11 ms·

Benefit of Microbiota Transfer Therapy on autism symptoms and gut microbiota

216 points by blockmarker 7y ago

gameswithgo 7y ago
when i read this i saw no mention of a control group?
- peteretep 7y ago
  No, and the last sentence acknowledges that this should now be repeated more rigorously
  - amelius 7y ago
    A bit strange that this was accepted in "Nature" then (?)
    - dgacmu 7y ago
      Not really. It's common to accept papers based upon some function of Interesting & confidence, as long as the papers are very clear about their significance (or in this case, lack of a control). this kind of preliminary study is important in being able to make a case for funding a much larger formal study.
    - galangalalgol 7y ago
      It is a hot trend to correlate things to gut biome. Even so, the fact so many researchers are able to do so is quite interesting.
      - pvaldes 7y ago
        It has been hypotesized that autism increase in the last decades might be correlated with the increase in the use of pesticides. Early damage in nervous system that leads to a permanent particular architecture in the brain and all the stuff. Some gut bioma could theoretically be slightly better than other to deal with it. Some bacterias could be more efficient metabolizing some damaging products in our diet into other not so bad or even inocuous. Is teorethically possible. Both problems could be related and in this sense is a pretty interesting field. They could just give to an artificial gut bioma in a petri dish some diluted compounds, (or just give some autist children organic cultured fruits and keep it in a pesticide free environment) and see what happens
        lordlimecat 7y ago
        Is there any evidence that the amount and types of pesticides used today are more damaging than those used 30 years ago? Or 60 years ago? Gut feeling: regulatory environment is a lot more strict these days, so we're probably a lot better off with today's pesticides than whatever straight-up toxic chemicals were used in the past. I bet if we started looking we'd see things like arsenic and similar used in the past.
        pvaldes 7y ago
        Don't need to be more damaging. Can be harmful in a different sense.
    - ramraj07 7y ago
      This is not Nature, this is "scientific report", which is not a bad journal but no Nature either.
      - jessriedel 7y ago
        Slight clarification: The journal is called Scientific Reports, which as you correctly emphasize is very different than the journal Nature even though they are owned by the same company. The articles are still called "articles" though.
      - azeotropic 7y ago
        It's basically Springer-Nature's answer to PLoS One. As long as it's not obviously crazy, anything goes. This doesn't look very convincing though. Without a no-treatment or sham treatment control, the results could be placebo effect, reversion to the mean on their metrics, or due to the antibiotic treatment rather than the transplanted gut bacteria, or a just a statistical fluke with this small population. One thing that stands out to me is the lack of difference in developmental age between 8 weeks and 2 years after treatment. I find it hard to understand how that would occur under the model where this treatment does something.
    - hyperbovine 7y ago
      Nature Scientific Reports, not the same.
      - jessriedel 7y ago
        In fact, "Nature" isn't even in the office journal title, unlike basically every other journal owned by the Springer Nature publishing company, e.g., Nature Communications, Nature Chemistry, Nature Methods. This highlights that it's considered to be a significantly lower tier in prestige, and the acceptance rates are much higher. Which is why I've published there :D
    - skosuri 7y ago
      Scientific reports is a nature family journal somewhat akin to Plos One (very little importance review). It should set some warning lights on.
    - avip 7y ago
      It wasn’t.
    - SubiculumCode 7y ago
      This is Nature Scientific Reports, a low impact journal.
- strainer 7y ago
  But the results are very strong. In the treatment group, almost 1 in 5 patients went from severe autistic symptoms to normal (clear). And almost 2 in 5 patients went from severe to mild. This begs the question, is any other treatment known to produce such strong results?
  - gameswithgo 7y ago
    Given the method of measuring the results I'm not sure we can know anything about how strong the results are without a control group. It seems there is a deal of subjectivity in interpreting the results, and when this is the case crazy stuff can and does happen, regularly.
    - strainer 7y ago
      Can you clarify what you are saying about the method of measuring results?
      - teraflop 7y ago
        The study evaluated the severity of autism symptoms (using subjective questionnaires) before and after the treatment, but didn't compare those results to a control group of people who weren't treated the same way. It's like finding a couple dozen people with the flu, feeding them chicken soup, and then reporting that a month later they feel healthier, so the soup must have helped. Maybe it did, maybe it didn't, but you didn't measure that so you don't know.
