[{"command":"openDialog","selector":"#drupal-modal","settings":null,"data":"\u003Cdiv id=\u0022republish_modal_form\u0022\u003E\u003Cform class=\u0022modal-form-example-modal-form ecl-form\u0022 data-drupal-selector=\u0022modal-form-example-modal-form\u0022 action=\u0022\/en\/article\/modal\/11294\u0022 method=\u0022post\u0022 id=\u0022modal-form-example-modal-form\u0022 accept-charset=\u0022UTF-8\u0022\u003E\u003Cp\u003EHorizon articles can be republished for free under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence.\u003C\/p\u003E\n \u003Cp\u003EYou must give appropriate credit. We ask you to do this by:\u003Cbr \/\u003E\n 1) Using the original journalist\u0027s byline\u003Cbr \/\u003E\n 2) Linking back to our original story\u003Cbr \/\u003E\n 3) Using the following text in the footer: This article was originally published in \u003Ca href=\u0027#\u0027\u003EHorizon, the EU Research and Innovation magazine\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003ESee our full republication guidelines \u003Ca href=\u0027\/horizon-magazine\/republish-our-stories\u0027\u003Ehere\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003EHTML for this article, including the attribution and page view counter, is below:\u003C\/p\u003E\u003Cdiv class=\u0022js-form-item form-item js-form-type-textarea form-item-body-content js-form-item-body-content ecl-form-group ecl-form-group--text-area form-no-label ecl-u-mv-m\u0022\u003E\n \n\u003Cdiv\u003E\n \u003Ctextarea data-drupal-selector=\u0022edit-body-content\u0022 aria-describedby=\u0022edit-body-content--description\u0022 id=\u0022edit-body-content\u0022 name=\u0022body_content\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea ecl-text-area\u0022\u003E\u003Ch2\u003EClues to autism\u2019s causes may lie in the gut\u003C\/h2\u003E\u003Cp\u003EProfessor Alessio Fasano is keenly aware of the challenges faced by families that have children with autism.\u003C\/p\u003E\u003Cp\u003EFasano, a gastroenterologist at Massachusetts General Hospital in the US, has several relatives and friends raising children with autism \u2013 a neurological disorder characterised by impaired social behaviour.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EParallel worlds\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EAutism symptoms usually emerge during the first two years of a child\u2019s life, with the likely causes being a combination of genetic and environmental influences. Environmental risk factors act during the embryonic stage and may include\u0026nbsp;prenatal exposure to an infection or to toxic chemicals such as pollution and maternal diabetes.\u003C\/p\u003E\u003Cp\u003E\u2018Parents find themselves living in a parallel world to their child where communication is enormously difficult and there is nothing they can do about it,\u2019 said Fasano, who hopes to provide help.\u003C\/p\u003E\u003Cp\u003EHe leads a research project that received EU funding to explore the links between autism and gut health. The six-year initiative, called\u0026nbsp;\u003Ca href=\u0022https:\/\/cordis.europa.eu\/project\/id\/825033\u0022\u003EGEMMA\u003C\/a\u003E, runs until the end of 2024.\u003C\/p\u003E\u003Cp\u003EAutism\u0026nbsp;\u2013 formally known as autism spectrum disorder or ASD \u2013 is estimated to affect at least one in 100 people worldwide. Over the past three decades, reported cases have increased \u2018rapidly\u2019 in countries where prevalence studies have been carried out, according to advocacy group\u0026nbsp;\u003Ca href=\u0022https:\/\/www.autismeurope.org\/about-autism\/prevalence-rate-of-autism\/\u0022\u003EAutism Europe\u003C\/a\u003E.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u2018There\u2019s a huge increase in incidence worldwide,\u2019 said Fasano, who suspects\u0026nbsp;that\u0026nbsp;broader diagnostic criteria have contributed to the reported rise in cases.\u003C\/p\u003E\u003Cp\u003EHe believes it might be possible to treat some autistic behavioural traits by restoring balance to the ecosystem of myriad microorganisms in the human gut \u2013 often referred to as the microbiome.\u003C\/p\u003E\u003Cp\u003E\u2018There\u2019s good evidence that communication between the gut and the brain influences many neurological conditions including autism,\u2019 Fasano said. \u2018It raises the possibility that gut microbial-based treatments may be useful as a safe therapeutic approach for the disorder.