Faecal microbiota transplantation as a novel approach for autism-associated anxiety: A critical therapeutic appraisal

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized by social communication deficits and restrictive, repetitive behaviors. A significant proportion of individuals with ASD also suffer from anxiety disorders, further compounding their behavioral and emotional chall...

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Main Authors: Tanushree D. Malode, Pranali Chandurkar, Brijesh G. Taksande, Amol A. Tatode, Mohammad Qutub, Tanvi Premchandani, Milind J. Umekar, Jayshree B. Taksande
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Medicine in Microecology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2590097825000199
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author Tanushree D. Malode
Pranali Chandurkar
Brijesh G. Taksande
Amol A. Tatode
Mohammad Qutub
Tanvi Premchandani
Milind J. Umekar
Jayshree B. Taksande
author_facet Tanushree D. Malode
Pranali Chandurkar
Brijesh G. Taksande
Amol A. Tatode
Mohammad Qutub
Tanvi Premchandani
Milind J. Umekar
Jayshree B. Taksande
author_sort Tanushree D. Malode
collection DOAJ
description Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized by social communication deficits and restrictive, repetitive behaviors. A significant proportion of individuals with ASD also suffer from anxiety disorders, further compounding their behavioral and emotional challenges. Conventional therapies for anxiety in ASD, including pharmacological and behavioral interventions, often yield suboptimal results and carry notable limitations. Growing research highlights the critical role of the gut-brain axis in neurodevelopment and emotional regulation, with gut microbiota dysbiosis increasingly implicated in both ASD and anxiety pathogenesis. Faecal microbiota transplantation (FMT), a therapeutic approach aimed at restoring microbial homeostasis by transferring fecal material from healthy donors, has emerged as a novel intervention of interest. Preclinical studies have demonstrated that alterations in gut microbiota can modulate social behaviors and anxiety-like symptoms, with FMT reversing many pathological features in animal models. Early clinical investigations, though limited, suggest that FMT may improve gastrointestinal health, core ASD symptoms, and comorbid anxiety. Mechanistically, FMT is thought to reduce neuroinflammation, restore neurotransmitter balance, and normalize stress responses by enhancing gut microbial diversity and metabolic function. However, significant challenges remain, including concerns about safety, standardization, donor selection, and regulatory approval. Future research must focus on large-scale, controlled trials and the identification of biomarkers predictive of FMT response to establish its therapeutic potential more conclusively. This review critically examines the existing evidence, explores the mechanistic pathways linking gut microbiota to anxiety in ASD, and discusses the future directions necessary to translate FMT into a viable clinical strategy for autism-associated anxiety.
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spelling doaj-art-7eb23e23a6bb44409c849bbdf7c769472025-08-20T04:03:25ZengElsevierMedicine in Microecology2590-09782025-09-012510013810.1016/j.medmic.2025.100138Faecal microbiota transplantation as a novel approach for autism-associated anxiety: A critical therapeutic appraisalTanushree D. Malode0Pranali Chandurkar1Brijesh G. Taksande2Amol A. Tatode3Mohammad Qutub4Tanvi Premchandani5Milind J. Umekar6Jayshree B. Taksande7Division of Neurotherapeutics, Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Dist. Nagpur, Maharashtra, 441002, IndiaDivision of Neuroscience, Department of Pharmacology, Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Dist. Nagpur, Maharashtra, 441002, IndiaDivision of Neuroscience, Department of Pharmacology, Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Dist. Nagpur, Maharashtra, 441002, IndiaDivision of Neurotherapeutics, Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Dist. Nagpur, Maharashtra, 441002, IndiaDivision of Neurotherapeutics, Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Dist. Nagpur, Maharashtra, 441002, IndiaDivision of Neurotherapeutics, Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Dist. Nagpur, Maharashtra, 441002, IndiaDivision of Neurotherapeutics, Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Dist. Nagpur, Maharashtra, 441002, IndiaDivision of Neurotherapeutics, Smt. Kishoritai Bhoyar College of Pharmacy, Kamptee, Dist. Nagpur, Maharashtra, 441002, India; Corresponding author.Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition characterized by social communication deficits and restrictive, repetitive behaviors. A significant proportion of individuals with ASD also suffer from anxiety disorders, further compounding their behavioral and emotional challenges. Conventional therapies for anxiety in ASD, including pharmacological and behavioral interventions, often yield suboptimal results and carry notable limitations. Growing research highlights the critical role of the gut-brain axis in neurodevelopment and emotional regulation, with gut microbiota dysbiosis increasingly implicated in both ASD and anxiety pathogenesis. Faecal microbiota transplantation (FMT), a therapeutic approach aimed at restoring microbial homeostasis by transferring fecal material from healthy donors, has emerged as a novel intervention of interest. Preclinical studies have demonstrated that alterations in gut microbiota can modulate social behaviors and anxiety-like symptoms, with FMT reversing many pathological features in animal models. Early clinical investigations, though limited, suggest that FMT may improve gastrointestinal health, core ASD symptoms, and comorbid anxiety. Mechanistically, FMT is thought to reduce neuroinflammation, restore neurotransmitter balance, and normalize stress responses by enhancing gut microbial diversity and metabolic function. However, significant challenges remain, including concerns about safety, standardization, donor selection, and regulatory approval. Future research must focus on large-scale, controlled trials and the identification of biomarkers predictive of FMT response to establish its therapeutic potential more conclusively. This review critically examines the existing evidence, explores the mechanistic pathways linking gut microbiota to anxiety in ASD, and discusses the future directions necessary to translate FMT into a viable clinical strategy for autism-associated anxiety.http://www.sciencedirect.com/science/article/pii/S2590097825000199Autism spectrum disorderFaecal microbiota transplantationAnxietyGut microbiotaDysbiosisGut brain axis
spellingShingle Tanushree D. Malode
Pranali Chandurkar
Brijesh G. Taksande
Amol A. Tatode
Mohammad Qutub
Tanvi Premchandani
Milind J. Umekar
Jayshree B. Taksande
Faecal microbiota transplantation as a novel approach for autism-associated anxiety: A critical therapeutic appraisal
Medicine in Microecology
Autism spectrum disorder
Faecal microbiota transplantation
Anxiety
Gut microbiota
Dysbiosis
Gut brain axis
title Faecal microbiota transplantation as a novel approach for autism-associated anxiety: A critical therapeutic appraisal
title_full Faecal microbiota transplantation as a novel approach for autism-associated anxiety: A critical therapeutic appraisal
title_fullStr Faecal microbiota transplantation as a novel approach for autism-associated anxiety: A critical therapeutic appraisal
title_full_unstemmed Faecal microbiota transplantation as a novel approach for autism-associated anxiety: A critical therapeutic appraisal
title_short Faecal microbiota transplantation as a novel approach for autism-associated anxiety: A critical therapeutic appraisal
title_sort faecal microbiota transplantation as a novel approach for autism associated anxiety a critical therapeutic appraisal
topic Autism spectrum disorder
Faecal microbiota transplantation
Anxiety
Gut microbiota
Dysbiosis
Gut brain axis
url http://www.sciencedirect.com/science/article/pii/S2590097825000199
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