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Journal of Autism and Developmental Disorders
Gepubliceerd in:

20-04-2022 | Original Paper

Determinants of Leaky Gut and Gut Microbiota Differences in Children With Autism Spectrum Disorder and Their Siblings

Auteurs: Gülsüm Yitik Tonkaz, Ibrahim Selçuk Esin, Bahadir Turan, Hakan Uslu, Onur Burak Dursun

Gepubliceerd in: Journal of Autism and Developmental Disorders | Uitgave 7/2023

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Abstract

Leaky gut hypothesis is one of the well-known theory which tries to explain etiology of Autism Spectrum Disorder (ASD). Unfortunately there is still a gap of evidence to investigate the corner points of the hypothesis. The aim of this study was to investigate the determinants of leaky gut in children with ASD, their siblings and healthy controls. Intestinal microbiota was found to be similar between ASD and sibling groups. Biological markers of bacterial translocation showed a significant difference in the sibling group, whereas the marker indicating local inflammation was not different between the groups. The findings from this study did not support the role of Gut microbiota or leaky gut on the etiology of autism.
vorige artikel Attitudes Toward Inclusion and Benefits Perceived by Families in Schools with Students with Autism Spectrum Disorders
volgende artikel High School Math and Motivation for autistic students
Literatuur
Adams, J. B., Johansen, L. J., Powell, L. D., Quig, D., & Rubin, R. A. (2011). Gastrointestinal flora and gastrointestinal status in children with autism–comparisons to typical children and correlation with autism severity. BMC gastroenterology, 11(1), 1–13CrossRef
Alibrahim, B., Aljasser, M. I., & Salh, B. (2015). Fecal calprotectin use in inflammatory bowel disease and beyond: a mini-review.Canadian Journal of Gastroenterology and Hepatology, 29
Andreo-Martínez, P., Rubio-Aparicio, M., Sánchez-Meca, J., Veas, A., & Martínez-González, A. E. (2021). A Meta-analysis of Gut Microbiota in Children with Autism.Journal of autism and developmental disorders,1–14
Andreo-Martínez, P., García‐Martínez, N., Sánchez‐Samper, E. P., & Martínez‐González, A. E. (2020). An approach to gut microbiota profile in children with autism spectrum disorder. Environmental microbiology reports, 12(2), 115–135PubMedCrossRef
Babinska, K., Tomova, A., Celušáková, H., Babkova, J., Repiska, G., Kubranska, A., & Ostatnikova, D. (2017). Fecal calprotectin levels correlate with main domains of the autism diagnostic interview-revised (ADI-R) in a sample of individuals with autism spectrum disorders from Slovakia. Physiol Res, 66(Suppl 4), S517–S522PubMedCrossRef
Bergey, D. H. (1994). Bergey’s manual of determinative bacteriology. Lippincott Williams & Wilkins
Clarke, G., Grenham, S., Scully, P., Fitzgerald, P., Moloney, R., Shanahan, F., & Cryan, J. (2013). The microbiome-gut-brain axis during early life regulates the hippocampal serotonergic system in a sex-dependent manner. Molecular psychiatry, 18(6), 666–673PubMedCrossRef
Coretti, L., Paparo, L., Riccio, M. P., Amato, F., Cuomo, M., Natale, A., & Comegna, M. (2018). Gut microbiota features in young children with autism spectrum disorders. Frontiers in microbiology, 9, 3146PubMedPubMedCentralCrossRef
