(Nelson & Wexler 2000) 自閉症と抗生物質
「自閉症児には〇〇が良い。」あるいは「〇〇が悪い。」そんな文章をよく目にする。本当に良いものや悪いものがあるのだろうか？ あるとすればどのようなものなのだろうか？ これからそれを調べていきたい。
まずは抗生物質から。
J Child Neurol. 2000 Jul;15(7):429-35.
Short-term benefit from oral vancomycin treatment of regressive-onset autism.
Sandler RH, Finegold SM, Bolte ER, Buchanan CP, Maxwell AP, Väisänen ML, Nelson MN, Wexler HM.
Section of Pediatric Gastroenterology and Nutrition, Rush Children's Hospital, Rush Medical College, Chicago, IL 60612, USA. rushstudy@aol.com
Abstract
In most cases symptoms of autism begin in early infancy. However, a subset of children appears to develop normally until a clear deterioration is observed. Many parents of children with "regressive"-onset autism have noted antecedent antibiotic exposure followed by chronic diarrhea. We speculated that, in a subgroup of children, disruption of indigenous gut flora might promote colonization by one or more neurotoxin-producing bacteria, contributing, at least in part, to their autistic symptomatology. To help test this hypothesis, 11 children with regressive-onset autism were recruited for an intervention trial using a minimally absorbed oral antibiotic. Entry criteria included antecedent broad-spectrum antimicrobial exposure followed by chronic persistent diarrhea, deterioration of previously acquired skills, and then autistic features. Short-term improvement was noted using multiple pre- and post-therapy evaluations. These included coded, paired videotapes scored by a clinical psychologist blinded to treatment status; these noted improvement in 8 of 10 children studied. Unfortunately, these gains had largely waned at follow-up. Although the protocol used is not suggested as useful therapy, these results indicate that a possible gut flora-brain connection warrants further investigation, as it might lead to greater pathophysiologic insight and meaningful prevention or treatment in a subset of children with autism.
Comment in
J Child Neurol. 2001 May;16(5):387.
PMID: 10921511 [PubMed - indexed for MEDLINE]
Short-term benefit from oral vancomycin treatment of regressive-onset autism. - PubMed - NCBI
退行発症型自閉症へのバンコマイシン経口投与の短期的効果
自閉症児は通常幼児期から何らかの症状を示すことが多い。一方で正常に発達していたにもかかわらず、「退行発症型自閉症 (regressive-onset autism)」が発症することがあるという。そしてそれは慢性の下痢と関係している。この論文の著者は下痢の治療に使った抗生物質が腸内細菌叢を破壊し、そのために産生された神経毒が自閉症の原因となったという仮説を立てた。確認のために少量の抗生物質を使った介入試験が行われたが、改善は認められなかった。
