ARI Publication 40 – 2013 Version

Research – Treatment
A small open-label treatment study by Sandler et al with a potent non-absorbable antibiotic
(Vancomycin) found temporary improvement in gut function and behavior, but the gains were lost
when the treatment was stopped. These mixed results may be due to the inability for antibiotics to
destroy spores produced by clostridia or other bacteria. This study demonstrated the importance of
abnormal gut bacteria, and the difficulty in treating them long-term.

Sander et al, Short-term benefit from oral vancomycin treatment ofregressive-onset autism.
J Child Neural. 2000 Ju/;15(7):429-35.

Research on Gut Bacteria
Historically it has been very difficult to assess gut bacteria, because there are about 1000 different
types of bacteria in each person’s gut, and standard culture methods can only assess a few dozen
of them. However, new DNA-based methods are rapidly changing the ability to assess gut bacteria.
Two small studies by Finegold, et al found some limited evidence of abnormal anaerobic bacteria,
primarily increases in clostridia. They did not test for AGNB. A study by Parracho, et al also found
increased amounts of clostridia.

Song Y, Liu c;. Anegold SM. Real-time PCR quantitation ofclostridia in feces ofautistic children.
Appl Environ Microbial. 2004 Nov;70{11}:6459-6S.
Anegold et al, Gastrointestinal microflora studies in late-onset autism. Clin Infect Dis. 2002 Sep 1;35
(Suppl 1):56-516.
Parracho HM et al., Differences between the gut microflora ofchildren with autistic spectrum disorders
and that ofhealthy children. J Med Microbial. 2005 Oct;54(?t 10):987-91.

One study of 58 children with autism vs. 39 controls found that the severity of gut problems
strongly correlated with autism severity. Individuals with gut problems had much worse scores on
the ATEC subscales of speech, social, sensory cognitive, and health/physical behavior. That study
found some abnormalities in gut bacteria, including decreased levels of bifidobacteria (an important
beneficial bacteria) in children with autism compared to controls. However, they did not find
elevated yeast (by culture or microscopically) in stool samples.

Adams JB et al., Gastrointestinal Flora and Gastrointestinal Status in Children with Autism Comparisons
to Neurotypical Children and Correlation with Autism Severity, BMC Gastroenterology 2011, 11:22 (16
March 2011).

Two small studies using DNA-based methods to investigate all gut bacteria have been conducted,
but yielded dissimilar results – much larger studies are needed. One study (Finegold et al 2011)
found increased levels of desulfovibrio bacteria in children with autism, while another study
(Williams et al 2012) found Sutterela bacteria in half of the 23 children with autism but not in any of
the 9 controls.

 Finegold SM et al, Pyrosequencing study offecal microflora ofautistic and control children., Anaerobe.
2010 Aug;16(4):444-53. Epub 2010Jul 9.
Williams BL et al., Impaired carbohydrate digestion and transport and mucosa! dysbiosis in the intestines
ofchildren with autism andgastrointestinal disturbances. PloS One. 2011;6(9):e2458S. Epub 2011 Sep

Agape is proud to have
been involved in this study and
mentioned on page 16.