A quarterly publication of the Autism Research Institute

The Autism Research Review International is quarterly publication of the Autism Research Institute

Spring, 2019 | Number 2, Volume 33

Biomarker may aid doctors in choosing GI treatments

Researchers say they may have discovered a biomarker that could help gastroenterologists better treat children with ASD and comorbid gastrointestinal (GI) problems.

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Stephen Walker and colleagues say that they have identified two distinct groups of children with ASD and comorbid chronic constipation and colonic inflammation. One group, dubbed fast responders, experiences a stable remission of GI symptoms in response to brief immunosuppression followed by continuing anti-inflammatory therapy. Another group, dubbed slow responders, has recurrent right-sided constipation that necessitates regular colon cleanouts.

To see if they could identify molecular biomarkers for each group, the researchers took ascending colon tissue biopsies from 35 children with ASD, including 20 slow responders and 15 fast responders. They report, “Significant differences were found between the two clusters, with the fast responder-predominant cluster showing an upregulation of [RNA] transcripts involved in the activation of immune and inflammatory response and the slow responder-predominant cluster showing significant over-representation of pathways impacting colonic motility (e.g. genes involved in tryptophan and serotonin degradation and mitochondrial dysfunction).” They identified one specific long non-coding RNA that could predict cluster assignment with very high specificity, sensitivity, and accuracy.

The researchers say their findings, if replicated, may help doctors determine which patients with ASD will respond to standard anti-inflammatory therapy and which might benefit from an alternative strategy.


“A molecular biomarker for prediction of clinical outcome in children with ASD, constipation, and intestinal inflammation,” Stephen J. Walker, Carl D. Langefeld, Kip Zimmerman, Marshall Z. Schwartz, and Arthur Krigsman, Scientific Reports, Vol. 9, No. 1, 2019, 1-13. Address: Stephen Walker, Wake Forest University Health Sciences, Winston Salem, NC 27157, [email protected].