Gut microbiota markers for autism spectrum disorder | Hacker News Reader

Gut microbiota markers for autism spectrum disorder

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48 pointspeutetre36 comments

There's so much talk of replenishing gut biota, of changing its composition, but I still don't have a mental image of how easy and how fast that can be done. Is it a matter of days? weeks? more?

How does one change the composition?

A lot of research says that pre and probititics don’t get absorbed very well by the gut

Prebiotics are generally sugars that are specifically chosen to not be absorbed by the gut, so that they can be food for the yeasts and microbes that live in your lower intestines.

Probiotics are doses of the yeasts and microbes - and again you don't want these to be absorbed by the gut - they need to live on the gut walls and feed on your stools.

But yes, I agree - research shows that only limited amounts of both of these will reach the lower intestine. BUT, once there they should multiply on the rich food source. With a small 5g bag of yeast, I can easily ferment a 25 litre bucket of wort to make beer (as long as no other bacteria or yeast get their first, that the wort isn't treated with something poisonous to yeast, that the temperature isn't too hot or too cold...)

Fecal transplants or probiotic enemas are a good way to bypass the upper GI

Totally, they sound gross, but already there is loads of positive research (and anecdotes) on the benefits.

Poop transplants.

https://en.m.wikipedia.org/wiki/Fecal_microbiota_transplant

I've been reading about this for a while (and I didn't do a great job of collecting my sources to link here) but from what I understand as a layman, truly changing the composition of the gut involves killing the current population, transplanting a new population in from a healthy host (person, mouse, whatever species you're working with) and then suppress the immune system while the new population takes hold. It's dangerous because of the immune suppression, but the outcomes in mouse populations (and in extreme cases where they actually do it in humans) are incredible.

There are less invasive methods being practiced that just involve putting a healthy gut population into a human's gut, and from what I've read it's still in the research phase.

Evidence of curing obesity, curing IBS in mice. I haven't seen any studies that are statistically significant in humans yet, because this is still relatively new.

https://my.clevelandclinic.org/health/treatments/25202-fecal...

There has also been some really interesting study of the brain-gut connection and the effect this microbe population has on mental health. Really interesting things where mice with aberrant gut microbiomes have "metal health conditions" (how ever you measure that in mice) and then have their vagus nerve (gut to brain, a huge nerve) cut. The outcomes were shocking, basically a curing of the condition. There is research here about humans: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9685564/

    "metal health conditions" (how ever you measure that in mice)

I know cortisol levels are a way one can diagnose stress/anxiety in animals. (My vet said they look to that as a proxy for "is my animal in discomfort" at times)

My wife is an educational therapist. Helps kids with autism/add/dyslexia/other. She told me it's a thing now to get autistic kids off gluten, sugar, and milk. She said it helps to reduce/isolate triggers, and as a behaviour resurfaces you can start addressing them one by one.

“From this metagenomic information, the researchers developed a 31-marker microbial panel. Using a machine learning model, they tested the panel. They found that it accurately predicted ASD diagnosis across different ages, sexes, populations, and geographical locations, much better than using a single species of microorganism, such as bacteria.”

From the abstract: “Machine learning using single-kingdom panels showed area under the curve (AUC) of 0.68 to 0.87 in differentiating children with ASD from those that are neurotypical. A panel of 31 multikingdom and functional markers showed a superior diagnostic accuracy with an AUC of 0.91, with comparable performance for males and females. Accuracy of the model was predominantly driven by the biosynthesis pathways of ubiquinol-7 or thiamine diphosphate, which were less abundant in children with ASD. Collectively, our findings highlight the potential application of multikingdom and functional gut microbiota markers as non-invasive diagnostic tools in ASD.”

https://www.nature.com/articles/s41564-024-01739-1

They don’t say in the abstract what proportion of their sample had ASD. Without this information, the ROC AUC is meaningless. You will get very high AUC on an unbalanced sample even with a trivial predictor like “always say no.”

Weren't a lot of ASD <=> Gut hypotheses very closely knit with Wakefield's MMR vax-equals-autism scare? Still, looks promising.

The fascinating bit is "Accuracy of the model was predominantly driven by the biosynthesis pathways of ubiquinol-7 or thiamine diphosphate, which were less abundant in children with ASD"

That gives us something interesting to work with.

i wonder if they controlled for the selective diets asd children have?

To be fair, the article is only promising diagnosis, which doesn't care about the direction of causality.

