Potential links between neurological, cognitive conditions and gut microbiomes of children

In this Contemporary Pediatrics® video, Rob Knight, PhD, Wolfe Endowed Chair in Microbiome Science at Rady Children's Hospital-San Diego, professor of pediatrics, bioengineering, computer science and engineering, UCSD, explains correlations of the brain and gut related to neurological and cognitive conditions. He explains that discussions regarding these associations continue to occur in the field, and that there is growing interest on the subject.

Transcript (edited for clarity):

Contemporary Pediatrics:
Thank you so much for visiting Contemporary Pediatrics, I’m editor Joshua Fitch.

Rob Knight, PhD:
Thanks for having me. I'm Rob Knight, I direct the Center for Microbiome Innovation at UC San Diego, where I'm a professor of pediatrics, computer science and engineering, and bioengineering. I'm also the Wolf Endowed Chair in Microbiome Research at Rady Children's Hospital.

Contemporary Pediatrics:
Dr. Knight, thank you so much for taking the time to speak with us. First, what associations are there with pediatric brain health and the GI tract or the gut, and what evidence is supporting it in this patient population?

Knight:
Well, a lot of what we know about the general elements of the gut-brain axis are coming from experiments with mice and from adult medicine. But what we're finding is more and more ways, we can translate those findings into things that are directly relevant for children. One particular area that's fairly far ahead in children is the study of autism, where we're learning more about the role of the gut and the microbes in the gut in autism. There's even been one intriguing trial that demonstrated that you could alleviate both GI and cognitive symptoms of autism by doing what's called a fecal transplant, where you literally take fecal matter from someone who's healthy and you transplant it into someone who has autism. There's a lot of excitement in the area of major depressive disorder and also other neurological conditions, including ADHD. The concept is that the gut microbes may play a large role in those conditions, although at this stage, much of the evidence is from adult medicine rather than studies in children directly. However, that's one of the things we're trying to fix at Rady’s. There's also a lot of interest in understanding how the microbiome contributes to normal development. For example, we've done some work with Merete Eggesbo in Norway, showing that the early-life gut microbiome has a correlation years and years later, even out to age 8 or 10, with how the children perform on cognitive tests. So we think there is a tremendous amount of new knowledge we’re going to gain about these links in the coming years.

Contemporary Pediatrics:
Could you talk about the prevalence of this topic in recent years? Have you noticed an increase in discussion?

Knight:
Absolutely, the discussions have dramatically taken off. It’s interesting, back in 2011 when we published in Dialogues in Clinical Neuroscience, the idea that the gut and the brain might be more related than people had thought, and that the microbes were having a role in it, a lot of my colleagues thought that I was the one who should have my head examined for being crazy enough to think that. That was the only link they could see. Reports of the fecal transplant trial I mentioned. The increasing appreciation that nutrition has a huge impact on cognition and on mood, and how the gut microbiome plays a role in that. Then the increasing concern about antibiotics. There’s just more and more discussion around looking for these links, then understanding how we can keep patients as healthy as possible given the many different interventions that are going to be needed during their lifetime.