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ABSTRACT: There is growing interest in the role of gastrointestinal (GI) pathology and clinical expression of autism. Recent studies have demonstrated differences in the faecal clostridial populations harboured by autistic and non-autistic children. The potential of Lactobacillus plantarum WCSF1 (a probiotic) to modulate the gut microbiota of autistic subjects was investigated during a double-blind, placebo-controlled, crossover-designed feeding study. The faecal microbiota, gut function and behaviour scores of subjects were examined throughout the 12-week study. Lactobacillus plantarum WCFS1 feeding significantly increased Lab158 counts (lactobacilli and enterococci group) and significantly reduced Erec482 counts (Clostridium cluster XIVa) compared to placebo. Probiotic feeding also resulted in significant differences in the stool consistency compared to placebo and behaviour scores (total score and scores for some subscales) compared to baseline. The major finding of this work was the importance of study protocol in relation to the specific considerations of this subject population, with an extremely high dropout rate seen (predominantly during the baseline period). Furthermore, the relatively high inter-individual variability observed suggests that subsequent studies should use defined subgroups of autistic spectrum disorders, such as regressive or late-onset autism. In summary, the current study has highlighted the potential benefit of L. plantarum WCFS1 probiotic feeding in autistic individuals.
KEY WORDS: Autism, Gut Microbiota, Lactobacillus plantarum, Probiotics
Abbreviations: ASD, autistic spectrum disorder; FISH, fluorescence in situ hybridization; GI, gastrointestinal.
INTRODUCTION
Autistic spectrum disorders (ASDs) are complex developmental disorders, which affect a number of systems including behaviour, imagination and communication (Wing, 1997). Various theories on causes and triggers have been proposed; however, the aetiology of ASD remains unknown (O'Sullivan, 2000). The majority of individuals with ASD frequently develop gastrointestinal (GI) abnormalities (Kidd, 2003). The most common GI symptoms include constipation, diarrhoea, abdominal discomfort, bloating, gaseousness and distension (White, 2003).
Studies have suggested that certain clostridial populations may be associated with autism (Bolte, 1998). Studies by Finegold et al. (2002) and Song et al. (2004) have shown distinctive Clostridium species in autistic children compared with healthy controls. Parracho et al. (2005) also demonstrated that the faecal microbiota of children with ASD contains a higher incidence of Clostridium clusters I and II compared with non-ASD control groups (siblings or unrelated children). Addressing an imbalanced intestinal microbiota in ASD could be an important step...