Department of Neurology, Konkuk University School of Medicine, Seoul, Republic of Korea.
Research Laboratories, Ildong Pharmaceutical Co., Ltd., Hwaseong, Gyeonggi, Republic of Korea.
Epilepsy Res. 2021 May;172:106601. doi: 10.1016/j.eplepsyres.2021.106601. Epub 2021 Mar 8.
Approximately one-third of epilepsy patients suffer from drug-resistant epilepsy. The gut microbiome, which is the total genetic makeup of all of the total microbes inhabiting the gut, can affect the CNS through various mechanisms. However, there are only limited studies about the relationship between the gut microbiome and epilepsy. We investigated the composition and characteristics of the gut microbiota among adult patients who have drug-responsive and drug-resistant epilepsy.
We prospectively included 44 adult epilepsy patients and classified them into drug-responsive and drug-resistant groups. We collected fecal samples for the next-generation sequencing analysis. We statistically estimated the bacterial differences and alpha and beta diversities in each category.
Although there was no difference in demographic factors between the drug-responsive and drug-resistant groups, there was a significant difference in the composition of the gut microbiota. While the relative abundance of Bacteroides finegoldii and Ruminococcus_g2 increased in the drug-responsive group, the relative abundance of Negativicutes, which belong to Firmicutes increased in the drug-resistant group. Bifidobacterium was relatively abundant in epilepsy patients with a normal electroencephalogram. There was no significant difference between the two groups in analyses of alpha and beta diversities.
We found a significant difference in the composition of the gut microbiota among adult patients with drug-responsive and drug-resistant epilepsy. Difference in gut microbiota can be used as a novel biomarker to predict prognosis and evaluate treatment response in epilepsy patients. In addition, modification of gut microbiome can be an effective treatment strategy for patient with drug-resistant epilepsy.
大约三分之一的癫痫患者患有耐药性癫痫。肠道微生物组是栖息在肠道中的所有微生物的总遗传组成，可以通过多种机制影响中枢神经系统。然而，关于肠道微生物组与癫痫之间的关系的研究有限。我们调查了药物反应性和耐药性癫痫成年患者的肠道微生物群的组成和特征。
我们前瞻性地纳入了 44 名成年癫痫患者，并将他们分为药物反应性和耐药性组。我们收集粪便样本进行下一代测序分析。我们统计估计了每个类别中的细菌差异和 alpha 和 beta 多样性。
尽管药物反应性和耐药性组之间在人口统计学因素方面没有差异，但肠道微生物群的组成存在显著差异。虽然药物反应性组中 Bacteroides finegoldii 和 Ruminococcus_g2 的相对丰度增加，但耐药性组中属于 Firmicutes 的 Negativicutes 的相对丰度增加。在脑电图正常的癫痫患者中，双歧杆菌相对丰富。在 alpha 和 beta 多样性分析中，两组之间没有显著差异。
我们发现药物反应性和耐药性癫痫成年患者肠道微生物群的组成存在显著差异。肠道微生物群的差异可以用作预测癫痫患者预后和评估治疗反应的新型生物标志物。此外，肠道微生物组的修饰可以成为耐药性癫痫患者的有效治疗策略。
