OTİZM SPEKTRUM BOZUKLUĞUNDA PROBİYOTİKLERİN BİLİŞSEL FONKSİYONLARA ETKİSİ

Öz

Otizm spektrum bozukluğu (OSB), sosyal iletişim ve etkileşimde zorluklar ile birlikte sınırlı ve tekrarlayan davranış kalıplarıyla karakterize edilen karmaşık bir nörogelişimsel bozukluktur. OSB'nin etiyolojisi, genetik ve çevresel faktörlerin karmaşık etkileşimleri ile şekillenmektedir. Son yıllarda, bağırsak mikrobiyotasının OSB üzerindeki etkileri ve probiyotik takviyelerinin potansiyeli üzerine artan bir ilgi bulunmaktadır. Bağırsak-beyin ekseni, bağırsak mikrobiyotasının beyin fonksiyonları üzerindeki etkilerini açıklamakta önemli bir rol oynamaktadır. Bağırsak mikrobiyotası, bireylerin genel sağlık durumunu etkileyen birçok bileşeni barındırır ve bu mikrobiyota, bağışıklık sistemi, metabolizma ve nörotransmitter üretimi üzerinde önemli bir etkiye sahiptir. Probiyotikler, bağırsak sağlığını iyileştirerek, bilişsel fonksiyonları ve davranışsal semptomları olumlu yönde etkileyebilir. Yapılan araştırmalar, probiyotik takviyesinin OSB'li bireylerde gastrointestinal semptomları hafiflettiğini ve davranışsal sorunları azalttığını göstermektedir. Probiyotikler GABA, serotonin ve dopamin gibi nörotransmitterlerin üretimini destekleyerek, iltihaplanmayı azaltma potansiyeline sahiptir. Probiyotiklerin, bağırsak bariyerini güçlendirmesi ve bağırsak iltihabını azaltması, OSB'li bireylerde bilişsel fonksiyonların iyileşmesine katkı sağlayabilir. Bununla birlikte, probiyotiklerin bilişsel fonksiyonlar üzerindeki etkileri hâlâ sınırlıdır ve mevcut veriler ön sonuçlar niteliğindedir. Dolayısıyla, bu alanda daha kesin ve kapsamlı veriler elde etmek için geniş çaplı ve uzun süreli araştırmalara ihtiyaç vardır. OSB'li bireylerin yaşam kalitesini artırmak için probiyotiklerin potansiyel faydalarını araştırmak, tedavi stratejilerinin geliştirilmesi açısından önem taşımaktadır. Bu bağlamda, probiyotiklerin kullanımı, hem bilişsel hem de davranışsal belirtilerin yönetiminde umut verici bir strateji olarak ortaya çıkmaktadır.

Anahtar Kelimeler

• Otizm
• Bilişsel Fonksiyon
• Mikrobiyota
• Probiyotik

EFFECTS OF PROBIOTICS ON COGNITIVE FUNCTIONS IN AUTISM SPECTRUM DISORDER

Öz

Autism spectrum disorder (ASD) is a multifaceted neurodevelopmental condition marked by restricted and repetitive behaviors, as well as challenges in social communication and engagement. The etiology of ASD is influenced by intricate interactions between genetic and environmental variables. The influence of gut microbiota on ASD and the possible benefits of probiotic supplements have attracted growing attention in recent years. The gut-brain axis is crucial in understanding the impact of gut microbiota on cognitive function. The gut microbiota comprises numerous elements that affect individual health and significantly impact the immune system, metabolism, and neurotransmitter synthesis. Probiotics may enhance cognitive performance and behavioral symptoms by increasing gut health. Research indicates that probiotic administration mitigates gastrointestinal symptoms and diminishes behavioral issues in individuals with ASD. Probiotics have the potential to reduce inflammation by supporting the production of neurotransmitters such as GABA, serotonin, and dopamine. Probiotics may enhance cognitive performance in persons with ASD by fortifying the intestinal barrier and diminishing intestinal inflammation. The impact of probiotics on cognitive function remains constrained, and the existing findings are preliminary. Consequently, extensive, longitudinal research are required to acquire more conclusive and thorough data in this area. Examining the possible advantages of probiotics in enhancing the quality of life for patients with ASD is essential for formulating treatment methods. The utilization of probiotics is emerging as a potential approach for addressing cognitive and behavioral problems.

