Many autistic children have extremely limited diets. For example, a geneticist friend of mine saw a case where an autistic child had been referred for genetic testing because of horrific, chronic, spontaneous wounds on gums and skin. Turned out to be scurvy, because he had exclusively eaten Wheat Thins for the last 3-4 years, which aren’t fortified with vitamin C.
I would fully expect that a monotonous diet leads to a heavy skew in the gut microbiome as specific bacterial species that thrive on that diet are selected for, others against. It makes some sense that a fecal transplant could repair the damage. If the diet has shifted or expanded, the transplant could lead to long term benefits by restoring newly-viable bacterial species, perhaps by facilitating digestion of the new types of food.
I’d be curious to see a factoring out of the diet composition, gut microbiome, genetics, and severity of autism symptoms.
The microbiome might have some modulating effect, but the fidelity of gut-brain axis communication isn’t so strong that our gut microbiome is driving us around with highly specific inputs.
The theories for how gut-brain axis modulation works include altering the balance of nutrients that get absorbed and modulating the vagus nerve, primarily. For someone with autism it might be possible that altering some of these balances could make the condition better or worse, but that’s all theory without much foundation.
What is known, however, is that diet has a massive impact on the microbiome. Even the mechanism for that is obvious: Bacteria thrive on different foods, so if you eat more of one class of nutrients and less of another then the microbiome proportions will adjust based on which ones thrive on that diet.
I’m not going to pretend to be an expert here, but I remember a study that found gut bacteria composition predicted whether or not an individual was chocolate-craving or not in individuals eating identical diets: https://pubmed.ncbi.nlm.nih.gov/17929959
putting aside what others have commented about the truastability of studies and similar
- what all studies show is some vague "craving" for something generic, e.g. the link between iron deficiency and craving for ice
- but what you see in autists is often a far stronger effect and not just for eating something, but also against eating most other food. A craving for chocolate does not remove appetite and willingness to eat other food. It just makes you really want to eat chocolate.
- more important the way autistic people get fixated on a monotonous diet is far more specific then any effects we have observed from gut bacteria or other similar sources AFIK. Like lets say your gut bacteria might make you crave fish. You autism on the other hand might make you crave dino formed fish sticks with a specific texture. And there is just no way gut bacteria care about your fish sticks being dino formed or the specific texture of them... But a autistic person often does care, quite a bit even.
You have to be careful with microbiome research because it’s a buzzword that gets crammed into a lot of research papers to imply something bigger. This is a single paper from Nestle Research Center (yes that Nestle) from 2007 that doesn’t even cite a number of people sampled in the abstract.
They didn’t run any experiments trying to change the diet or microbiome. They just correlated dietary preferences with some markers that might be correlated with the microbiome.
The paper does not say anything about how changing the microbiome might change preferences. The simplest and most well tested explanation is that dietary preference are driving the microbiome.
There’s a lot of woo-woo microbiome discussion out there that misses the really obvious basics of how the microbiome comes to exist and thrive: What you eat is what the microbiome eats, so changing what you eat will change the composition of bacteria that thrive. People who prefer chocolate are correlated with people who prefer sweet diets. High sugar intake is proven to alter the microbiome.
It makes sense for chocolate given that cocoa flavanols are prebiotic fiber for GABA-secreting bacteria which of course affects the parasympathetic nervous system.
The paper didn’t say that the microbiome was driving food preferences.
It measured some bio markers and some dietary preferences and claims some correlation.
The correlation is that what you eat fuels the microbiome. So your diet influences the microbiome by fueling or starving different bacteria.
Complex theories about causality going the other way through complex chains of flavonoids to bacteria to neurotransmitters to the parasympathetic nervous system sound impressive with all of the big words, but it’s such a complex theory that would need other testing to even begin to understand if there was something there.
Testing the other direction is easy and obvious. You can grow many bacteria in a Petri dish and see that some grow better or worse with different nutrients.
this relies a bit on a healthy brain to make s good correlation. an unhealthy brain might make a bad diet just out of habit/compulsion rather than driven by their biology.
Yes! My son who has autism would eat anything we put in front of him until age 3, when his weight, appetite and health suddenly and alarmingly crashed. Ever since that episode, he's had a much more restrictive diet and food preferences. Night and day.
They never successfully identified what happened. Just diagnosed it generally as failure to thrive.
There’s some research on sudden onset autism being treated with antifungals; so at least sometimes a sudden change may be the result of something very specific in the gut.
You seed the gut with nutrients. having lots of fiber and a varied diet increases the number of species that an adult has which is between a couple hundred to a thousand or so.
Our guts are generally dominated by a bunch of beneficial bacteria.
which for many is not the case for a variety of social economic or behavioral reasons. Add in with explosions of bacterial populations due to alcohol or sugar and you can see how we can change our gut biome drastically from week to week.
I’ve noticed I really need to keep alcohol and sugar consumption in check. Sometimes it seems like one drink is enough to kick off a gut ecosystem collapse, and other times my gut is more resistant to the effects. Definitely trying to increase fiber consumption significantly.
Simple starches and sugars (the former being rapidly converted into the latter) are probably the most harmful ingredient once we exclude actual poisons. And they’re just as normalized with most food being primarily composed of them, even though normal people barely need them.
autists have often a much much stronger need for habits and avoidance of change. This includes a change of, or a less repeting/habitual diet. The effect if applified due to autism being commonly comorbid with ADHD and hyper fixation on specific foods being a very common thing (not (mainly) caused by gut bacteria as the effect is too strong and too specific to be "just" a preference caused by gut bacteria)
but this can lead to a imbalance of gut bacteria and that can have an reinforcing effect on wanting a even more monotonous diet, but in the end this is AFIK "just" a secondary reinforcing reason not the root cause
We usually call these our "safe foods" and yes, it is a very real problem for many of us in the autistic community, specifically around nutritional deficiencies. In a similar vein, as a child I went several years just eating plain Cheerios. For a close friend it was chicken nuggets.
Given how many kids are told to just "shut up and eat it" - and/or didn't have extreme pickiness but got DX'ed perhaps as an adult - I'd say there's a ton of research required to even suggest this as a plausible cause (even for a limited number of cases). It might make things worse, but I highly doubt it's causative.
> [...] the treatment, which involved a bowel cleanse and daily transplants of fecal microbiota over a period of seven to eight weeks
Maybe I'm misinterpreting what the process of that daily transplant looked like, but I expect they ate a not insignificant amount of hospital food if there were 7-8 weeks of daily treatments.
I didn't realize it was such a protracted process, but even if it's a long series of daily treatment, they aren't going to admit you for that if it can be done outpatient. You will be admitted if it's a risky enough procedure that it requires extended/overnight observation. If you can safely go home and come back the next day that is what they will ask you to do.
In my experience (instant cure for recurrent c. diff) a fecal transplant is easier and simpler than a colonoscopy, which themselves are easy enough to be outpatient.
>Editor's note: Readers often ask us for follow-ups on memorable stories. What has happened to this story over the years? This article was originally published in 2019 but it has been re-edited and updated with new information current as of April 7, 2025. Enjoy!
Now that is something that should be done more often - especially in science journalism, but not only. We cruelly lack long-term vision - not only forward but backwards too.
I agree about the updates. However, news sites like this one aren’t combing through research to find things to update. They’re responding to PR outreach from companies. Did you notice there isn’t actually a link to a new publication? It’s only quotes from the company. They’re repeating PR material, not updates on the research.
There’s a subtext here that isn’t immediately obvious without reading more from the company trying to commercialize this formula: Their small phase 2 trial is underway but results haven’t fully been released as far as I can tell. It appears they’re trying to do a PR push based on their early claims of positive results, before publishing everything. If anyone can find more details please correct me if I’m wrong.
This can be a little suspicious when companies do this because before the full results are available because it’s usually associated with a rushed push to drive investor interest at the time they think it’s most optimal. When the optimal PR push timing is before full results are released, it’s not a good signal that the results are on track to be great.
They aren't the only company doing this exact therapy.
It isn't a good one.
When I looked at preclinical for one of their competitors, that was the exact same thing, the issue was study design. Specifically, you are shoving something up an autistic kid's butt once a day or twice a day. They only did this to the placebo arm for 3 days, and only to healthy kids, whereas the treatment arm did this for 8 weeks.
If I punched you in the chest as hard as I could once or twice a day, do you think you'd have a behavioral change? That's their endpoint. If I called it a "medical" punch, does that change anything?
Can an autistic kid learn how to answer a test to get the thing to stop being shoved up their butt? I think so. By all means though, I encourage people to make this risky investment if they think this treatment pathway is real. It sort of is! If you want a behavioral change, we have a good idea of a way to get that from defenseless kids. But not for a good reason.
Given there are cases of sudden onset autism being resolved with antifungals, it’s at least not implausible that fecal transplants could be effective too.
There are so many claims of autism being cured in a couple people with different drugs or supplements out there.
They’re always followed by thousands of self-experimenters where nobody can reproduce the result.
The explanation is almost always placebo effect. A parent or doctor is so convinced that they’ve found a cure that they change assume it worked, change their behavior toward the autistic person, and believe that a dramatic change has occurred.
