ISSN 1671-3710
CN 11-4766/R
主办:中国科学院心理研究所
出版:科学出版社

心理科学进展 ›› 2025, Vol. 33 ›› Issue (4): 611-619.doi: 10.3724/SP.J.1042.2025.0611 cstr: 32111.14.2025.0611

• 多学科视角下的孤独症神经心理机制专栏 • 上一篇    下一篇

炎症性肠病与儿童孤独症谱系障碍的关系

范桂容, 翁旭初, 耿红岩()   

  1. 华南师范大学脑科学与康复医学研究院, 广州 510898
  • 收稿日期:2023-06-03 出版日期:2025-04-15 发布日期:2025-03-05
  • 通讯作者: 耿红岩, E-mail: snail.yanzi@163.com
  • 基金资助:
    国家社会科学基金重大项目(20&ZD296)

Relationship between inflammatory bowel disease and autism spectrum disorder in children

FAN Guirong, WENG Xuchu, GENG Hongyan()   

  1. Institute of Brain Research and Rehabilitation, South China Normal University, Guangzhou 510898, China
  • Received:2023-06-03 Online:2025-04-15 Published:2025-03-05

摘要:

孤独症谱系障碍(Autism spectrum disorder, ASD)是一类神经发育障碍疾病, 除了社交障碍、重复刻板行为等核心症状外, 几乎一半的ASD患者出现了胃肠道症状, 表现出炎症性肠病(inflammatory bowel disease, IBD)。IBD是一种与免疫失调、肠道微生物组改变、微量营养吸收不良和贫血相关的慢性疾病, 这些特征可能是ASD相关的围产期因素。患有ASD的儿童很可能被诊断出患有包括IBD在内的共生疾病。通过治疗IBD来缓解或干预儿童ASD的治疗方式已经初见成效, 未来可以开展更多临床实验来证实IBD治疗的有效性和安全性。对IBD与ASD、父母IBD和儿童ASD之间关系的探究可以为儿童ASD的病因研究、早期筛查及临床治疗提供进一步的证据支持。

关键词: 孤独症谱系障碍, 炎症性肠病, 克罗恩病, 溃疡性结肠炎

Abstract:

Autism spectrum disorder (ASD) is a neurodevelopmental condition. In addition to core symptoms like social impairments and restricted repetitive behaviors, about half of individuals with ASD also experience gastrointestinal symptoms and inflammatory bowel disease (IBD). IBD is a kind of chronic disease associated with immune dysregulation, gut microbiome alterations, micronutrient malabsorption and anaemia, which may be perinatal factors associated with ASD. It's likely that comorbidities like IBD are diagnosed in children with ASD.

This article examines the relationship between IBD and ASD in children by analyzing the relevant domestic and foreign literature. Firstly, the results of the analysis indicate a considerable correlation between childhood IBD and ASD; nevertheless, the effect of ASD on IBD seems to be greater than that of IBD on ASD in children, necessitating more thorough study to substantiate this claim. Secondly, we provide explanations for the potential causes of the lack of a genetic correlation between juvenile ASD and IBD. Furthermore, we analyze the differences in the results between the two phases of the study from the perspective of parental IBD and childhood ASD, and we also suggest possible factors that might have affected this outcome. Finally, in terms of the therapeutic approach, we think that treating IBD in children can have an impact on ASD. To achieve this, we are attempting to implement a strategy that combines multiple therapeutic approaches, such as a combination of nutritional therapy and basic medication, treatment with biologics, and behavioral or psychological interventions.

The following aspects may need to be considered in future research: First, additional empirical evidence is required to support the claim that there is a causal association between ASD and IBD rather than reverse causality. The quantity of samples involved, age, ASD and IBD diagnosis criteria, severity, and analytic models employed will all affect the final experimental conclusions. Therefore, in order to get more persuasive results, it is important to make the elements impacting the confirmation of forward or reverse causality as consistent as feasible. Second, in order to avoid bias in experimental results caused by ignoring the influence of any of these components, the genetic association between IBD and ASD should be established by taking into account the roles of dominant genes, recessive genes, and environmental factors. Third, despite earlier research demonstrating a connection between ASD and IBD, the pathophysiological processes underlying the two conditions remain unclear. Using bioinformatics methods to explore potential regulatory factors, follow-up studies could examine the pathophysiology and common influencing factors of both disorders. Fourth, it's challenging to figure out if childhood ASD and parental IBD are causally related. In order to prove the association, further and more conclusive investigations will be required in the future due to the divergent opinions found in the present studies. Furthermore, while investigating this relationship, we should take into account the roles performed by the mother and father as well as control for or exclude out the influence of additional factors that may result in childhood ASD. Specific requirements for sample selection and classification should also be followed. Fifth, there's a possibility that clinicians' diagnosis of IBD symptoms in children's ASD and IBD research was inadequate. Future research may consequently require to develop a more objective way to diagnose IBD symptoms through clinical diagnosis, the use of Bristol Stool Scale and so on.

In conclusion, this article may offer novel ideas and approaches for investigating the etiology of ASD in children as well as for clinical therapy, since it examines the connection between IBD and ASD and offers some potential strategies for intervening in children's ASD through the treatment of IBD.

Key words: Autism spectrum disorder, inflammatory bowel disease, Crohn’s disease, ulcerative colitis

中图分类号: