title: Gut permeability in autism spectrum disorders.
abstract: OBJECTIVE
  To test whether gut permeability is increased in autism spectrum disorders (ASD) by evaluating gut permeability in a population-derived cohort of children with ASD compared with age- and intelligence quotient-matched controls without ASD but with special educational needs (SEN).
  
  
  METHODS
  One hundred thirty-three children aged 10-14 years, 103 with ASD and 30 with SEN, were given an oral test dose of mannitol and lactulose and urine collected for 6 hr. Gut permeability was assessed by measuring the urine lactulose/mannitol (L/M) recovery ratio by electrospray mass spectrometry-mass spectrometry. The ASD group was subcategorized for comparison into those without (n = 83) and with (n = 20) regression.
  
  
  RESULTS
  There was no significant difference in L/M recovery ratio (mean (95% confidence interval)) between the groups with ASD: 0.015 (0.013-0.018), and SEN: 0.014 (0.009-0.019), nor in lactulose, mannitol, or creatinine recovery. No significant differences were observed in any parameter for the regressed versus non-regressed ASD groups. Results were consistent with previously published normal ranges. Eleven children (9/103 = 8.7% ASD and 2/30 = 6.7% SEN) had L/M recovery ratio > 0.03 (the accepted normal range cut-off), of whom two (one ASD and one SEN) had more definitely pathological L/M recovery ratios > 0.04.
  
  
  CONCLUSIONS
  There is no statistically significant group difference in small intestine permeability in a population cohort-derived group of children with ASD compared with a control group with SEN. Of the two children (one ASD and one SEN) with an L/M recovery ratio of > 0.04, one had undiagnosed asymptomatic celiac disease (ASD) and the other (SEN) past extensive surgery for gastroschisis.
authors: WellChild Laboratory, Evelina Children's Hospital & King's College London, London.
authors: Neil
authors: N
authors: Dalton
authors: Susie
authors: S
authors: Chandler
authors: Charles
authors: C
authors: Turner
authors: Tony
authors: T
authors: Charman
authors: Andrew
authors: A
authors: Pickles
authors: Tom
authors: T
authors: Loucas
authors: Emily
authors: E
authors: Simonoff
authors: Peter
authors: P
authors: Sullivan
authors: Gillian
authors: G
authors: Baird
mesh_terms: D000293:Adolescent; D002463:Cell Membrane Permeability / Q000502:physiology*; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000652:urine*; D005260:Female; D065569:Gastrointestinal Absorption / Q000502:physiology*; D041981:Gastrointestinal Tract / Q000378:metabolism*; D006801:Humans; D007792:Lactulose / Q000652:urine; D008297:Male; D008353:Mannitol / Q000652:urine; D053719:Tandem Mass Spectrometry / Q000379:methods
chemical_list: D008353:Mannitol; D007792:Lactulose
keywords: autism; autism spectrum disorders; gut permeability; lactulose/mannitol ratio