This is also why the placebo arm of every autism study also shows improvement.
No. No chance. It's completely implausible. This is reflected in their actual Phase II trial - NCT06503978 - whose primary endpoint is relieving GI symptoms. It's far from curing autism. It is idiosyncratic to target this population. They could do the same trial with healthy adults, but of course, twice daily massive laxatives is not something very marketable. The reason this product is the way it is is because ASD kids cannot really say no.
This seems a wild theory. So in your view, effectively abusing autistic kids results in a long-term, sustained, massive reduction in their autism symptoms? Highly skeptical on that, chief. I’d bet good money it goes the other way, and causing intentional pain and suffering in autistic kids would only worsen their symptoms.
I don’t even think I understand your proposed mechanism here. So these kids have this treatment multiple times a day, for eight weeks, and nothing they do during that time changes it, but then suddenly it stops, but they modulate their behavior for many months, what, just in case it happens again? When their behavior changes during the treatment had no effect on whether they keep getting the treatment? How does that make any sense?
The typical publishing methods kind of favors that approach of publishing new articles instead of updating existing ones though, for better or worse.
Maybe science journalism should just adopt a wiki-model instead, where there is one article per "subject" then any new (confirmed?) information/data goes into that, and interested people can subscribe to updates there instead.
Wikis generally have much better long-term maintenance given the right individuals running it, compared to a "publication journal" where things tend to get out of date eventually, with no way of actually seeing when old articles get updated.
No problem with publishing new articles, as long as they're properly contextualized and link to their predecessors – and the latter updated to link to the new information as well.
Grate example of how misleading just reading headlines can be, even if the headline isn't intentional misleading/click bait.
> reduce autism symptoms
> chronic gastrointestinal issues are a harsh reality
> boosting microbial diversity
> when [...] treat those gastrointestinal problems, their behavior improves
Through my opinionated take is:
- gastrointestinal issue are a common comorbidity of autism
- fixing that help autistic people to mask better/easier
- which makes a lot of sense as gastrointestinal issue are very stressful and so is masking. It's quite common that autistic people under stress have a harder time masking
- and masking is removing many of the "symptoms" of autism at cost of stress and other risks (e.g. depression), and society(^1) is conditioning(^2) children to mask autism subconsciously all the time
(^1): Pretty much any society out there.
(^2): Both intentional and accidental. For most autistic people masking isn't a conscious choice, but something through live so strongly reinforced that it's done unconsciously even if they don't want to in any situation except a private one with at most some very trusted people around.
---
Through a much more disturbing implication from this article is that at least in US/Arizona children with gastrointestinal issues commonly do not get appropriate treatment... Or else they couldn't have done the test as they wouldn't have found a non highly selection biased sample of autistic children.
Like treating of gastrointestinal issues shouldn't be a thing you do to reduce autistic symptoms, but something you do anyway. Even if not for quality of live, then for the reason of such issues often causing much more server long term issues if they stay untreated for years.
It is marked as having results submitted but quality review has not been completed.
N=60 and a placebo group, which is better than the N=18 and no placebo group of the first study.
There have been so many small scale trials showing amazing autism improvements that failed to replicate in larger, better controlled trials. I wouldn’t get excited yet.
The typical pattern is to show unbelievably good results in the first open-label trial with a small number of patients (their n=18 trial that claims to have cured severe autism in many children), squeak by with some marginal improvement in the next trial over placebo, then the third trial becomes a game of trying to keep the study small enough that they can hope to p-hack a result that the FDA might accept.
I've never really thought about this but, could it be because they don't want people to "try this at home"? Either because of safety issues, or my actual hypothesis, because they want to keep their possible pool of candidates as big as possible?
No, they have a patent so they would be in a hurry to publish if the results were good.
From the comments in the article above, it sounds like it may have failed it's primary outcome (autism symptoms). They only say there was significant benefit for "average of all symptoms", but it isn't clear if that is the same thing.
>> In early 2022 Krajmalnik-Brown and colleagues patented a specific bacterial formulation and spun-off a commercial company called Gut-Brain Axis Therapeutics.
I was a little surprised to see this.
So the university researchers use time and money from the university to make a discovery, extending on previous published research, and then patent it and start their own for-profit?
Excuse my ignorance, but is that how it's done generally? Where's the upside for all those who are potentially affected?
It kinda makes sense - Presumably the university is involved somewhere still, and it needs to be commercialised somehow, but..
Often universities do this, they may own the patent and license it to the company or take a cut etc. Arizona State University appear to do this through Skysong Innovations:
This is how it works. Universities are doing research, they aren't doing products. If a commercially viable product comes out of their research it is far outside the scope of universities.
Also keep in mind that most sciences usually don't produce commercially viable research (think social sciences, archeology, geography etc.)
And as others said: how the universities gets a cut from the spin offs differs from university to university.
“Universities” aren’t doing anything. Without the people that drive this they would just be admin people looking at each other and professors teaching to empty desks. Let’s not forget that often if a research was ran by X little group of people, once they move on, the people that come in have their own interests and it’s unlikely they’ll continue the project. How many unpublished papers sit because the student doing the research got a job, a life, doesn’t have time to continue and the PI can’t have some other student relearn the whole thing to finish it?
I understand the researchers lean on the infrastructure of the university, but I’m sure they paid their dues both in money payments to the university, depraved sleep and sweat.
People need to eat, so I see nothing wrong with them putting their effort to work if that means the research continues and gets to the people, the university likely gets a cut as others mentioned.
Yep. The alternative is usually that the product doesn't get manuactured. And the public funds loads of research which starts within private companies and stays there anyway...
As others have said, very common. A famous example is Lyrica, which made an enormous amount of money for Northwestern, probably around $1 billion dollars. It played a not-insignificant role in the university's rise in the last 10-20 years.
Universities love this and encourage it. Any big place will have an office of "technology transfer" or similar to help researchers make this happen.
It's quite common historically. The Entrepreneurial State by Mariana Mazzucato looks at this phenomenon of companies privatizing the benefits of publicly funded research and, she argues, not giving enough in return
The economist Mariana Mazzucato has some eye opening books about innovation and the role of governments. They are eye opening and dispel a lot of myths
I think the university gets a cut. Kinda like how Gatorade is making I can’t remember which university incredible amounts of money for the last several decades.
Funny thing is, that may be a bigger concern here, that the research is often publicly funded while the uses of that research and the profits that come with them are kept private. It’s complicated and I buy the notion that research improves the economy as a whole, but it is also true that when research gets patented and becomes a billion dollar product, those dollars don’t reduce any taxes directly.
What do you mean? Research funding absolutely is an investment. Research that is productized is a venture, and the universities involved absolutely do invest in the venture, and sometimes see a handsome ROI.
In terms of why the public funds research, your statement might be true, but isn’t addressing the concern that many in the public have raised before: the results of the research should be public, given that the research was publicly funded. We have laws about open access to government functions, so why is research different?
There are often a lot of steps between a discovery (or even a patent) and commercial viability. Patents make it easier for the companies to raise funding to do that work and move from theoretical or small scale to an actual product.
Also you could argue that patents are open access. The whole point of a patent is you give a complete summary of what the invention is and how to replicate it (with a level of detail that would allow someone knowledgeable in the field to recreate it) in exchange for a time limited legal moat.
> In terms of why the public funds research, your statement might be true
Yes this is what I meant. We fund research because we think pure research is valuable. It needs to be done without requiring a financial return. Products sometimes come out of it and that's also a public benefit, but direct results of the research are not a "product" they are the starting point to a possible product. There is still a lot of development that has to occur to get to the product stage.
> So the university researchers use time and money from the university to make a discovery, extending on previous published research, and then patent it and start their own for-profit?
it happens all the time, and in many countries. Its quite common in the UK.
100% is common. Stanford was paid hundreds of millions by Google over the years for the use of the patented PageRank algorithm, invented by Google's founders while Stanford students, and therefore owned by Stanford.
Most universities have IP policies giving them ownership of most of the IP their academics create, and student IP may or may not be included. Some exceptions are Duke and Waterloo.
Yes, it's really common. Most universities actually support this and there is a specific contractual framework for staff which basically says "If you create a company during or after your work at university which touches the field you were researching in, we get 1% (or 10% or 20%) of your annual revenue as license fees".
The alternatives are lengthy court battles between universities and their best (e.g. most commercial) researchers. This creates bad PR for the university and uncertainty for the researcher & their startups because potential investors don't like open court cases.
So people came around to make this kind of license fee contract and researchers check it before deciding to join a certain university.
Yes this is really common. Not all universities own the research you do. I have a similar setup within my university. They get to use the research technique I've worked on, but I have the rights to take it out of the university and sell it.
> Prior to the study, 83% of participants had "severe" autism. Two years later, only 17% were rated as severe, 39% as mild or moderate, and incredibly, 44% were below the cut-off for mild ASD.
I think the terminology of "incredible" is the operative word but I agree, if it could help, great. But I'm very skeptical. I find it hard to think that your gut biome can affect your brain so much that you struggle with social queues but are able to have an amazing memory.
But then I've met people not on "the spectrum" who have an amazing memory, such as a professor I recently met with who could remember the page numbers for certain phrases in books. Perhaps Asperger-level people just have the ability with the added challenges of autism?
