Paradigm Shift in Autism-Spectrum Disorder (ASD) Treatment (July 2019)

Paradigm Shift in Autism-spectrum disorder (ASD) treatment

That’s a big claim, but it’s what the Economist called it, in an article in on June 1, 2019.

There is increased recognition that the billions of apparently non-pathogenic bacteria in our bodies are actually important for our health.  In the case of ASD, the absence of some of these bacteria may explain the cause of this condition and this recognition may also lead to its effective treatment.  Recent published studies reinforce this idea.

Missing bacterial species

A while back, Dr Rosa Krajmalnik and Dr James of Arizona State University sequenced the DNA of gut bacteria from 20 autistic children to find out which species were present.  They found that the children in their sample were missing hundreds of the thousand-plus bacterial species that occur in a ‘neuro-typical’ person’s intestine. One key missing bug was Prevotella, abundant in farmers and hunter-gatherers in places like Africa, rare in western European and Americans, and nearly non-existent in children with ASD.  

Restoring the missing species

This discovery led Dr Krajmalnik and Dr Adams to the idea that restoring the missing bacteria might alleviate autistic symptoms. A human study started two years ago, testing the idea with 18 autistic children aged between 7 and 16.  The latest results came out a few weeks ago in Scientific Reports. All the subjects showed on the Childhood Autism Rating Scale, as having “severe” autism. Ten weeks after treatment started the children’s Prevotella levels had multiplied over 700 time.  Now, two years later, though levels have fallen back somewhat, they are still over 80 times higher than they were before the experiment started.

What happened with the children?

Crucially, the changes in gut bacteria translated into behavioural changes.  Even 18 weeks after treatment began the children showed reduced symptoms of autism.  After two years, only three of them were still rated as severe, while eight fell below the diagnostic cut-off point for ASD altogether.  These eight now count as neurotypical.

Meanwhile, the success of this study in Arizona has prompted America’s Food and Drug Administration (FDA) to look into the matter, and to “fast-track” the effort by a firm called Finch Therapeutics Group in the USA to commercialise the treatment method.  Dr Krajmalnik-Brown and Dr Adams are now recruiting volunteers for a large-scale trial for adults with ASD, to see if they too can benefit.