Anahtar Kelimeler

• Autism
• Cognitive Function
• Microbiota
• Probiotic

Kaynakça

1. Adams, J. B., Johansen, L. J., Powell, L. D., Quig, D., & Rubin, R. A. (2011). Gastrointestinal flora and gastrointestinal status in children with autism— comparisons to typical children and correlation with autism severity. BMC Gastroenterology, 11, Article 22. https://doi.org/10.1186/1471-230X-11-22
2. Baio, J., Wiggins, L., Christensen, D. L., Maenner, M. J., Daniels, J., Warren, Z., et al. (2018). Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years—Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR Surveillance Summaries, 67(6), 1-23. https://doi.org/10.15585/mmwr.mm6766a1
3. Canitano, R. (2014). New experimental treatments for core social domain in autism spectrum disorders. Frontiers in Pediatrics, 2, 61. https://doi.org/10.3389/fped.2014.0006
4. Critchfield, J. W., Van Hemert, S., Ash, M., Mulder, L., & Ashwood, P. (2011). The potential role of probiotics in the management of childhood autism spectrum disorders. Gastroenterology Research and Practice, 2011. https://doi.org/10.1155/2011/161358
5. Darwesh, M. A. K., Bakr, W., Omar, T. E., El-Kholy, M. A., & Azzam, N. F. (2024). Unraveling the relative abundance of psychobiotic bacteria in children with Autism Spectrum Disorder. Scientific Reports, 14(1), 24321. https://doi.org/10.1038/s41598-024-01883-0
6. D’Angelo, E., Fiori, F., Ferraro, G. A., Tessitore, A., Nazzaro, L., Serpico, R., & Contaldo, M. (2025). Autism Spectrum Disorder, Oral Implications, and Oral Microbiota. Children, 12(3), 368. https://doi.org/10.3390/children12030368
7. Długosz, A., Wróblewski, M., Błaszak, B., & Szulc, J. (2025). The role of nutrition, oxidative stress, and trace elements in the pathophysiology of autism spectrum disorders. International Journal of Molecular Sciences, 26(2), 808. https://doi.org/10.3390/ijms26030808
8. Doenyas, C. (2018). Dietary interventions for autism spectrum disorder: New perspectives from the gutbrain axis. Physiology & Behavior, 194, 577-582. https://doi.org/10.1016/j.physbeh.2018.05.024

