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Review
. 2025 Dec;17(1):2499580.
doi: 10.1080/19490976.2025.2499580. Epub 2025 May 16.

Interventions targeting the gut microbiota and their possible effect on gastrointestinal and neurobehavioral symptoms in autism spectrum disorder

Evelyn Takyi  1 , Khemlal Nirmalkar  1 , James Adams  1   2 , Rosa Krajmalnik-Brown  1   3
Affiliations
Review

Interventions targeting the gut microbiota and their possible effect on gastrointestinal and neurobehavioral symptoms in autism spectrum disorder

Evelyn Takyi et al. Gut Microbes. 2025 Dec.

Abstract

Autism spectrum disorder (ASD) is a developmental disorder that is characterized by deficits in social communication and restricted, repetitive, and stereotyped behaviors. In addition to neurobehavioral symptoms, children with ASD often have gastrointestinal symptoms (e.g. constipation, diarrhea, gas, abdominal pain, reflux). Several studies have proposed the role of gut microbiota and metabolic disorders in gastrointestinal symptoms and neurodevelopmental dysfunction in ASD patients; these results offer promising avenues for novel treatments of this disorder. Interventions targeting the gut microbiota - such as fecal microbiota transplant (FMT), microbiota transplant therapy (MTT), probiotics, prebiotics, synbiotics, antibiotics, antifungals, and diet - promise to improve gut health and can potentially improve neurological symptoms. The modulation of the gut microbiota using MTT in ASD has shown beneficial and long-term effects on GI symptoms and core symptoms of autism. Also, the modulation of the gut microbiota to resemble that of typically developing individuals seems to be the most promising intervention. As most of the studies carried out with MTT are open-label studies, more extensive double-blinded randomized control trials are needed to confirm the efficacy of MTT as a therapeutic option for ASD. This review examines the current clinical research evidence for the use of interventions that target the microbiome - such as antibiotics, antifungals, probiotics/prebiotics, synbiotics, and MTT - and their effectiveness in changing the gut microbiota and improving gastrointestinal and neurobehavioral symptoms in ASD.

Keywords: ASD; Autism; FMT; MTT; fecal microbiota transplant; gut microbiome; microbiota transplant therapy; prebiotics; probiotics; synbiotics.

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Conflict of interest statement

K.N., J.B.A. and R.K.-B. have pending/approved patents for autism biomarkers and the use of FMT for various conditions, including autism. J.B.A. and R.K.-B are co-founders of Autism Diagnostics LLC and Gut-Brain Axis Therapeutics. E.T declares no competing interests.

Figures

Figure 1.
Figure 1.
An overview of the gut microbiome effects on gastrointestinal symptoms and possible metabolite-based gut-brain connection in ASD and typically developing individuals.
Figure 2.
Figure 2.
Summary of microbiota interventions targeting the gut microbiome and possibly GI and ASD symptoms outcomes.
See this image and copyright information in PMC

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