        strainer 7y ago
        I asked as an aside to the matter of control group - what is considered "given" about "the method of measurement" ? According to this professional medical trial, the recorded ASD scores are "based on the Childhood Autism Rating Scale (CARS) rated by a professional evaluator" You should have specific knowledge of that evaluation in order to criticize it as relying on "subjective questionnaires" and shouldn't introduce doubt by simply stating something as "given".
- RobertRoberts 7y ago
  Lot's of scientific studies have no control groups.
  - lordlimecat 7y ago
    Not good ones. Any study attempting to show or imply causation needs to control for confounding variables; this is statistics 101. Usually you do this with an aptly named control group. If you don't have that control, you're left with "either my results are meaningful or else (very likely) there is a confounding factor." Great, that's not very useful.
    - RobertRoberts 7y ago
      Not a single study on the efficacy of vaccines has had a control group. When I asked why, I was told it was "unethical". So either, vaccine studies are "not good ones" as you say, or you perhaps have overlooked something?
      - gus_massa 7y ago
        LMGTFY It was difficult, but I got these two: (1954) Salk study of anti polio vaccine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1114166/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1114166/ (2009) Pregnancy and infant results after anti human papillomavirus: https://www.ncbi.nlm.nih.gov/pubmed/19935017 https://www.ncbi.nlm.nih.gov/pubmed/19935017 There are probably more, but they are difficult to find.
        RobertRoberts 7y ago
        Neither of these studies did they control for who was exposed to the actual disease. As far as I have found, the only experiments that did do this were completely unethical, and have not been repeated in modern western science: (that I know of) https://encyclopedia.ushmm.org/content/en/article/nazi-medical-experiments https://encyclopedia.ushmm.org/content/en/article/nazi-medic... http://www.auschwitz.dk/Bullenhuser.htm http://www.auschwitz.dk/Bullenhuser.htm
peteretep 7y ago
Plot twist: MMR vaccine turns out to kill off Bifidobacteria and Prevotella (please don’t downvote me it’s a joke)
- jMyles 7y ago
  Not sure if you realize this, but Wakefield's original assertion (and the only way that he was able to get legitimate scientists aboard for his wild, fraudulent ride) was to claim to have found a connection between the vaccine and what he called "non-specific colitis", which in turn caused autism, he said. So that plot twist has already occurred. Meanwhile, the connection between gut disorders and autism has received very little study after his wacko paper was retracted. With the relatively sudden (ie, in the space of a generation) proliferation of HFCS and hydrogenated oils (one or the other of which is in - or at least was in - nearly everything that has more than 5 ingredients), it seems like a very legitimate target for research. The fact that the vaccine connection has been debunked does not, as I understand it, also debunk the connection with gut disorders, which the other scientists had apparently independently observed and written about. People have been pointing this out for nearly 5 years now (ie, see [0]), but it seems that research is only now venturing out. People are terrified to be even vaguely associated with Wakefield, even if they don't share his conflict of interest or willingness to lie. 0: https://www.forbes.com/sites/emilywillingham/2014/04/30/blame-wakefield-for-missed-autism-gut-connection/ https://www.forbes.com/sites/emilywillingham/2014/04/30/blam...
  - pbhjpbhj 7y ago
    Well I'm glad the parent posted that, because I'd not heard the info from your comment before, only that Wakefield was connecting thiomersal (a mercury containing compound) with autism; the compound then being removed in USA with no downward change in autism cases. In response to the link, blaming Wakefield seems counter-productive, we need to take a more nuanced approach to disagreement and avoid "throwing the baby [area of research] out with the bathwater [discredited hypothesis]". Seems like there's a socio-political problem that needs fixing there and blaming Wakefield for our response to his fraud seems to go too far.
  - 7y ago
fasteo 7y ago
Maybe offtopic, but reinforces the gut-brain connection: The purported benefits of the ketogenic diet [1] to some epilepsy patients seems to be mediated by the gut bacteria [2]. [1] https://www.epilepsy.com/learn/treating-seizures-and-epilepsy/dietary-therapies/ketogenic-diet https://www.epilepsy.com/learn/treating-seizures-and-epileps... [2] https://www.cell.com/cell/fulltext/S0092-8674(18)30520-8 https://www.cell.com/cell/fulltext/S0092-8674(18)30520-8
- est31 7y ago
  Also, parkinson: https://www.sciencealert.com/there-s-mounting-evidence-that-parkinson-s-starts-in-the-gut-not-the-brain https://www.sciencealert.com/there-s-mounting-evidence-that-...
- pieter_mj 7y ago
