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Microbiota-based interventions for autism spectrum disorder: a systematic review of efficacy and clinical potential

Summary

This comprehensive review examines how modifications to gut bacteria through probiotics, prebiotics, synbiotics, and fecal transplants can help children with autism. The research found that while all these treatments showed some promise, fecal microbiota transplantation (FMT) produced the most consistent improvements in both autism-related behaviors and digestive symptoms. These microbiota-based approaches work through the gut-brain connection and were generally safe, making them potentially valuable additions to autism management strategies.

Background

Autism spectrum disorder (ASD) is increasingly linked to gut microbiota imbalances that influence both behavioral and gastrointestinal symptoms. Up to 70% of individuals with ASD experience GI issues, suggesting a bidirectional relationship between gut health and neurological outcomes mediated by the gut-brain axis.

Objective

This systematic review assesses the efficacy of microbiota-based interventions including probiotics, prebiotics, synbiotics, and fecal microbiota transplantation (FMT) in improving ASD-related behavioral and gastrointestinal symptoms to provide insights into their therapeutic potential.

Results

Among 33 studies, probiotics showed moderate behavioral improvements with multi-strain formulations more effective than single strains. Prebiotics and synbiotics yielded mixed results. FMT demonstrated the most consistent and sustained improvements in both ASD-related behaviors and GI function. Adverse events were minimal, primarily involving transient GI symptoms.

Conclusion

Microbiota-targeted interventions, particularly FMT, hold promise for managing ASD symptoms, though probiotics, prebiotics, and synbiotics present variable efficacy. Standardized protocols, larger controlled trials, and personalized microbiome-based approaches are necessary to refine these therapeutic strategies and enhance clinical applicability.
  • Published in:Frontiers in Microbiology,
  • Study Type:Systematic Review,
  • Source: PMC12512243, PMID: 41078532
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