Modulating autism spectrum disorder pathophysiology using a trace amine-focused approach: targeting the gut

Abstract Autism spectrum disorder (ASD) affects approximately 1% of the population directly, but also a much higher proportion (family and caregivers) indirectly. Although ASD is characterized by high prevalence of anxiety and poor gastrointestinal health, current treatment strategies are mainly foc...

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Main Authors: L. Pretorius, J. A. Coetzee, A. P. dos Santos, C. Smith
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Molecular Medicine
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Online Access:https://doi.org/10.1186/s10020-025-01232-3
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author L. Pretorius
J. A. Coetzee
A. P. dos Santos
C. Smith
author_facet L. Pretorius
J. A. Coetzee
A. P. dos Santos
C. Smith
author_sort L. Pretorius
collection DOAJ
description Abstract Autism spectrum disorder (ASD) affects approximately 1% of the population directly, but also a much higher proportion (family and caregivers) indirectly. Although ASD is characterized by high prevalence of anxiety and poor gastrointestinal health, current treatment strategies are mainly focused on neurological symptomatic treatment, with little to no attention to gut health. Furthermore, many psychiatric drugs used for management of secondary neurological symptoms, are known to exacerbate gut health issues and neurological dysregulation across the gut-brain axis. Trace amines are neurotransmitter-like substances synthesized endogenously in the human brain – in trace amounts – but also in high abundance by the microbiome. Emerging evidence suggests dysregulation of the trace amine system in ASD. Since trace aminergic signalling is central to regulatory system homeostasis, we hypothesize targeting this system in the ASD context. Given the various sources of trace amines, we suggest that normalization of functional dysbiosis in terms of trace aminergic signalling – rather than microbial compositional dysbiosis – should be a focus in medicines development. In addition, a holistic consideration including also other factors at play in determining trace aminergic signalling outcome – such as receptor binding, enzymatic role players, etc. – is required to fully elucidate and therapeutically modify the pathophysiology of regulatory systems implicated in ASD. This review firstly provides a brief overview of trace amine dysregulation in ASD for context. Secondly, we formulate our hypothesis on how this may therapeutically address symptomology, with consideration of cellular and molecular mechanism interplay across the gut-brain axis. Finally, we provide a critical assessment of advances in therapeutics development and drug re-purposing, gaps in knowledge and priorities for medicines development going forward.
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spelling doaj-art-e9bf60015dcd4e408c6289d3eadc12af2025-08-20T01:53:19ZengBMCMolecular Medicine1528-36582025-05-0131112010.1186/s10020-025-01232-3Modulating autism spectrum disorder pathophysiology using a trace amine-focused approach: targeting the gutL. Pretorius0J. A. Coetzee1A. P. dos Santos2C. Smith3Experimental Medicine Group, Dept Medicine, Stellenbosch UniversityExperimental Medicine Group, Dept Medicine, Stellenbosch UniversityExperimental Medicine Group, Dept Medicine, Stellenbosch UniversityExperimental Medicine Group, Dept Medicine, Stellenbosch UniversityAbstract Autism spectrum disorder (ASD) affects approximately 1% of the population directly, but also a much higher proportion (family and caregivers) indirectly. Although ASD is characterized by high prevalence of anxiety and poor gastrointestinal health, current treatment strategies are mainly focused on neurological symptomatic treatment, with little to no attention to gut health. Furthermore, many psychiatric drugs used for management of secondary neurological symptoms, are known to exacerbate gut health issues and neurological dysregulation across the gut-brain axis. Trace amines are neurotransmitter-like substances synthesized endogenously in the human brain – in trace amounts – but also in high abundance by the microbiome. Emerging evidence suggests dysregulation of the trace amine system in ASD. Since trace aminergic signalling is central to regulatory system homeostasis, we hypothesize targeting this system in the ASD context. Given the various sources of trace amines, we suggest that normalization of functional dysbiosis in terms of trace aminergic signalling – rather than microbial compositional dysbiosis – should be a focus in medicines development. In addition, a holistic consideration including also other factors at play in determining trace aminergic signalling outcome – such as receptor binding, enzymatic role players, etc. – is required to fully elucidate and therapeutically modify the pathophysiology of regulatory systems implicated in ASD. This review firstly provides a brief overview of trace amine dysregulation in ASD for context. Secondly, we formulate our hypothesis on how this may therapeutically address symptomology, with consideration of cellular and molecular mechanism interplay across the gut-brain axis. Finally, we provide a critical assessment of advances in therapeutics development and drug re-purposing, gaps in knowledge and priorities for medicines development going forward.https://doi.org/10.1186/s10020-025-01232-3β-PEATyramineTryptamineAgmatinePolyamineTAAR
spellingShingle L. Pretorius
J. A. Coetzee
A. P. dos Santos
C. Smith
Modulating autism spectrum disorder pathophysiology using a trace amine-focused approach: targeting the gut
Molecular Medicine
β-PEA
Tyramine
Tryptamine
Agmatine
Polyamine
TAAR
title Modulating autism spectrum disorder pathophysiology using a trace amine-focused approach: targeting the gut
title_full Modulating autism spectrum disorder pathophysiology using a trace amine-focused approach: targeting the gut
title_fullStr Modulating autism spectrum disorder pathophysiology using a trace amine-focused approach: targeting the gut
title_full_unstemmed Modulating autism spectrum disorder pathophysiology using a trace amine-focused approach: targeting the gut
title_short Modulating autism spectrum disorder pathophysiology using a trace amine-focused approach: targeting the gut
title_sort modulating autism spectrum disorder pathophysiology using a trace amine focused approach targeting the gut
topic β-PEA
Tyramine
Tryptamine
Agmatine
Polyamine
TAAR
url https://doi.org/10.1186/s10020-025-01232-3
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AT jacoetzee modulatingautismspectrumdisorderpathophysiologyusingatraceaminefocusedapproachtargetingthegut
AT apdossantos modulatingautismspectrumdisorderpathophysiologyusingatraceaminefocusedapproachtargetingthegut
AT csmith modulatingautismspectrumdisorderpathophysiologyusingatraceaminefocusedapproachtargetingthegut