I got bad chronic constipation after four years as a strict carnivore. I didn't get relief just by adding back fiber, but I did by adding fermented foods like kimchi. I wonder if ferments are a more natural way than fecal transplants to repair the gut microbiome, possibly treating autism. Studies have been non conclusive, but this story makes me think it's worth pursuing.
The microbiota is passed from mother to son on birth, not totally from the environment.
What we currently don’t understand is why for some people they never got them (we have techniques to transport the biota from the mother during birth for non-natural procedures) or they loose them.
Even with the transplant, the microbes won’t stick around on those people (not taking about autistic people here, but people in general).
Diverse food really helps, just as not eating ultraprocessed (they won’t reach the end of the intestines).
Fermented and other pre or probiotics will really help too.
But none of those will recover the biota in some people.
In some countries the number of kids born through c-section are very high, more than half the kids in Brazil are born that way for example, so definitely people can be healthy without getting it from their mothers.
I read it is a practice these days to do this fecal "rub" for newborns as a way to compensate for the C-section lack of it. I do not know if it happens in Brazil. Another factor to consider.
I've never heard of moms doing fecal rubs, but I've heard of many that do vaginal "transplants". I work in a hospital and we get questions quite a bit, moms will often take moist, sterile gauze and conduct the transplant themselves (staff can't really be involved for liability issues).
I just saw it in some documentary, but do not remember where. I found these, which look like what I heard described. I believe it is the same you mention:
It’s (meant to be) an emergency procedure. Benefits: life. Downsides: plenty.
Maybe most relevant in the context of this thread:
“In this systematic review and meta-analysis of 61 studies comprising more than 20 million deliveries, birth by cesarean delivery was significantly associated with autism spectrum disorder and attention-deficit/hyperactivity disorder.“
Zhang, T., Sidorchuk, A., Sevilla-Cermeño, L., Vilaplana-Pérez, A., Chang, Z., Larsson, H., Mataix-Cols, D., Fernández de la Cruz, L., & D’Onofrio, B. M. (2019). Association of cesarean delivery with risk of neurodevelopmental and psychiatric disorders in the offspring: A systematic review and meta-analysis. JAMA Network Open, 2(8), e1910236. https://doi.org/10.1001/jamanetworkopen.2019.10236
A selection of some more:
Keag, O. E., Norman, J. E., & Stock, S. J. (2018). Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: Systematic review and meta-analysis. PLOS Medicine, 15(1), e1002494. https://doi.org/10.1371/journal.pmed.1002494
De Mucio, B., Serruya, S., Alemán, A., Castellano, G., & Sosa, C. G. (2019). A systematic review and meta-analysis of cesarean delivery and other uterine surgery as risk factors for placenta accreta. International Journal of Gynecology & Obstetrics, 147(3), 281–291. https://doi.org/10.1002/ijgo.12948
Sandall, J., Tribe, R. M., Avery, L., Mola, G., Visser, G. H. A., Homer, C. S. E., Gibbons, D., Kelly, N. M., Kennedy, H. P., Kidanto, H., Taylor, P., & Temmerman, M. (2018). Short-term and long-term effects of caesarean section on the health of women and children. The Lancet, 392(10155), 1349–1357. https://doi.org/10.1016/S0140-6736(18)31930-5
Li, H.-T., Zhou, Y.-B., & Liu, J.-M. (2013). The impact of cesarean section on offspring overweight and obesity: A systematic review and meta-analysis. International Journal of Obesity, 37(7), 893–899. https://doi.org/10.1038/ijo.2012.195
S., Fleming, J., Bromley, A., Shields, M. D., & Cardwell, C. R. (2008). A meta-analysis of the association between Caesarean section and childhood asthma. Clinical & Experimental Allergy, 38(4), 629–633. https://doi.org/10.1111/j.1365-2222.2007.02780.x
Mascarello, K. C., Horta, B. L., & Silveira, M. F. (2017). Maternal complications and cesarean section without indication: Systematic review and meta-analysis. Revista de Saúde Pública, 51, 105. https://doi.org/10.11606/S1518-8787.2017051000389
Eating yoghurt and fresh fruit to replenish gut bacteria has long been common medical advice after severe-diarrhea illnesses. Something does indeed get through.
Dieting is calories in and calories out, but protein takes more calories to digest than fat or carbs and is often very filling so it's a good way to help someone diet who struggles with feeling hungry.
You feel satiated and you're reducing your caloric intake. You can only eat so much beef jerky compared to eating a whole bag of chips before getting sick. It's helpful for people who are binge eaters.
Can you elaborate please? Type 1 or type 2? If type 1, does that mean your body can now produce insulin on its own? If type 2, does that mean the insulin sensitivity of your cells is now back to normal levels and you could eat sugary food without issues?
1) I had constipation on a very high fiber diet before starting carnivore. That was fixed in literally one day. It was the most dramatic change. Then it gradually came back after about 3.5 years.
2) beef, butter, chicken, pork, lamb, eggs, bacon, for > 95%. I do indulge in some processed meats with seasonings. Salt is the only seasoning I add, so I've become a salt snob and get the premium stuff.
After that unspicy diet, full strength kimchi is an experience.
Just all foods including salt and water consumed over a 4 year time period with some unknown offset from present, sure seems like a reasonable amount of effort in response to some random guys HN post.
I would still be cautious with such findings. Many autistic people are picky eaters, also some of them have issues with peristalsis. This might affect the microbiome as well. While it's plausible that it might help a subset of people, we should not overgeneralize since autism is a very heterogeneous condition, usually with pronounced genetic predisposition. Overall, it doesn't seem to be a cure.
I had a similar question to.
From my understanding of the study, which was double blind placebo study, it does not treat autism but its shown to greatly improve symptoms of autism.
They basically wiped the gut clean with antibiotics then started treating and saw improvements.
Could be that GI issues increase irritability which makes the measured autism symptoms more aggressive but it looks very promising for families.
True that, but it could be both cause and effect. There are reports that gut bacteria can induce depression, which benefits the bacteria because it sends more calorie-rich, highly processed food down the gullet (think ice cream binges when depressed). Not hard to believe that gut bacteria optimized for a particular kind of food could evolve the ability to induce their host to eat that food exclusively. It would have the side-benefit (for the bacteria) of reducing competition from other microbes that aren't optimized for that, by starving them out. Things aren't always just cause or effect, especially in biology.
Maybe. IMHO there is also a microbiome hype train in the recent years. Most of these microbiome studies aren't considering a lot confounding factors. Here is a paper: https://www.cell.com/cell/fulltext/S0092-8674(21)01231-9 that found only very little evidence for association between ASD and gut microbiome.
What's more plausible? Did they cure low functioning autism in two years? Or did they simpily miscategorize the kids and the kids grew out of their diagnosis as they matured?
They say that they started a phase 2 trial with placebo control in 2022 and they see better outcome than placebo
> Our phase 2 study for adults with autism found that the treatment group improved more than placebo on the primary outcome (autism symptoms) and on a secondary outcome (daily stool record),
I can't find full analysis but the primary autism-symptom outcome improved by 9% in treatment group and 4% in controls. I guess there is no statistical significance because that metric likely has high variance.
In abnormal stools there was 42% improvement in treatment vs 23% in control.
The combination of GI disorder and autism in these trials make blinding almost impossible. The patients will notice if the GI symptoms change. And the results seem to be that this fecal transplant has larger effect for the GI part anyway.
It's a bit speculative. They need placebo-controlled trials and so far the results have not been very convincing for many psychiatric outcomes. There is exciting research around gut microbiota, but many of these studies which make rounds in HN and other online forums, seem to be mostly open-label or uncontrolled studies.
That's what I'm saying. It's a misdiagnosis. Whether or not they have tantrums should not be a factor in whether or not they are high-functioning or low-functioning.
It does not have to be misdiagnosis. If kid has both autism and gut issues, the gut issues could make the autistic symptoms worse, by causing distress to the kid, which could make the interactions with caregivers harder for both in a quite formative period. Treating the gut issues could help this way without gut being directly related to autism and without it being a misdiagnosis. It is telling that they report quite high (0.7) correlations between improvement in gut and autistic symptoms.
However they say they also have an adult trial running that seems to show similar effects, so there might be something more into it.
"High-functioning" and "low-functioning" are not meaningful as permanent diagnoses, because how a person functions is heavily-dependent on their environment (social, physical, and societal), including stimulus and chemical signalling from their own body.
An environment in which one person can thrive, labour, and enjoy life could be boring or incomprehensible or unduly stressful to another. I know people who would be diagnosed "low-functioning" if assessed in an everyday environment, but "high-functioning" if assessed in a clinical environment, and I know people who might not be diagnosed at all in an everyday environment but would be diagnosed with several seconds of acronyms in a clinical environment; and I know people who've been able to fight to get themselves an everyday environment that works for them, and I know people with vast potential who have conceded that fight and are rotting in the social care system.
If you eliminate what "should not be a factor" from the diagnostic process, then you eliminate the high-functioning / low-functioning distinction entirely. But all models are wrong, and some models are useful: while I find this particular model distasteful, there are contexts where it is necessary to get people in an environment where they can thrive (which, for children, usually means getting their parents the support they need, and occasionally the education).
