Gut Microbiota Alterations in Children with Autism Spectrum Disorder: A Systematic Review of a Decade of Evidence (2015–2025)
Abstract
Background: Children with Autism Spectrum Disorder (ASD) often experience gastrointestinal symptoms, prompting interest in the gut–brain axis and the potential role of gut microbiota in ASD pathology. To systematically review human studies from 2015–2025 comparing gut microbiota in children with ASD to neurotypical controls.
Methods: We reviewed global observational and clinical studies involving children aged 2–18 that assessed gut microbiota using DNA-based methods, primarily 16S rRNA sequencing. Outcomes included microbial diversity (alpha and beta) and taxonomic composition.
Results: Most studies reported altered gut microbiota in ASD. Alpha-diversity was frequently lower in ASD, indicating reduced microbial richness, though not universally. In contrast, beta-diversity consistently showed distinct microbial community structures between ASD and control groups. Common compositional findings in ASD included reduced Bifidobacterium and Prevotella, and increased Clostridium, Desulfovibrio, Sutterella, and other Proteobacteria. These shifts may contribute to immune activation, GI inflammation, and neuroactive metabolite production (e.g., short-chain fatty acids, lipopolysaccharide), potentially influencing ASD symptoms.
Conclusions: Evidence supports the presence of gut dysbiosis in children with ASD, marked by decreased beneficial microbes and increased potentially pro-inflammatory taxa. While findings vary by region and methodology, the microbiota appears to play a role in ASD via metabolic and immune-mediated mechanisms. The gut microbiome may serve as both a biomarker and therapeutic target in ASD, but further large-scale, standardized studies are needed
Downloads
Metrics
References
Lewandowska-Pietruszka Z, Figlerowicz M, Mazur-Melewska K. Microbiota in Autism Spectrum Disorder: A Systematic Review. Int J Mol Sci 2023;24:16660. doi: 10.3390/ijms242316660.
Korteniemi J, Karlsson L, Aatsinki A. Systematic Review: Autism Spectrum Disorder and the Gut Microbiota. Focus: Journal of Life Long Learning in Psychiatry 2024;22:242. doi: 10.1176/appi.focus.24022008.
Bakhtiar B, Ahmadwirawan A, Makkadafi M, Qanitha A, Faruk M, Laidding SR. Gut microbiota analysis in patients with Hirschsprung’s disease: A genomic pilot study. Acta Biomedica Atenei Parmensis 2025;96:16151. doi: 10.23750/abm.v96i1.16151.
Wong GC, Montgomery JM, Taylor MW. The Gut-Microbiota-Brain Axis in Autism Spectrum Disorder. In: Grabrucker AM, ed. Autism Spectrum Disorders. Brisbane (AU): Exon Publications; 2021.
Yano JM, Yu K, Donaldson GP, Shastri GG, Ann P, Ma L, et al. Indigenous bacteria from the gut microbiota regulate host serotonin biosynthesis. Cell 2015;161:264–76. doi: 10.1016/j.cell.2015.02.047.
Breit S, Kupferberg A, Rogler G, Hasler G. Vagus Nerve as Modulator of the Brain–Gut Axis in Psychiatric and Inflammatory Disorders. Front Psychiatry 2018;9:44. doi: 10.3389/fpsyt.2018.00044.
Gao X, Cao Q, Cheng Y, Zhao D, Wang Z, Yang H, et al. Chronic stress promotes colitis by disturbing the gut microbiota and triggering immune system response. Proc Natl Acad Sci U S A 2018;115:E2960–9. doi: 10.1073/pnas.1720696115.
Grover M, Kashyap PC. Germ free mice as a model to study effect of gut microbiota on host physiology. Neurogastroenterol Motil 2014;26:745–8. doi: 10.1111/nmo.12366.
Neufeld KM, Kang N, Bienenstock J, Foster JA. Reduced anxiety-like behavior and central neurochemical change in germ-free mice. Neurogastroenterol Motil 2011;23:255–64, e119. doi: 10.1111/j.1365-2982.2010.01620.x.
Liu F, Li J, Wu F, Zheng H, Peng Q, Zhou H. Altered composition and function of intestinal microbiota in autism spectrum disorders: a systematic review. Transl Psychiatry 2019;9:1–13. doi: 10.1038/s41398-019-0389-6.
Ding H, Yi X, Zhang X, Wang H, Liu H, Mou W-W. Imbalance in the Gut Microbiota of Children With Autism Spectrum Disorders. Front Cell Infect Microbiol 2021;11:572752. doi: 10.3389/fcimb.2021.572752.
Ma B, Liang J, Dai M, Wang J, Luo J, Zhang Z, et al. Altered Gut Microbiota in Chinese Children With Autism Spectrum Disorders. Front Cell Infect Microbiol 2019;9:40. doi: 10.3389/fcimb.2019.00040.
He J, Gong X, Hu B, Lin L, Lin X, Gong W, et al. Altered Gut Microbiota and Short-chain Fatty Acids in Chinese Children with Constipated Autism Spectrum Disorder. Sci Rep 2023;13:19103. doi: 10.1038/s41598-023-46566-2.
Ho LKH, Tong VJW, Syn N, Nagarajan N, Tham EH, Tay SK, et al. Gut microbiota changes in children with autism spectrum disorder: a systematic review. Gut Pathog 2020;12:6. doi: 10.1186/s13099-020-0346-1.
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. doi: 10.1016/j.physbeh.2014.10.033.
Strati F, Cavalieri D, Albanese D, De Felice C, Donati C, Hayek J, et al. New evidences on the altered gut microbiota in autism spectrum disorders. Microbiome 2017;5:24. doi: 10.1186/s40168-017-0242-1.
Iglesias-Vázquez L, Van Ginkel Riba G, Arija V, Canals J. Composition of Gut Microbiota in Children with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. Nutrients 2020;12:792. doi: 10.3390/nu12030792.
Xu M, Xu X, Li J, Li F. Association Between Gut Microbiota and Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. Front Psychiatry 2019;10:473. doi: 10.3389/fpsyt.2019.00473.
Chen Z, Shi K, Liu X, Dai Y, Liu Y, Zhang L, et al. Gut Microbial Profile Is Associated With the Severity of Social Impairment and IQ Performance in Children With Autism Spectrum Disorder. Front Psychiatry 2021;12:789864. doi: 10.3389/fpsyt.2021.789864.
Abuljadayel D, Alotibi A, Algothmi K, Basingab F, Alhazmi S, Almuhammadi A, et al. Gut microbiota of children with autism spectrum disorder and healthy siblings: A comparative study. Exp Ther Med 2024;28:430. doi: 10.3892/etm.2024.12719.
De Sales-Millán A, Aguirre-Garrido JF, González-Cervantes RM, Velázquez-Aragón JA. Microbiome–Gut–Mucosal–Immune–Brain Axis and Autism Spectrum Disorder (ASD): A Novel Proposal of the Role of the Gut Microbiome in ASD Aetiology. Behavioral Sciences 2023;13:548. doi: 10.3390/bs13070548.
De Angelis M, Francavilla R, Piccolo M, De Giacomo A, Gobbetti M. Autism spectrum disorders and intestinal microbiota. Gut Microbes 2015;6:207–13. doi: 10.1080/19490976.2015.1035855.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Andi Alfia Muthmainnah Tanra, Martira Maddeppungeng, Ema Alasiry, Hadia Angriani, Setia Budi Salekede, Urfianty, Merlyn Meta Astari
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
