The use of probiotics in the treatment of Autism Spectrum Disorder: a narrative review

Authors

  • Estela Parreira Romão Bueno

DOI:

https://doi.org/10.34119/bjhrv9n1-008

Keywords:

probiotics, gut microbiota, Autism Spectrum Disorder, children, gastrointestinal symptoms

Abstract

Gastrointestinal symptoms affect approximately 70% of individuals with Autism Spectrum Disorder (ASD), suggesting a strong interaction between gut physiology and behavioral manifestations (McElhanon, 2014). Considering the relevance of the gut–brain axis, numerous studies have investigated the potential therapeutic role of probiotics in ASD. This narrative review aims to analyze clinical findings on probiotic supplementation in children and adolescents with ASD. A literature search was conducted in PubMed, SciELO, and Google Scholar, identifying 137 studies; 18 met the inclusion criteria. Results indicate that probiotic supplementation—particularly strains such as Lactobacillus plantarum, Lactobacillus reuteri, Bifidobacterium longum, and multistrain formulations—consistently improves gastrointestinal symptoms, including constipation, abdominal pain, diarrhea, and dysbiosis (Liu et al., 2019; Santocchi et al., 2020). Several studies also reported secondary behavioral improvements (e.g., reduced irritability, enhanced attention, lower hyperactivity) associated with improved gastrointestinal function (Hsiao et al., 2013; Sanctuary et al., 2019). However, heterogeneity in study design, supplementation protocols, dosage, and ASD severity limits definitive conclusions. Overall, probiotics appear to be a safe and promising complementary therapy for gastrointestinal symptoms in ASD, although further randomized clinical trials with standardized methodologies are needed.

References

ANGELIS, M. de et al. - Autism spectrum disorders and intestinal microbiota. Gut Microbes. ISSN 19490984. 6:3 (2015) 207–213.

ARNOLD, L. E.; LUNA, R. A.; WILLIAMS, K.; HAN, J.; PARKER, R. A.; WU, Q. et al. Probiotics for Gastrointestinal Symptoms and Quality of Life in Autism: A Placebo- Controlled Pilot Trial. Child Adolesc Psychopharmacol (2019) 29:659–69. doi: 10.1089/cap.2018.0156.

BADARÓ, A.C.L.; GUTTIERRES, A. P. M.; REZENDE, A. C. V.; STRINGHETA, P. C. Alimentos probióticos: aplicações como promotores da saúde humana parte 1. Nutrir Gerais 2008 ago/dez; 2(3):1-29.

BERDING, K.; DONOVAN, S.M. Microbiome and nutrition in autism spectrum disorder: current knowledge and research needs. Nutrition Reviews. Dezembro de 2016;74(12):723–36.

BIENENSTOCK; JOHN; KUNZE; WOLFGANG; FORSYTHE; PAUL- Microbiota and the gutbrain axis. Nutrition reviews. . ISSN 17534887. 73:(2015) 28–31.

BRUNONI, D.; SCHWARTZMAN, J. A; ARAÚJO, A. C.; Genética e os Transtornos do Espectro do Autismo. São Paulo: Memnon, 2011. Cap. 05. p.55 - 64.

BUTEL, M.J. Probiotics, gut microbiota and health. Med. Mal. Infect. v.44, p.1– 8, 2014.

CAMPION, D.; PONZO, P.; ALESSANDRIA, C.; SARACCO G. M.; BALZOLA, F. Role of microbiota in the autism spectrum disorders. Minerva Gastroenterol Dietol. 2018.

DINAN; TIMOTHY G.; CRYAN, JOHN F. - The Microbiome-Gut-Brain Axis in Health and Disease. Gastroenterology Clinics of North America. . ISSN 15581942. 46:1 (2017) 77–89, Disorder: A Systematic Review of Clinical Trials. Curr. Med. Sci. 2019, 39, 173–184. [CrossRef] [PubMed]

DOENYAS C., Dietary interventions for autism spectrum disorder: New perspectives from the gut-brain axis. Physiol Behav.2018;194:577-82.

doi: 10.1016/j.physbeh.2014.10.033

FAO/WHO. Guidelines for the evaluation of probiotics in food. Report of a Joint FAO/WHO Working Group on Drafting Guidelines for the Evaluation of Probiotics in Food. Ontario, Canada; 2002.

GWEE, K. A.; LEE, W. W.; LING, K. L.; OOI, C.J.; QUAK, S. H.; DAN, Y. Y.; SIAH, K.T.; HUANG, J.G.; CHUA, A.S.; HILMI, I.N.; et al. Consensus and contentious statements on the use of probiotics in clinical practice: A south east Asian gastro-neuro motility association working team report. J. Gastroenterol. Hepatol. 2018, 33, 1707–1716. [CrossRef].