De Angelis, M., Piccolo, M., Vannini, L., Siragusa, S., De Giacomo, A., Serrazzanetti, D. I., & Francavilla, R. (2013). Fecal microbiota and metabolome of children with autism and pervasive developmental disorder not otherwise specified.PloS one, 8(10), e76993
de Magistris, L., Familiari, V., Pascotto, A., Sapone, A., Frolli, A., Iardino, P., & Riegler, G. (2010). Alterations of the intestinal barrier in patients with autism spectrum disorders and in their first-degree relatives. Journal of pediatric gastroenterology and nutrition, 51(4), 418–424PubMedCrossRef
de Theije, C. G., Wu, J., Silva, D., Kamphuis, S. L., Garssen, P. J., Korte, J., S. M., & Kraneveld, A. D. (2011). Pathways underlying the gut-to-brain connection in autism spectrum disorders as future targets for disease management. European journal of pharmacology, 668, S70–S80PubMedCrossRef
Delroisse, J. M., Boulvin, A. L., Parmentier, I., Dauphin, R. D., Vandenbol, M., & Portetelle, D. (2008). Quantification of Bifidobacterium spp. and Lactobacillus spp. in rat fecal samples by real-time PCR. Microbiological research, 163(6), 663–670PubMedCrossRef
Dinh, D. M., Volpe, G. E., Duffalo, C., Bhalchandra, S., Tai, A. K., Kane, A. V., & Ward, H. D. (2014). Intestinal microbiota, microbial translocation, and systemic inflammation in chronic HIV infection. The Journal of infectious diseases, 211(1), 19–27PubMedPubMedCentralCrossRef
Dursun, O., Guvenir, T., Aras, S., Ergin, C., Mutlu, C., Baydur, H., & Iscanli, L. (2013). A new diagnostic approach for Turkish speaking populations DAWBA Turkish Version. Epidemiology and psychiatric sciences, 22(3), 275–282PubMedCrossRef
Elder, J. H., Shankar, M., Shuster, J., Theriaque, D., Burns, S., & Sherrill, L. (2006). The gluten-free, casein-free diet in autism: results of a preliminary double blind clinical trial. Journal of autism and developmental disorders, 36(3), 413–420PubMedCrossRef
Emanuele, E., Orsi, P., Boso, M., Broglia, D., Brondino, N., Barale, F., & Politi, P. (2010a). Low-grade endotoxemia in patients with severe autism. Neuroscience letters, 471(3), 162–165PubMedCrossRef
Emanuele, E., Orsi, P., Boso, M., Broglia, D., Brondino, N., Barale, F., & Politi, P. (2010b). Low-grade endotoxemia in patients with severe autism. Neurosci Lett, 471(3), 162–165. doi:10.1016/j.neulet.2010b.01.033CrossRefPubMed
ERSÖZ ALAN, B., & Gülerman, F. (2019). The Role of Gut Microbiota in Autism Spectrum Disorder.Turk Psikiyatri Dergisi, 30(3)
Esnafoglu, E., Cırrık, S., Ayyıldız, S. N., Erdil, A., Ertürk, E. Y., Daglı, A., & Noyan, T. (2017). Increased serum zonulin levels as an intestinal permeability marker in autistic subjects. The Journal of Pediatrics, 188, 240–244PubMedCrossRef
Fattorusso, A., Di Genova, L., Dell’Isola, G. B., Mencaroni, E., & Esposito, S. (2019). Autism spectrum disorders and the gut microbiota. Nutrients, 11(3), 521PubMedPubMedCentralCrossRef
Fernell, E., Fagerberg, U. L., & Hellström, P. M. (2007). No evidence for a clear link between active intestinal inflammation and autism based on analyses of faecal calprotectin and rectal nitric oxide. Acta paediatrica, 96(7), 1076–1079PubMedCrossRef
Finegold, S. M., Dowd, S. E., Gontcharova, V., Liu, C., Henley, K. E., Wolcott, R. D., & Dixon, D. (2010). Pyrosequencing study of fecal microflora of autistic and control children. Anaerobe, 16(4), 444–453PubMedCrossRef