\u2019\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EGut check\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EWhile autism was first described in the 1940s, the underlying causes aren\u2019t clearly understood eight decades later.\u003C\/p\u003E\u003Cp\u003E\u003Cblockquote class=\u0022tw-text-center tw-text-blue tw-font-bold tw-text-2xl lg:tw-w-1\/2 tw-border-2 tw-border-blue tw-p-12 tw-my-8 lg:tw-m-12 lg:tw--ml-16 tw-float-left\u0022\u003E\n \u003Cspan class=\u0022tw-text-5xl tw-rotate-180\u0022\u003E\u201c\u003C\/span\u003E\n \u003Cp class=\u0022tw-font-serif tw-italic\u0022\u003ECommunication between the gut and the brain influences many neurological conditions including autism.\u003C\/p\u003E\n \u003Cfooter\u003E\n \u003Ccite class=\u0022tw-not-italic tw-font-normal tw-text-sm tw-text-black\u0022\u003EProfessor Alessio Fasano, GEMMA\u003C\/cite\u003E\n \u003C\/footer\u003E\n\u003C\/blockquote\u003E\n\u003C\/p\u003E\u003Cp\u003EWhat is known is that the condition has a strong genetic basis with multiple genes \u2013 maybe as many as 100 \u2013 involved.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EBut inflammation of the nerve cells in the brain is also thought to play a role. And here it\u2019s believed that environmental factors \u2013 including gut health \u2013 could come into play.\u003C\/p\u003E\u003Cp\u003EIn a healthy person, the semi-permeable wall of the intestine acts as a barrier. It controls the transport of essential ions, nutrients and water into the body while restricting the movement of harmful substances both into and out of the gut.\u003C\/p\u003E\u003Cp\u003EWhen a breach occurs in this barrier, substances from the gut leak into the body. This triggers an immune response that contributes to inflammatory diseases and metabolic disorders, which\u0026nbsp;\u2013 it\u2019s speculated \u2013 in turn influence the brain.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EThis condition is commonly known as \u201cleaky gut\u201d.\u003C\/p\u003E\u003Cp\u003E\u2018What chronic inflammatory diseases have in common with autism is that they\u2019re caused by a combination of genetic predisposition and exposure to environmental triggers leading to inflammation,\u2019 said Fasano. \u2018With autism, it seems that the gut-brain axis communication is compromised and is letting things into the brain that cause neuroinflammation.\u2019\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EInfant tracking\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EThe GEMMA researchers are following 500 infants who range in age from zero to 36 months and are siblings of children with autism.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EThe likelihood of a child being born with autism is thought to\u0026nbsp;\u003Ca href=\u0022https:\/\/www.mdpi.com\/2072-6643\/13\/10\/3492\u0022\u003Eincrease 10-fold\u003C\/a\u003E when an older sibling is on the spectrum.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EThe team is tracking \u2013 among other things \u2013 the microbial contents of the infants\u2019 stools. A balanced composition of bacteria in the intestine is known to maintain the integrity of the gut wall.\u003C\/p\u003E\u003Cp\u003EGastrointestinal disorders ranging from stomach cramps to diarrhoea are particularly common in people with autism. Furthermore, the condition is often associated with an imbalance of gut microbes: people with autism have less microbial diversity and a higher ratio of harmful-to-healthy bacteria.\u003C\/p\u003E\u003Cp\u003EGEMMA aims to restore balance to the microbiome and repair the gut barrier by finding a treatment that contains healthy bacteria, known as probiotics, along with prebiotics \u2013 non-digestible fibre that stimulates the growth of healthy bacteria.\u003C\/p\u003E\u003Cp\u003E\u2018This could be a novel approach to improve both the intestinal problems that are so common in children with autism and behavioural symptoms,\u2019 said Fasano.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EFaster detection\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EAt present, the youngest age at which a child can be diagnosed with autism is 18 months. But most are diagnosed closer to three years of age.