Autism and Antibiotics

This week, I thought I’d spend some time going back to some of my personal favorite gut papers over the years.  I’m making today a TBT (throw back Tuesday)!

In 2010, at an autism conference, I saw Dr. Jeremy Nicolson of Imperial College London present the findings he was just publishing in the Journal of Proteome Research.[i]  He and his colleagues looked at the urinary metabolic profiles of about 80 children on the autism spectrum and compared these to their unaffected siblings and other controls.  They found many abnormalities in the samples from the spectrum kids including significant differences in the urinary patterns of  many amino acids (indicating abnormalities in sulfur and amino acid metabolism), and found many abnormal metabolites:  “These biochemical changes are consistent with the known abnormalities of gut microbiota found in autistic individuals and the associated gastrointestinal dysfunction….”

Dr. Nicholson is a particularly renowned researcher, and this paper made big waves at the time, confirming the growing scientific evidence that the bacterial microbiome was associated with autism.  I’ve mentioned before on this blog how the first thing I ever learned about the medical causes of autism was alterations in the gut flora.  I still remember reading this sentence the first time and thinking about my son, Alex’s, 5 days of IV antibiotics in the hospital directly after birth: “Individuals with ASD are commonly exposed to repeated courses of multiple antibiotic therapies and this may contribute to the complex relationships between gastrointestinal dysbiosis and ASD by altering the composition or stability of their microbiota.”

5 years prior to this, a paper[ii] had appeared in the Journal of Medical Microbiology that compared stool samples from children on the spectrum versus their healthy siblings and found that the ASD kids had markedly higher levels of certain types of Clostridium, “…which are recognized toxin-producers and may contribute towards gut dysfunction, with their metabolic products also exerting systemic effects.”   This is likely around the time I first saw Dr. MacFabe speak (see my post about him).  It seemed to me back in 2010, that between all this research, with Dr. Nicholson’s paper being the cherry on the sundae, that things were bound to change for the better.

What strikes me, now 12 years later, is how little has actually changed.  Last week, I read[iii] that half of Australian children are treated with antibiotics during their first year of life, which is the highest rate in the world. “The researchers are now investigating whether exposure to antibiotics has affected the children’s gut bacteria and other health outcomes such as allergies, asthma, eczema and obesity.”

Wait…what?! Not autism?[iv]

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[i] Yap, IKS, Angley, M, Veselkov, KA, Holmes, E, Lindon, JC, Nicholson, JK.  Urinary metabolic phenotyping differentiates children with autism, from their unaffected siblings and age-matched controls. Journal of Proteome Research. 2010;9(6):20996-3004.

[ii] Parracho, HMRT, Bingham, MO, Gibson, GR, McCartney, AL. Differences between the gut microflora of children with autistic spectrum disorders and that of healthy children.  Journal of Medical Microbiology. 2005;54:987-991.

[iii] https://medicalxpress.com/news/2017-08-antibiotic-overload-aussie-kids.html

[iv] Let me just point out that this is from the Australian government’s website: (http://www.aihw.gov.au/disability/autism-in-australia/)  “According to the Australian Bureau of Statistics (ABS) Survey of Disability, Ageing and Carers (SDAC), an estimated 164,000 Australians had autism in 2015 (ABS 2016b; see also Box 1). This represented an overall prevalence rate of 0.7%, or about 1 in 150 people. The number of people with autism in Australia has increased considerably in recent years, up from an estimated 64,400 people in 2009 (ABS 2014). Of those who were estimated to have autism in 2015,