First, M. B. (2013). DSM-5 handbook of differential diagnosis. American Psychiatric Pub
Funda, D. P., Tučková, L., Farré, M. A., Iwase, T., Moro, I., & Tlaskalová-Hogenová, H. (2001). CD14 is expressed and released as soluble CD14 by human intestinal epithelial cells in vitro: lipopolysaccharide activation of epithelial cells revisited. Infection and immunity, 69(6), 3772–3781PubMedPubMedCentralCrossRef
Ghalichi, F., Ghaemmaghami, J., Malek, A., & Ostadrahimi, A. (2016). Effect of gluten free diet on gastrointestinal and behavioral indices for children with autism spectrum disorders: a randomized clinical trial. World Journal of Pediatrics, 12(4), 436–442PubMedCrossRef
Gondalia, S. V., Palombo, E. A., Knowles, S. R., Cox, S. B., Meyer, D., & Austin, D. W. (2012). Molecular characterisation of gastrointestinal microbiota of children with autism (with and without gastrointestinal dysfunction) and their neurotypical siblings. Autism Research, 5(6), 419–427PubMedCrossRef
González-Sarrías, A., Romo‐Vaquero, M., García‐Villalba, R., Cortés‐Martín, A., Selma, M. V., & Espín, J. C. (2018). The Endotoxemia Marker Lipopolysaccharide‐Binding Protein is Reduced in Overweight‐Obese Subjects Consuming Pomegranate Extract by Modulating the Gut Microbiota: A Randomized Clinical Trial. Molecular nutrition & food research, 62(11), 1800160CrossRef
Guo, X., Xia, X., Tang, R., Zhou, J., Zhao, H., & Wang, K. (2008). Development of a real-time PCR method for Firmicutes and Bacteroidetes in faeces and its application to quantify intestinal population of obese and lean pigs. Letters in applied microbiology, 47(5), 367–373PubMedCrossRef
Heijtz, R. D., Wang, S., Anuar, F., Qian, Y., Björkholm, B., Samuelsson, A., & Pettersson, S. (2011). Normal gut microbiota modulates brain development and behavior. Proceedings of the National Academy of Sciences, 108(7), 3047–3052
Hsiao, E. Y., McBride, S. W., Hsien, S., Sharon, G., Hyde, E. R., McCue, T., & Petrosino, J. F. (2013). The microbiota modulates gut physiology and behavioral abnormalities associated with autism. Cell, 155(7), 1451PubMedPubMedCentralCrossRef
Hsu, C. L., Lin, C., Chen, C. L., Wang, C. M., & Wong, M. (2009). The effects of a gluten and casein-free diet in children with autism: a case report. Chang Gung Med J, 32(4), 459–465PubMed
Iglesias-Vázquez, L., Van Ginkel Riba, G., Arija, V., & Canals, J. (2020). Composition of gut microbiota in children with autism spectrum disorder: A systematic review and meta-analysis. Nutrients, 12(3), 792PubMedPubMedCentralCrossRef
Ikhtaire, S., Shajib, M. S., Reinisch, W., & Khan, W. I. (2016). Fecal calprotectin: its scope and utility in the management of inflammatory bowel disease. Journal of gastroenterology, 51(5), 434–446PubMedCrossRef
Jiang, N. M., Tofail, F., Ma, J. Z., Haque, R., Kirkpatrick, B., Nelson, I. I. I., C. A., & Petri, W. A. Jr. (2017). Early life inflammation and neurodevelopmental outcome in Bangladeshi infants growing up in adversity. The American journal of tropical medicine and hygiene, 97(3), 974–979PubMedPubMedCentralCrossRef
Johansson, V., Jakobsson, J., Fortgang, R. G., Zetterberg, H., Blennow, K., Cannon, T. D., & Landén, M. (2017). Cerebrospinal fluid microglia and neurodegenerative markers in twins concordant and discordant for psychotic disorders. European archives of psychiatry and clinical neuroscience, 267(5), 391–402PubMedCrossRef
