19 comments

  • directevolve 1 hour ago
    Many autistic children have extremely limited diets. For example, a geneticist friend of mine saw a case where an autistic child had been referred for genetic testing because of horrific, chronic, spontaneous wounds on gums and skin. Turned out to be scurvy, because he had exclusively eaten Wheat Thins for the last 3-4 years, which aren’t fortified with vitamin C.

    I would fully expect that a monotonous diet leads to a heavy skew in the gut microbiome as specific bacterial species that thrive on that diet are selected for, others against. It makes some sense that a fecal transplant could repair the damage. If the diet has shifted or expanded, the transplant could lead to long term benefits by restoring newly-viable bacterial species, perhaps by facilitating digestion of the new types of food.

    I’d be curious to see a factoring out of the diet composition, gut microbiome, genetics, and severity of autism symptoms.

    • dimes 39 minutes ago
      Just to play devil’s advocate, isn’t it also possible that the preference for a monotonous diet is driven by gut makeup?
      • Aurornis 16 minutes ago
        The microbiome might have some modulating effect, but the fidelity of gut-brain axis communication isn’t so strong that our gut microbiome is driving us around with highly specific inputs.

        The theories for how gut-brain axis modulation works include altering the balance of nutrients that get absorbed and modulating the vagus nerve, primarily. For someone with autism it might be possible that altering some of these balances could make the condition better or worse, but that’s all theory without much foundation.

        What is known, however, is that diet has a massive impact on the microbiome. Even the mechanism for that is obvious: Bacteria thrive on different foods, so if you eat more of one class of nutrients and less of another then the microbiome proportions will adjust based on which ones thrive on that diet.

      • stephenitis 27 minutes ago
        You seed the gut with nutrients. having lots of fiber and a varied diet increases the number of species that an adult has which is between a couple hundred to a thousand or so. Our guts are generally dominated by a bunch of beneficial bacteria.

        which for many is not the case for a variety of social economic or behavioral reasons. Add in with explosions of bacterial populations due to alcohol or sugar and you can see how we can change our gut biome drastically from week to week.

        • therobots927 10 minutes ago
          I’ve noticed I really need to keep alcohol and sugar consumption in check. Sometimes it seems like one drink is enough to kick off a gut ecosystem collapse, and other times my gut is more resistant to the effects. Definitely trying to increase fiber consumption significantly.
    • smallnix 44 minutes ago
      Imagine the factor overlooked is the nasty but nutritional hospital food they got when receiving the transplant (assuming they got hospitalized).
  • Arodex 2 hours ago
    >Editor's note: Readers often ask us for follow-ups on memorable stories. What has happened to this story over the years? This article was originally published in 2019 but it has been re-edited and updated with new information current as of April 7, 2025. Enjoy!

    Now that is something that should be done more often - especially in science journalism, but not only. We cruelly lack long-term vision - not only forward but backwards too.

    • embedding-shape 1 hour ago
      The typical publishing methods kind of favors that approach of publishing new articles instead of updating existing ones though, for better or worse.

      Maybe science journalism should just adopt a wiki-model instead, where there is one article per "subject" then any new (confirmed?) information/data goes into that, and interested people can subscribe to updates there instead.

      Wikis generally have much better long-term maintenance given the right individuals running it, compared to a "publication journal" where things tend to get out of date eventually, with no way of actually seeing when old articles get updated.

      • Sharlin 1 hour ago
        No problem with publishing new articles, as long as they're properly contextualized and link to their predecessors – and the latter updated to link to the new information as well.
    • aaron695 1 hour ago
      [dead]
  • wartywhoa23 1 minute ago
    So there is finally a huge job market to for all those affected by AI-driven workforce purges: that of fecal donorship!

    All applicants will be fed recycled byproducts for free.

  • _puk 1 hour ago
    >> In early 2022 Krajmalnik-Brown and colleagues patented a specific bacterial formulation and spun-off a commercial company called Gut-Brain Axis Therapeutics.

    I was a little surprised to see this.