  Also, schizophrenia : https://bigthink.com/surprising-science/schizophrenias-link-to-the-gut https://bigthink.com/surprising-science/schizophrenias-link-...
- deleted 7y ago
  [deleted]
Nasrudith 7y ago
I can't help but eyeroll at that dumb trope of people unwilling to accept the genetic link as someone actually autistic but it brings to mind a socratically trolling joke. "Doesn't this imply that being neurotypical is the actual disease and we have the means to deploy a cure for it?" Not a serious position but one to hopefully get people thinking about norms.
- 9wzYQbTYsAIc 7y ago
  What if one of the genetic links were related to the GI?
  - deleted 7y ago
    [deleted]
- cannedslime 7y ago
  I think its because autism is something that gets thrown around everywhere these days. Im sure many are diagnozed with ADHD or similar condition on the autistic spectrum when in reality its probably more related to diet, upbringing etc. Autism can be genetic for sure. But I think many are diagnosed on the spectrum to hastely.
  - ranit 7y ago
    It is on the first sentence of the Abstract: autism-like behaviors >> Many studies have reported abnormal gut microbiota in individuals with Autism Spectrum Disorders (ASD), suggesting a link between gut microbiome and autism-like behaviors.
    - dragonwriter 7y ago
      Autism Spectrum Disorder is autism (it is the formal name of the DSM 5 diagnosis) not merely “autism-like behaviors”.
      - ranit 7y ago
thinkingemote 7y ago
I've been pondering that the term "anally retentive" to describe a pattern of behaviour (totally unconnected to Autism) associated with strong disgust reflexes might itself be a symptom which happens due to poo retention, orderliness and extreme clensiness which reduces the diversity in gut bacteria.
- plutonorm 7y ago
  I always figured this was to do with stress levels. More stress = higher muscle tone, more retention and less bowel motion. But yeah, you could be right, I see there could be a feedback there.
- Jolter 7y ago
  That sounds quite far fetched and completely unfounded in facts. Btw Freud was wrong and his model of child development have been disproven for a hundred years now. Don't pay attention to stuff like "anal retentiveness", it's an inaccurate model of real psychology.
pimmen 7y ago
I have a very mild form of autism but I would say that I suffer from autism. I'm very sensitive to which environment I can be productive in and I need very clear protocols for human interaction. It's fine for engineering but I want to work more with people too (that's generally how you advance career-wise) and I have big problems knowing when to keep quiet in meetings and what topics for discussion are poor choices, even though I'm close to 30 years old now. If I could just be "normal" I think my life would improve immensely. I say "I think" because I'm not sure if I would like losing the things that make me "me". A friday night just reading all kinds of odd books to learn new things is totally fine by me right now and even though I have problems regulating my emotions I can now, after decades of coping, channel them into passion to get stuff done. I do however think my childhood would've been much easier if I was somehow treated as a young child; the years of being bullied and not making friends have taken its toll on me, something I struggle with to this day in business settings when I have to deal with unfamiliar people.
- billman 7y ago
  Maybe the world needs more people like you. We have far enough "normal" people.
- hyperbovine 7y ago
  > A friday night just reading all kinds of odd books to learn new things That's simply a hallmark of intellectualism, not autism.
  - loriverkutya 7y ago
    Thanks for giving a diagnosis based on one sentence :)
    - hyperbovine 7y ago
      What diagnosis? Your word, not mine.
- pault 7y ago
  My story is pretty much the same as yours, but I have an extra ten years on you. I've been able to get it under control (my career is really taking off now at the age of 39) by practicing it like any other skill. Mostly it's the art of omission; I consciously suppress my impulse to interrupt people in meetings and conversation by preparing a response in my head until they finish. This has the effect of making people think of me as a good listener, and also gives me time to cut their argument to shreds if they are spewing nonsense (the old maxim "don't interrupt your enemy while they are making a mistake"). Also, it's good to be thought of as the quiet smart guy. On the topic of inappropriate topics, I just don't say anything that isn't related to work in public conversations. Once you start getting close to people in a company you can usually talk about anything in private. All the "acting normal" can take a toll on you, though.
aussieguy1234 7y ago
Prior to the study, 83 percent of participants had "severe" autism. Now, only 17 percent are rated as severe, 39 percent as mild or moderate, and incredibly, 44 percent are below the cut-off for mild ASD. https://newatlas.com/fecal-transplants-autism-symptoms-reduction/59278/ https://newatlas.com/fecal-transplants-autism-symptoms-reduc...
- arkades 7y ago
