Title: Intestinal Permeability and Glucagon-like peptide-2 in Children with Autism: A Controlled Pilot Study.
Source:Robertson, M.A., Sigalet, D.L., Holst, J.J., Meddings, J.B., Wood, J., Sharkey, K.A. (2008). Intestinal Permeability and Glucagon-like peptide-2 in Children with Autism: A Controlled Pilot Study. Journal of Autism and Developmental Disorders DOI: 10.1007/s10803-007-0482-1

One of the many theories that have been proposed to explain possible causes of autism is the “leaky-gut, opioid-excess” theory. This theory suggests that children with autism have increased permeability of their intestinal track leading to faster absorption of peptides which could disrupt neural development during the early stages of life. To test this theory, the authors measured intestinal permeability in a group of 14 children with autism (diagnosed via DSM-IV criteria by a developmental pediatrician), 7 typically developing siblings of these children, and 8 typically developing additional children. They tested the leaky gut theory in two ways. First they observed the levels of a hormone (GLP-2) in response to feeding, which is believed to control satiation. Low levels of this hormone could lead to, or reflect, dysregulated peptide absorption. Second, intestinal permeability was assessed via a differential sugar-absorption test. They used different types of sugars that have different molecular weights. In a normal intestinal system, sugars with small molecular weight will pass through the walls easily as compared to heavy sugars, leading to high levels of the small sugars in urine. However, in a highly permeable intestinal system, the ratio of these two sugars in urine will change as the sugars with large molecular weights pass through the intestinal barrier at a higher rate. Results: The authors found no differences between any of the 3 groups of children in GLP-2 response to feeding or the ratio of sugars in urine. The authors concluded that in this small sample of children with autism there was no evidence of increased intestinal permeability as hypothesized in the ‘leaky-gut’ hypothesis.

Side note: I always thought “Developmental Pediatrician” was a completely redundant label, and comparable to ‘heart cardiologist’ or ‘eye ophthalmologist’. Although sadly, my experience with some pediatricians does suggest that some really don’t know anything about human development.

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