Summary
The therapeutic potentials of probiotics in autism spectrum disorder (ASD) remains controversial, with the only existing systematic review on this topic published in 2015. Results from new trials have become available in recent years. We therefore conducted an updated systematic review, to assess the efficacy of probiotics in relieving behavioral symptoms of ASD and gastrointestinal comorbidities. Our review includes two randomized controlled trials, which showed improvement of ASD behaviors, and three open trials, all which exhibited a trend of improvement. Four of these trials concluded from subjective measures that gastrointestinal function indices showed a trend of improvement with probiotic therapy. Additional rigorous trials are needed to evaluate the effects of probiotic supplements in ASD.
Similar content being viewed by others
References
Baio J, Wiggins L, Christensen DL, et al. Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR Surveill Summ, 2018,67(6):1–23
Ouellette-Kuntz H, Coo H, Lam M, et al. The changing prevalence of autism in three regions of Canada. J Autism Dev Disord, 2014,44(1):120–136
Taylor B, Jick H, Maclaughlin D. Prevalence and incidence rates of autism in the UK: time trend from 2004–2010 in children aged 8 years. BMJ Open, 2013,3(10):e003219
Karimi P, Kamali E, Mousavi SM, et al. Environmental factors influencing the risk of autism. J Res Med Sci, 2017,22:27
Matelski L, Van de Water J. Risk factors in autism: Thinking outside the brain. J Autoimmun, 2016,67:1–7
Berding K, Donovan SM. Microbiome and nutrition in autism spectrum disorder: current knowledge and research needs. Nutr Rev, 2016,74(12):723–736
Rosenfeld CS. Microbiome Disturbances and Autism Spectrum Disorders. Drug Metab Dispos, 2015,43(10):1557–1571
Adams JB, Johansen LJ, Powell LD, et al. Gastrointestinal flora and gastrointestinal status in children with autism-comparisons to typical children and correlation with autism severity. BMC Gastroenterol, 2011,11:22
Kang V, Wagner GC, Ming X. Gastrointestinal dysfunction in children with autism spectrum disorders. Autism Res, 2014,7(4):501–506
Chaidez V, Hansen RL, Hertz-Picciotto I. Gastrointestinal problems in children with autism, developmental delays or typical development. J Autism Dev Disord, 2014,44(5):1117–1127
Liu J, Zhang M, Kong X. Gut Microbiome and Autism: Recent Advances and Future Perspectives. N Am J Med Sci, 2016,9(3):104–115
Kang DW, Adams JB, Gregory AC, et al. Microbiota transfer therapy alters gut ecosystem and improves gastrointestinal and autism symptoms: an open-label study. Microbiome, 2017,5(1):10
Parracho H, Gibson GR, Knott F, et al. A double-blind, placebo-controlled, crossover-designed probiotic feeding study in children diagnosed with autistic spectrum disorders. Int J Probiotics and Prebiotics, 2010,5(2):69–74
Navarro F, Liu Y, Rhoads JM. Can probiotics benefit children with autism spectrum disorders? World J Gastroenterol, 2016,22(46):10093–10102
Sathe N, Andrews JC, McPheeters ML, et al. Nutritional and Dietary Interventions for Autism Spectrum Disorder: A Systematic Review. Pediatrics, 2017,139(6): pii:e20170346
Srinivasjois R, Rao S, Patole S. Probiotic supplementation in children with autism spectrum disorder. Arch Dis Child, 2015,100(5):505–506
Ghouri YA, Richards DM, Rahimi EF, et al. Systematic review of randomized controlled trials of probiotics, prebiotics, and synbiotics in inflammatory bowel disease. Clin Exp Gastroenterol, 2014,7:473–487
Ouwehand AC. A review of dose-responses of probiotics in human studies. Benef Microbes, 2017,8(2):143–151
Dolan KE, Finley HJ, Burns CM, et al. Probiotics and Disease: A Comprehensive Summary-Part 1, Mental and Neurological Health. Integr Med (Encinitas), 2016,15(5):46–58
Kaur IP, Kuhad A, Garg A, et al. Probiotics: delineation of prophylactic and therapeutic benefits. J Med Food, 2009,12(2):219–235
Buffington SA, Di Prisco GV, Auchtung TA, et al. Microbial Reconstitution Reverses Maternal Diet-Induced Social and Synaptic Deficits in Offspring. Cell, 2016,165(7):1762–1775
Hsiao EY, McBride SW, Hsien S, et al. Microbiota modulate behavioral and physiological abnormalities associated with neurodevelopmental disorders. Cell, 2013,155(7):1451–1463
Kaluzna-Czaplinska J, Blaszczyk S. The level of arabinitol in autistic children after probiotic therapy. Nutrition, 2012,28(2):124–126
West NP, Horn PL, Pyne DB, et al. Probiotic supplementation for respiratory and gastrointestinal illness symptoms in healthy physically active individuals. Clin Nutr, 2014,33(4):581–587
Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. New Jersey: A John Wiley & Sons, Ltd., Publication, 2011.
Slim K, Nini E, Forestier D, et al. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg, 2003,73(9):712–716
Liu YW, Liong MT, Chung YCE, et al. Lactobacillus plantarum PS128 alleviates symptoms of autism spectrum disorder in Taiwanese children: A randomized, double-blind, placebo-controlled trial. Under review in Scientific Reports, 2018.
Shaaban SY, El Gendy YG, Mehanna NS, et al. The role of probiotics in children with autism spectrum disorder: A prospective, open-label study. Nutr Neurosci, 2018,21(9):676–681
Matthes H, Krummenerl T, Giensch M, et al. Clinical trial: probiotic treatment of acute distal ulcerative colitis with rectally administered Escherichia coli Nissle 1917 (EcN). BMC Complement Altern Med, 2010,10:13
Minelli E, Benini A. Relationship between number of bacteria and their probiotic effects. Microb Ecol Health Dis, 2008,20(4):180–183
Acknowledgements
We thank Clara Hobbie for manuscript editing.
Author information
Authors and Affiliations
Corresponding author
Additional information
Conflict of Interest Statement
Authors declare no conflicts of interests.
Rights and permissions
About this article
Cite this article
Liu, J., Wan, Gb., Huang, Ms. et al. Probiotic Therapy for Treating Behavioral and Gastrointestinal Symptoms in Autism Spectrum Disorder: A Systematic Review of Clinical Trials. CURR MED SCI 39, 173–184 (2019). https://doi.org/10.1007/s11596-019-2016-4
Received:
Revised:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11596-019-2016-4