That would only work if there was a one-to-one correlation of autism with having a selective diet and it being the same diet for all.

And diagnosing selective diet by itself by just asking questions isn't that hard anyway, is it? If it was a cheatcode to a diagnosis I think we'd figured it out already.

Why is it being viewed as a medical condition? As something to be "cured"?

Because it makes one's inner life difficult and intense for no good reason.

The article is about diagnosis only.

We're slowly moving from pathologizing difference to acknowledging that people outside the normative still need support to survive our very normative society without developing adjacent issues, particularly mental health problems. That's of course putting cultural issues aside, medical professionals don't really handle those.

ICD-11's rationale for moving F64 out of F is a good example of that.

Not sure what else it would be views as? Just because something is considered a "medical condition" does not necessarily imply something negative or even necessarily something to cure.

You are "diagnosed" with Autism.

Wether or not we are "curing" it or just taking steps earlier to better set someone up for success with it, you still need a diagnoses.

Sleep, gastrointestinal and feeding difficulties are correlated with Autism. Correcting the gut microbiota may not "fix" autism (nor should we think about it as fixing), but it might be helpful in fixing gut symptoms knowing that people in this community have issues as such.

Early diagnosis may also help with getting neurodiverse individuals support in navigating a hostile world. (Considering that some therapies have been harmful to autistic people, we should be careful here!)

Is it just me or has there been an article trying to deduce the cause of Autism at least once a week for a while now?

This article is about correlation and diagnosis, not causation.

Like, in general? Suspect there’s an article for every topic under the sun once a week, somewhere out there.

Pretty much. They said it was overgrown brains last week.

new autism cure: yakult

Wasn't this previously attributed to lifestyle differences in another study?

Correlation or causation: sensory issues leading to food preferences and therefore different biome?

That doesn't change the fact that it can make a reasonable diagnostic marker.

Any hope for a “cure”? Autism might be a superpower for a tech career, but it’s debilitating in every other way. I’d love to get rid of it from my self as soon as possible, even if it means losing the ability to make the $$$ that all other spergy techbros use to protect themselves.

I don't have a cure but I've pushed back hard against the symptoms and tech is less of an all-consuming interest than it used to be, but I'm still quite good at it. I personally don't think a cure is going to take away that tech ability either.

It is pretty fascinating the more we find out about out gut biome and how it affects us.

I can't read the full paper and the article also does not have this information but I have a few questions.

I am curious more about the sample size, all we know is that 1627 Children were studied, but what was the breakdown of neurotypical and Children with ASD. The only percent given is female (which seems odd that in the abstract that that is the percent they chose to give).

I am also curious about the diversity of the children studied. From a culture, income, etc. All things that would impact their diets and possibly the biome.

Finally, "considered neurotypical", does that imply that they were actually tested or that they are assumed neurotypical?

Just some questions I don't see answered that jump out to me as big questions that I wish this article brought up.

The study is from Hong Kong, so guessing that the ethnic/racial/cultural group is overwhelmingly continental South East Asian/Chinese/Cantonese/Hong Konger.

My guess about the weird over emphasis on the percent of females in the study is due to autism diagnoses and research concentrating around males.

Your oyher questions are a bit odd given you concede you haven't read the research article which may indeed answer all these questions. The OP can't replicate everything from the original article.

That said, neurotypical kind of implies being taken as the normative, default case, so I'm guessing they're assumed to be neurotypical if they don't have a diasnosis for anything else. I don't think there any way to diagnose someone as having no neurodivergence.

So the reason I asked the questions isn’t just that I didn’t read it, but that I can’t without paying for it.

I would assume that if you were doing a study on this, you would test anyone that is taking place in it if they are not already tested.

Otherwise, your data would be possibly based on a flawed datapoint.

That is what I am asking. Are we assuming they are neurotypical or was ever child tested.

>> I don't think there any way to diagnose someone as having no neurodivergence.

That doesn’t really make sense to me. I could see that it may not be cut and dry but if you can test for it you also get not.

I acknowledge that it is a spectrum and this is complicated. But I would think just assuming neurotypical also isn’t the answer either if you are studying this.

Oh yes, I agree with everything you said except on being able to test for being neurotypical. That's like expecting a test for being "not sick"/"not unhealthy"/"not physically abnormal". You can test for specific conditions or indicators and get negative results, but there's no test that can produce a positive result of "nothing wrong".

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