Autism: when the gut calls the shots

The gut is often referred to as our second brain. For good reason, since it seems to be intimately linked to the ‘first’ brain. The quality of the gut microbiota is a gauge of our morale, our behavior and even our mental health, and may also influence the severity of symptoms in neurobiological diseases such as autism.

Created 20 April 2021
Updated 06 October 2021
Actu GP : Autisme : quand l’intestin fait la pluie et le beau temps

About this article

Created 20 April 2021
Updated 06 October 2021

What causes Autism Spectrum Disorders (ASD)? The question has puzzled the scientific community for decades. While the gut cannot fully explain the causes of ASD (characterized by difficulties in socializing and communicating, or even obsessive-compulsive disorders (OCD)), it may provide some of the answers. These answers are to be found in the billions of bacteria and other microorganisms that populate the gut microbiota, for better or worse.

Gut disorders and ASD: a dangerous liaison

Since ASD was first described in 1943, numerous symptoms have been identified. Gut disorders (diarrhea, constipation, irritable bowel, etc.) are among the most standard physical symptoms. Children with ASD experience three to four times more gastrointestinal disturbances than the norm. Severe autism often goes hand in hand with the most severe gut disorders–and vice versa. In fact, researchers have even shown that autistic patients show an improvement in behavior following treatment of a gastrointestinal disorder. They therefore became interested in the mechanisms behind these gastrointestinal disorders and took a closer look at the gut microbiota.

A microbiota that believes itself to be the brain

Observation no. 1: autistic patients often present an altered gut flora (dysbiosis) that is poor in beneficial bacteria and richer in microbes involved in certain gut disorders (diarrhea, constipation, etc.). Not content with troubling the gut, these microbes also produce “signal” molecules used by the gut and the brain to communicate. Produced to excess, these molecules could interfere with the communication process and lead to behavioral disorders such as those encountered in ASD.

A leaky gut?

Observation no. 2: the gut barrier no longer does its job, i.e., preventing microbes, allergens and other foreign molecules from entering the bloodstream. The immune system is activated as a result, triggering inflammatory reactions. Many autistic patients exhibit gut permeability, gut and neuronal inflammation and gut disorders associated with a response to heightened stress. These data suggest a strong gut-brain link in ASD. However, the mechanisms by which gastrointestinal disorders contribute to autism are extremely complex. Further research is therefore required to identify therapies to treat these gut problems and improve the quality of life of patients with ASD.

Old sources

Sources:

Bjørklund G, Pivina L, Dadar M, et al. Gastrointestinal alterations in autism spectrum disorder: What do we know? Neurosci Biobehav Rev. 2020 Nov;118:111-120. doi: 10.1016/j.neubiorev.2020.06.033. Epub 2020 Jul 1.

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