If it was anything else but gut bacteria, I would be inclined to agree with you, but gut microbiota is slowly turning out to be an extremely important factor in our health and it also turns out that modern highly processed diet tends to damage it and make it less diverse. Even higher frequency of Caesarian section seems to make gut microbiota less diverse and there seem to be some diseases downstream from that.
At the same time, gut microbiota is extremely complex to study.
So, this may be a plausible result. I cannot judge the plausibilities right away in the way you suggest it.
Noe you’re making me self-conscious about when I get into a self-hating mood; unfortunately this gives me yet another new reason to hate myself: it’s not a good look.
First website where I've had to disable first-party JavaScript just to be able to read a text-based article. Even Firefox's reader mode was hijacked by their anti-ad-blocker script. Shameful.
AFAIK fecal transplants do not work well long term, has there been any research in making them more sticky? Lots of things you could trial but I have a feeling it’s the immune system responding to the right bacteria incorrectly…
Being told to eat shit has been typical of most of my experience of trying to get normies to understand my mild nuerodiversity.
My slightly more serious experience is that in my late 20s I started getting digestive problems and gaining weight. I feel like my neurodiversity got worse, but that could easily be that environmental factors exposed it.
How does one take advantage of a study like this? I would be difficult to get medically sanctioned poo right now. So what can I do? Coprophilia seems high risk.
I mean I can eat Kimchi and oats, but that seems more about encouraging the bugs that are already there than replacing missing bugs. Are we close to over the counter poo pills?
Aren't probiotics essentially gut bacteria? Is the problem that they aren't the right gut bacteria, or that they get released at the wrong stage of the digestive pipeline? If it's the latter, is it just a matter of making the capsule release at the right point?
Or is the problem that there are different sets of issues, and finding the right mix of bacteria to fix the issue is difficult?
I wonder if there’s any study linking C-section birth, autism and microbiota? Or newborns that have to stay in incubators?
I understand a newborn gets its microbiota naturally by contact with the mom in the first days, maybe all the sterile environment involved in surgery changes that.
Title is a bit misleading. It’s not a fecal transplant. It’s tablets and powder (for the pitt-hopkins cases) of microbes from fecal donors. Consumes orally.
First they gave them the name "assburgers" (aspergers) and now this is the solution medicine is proposing?
It's like the medical community wants all high functioning autistics to get bullied like hell in their formative years. Similar irony to "lisp" being unpronounceable by the very people who have a lisp.
I find this interesting because my first awareness of a link between gastrointestinal problems and autism was in the retracted so labelled "fraud" paper by Andrew Wakefield et al in 1998 which noted a link between gastrointestinal disease and autism in the subjects of the study.
In fact it is the subject of the paper, not the MMR vaccine which was the cause of the "controversy".
Well no, what they're saying is it seems to be capable of reducing autism-related struggles and misbehavior, not that it can somehow remove autism. Truly removing autism in any meaningful way is probably impossible since the brain was trained with it since birth.
No, that appears to be the implication of this study, which frankly seems like such a large effect that I'm pretty skeptical! I'd say "where's the control group" except the claimed effect is so large that you kind of don't need one, if it's real:
> Prior to the study, 83% of participants had "severe" autism. Two years later, only 17% were rated as severe, 39% as mild or moderate, and incredibly, 44% were below the cut-off for mild ASD.
Emphasis mine. If you are below the cutoff for mild ASD you wouldn't be diagnosed at all.
My reasing of the study is children with significant gut issues and diagnosed with autism see a significant reduction in symptoms when the gut issues are treated.
Which leads me to wonder if for some of these children is the root cause just gut issues.
If all they have figured out how to so is treat significant gut issues that sounds very promising.
That was the study without a control; for the placebo controlled study, they don't give the numbers, just say "statistically significant improvements" on several metrics.
(Without a control group, you have questions about how people of that age generally progress, and what other treatment/therapies they receive over those 2 years. The phase 1 trial was with children whose parents presumably sought ever possible way to help them, while the placebo controlled phase 2 was adults who may have plateaued.)
> If you are below the cutoff for mild ASD you wouldn't be diagnosed at all.
That makes sense, since ASD is a disorder classification and is mainly relevant for treatment and benefits. Plenty of autistic people are not diagnosed with ASD.
The article certainly could do more to differentiate between the autistic spectrum itself and the diagnosis of ASD, but as long as you know not to conflate the two, it seems perfectly clear to me.
You want to land a substantial amount of, ahem, shit in there, since don't just want it to colonize one portion of the gut, and it's got quite a lot of competition.
So you would be talking a truly astonishing number of pills, I think, to compare to the volume you can manage with a tube.
WP suggests that it's about 100g (or 100000mg) of actual feces then mixed in a larger volume of saline or milk, and you'd probably need to have additional volume for assumed losses and whatever coating you think would work.
Good point, but shit seems to be made of a lot of stuff- ~75% water, undigested food and fiber, fats, inorganic matter... Bacteria seem to be about ~30% of the dry weight. So of those 100 grams, you'd get maybe 7/8 grams of bacteria? If so, these could possibly be delivered by a number of small capsules taken in the course of several days.
There really isn't. From the mouth is basically the same distance and it contains teeth and a tongue. Through the rectum is much much much farther through meters of intestine. Through the skin creates a surgical hole that's going to be difficult to keep sterile.
The number of stories I’ve read in the last 15 years that amount to: “desperate after years of trying everything, we bought a blender and ground up my wife’s shit and put it up my butt, and within a 24 hours I was totally fine”
my wife is autistic and suffers from many gastro illnesses including MCAS and SIBO. The amount of times i've seriously thought of figuring out the logistics of giving her a fecal transplant from my iron stomach...
Many autistic children have extremely limited diets. For example, a geneticist friend of mine saw a case where an autistic child had been referred for genetic testing because of horrific, chronic, spontaneous wounds on gums and skin. Turned out to be scurvy, because he had exclusively eaten Wheat Thins for the last 3-4 years, which aren’t fortified with vitamin C.
I would fully expect that a monotonous diet leads to a heavy skew in the gut microbiome as specific bacterial species that thrive on that diet are selected for, others against. It makes some sense that a fecal transplant could repair the damage. If the diet has shifted or expanded, the transplant could lead to long term benefits by restoring newly-viable bacterial species, perhaps by facilitating digestion of the new types of food.
I’d be curious to see a factoring out of the diet composition, gut microbiome, genetics, and severity of autism symptoms.
Just to play devil’s advocate, isn’t it also possible that the preference for a monotonous diet is driven by gut makeup?
The microbiome might have some modulating effect, but the fidelity of gut-brain axis communication isn’t so strong that our gut microbiome is driving us around with highly specific inputs.
The theories for how gut-brain axis modulation works include altering the balance of nutrients that get absorbed and modulating the vagus nerve, primarily. For someone with autism it might be possible that altering some of these balances could make the condition better or worse, but that’s all theory without much foundation.
What is known, however, is that diet has a massive impact on the microbiome. Even the mechanism for that is obvious: Bacteria thrive on different foods, so if you eat more of one class of nutrients and less of another then the microbiome proportions will adjust based on which ones thrive on that diet.
I’m not going to pretend to be an expert here, but I remember a study that found gut bacteria composition predicted whether or not an individual was chocolate-craving or not in individuals eating identical diets: https://pubmed.ncbi.nlm.nih.gov/17929959
putting aside what others have commented about the truastability of studies and similar
- what all studies show is some vague "craving" for something generic, e.g. the link between iron deficiency and craving for ice
- but what you see in autists is often a far stronger effect and not just for eating something, but also against eating most other food. A craving for chocolate does not remove appetite and willingness to eat other food. It just makes you really want to eat chocolate.
- more important the way autistic people get fixated on a monotonous diet is far more specific then any effects we have observed from gut bacteria or other similar sources AFIK. Like lets say your gut bacteria might make you crave fish. You autism on the other hand might make you crave dino formed fish sticks with a specific texture. And there is just no way gut bacteria care about your fish sticks being dino formed or the specific texture of them... But a autistic person often does care, quite a bit even.
You have to be careful with microbiome research because it’s a buzzword that gets crammed into a lot of research papers to imply something bigger. This is a single paper from Nestle Research Center (yes that Nestle) from 2007 that doesn’t even cite a number of people sampled in the abstract.
They didn’t run any experiments trying to change the diet or microbiome. They just correlated dietary preferences with some markers that might be correlated with the microbiome.
The paper does not say anything about how changing the microbiome might change preferences. The simplest and most well tested explanation is that dietary preference are driving the microbiome.
There’s a lot of woo-woo microbiome discussion out there that misses the really obvious basics of how the microbiome comes to exist and thrive: What you eat is what the microbiome eats, so changing what you eat will change the composition of bacteria that thrive. People who prefer chocolate are correlated with people who prefer sweet diets. High sugar intake is proven to alter the microbiome.
It makes sense for chocolate given that cocoa flavanols are prebiotic fiber for GABA-secreting bacteria which of course affects the parasympathetic nervous system.
