Alterations of the intestinal barrier in patients with autism spectrum disorders and in their first-degree relatives.
OBJECTIVE
Intestinal permeability (IPT) was investigated in patients with autism as well as in their first-degree relatives to investigate leaky gut hypothesis. Faecal calprotectin (FC) was also measured in patients with autism, either with or without gastrointestinal symptoms, and in their first-degree relatives.


METHODS
IPT results, assessed by means of the lactulose/mannitol test, were compared with adult and child controls and with FC values.


RESULTS
A high percentage of abnormal IPT values were found among patients with autism (36.7%) and their relatives (21.2%) compared with normal subjects (4.8%). Patients with autism on a reported gluten-casein-free diet had significantly lower IPT values compared with those who were on an unrestricted diet and controls. Gastrointestinal symptoms were present in 46.7% of children with autism: constipation (45.5%), diarrhoea (34.1%), and others (alternating diarrhoea/constipation, abdominal pain, etc: 15.9%). FC was elevated in 24.4% of patients with autism and in 11.6% of their relatives; it was not, however, correlated with abnormal IPT values.


CONCLUSIONS
The results obtained support the leaky gut hypothesis and indicate that measuring IPT could help to identify a subgroup of patients with autism who could benefit from a gluten-free diet. The IPT alterations found in first-degree relatives suggest the presence of an intestinal (tight-junction linked) hereditary factor in the families of subjects with autism.
de Magistris
Laura
L
Department Magrassi-Lanzara, Gastroenterology, Second University of Naples, Italy. laura.demagistris@unina2.it
Familiari
Valeria
V
Pascotto
Antonio
A
Sapone
Anna
A
Frolli
Alessandro
A
Iardino
Patrizia
P
Carteni
Maria
M
De Rosa
Mario
M
Francavilla
Ruggiero
R
Riegler
Gabriele
G
Militerni
Roberto
R
Bravaccio
Carmela
C
D015746:Abdominal Pain / Q000453:epidemiology; D000704:Analysis of Variance; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000453:epidemiology* / Q000378:metabolism; D015897:Comorbidity; D003248:Constipation / Q000453:epidemiology; D003967:Diarrhea / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005190:Family; D005243:Feces; D005260:Female; D006801:Humans; D007249:Inflammation / Q000453:epidemiology; D007410:Intestinal Diseases / Q000453:epidemiology* / Q000378:metabolism; D007413:Intestinal Mucosa / Q000378:metabolism / Q000503:physiopathology*; D007558:Italy / Q000453:epidemiology; D039841:Leukocyte L1 Antigen Complex / Q000378:metabolism; D008297:Male; D010539:Permeability
D039841:Leukocyte L1 Antigen Complex