Customized synbiotics may improve autism spectrum disorder (ASD) symptoms via the gut-brain axis, according to a new joint metagenomics study. Researchers at Arizona State University and the probiotic company Sun Genomics found that 62% of study participants with ASD reported better gastrointestinal and ASD-related symptoms following supplementation with personalized supplements.
This study was “the first of its kind” to measure precision nutrition’s impact on ASD, says James Adams, professor and director of Arizona State University Autism/Asperger’s research program, tells Nutrition Insight.
“There have been many studies of probiotics for ASD with mixed results; this is the first attempt to personalize the probiotic based on detailed evaluations of the individual person’s gut microbiome.
The study used Floré-branded probiotic supplements, tailored based on a combination of scientific literature, participants surveys and their microbiomes.
Sunny Jain, founder and CEO of Sun Genomics, which produces Floré, says the company developed a natural language processing algorithm to screen thousands of peer-reviewed publications on ingredients that can benefit those with ASD.
“We then deploy an AI to help match peer-reviewed evidence to participants’ surveys and microbiomes. Having been in business for eight years, customer feedback has allowed us to learn which ingredients work in real-world situations.”
Methodology and key findings
170 participants completed the open-label study, which began with 296 children and adults diagnosed with ASD and 123 age-matched neurotypical controls.
Based on an analysis of their unique gut microbiota, each participant was given customized probiotics that they used for three months or longer.
They also completed a series of questionnaires, including the Parent Global Impressions of Autism (PGIA), Gastrointestinal Symptom Rating Scale and the Social Responsiveness Scale, before taking the probiotics and repeated the questionnaires three months later.
According to Rosy Krajmalnik-Brown, a study co-author and director of the Biodesign Center for Health Through Microbiomes at the Arizona State University, says she was surprised to see that a customized probiotic was able to increase taxonomic diversity.
“This is not that easy to achieve with a simple intervention,” she says.
Other key findings include:
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Gastrointestinal Improvement: According to the PGIA, 62% of individuals with autism spectrum disorder reported reduced gastrointestinal discomfort and improved overall autism-related symptoms.
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Behavioral and Autism Symptoms: Follow-up surveys revealed moderate improvement in participants’ thinking abilities, sensory experiences and overall autism-related symptoms.
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Microbial Changes: Study participants who showed improvement had notable increases in beneficial gut bacteria over time.
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Diversity Findings: While there wasn’t a significant overall difference in the variety of microbes between groups — such as age or gender — there were notable changes in the diversity of microbes within individuals (alpha diversity).
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Relationship with Diet and Symptoms: Certain dietary habits, such as daily fruit consumption outside of the study, were associated with increases in microbial diversity and specific species.
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Dietary Impact on Microbes: There were significant variations in microbial composition between individuals who followed a gluten- and dairy-free diet and those who consumed these products.
Scientific literature suggests concentrated levels of Clostridium bolteae are associated with ASD.The gut-brain connection
Researchers have been looking into the connection between ASD and the gut microbiome for several decades.
For Jain, that journey began in 2016 when he screened his son’s stool using a method that he has now patented.
“What I found was quite surprising. Instead of the typical Bifdobacterium infantis found in most infants, we found a high level of Clostridium bolteae. When I searched the literature for what this organism does, I found a paper by the late UCLA professor Dr. Syndney Finegold.”
“Using molecular methods, he found that the same organism I had just found in my son was also found in children with ASD at concentrations up to 46 times that of controls.”
Adams at Arizona University points out that a study from 2000 found that antibiotic therapy led to great temporary improvements in both gut and ASD symptoms, but benefits were lost within a few weeks of stopping treatment.
Reinforcing the connection between the gut and ASD, Adams’ team published a paper in 2011 demonstrating that children with ASD had much worse behavioral symptoms if they also experienced gut discomfort.
“Our studies with microbiota transplant therapy found great lasting improvement by transplanting gut bacteria from healthy humans,” declares Adams.
The most recent clinical trial sought to find less invasive alternatives to their successful transplant therapy work.
The study follows a successful trial on microbiome transplant therapy that exerted lasting benefits on people with ASD.Reinforcing barriers
Although it is still not known exactly how improvements with probiotics are made, one theory is that they help reduce permeability in the gut.
“We generally know that certain gut bacteria and fungi release harmful metabolites that can lead to intestinal barrier permeability. This is sometimes referred to as ‘leaky gut.’ The gut lining is the portal from the external world into everything we eat, breathe and get exposed to, as well as our internal circulatory system and organs,” details Jain.
“If the gut lining is ‘leaky’ and allows external factors to pass through, it may trigger the metabolites to get access to our bodies and therefore activate a cascade of signaling harm to our bodies. If we can shift the gut away from the release of harmful metabolites and alter the composition to favor higher concentrations of beneficial bacteria like probiotics, that will then foster the release of good metabolites.”
Individuals may then experience a positive influence on their GI symptoms that subsequently translate to overall Autism-related symptoms, he suggests.
Next steps
As a result of the study’s findings, Sun Genomics is developing and beta-testing three custom Floré probiotic formulations for people with neurodiversity to help improve gastrointestinal symptoms and support mood, speech and neurological pathways. The next step is a randomized, double-blind and placebo-controlled study, which is needed to confirm the clinical study findings.
Jain shares that he feels fortunate to have a like-minded investor (Sean O’Sullivan), researchers (Dr. Jim Adams and Dr. Rosy Krajmalnik-Brown) and the Floré team (lead author Dr. Joann Phan) who all support the notion that ASD may not exclusively be a human genetic disorder, but one based on multiple factors.
“Just like Dr. Finegold said, more studies need to be done, but we can at least work on digestive solutions based on what we know today and help many neurodiverse individuals with their respective GI-related issues,” he concludes.
Playing an active role in the personalized nutrition space, last year Sun Genomics partnered with dsm-firmenich to develop a customizable multivitamin.