HENDREN, R.L. et al. Randomized, placebo-controlled trial of methyl B12 for children with autism. Journal of child and adolescent psychopharmacology, v. 26, n. 9, p. 774-783, 2016.

HSIAO, E. Y.; MCBRIDE, S. W.; HSIEN, S.; SHARON, G.; HYDE, E. R.; MCCUE, T.; CODELLI, J. A.; CHOW, J.; REISMAN, S. E.; PETROSINO, J. F.; PATTERSON, P. H; MAZMANIAN, S.K. (2013). Microbiota modulate behavioral and physiological abnormalities associated with neurodevelopmental disorders. Cell 155:1451–1463.

JORGE, L. M.; SANTOS, A. A. Avaliação Cognitiva de Indivíduos com Transtornos do Espectro do Autismo. In: BRITO, Maria Cláudia; 2013.

KALUZNA-CZAPLINSKA, J.; BLASZCZYK, S. The level of arabinitol in autistic children after probiotic therapy. Nutrition (2012) 28:124–6. doi: 10.1016/ j.nut.2011.08.002.

KRANEVELD, A.D; SZKLANY, K.; THEIJE C. G.M.; GARSSEN, J. Gut-to-Brain Axis in Autism Spectrum Disorders. In: International Review of Neurobiology [Internet]. Elsevier; 2016 [citado 22 denovembro de 2018]. p. 263–87.

LATALOVA, K.; HAJDA, M.; PRASKO, Jan - Can gut microbes play a role in mental disorders and their treatment? Psychiatria Danubina. . ISSN 03535053. 29:1 (2017) 28–30.

LEVY, S. E.; HYMAN, S.L. Complementary and alternative medicine treatments for children with autism spectrum disorders. Child Adolesc Psychiatr Clin N Am. 2015;24: 117–143.

LI, Q.; ZHOU, J. M. - The microbiota-gut-brain axis and its potential therapeutic role in autism spectrum disorder. Neuroscience. ISSN 18737544. 324:March (2016) 131– 139.

LIMA, G.B.F. A Influência Da Nutrição Em Crianças Com Transtorno Do Espectro Autista. 2018. Adams.

LIU, J.; WAN, G.-B.; HUANG, M.-S.; AGYAPONG, G.; ZOU, T.; ZHANG, X.-Y.; LIU, Y.-W.; SONG, Y.-Q.; TSAI, Y.-C.; KONG, X.- Efects of Lactobacillus Plantarum PS128 on Children with Autism Spectrum Disorder in Taiwan: A Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients 2019, 11, 820. [CrossRef]

MCELHANON, B.O.; MCCRACKEN, C.; KARPEN, S.; SHARP, W.G. Gastrointestinal symptoms in autism spectrum disorder: A meta-analysis. Pediatrics 2014, 133, 872–883. [CrossRef] [PubMed]

NG, Q.X.; SOH, A.Y.; VENKATANARAYANAN, N.; HO, C.Y.; LIM, D.Y.; YEO, W.S. A systematic review of the effects of probiotics on schizophrenia symptoms. Neuropsychobiologygy. 2019, 78, 1–6. [CrossRef]

PARRACHO, H.M.; GIBSON, G.R.; KNOTT, F.; BOSSCHER, D.; KLEEREBEZEM, M.; MCCARTNEY, A.L. A double-blind, placebo-controlled, crossover-designed probiotic feeding study in children diagnosed with autistic spectrum disorders. Int. J. Probiotics Prebiotics 2010, 5, 69–74.

PLAZA-DIAZ, J., GOMEZ-LLORENTE, C.; FONTANA, L.; GIL, A. Modulation of immunity and inflammatory gene expression in the gut, in inflammatory diseases of the gut and in the liver by probiotics. World J Gastroenterol, 2014, 20(42):15632-49. doi: 10.3748/wjg.v20.i42.15632

PULIKKAN, L.; MAJI, A.; DHAKAN, D. B.; SAXENA, R.; MOHAN, B.; ANTO, M. M., et al. Gut Microbial Dysbiosis in Indian Children with Autism Spectrum Disorders. Microb Ecol. 2018.

RICE, C. E.; BAIO, J.; AN NAARDEN, B. K.; DOERNBERG, N.; MEANEY, F. J.; KIRBY, R. S.; ADDM Network. A public health collaboration for the surveillance of autism spectrum disorders. Paediatr Perinat Epidemiol 2007;21:179–90.

ROUSSIN, L.; PRINCE, N.; P, P.; KRANEVELD, A.D.; RABOT, S.; NAUDON, L. Role of the Gut Microbiota in the Pathophysiology of Autism Spectrum Disorder: Clinical and Preclinical Evidence. Microorganisms. 2020, 8, 1369. Disponível em: https://doi.org/10.3390/microorganisms8091369. Acesso em: 4 set. 2020.