Karaağaoğlu, N., & Samur, G. E. (2011). Anne ve çocuk beslenmesi. Ankara, Pegem Akademi
Kawicka, A., & Regulska-Ilow, B. (2013). How nutritional status, diet and dietary supplements can affect autism. A review.Roczniki Państwowego Zakładu Higieny, 64(1)
Kushak, R. I., Buie, T. M., Murray, K. F., Newburg, D. S., Chen, C., Nestoridi, E., & Winter, H. S. (2016). Evaluation of intestinal function in children with autism and gastrointestinal symptoms. Journal of pediatric gastroenterology and nutrition, 62(5), 687–691PubMedCrossRef
Lange, K. W., Hauser, J., & Reissmann, A. (2015). Gluten-free and casein-free diets in the therapy of autism. Current Opinion in Clinical Nutrition & Metabolic Care, 18(6), 572–575CrossRef
Lien, E., Aukrust, P., Sundan, A., Müller, F., Frøland, S. S., & Espevik, T. (1998). Elevated levels of serum-soluble CD14 in human immunodeficiency virus type 1 (HIV-1) infection: correlation to disease progression and clinical events. Blood, 92(6), 2084–2092PubMedCrossRef
Liu, S., Li, E., Sun, Z., Fu, D., Duan, G., Jiang, M., & Tang, Y. (2019). Altered gut microbiota and short chain fatty acids in Chinese children with autism spectrum disorder. Scientific reports, 9(1), 1–9
Liu, Z., Li, N., & Neu, J. (2005). Tight junctions, leaky intestines, and pediatric diseases. Acta paediatrica, 94(4), 386–393PubMedCrossRef
Ma, B., Liang, J., Dai, M., Wang, J., Luo, J., Zhang, Z., & Jing, J. (2019). Altered gut microbiota in chinese children with autism spectrum disorders. Frontiers in cellular and infection microbiology, 9, 40PubMedPubMedCentralCrossRef
Manco, M., Putignani, L., & Bottazzo, G. F. (2010). Gut microbiota, lipopolysaccharides, and innate immunity in the pathogenesis of obesity and cardiovascular risk. Endocrine reviews, 31(6), 817–844PubMedCrossRef
Martínez-González, A. E., & Andreo-Martínez, P. (2019). The role of gut microbiota in gastrointestinal symptoms of children with ASD. Medicina, 55(8), 408PubMedPubMedCentralCrossRef
McCann, D., Barrett, A., Cooper, A., Crumpler, D., Dalen, L., Grimshaw, K., & Prince, E. (2007). Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial. The Lancet, 370(9598), 1560–1567CrossRef
McElhanon, B. O., McCracken, C., Karpen, S., & Sharp, W. G. (2014). Gastrointestinal symptoms in autism spectrum disorder: a meta-analysis. Pediatrics, 133(5), 872–883PubMedCrossRef
Nadkarni, M. A., Martin, F. E., Jacques, N. A., & Hunter, N. (2002). Determination of bacterial load by real-time PCR using a broad-range (universal) probe and primers set. Microbiology, 148(1), 257–266PubMedCrossRef
Ongol, M. P., & Asano, K. (2009). Main microorganisms involved in the fermentation of Ugandan ghee. International journal of food microbiology, 133(3), 286–291PubMedCrossRef
Ott, S. J., Musfeldt, M., Ullmann, U., Hampe, J., & Schreiber, S. (2004). Quantification of intestinal bacterial populations by real-time PCR with a universal primer set and minor groove binder probes: a global approach to the enteric flora. Journal of clinical microbiology, 42(6), 2566–2572PubMedPubMedCentralCrossRef
Parracho, H. M., Bingham, M. O., Gibson, G. R., & McCartney, A. L. (2005). Differences between the gut microflora of children with autistic spectrum disorders and that of healthy children. Journal of medical microbiology, 54(10), 987–991PubMedCrossRef
