接受粪便微生物群移植（FMT）与生酮饮食治疗的自闭症谱系障碍（ASD）患儿的临床疗效及肠道微生物群特征对比研究

Abstract

Objective Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social communication and interaction, along with restricted, repetitive patterns of behavior. It is often accompanied by gastrointestinal dysfunction and gut microbiota dysbiosis. Fecal Microbiota Transplantation (FMT) and the Ketogenic Diet (KD) are interventions targeting the gut microbiota for ASD. Methods 30 participants were diagnosed with ASD according to DSM-5 and ADOS-2. ASD core symptoms were evaluated with CARS and ABC. Gut microbiota composition was analyzed by shotgun metagenomic sequencing. Results Both groups demonstrated significant improvements in core symptoms. In the FMT group, the mean CARS score significantly decreased from 34.87 to 33.53 ( p  < 0.01); in the KD group, it declined from 35.13 to 33 ( p  < 0.01). The mean ABC score reduced from 79.93 to 69.33 ( p  = 0.064) in the FMT group and from 63.07 to 42.73 ( p  < 0.01) in the KD group. Following the intervention, no statistically significant changes were observed in α-diversity or β-diversity within either group. LEfSe analysis revealed distinct post-intervention microbial signatures: FMT significantly enriched butyrate-producing taxa ( Wujia chipingensis , Eubacterium sp. MSJ-33 , and Butyrivibrio crossotus ), while KD elevated Blautia massiliensis and decreased propionate metabolism -associated taxa ( Veillonella sp. S12025-13 and Veillonella nakazawae ). KEGG enrichment analysis revealed that KD enriched propionate metabolism (Fold enrichment = 3.747, q  = 0.010) and aromatic compound degradation (Fold enrichment = 3.591, q  = 0.010). Conclusions Both interventions significantly improved clinical symptoms among children with ASD, potentially through distinct patterns of gut microbiota modulation. Clinical trials number NCT06348433 (03/21/2024).