    So the university researchers use time and money from the university to make a discovery, extending on previous published research, and then patent it and start their own for-profit?

    Excuse my ignorance, but is that how it's done generally? Where's the upside for all those who are potentially affected?

    It kinda makes sense - Presumably the university is involved somewhere still, and it needs to be commercialised somehow, but..

    • helsinkiandrew 1 hour ago
      Often universities do this, they may own the patent and license it to the company or take a cut etc. Arizona State University appear to do this through Skysong Innovations:

      https://skysonginnovations.com/startups/list/

      It's interesting they got a lot of funding from over 100 families with autism children:

      https://skysonginnovations.com/startups/list/

    • markgall 8 minutes ago
      As others have said, very common. A famous example is Lyrica, which made an enormous amount of money for Northwestern, probably around $1 billion dollars. It played a not-insignificant role in the university's rise in the last 10-20 years.

      Universities love this and encourage it. Any big place will have an office of "technology transfer" or similar to help researchers make this happen.

    • jcattle 32 minutes ago
      This is how it works. Universities are doing research, they aren't doing products. If a commercially viable product comes out of their research it is far outside the scope of universities.

      Also keep in mind that most sciences usually don't produce commercially viable research (think social sciences, archeology, geography etc.)

      And as others said: how the universities gets a cut from the spin offs differs from university to university.

    • kcyb 1 hour ago
      It's quite common historically. The Entrepreneurial State by Mariana Mazzucato looks at this phenomenon of companies privatizing the benefits of publicly funded research and, she argues, not giving enough in return
    • an0malous 1 hour ago
      > So the university researchers use time and money from the university

      Don’t worry, the money is usually coming from taxpayers so the universities don’t have to dip into their endowments

      • dahart 7 minutes ago
        Funny thing is, that may be a bigger concern here, that the research is often publicly funded while the uses of that research and the profits that come with them are kept private. It’s complicated and I buy the notion that research improves the economy as a whole, but it is also true that when research gets patented and becomes a billion dollar product, those dollars don’t reduce any taxes directly.
    • hariseldom 1 hour ago
      Universities often keep up to 50% of rights over IP in such cases but I am unsure about this specific case.
    • bflesch 1 hour ago
      Yes, it's really common. Most universities actually support this and there is a specific contractual framework for staff which basically says "If you create a company during or after your work at university which touches the field you were researching in, we get 1% (or 10% or 20%) of your annual revenue as license fees".

      The alternatives are lengthy court battles between universities and their best (e.g. most commercial) researchers. This creates bad PR for the university and uncertainty for the researcher & their startups because potential investors don't like open court cases.

      So people came around to make this kind of license fee contract and researchers check it before deciding to join a certain university.

      Not a fan of gene / bacteria patents though.

    • ktallett 1 hour ago
      Yes this is really common. Not all universities own the research you do. I have a similar setup within my university. They get to use the research technique I've worked on, but I have the rights to take it out of the university and sell it.
  • Aurornis 23 minutes ago
    I think this is the clinical trial registration: https://clinicaltrials.gov/study/NCT03408886?tab=results

    It is marked as having results submitted but quality review has not been completed.

    N=60 and a placebo group, which is better than the N=18 and no placebo group of the first study.

    There have been so many small scale trials showing amazing autism improvements that failed to replicate in larger, better controlled trials. I wouldn’t get excited yet.

    The typical pattern is to show unbelievably good results in the first open-label trial with a small number of patients (their n=18 trial that claims to have cured severe autism in many children), squeak by with some marginal improvement in the next trial over placebo, then the third trial becomes a game of trying to keep the study small enough that they can hope to p-hack a result that the FDA might accept.