  Prior to the 18 patient study of rapidly growing teenagers, with subjective rating scales performed by unblinded investigators, 83 percent of participants had "severe" autism. Now, only 17 percent are rated as severe, 39 percent as mild or moderate, and incredibly, 44 percent are below the cut-off for mild ASD. Just adding context.
  - candiodari 7y ago
    How many would have been expected to get cured without any action at all ? (because Autism does mostly resolve itself, either "for real" or because the patients learn to mask it well enough to "not have symptoms")
    - okmokmz 7y ago
      >Autism does mostly resolve itself, either "for real" or because the patients learn to mask it well enough to "not have symptoms" This is absolutely not true for the vast majority of those diagnosed with ASD
    - pimmen 7y ago
      But two years is a very short time. I have a mild form but it still took me decades to get to where I am today. People don't suspect I'm autistic and are surprised when I say it, but I'm absolutely exhausted from a day of masking it at work if there's a lot of meetings with new people.
    - folkrav 7y ago
      > Autism does mostly resolve itself, either "for real" or because the patients learn to mask it well enough to "not have symptoms" Having worked with autistic youth before, that's simply not true. First, autism is not a disorder that can be cured but worked with. Second, it doesn't do it by itself, but _can_ get better, with different approaches, and most of them involve hard and persistent education work. Lastly, the part of the spectrum that can look as if they were "normal" is a rather small proportion of the whole ASD.
arkades 7y ago
(1) This isn't Nature, it's SciRep. Don't get distracted by the URL. (2) Nature is an extremely high impact factor journal. However, it's ... not really a medical journal. Nor a psych journal. Nor a developmental peds journal. It's a basic sciences journal. What I mean to say is, even if this were Nature, it'd be a super high-impact journal that isn't actually read by clinicians who would be best positioned to criticize the study. (2a) For instance, their bowel transfer prep involved a clean-out with a two week course of vanco. The only bowel bugs it's used for are c. diff colitis and staph aureus enterocolitis. The reason it's really only used for that is because it really doesn't touch any other common bowel inhabitants. It's useful for those because it doesn't absorbed very effectively, so if you've got C Diff sitting in the bowel lumen, great, send a wash of vanco down the pipe. But, uh, for any other bugs in the gut? It's not even second line. So, how weird that it would be used to knock out pre-existing gut flora and "suppress pathogenic bacteria." C Diff and MRSA are not the leading pathogenic gut bacteria. The pre-existing flora are predominantly anaerobes. (3) An unblinded, uncontrolled trial of a disease whose symptoms are highly subjective in measure? Excellent. I'm sure they took measures to ensure they weren't influenced in their subjective analys- (3a) Oh. The senior author has a bunch of patents out trying to commercialize probiotics for autism. (3b) Oh, they used the PGI3, CARS, SRS, and ABC scores. I guess if you fill out enough bubbles you can overcome the fact that those are still subjective enough that they're shit for an open-label trial. Whoops. I don't mean to be overly dismissive. It's a fine pilot. The results are interesting enough that I'd want to see a real study tackle this. My comments are mostly aimed at the prevailing sentiment here taking this at face value.
- conistonwater 7y ago
  Do you know/understand how this study deals with regression to the mean? I can't figure it out from reading it. Also, what exactly is SciRep?
  - teraflop 7y ago
    Regression to the mean is briefly touched on (although they don't call it that) near the end of the "Results and Discussion" section. tl;dr: "In this other observational study, many subjects with autism didn't improve over time on a different metric, so the improvements in our metrics were probably because of the treatment and not spontaneous. Also, we asked the parents if there was any regression to the mean, and they said no."
tapland 7y ago
As my autistic SO said: > Can't wait to see hysterical autism moms doing home enemas with feces, hopefully some anti-vaxxers stories as well trying to mitigate having to get their kid vaccinated for kindergarden. Not fun for the children, but any case like this would bring it over the top and hopefully create a bigger uproar.
- rangibaby 7y ago
  It’s an improvement on bleach enemas
pieter_mj 7y ago
Gut microbiome diversity has been declining for years in the general population. Could this be an additional factor (next to better diagnostics) in the increasing prevalence of ASD?
gwbas1c 7y ago
I wonder if there's any relation to taking oral antibiotics at a particular age, or mothers taking antibiotics?
- charlieflowers 7y ago
  I very much wonder that too.
robinanil 7y ago
All they needed was some good shit. Jokes aside there has been plenty of research around insulin spike and how it is dependent on the gut bacteria and food you eat.

