SEARCHSYSTEMATIC_REVIEWpediatrics, psychiatry

systematic_review·pediatrics, psychiatry, systematic review, gastroenterology, immunology·PMC10017995

Effect of fecal microbiota transplantation in children with autism spectrum disorder: A systematic review

Frontiers in Psychiatry · 8 authors, 6 centres

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TL;DR

This systematic review analyzed five observational studies (no randomized controlled trials) and found that fecal microbiota transplantation was associated with significant improvements in behavioral assessment scores for autism symptoms in children.

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This systematic review assessed the effect of fecal microbiota transplantation (FMT) in children with autism spectrum disorder (ASD). The authors searched databases and included five studies: two prospective open-label, two retrospective observational, and one case report; no randomized controlled trials were found. Treatment effects were maintained at an 8-week follow-up in two studies. Adverse effects were generally mild, including hyperactivity and aggression, and were considered well-tolerated. The review's primary limitation is the lack of high-quality randomized controlled trials, meaning the observed effects are from observational data and cannot establish definitive efficacy.

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systematic_review

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pediatrics

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100% · A

ORIGINAL PAPER

PMC10017995

Effect of fecal microbiota transplantation in children with autism spectrum disorder: A systematic review

Frontiers in Psychiatry

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ABSTRACT

Background Fecal microbiota transplantation (FMT) may be helpful in the treatment of autism spectrum disorder (ASD) as rebalancing the gut microbiome has been shown to potentially improve behavioral symptoms in children with ASD. Methods This systematic review was conducted to assess the effect of FMT for children with ASD. The Embase, PubMed, Web of Science, and Cochrane Library databases were searched for articles published from inception to October 6, 2022. Two reviewers independently screened the identified records and undertook data extraction. Results The search identified a total of five studies: two prospective open-label studies, two retrospective observational studies, and a case report; however, no randomized controlled trial was identified. All five studies reported a significant post-FMT-treatment improvement in neuropsychological assessment of ASD. The two prospective open-label studies suggested that the Autism Behavior Checklist (ABC) score, and the Social Responsiveness Scale (SRS) score at the posttreatment assessment decreased from the baseline (Wilcoxon signed-rank test; all p < 0.01]). The two retrospective observational studies suggested that FMT helped to improve the ASD symptoms. One observational study reported that the Childhood Autism Rating Scale (CARS) score and ABC score of the constipation group decreased from the baseline after the second course assessment (CARS [baseline: mean 35.25 ± standard deviation 4.36, second course: 32.5 ± 3.1, p = 0.015]; ABC [baseline: 56.21 ± 16.08, second course: 46.54 ± 16.54, p = 0.046]). Another observational study found that both ABC and CARS scores decreased as the number of FMT courses increased, and significant differences were found at the end of each course as compared with the baseline. Conclusion Compared with the baseline, FMT significantly improved symptoms of autism in children with ASD in observational studies. However, rigorously designed randomized controlled clinical trials are needed to establish the safety and efficacy of FMT as a treatment for ASD.

CITATION EXPORT

Jing Zhang, Gang Zhu, Lin Wan et al.. Effect of fecal microbiota transplantation in children with autism spectrum disorder: A systematic review. Frontiers in Psychiatry. (2023). https://doi.org/10.3389/fpsyt.2023.1123658

AUTHORS

8 · 6 CENTRES

Jing Zhang, Gang Zhu, Lin Wan, Yan Liang, Xinting Liu, Huimin Yan, Bo Zhang, Guang Yang

1Senior Department of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, China
2Department of Pediatrics, The First Medical Center of Chinese PLA General Hospital, Beijing, China
3Medical School of Chinese PLA, Beijing, China
4Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
5Biostatistics and Research Design Center, Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
6Second School of Clinical Medicine, Southern Medical University, Guangzhou, China