Neuropediatric Department, Astrid Lindgren Children's Hospital, Karolinska Hospital, Stockholm, Sweden.
Center for Translational Microbiome Research (CTMR), Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
EBioMedicine. 2019 Jun;44:741-746. doi: 10.1016/j.ebiom.2019.05.024. Epub 2019 May 31.
Recently, evidence from both animal studies and human cases has emerged that a dysbiosis in the gut may be associated with certain forms of epilepsy. The ketogenic diet is an alternative treatment of drug-resistant epilepsy, although its precise mechanism of action has been unclear. It has now been shown that the ketogenic diet changes the composition and function of the gut microbiome in epilepsy patients. Studies in mice have demonstrated that the gut microbiota was necessary for the therapeutic effect of the diet and a mechanism of action has been proposed, providing new potential strategies for treatment. Further studies are needed to confirm the clinical relevance of this discovery. Below, we will discuss the scientific evidence of the role of the microbiome in seizure disorders, the impact of the ketogenic diet on the intestinal microbiota as well as the interactions described between commonly used antiepileptic drugs and intestinal microbial communities. We also discuss the potential of modulators of the gut microbiota as possible future anti-seizure therapeutics.
最近,动物研究和人类病例的证据表明,肠道菌群失调可能与某些类型的癫痫有关。生酮饮食是一种治疗耐药性癫痫的替代方法,但其确切的作用机制尚不清楚。现在已经表明,生酮饮食改变了癫痫患者肠道微生物组的组成和功能。在小鼠中的研究表明,肠道微生物群对于饮食的治疗效果是必需的,并且提出了一种作用机制,为治疗提供了新的潜在策略。需要进一步的研究来确认这一发现的临床相关性。下面,我们将讨论肠道微生物组在癫痫发作中的作用的科学证据,生酮饮食对肠道微生物群的影响以及描述的常用抗癫痫药物与肠道微生物群落之间的相互作用。我们还讨论了肠道微生物群调节剂作为潜在的未来抗癫痫治疗的可能性。