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Significance of this study/article
Evidence indicates that gut bacteria may be at the crossroads of genetics, digetsive enzymes of autism spectrum disorders. This study of altered corroborates the hypothesis and provides clues to how altered bacteria may be involved in causing and sustaining autism.
Furthermore, it provides further support for role of dietary manipulation and probiotics in the management of autism as a whole and not just for gastrointestinal disorders or manifestations.
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Background
Patients with autism spectrum disorders frequently suffer from gastrointestinal problems. The severity of gastrointestinal problems correlate with severity of many of the neuropsychological symptoms of autism.
- While multiple pathophysiological mechanisms have been proposed as part of pathogenesis, the role of intestinal bacteria in autism is receiving increasing attention.
- The mechanisms through which the gastrointestinal bacteria may participate in pathogenesis continues to be mired in debate and is a matter of continued research.
- It should be noted that short chain fatty acids (SCFAs) are essential for a healthy colon and serve as an important course of energy/nutrition for the colon wall.
Mechanism of action of gut bacteria in autism
Is It Leaky Gut or Leaky Gut Syndrome?
One of the mechanisms through which the intestinal bacteria may affect the human host is via their functionally active metabolic products of the bacterial fermentation of undigested food that reaches colon. Different bacteria act on different types of undigested carbohydrates or proteins.
- Different patterns of bacteria result in different bacterial products. Think like, some people have foul flatus while others not as much!
- Some of the fermentation products not only have genotoxic, mutation and cancer causing properties, they also adversely affect the beneficial lactic acid bacteria in the gut.
- Altered bacterial fermentation products may be the common link between the gastrointestinal and neurological dysfunction seen in autism.
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Fermented products of undigested carbohydrates in gut
- Short chain fatty acids (SCFAs)
Fermentation products of undigested protein in the gut
- Phenols, amines, and ammonia. Hydrogen sulfide is another very toxic compound and in environmental conditions, breathing in excess can even be fatal.
- All of above may be potentially toxic.
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Background of Autism-Bacterial Fermentation Products Study
Since the metabolic products of fermentation may be toxic, Wang and colleagues from the Sansom Institute for Health Research, University of South Australia, Adelaide, Australia studied the amount of various compounds resulting from bacterial fermentation of undigested food in stools of autism spectrum disorders subjects and healthy controls.
Study subjects in Autism-Bacterial Fermentation Products Study
- Age matched 23 subjects with autism and 31 controls.
- There was no difference in the nutrient intake including starch, proteins, fat, fiber and sugar. Three of the autism subjects were on gluten-free diet, while one was on casein-free diet.
- There was no difference in the probiotic or antibiotic intake between the two groups.
- There was no difference in stool output or pH.
Parameters studied
- Total short chain fatty acids (SCFAs)
- Individual SCFAs: Acetic acid, Propionic acid, Butyric acid, isobutyric acid, valeric acid, caproic acid
- Ammonia
- Phenols
Results of Autism-Bacterial Fermentation Products Study
- Both the total short chain fatty acids and ammonia levels were increased in stool of autism subjects.
- Concentrations of most individual SCFAs like acetic acid, propionic acid and butyrate were increased.
- In contrast, the concentrations of p-cresol and phenol were similar.
Significance of altered products of bacterial fermentation
Increased Propionic Acid
Of the short chain fatty acids, the increase in propionic acid was the most striking. This is significant because propionic acid can induce autism like behaviors in animals.
Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health
Increased Acetic Acid
- While it protects against certain bacteria, acetic acid is also toxic to the gut. It increases intestinal permeability aka leaky gut and is in fact used to induce colitis in animals for study of inflammatory bowel disease.
- Tjellstrom and colleagues from the Microbiology and Tumor Biology Center, Karolinska Institute, Stockholm, Sweden have shown that acetic acid is also increased in celiac disease which while primarily an intestinal disorder has manifestations beyond gut.
Increased Ammonia
- Ammonia level is a commonly performed test in patients with liver disease and brain dysfunction.
- The results of increased ammonia levels in the current study is consistent with previous studies on this topic.
- Like acetic acid, ammonia is also injurious to colon wall and increases intestinal permeability.
Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health
Explanation for differences in fermentation products in autism
- Differences in types of intestinal bacteria
- Differences in food intake; however the food intake was similar between the two groups the the study outlined above)
- Alterations in metabolic processes in the gut
- Differences in colon wall uptake
Conclusions of Autism-Bacterial fermentation products study
- Above results provide further circumstantial evidence that ASD is associated with a disturbance of bacterial fermentation processes in the gastrointestinal tract.
- It should be pointed out that a previous study by Adams and colleagues actually documented lower SCFAs in autism patients; however this was attributed primarily to use of probiotics in those patients.
Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health
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Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health
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