9. Fattorusso, A., Di Genova, L., Dell'Isola, G. B., Mencaroni, E., & Esposito, S. (2019). Autism Spectrum Disorders and the Gut Microbiota. Nutrients, 11(3), 521. https://doi.org/10.3390/nu11030521
10. Fidan, H. M., & Özkaya, V. (2024). Otizm Spektrum Bozukluğu Olan Çocuklarda Uygulanan Güncel Diyet Yaklaşımları. Gazi Sağlık Bilimleri Dergisi, 9(2), 133- 145. https://doi.org/10.35378/gazi.1155126
11. He, X., Liu, W., Tang, F., Chen, X., & Song, G. (2023). Effects of probiotics on autism spectrum disorder in children: A systematic review and meta-analysis of clinical trials. Nutrients, 15(6), 1415. https://doi.org/10.3390/nu15061415
12. Kang, D. W., Park, J. G., Ilhan, Z. E., Wallstrom, G., LaBaer, J., Adams, J. B., & Krajmalnik-Brown, R. (2013). Reduced incidence of Prevotella and other fermenters in intestinal microflora of autistic children. PloS One, 8(7), e68322. https://doi.org/10.1371/journal.pone.0068322
13. Khanna, H. N., Roy, S., Shaikh, A., Chhabra, R., & Uddin, A. (2025). Impact of probiotic supplements on behavioral and gastrointestinal symptoms in children with autism spectrum disorder: A randomized controlled trial. BMJ Paediatrics Open, 9(1), e003045. https://doi.org/10.1136/bmjpo-2024-003045
14. Khanna, H. N., Roy, S., Shaikh, A., et al. (2022). Emerging Role and Place of Probiotics in the Management of Pediatric Neurodevelopmental Disorders. Euroasian Journal of Hepato-Gastroenterology, 12(2), 102–108. https://doi.org/10.5005/eajhg-12-2-102
15. Kilicaslan, F., Tufan, A.E. (2022). Autism spectrum disorder: Comorbidity and demographics in a clinical sample. Int J Dev Disabil, 70(2), 241-250. https://doi.org/10.1080/20473869.2022.2074242
16. Liang, D., Wu, F., Zhou, D., Tan, B., & Chen, T. (2024). Commercial probiotic products in public health: Current status and potential limitations. Critical Reviews in Food Science and Nutrition, 64(19), 6455- 6476. https://doi.org/10.1080/10408398.2023.2231630
17. Liu, Y., Tian, X., He, B., Hoang, T. K., Taylor, C. M., Blanchard, E., ... & Rhoads, J. M. (2019). Lactobacillus reuteri DSM 17938 feeding of healthy newborn mice regulates immune responses while modulating gut microbiota and boosting beneficial metabolites. American Journal of Physiology-Gastrointestinal and Liver Physiology, 317(6), G824-G838. https://doi.org/10.1152/ajpgi.00247.2019
18. Maenner, M. J., Shaw, K. A., Bakian, A. V., Bilder, D. A., Durkin, M. S., Esler, A., et al. (2023). Prevalence and characteristics of autism spectrum disorder among children aged 8 years - Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2020. MMWR Surveillance Summaries, 72(2), 1-14. https://doi.org/10.15585/mmwr.mm722e1
19. Mintál, K., Tóth, A., Hormay, E., Kovács, A., László, K., Bufa, A., ... & Karádi, Z. (2022). Novel probiotic treatment of autism spectrum disorder associated social behavioral symptoms in two rodent models. Scientific Reports, 12(1), 5399. https://doi.org/10.1038/s41598-022- 09191-7
20. Navarro, F., Liu, Y., & Rhoads, J. M. (2016). Can probiotics benefit children with autism spectrum disorders? World Journal of Gastroenterology, 22(46), 10093. https://doi.org/10.3748/wjg.v22.i46.10093
21. Parracho, H. M. R. T., Bingham, M. O., Gibson, G. R., & McCartney, A. L. (2005). Differences between the gut microflora of children with autistic spectrum disorders and that of healthy children. Journal of Medical Microbiology, 54(10), 987–991. https://doi.org/10.1099/jmm.0.46101-0
22. Parracho, H. M., Gibson, G. R., Knott, F., Bosscher, D., Kleerebezem, M., & McCartney, A. L. (2010). A doubleblind, placebo-controlled, crossover-designed probiotic feeding study in children diagnosed with autistic spectrum disorders. International Journal of Probiotics & Prebiotics, 5(2), 69.
23. Qing, L., Qian, X., Zhu, H., Wang, J., Sun, J., Jin, Z., ... & Tian, P. (2025). Maternal-infant probiotic transmission mitigates early-life stress-induced autism in mice. Gut Microbes, 17(1), 2456584. https://doi.org/10.1080/19490976.2025.2456584
24. Rojo-Marticella, M., Arija, V., & Canals-Sans, J. (2025). Effect of Probiotics on the Symptomatology of Autism Spectrum Disorder and/or Attention Deficit/Hyperactivity Disorder in Children and Adolescents: Pilot Study. Research on Child and Adolescent Psychopathology, 53, 163–178. https://doi.org/10.1007/s10802-024-01278-7
25. Roman, P., Rueda-Ruzafa, L., Cardona, D., & Cortes- Rodríguez, A. (2018). Gut–brain axis in the executive function of autism spectrum disorder. Behavioural Pharmacology, 29(7), 654-663. https://doi.org/10.1097/FBP.0000000000000426
26. Santocchi, E., Guiducci, L., Fulceri, F., et al. (2016). 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, 16, 183. https://doi.org/10.1186/s12888-016-0887-5
27. Santocchi, E., Guiducci, L., Prosperi, M., Calderoni, S., Gaggini, M., Apicella, F., ... & Muratori, F. (2020). Effects of probiotic supplementation on gastrointestinal, sensory and core symptoms in autism spectrum disorders: a randomized controlled trial. Frontiers in Psychiatry, 11, 550593. https://doi.org/10.3389/fpsyt.2020.550593
28. Shaaban, S. Y., El Gendy, Y. G., Mehanna, N. S., El-Senousy, W. M., El-Feki, H. S., Saad, K., & El-Asheer, O. M. (2018). The role of probiotics in children with autism spectrum disorder: A prospective, open-label study. Nutritional Neuroscience, 21(9), 676-681. https://doi.org/10.1080/1028415X.2017.1386700
29. Soleimanpour, S., Abavisani, M., Khoshrou, A., & Sahebkar, A. (2024). Probiotics for autism spectrum disorder: An updated systematic review and metaanalysis of effects on symptoms. Journal of Psychiatric Research, 179, 92-104. https://doi.org/10.1016/j.jpsychires.2024.07.008
30. Tekin, T., Çiçek, B., & Konyalıgil, N. (2018). İntestinal mikrobiyota ve obezite ilişkisi. Sağlık Bilimleri Dergisi, 27(1), 95-99.
31. Wang, X., Yang, J., Zhang, H., Yu, J., & Yao, Z. (2019). Oral probiotic administration during pregnancy prevents autism‐related behaviors in offspring induced by maternal immune activation via anti‐inflammation in mice. Autism Research, 12(4), 576-588. https://doi.org/10.1002/aur.2007
32. World Health Organization. (2024). Autism spectrum disorders. Available at: https://www.who.int/newsroom/ fact-sheets/detail/autism-spectrum-disorders. Accessed Feb 3, 2024.
33. Yap, I. K. S., Angley, M., Veselkov, K. A., Holmes, E., Lindon, J. C., & Nicholson, J. K. (2010). Urinary metabolic phenotyping differentiates children with autism from their unaffected siblings and age-matched controls. Journal of Proteome Research, 9(6), 2996–3004. https://doi.org/10.1021/pr100003s
34. Yitik, G., Dursun, O. B., Esin, I. S., & Uslu, H. (2019). A study of the relationship between gut microbiota and autism spectrum disorders. Psychiatry and Clinical Psychopharmacology, 29, 105-106. https://doi.org/10.1080/24750573.2019.1591519