Pennesi, C. M., & Klein, L. C. (2012). Effectiveness of the gluten-free, casein-free diet for children diagnosed with autism spectrum disorder: based on parental report. Nutritional neuroscience, 15(2), 85–91PubMedCrossRef
Peretti, S., Mariano, M., Mazzocchetti, C., Mazza, M., Pino, M., Di Pianella, V., A., & Valenti, M. (2019). Diet: the keystone of autism spectrum disorder? Nutritional neuroscience, 22(12), 825–839PubMedCrossRef
Plaza-Díaz, J., Gómez-Fernández, A., Chueca, N., Torre-Aguilar, M. J., Gil, Á., Perez-Navero, J. L., & Ruiz-Ojeda, F. J. (2019). Autism spectrum disorder (ASD) with and without mental regression is associated with changes in the fecal microbiota. Nutrients, 11(2), 337PubMedPubMedCentralCrossRef
Pusponegoro, H. D., Ismael, S., Sastroasmoro, S., Firmansyah, A., & Vandenplas, Y. (2015). Maladaptive behavior and gastrointestinal disorders in children with autism spectrum disorder. Pediatric gastroenterology, hepatology & nutrition, 18(4), 230CrossRef
Qin, L., Wu, X., Block, M. L., Liu, Y., Breese, G. R., Hong, J. S., & Crews, F. T. (2007). Systemic LPS causes chronic neuroinflammation and progressive neurodegeneration. Glia, 55(5), 453–462PubMedPubMedCentralCrossRef
Rellini, E., Tortolani, D., Trillo, S., Carbone, S., & Montecchi, F. (2004). Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) correspondence and conflicts with DSM-IV criteria in diagnosis of autism. Journal of autism and developmental disorders, 34(6), 703–708PubMedCrossRef
Riccio, P., & Rossano, R. (2019). Undigested food and gut microbiota may cooperate in the pathogenesis of neuroinflammatory diseases: a matter of barriers and a proposal on the origin of organ specificity. Nutrients, 11(11), 2714PubMedPubMedCentralCrossRef
Rinttilä, T., Kassinen, A., Malinen, E., Krogius, L., & Palva, A. (2004). Development of an extensive set of 16S rDNA-targeted primers for quantification of pathogenic and indigenous bacteria in faecal samples by real‐time PCR. Journal of applied microbiology, 97(6), 1166–1177PubMedCrossRef
Rose, D. R., Yang, H., Serena, G., Sturgeon, C., Ma, B., Careaga, M., & Hertz-Picciotto, I. (2018). Differential immune responses and microbiota profiles in children with autism spectrum disorders and co-morbid gastrointestinal symptoms. Brain, behavior, and immunity, 70, 354–368PubMedPubMedCentralCrossRef
Schneider, C. K., Melmed, R. D., Barstow, L. E., Enriquez, F. J., Ranger-Moore, J., & Ostrem, J. A. (2006). Oral human immunoglobulin for children with autism and gastrointestinal dysfunction: a prospective, open-label study. Journal of autism and developmental disorders, 36(8), 1053–1064PubMedCrossRef
Schopler, E., Reichler, R. J., & Renner, B. R. (2010). The childhood autism rating scale (CARS). WPS Los Angeles
Severance, E. G., Gressitt, K. L., Stallings, C. R., Origoni, A. E., Khushalani, S., Leweke, F. M., & Yolken, R. H. (2013). Discordant patterns of bacterial translocation markers and implications for innate immune imbalances in schizophrenia. Schizophrenia research, 148(1–3), 130–137PubMedCrossRef
Son, J. S., Zheng, L. J., Rowehl, L. M., Tian, X., Zhang, Y., Zhu, W., & Robertson, C. E. (2015). Comparison of fecal microbiota in children with autism spectrum disorders and neurotypical siblings in the simons simplex collection. PloS one, 10(10), e0137725PubMedPubMedCentralCrossRef
