Pilot study of probiotic/colostrum supplementation on gut function in children with autism and gastrointestinal symptoms

Abstract

Over half of all children with autism spectrum disorders (ASD) have gastrointestinal (GI) co-morbidities including chronic constipation, diarrhea, and irritable bowel syndrome. The severity of these symptoms has been correlated with the degree of GI microbial dysbiosis. The study objective was to assess tolerability of a probiotic (Bifidobacterium infantis) in combination with a bovine colostrum product (BCP) as a source of prebiotic oligosaccharides and to evaluate GI, microbiome and immune factors in children with ASD and GI co-morbidities. This pilot study is a randomized, double blind, controlled trial of combination treatment (BCP + B. infantis) vs. BCP alone in a cross-over study in children ages 2–11 with ASD and GI co-morbidities (n = 8). This 12-week study included 5 weeks of probiotic-prebiotic supplementation, followed by a two-week washout period, and 5 weeks of prebiotic only supplementation. The primary outcome of tolerability was assessed using validated questionnaires of GI function and atypical behaviors, along with side effects. Results suggest that the combination treatment is well-tolerated in this cohort. The most common side effect was mild gassiness. Some participants on both treatments saw a reduction in the frequency of certain GI symptoms, as well as reduced occurrence of particular aberrant behaviors. Improvement may be explained by a reduction in IL-13 and TNF-α production in some participants. Although limited conclusions can be drawn from this small pilot study, the results support the need for further research into the efficacy of these treatments.

Could Gut Modulation through Probiotic Supplementation Be Beneficial in Autism Spectrum Disorder?

“…To date only few studies explored the effects of probiotics on ASD clinical features in humans. Table 1 synthesizes available evidence on the efficacy and safety of probiotic supplementation as an adjunctive treatment for ASD [49,51,73,[95][96][97][98][99][100][101][102][103][104][105][106]. In these studies, probiotic interventions varied across all of the trials.…”

“…Additionally, in the same study, the efficacy of probiotic supplementation seemed to be age-dependent, with better effects noticed on younger children, underscoring the importance of early interventions. Although all aforementioned studies showed changes in GM after the implementation diet with probiotics, only some of them analyzed the correlations with GI symptoms and reported improvement of GI function indices [96,98,101,102,105]. In fact, a survey conducted on caregivers showed that daily administration of a specific five-strain probiotic decreased the severity of comorbid GI problems [99].…”

“…In fact, a survey conducted on caregivers showed that daily administration of a specific five-strain probiotic decreased the severity of comorbid GI problems [99]. Concurrent with increases in the proportion of normal stools, there was an increased appetite and willingness to consume novel foods that may be due to reduced abdominal pain or improved stool evacuation [105]. Besides, in one case study report, a multi-strain mixture of 10 probiotics not only relieved the GI disturbances but also improved ASD core symptoms [101].…”

“…Most of these studies recorded a reduction in the severity of ASD symptoms, although not all reached significance. Noted positive effects on mood and general behavior were (i) statistically significant differences in behavioral scores for disruptive/ antisocial behavior, anxiety problems, communication disturbances, and selfabsorbed behavior compared to baseline [96,104]; (ii) decrease in the severity of speech/language/communication performance [97,101]; (iii) progress in sociability, sensory and cognitive awareness, physical health, and behavior [99,102]; and (iv) changes in adaptive, repetitive, and aberrant behaviors including irritability, lethargy, stereotypy, and hyperactivity [105]. Conversely, in other investigations, no statistically significant differences in behavioral scores were detected between probiotics and placebo control groups [73,103].…”

“…At last, though probiotics are considered a relatively risk-free option for individuals with ASD, the current literature cannot confidently state their safety as there is a paucity of systematic reporting of adverse events. However, among the studies that monitored side effects, the reported ones (bloating, skin rash, worsening constipation or diarrhea, and weight loss) appear to be mild, transient, and infrequent [96,99,102,105]. Conclusively, due to the large heterogeneity between trials, studies provide only suggestive but not conclusive evidence regarding the efficacy of probiotics on GI and behavioral symptoms among ASD patients.…”