The paper didn’t say that the microbiome was driving food preferences.
It measured some bio markers and some dietary preferences and claims some correlation.
The correlation is that what you eat fuels the microbiome. So your diet influences the microbiome by fueling or starving different bacteria.
Complex theories about causality going the other way through complex chains of flavonoids to bacteria to neurotransmitters to the parasympathetic nervous system sound impressive with all of the big words, but it’s such a complex theory that would need other testing to even begin to understand if there was something there.
Testing the other direction is easy and obvious. You can grow many bacteria in a Petri dish and see that some grow better or worse with different nutrients.
this relies a bit on a healthy brain to make s good correlation. an unhealthy brain might make a bad diet just out of habit/compulsion rather than driven by their biology.
Yes! My son who has autism would eat anything we put in front of him until age 3, when his weight, appetite and health suddenly and alarmingly crashed. Ever since that episode, he's had a much more restrictive diet and food preferences. Night and day.
They never successfully identified what happened. Just diagnosed it generally as failure to thrive.
There’s some research on sudden onset autism being treated with antifungals; so at least sometimes a sudden change may be the result of something very specific in the gut.
There is not reasonable evidence supporting the idea that autism can be treated with antifungals.
Case reports are unreliable due to placebo effect.
The antifungal myth has been tested by too many well-meaning parents with no results.
You seed the gut with nutrients. having lots of fiber and a varied diet increases the number of species that an adult has which is between a couple hundred to a thousand or so. Our guts are generally dominated by a bunch of beneficial bacteria.
which for many is not the case for a variety of social economic or behavioral reasons. Add in with explosions of bacterial populations due to alcohol or sugar and you can see how we can change our gut biome drastically from week to week.
I’ve noticed I really need to keep alcohol and sugar consumption in check. Sometimes it seems like one drink is enough to kick off a gut ecosystem collapse, and other times my gut is more resistant to the effects. Definitely trying to increase fiber consumption significantly.
How are you judging the impact of things on your gut/microbiome?
Toilet visits?
How is one judging a "gut ecosystem collapse" from toilet visits?
Loose and unsatisfying stool?
Simple starches and sugars (the former being rapidly converted into the latter) are probably the most harmful ingredient once we exclude actual poisons. And they’re just as normalized with most food being primarily composed of them, even though normal people barely need them.
no and yes
autists have often a much much stronger need for habits and avoidance of change. This includes a change of, or a less repeting/habitual diet. The effect if applified due to autism being commonly comorbid with ADHD and hyper fixation on specific foods being a very common thing (not (mainly) caused by gut bacteria as the effect is too strong and too specific to be "just" a preference caused by gut bacteria)
but this can lead to a imbalance of gut bacteria and that can have an reinforcing effect on wanting a even more monotonous diet, but in the end this is AFIK "just" a secondary reinforcing reason not the root cause
We usually call these our "safe foods" and yes, it is a very real problem for many of us in the autistic community, specifically around nutritional deficiencies. In a similar vein, as a child I went several years just eating plain Cheerios. For a close friend it was chicken nuggets.
Given how many kids are told to just "shut up and eat it" - and/or didn't have extreme pickiness but got DX'ed perhaps as an adult - I'd say there's a ton of research required to even suggest this as a plausible cause (even for a limited number of cases). It might make things worse, but I highly doubt it's causative.
DX?
Diagnosed, sorry for the confusion
Yeah, I see the word "DX'ed" and immediately think of getting clotheslined by Triple H.
Now I'm even more confused. I can read every word in that sentence but I have no idea what it means.
I believe they're talking about wrestling, the WWE type of wrestling with characters and story lines and flashy moves.
Diagnosed
Imagine the factor overlooked is the nasty but nutritional hospital food they got when receiving the transplant (assuming they got hospitalized).
Doesn't seem like something that would require an inpatient stay.
> [...] the treatment, which involved a bowel cleanse and daily transplants of fecal microbiota over a period of seven to eight weeks
Maybe I'm misinterpreting what the process of that daily transplant looked like, but I expect they ate a not insignificant amount of hospital food if there were 7-8 weeks of daily treatments.
I didn't realize it was such a protracted process, but even if it's a long series of daily treatment, they aren't going to admit you for that if it can be done outpatient. You will be admitted if it's a risky enough procedure that it requires extended/overnight observation. If you can safely go home and come back the next day that is what they will ask you to do.
In my experience (instant cure for recurrent c. diff) a fecal transplant is easier and simpler than a colonoscopy, which themselves are easy enough to be outpatient.
>Editor's note: Readers often ask us for follow-ups on memorable stories. What has happened to this story over the years? This article was originally published in 2019 but it has been re-edited and updated with new information current as of April 7, 2025. Enjoy!
Now that is something that should be done more often - especially in science journalism, but not only. We cruelly lack long-term vision - not only forward but backwards too.
I agree about the updates. However, news sites like this one aren’t combing through research to find things to update. They’re responding to PR outreach from companies. Did you notice there isn’t actually a link to a new publication? It’s only quotes from the company. They’re repeating PR material, not updates on the research.
There’s a subtext here that isn’t immediately obvious without reading more from the company trying to commercialize this formula: Their small phase 2 trial is underway but results haven’t fully been released as far as I can tell. It appears they’re trying to do a PR push based on their early claims of positive results, before publishing everything. If anyone can find more details please correct me if I’m wrong.
This can be a little suspicious when companies do this because before the full results are available because it’s usually associated with a rushed push to drive investor interest at the time they think it’s most optimal. When the optimal PR push timing is before full results are released, it’s not a good signal that the results are on track to be great.
They aren't the only company doing this exact therapy.
It isn't a good one.
When I looked at preclinical for one of their competitors, that was the exact same thing, the issue was study design. Specifically, you are shoving something up an autistic kid's butt once a day or twice a day. They only did this to the placebo arm for 3 days, and only to healthy kids, whereas the treatment arm did this for 8 weeks.
If I punched you in the chest as hard as I could once or twice a day, do you think you'd have a behavioral change? That's their endpoint. If I called it a "medical" punch, does that change anything?
Can an autistic kid learn how to answer a test to get the thing to stop being shoved up their butt? I think so. By all means though, I encourage people to make this risky investment if they think this treatment pathway is real. It sort of is! If you want a behavioral change, we have a good idea of a way to get that from defenseless kids. But not for a good reason.
Given there are cases of sudden onset autism being resolved with antifungals, it’s at least not implausible that fecal transplants could be effective too.
There are so many claims of autism being cured in a couple people with different drugs or supplements out there.
They’re always followed by thousands of self-experimenters where nobody can reproduce the result.
The explanation is almost always placebo effect. A parent or doctor is so convinced that they’ve found a cure that they change assume it worked, change their behavior toward the autistic person, and believe that a dramatic change has occurred.
This is also why the placebo arm of every autism study also shows improvement.
No. No chance. It's completely implausible. This is reflected in their actual Phase II trial - NCT06503978 - whose primary endpoint is relieving GI symptoms. It's far from curing autism. It is idiosyncratic to target this population. They could do the same trial with healthy adults, but of course, twice daily massive laxatives is not something very marketable. The reason this product is the way it is is because ASD kids cannot really say no.
This seems a wild theory. So in your view, effectively abusing autistic kids results in a long-term, sustained, massive reduction in their autism symptoms? Highly skeptical on that, chief. I’d bet good money it goes the other way, and causing intentional pain and suffering in autistic kids would only worsen their symptoms.
I don’t even think I understand your proposed mechanism here. So these kids have this treatment multiple times a day, for eight weeks, and nothing they do during that time changes it, but then suddenly it stops, but they modulate their behavior for many months, what, just in case it happens again? When their behavior changes during the treatment had no effect on whether they keep getting the treatment? How does that make any sense?
The typical publishing methods kind of favors that approach of publishing new articles instead of updating existing ones though, for better or worse.
Maybe science journalism should just adopt a wiki-model instead, where there is one article per "subject" then any new (confirmed?) information/data goes into that, and interested people can subscribe to updates there instead.
Wikis generally have much better long-term maintenance given the right individuals running it, compared to a "publication journal" where things tend to get out of date eventually, with no way of actually seeing when old articles get updated.
No problem with publishing new articles, as long as they're properly contextualized and link to their predecessors – and the latter updated to link to the new information as well.
Grate example of how misleading just reading headlines can be, even if the headline isn't intentional misleading/click bait.
> reduce autism symptoms
> chronic gastrointestinal issues are a harsh reality
> boosting microbial diversity
> when [...] treat those gastrointestinal problems, their behavior improves
Through my opinionated take is:
- gastrointestinal issue are a common comorbidity of autism
- fixing that help autistic people to mask better/easier
- which makes a lot of sense as gastrointestinal issue are very stressful and so is masking. It's quite common that autistic people under stress have a harder time masking
- and masking is removing many of the "symptoms" of autism at cost of stress and other risks (e.g. depression), and society(^1) is conditioning(^2) children to mask autism subconsciously all the time
(^1): Pretty much any society out there.
(^2): Both intentional and accidental. For most autistic people masking isn't a conscious choice, but something through live so strongly reinforced that it's done unconsciously even if they don't want to in any situation except a private one with at most some very trusted people around.
