nei THIS MONTH IN
PSYCHOPHARMACOLOGY
Microbiota Transfer For Autism
March 31, 2017   

A newly published study investigating the effects of microbiota transfer therapy (MTT) on gastrointestinal and behavioral symptoms may be the first step toward developing a potentially effective, long-lasting, and well-tolerated treatment for children with autism. Although the causes of autism are complex and largely undetermined, it has been known for quite some time that the gut microbiome (the collection of bacteria and viruses) is often abnormal in patients with autism spectrum disorders (ASD). Not only does a dysbiotic gut microbiome lead to gastrointestinal (GI) issues; the latest data indicate a profound two-way connection between the gut microbiome and the brain. Thus, a dysregulated gut microbiome may contribute to the aberrant behaviors evidenced in several psychiatric conditions, including ASD. In this small study involving 18 children (ages 7-16) with ASD and GI issues (as well as 20 matched, neurotypical children), an MTT treatment regimen consisting of 14 days of oral vancomycin (an antibiotic to suppress pathogenic bacteria), followed by 12-24 hours of fasting and bowel cleansing, then a high initial dose of Standardized Human Gut Microbiota (derived from healthy stool samples) administered either orally or rectally followed by lower, daily oral doses for 7-8 weeks. A stomach acid suppressor (to reduce stomach acidity) was also administered throughout the course of treatment. The investigators found that MTT normalized the gut microbiome, significantly improved GI issues, reduced autism symptom severity, and ameliorated a wide range of autism symptoms including social skill deficits, stereotypical behaviors, and communication issues. Excitingly, these beneficial effects of MTT were maintained for at least 8 weeks following cessation of treatment. Another positive note was that both rectal and oral administration of the initial high-dose of Standardized Human Gut Microbiota appeared to be equally effective.

Although this was a small, non-randomized, non-placebo-controlled study, the investigation was quite comprehensive and the results very promising. Further studies involving a larger sample size are definitely warranted and eagerly anticipated.


     Additional Resources:

Encore Presentation Clip:
Fecal Transplant Studies and Mental Health

Dr. Roger McIntyre discussing fecal transplant at the 2016 NEI Synapse meeting.

References:

Kang, D-W, Adams JB, Gregory AC et al. Microbiota transfer therapy alters gut ecosystem and improves gastrointestinal and autism symptoms: an open-label study. Microbiome 2017;5:10.

>> Kang DW, Adams JB, Gregory AC, et al. Microbiome. 2017;5(1):10.