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Gut-oral Axis Microbiome in Autism Spectrum Disorders

The Role of Gut-oral Axis Microbiome in Autism Spectrum Disorders

Status
Recruiting
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT05830591
Enrollment
86
Registered
2023-04-26
Start date
2021-05-20
Completion date
2024-12-31
Last updated
2024-06-14

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Autism Spectrum Disorder, Microbiota

Keywords

Autism Spectrum Disorder, Microbiota, Inflammatory cytokines

Brief summary

Autism Spectrum Disorder (ASD) is a neurodevelopment disorder characterized by impairment in social interaction, communication, and behavior, as well as sensory challenges. In addition, secondary symptoms can appear, such as gastrointestinal disorders. Gut microbiota has an important role in the harvest of nutrients and energy from our diet. It influences a wide range of metabolic, developmental, and physiological processes such as the maintenance of the gut epithelial layer, immune system development, protection against pathogens, detoxification and xenobiotics degradation. The ecosystem of a healthy human gastrointestinal (GI) tract is mainly populated by Firmicutes and Bacteroidetes phyla, to a lesser extent by Actinobacteria and Proteobacteria, in this case the microbiota is in an eubiosis condition. Whether a disturbance of the microbial ecosystem occurs, gut microbiota is in a dysbiosis condition and it could lead different metabolic disorders. The two-way communication between gut microbiota and central nervous system (CNS) affects stress response, pain perception, neurochemistry and several disorders. The gut microbiota in ASD patients revealed some peculiarities such as the high percentage of Propionibacter and Clostridium, well known for their production of pro inflammatory metabolites, or an increment of Sutterella spp. and Ruminococcus torques, which are negatively associated with the health of the gut. Recent studies suggest that also the oral microbiota may be involved in ASD symptoms assuming the existence of a microbiota-oral-brain axis. ASD patients are often suffering of several oral cavity disorders like caries, gingivitis and periodontitis, probably due to the poor oral hygiene. These disorders are linked to a dysbiosis of the oral microbiota: the characterization of the ASD subjects oral microbiota showed a lower biodiversity of bacteria species and different levels of specific bacteria, comparing to the controls. Several studies suggest that some bacteria species invade the blood-brain barriers as well as their metabolites, triggering inflammatory response and an alteration of the metabolic activity in the CNS. It has been demonstrated that ASD patients have a high level of pro-inflammatory cytokines and chemokines in the cerebrospinal fluid and an upregulation of the microglia. The oral microbiota could also affect the lower GI tract and have a significant role within the ASD-associated GI disorders and CNS inflammation

Detailed description

Autism Spectrum Disorder (ASD) is a neurodevelopment disorder characterized by impairment in social interaction, communication, and behavior, as well as sensory challenges. In addition to the main symptoms, secondary symptoms can appear, such as gastrointestinal disorders. Gut microbiota has an important role in the harvest of nutrients and energy from our diet. Furthermore, it influences a wide range of metabolic, developmental, and physiological processes such as the maintenance of the gut epithelial layer, immune system development, protection against pathogens, detoxification and xenobiotics degradation. The ecosystem of a healthy human gastrointestinal (GI) tract is mainly populated by Firmicutes and Bacteroidetes phyla, to a lesser extent by Actinobacteria and Proteobacteria, in this case the microbiota is in an eubiosis condition. Whether a disturbance of the microbial ecosystem occurs, gut microbiota is in a dysbiosis condition and it could lead different metabolic disorders. For instance, the two-way communication between gut microbiota and central nervous system (CNS) affects stress response, pain perception, neurochemistry and several disorders. The gut microbiota in ASD patients revealed some peculiarities such as the high percentage of Propionibacter and Clostridium, well known for their production of pro inflammatory metabolites (like some short-chain fatty acids: acetate and propionate) or an increment of Sutterella spp. and Ruminococcus torques in feces of ASD children, which are negatively associated with the health of the gut. Similarly, very recent studies suggest that also the oral microbiota may be involved in ASD symptoms assuming the existence of a microbiota-oral-brain axis. ASD patients are often suffering of several oral cavity disorders like caries, gingivitis and periodontitis, probably due to the poor oral hygiene. These disorders are linked to a dysbiosis of the oral microbiota: as a matter of fact, the characterization of the ASD subjects oral microbiota showed a lower biodiversity of bacteria species and different levels of specific bacteria, comparing to the controls. Several studies suggest that some bacteria species invade the blood-brain barriers as well as their metabolites, triggering inflammatory response and an alteration of the metabolic activity in the CNS. Interestingly, it has been demonstrated that ASD patients have a high level of pro-inflammatory cytokines and chemokines in the cerebrospinal fluid and an upregulation of the microglia. The oral microbiota could also affect the lower gastro-intestinal (GI) tract, given the transit of bacteria from the oral cavity to the gut, leading to different effects depending on the type of bacteria. This implies that an oral microbiota dysbiosis may be one of the leading causes of the gut microbiota dysbiosis reported in numerous ASD studies as demonstrated by studies of the Human Microbiome Project, the 45% of the gut and oral microbiota bacteria over-lap. In light of these facts, the oral microbiota could have a significant role within the ASD-associated GI disorders and CNS inflammation. The main objective of this project is to identify descriptive features relative to bacterial species in gut and oral microbiota of pediatric subjects with ASD diagnosis. The purpose is to find whether these species overlap in order to identify descriptive features of ASD, which are collectable by means of a simple oral swab (rather than a fecal sample). These species will be identified with both DNA sequencing, followed by bioinformatic analysis, and a culturomic approach. The innovative approach of network analysis will be employed in order to find definite bacterial consortia, named Species Interacting Groups (SIGs) able to collect the abovementioned featuring species. These data could be useful for a better ASD description in terms of bacterial compositional differences, especially within a defined pediatric group.

