Střevní mikrobiota a poruchy autistického spektra

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Authors: P. Danhofer ¹; O. Horák ¹; L. Knedlíková ¹; S. Kolář ¹; A. M. Bittnerová ¹; P. Jabandžiev ²; H. Ošlejšková ¹
Authors‘ workplace: Department of Pediatric Neurology, Masaryk University and University, Hospital, Brno, Czech Republic ¹; Department of Pediatrics, Masaryk, University and University Hospital, Brno, Czech Republic ²
Published in: Cesk Slov Neurol N 2021; 84/117(2): 127-134
Category: Review Article
doi: https://doi.org/10.48095/cccsnn2021127

Overview

Poruchy autistického spektra (PAS) se řadí mezi neurovývojové a neuropsychiatrické poruchy s klinickou manifestací v dětském věku charakterizované obtížemi v sociální interakci a komunikaci, limitovanými zájmy a repetitivními prvky v chování. V posledních letech došlo k významnému nárůstu prevalence PAS, aktuálně postihuje 1–2 % dětí. V etiopatogenezi onemocnění se uplatňují genetické faktory, určitou roli hrají i faktory prostředí. U celé řady pacientů s PAS jsou přítomny rozmanité gastrointestinální obtíže, především zácpa nebo růjem, plynatost nebo nespecifické bolesti břicha. Spojitost mezi těmito obtížemi a symptomy PAS se dostává v posledních letech do popředí vědeckého zájmu, a to především z hlediska vývoje nových molekulárně-biologických metod, které zkoumají složení střevní mikrobioty. Komunikace mezi střevem a CNS (tzv. osa střevo-mozek) je umožněna vysoce komplexním obousměrným neurohumorálním komunikačním systémem. Tento systém umožňuje působení střevní mikrobioty na mozkové funkce a umožňuje, aby mozkové signály ovlivňovaly aktivitu střevní mikrobioty a funkce gastrointestinálního traktu. Autoři shrnují různé patofyziologické mechanizmy zapojené do těchto procesů a jsou detailně diskutovány i rozličné terapeutické modality, které zasahují do složení a funkce střevní mikrobioty, jako je užívání vankomycinu, oxytocinu, prebiotik a probiotik. Jsou shrnuty i dosavadní poznatky z oblasti indikace a účinnosti fekální transplantace u dětí s PAS.

Klíčová slova:

autismus – poruchy autistického spectra – střevní mikrobiota – probiotika – fekální transplantace

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