Pilot study of probiotic/colostrum supplementation on gut function in children with autism and gastrointestinal symptoms.
Sanctuary MR, Kain JN, Chen SY, Kalanetra K, Lemay DG, Rose DR, Yang HT, Tancredi DJ, German JB, Slupsky CM, Ashwood P, Mills DA, Smilowitz JT, Angkustsiri K
PLoS One. 2019. doi: 10.1371/journal.pone.0210064
COMMENT: Gastrointestinal disorders and associated symptoms as well as inmune imbalances in the gut are commonly reported in children with autism spectrum disorder (ASD). In children with ASD, interventions focused on resolving intestinal dysbiosis could reduce the GI symptoms and also help balance the inmune system. This work describes the results obtained in a pilot study in which children with ASD and chronic GI symptoms were supplemented with a bovine colostrum product (BCP) for five weeks and a combination of BCP and a probiotic organism (Bifidobacterium longum subsp infantis) for another five weeks.
To assess supplement tolerability as well as changes in the intestinal microbiota, in peripheral blood mononuclear cell (PBMC) cytokines expression and in host and microbial metabolism to establish trial feasibility to design a larger future study of a combined probiotic - BCP supplement.
There was a reduction in frequency of pain associated with bowel movements for both the BCP only (...) and the combination treatment (...) groups. There was also a reduction in frequency of diarrhea in the BCP only group. While changes in frequency of normal stools were not significant for either group, changes in stool consistency were significant for both the BCP only (...) and combination treatment.
While there were no significant differences in most scores between treatment groups, there was a significant improvement in stereotypy in the BCP only group compared to the combined treatment group.
No global changes in the fecal microbiome and in the fecal, urinary or serum metabolite profiles were observed with either treatment.
Overall, there was a reduction in intracellular expression of certain cytokines by both CD4+ and CD8+ T cells. In stimulated cells, the frequency of CD4+/IL-13+ T cells was significantly lower after combination treatment. There was also a significant reduction in the frequency of CD8+/TNF-α+ T cells with the BCP only treatment (...) We found no significant differences in the frequency of CD4+ or CD8+ T cells expressing IFN-γ, IL-17, or IL-6
Children with ASD and gastrointestinal symptoms tend to experience gut immune dysfunction and bacterial dysbiosis. Bovine colostrum product appears to be well-tolerated in these children as its own treatment as well as when combined with the probiotic B. infantis. It is important to note that some of these children experienced improvement in chronic GI symptoms that were not amenable to a number of other common intervention strategies. However, conclusions from this study are limited due to the small sample size and high heterogeneity of symptoms between participants. The limited number of mild side effects coupled with reduced frequency of some GI symptoms in children supplemented with BCP with and without B. infantis support the need for larger well-controlled trials to determine efficacy of these treatments.