---
Through a much more disturbing implication from this article is that at least in US/Arizona children with gastrointestinal issues commonly do not get appropriate treatment... Or else they couldn't have done the test as they wouldn't have found a non highly selection biased sample of autistic children.
Like treating of gastrointestinal issues shouldn't be a thing you do to reduce autistic symptoms, but something you do anyway. Even if not for quality of live, then for the reason of such issues often causing much more server long term issues if they stay untreated for years.
I think this is the clinical trial registration: https://clinicaltrials.gov/study/NCT03408886?tab=results
It is marked as having results submitted but quality review has not been completed.
N=60 and a placebo group, which is better than the N=18 and no placebo group of the first study.
There have been so many small scale trials showing amazing autism improvements that failed to replicate in larger, better controlled trials. I wouldn’t get excited yet.
The typical pattern is to show unbelievably good results in the first open-label trial with a small number of patients (their n=18 trial that claims to have cured severe autism in many children), squeak by with some marginal improvement in the next trial over placebo, then the third trial becomes a game of trying to keep the study small enough that they can hope to p-hack a result that the FDA might accept.
Study completed in 2022, but still no results posted or study published.
I've never really thought about this but, could it be because they don't want people to "try this at home"? Either because of safety issues, or my actual hypothesis, because they want to keep their possible pool of candidates as big as possible?
No, they have a patent so they would be in a hurry to publish if the results were good.
From the comments in the article above, it sounds like it may have failed it's primary outcome (autism symptoms). They only say there was significant benefit for "average of all symptoms", but it isn't clear if that is the same thing.
>> In early 2022 Krajmalnik-Brown and colleagues patented a specific bacterial formulation and spun-off a commercial company called Gut-Brain Axis Therapeutics.
I was a little surprised to see this.
So the university researchers use time and money from the university to make a discovery, extending on previous published research, and then patent it and start their own for-profit?
Excuse my ignorance, but is that how it's done generally? Where's the upside for all those who are potentially affected?
It kinda makes sense - Presumably the university is involved somewhere still, and it needs to be commercialised somehow, but..
Often universities do this, they may own the patent and license it to the company or take a cut etc. Arizona State University appear to do this through Skysong Innovations:
https://skysonginnovations.com/startups/list/
It's interesting they got a lot of funding from over 100 families with autism children:
https://skysonginnovations.com/startups/list/
This is how it works. Universities are doing research, they aren't doing products. If a commercially viable product comes out of their research it is far outside the scope of universities.
Also keep in mind that most sciences usually don't produce commercially viable research (think social sciences, archeology, geography etc.)
And as others said: how the universities gets a cut from the spin offs differs from university to university.
“Universities” aren’t doing anything. Without the people that drive this they would just be admin people looking at each other and professors teaching to empty desks. Let’s not forget that often if a research was ran by X little group of people, once they move on, the people that come in have their own interests and it’s unlikely they’ll continue the project. How many unpublished papers sit because the student doing the research got a job, a life, doesn’t have time to continue and the PI can’t have some other student relearn the whole thing to finish it?
I understand the researchers lean on the infrastructure of the university, but I’m sure they paid their dues both in money payments to the university, depraved sleep and sweat. People need to eat, so I see nothing wrong with them putting their effort to work if that means the research continues and gets to the people, the university likely gets a cut as others mentioned.
Yep. The alternative is usually that the product doesn't get manuactured. And the public funds loads of research which starts within private companies and stays there anyway...
As others have said, very common. A famous example is Lyrica, which made an enormous amount of money for Northwestern, probably around $1 billion dollars. It played a not-insignificant role in the university's rise in the last 10-20 years.
Universities love this and encourage it. Any big place will have an office of "technology transfer" or similar to help researchers make this happen.
The best part for NU is they didn’t even have to pay for the research, it was publicly funded:
> Pregabalin was discovered largely on the basis of publicly funded research at Northwestern University
https://pubmed.ncbi.nlm.nih.gov/34493615/
It's quite common historically. The Entrepreneurial State by Mariana Mazzucato looks at this phenomenon of companies privatizing the benefits of publicly funded research and, she argues, not giving enough in return
The economist Mariana Mazzucato has some eye opening books about innovation and the role of governments. They are eye opening and dispel a lot of myths
I think the university gets a cut. Kinda like how Gatorade is making I can’t remember which university incredible amounts of money for the last several decades.
Florida. The name comes from the name of their athletic teams: The Gators.
> So the university researchers use time and money from the university
Don’t worry, the money is usually coming from taxpayers so the universities don’t have to dip into their endowments
Funny thing is, that may be a bigger concern here, that the research is often publicly funded while the uses of that research and the profits that come with them are kept private. It’s complicated and I buy the notion that research improves the economy as a whole, but it is also true that when research gets patented and becomes a billion dollar product, those dollars don’t reduce any taxes directly.
The public funds the research so that it gets done in the first place. It's not a venture investment.
What do you mean? Research funding absolutely is an investment. Research that is productized is a venture, and the universities involved absolutely do invest in the venture, and sometimes see a handsome ROI.
In terms of why the public funds research, your statement might be true, but isn’t addressing the concern that many in the public have raised before: the results of the research should be public, given that the research was publicly funded. We have laws about open access to government functions, so why is research different?
There are often a lot of steps between a discovery (or even a patent) and commercial viability. Patents make it easier for the companies to raise funding to do that work and move from theoretical or small scale to an actual product.
Also you could argue that patents are open access. The whole point of a patent is you give a complete summary of what the invention is and how to replicate it (with a level of detail that would allow someone knowledgeable in the field to recreate it) in exchange for a time limited legal moat.
> In terms of why the public funds research, your statement might be true
Yes this is what I meant. We fund research because we think pure research is valuable. It needs to be done without requiring a financial return. Products sometimes come out of it and that's also a public benefit, but direct results of the research are not a "product" they are the starting point to a possible product. There is still a lot of development that has to occur to get to the product stage.
> So the university researchers use time and money from the university to make a discovery, extending on previous published research, and then patent it and start their own for-profit?
it happens all the time, and in many countries. Its quite common in the UK.
Universities often keep up to 50% of rights over IP in such cases but I am unsure about this specific case.
100% is common. Stanford was paid hundreds of millions by Google over the years for the use of the patented PageRank algorithm, invented by Google's founders while Stanford students, and therefore owned by Stanford.
Most universities have IP policies giving them ownership of most of the IP their academics create, and student IP may or may not be included. Some exceptions are Duke and Waterloo.
Yes this is very common and a big part of why scientific progress often seems so hamstrung
Why hamstrung?
Yes, it's really common. Most universities actually support this and there is a specific contractual framework for staff which basically says "If you create a company during or after your work at university which touches the field you were researching in, we get 1% (or 10% or 20%) of your annual revenue as license fees".
The alternatives are lengthy court battles between universities and their best (e.g. most commercial) researchers. This creates bad PR for the university and uncertainty for the researcher & their startups because potential investors don't like open court cases.
So people came around to make this kind of license fee contract and researchers check it before deciding to join a certain university.
Not a fan of gene / bacteria patents though.
Yes this is really common. Not all universities own the research you do. I have a similar setup within my university. They get to use the research technique I've worked on, but I have the rights to take it out of the university and sell it.
> Prior to the study, 83% of participants had "severe" autism. Two years later, only 17% were rated as severe, 39% as mild or moderate, and incredibly, 44% were below the cut-off for mild ASD.
Pretty incredible if true!
I think the terminology of "incredible" is the operative word but I agree, if it could help, great. But I'm very skeptical. I find it hard to think that your gut biome can affect your brain so much that you struggle with social queues but are able to have an amazing memory.
But then I've met people not on "the spectrum" who have an amazing memory, such as a professor I recently met with who could remember the page numbers for certain phrases in books. Perhaps Asperger-level people just have the ability with the added challenges of autism?
who knows
Savantism is a separate concept from autism, though popular culture has somehow associated the two.
I got bad chronic constipation after four years as a strict carnivore. I didn't get relief just by adding back fiber, but I did by adding fermented foods like kimchi. I wonder if ferments are a more natural way than fecal transplants to repair the gut microbiome, possibly treating autism. Studies have been non conclusive, but this story makes me think it's worth pursuing.
The microbiota is passed from mother to son on birth, not totally from the environment.
What we currently don’t understand is why for some people they never got them (we have techniques to transport the biota from the mother during birth for non-natural procedures) or they loose them.
Even with the transplant, the microbes won’t stick around on those people (not taking about autistic people here, but people in general).
Diverse food really helps, just as not eating ultraprocessed (they won’t reach the end of the intestines).
Fermented and other pre or probiotics will really help too.
But none of those will recover the biota in some people.
In some countries the number of kids born through c-section are very high, more than half the kids in Brazil are born that way for example, so definitely people can be healthy without getting it from their mothers.
I read it is a practice these days to do this fecal "rub" for newborns as a way to compensate for the C-section lack of it. I do not know if it happens in Brazil. Another factor to consider.
I've never heard of moms doing fecal rubs, but I've heard of many that do vaginal "transplants". I work in a hospital and we get questions quite a bit, moms will often take moist, sterile gauze and conduct the transplant themselves (staff can't really be involved for liability issues).