  • andy_ppp 5 minutes ago
    AFAIK fecal transplants do not work well long term, has there been any research in making them more sticky? Lots of things you could trial but I have a feeling it’s the immune system responding to the right bacteria incorrectly…
  • senfiaj 48 minutes ago
    I would still be cautious with such findings. Many autistic people are picky eaters, also some of them have issues with peristalsis. This might affect the microbiome as well. While it's plausible that it might help a subset of people, we should not overgeneralize since autism is a very heterogeneous condition, usually with pronounced genetic predisposition. Overall, it doesn't seem to be a cure.
    • rossdavidh 36 minutes ago
      True that, but it could be both cause and effect. There are reports that gut bacteria can induce depression, which benefits the bacteria because it sends more calorie-rich, highly processed food down the gullet (think ice cream binges when depressed). Not hard to believe that gut bacteria optimized for a particular kind of food could evolve the ability to induce their host to eat that food exclusively. It would have the side-benefit (for the bacteria) of reducing competition from other microbes that aren't optimized for that, by starving them out. Things aren't always just cause or effect, especially in biology.
    • tt_dev 36 minutes ago
      I had a similar question to. From my understanding of the study, which was double blind placebo study, it does not treat autism but its shown to greatly improve symptoms of autism.

      They basically wiped the gut clean with antibiotics then started treating and saw improvements.

      Could be that GI issues increase irritability which makes the measured autism symptoms more aggressive but it looks very promising for families.

      Not affiliated just read the study.

  • mgaunard 17 minutes ago
    So if I eat somebody else's poo I'll become more social?

    An unexpected result for sure.

  • delichon 1 hour ago
    I got bad chronic constipation after four years as a strict carnivore. I didn't get relief just by adding back fiber, but I did by adding fermented foods like kimchi. I wonder if ferments are a more natural way than fecal transplants to repair the gut microbiome, possibly treating autism. Studies have been non conclusive, but this story makes me think it's worth pursuing.
    • motoboi 1 hour ago
      The microbiota is passed from mother to son on birth, not totally from the environment.

      What we currently don’t understand is why for some people they never got them (we have techniques to transport the biota from the mother during birth for non-natural procedures) or they loose them.

      Even with the transplant, the microbes won’t stick around on those people (not taking about autistic people here, but people in general).

      Diverse food really helps, just as not eating ultraprocessed (they won’t reach the end of the intestines).

      Fermented and other pre or probiotics will really help too.

      But none of those will recover the biota in some people.

      • jwrallie 1 hour ago
        In some countries the number of kids born through c-section are very high, more than half the kids in Brazil are born that way for example, so definitely people can be healthy without getting it from their mothers.
        • mejutoco 57 minutes ago
          I read it is a practice these days to do this fecal "rub" for newborns as a way to compensate for the C-section lack of it. I do not know if it happens in Brazil. Another factor to consider.
          • giarc 51 minutes ago
            I've never heard of moms doing fecal rubs, but I've heard of many that do vaginal "transplants". I work in a hospital and we get questions quite a bit, moms will often take moist, sterile gauze and conduct the transplant themselves (staff can't really be involved for liability issues).
        • 47282847 31 minutes ago
          > can be healthy

          Or can they.

          It’s (meant to be) an emergency procedure. Benefits: life. Downsides: plenty.

          Maybe most relevant in the context of this thread:

          “In this systematic review and meta-analysis of 61 studies comprising more than 20 million deliveries, birth by cesarean delivery was significantly associated with autism spectrum disorder and attention-deficit/hyperactivity disorder.“

          Zhang, T., Sidorchuk, A., Sevilla-Cermeño, L., Vilaplana-Pérez, A., Chang, Z., Larsson, H., Mataix-Cols, D., Fernández de la Cruz, L., & D’Onofrio, B. M. (2019). Association of cesarean delivery with risk of neurodevelopmental and psychiatric disorders in the offspring: A systematic review and meta-analysis. JAMA Network Open, 2(8), e1910236. https://doi.org/10.1001/jamanetworkopen.2019.10236

          A selection of some more:

          Keag, O. E., Norman, J. E., & Stock, S. J. (2018). Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: Systematic review and meta-analysis. PLOS Medicine, 15(1), e1002494. https://doi.org/10.1371/journal.pmed.1002494

