Pediatr Gastroenterol Hepatol Nutr.  2015 Dec;18(4):230-237. 10.5223/pghn.2015.18.4.230.

Maladaptive Behavior and Gastrointestinal Disorders in Children with Autism Spectrum Disorder

• Pusponegoro HD
• Ismael S
• Sastroasmoro S
• Firmansyah A
• Vandenplas Y

• KMID: 2383300
• DOI: http://doi.org/10.5223/pghn.2015.18.4.230

Abstract

PURPOSE
Various gastrointestinal factors may contribute to maladaptive behavior in children with autism spectrum disorders (ASD). To determine the association between maladaptive behavior in children with ASD and gastrointestinal symptoms such as severity, intestinal microbiota, inflammation, enterocyte damage, permeability and absorption of opioid peptides.
METHODS
This observational cross-sectional study compared children with ASD to healthy controls, aged 2-10 years. Maladaptive behavior was classified using the Approach Withdrawal Problems Composite subtest of the Pervasive Developmental Disorder Behavior Inventory. Dependent variables were gastrointestinal symptom severity index, fecal calprotectin, urinary D-lactate, urinary lactulose/mannitol excretion, urinary intestinal fatty acids binding protein (I-FABP) and urinary opioid peptide excretion.
RESULTS
We did not find a significant difference between children with ASD with severe or mild maladaptive behavior and control subjects for gastrointestinal symptoms, fecal calprotectin, urinary D-lactate, and lactulose/mannitol ratio. Urinary opioid peptide excretion was absent in all children. Children with ASD with severe maladaptive behavior showed significantly higher urinary I-FABP levels compared to those with mild maladaptive behavior (p=0.019) and controls (p=0.015).
CONCLUSION
In our series, maladaptive behavior in ASD children was not associated with gastrointestinal symptoms, intestinal inflammation (no difference in calprotectin), microbiota (no difference in urinary D-lactate) and intestinal permeability (no difference in lactulose/manitol ratio). ASD children with severe maladaptive behavior have significantly more enterocyte damage (increased urinary I-FABP) than ASD children with mild maladaptive behavior and normal children.

Keyword

Autism spectrum disorder; Intestinal inflammation; Intestinal permeability; Enterocyte damage; Urinary opioids

MeSH Terms

Absorption
Autistic Disorder*
Carrier Proteins
Autism Spectrum Disorder*
Child*
Cross-Sectional Studies
Enterocytes
Fatty Acids
Humans
Inflammation
Leukocyte L1 Antigen Complex
Microbiota
Opioid Peptides
Permeability
Carrier Proteins
Fatty Acids
Leukocyte L1 Antigen Complex
Opioid Peptides

Figure

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  Fig. 1 Recruitment of study subjects. ASD: autism spectrum disorders.

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  Fig. 2 Gastrointestinal disturbance, stool calprotectine level, urine intestinal fatty acids binding protein and lactulose excretion ratio in the autism spectrum disorders (ASD).

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