对一名十九岁的重度自闭症青少年进行家族性粪便微生物群移植后,其肠道微生物群组成和临床症状均有所改善。

Journal of medical cases Pub Date : 2024-05-01 Epub Date: 2024-05-02 DOI:10.14740/jmc4209
Sabine Hazan, Jonathan Haroon, Sheldon Jordan, Stephen J Walker
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引用次数: 0

摘要

本病例报告描述了一种针对严重自闭症谱系障碍(ASD)患者的新型疗法,值得进一步研究。一名患有自闭症谱系障碍(ASD)的 19 岁男性青少年接受了粪便微生物群移植(FMT)治疗,该疗法使用的供体材料来自其发育正常的女性兄弟姐妹。患者的自闭症症状由评估人员进行评估,评估人员对患者过去的自闭症症状视而不见。评估人员使用儿童自闭症评定量表(CARS)进行评估,这是一种基于观察的评定量表,用于评估自闭症儿童的发育迟缓情况(CARS 评分范围为 15 - 60 分;得分大于 28 分表示患有自闭症;得分越高,严重程度越高)。在接受 FMT 治疗后的一年半时间里,患者的微生物群多样性和组成有了明显改善。此外,该患者之前不会说话,但在 FMT 术后 1 个月,他学会了说第一句话,攻击性也有所减少。据作者所知,这是第一份证明在患有 ASD 的青少年患者中使用家族 FMT 的报告。鉴于FMT术后ASD症状的改善往往发生在年龄较小的患者身上,作者推测,使用家族供体可能是导致这名年龄较大的儿童病情好转的一个重要因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Improvements in Gut Microbiome Composition and Clinical Symptoms Following Familial Fecal Microbiota Transplantation in a Nineteen-Year-Old Adolescent With Severe Autism.

This case report describes a novel therapy for patients with severe autism spectrum disorder (ASD) that is worth further investigation. A 19-year-old male adolescent with ASD, who was not responding to standard treatment received fecal microbiota transplant (FMT) using donor material from his typically developing female sibling. The patient's ASD symptoms were assessed by assessors who were blind to the patient's past ASD symptomatology. Assessors used the Childhood Autism Rating Scale (CARS), an observation-based rating scale to assess developmental delay in children with autism (range of CARS scores is 15 - 60; a score > 28 is indicative of autism; higher score is positively correlated with degree of severity), at baseline and again at six timepoints post-FMT. The patient experienced marked improvements in microbiome diversity and composition over the year and a half period that followed the FMT procedure. Additionally, the patient who was previously nonverbal said his first two words and experienced a reduction in aggression 1-month post-FMT. To the authors' knowledge, this is the first report to demonstrate the use of familial FMT in an adolescent patient with ASD. Given that ASD symptom improvements post-FMT tend to occur in younger patients, the authors hypothesize that the use of a familial donor may be an important factor that contributed to the improved outcomes experienced by this older child.

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