          De Mucio, B., Serruya, S., Alemán, A., Castellano, G., & Sosa, C. G. (2019). A systematic review and meta-analysis of cesarean delivery and other uterine surgery as risk factors for placenta accreta. International Journal of Gynecology & Obstetrics, 147(3), 281–291. https://doi.org/10.1002/ijgo.12948

          Sandall, J., Tribe, R. M., Avery, L., Mola, G., Visser, G. H. A., Homer, C. S. E., Gibbons, D., Kelly, N. M., Kennedy, H. P., Kidanto, H., Taylor, P., & Temmerman, M. (2018). Short-term and long-term effects of caesarean section on the health of women and children. The Lancet, 392(10155), 1349–1357. https://doi.org/10.1016/S0140-6736(18)31930-5

          Li, H.-T., Zhou, Y.-B., & Liu, J.-M. (2013). The impact of cesarean section on offspring overweight and obesity: A systematic review and meta-analysis. International Journal of Obesity, 37(7), 893–899. https://doi.org/10.1038/ijo.2012.195

          S., Fleming, J., Bromley, A., Shields, M. D., & Cardwell, C. R. (2008). A meta-analysis of the association between Caesarean section and childhood asthma. Clinical & Experimental Allergy, 38(4), 629–633. https://doi.org/10.1111/j.1365-2222.2007.02780.x

          Mascarello, K. C., Horta, B. L., & Silveira, M. F. (2017). Maternal complications and cesarean section without indication: Systematic review and meta-analysis. Revista de Saúde Pública, 51, 105. https://doi.org/10.11606/S1518-8787.2017051000389

    • shermantanktop 31 minutes ago
      The lower intestinal region is guarded by a vat of acid. Not sure how much of those probiotic pills get through.
    • fontain 1 hour ago
      Why did you follow a strict carnivore diet? Health? Accident? Aside from the constipation did it benefit your health?
      • delichon 52 minutes ago
        Obesity and diabetes. It solved about half of the obesity and all of the diabetes.
    • dennis_jeeves2 1 hour ago
      >I got bad chronic constipation after four years as a strict carnivore.

      2 questions:

      1) Did your constipation start right after you did strict carnivore? Or was it after 4 years?

      2) List all foods that you ate on strict carnivore. (Include salt, water etc. I presume it won't be a long list)

      • delichon 43 minutes ago
        1) I had constipation on a very high fiber diet before starting carnivore. That was fixed in literally one day. It was the most dramatic change. Then it gradually came back after about 3.5 years.

        2) beef, butter, chicken, pork, lamb, eggs, bacon, for > 95%. I do indulge in some processed meats with seasonings. Salt is the only seasoning I add, so I've become a salt snob and get the premium stuff.

        After that unspicy diet, full strength kimchi is an experience.

      • idiotsecant 1 hour ago
        Just all foods including salt and water consumed over a 4 year time period with some unknown offset from present, sure seems like a reasonable amount of effort in response to some random guys HN post.
  • geremiiah 2 hours ago
    What's more plausible? Did they cure low functioning autism in two years? Or did they simpily miscategorize the kids and the kids grew out of their diagnosis as they matured?
    • freehorse 1 hour ago
      They say that they started a phase 2 trial with placebo control in 2022 and they see better outcome than placebo

      > Our phase 2 study for adults with autism found that the treatment group improved more than placebo on the primary outcome (autism symptoms) and on a secondary outcome (daily stool record),

      • rzmmm 33 minutes ago
        Looks like this is the placebo-controlled trial https://clinicaltrials.gov/study/NCT03408886

        I can't find full analysis but the primary autism-symptom outcome improved by 9% in treatment group and 4% in controls. I guess there is no statistical significance because that metric likely has high variance.

        In abnormal stools there was 42% improvement in treatment vs 23% in control.

        The combination of GI disorder and autism in these trials make blinding almost impossible. The patients will notice if the GI symptoms change. And the results seem to be that this fecal transplant has larger effect for the GI part anyway.

