Intestinal Permeability and Glucagon-like peptide-2 in Children with Autism: A Controlled Pilot Study

Robertson, M A; Sigalet, David L.; Holst, Jens J.; Meddings, Jon; Wood, Julie; Sharkey, Keith A.

doi:10.1007/s10803-007-0482-1

Cited by 43 publications

(28 citation statements)

References 37 publications

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“…Patients with autism on a reported GFCF diet had significantly lower intestinal permeability test values compared with those who were on an unrestricted diet and controls [20] . However, Robertson et al [21] did not detect any changes in intestinal permeability in a small cohort of ASD children. In another study, neither the L/M ratio nor behavioral scores were different between groups exposed to gluten/dairy or placebo.…”

Section: Gluten Sensitivity and Autismmentioning

confidence: 88%

Gluten Sensitivity

Catassi¹

2015

Ann Nutr Metab

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Non-celiac gluten sensitivity (NCGS) is a syndrome characterized by intestinal and extraintestinal symptoms related to the ingestion of gluten-containing food in subjects who are not affected by either celiac disease (CD) or wheat allergy (WA). The prevalence of NCGS is not clearly defined yet. Indirect evidence suggests that NCGS is slightly more common than CD, the latter affecting around 1% of the general population. NCGS has been mostly described in adults, particularly in females in the age group of 30-50 years; however, pediatric case series have also been reported. Since NCGS may be transient, gluten tolerance needs to be reassessed over time in patients with NCGS. NCGS is characterized by symptoms that usually occur soon after gluten ingestion, disappear with gluten withdrawal, and relapse following gluten challenge within hours/days. The ‘classical' presentation of NCGS is a combination of irritable bowel syndrome-like symptoms, including abdominal pain, bloating, bowel habit abnormalities (either diarrhea or constipation), and systemic manifestations such as ‘foggy mind', headache, fatigue, joint and muscle pain, leg or arm numbness, dermatitis (eczema or skin rash), depression, and anemia. In recent years, several studies explored the relationship between the ingestion of gluten-containing food and the appearance of neurological and psychiatric disorders/symptoms like ataxia, peripheral neuropathy, schizophrenia, autism, depression, anxiety, and hallucinations (so-called gluten psychosis). The diagnosis of NCGS should be considered in patients with persistent intestinal and/or extraintestinal complaints showing a normal result of the CD and WA serological markers on a gluten-containing diet, usually reporting worsening of symptoms after eating gluten-rich food. NCGS should not be an exclusion diagnosis only. Unfortunately, no biomarker is sensitive and specific enough for diagnostic purposes; therefore, the diagnosis of NCGS is currently based on establishing a clear-cut cause-effect relationship between the ingestion of gluten and the appearance of symptoms by a standardized double-blind, placebo-controlled gluten challenge.

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Section: Gluten Sensitivity and Autismmentioning

confidence: 88%

Gluten Sensitivity

Catassi¹

2015

Ann Nutr Metab

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“…Thus, although a degraded mucus barrier and less mucus-degrading bacteria seems paradoxical, A. municiphila could be a possible marker for altered mucus turnover and a thin, thus possibly more 'leaky', gut barrier (66) . However, another recent study showed no abnormal intestinal permeability in autistic children compared with healthy siblings and non-related controls (67) . The same test (a differential sugar-absorption test) was used as well as measuring glucagon-like peptide-2, an enteroendocrine molecule that is released from the GI tract in response to nutrients, which has been found to reduce intestinal permeability (68,69) .…”

Section: Abnormal Intestinal Permeabilitymentioning

confidence: 91%

Autism and nutrition: the role of the gut–brain axis

2014

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Autism spectrum disorder (ASD) is characterised by deficits in the ability to socialise, communicate and use imagination, and displays of stereotypical behaviour. It is widely accepted that ASD involves a disorder in brain development. However, the real causes of the neurodevelopmental disorders associated with ASD are not clear. In this respect, it has been found that a majority of children with ASD display gastrointestinal symptoms, and an increased intestinal permeability. Moreover, large differences in microbiotic composition between ASD patients and controls have been reported. Therefore, nutrition-related factors have been hypothesised to play a causal role in the aetiology of ASD and its symptoms. Through a review of the literature, it was found that abnormalities in carbohydrate digestion and absorption could explain some of the gastrointestinal problems observed in a subset of ASD patients, although their role in the neurological and behavioural problems remains uncertain. In addition, the relationship between an improved gut health and a reduction of symptoms in some patients was evaluated. Recent trials involving gluten-free diets, casein-free diets, and pre-and probiotic, and multivitamin supplementation show contradictive but promising results. It can be concluded that nutrition and other environmental influences might trigger an unstable base of genetic predisposition, which may lead to the development of autism, at least in a subset of ASD patients. Clear directions for further research to improve diagnosis and treatment for the different subsets of the disorder are provided.

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“…We were interested in contrasting urinary p-cresol levels in autistic and typically developing children because ASD has been associated with enhanced frequencies of (1) excessive gut permeability, reported by at least some (D'Eufemia et al, 1996;De Magistris et al, 2010), though not all studies (Robertson et al, 2008) and (2) gut infection with cresolproducing C. difficile (Finegold et al, 2002;De Angelis et al, 2013;Keşli et al, 2014;Selmer & Andrei, 2001;Wang et al, 2011). Our initial study reported significantly elevated amounts of urinary p-cresol in 59 Italian ASD children compared with 59 age-and sex-matched controls (p50.05) (Altieri et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Urinaryp-cresol is elevated in young French children with autism spectrum disorder: a replication study

et al. 2014

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The aromatic compound p-cresol (4-methylphenol) has been found elevated in the urines of Italian autistic children up to 8 years of age. The present study aims at replicating these initial findings in an ethnically distinct sample and at extending them by measuring also the three components of urinary p-cresol, namely p-cresylsulfate, p-cresylglucuronate and free p-cresol. Total urinary p-cresol, p-cresylsulfate and p-cresylglucuronate were significantly elevated in 33 French autism spectrum disorder (ASD) cases compared with 33 sex-and age-matched controls (p50.05). This increase was limited to ASD children aged 8 years (p50.01), and not older (p ¼ 0.17). Urinary levels of p-cresol and p-cresylsulfate were associated with stereotypic, compulsive/repetitive behaviors (p50.05), although not with overall autism severity. These results confirm the elevation of urinary p-cresol in a sizable set of small autistic children and spur interest into biomarker roles for p-cresol and p-cresylsulfate in autism.

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Intestinal Permeability and Glucagon-like peptide-2 in Children with Autism: A Controlled Pilot Study

Cited by 43 publications

References 37 publications

Gluten Sensitivity

Gluten Sensitivity

Autism and nutrition: the role of the gut–brain axis

Urinaryp-cresol is elevated in young French children with autism spectrum disorder: a replication study

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