>Editor's note: Readers often ask us for follow-ups on memorable stories. What has happened to this story over the years? This article was originally published in 2019 but it has been re-edited and updated with new information current as of April 7, 2025. Enjoy!
Now that is something that should be done more often - especially in science journalism, but not only. We cruelly lack long-term vision - not only forward but backwards too.
The typical publishing methods kind of favors that approach of publishing new articles instead of updating existing ones though, for better or worse.
Maybe science journalism should just adopt a wiki-model instead, where there is one article per "subject" then any new (confirmed?) information/data goes into that, and interested people can subscribe to updates there instead.
Wikis generally have much better long-term maintenance given the right individuals running it, compared to a "publication journal" where things tend to get out of date eventually, with no way of actually seeing when old articles get updated.
No problem with publishing new articles, as long as they're properly contextualized and link to their predecessors – and the latter updated to link to the new information as well.
>> In early 2022 Krajmalnik-Brown and colleagues patented a specific bacterial formulation and spun-off a commercial company called Gut-Brain Axis Therapeutics.
I was a little surprised to see this.
So the university researchers use time and money from the university to make a discovery, extending on previous published research, and then patent it and start their own for-profit?
Excuse my ignorance, but is that how it's done generally? Where's the upside for all those who are potentially affected?
It kinda makes sense - Presumably the university is involved somewhere still, and it needs to be commercialised somehow, but..
Yes, it's really common. Most universities actually support this and there is a specific contractual framework for staff which basically says "If you create a company during or after your work at university which touches the field you were researching in, we get 1% (or 10% or 20%) of your annual revenue as license fees".
The alternatives are lengthy court battles between universities and their best (e.g. most commercial) researchers. This creates bad PR for the university and uncertainty for the researcher & their startups because potential investors don't like open court cases.
So people came around to make this kind of license fee contract and researchers check it before deciding to join a certain university.
Yes this is really common. Not all universities own the research you do. I have a similar setup within my university. They get to use the research technique I've worked on, but I have the rights to take it out of the university and sell it.
I got bad chronic constipation after four years as a strict carnivore. I didn't get relief just by adding back fiber, but I did by adding fermented foods like kimchi. I wonder if ferments are a more natural way than fecal transplants to repair the gut microbiome, possibly treating autism. Studies have been non conclusive, but this story makes me think it's worth pursuing.
Just all foods including salt and water consumed over a 4 year time period with some unknown offset from present, sure seems like a reasonable amount of effort in response to some random guys HN post.
The microbiota is passed from mother to son on birth, not totally from the environment.
What we currently don’t understand is why for some people they never got them (we have techniques to transport the biota from the mother during birth for non-natural procedures) or they loose them.
Even with the transplant, the microbes won’t stick around on those people (not taking about autistic people here, but people in general).
Diverse food really helps, just as not eating ultraprocessed (they won’t reach the end of the intestines).
Fermented and other pre or probiotics will really help too.
But none of those will recover the biota in some people.
In some countries the number of kids born through c-section are very high, more than half the kids in Brazil are born that way for example, so definitely people can be healthy without getting it from their mothers.
What's more plausible? Did they cure low functioning autism in two years? Or did they simpily miscategorize the kids and the kids grew out of their diagnosis as they matured?
They say that they started a phase 2 trial with placebo control in 2022 and they see better outcome than placebo
> Our phase 2 study for adults with autism found that the treatment group improved more than placebo on the primary outcome (autism symptoms) and on a secondary outcome (daily stool record),
That's what I'm saying. It's a misdiagnosis. Whether or not they have tantrums should not be a factor in whether or not they are high-functioning or low-functioning.
It does not have to be misdiagnosis. If kid has both autism and gut issues, the gut issues could make the autistic symptoms worse, by causing distress to the kid, which could make the interactions with caregivers harder for both in a quite formative period. Treating the gut issues could help this way without gut being directly related to autism and without it being a misdiagnosis. It is telling that they report quite high (0.7) correlations between improvement in gut and autistic symptoms.
However they say they also have an adult trial running that seems to show similar effects, so there might be something more into it.
If it was anything else but gut bacteria, I would be inclined to agree with you, but gut microbiota is slowly turning out to be an extremely important factor in our health and it also turns out that modern highly processed diet tends to damage it and make it less diverse. Even higher frequency of Caesarian section seems to make gut microbiota less diverse and there seem to be some diseases downstream from that.
At the same time, gut microbiota is extremely complex to study.
So, this may be a plausible result. I cannot judge the plausibilities right away in the way you suggest it.
I wonder if there’s any study linking C-section birth, autism and microbiota? Or newborns that have to stay in incubators?
I understand a newborn gets its microbiota naturally by contact with the mom in the first days, maybe all the sterile environment involved in surgery changes that.
You want to land a substantial amount of, ahem, shit in there, since don't just want it to colonize one portion of the gut, and it's got quite a lot of competition.
So you would be talking a truly astonishing number of pills, I think, to compare to the volume you can manage with a tube.
WP suggests that it's about 100g (or 100000mg) of actual feces then mixed in a larger volume of saline or milk, and you'd probably need to have additional volume for assumed losses and whatever coating you think would work.
Good point, but shit seems to be made of a lot of stuff- ~75% water, undigested food and fiber, fats, inorganic matter... Bacteria are seem to be about ~30% of the dry weight. So of those 100 grams, you'd get maybe 7/8 grams of bacteria?
