Gut Microbiome and Sex Bias in Autism Spectrum Disorders

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Purpose of Review

Autism spectrum disorders (ASD) express as impaired social interactions and stereotypes. The gut microbiome which is remarkably different in ASD compared with controls may contribute to the sex bias of this disorder, with females being less vulnerable to clinically present autism. This review aims to understand the role of gut microbiota and female sex hormone in the sex bias of autism.

Recent Findings

Recent evidence proved that transplanted gut microbiota from autistic donors but not healthy controls into germ-free mice were effective in inducing autistic features. Moreover selective probiotic known to be more abundant in females than males was effective as a treatment strategy.


The higher autistic phenotypes in males compared with females could be attributed to the protective effect of estrogen, the higher diversity and predominance of probiotics in females, the lower liability of females to develop leaky gut, neuroinflammation, and excitotoxicity as etiological mechanisms.

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Autism spectrum disorders




Microbiota epitopes


Maternal immune activation


Microbiota transfer therapy


γ-Aminobutyric acid


Zonula occluden-1


Trypsin-like activity protein


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    Correspondence to Afaf El-Ansary.

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    El-Ansary, A., Bhat, R.S. & Zayed, N. Gut Microbiome and Sex Bias in Autism Spectrum Disorders. Curr Behav Neurosci Rep (2020) doi:10.1007/s40473-020-00197-3

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    • Autism spectrum disorders
    • Sex bias
    • Gut microbiota
    • Leaky gut
    • Glutamate excitotoxicity