Benefit of Microbiota Transfer Therapy on autism symptoms and gut microbiota
(1) This isn't Nature, it's SciRep. Don't get distracted by the URL.(2) Nature is an extremely high impact factor journal. However, it's ... not really a medical journal. Nor a psych journal. Nor a developmental peds journal. It's a basic sciences journal. What I mean to say is, even if this were Nature, it'd be a super high-impact journal that isn't actually read by clinicians who would be best positioned to criticize the study.(2a) For instance, their bowel transfer prep involved a clean-out with a two week course of vanco. The only bowel bugs it's used for are c. diff colitis and staph aureus enterocolitis. The reason it's really only used for that is because it really doesn't touch any other common bowel inhabitants. It's useful for those because it doesn't absorbed very effectively, so if you've got C Diff sitting in the bowel lumen, great, send a wash of vanco down the pipe. But, uh, for any other bugs in the gut? It's not even second line. So, how weird that it would be used to knock out pre-existing gut flora and "suppress pathogenic bacteria." C Diff and MRSA are not the leading pathogenic gut bacteria. The pre-existing flora are predominantly anaerobes.(3) An unblinded, uncontrolled trial of a disease whose symptoms are highly subjective in measure? Excellent. I'm sure they took measures to ensure they weren't influenced in their subjective analys-(3a) Oh. The senior author has a bunch of patents out trying to commercialize probiotics for autism.(3b) Oh, they used the PGI3, CARS, SRS, and ABC scores. I guess if you fill out enough bubbles you can overcome the fact that those are still subjective enough that they're shit for an open-label trial. Whoops.I don't mean to be overly dismissive. It's a fine pilot. The results are interesting enough that I'd want to see a real study tackle this. My comments are mostly aimed at the prevailing sentiment here taking this at face value.