Fecal extracellular vesicles from adults with autism spectrum disorder affect mouse behavior and gut motility by targeting the neuronal nitrergic pathway

Beside behavioral symptoms, many patients with autism spectrum disorder (ASD) present gastrointestinal disorders and gut microbiota dysbiosis. In order to better understand the mechanisms underlying microbiota-gut-brain interactions in ASD, we isolated fecal extracellular vesicles (EVs), as a source of microbiota-derived EVs, from control individuals (f-EV-CTL) and patients with ASD (f-EV-ASD) to study in mice their impact on brain and gut. The f-EV-ASD induced hypersocial and anxiolytic-like behavior, and reduced gastrointestinal transit time compared to mice treated with f-EV-CTL. In the colon, f-EV-ASD altered motility through the enteric neuronal nitric oxide (NO)-sensitive component. f-EV-ASD potentiated NO signaling and disrupted intracellular calcium dynamics in enteric neurons. This effect was mediated by butyrate and valerate through FFAR3 receptor. Our findings establish fecal EVs as critical mediators of microbiota-host communication, linking microbial metabolites to altered behavior and gut function and identifying a potential mechanism underlying ASD pathophysiology.