RUSSO, A. J. (2015). Decreased plasma myeloperoxidase associated with probiotic therapy in autistic children. Clin Med Insights Pediatria 9:13–17.

SANCTUARY, M.R.; KAIN, J.N.; CHEN, S.Y.; KALANETRA, K.; LEMAY, D.G.; ROSE, D.R.; YANG, H.T.; TANCREDI, D.J.; GERMAN, J.B.; SLUPSKY, C.M.; et al. Pilot study of probiotic/colostrum supplementation on gut function in children with autism and gastrointestinal symptoms. PLoS ONE 2019, 14, e0210064. [CrossRef]

SANTOCCHI, E.; GUIDUCCI, L.; FULCERI, F.; BILLECI, L.; BUZZIGOLI, E.; APICELLA, F. et al. Gut to brain interaction in Autism Spectrum Disorders: a randomized controlled trial on the role of probiotics on clinical, biochemical and neurophysiological parameters. BMC Psychiatry (2016) 16:183. doi: 10.1186/s12888-016-0887.

SANTOCCHI, E.; GUIDUCCI, L.; PROSPERI, M.; CALDERONI, S.; GAGGINI, M.; APICELLA, F.; TANCREDI, R.; BILLECI, L.; MASTROMARINO, P.; GROSSI, E.; GASTALDELLI, A.; MORALES, M.A.; MURATORI, F. (2020) Effects of

Probiotic Supplementation on Gastrointestinal, Sensory and Core Symptoms in Autism Spectrum Disorders: A Randomized Controlled Trial.

Front. Psychiatry 11:550593. doi: 10.3389/fpsyt.2020.550593

SHAABAN, S.Y.; EL GENDY, Y.G.; MEHANNA, N. S.; EL-SENOUSY, W. M.; EL-FEKI, H. S. A; SAAD, K. et al. The role of probiotics in children with autism spectrum disorder: A prospective, open-label study. Nutr Neurosci (2018) 21:676–81. doi: 10.1080/1028415X.2017.1347746

SLYKERMAN, R.F.; KANG, J.; VAN ZYL, N.; BARTHOW, C.; WICKENS, K.; STANLEY, T.; COOMARASAMY, C.; PURDIE, G.; MURPHY, R.; CRANE, J.; et al. Effect of early probiotic supplementation on childhood cognition, behaviour and mood a randomised, placebo-controlled trial. Acta Paediatr. 2018, 107, 2173–2178. [CrossRef]

TAKADA, M.; NISHIDA, K.; KATAOKAKATO, A. et al. Probiotic Lactobacillus casei strain Shirota relieves stressassociate symptoms by modulating the gutbrain interaction in human and animal models. Neurogastroenterol Motil v.28, p.10271036, 2016.

THEIJE, C. G.; WU, J.; SILVA, S.L.; KAMPHUIS, P.J.; GARSSEN, J.; KORTE, S.M. et al. Pathways underlying the gut-to-brain connection in autism spectrum disorders as future targets for disease management. Eur J Pharmacol. 2011;668(Suppl 1): S70-80.

TOMOVA, A.; HUSAROVA, V.; LAKATOSOVA, S.; BAKOS, J.; VLKOVA, B.; BABINSKA, K. et al. Gastrointestinal microbiota in children with autism in Slovakia. Physiol Behav (2015) 138:179–87.

WANG, L.; CHRISTOPHERSEN, C.T.; SORICH, M.J.; GERBER, J.P.; ANGLEY, M.T.; Conlon, M.A. Low Relative Abundances of the Mucolytic Bacterium Akkermansia Muciniphila and Bifidobacterium Spp. in Feces of Children with Autism. Appl. Environ. Microbiol. 2011, 77, 6718–6721.

WANG, M.; WAN, J.; RONG, H.; HE, F.; WANG, H.; ZHOU, J.; CAI, C.; WANG, Y.; XU, R.; YIN, Z.; ZHOU, W. 2019. Alterations in gut glutamate metabolism associated with changes in gut microbiota composition in children with autism spectrum disorder. mSystems 4: e00321-18. Disponível em: https://doi.org/10.1128/mSystems.00321-18. Acesso em: 4 out 2020.

WEST, D. E. R.; SICHEL, L.S.; SICHEL, J. Improvements in Gastrointestinal Symptoms among Children with Autism Spectrum Disorder Receiving the Delpro® Probiotic and Immunomodulator Formulation. Probiotics Health (2013) 1:102. doi: 10.4172/2329-8901.1000102.

Downloads

Published

01/05/2026

How to Cite

BUENO, E. P. R. The use of probiotics in the treatment of Autism Spectrum Disorder: a narrative review. Brazilian Journal of Health Review, [S. l.], v. 9, n. 1, p. e84909, 2026. DOI: 10.34119/bjhrv9n1-008. Disponível em: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/84909. Acesso em: 20 oct. 2026.

Issue

Section

Original Papers