Abstract
The role of the gut microbiota in triggering autism is a rapidly emerging field of research. Gut microbiota have been incriminated because autistic children often have gastrointestinal symptoms. Pathogenic gut bacteria in children with autism spectrum disorders (ASD) have been reported. The present study aimed to assess Clostridium difficile in the stool of children with ASD and its relation to gastrointestinal (GI) comorbidities, autism severity, and sensory impairment. The study included 58 ASD patients, 45 of their neurotypical siblings, and 45 unrelated controls. Childhood Autism Rating Scale (CARS) was used to assess the severity of autism. Sensory problems were evaluated using the Short Sensory Profile (SSP). GI symptoms were assessed with a modified six-item GI Severity Index (6-GSI) questionnaire. Quantitative real-time PCR was done for the detection and quantitation of C. difficile and its toxins A and B. C. difficile was detected in 25.9%, 40%, and 15.6% of ASD cases, siblings, and unrelated control respectively. Regarding toxin A and B production, 73.3%, 77.8%, and 71.4% of C. difficile in positive ASD, siblings, and unrelated control cases respectively were toxigenic. There was no statistically significant difference between the three groups as regards C. difficile qualitative, quantitative, and toxin production results. In conclusion, C. difficile is not specifically prevalent in the gut of children with ASD. Although most of the strains are toxigenic, there were no GI symptoms in the control groups and no statistically significant association with GI Severity Index in autistic cases. Gastrointestinal dysfunction and sensory impairment are common comorbidities in ASD.
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The authors thank the staff members of Pediatric Neurology and Medical Microbiology Department in addition to the participants who provided samples and data for this work.
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• Study concept and design: Hanan, Shwikar Mona, Omneya
• Acquisition of data: Hala.
• Bacteriological analysis: Shwikar.
• Analysis and interpretation of data: Hanan, Shwikar, Mona, Omneya.
• Drafting of the manuscript: Shwikar, Omneya, Hanan, Mona‚ Hala.
• Critical revision of the manuscript for important intellectual content: Shwikar, Omneya‚ Hanan‚ Mona.
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All procedures completed in the study involving human participants were in agreement with the ethical standards of the institutional research committee (Medical Research Ethics Committee of Alexandria Faculty of Medicine, Egypt) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Khalil, M., Azouz, H.G., Ahmed, S.A. et al. Sensory Processing and Gastrointestinal Manifestations in Autism Spectrum Disorders: No Relation to Clostridium difficile. J Mol Neurosci 71, 153–161 (2021). https://doi.org/10.1007/s12031-020-01636-2
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DOI: https://doi.org/10.1007/s12031-020-01636-2