216 points by blockmarker 7y ago

gameswithgo 7y ago

when i read this i saw no mention of a control group?

peteretep 7y ago
No, and the last sentence acknowledges that this should now be repeated more rigorously
- amelius 7y ago
  A bit strange that this was accepted in "Nature" then (?)
  - dgacmu 7y ago
    Not really. It's common to accept papers based upon some function of Interesting & confidence, as long as the papers are very clear about their significance (or in this case, lack of a control). this kind of preliminary study is important in being able to make a case for funding a much larger formal study.
  - galangalalgol 7y ago
    It is a hot trend to correlate things to gut biome. Even so, the fact so many researchers are able to do so is quite interesting.
    - pvaldes 7y ago
      It has been hypotesized that autism increase in the last decades might be correlated with the increase in the use of pesticides. Early damage in nervous system that leads to a permanent particular architecture in the brain and all the stuff. Some gut bioma could theoretically be slightly better than other to deal with it. Some bacterias could be more efficient metabolizing some damaging products in our diet into other not so bad or even inocuous. Is teorethically possible. Both problems could be related and in this sense is a pretty interesting field. They could just give to an artificial gut bioma in a petri dish some diluted compounds, (or just give some autist children organic cultured fruits and keep it in a pesticide free environment) and see what happens
      - lordlimecat 7y ago
        Is there any evidence that the amount and types of pesticides used today are more damaging than those used 30 years ago? Or 60 years ago? Gut feeling: regulatory environment is a lot more strict these days, so we're probably a lot better off with today's pesticides than whatever straight-up toxic chemicals were used in the past. I bet if we started looking we'd see things like arsenic and similar used in the past.
        pvaldes 7y ago
        Don't need to be more damaging. Can be harmful in a different sense.
  - ramraj07 7y ago
    This is not Nature, this is "scientific report", which is not a bad journal but no Nature either.
    - jessriedel 7y ago
      Slight clarification: The journal is called Scientific Reports, which as you correctly emphasize is very different than the journal Nature even though they are owned by the same company. The articles are still called "articles" though.
    - azeotropic 7y ago
      It's basically Springer-Nature's answer to PLoS One. As long as it's not obviously crazy, anything goes. This doesn't look very convincing though. Without a no-treatment or sham treatment control, the results could be placebo effect, reversion to the mean on their metrics, or due to the antibiotic treatment rather than the transplanted gut bacteria, or a just a statistical fluke with this small population. One thing that stands out to me is the lack of difference in developmental age between 8 weeks and 2 years after treatment. I find it hard to understand how that would occur under the model where this treatment does something.
  - hyperbovine 7y ago
    Nature Scientific Reports, not the same.
    - jessriedel 7y ago
      In fact, "Nature" isn't even in the office journal title, unlike basically every other journal owned by the Springer Nature publishing company, e.g., Nature Communications, Nature Chemistry, Nature Methods. This highlights that it's considered to be a significantly lower tier in prestige, and the acceptance rates are much higher. Which is why I've published there :D
  - skosuri 7y ago
    Scientific reports is a nature family journal somewhat akin to Plos One (very little importance review). It should set some warning lights on.
  - avip 7y ago
    It wasn’t.
  - SubiculumCode 7y ago
    This is Nature Scientific Reports, a low impact journal.
strainer 7y ago
But the results are very strong. In the treatment group, almost 1 in 5 patients went from severe autistic symptoms to normal (clear). And almost 2 in 5 patients went from severe to mild. This begs the question, is any other treatment known to produce such strong results?
- gameswithgo 7y ago
  Given the method of measuring the results I'm not sure we can know anything about how strong the results are without a control group. It seems there is a deal of subjectivity in interpreting the results, and when this is the case crazy stuff can and does happen, regularly.
  - strainer 7y ago
    Can you clarify what you are saying about the method of measuring results?
    - teraflop 7y ago
      The study evaluated the severity of autism symptoms (using subjective questionnaires) before and after the treatment, but didn't compare those results to a control group of people who weren't treated the same way. It's like finding a couple dozen people with the flu, feeding them chicken soup, and then reporting that a month later they feel healthier, so the soup must have helped. Maybe it did, maybe it didn't, but you didn't measure that so you don't know.
      - strainer 7y ago
        I asked as an aside to the matter of control group - what is considered "given" about "the method of measurement" ? According to this professional medical trial, the recorded ASD scores are "based on the Childhood Autism Rating Scale (CARS) rated by a professional evaluator" You should have specific knowledge of that evaluation in order to criticize it as relying on "subjective questionnaires" and shouldn't introduce doubt by simply stating something as "given".
RobertRoberts 7y ago
Lot's of scientific studies have no control groups.
- lordlimecat 7y ago
  Not good ones. Any study attempting to show or imply causation needs to control for confounding variables; this is statistics 101. Usually you do this with an aptly named control group. If you don't have that control, you're left with "either my results are meaningful or else (very likely) there is a confounding factor." Great, that's not very useful.
  - RobertRoberts 7y ago
    Not a single study on the efficacy of vaccines has had a control group. When I asked why, I was told it was "unethical". So either, vaccine studies are "not good ones" as you say, or you perhaps have overlooked something?
    - gus_massa 7y ago
      LMGTFY It was difficult, but I got these two: (1954) Salk study of anti polio vaccine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1114166/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1114166/ (2009) Pregnancy and infant results after anti human papillomavirus: https://www.ncbi.nlm.nih.gov/pubmed/19935017 https://www.ncbi.nlm.nih.gov/pubmed/19935017 There are probably more, but they are difficult to find.
      - RobertRoberts 7y ago
        Neither of these studies did they control for who was exposed to the actual disease. As far as I have found, the only experiments that did do this were completely unethical, and have not been repeated in modern western science: (that I know of) https://encyclopedia.ushmm.org/content/en/article/nazi-medical-experiments https://encyclopedia.ushmm.org/content/en/article/nazi-medic... http://www.auschwitz.dk/Bullenhuser.htm http://www.auschwitz.dk/Bullenhuser.htm

