbiota OR gut) AND (autism OR social OR ASD), a systematic literature search was conducted on PubMed, EMBASE, Medline, Clinicaltrials.gov and Google Scholar databases. The inclusion criteria were original clinical trials, published in English between the period 1st January 1988 and 1st February 2019. Results: A total of eight clinical trials were systematically reviewed. Two clinical trials examined the use of prebiotic and/or diet exclusion while six involved the use of probiotic supplementation in children with ASD. Most of these were prospective, open-label studies. Prebiotics only improved certain GI symptoms; however, when combined with an exclusion diet (gluten and casein free) showed a significant reduction in anti-sociability scores. As for probiotics, there is limited evidence to support the role of probiotics in alleviating the GI or behavioral symptoms in children with ASD. The two available double-blind, randomized, placebo-controlled trials found no significant difference in GI symptoms and behavior. Conclusion: Despite promising preclinical findings, prebiotics and probiotics have demonstrated an overall limited efficacy in the management of GI or behavioral symptoms in children with ASD. In addition, there was no standardized probiotics regimen, with multiple different strains and concentrations of probiotics, and variable duration of treatments.
摘要译文
背景:自闭症谱系障碍(ASD)是一种复杂的发育状况,其特征在于社会和交流行为中的缺陷以及行为的重复模式。尽管其普遍存在(影响全球人口的0.1%至1.8%),但ASD的发病机制仍然不完全理解。据报道,患有ASD的患者具有更频繁的胃肠道(GI)抱怨。有一些轶事证据表明益生菌能够缓解GI症状,以及改善亚本儿童的行为问题。然而,对益生元/益生菌对ASD的影响及其相关症状的系统审查缺乏。方法:使用关键词(益生元或益生菌或微生物生物群或肠道)和(自闭症或社交或ASD),在PubMed,Embase,Medline,Clinicaltrials.gov和Google Scholar数据库上进行了系统文献搜索。纳入标准是原始的临床试验,在1988年1月1日至2019年2月1日之间发表英语。结果:系统地审查了八项临床试验。两项临床试验检测了益生元和/或饮食排除的使用,同时六个涉及使用亚当的儿童使用益生菌补充剂。其中大多数是前瞻性的开放标签研究。益生元只改善了某些GI症状;然而,当与排除饮食相结合时(麸质和酪蛋白)表现出抗足迹分数的显着降低。至于益生菌,有限的证据表明益生菌在减轻亚本儿童中的GI或行为症状方面的作用。两种可用的双盲,随机的安慰剂对照试验发现GI症状和行为没有显着差异。结论:尽管有前列的临床前发现,益生元和益生菌已经证明了在ASD的儿童的GI或行为症状的管理中表现出总体有限的疗效。此外,没有标准化的益生菌方案,具有多种不同的菌株和益生菌浓度,以及可变的治疗持续时间。
Qin Xiang Ng[ 1;2;[*]; Wayren Loke[ 1]; Nandini Venkatanarayanan[ 1;3]; Donovan Yutong Lim[ 4]; Alex Yu Sen Soh[ 3;5];Wee Song Yeo[ 3;5]. A Systematic Review of the Role of Prebiotics and Probiotics in Autism Spectrum Disorders[J]. Medicina, 2019,55(5): 129