Song, Y., Liu, C., & Finegold, S. M. (2004). Real-time PCR quantitation of clostridia in feces of autistic children. Applied and environmental microbiology, 70(11), 6459–6465PubMedPubMedCentralCrossRef
Strati, F., Cavalieri, D., Albanese, D., De Felice, C., Donati, C., Hayek, J., & Calabrò, A. (2017). New evidences on the altered gut microbiota in autism spectrum disorders. Microbiome, 5(1), 1–11CrossRef
Tomova, A., Husarova, V., Lakatosova, S., Bakos, J., Vlkova, B., Babinska, K., & Ostatnikova, D. (2015). Gastrointestinal microbiota in children with autism in Slovakia. Physiology & behavior, 138, 179–187CrossRef
Türkay, Ö., & Saka, M. (2016). Konstipasyon ve diyet. Güncel Gastroenteroloji, 20(3), 234–239
Wang, L., Christophersen, C. T., Sorich, M. J., Gerber, J. P., Angley, M. T., & Conlon, M. A. (2011a). Low relative abundances of the mucolytic bacterium Akkermansia muciniphila and Bifidobacterium spp. in feces of children with autism. Applied and environmental microbiology, 77(18), 6718–6721PubMedPubMedCentralCrossRef
Wang, L. W., Tancredi, D. J., & Thomas, D. W. (2011b). The prevalence of gastrointestinal problems in children across the United States with autism spectrum disorders from families with multiple affected members. Journal of Developmental & Behavioral Pediatrics, 32(5), 351–360CrossRef
Williams, B. L., Hornig, M., Buie, T., Bauman, M. L., Paik, C., Wick, M., & Lipkin, I., W. I (2011a). Impaired carbohydrate digestion and transport and mucosal dysbiosis in the intestines of children with autism and gastrointestinal disturbances. PloS one, 6(9), e24585PubMedPubMedCentralCrossRef
Williams, B. L., Hornig, M., Buie, T., Bauman, M. L., Paik, M. C., Wick, I., & Lipkin, W. I. (2011b). Impaired carbohydrate digestion and transport and mucosal dysbiosis in the intestines of children with autism and gastrointestinal disturbances. PloS one, 6(9), e24585PubMedPubMedCentralCrossRef
Xu, M., Xu, X., Li, J., & Li, F. (2019). Association between gut microbiota and autism spectrum disorder: a systematic review and meta-analysis. Frontiers in psychiatry, 10, 473PubMedPubMedCentralCrossRef
Yang, X. L., Liang, S., Zou, M. Y., Sun, C. H., Han, P. P., Jiang, X. T., & Wu, L. J. (2018). Are gastrointestinal and sleep problems associated with behavioral symptoms of autism spectrum disorder? Psychiatry research, 259, 229–235PubMedCrossRef
Zablotsky, B., Black, L. I., Maenner, M. J., Schieve, L. A., & Blumberg, S. J. (2015). Estimated prevalence of autism and other developmental disabilities following questionnaire changes in the 2014 National Health Interview Survey
Zhu, J., Guo, M., Yang, T., Lai, X., Lei, Y., He, M., & Li, T. (2017). Association between behavioral problems and gastrointestinal disorders among children with autism spectrum disorder. Zhonghua er ke za zhi = Chinese Journal of Pediatrics, 55(12), 905–910PubMed
Metagegevens
Titel
Determinants of Leaky Gut and Gut Microbiota Differences in Children With Autism Spectrum Disorder and Their Siblings
Auteurs
Gülsüm Yitik Tonkaz
Ibrahim Selçuk Esin
Bahadir Turan
Hakan Uslu
Onur Burak Dursun
Publicatiedatum
20-04-2022
Uitgeverij
Springer US
Gepubliceerd in
Journal of Autism and Developmental Disorders / Uitgave 7/2023
Print ISSN: 0162-3257
Elektronisch ISSN: 1573-3432
DOI
https://doi.org/10.1007/s10803-022-05540-z

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