peteretep 7y ago

Plot twist: MMR vaccine turns out to kill off Bifidobacteria and Prevotella (please don’t downvote me it’s a joke)

jMyles 7y ago
Not sure if you realize this, but Wakefield's original assertion (and the only way that he was able to get legitimate scientists aboard for his wild, fraudulent ride) was to claim to have found a connection between the vaccine and what he called "non-specific colitis", which in turn caused autism, he said. So that plot twist has already occurred. Meanwhile, the connection between gut disorders and autism has received very little study after his wacko paper was retracted. With the relatively sudden (ie, in the space of a generation) proliferation of HFCS and hydrogenated oils (one or the other of which is in - or at least was in - nearly everything that has more than 5 ingredients), it seems like a very legitimate target for research. The fact that the vaccine connection has been debunked does not, as I understand it, also debunk the connection with gut disorders, which the other scientists had apparently independently observed and written about. People have been pointing this out for nearly 5 years now (ie, see [0]), but it seems that research is only now venturing out. People are terrified to be even vaguely associated with Wakefield, even if they don't share his conflict of interest or willingness to lie. 0: https://www.forbes.com/sites/emilywillingham/2014/04/30/blame-wakefield-for-missed-autism-gut-connection/ https://www.forbes.com/sites/emilywillingham/2014/04/30/blam...
- pbhjpbhj 7y ago
  Well I'm glad the parent posted that, because I'd not heard the info from your comment before, only that Wakefield was connecting thiomersal (a mercury containing compound) with autism; the compound then being removed in USA with no downward change in autism cases. In response to the link, blaming Wakefield seems counter-productive, we need to take a more nuanced approach to disagreement and avoid "throwing the baby [area of research] out with the bathwater [discredited hypothesis]". Seems like there's a socio-political problem that needs fixing there and blaming Wakefield for our response to his fraud seems to go too far.
- 7y ago

fasteo 7y ago

Maybe offtopic, but reinforces the gut-brain connection: The purported benefits of the ketogenic diet [1] to some epilepsy patients seems to be mediated by the gut bacteria [2]. [1] https://www.epilepsy.com/learn/treating-seizures-and-epilepsy/dietary-therapies/ketogenic-diet https://www.epilepsy.com/learn/treating-seizures-and-epileps... [2] https://www.cell.com/cell/fulltext/S0092-8674(18)30520-8 https://www.cell.com/cell/fulltext/S0092-8674(18)30520-8

est31 7y ago
Also, parkinson: https://www.sciencealert.com/there-s-mounting-evidence-that-parkinson-s-starts-in-the-gut-not-the-brain https://www.sciencealert.com/there-s-mounting-evidence-that-...
pieter_mj 7y ago
Also, schizophrenia : https://bigthink.com/surprising-science/schizophrenias-link-to-the-gut https://bigthink.com/surprising-science/schizophrenias-link-...
deleted 7y ago
[deleted]

Nasrudith 7y ago

I can't help but eyeroll at that dumb trope of people unwilling to accept the genetic link as someone actually autistic but it brings to mind a socratically trolling joke. "Doesn't this imply that being neurotypical is the actual disease and we have the means to deploy a cure for it?" Not a serious position but one to hopefully get people thinking about norms.