Well no, what they're saying is it seems to be capable of reducing autism-related struggles and misbehavior, not that it can somehow remove autism. Truly removing autism in any meaningful way is probably impossible since the brain was trained with it since birth.
No, that appears to be the implication of this study, which frankly seems like such a large effect that I'm pretty skeptical! I'd say "where's the control group" except the claimed effect is so large that you kind of don't need one, if it's real:
> Prior to the study, 83% of participants had "severe" autism. Two years later, only 17% were rated as severe, 39% as mild or moderate, and incredibly, 44% were below the cut-off for mild ASD.
Emphasis mine. If you are below the cutoff for mild ASD you wouldn't be diagnosed at all.
That was the study without a control; for the placebo controlled study, they don't give the numbers, just say "statistically significant improvements" on several metrics.
(Without a control group, you have questions about how people of that age generally progress, and what other treatment/therapies they receive over those 2 years. The phase 1 trial was with children whose parents presumably sought ever possible way to help them, while the placebo controlled phase 2 was adults who may have plateaued.)
> If you are below the cutoff for mild ASD you wouldn't be diagnosed at all.
That makes sense, since ASD is a disorder classification and is mainly relevant for treatment and benefits. Plenty of autistic people are not diagnosed with ASD.
The article certainly could do more to differentiate between the autistic spectrum itself and the diagnosis of ASD, but as long as you know not to conflate the two, it seems perfectly clear to me.
imho part of the communication problem is that a 6 year reduction actually is large, but it doesn't sound large. Smoking takes about 10 years off your life, and it's deadly in a very mechanical and understood way.
Now that is something that should be done more often - especially in science journalism, but not only. We cruelly lack long-term vision - not only forward but backwards too.
Maybe science journalism should just adopt a wiki-model instead, where there is one article per "subject" then any new (confirmed?) information/data goes into that, and interested people can subscribe to updates there instead.
Wikis generally have much better long-term maintenance given the right individuals running it, compared to a "publication journal" where things tend to get out of date eventually, with no way of actually seeing when old articles get updated.
I was a little surprised to see this.
So the university researchers use time and money from the university to make a discovery, extending on previous published research, and then patent it and start their own for-profit?
Excuse my ignorance, but is that how it's done generally? Where's the upside for all those who are potentially affected?
It kinda makes sense - Presumably the university is involved somewhere still, and it needs to be commercialised somehow, but..
The alternatives are lengthy court battles between universities and their best (e.g. most commercial) researchers. This creates bad PR for the university and uncertainty for the researcher & their startups because potential investors don't like open court cases.
So people came around to make this kind of license fee contract and researchers check it before deciding to join a certain university.
Not a fan of gene / bacteria patents though.
2 questions:
1) Did your constipation start right after you did strict carnivore? Or was it after 4 years?
2) List all foods that you ate on strict carnivore. (Include salt, water etc. I presume it won't be a long list)
What we currently don’t understand is why for some people they never got them (we have techniques to transport the biota from the mother during birth for non-natural procedures) or they loose them.
Even with the transplant, the microbes won’t stick around on those people (not taking about autistic people here, but people in general).
Diverse food really helps, just as not eating ultraprocessed (they won’t reach the end of the intestines).
Fermented and other pre or probiotics will really help too.
But none of those will recover the biota in some people.
> Our phase 2 study for adults with autism found that the treatment group improved more than placebo on the primary outcome (autism symptoms) and on a secondary outcome (daily stool record),
However they say they also have an adult trial running that seems to show similar effects, so there might be something more into it.
At the same time, gut microbiota is extremely complex to study.
So, this may be a plausible result. I cannot judge the plausibilities right away in the way you suggest it.
I understand a newborn gets its microbiota naturally by contact with the mom in the first days, maybe all the sterile environment involved in surgery changes that.
(They run a tube through your nose, down your throat, through the stomach to the top of the intestines, and introduce the bacterial slurry there.)
Also, "fecal transplant" is marketable only to weirdos. "Probiotic infusion" would work better.
For those who want to gain some artistic talent, there's this (but is expensive):
https://en.wikipedia.org/wiki/Artist's_Shit
You want to land a substantial amount of, ahem, shit in there, since don't just want it to colonize one portion of the gut, and it's got quite a lot of competition.
So you would be talking a truly astonishing number of pills, I think, to compare to the volume you can manage with a tube.
WP suggests that it's about 100g (or 100000mg) of actual feces then mixed in a larger volume of saline or milk, and you'd probably need to have additional volume for assumed losses and whatever coating you think would work.
That is a _huge_ amount to put in pills.
> Prior to the study, 83% of participants had "severe" autism. Two years later, only 17% were rated as severe, 39% as mild or moderate, and incredibly, 44% were below the cut-off for mild ASD.
Emphasis mine. If you are below the cutoff for mild ASD you wouldn't be diagnosed at all.
(Without a control group, you have questions about how people of that age generally progress, and what other treatment/therapies they receive over those 2 years. The phase 1 trial was with children whose parents presumably sought ever possible way to help them, while the placebo controlled phase 2 was adults who may have plateaued.)
That makes sense, since ASD is a disorder classification and is mainly relevant for treatment and benefits. Plenty of autistic people are not diagnosed with ASD.
The article certainly could do more to differentiate between the autistic spectrum itself and the diagnosis of ASD, but as long as you know not to conflate the two, it seems perfectly clear to me.
I’m seeing M75/F77 w/o learning disability, and M72/F70 w/ learning disability: https://www.autism.org.uk/learn/knowledge-hub/professional-p...