The gut microbiome as a modifiable contributor to autism spectrum disorder: a precision gut–immune–brain perspective

Abstract

human observational studies, clinical trials, and mechanistic animal studies. Genetic susceptibility, early neurodevelopment, family environment, medications, restricted eating, and gastrointestinal symptoms may shape gut microbiome composition and function. Microbial communities may influence ASD-related traits through metabolites such as glutamate/GABA-related pathways, tryptophan-related metabolites, short-chain fatty acids, and 3-hydroxyglutaric acid. These signals may affect immune pathways involving CD4+ T cells, microglia, cytokines, and neuroinflammation, ultimately influencing brain activity and behavioral domains. Rather than presenting the microbiome as a single cause of ASD, this framework may support future precision approaches using microbiome monitoring, metabolite profiling, biological subgrouping, strain-specific probiotics, and targeted dietary or microbial interventions. Created by the authors with Canva.