Analysis of washed microbiota transplant efficacy for autism and donor-recipient gut microbiota characteristics.

UNLABELLED: Emerging evidence suggests that washed microbiota transplantation (WMT) can be used to effectively treat autism spectrum disorder (ASD). This study aimed to evaluate the efficacy of WMT, investigate structural changes in the gut microbiota of children with ASD after WMT, and determine the relationship between donor and recipient gut microbiota characteristics in ASD with different treatment efficacies. This study included 38 ASD patients who underwent a full course of WMT from a single donor between July 2019 and December 2024. The clinical rating scale and stool samples were collected before and 4 weeks after WMT. Using 16S rRNA sequencing, patients were stratified by enterotype, Bacteroides (ET-B), or Prevotella (ET-P), to compare gut microbiota features with healthy donors and assess how microbial characteristics influence WMT efficacy. Finally, we found that WMT has statistically significant effects on the scale scores changes of core symptoms, sleep disturbances, and gastrointestinal symptoms in patients with ASD. In addition, the efficacy of WMT for ASD was correlated with donor and recipient gut microbiota characteristics before WMT. Among donors and recipients with Bacteroides as the dominant genus, the closer the recipient gut microbiota was to that of the donor, the better the efficacy of WMT in patients with ASD.

CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn/index.html, identifier ChiCTR2400089296.