I just saw it in some documentary, but do not remember where. I found these, which look like what I heard described. I believe it is the same you mention:
https://pmc.ncbi.nlm.nih.gov/articles/PMC11095576/
https://www.nature.com/articles/d41586-024-03449-4
It's not
> can be healthy
Or can they.
It’s (meant to be) an emergency procedure. Benefits: life. Downsides: plenty.
Maybe most relevant in the context of this thread:
“In this systematic review and meta-analysis of 61 studies comprising more than 20 million deliveries, birth by cesarean delivery was significantly associated with autism spectrum disorder and attention-deficit/hyperactivity disorder.“
Zhang, T., Sidorchuk, A., Sevilla-Cermeño, L., Vilaplana-Pérez, A., Chang, Z., Larsson, H., Mataix-Cols, D., Fernández de la Cruz, L., & D’Onofrio, B. M. (2019). Association of cesarean delivery with risk of neurodevelopmental and psychiatric disorders in the offspring: A systematic review and meta-analysis. JAMA Network Open, 2(8), e1910236. https://doi.org/10.1001/jamanetworkopen.2019.10236
A selection of some more:
Keag, O. E., Norman, J. E., & Stock, S. J. (2018). Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: Systematic review and meta-analysis. PLOS Medicine, 15(1), e1002494. https://doi.org/10.1371/journal.pmed.1002494
De Mucio, B., Serruya, S., Alemán, A., Castellano, G., & Sosa, C. G. (2019). A systematic review and meta-analysis of cesarean delivery and other uterine surgery as risk factors for placenta accreta. International Journal of Gynecology & Obstetrics, 147(3), 281–291. https://doi.org/10.1002/ijgo.12948
Sandall, J., Tribe, R. M., Avery, L., Mola, G., Visser, G. H. A., Homer, C. S. E., Gibbons, D., Kelly, N. M., Kennedy, H. P., Kidanto, H., Taylor, P., & Temmerman, M. (2018). Short-term and long-term effects of caesarean section on the health of women and children. The Lancet, 392(10155), 1349–1357. https://doi.org/10.1016/S0140-6736(18)31930-5
Li, H.-T., Zhou, Y.-B., & Liu, J.-M. (2013). The impact of cesarean section on offspring overweight and obesity: A systematic review and meta-analysis. International Journal of Obesity, 37(7), 893–899. https://doi.org/10.1038/ijo.2012.195
S., Fleming, J., Bromley, A., Shields, M. D., & Cardwell, C. R. (2008). A meta-analysis of the association between Caesarean section and childhood asthma. Clinical & Experimental Allergy, 38(4), 629–633. https://doi.org/10.1111/j.1365-2222.2007.02780.x
Mascarello, K. C., Horta, B. L., & Silveira, M. F. (2017). Maternal complications and cesarean section without indication: Systematic review and meta-analysis. Revista de Saúde Pública, 51, 105. https://doi.org/10.11606/S1518-8787.2017051000389
The lower intestinal region is guarded by a vat of acid. Not sure how much of those probiotic pills get through.
Eating yoghurt and fresh fruit to replenish gut bacteria has long been common medical advice after severe-diarrhea illnesses. Something does indeed get through.
Why did you follow a strict carnivore diet? Health? Accident? Aside from the constipation did it benefit your health?
Dieting is calories in and calories out, but protein takes more calories to digest than fat or carbs and is often very filling so it's a good way to help someone diet who struggles with feeling hungry.
You feel satiated and you're reducing your caloric intake. You can only eat so much beef jerky compared to eating a whole bag of chips before getting sick. It's helpful for people who are binge eaters.
Obesity and diabetes. It solved about half of the obesity and all of the diabetes.
> and all of the diabetes.
Can you elaborate please? Type 1 or type 2? If type 1, does that mean your body can now produce insulin on its own? If type 2, does that mean the insulin sensitivity of your cells is now back to normal levels and you could eat sugary food without issues?
>I got bad chronic constipation after four years as a strict carnivore.
2 questions:
1) Did your constipation start right after you did strict carnivore? Or was it after 4 years?
2) List all foods that you ate on strict carnivore. (Include salt, water etc. I presume it won't be a long list)
1) I had constipation on a very high fiber diet before starting carnivore. That was fixed in literally one day. It was the most dramatic change. Then it gradually came back after about 3.5 years.
2) beef, butter, chicken, pork, lamb, eggs, bacon, for > 95%. I do indulge in some processed meats with seasonings. Salt is the only seasoning I add, so I've become a salt snob and get the premium stuff.
After that unspicy diet, full strength kimchi is an experience.
Thanks.
Regarding full strength kimchi - did you make it yourself or did you buy it? If you bought it, what brand?
Just all foods including salt and water consumed over a 4 year time period with some unknown offset from present, sure seems like a reasonable amount of effort in response to some random guys HN post.
I would still be cautious with such findings. Many autistic people are picky eaters, also some of them have issues with peristalsis. This might affect the microbiome as well. While it's plausible that it might help a subset of people, we should not overgeneralize since autism is a very heterogeneous condition, usually with pronounced genetic predisposition. Overall, it doesn't seem to be a cure.
I had a similar question to. From my understanding of the study, which was double blind placebo study, it does not treat autism but its shown to greatly improve symptoms of autism.
They basically wiped the gut clean with antibiotics then started treating and saw improvements.
Could be that GI issues increase irritability which makes the measured autism symptoms more aggressive but it looks very promising for families.
Not affiliated just read the study.
True that, but it could be both cause and effect. There are reports that gut bacteria can induce depression, which benefits the bacteria because it sends more calorie-rich, highly processed food down the gullet (think ice cream binges when depressed). Not hard to believe that gut bacteria optimized for a particular kind of food could evolve the ability to induce their host to eat that food exclusively. It would have the side-benefit (for the bacteria) of reducing competition from other microbes that aren't optimized for that, by starving them out. Things aren't always just cause or effect, especially in biology.
Maybe. IMHO there is also a microbiome hype train in the recent years. Most of these microbiome studies aren't considering a lot confounding factors. Here is a paper: https://www.cell.com/cell/fulltext/S0092-8674(21)01231-9 that found only very little evidence for association between ASD and gut microbiome.
What's more plausible? Did they cure low functioning autism in two years? Or did they simpily miscategorize the kids and the kids grew out of their diagnosis as they matured?
They say that they started a phase 2 trial with placebo control in 2022 and they see better outcome than placebo
> Our phase 2 study for adults with autism found that the treatment group improved more than placebo on the primary outcome (autism symptoms) and on a secondary outcome (daily stool record),
Looks like this is the placebo-controlled trial https://clinicaltrials.gov/study/NCT03408886
I can't find full analysis but the primary autism-symptom outcome improved by 9% in treatment group and 4% in controls. I guess there is no statistical significance because that metric likely has high variance.
In abnormal stools there was 42% improvement in treatment vs 23% in control.
The combination of GI disorder and autism in these trials make blinding almost impossible. The patients will notice if the GI symptoms change. And the results seem to be that this fecal transplant has larger effect for the GI part anyway.
I'm guessing that the kids now have less stomachpain, constipation, and are feeling less bloated/nauseous. Thus have less voilent reactions
No, there’s a clear link between gut microbiome and behavioral/mental issues that has nothing to do with physical digestive symptoms. It’s been seen with other disorders, like depression: https://hms.harvard.edu/news/drawing-line-gut-microbiome-inf...
It's a bit speculative. They need placebo-controlled trials and so far the results have not been very convincing for many psychiatric outcomes. There is exciting research around gut microbiota, but many of these studies which make rounds in HN and other online forums, seem to be mostly open-label or uncontrolled studies.
That's what I'm saying. It's a misdiagnosis. Whether or not they have tantrums should not be a factor in whether or not they are high-functioning or low-functioning.
It does not have to be misdiagnosis. If kid has both autism and gut issues, the gut issues could make the autistic symptoms worse, by causing distress to the kid, which could make the interactions with caregivers harder for both in a quite formative period. Treating the gut issues could help this way without gut being directly related to autism and without it being a misdiagnosis. It is telling that they report quite high (0.7) correlations between improvement in gut and autistic symptoms.
However they say they also have an adult trial running that seems to show similar effects, so there might be something more into it.
"High-functioning" and "low-functioning" are not meaningful as permanent diagnoses, because how a person functions is heavily-dependent on their environment (social, physical, and societal), including stimulus and chemical signalling from their own body.
An environment in which one person can thrive, labour, and enjoy life could be boring or incomprehensible or unduly stressful to another. I know people who would be diagnosed "low-functioning" if assessed in an everyday environment, but "high-functioning" if assessed in a clinical environment, and I know people who might not be diagnosed at all in an everyday environment but would be diagnosed with several seconds of acronyms in a clinical environment; and I know people who've been able to fight to get themselves an everyday environment that works for them, and I know people with vast potential who have conceded that fight and are rotting in the social care system.
If you eliminate what "should not be a factor" from the diagnostic process, then you eliminate the high-functioning / low-functioning distinction entirely. But all models are wrong, and some models are useful: while I find this particular model distasteful, there are contexts where it is necessary to get people in an environment where they can thrive (which, for children, usually means getting their parents the support they need, and occasionally the education).