    • leikarnes 2 hours ago
      I'm guessing that the kids now have less stomachpain, constipation, and are feeling less bloated/nauseous. Thus have less voilent reactions
      • rafram 1 hour ago
        No, there’s a clear link between gut microbiome and behavioral/mental issues that has nothing to do with physical digestive symptoms. It’s been seen with other disorders, like depression: https://hms.harvard.edu/news/drawing-line-gut-microbiome-inf...
        • rzmmm 21 minutes ago
          It's a bit speculative. They need placebo-controlled trials and so far the results have not been very convincing for many psychiatric outcomes. There is exciting research around gut microbiota, but many of these studies which make rounds in HN and other online forums, seem to be mostly open-label or uncontrolled studies.
      • geremiiah 2 hours ago
        That's what I'm saying. It's a misdiagnosis. Whether or not they have tantrums should not be a factor in whether or not they are high-functioning or low-functioning.
        • freehorse 1 hour ago
          It does not have to be misdiagnosis. If kid has both autism and gut issues, the gut issues could make the autistic symptoms worse, by causing distress to the kid, which could make the interactions with caregivers harder for both in a quite formative period. Treating the gut issues could help this way without gut being directly related to autism and without it being a misdiagnosis. It is telling that they report quite high (0.7) correlations between improvement in gut and autistic symptoms.

          However they say they also have an adult trial running that seems to show similar effects, so there might be something more into it.

      • roywiggins 2 hours ago
        Their first study allegedly resulted in "44% were below the cut-off for mild ASD"- ie, practically cured, from a diagnostic point of view.
    • inglor_cz 2 hours ago
      If it was anything else but gut bacteria, I would be inclined to agree with you, but gut microbiota is slowly turning out to be an extremely important factor in our health and it also turns out that modern highly processed diet tends to damage it and make it less diverse. Even higher frequency of Caesarian section seems to make gut microbiota less diverse and there seem to be some diseases downstream from that.

      At the same time, gut microbiota is extremely complex to study.

      So, this may be a plausible result. I cannot judge the plausibilities right away in the way you suggest it.

    • Muromec 2 hours ago
      Kids got into tech industry and now it’s their spouses that have to deal with their tism, instead of parents
      • dacops 1 hour ago
        Buzz off. If you were trying to make a joke, it didn't land. It scans as ableist twat.
      • firstbabylonian 1 hour ago
        Self-hatred is not a good look.
        • DaiPlusPlus 39 minutes ago
          Noe you’re making me self-conscious about when I get into a self-hating mood; unfortunately this gives me yet another new reason to hate myself: it’s not a good look.
  • tt_dev 31 minutes ago
    Title is a bit misleading. It’s not a fecal transplant. It’s tablets and powder (for the pitt-hopkins cases) of microbes from fecal donors. Consumes orally.

    More like fecal food?

    • Balgair 12 minutes ago
      What did you think a fecal transplant was?
  • manoDev 1 hour ago
    I wonder if there’s any study linking C-section birth, autism and microbiota? Or newborns that have to stay in incubators?

    I understand a newborn gets its microbiota naturally by contact with the mom in the first days, maybe all the sterile environment involved in surgery changes that.

  • a-dub 32 minutes ago
    no placebo arm. result could be due to unisolated factors present in clinical trial fixturing.
  • ck2 54 minutes ago
  • davisr 2 hours ago
    So all I gotta do is eat some poop and it will save me from becoming a handsome, funny, unique genius?
    • quux 2 hours ago
      You don't eat it, don't be silly.... you stick the poop up your butt
      • saalweachter 2 hours ago
        I believe the best procedure is actually sticking it in your nose.

        (They run a tube through your nose, down your throat, through the stomach to the top of the intestines, and introduce the bacterial slurry there.)

        • giarc 53 minutes ago
          That's a fairly invasive way of doing it. It can be given through pills now. https://www.lhscri.ca/news/innovative-poop-pills-show-promis...
        • throw310822 1 hour ago
          Makes you wonder how hard would it be to just put it in a swallowable capsule that dissolves only in the upper intestine.

          Also, "fecal transplant" is marketable only to weirdos. "Probiotic infusion" would work better.