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EFasano\u0026nbsp;dreams of a time when detection and treatment can occur before the onset of symptoms and after a simple stool analysis.\u003C\/p\u003E\u003Cp\u003E\u2018We\u2019re aiming for precision medicine,\u2019 he said.\u003C\/p\u003E\u003Cp\u003EInformation from GEMMA suggests that autism may affect as many as one in 36 children.\u003C\/p\u003E\u003Cp\u003EFasano suspects that a Western lifestyle, including poor diets, may be partly responsible.\u003C\/p\u003E\u003Cp\u003E\u2018The environment we live in has probably changed too fast for our bodies to adapt,\u2019 he said.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EOther disorders\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003E\u003Cblockquote class=\u0022tw-text-center tw-text-blue tw-font-bold tw-text-2xl lg:tw-w-1\/2 tw-border-2 tw-border-blue tw-p-12 tw-my-8 lg:tw-m-12 lg:tw--ml-16 tw-float-left\u0022\u003E\n \u003Cspan class=\u0022tw-text-5xl tw-rotate-180\u0022\u003E\u201c\u003C\/span\u003E\n \u003Cp class=\u0022tw-font-serif tw-italic\u0022\u003EThe hope is that early identification of autism can lead to prevention or treatment.\u003C\/p\u003E\n \u003Cfooter\u003E\n \u003Ccite class=\u0022tw-not-italic tw-font-normal tw-text-sm tw-text-black\u0022\u003EProfessor Jan Buitelaar, CANDY\u003C\/cite\u003E\n \u003C\/footer\u003E\n\u003C\/blockquote\u003E\n\u003C\/p\u003E\u003Cp\u003EThe gut\u2019s connection to common neurological disorders is also the research focus of Jan Buitelaar, a professor of medical sciences at Radboud University in the Netherlands.\u003C\/p\u003E\u003Cp\u003EBuitelaar leads an EU-funded project hunting for shared\u0026nbsp;underlying characteristics in a range of seemingly distinct neurodevelopmental conditions. These include autism, attention-deficit hyperactivity disorder, intellectual disability and epilepsy.\u003C\/p\u003E\u003Cp\u003ENamed \u003Ca href=\u0022https:\/\/cordis.europa.eu\/project\/id\/847818\u0022\u003ECANDY\u003C\/a\u003E, the five-year project is\u0026nbsp;due to end at the same time as GEMMA in December 2024.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EIt\u2019s no coincidence that a child with autism will frequently also have attention-deficit disorder or\u0026nbsp;that someone with intellectual disability will have a sibling with epilepsy, according to Buitelaar.\u003C\/p\u003E\u003Cp\u003E\u2018Often, several of these conditions occur together and, on top of that, go along with other illnesses \u2013 most commonly epilepsy,\u2019 he said.\u003C\/p\u003E\u003Cp\u003E\u003Cstrong\u003EBacterial profiling\u003C\/strong\u003E\u003C\/p\u003E\u003Cp\u003EFor this project,\u0026nbsp;stool, urine, blood and saliva are being collected from three groups: children aged three to six, older ones and the mothers of young study participants.\u003C\/p\u003E\u003Cp\u003EBuitelaar and his colleagues are looking for common genetic abnormalities in people with differing neurodevelopmental conditions.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003EThe team is also profiling the immune systems of study participants and collecting microbiome samples from both mice and humans. The aim is to explore links between microbiome composition, neurodevelopmental disorders and their varying symptoms.\u003C\/p\u003E\u003Cp\u003E\u2018Our aim is to explore to what extent the microbiome plays a role in either mitigating or creating a vulnerability to an inflammatory response,\u2019 said Buitelaar.\u003C\/p\u003E\u003Cp\u003EIn addition, the researchers are seeking to determine whether certain types of bacteria are more present in people with severe forms of autism and, if so, how this information can be used for prevention and intervention.\u003C\/p\u003E\u003Cp\u003EAnother objective of CANDY is, like GEMMA, to detect neurodevelopmental conditions more speedily.\u0026nbsp;\u003C\/p\u003E\u003Cp\u003E\u2018The hope is that early identification of autism can lead to prevention or treatment,\u2019 said Buitelaar.\u003C\/p\u003E\u003Cp\u003E\u003Cem\u003EResearch in this article was funded by the EU\u2019s Horizon Programme. The views of the interviewees don\u2019t necessarily reflect those of the European Commission. 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