Interventions

OTHERCharacterization of the microbiome in oral and fecal samples

The oral and fecal samples are collected during the periodical dental hygiene session at the odonto-stomatology unit and during day hospital for younger children admitted for the first clinical evaluation at Division of Child Neurology and Psychiatry. Procedures will follow standardized protocols.

Sponsors

IRCCS Burlo Garofolo
Lead SponsorOTHER

Study design

Observational model
OTHER
Time perspective
CROSS_SECTIONAL

Eligibility

Sex/Gender
ALL
Age
1 Years to 17 Years
Healthy volunteers
No

Inclusion criteria

Case group 1. Caucasian 2. Diagnosed with ASD or with a newly formulated diagnosis of ASD 3. Aged between 1 and 17 years Control group 1. Caucasian 2. Healthy at the time of sampling 3. No ASD or other neurological disorders 4. Aged between 1 and 17 years

Exclusion criteria

1. Antibiotic use in the month before sample collection 2. Probiotic use in the month before sample collection 3. Other neurological diseases 4. Chronic inflammatory diseases 5. The use of constipation drugs during the three days before sample collection

Design outcomes

Primary

MeasureTime frameDescription
To compare oral and GI microbiotaAt baselineOral and GI bacterial species will be evaluated in oral and fecal samples collected and compared through bioinformatic and statistical analysis among case and control groups to isolate the discriminant ones. The technical activity is focused on samples DNA extraction and sequencing and on a culturomic approach.

Secondary

MeasureTime frameDescription
To evaluate the association between the key bacteria species found in ASD microbiota and soluble concentration of salivary cytokinesAt baselineOral and GI bacterial species will be evaluated in oral and fecal samples. The soluble concentrations (picograms per millilitre) of a panel of 27 cytokines and chemokines will be simultaneously assessed in saliva samples.
To evaluate the association between the key bacteria species found in ASD microbiota and soluble concentration of salivary chemokinesAt baselineOral and GI bacterial species will be evaluated in oral and fecal samples. The soluble concentrations (picograms per millilitre) of a panel of 27 cytokines and chemokines will be simultaneously assessed in saliva samples.
To evaluate the association between the microbiota structure and the severity of the ASD symptomsAt baselineOral and GI bacterial species will be evaluated in oral and fecal samples. Clinical data will be collected from medical records.
To evaluate the association between the microbiota structure and eating habits of ASD childrenAt baselineA food diary will be distributed at enrollment to evaluate eating habits of ASD children

Countries

Italy

Contacts

Primary ContactManola Comar, BSc
manola.comar@burlo.trieste.it+39.040.3785.527
Backup ContactManola Comar, BSc
manola.comar@burlo.trieste.it+390403785527

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026