          For those who want to gain some artistic talent, there's this (but is expensive):

          https://en.wikipedia.org/wiki/Artist's_Shit

          • rincebrain 1 hour ago
            From my understanding, the problem is volume.

            You want to land a substantial amount of, ahem, shit in there, since don't just want it to colonize one portion of the gut, and it's got quite a lot of competition.

            So you would be talking a truly astonishing number of pills, I think, to compare to the volume you can manage with a tube.

            WP suggests that it's about 100g (or 100000mg) of actual feces then mixed in a larger volume of saline or milk, and you'd probably need to have additional volume for assumed losses and whatever coating you think would work.

            That is a _huge_ amount to put in pills.

            • throw310822 1 hour ago
              Good point, but shit seems to be made of a lot of stuff- ~75% water, undigested food and fiber, fats, inorganic matter... Bacteria seem to be about ~30% of the dry weight. So of those 100 grams, you'd get maybe 7/8 grams of bacteria? If so, these could possibly be delivered by a number of small capsules taken in the course of several days.
        • someguyiguess 2 hours ago
          Pretty sure there’s a shorter path to the top of the intestines than through the nose but I’m no Biologist.
          • tyre 1 hour ago
            If you’re implying it is through the rectum, you’ve definitely got some bio to brush up on. The small intestine alone is >20ft long.
          • dacops 1 hour ago
            There really isn't. From the mouth is basically the same distance and it contains teeth and a tongue. Through the rectum is much much much farther through meters of intestine. Through the skin creates a surgical hole that's going to be difficult to keep sterile.

            The shortest safe path is via the nostril.

      • kotaKat 1 hour ago
        ... Back and forth, forever?
    • LoganDark 2 hours ago
      Well no, what they're saying is it seems to be capable of reducing autism-related struggles and misbehavior, not that it can somehow remove autism. Truly removing autism in any meaningful way is probably impossible since the brain was trained with it since birth.
      • roywiggins 2 hours ago
        No, that appears to be the implication of this study, which frankly seems like such a large effect that I'm pretty skeptical! I'd say "where's the control group" except the claimed effect is so large that you kind of don't need one, if it's real:

        > Prior to the study, 83% of participants had "severe" autism. Two years later, only 17% were rated as severe, 39% as mild or moderate, and incredibly, 44% were below the cut-off for mild ASD.

        Emphasis mine. If you are below the cutoff for mild ASD you wouldn't be diagnosed at all.

        • saalweachter 2 hours ago
          That was the study without a control; for the placebo controlled study, they don't give the numbers, just say "statistically significant improvements" on several metrics.

          (Without a control group, you have questions about how people of that age generally progress, and what other treatment/therapies they receive over those 2 years. The phase 1 trial was with children whose parents presumably sought ever possible way to help them, while the placebo controlled phase 2 was adults who may have plateaued.)

        • LoganDark 2 hours ago
          > If you are below the cutoff for mild ASD you wouldn't be diagnosed at all.

          That makes sense, since ASD is a disorder classification and is mainly relevant for treatment and benefits. Plenty of autistic people are not diagnosed with ASD.

          The article certainly could do more to differentiate between the autistic spectrum itself and the diagnosis of ASD, but as long as you know not to conflate the two, it seems perfectly clear to me.

    • n64controller 2 hours ago
      [flagged]
  • ZoomZoomZoom 1 hour ago
    Absolutely outrageous/hilarious clickbait title. It's not for autism but totally opposite.
  • jdw64 2 hours ago
    Personally, anyone looking to get a fecal transplant from Sir Demis Hassabis will have to line up behind me. I want to be first in line.
  • hank2000 52 minutes ago
    The number of stories I’ve read in the last 15 years that amount to: “desperate after years of trying everything, we bought a blender and ground up my wife’s shit and put it up my butt, and within a 24 hours I was totally fine”

    Is kind of impressive.

    • shlant 46 minutes ago
      my wife is autistic and suffers from many gastro illnesses including MCAS and SIBO. The amount of times i've seriously thought of figuring out the logistics of giving her a fecal transplant from my iron stomach...