Observation of the Therapeutic Effect of Washed Microbiota Transplantation on Childhood Autism Spectrum Disorder

Abstract

Background: This retrospective study evaluated the efficacy and safety of washed microbiota transplantation (WMT) via trans colonic endoscopic administration tube for children with autism spectrum disorder (ASD).

Methods: The clinical data of 19 children with ASD treated between November 2021 and December 2023 were analysed. The data included scores on the Autism Behaviour Checklist (ABC), Childhood Autism Rating Scale (CARS) and PedsQL™ 3.0 Gastrointestinal Symptoms Scales (PedsQL-GI) before treatment and one and six months post-WMT, as well as faecal 16S rRNA sequencing results (vs. healthy controls).

Results: ABC, CARS and PedsQL-GI scores improved significantly over time (all p < 0.001, large effect sizes). CARS and PedsQL-GI scores decreased notably at one and six months after treatment. ABC scores reduced significantly only at six months posttreatment. PedsQLGI scores at six months posttreatment further declined relative to those atone month posttreatment, whereas ABC and CARS scores remained stable. Subgroup analysis showed greater score reductions in the high-score ASD and constipation subgroups than in other patients. Faecal microbiota analysis revealed structural differences between ASD and healthy children. WMT altered gut flora structure and increased beneficial bacteria (e.g., Faecalibacterium).

Conclusions: Preliminary findings suggest that WMT may improve gastrointestinal and core symptoms in children with ASD, especially those in high-score subgroups. Caution is needed given this study’s small sample size, and large prospective studies are required for validation.