Their first study allegedly resulted in "44% were below the cut-off for mild ASD"- ie, practically cured, from a diagnostic point of view.
If it was anything else but gut bacteria, I would be inclined to agree with you, but gut microbiota is slowly turning out to be an extremely important factor in our health and it also turns out that modern highly processed diet tends to damage it and make it less diverse. Even higher frequency of Caesarian section seems to make gut microbiota less diverse and there seem to be some diseases downstream from that.
At the same time, gut microbiota is extremely complex to study.
So, this may be a plausible result. I cannot judge the plausibilities right away in the way you suggest it.
Kids got into tech industry and now it’s their spouses that have to deal with their tism, instead of parents
This is incredibly offensive.
Mods, please see to this comment.
Buzz off. If you were trying to make a joke, it didn't land. It scans as ableist twat.
Self-hatred is not a good look.
Noe you’re making me self-conscious about when I get into a self-hating mood; unfortunately this gives me yet another new reason to hate myself: it’s not a good look.
So if I eat somebody else's poo I'll become more social?
An unexpected result for sure.
First website where I've had to disable first-party JavaScript just to be able to read a text-based article. Even Firefox's reader mode was hijacked by their anti-ad-blocker script. Shameful.
It worked completely fine in my Firefox with uBlock Origin. I didn't have to do anything to read it, not even disabling UBO.
AFAIK fecal transplants do not work well long term, has there been any research in making them more sticky? Lots of things you could trial but I have a feeling it’s the immune system responding to the right bacteria incorrectly…
Being told to eat shit has been typical of most of my experience of trying to get normies to understand my mild nuerodiversity.
My slightly more serious experience is that in my late 20s I started getting digestive problems and gaining weight. I feel like my neurodiversity got worse, but that could easily be that environmental factors exposed it.
How does one take advantage of a study like this? I would be difficult to get medically sanctioned poo right now. So what can I do? Coprophilia seems high risk.
I mean I can eat Kimchi and oats, but that seems more about encouraging the bugs that are already there than replacing missing bugs. Are we close to over the counter poo pills?
Aren't probiotics essentially gut bacteria? Is the problem that they aren't the right gut bacteria, or that they get released at the wrong stage of the digestive pipeline? If it's the latter, is it just a matter of making the capsule release at the right point?
Or is the problem that there are different sets of issues, and finding the right mix of bacteria to fix the issue is difficult?
I wonder if there’s any study linking C-section birth, autism and microbiota? Or newborns that have to stay in incubators?
I understand a newborn gets its microbiota naturally by contact with the mom in the first days, maybe all the sterile environment involved in surgery changes that.
Title is a bit misleading. It’s not a fecal transplant. It’s tablets and powder (for the pitt-hopkins cases) of microbes from fecal donors. Consumes orally.
More like fecal food?
What did you think a fecal transplant was?
I'm embarrassed to admit this, but I always assumed a fecal transplant went in the other door
EDIT: looks like I was right, it can be done that way: https://en.wikipedia.org/wiki/Fecal_microbiota_transplant#Me...
No embarrassment, I thought the same. Feels like a far more sensible thought than fecal transplant via the mouth, for many reasons. Vindicating edit!
Suppository.
It many times is just someone else’s poop put into your butt
Yeah i'm not doing that. I'll just stay this way.
So there is finally a huge job market to for all those affected by AI-driven workforce purges: that of fecal donorship!
All applicants will be fed recycled byproducts for free.
Certain gut bacteria supplements are actually amazing. I found they lift brain fog substantially the next day after taking.
First they gave them the name "assburgers" (aspergers) and now this is the solution medicine is proposing?
It's like the medical community wants all high functioning autistics to get bullied like hell in their formative years. Similar irony to "lisp" being unpronounceable by the very people who have a lisp.
Maybe that's why some people love rimming? Is that a natural instinct to get more microbiome?
no placebo arm. result could be due to unisolated factors present in clinical trial fixturing.
original news source:
https://news.asu.edu/20190409-discoveries-autism-symptoms-re...
actual paper:
https://www.nature.com/articles/s41598-019-42183-0
I find this interesting because my first awareness of a link between gastrointestinal problems and autism was in the retracted so labelled "fraud" paper by Andrew Wakefield et al in 1998 which noted a link between gastrointestinal disease and autism in the subjects of the study.
In fact it is the subject of the paper, not the MMR vaccine which was the cause of the "controversy".
So all I gotta do is eat some poop and it will save me from becoming a handsome, funny, unique genius?
Autism fetishism.
This comment should be deleted.
Well no, what they're saying is it seems to be capable of reducing autism-related struggles and misbehavior, not that it can somehow remove autism. Truly removing autism in any meaningful way is probably impossible since the brain was trained with it since birth.
No, that appears to be the implication of this study, which frankly seems like such a large effect that I'm pretty skeptical! I'd say "where's the control group" except the claimed effect is so large that you kind of don't need one, if it's real:
> Prior to the study, 83% of participants had "severe" autism. Two years later, only 17% were rated as severe, 39% as mild or moderate, and incredibly, 44% were below the cut-off for mild ASD.
Emphasis mine. If you are below the cutoff for mild ASD you wouldn't be diagnosed at all.
My reasing of the study is children with significant gut issues and diagnosed with autism see a significant reduction in symptoms when the gut issues are treated.
Which leads me to wonder if for some of these children is the root cause just gut issues.
If all they have figured out how to so is treat significant gut issues that sounds very promising.
That was the study without a control; for the placebo controlled study, they don't give the numbers, just say "statistically significant improvements" on several metrics.
(Without a control group, you have questions about how people of that age generally progress, and what other treatment/therapies they receive over those 2 years. The phase 1 trial was with children whose parents presumably sought ever possible way to help them, while the placebo controlled phase 2 was adults who may have plateaued.)
> If you are below the cutoff for mild ASD you wouldn't be diagnosed at all.
That makes sense, since ASD is a disorder classification and is mainly relevant for treatment and benefits. Plenty of autistic people are not diagnosed with ASD.
The article certainly could do more to differentiate between the autistic spectrum itself and the diagnosis of ASD, but as long as you know not to conflate the two, it seems perfectly clear to me.
You don't eat it, don't be silly.... you stick the poop up your butt
I believe the best procedure is actually sticking it in your nose.
(They run a tube through your nose, down your throat, through the stomach to the top of the intestines, and introduce the bacterial slurry there.)
That's a fairly invasive way of doing it. It can be given through pills now. https://www.lhscri.ca/news/innovative-poop-pills-show-promis...
Makes you wonder how hard would it be to just put it in a swallowable capsule that dissolves only in the upper intestine.
Also, "fecal transplant" is marketable only to weirdos. "Probiotic infusion" would work better.
For those who want to gain some artistic talent, there's this (but is expensive):
https://en.wikipedia.org/wiki/Artist's_Shit
From my understanding, the problem is volume.
You want to land a substantial amount of, ahem, shit in there, since don't just want it to colonize one portion of the gut, and it's got quite a lot of competition.
So you would be talking a truly astonishing number of pills, I think, to compare to the volume you can manage with a tube.
WP suggests that it's about 100g (or 100000mg) of actual feces then mixed in a larger volume of saline or milk, and you'd probably need to have additional volume for assumed losses and whatever coating you think would work.
That is a _huge_ amount to put in pills.
Good point, but shit seems to be made of a lot of stuff- ~75% water, undigested food and fiber, fats, inorganic matter... Bacteria seem to be about ~30% of the dry weight. So of those 100 grams, you'd get maybe 7/8 grams of bacteria? If so, these could possibly be delivered by a number of small capsules taken in the course of several days.
Pretty sure there’s a shorter path to the top of the intestines than through the nose but I’m no Biologist.
If you’re implying it is through the rectum, you’ve definitely got some bio to brush up on. The small intestine alone is >20ft long.
There really isn't. From the mouth is basically the same distance and it contains teeth and a tongue. Through the rectum is much much much farther through meters of intestine. Through the skin creates a surgical hole that's going to be difficult to keep sterile.
The shortest safe path is via the nostril.
... Back and forth, forever?
))<>((
Wild to see multiple references in one place! That was one of the more memorable scenes ever…
))<>((
so all the people telling Musk to eat shit were in fact trying to heal him?
The number of stories I’ve read in the last 15 years that amount to: “desperate after years of trying everything, we bought a blender and ground up my wife’s shit and put it up my butt, and within a 24 hours I was totally fine”
Is kind of impressive.
my wife is autistic and suffers from many gastro illnesses including MCAS and SIBO. The amount of times i've seriously thought of figuring out the logistics of giving her a fecal transplant from my iron stomach...
Personally, anyone looking to get a fecal transplant from Sir Demis Hassabis will have to line up behind me. I want to be first in line.
Absolutely outrageous/hilarious clickbait title. It's not for autism but totally opposite.
That’s valid English. You take ibuprofen for headaches, or go to the hospital for a broken bone. Assuming the word ‘for’ means ‘causes’ is incorrect.
Did you also think "treatment for cancer" caused cancer where there was none?