9wzYQbTYsAIc 7y ago
What if one of the genetic links were related to the GI?
- deleted 7y ago
  [deleted]
cannedslime 7y ago
I think its because autism is something that gets thrown around everywhere these days. Im sure many are diagnozed with ADHD or similar condition on the autistic spectrum when in reality its probably more related to diet, upbringing etc. Autism can be genetic for sure. But I think many are diagnosed on the spectrum to hastely.
- ranit 7y ago
  It is on the first sentence of the Abstract: autism-like behaviors >> Many studies have reported abnormal gut microbiota in individuals with Autism Spectrum Disorders (ASD), suggesting a link between gut microbiome and autism-like behaviors.
  - dragonwriter 7y ago
    Autism Spectrum Disorder is autism (it is the formal name of the DSM 5 diagnosis) not merely “autism-like behaviors”.
    - ranit 7y ago

thinkingemote 7y ago

I've been pondering that the term "anally retentive" to describe a pattern of behaviour (totally unconnected to Autism) associated with strong disgust reflexes might itself be a symptom which happens due to poo retention, orderliness and extreme clensiness which reduces the diversity in gut bacteria.

plutonorm 7y ago
I always figured this was to do with stress levels. More stress = higher muscle tone, more retention and less bowel motion. But yeah, you could be right, I see there could be a feedback there.
Jolter 7y ago
That sounds quite far fetched and completely unfounded in facts. Btw Freud was wrong and his model of child development have been disproven for a hundred years now. Don't pay attention to stuff like "anal retentiveness", it's an inaccurate model of real psychology.

pimmen 7y ago

I have a very mild form of autism but I would say that I suffer from autism. I'm very sensitive to which environment I can be productive in and I need very clear protocols for human interaction. It's fine for engineering but I want to work more with people too (that's generally how you advance career-wise) and I have big problems knowing when to keep quiet in meetings and what topics for discussion are poor choices, even though I'm close to 30 years old now. If I could just be "normal" I think my life would improve immensely. I say "I think" because I'm not sure if I would like losing the things that make me "me". A friday night just reading all kinds of odd books to learn new things is totally fine by me right now and even though I have problems regulating my emotions I can now, after decades of coping, channel them into passion to get stuff done. I do however think my childhood would've been much easier if I was somehow treated as a young child; the years of being bullied and not making friends have taken its toll on me, something I struggle with to this day in business settings when I have to deal with unfamiliar people.

billman 7y ago
Maybe the world needs more people like you. We have far enough "normal" people.
hyperbovine 7y ago
> A friday night just reading all kinds of odd books to learn new things That's simply a hallmark of intellectualism, not autism.
- loriverkutya 7y ago
  Thanks for giving a diagnosis based on one sentence :)
  - hyperbovine 7y ago
    What diagnosis? Your word, not mine.
pault 7y ago
My story is pretty much the same as yours, but I have an extra ten years on you. I've been able to get it under control (my career is really taking off now at the age of 39) by practicing it like any other skill. Mostly it's the art of omission; I consciously suppress my impulse to interrupt people in meetings and conversation by preparing a response in my head until they finish. This has the effect of making people think of me as a good listener, and also gives me time to cut their argument to shreds if they are spewing nonsense (the old maxim "don't interrupt your enemy while they are making a mistake"). Also, it's good to be thought of as the quiet smart guy. On the topic of inappropriate topics, I just don't say anything that isn't related to work in public conversations. Once you start getting close to people in a company you can usually talk about anything in private. All the "acting normal" can take a toll on you, though.

aussieguy1234 7y ago

Prior to the study, 83 percent of participants had "severe" autism. Now, only 17 percent are rated as severe, 39 percent as mild or moderate, and incredibly, 44 percent are below the cut-off for mild ASD. https://newatlas.com/fecal-transplants-autism-symptoms-reduction/59278/ https://newatlas.com/fecal-transplants-autism-symptoms-reduc...

