Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Clin Pediatr. Dec 9, 2026; 15(4): 121115
Published online Dec 9, 2026. doi: 10.5409/wjcp.121115
Published online Dec 9, 2026. doi: 10.5409/wjcp.121115
Psychobiotics in pediatric autism spectrum disorder: A systematic review of efficacy, mechanisms, and clinical translation
Mohammed Al-Beltagi, Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31511, Algharbia, Egypt
Mohammed Al-Beltagi, Department of Pediatrics, University Hospital, Arabian Gulf University, Manama 26671, Bahrain
Nermin Kamal Saeed, Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, Governmental Hospitals, Ministry of Health, Manama 12, Bahrain
Nermin Kamal Saeed, Medical Microbiology Section, Department of Pathology, Royal College of Surgeons in Ireland-Bahrain, Busaiteen 15503, Muharraq, Bahrain
Yousif M Elbeltagi, Department of Medicine, Royal College of Surgeons in Ireland-Bahrain, Busaiteen 15503, Muharraq, Bahrain
Author contributions: Al-Beltagi M conceptualized and designed the study, supervised the research process, interpreted the data, and drafted and critically revised the manuscript for important intellectual content, he also contributed to the methodological planning and the final approval of the published version; Saeed NK contributed to study design, microbiological and mechanistic interpretation of microbiome-related findings, data analysis, and critical revision of the manuscript for scientific accuracy and clarity; Elbeltagi Y participated in literature acquisition, data extraction, statistical synthesis support, and drafting sections related to clinical interpretation and systemic implications, he also assisted in manuscript editing and preparation for submission; all authors reviewed and approved the final manuscript and agreed to be accountable for all aspects of the work.
AI contribution statement: No AI writing tools were used. Only Grammarly, which is built into Microsoft Office software, was used for grammar correction. Any part of the manuscript (abstract, introduction, materials and methods, results, discussion, or conclusion) was not generated by AI. Only Grammarly was used for a few grammatical and linguistic corrections. No AI tools were used in the process of research design, data analysis, or result interpretation. No AI-generated images were used.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest relevant to this work. The authors have no financial or non-financial relationships that could be perceived to influence the content of this manuscript. No funding sources or external organizations had any role in the design of the study; collection, analysis, or interpretation of data; writing of the manuscript; or decision to submit the article for publication.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Mohammed Al-Beltagi, MD, PhD, Professor, Department of Pediatrics, Faculty of Medicine, Tanta University, 1 Hassan Radwan Street, Tanta 31511, Algharbia, Egypt. mbelrem@hotmail.com
Received: March 16, 2026
Revised: April 28, 2026
Accepted: May 26, 2026
Published online: December 9, 2026
Processing time: 186 Days and 21.2 Hours
Revised: April 28, 2026
Accepted: May 26, 2026
Published online: December 9, 2026
Processing time: 186 Days and 21.2 Hours
Core Tip
Core Tip: Microbiome-targeted therapies are emerging as promising adjunctive strategies for children with autism spectrum disorder, particularly in those with co-existing gastrointestinal disorders. We observed from this systematic review that probiotics and prebiotics consistently improve gastrointestinal symptom severity, while synbiotics may provide broader modulation of gut microbial ecology. Fecal microbiota transplantation induced the largest observed improvements in both gastrointestinal outcomes and selected behavioral domains, although current evidence is limited by small sample sizes and methodological heterogeneity. These findings support strong evidence that the microbiota-gut-brain axis is a biologically reasonable therapeutic target and highlight the need for large, well-designed randomized trials.