31431
Investigating the Association between Gastro-Intestinal Symptoms and ASD Core Symptoms and Somatic and Psychiatric Comorbidities in a Large Cohort of High-Functioning ASD Adult Patients

Poster Presentation
Thursday, May 2, 2019: 11:30 AM-1:30 PM
Room: 710 (Palais des congres de Montreal)
A. Gaman1,2, S. Brouche1, I. Scheid1,2, A. Martinez Teruel1, J. Dubreucq1, K. Souyris2, H. Laouamri2, C. Gilet3, O. Khalfallah4, S. Barbosa4, N. Glaichenhaus4, M. Leboyer1 and L. Davidovic4, (1)INSERM U955, AP-HP, Université Paris-Est Créteil, Créteil, France, (2)Centre Expert Asperger, Fondation FondaMental, Créteil, France, (3)Université Côte d’Azur, CNRS, Laboratoire Informatique Signaux et Systèmes de Sophia Antipolis, Valbonne, France, (4)Université Côte d’Azur, CNRS, Institut de Pharmacologie Moléculaire et Cellulaire, Valbonne, France
Background:

While gastro-intestinal (GI) symptoms, including diarrhea, constipation, abdominal bloating or pain, and gastro-esophageal reflux (GOPR) are frequently reported in ASD (Horvath et al., 2002) the nature, frequency and severity of these symptoms vary from one patient to another. Several authors have suggested that there could be a causal relationship between GI and ASD core symptoms in at least a subset of ASD patients (Adams et al., 2011). Others have suggested that GI symptoms could be associated with low-grade inflammation. Along the same lines, it was suggested that clustering analysis of phenotypic traits in ASD patients could allow for identifying underlying pathogenic mechanisms in ASD (Sacco et al., 2012).

Objectives:

We have sought to investigate the association between GI symptoms and ASD core symptoms, ASD somatic and psychiatric comorbidities and peripheral biomarkers in high-functioning ASD adult patients.

Methods: Adult patients (n = 126) diagnosed with high-functioning ASD were assessed for GI symptoms (constipation, diarrhea, abnormal stool aspect, bloating, abdominal pain and GOPR), ASD core symptoms, somatic and psychiatric comorbidities, using both validated and in-house auto and hetero-questionnaires. We then used an unsupervised clustering method, K-sparse, to stratify patients in several subtypes based of the nature and severity of their GI symptoms. We then compared these subsets for ASD core symptoms and comorbidities as well as for the level of peripheral biomarkers.

Results:

We have identified two subtypes of patients: those with no or mild/rare GI symptoms, and those with severe/frequent GI symptoms. Patients from the second subtype accounted for 47,6% of all patients and were more likely to have been diagnosed with GI functional disorders or thyroid dysfunctions. In addition, patients from the two subtypes differed in the nature/severity of specific ASD core symptoms related to repetitive behaviors. While patients with high GI symptoms displayed less psychotic symptoms, comorbidities with anxiety, depression and mood disorders were similar in both groups. The two subsets of patients did not differ in the serum level of 30 immune/inflammation related biomarkers including C-reactive protein (CRP), calprotectin, and the pro-inflammatory cytokines Tumor Necrosis Factor (TNF)-alpha, interleukin (IL)-1-alpha, IL-1-beta, IL-6 and IL-17A.

Conclusions:

Our preliminary analysis of clinical data and biological samples from 126 high-functioning ASD adult patients revealed that ASD patients with frequent/severe GI symptoms were more likely to have been diagnosed with GI functional disorders and thyroid disorders. In contrast, they did not exhibit low-grade peripheral inflammation as assessed by serum levels of CRP and pro-inflammatory cytokines. Finally, our study revealed relationships between the severity of GI symptoms and ASD core symptoms related to repetitive behaviors.

See more of: Gastrointestinal (GI)
See more of: Gastrointestinal (GI)