arkades 7y ago
Prior to the 18 patient study of rapidly growing teenagers, with subjective rating scales performed by unblinded investigators, 83 percent of participants had "severe" autism. Now, only 17 percent are rated as severe, 39 percent as mild or moderate, and incredibly, 44 percent are below the cut-off for mild ASD. Just adding context.
- candiodari 7y ago
  How many would have been expected to get cured without any action at all ? (because Autism does mostly resolve itself, either "for real" or because the patients learn to mask it well enough to "not have symptoms")
  - okmokmz 7y ago
    >Autism does mostly resolve itself, either "for real" or because the patients learn to mask it well enough to "not have symptoms" This is absolutely not true for the vast majority of those diagnosed with ASD
  - pimmen 7y ago
    But two years is a very short time. I have a mild form but it still took me decades to get to where I am today. People don't suspect I'm autistic and are surprised when I say it, but I'm absolutely exhausted from a day of masking it at work if there's a lot of meetings with new people.
  - folkrav 7y ago
    > Autism does mostly resolve itself, either "for real" or because the patients learn to mask it well enough to "not have symptoms" Having worked with autistic youth before, that's simply not true. First, autism is not a disorder that can be cured but worked with. Second, it doesn't do it by itself, but _can_ get better, with different approaches, and most of them involve hard and persistent education work. Lastly, the part of the spectrum that can look as if they were "normal" is a rather small proportion of the whole ASD.

arkades 7y ago

(1) This isn't Nature, it's SciRep. Don't get distracted by the URL. (2) Nature is an extremely high impact factor journal. However, it's ... not really a medical journal. Nor a psych journal. Nor a developmental peds journal. It's a basic sciences journal. What I mean to say is, even if this were Nature, it'd be a super high-impact journal that isn't actually read by clinicians who would be best positioned to criticize the study. (2a) For instance, their bowel transfer prep involved a clean-out with a two week course of vanco. The only bowel bugs it's used for are c. diff colitis and staph aureus enterocolitis. The reason it's really only used for that is because it really doesn't touch any other common bowel inhabitants. It's useful for those because it doesn't absorbed very effectively, so if you've got C Diff sitting in the bowel lumen, great, send a wash of vanco down the pipe. But, uh, for any other bugs in the gut? It's not even second line. So, how weird that it would be used to knock out pre-existing gut flora and "suppress pathogenic bacteria." C Diff and MRSA are not the leading pathogenic gut bacteria. The pre-existing flora are predominantly anaerobes. (3) An unblinded, uncontrolled trial of a disease whose symptoms are highly subjective in measure? Excellent. I'm sure they took measures to ensure they weren't influenced in their subjective analys- (3a) Oh. The senior author has a bunch of patents out trying to commercialize probiotics for autism. (3b) Oh, they used the PGI3, CARS, SRS, and ABC scores. I guess if you fill out enough bubbles you can overcome the fact that those are still subjective enough that they're shit for an open-label trial. Whoops. I don't mean to be overly dismissive. It's a fine pilot. The results are interesting enough that I'd want to see a real study tackle this. My comments are mostly aimed at the prevailing sentiment here taking this at face value.

conistonwater 7y ago
Do you know/understand how this study deals with regression to the mean? I can't figure it out from reading it. Also, what exactly is SciRep?
- teraflop 7y ago
  Regression to the mean is briefly touched on (although they don't call it that) near the end of the "Results and Discussion" section. tl;dr: "In this other observational study, many subjects with autism didn't improve over time on a different metric, so the improvements in our metrics were probably because of the treatment and not spontaneous. Also, we asked the parents if there was any regression to the mean, and they said no."

tapland 7y ago

As my autistic SO said: > Can't wait to see hysterical autism moms doing home enemas with feces, hopefully some anti-vaxxers stories as well trying to mitigate having to get their kid vaccinated for kindergarden. Not fun for the children, but any case like this would bring it over the top and hopefully create a bigger uproar.

rangibaby 7y ago
It’s an improvement on bleach enemas

pieter_mj 7y ago

Gut microbiome diversity has been declining for years in the general population. Could this be an additional factor (next to better diagnostics) in the increasing prevalence of ASD?

gwbas1c 7y ago

I wonder if there's any relation to taking oral antibiotics at a particular age, or mothers taking antibiotics?

charlieflowers 7y ago
I very much wonder that too.

robinanil 7y ago

All they needed was some good shit. Jokes aside there has been plenty of research around insulin spike and how it is dependent on the gut bacteria and food you eat.