Mousavi Seyede Maryam, Younesian Sobhan, Ejtahed Hanieh-Sadat
Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Microb Pathog. 2025 Feb;199:107266. doi: 10.1016/j.micpath.2024.107266. Epub 2024 Dec 28.
There is accumulating evidence suggesting a connection between epilepsy, a neurologic disease with recurrent seizures, and gut microbiota. This systematic review and meta-analysis explores the alterations of GM composition in patients with epilepsy.
A systematic search was conducted up to June 26, 2024, across PubMed, Scopus, Web of Science, and Embase. The study outcomes were α- and β-diversity indexes, and relative abundance at different bacterial taxonomic levels, compared between epilepsy patients and healthy controls. Inverse variance-weighted meta-analysis was performed to estimate the standardized mean difference. We utilized the Newcastle-Ottawa Scale (NOS) to assess the quality of the included studies.
In this systematic review, we included 16 case-control studies encompassing 438 cases and 369 controls, and 12 studies were included in the meta-analyses. α-diversity was not significantly different between epilepsy and control group. Of the 11 studies measuring β-diversity, 8 studies showed that the microbiota compositions of the two groups differed significantly. Verrucomicrobia was significantly higher in the epilepsy group (SMD = 0.39 [0.05, 0.72], p = 0.022) than in the control group. At the genus level, Roseburia (SMD = -0.50 [-0.84, -0.17], p = 0.003), Blautia (SMD = -0.40 [-0.73, -0.06], p = 0.022), and Dialister (SMD = -0.40 [-0.74, -0.07], p = 0.018) were significantly less abundant in patients with epilepsy.
Our findings evince remarkable changes in gut microbiota composition in epilepsy. Bacterial genera that promote neuroinflammation are elevated in epilepsy. Our study revealed the interrelation between GM disruption and epileptogenesis, but the heterogeneity among the included results was high, and further investigation is encouraged.
越来越多的证据表明，癫痫（一种伴有反复发作的神经系统疾病）与肠道微生物群之间存在联系。本系统评价和荟萃分析探讨了癫痫患者肠道微生物群组成的改变。
截至2024年6月26日，在PubMed、Scopus、Web of Science和Embase数据库中进行了系统检索。研究结果为α和β多样性指数，以及癫痫患者与健康对照在不同细菌分类水平上的相对丰度。采用逆方差加权荟萃分析来估计标准化平均差异。我们使用纽卡斯尔-渥太华量表（NOS）来评估纳入研究的质量。
在本系统评价中，我们纳入了16项病例对照研究，包括438例病例和369例对照，12项研究纳入了荟萃分析。癫痫组与对照组之间的α多样性无显著差异。在测量β多样性的11项研究中，8项研究表明两组的微生物群组成存在显著差异。疣微菌门在癫痫组中显著高于对照组（标准化平均差[SMD]=0.39[0.05，0.72]，p=0.022）。在属水平上，罗斯氏菌属（SMD=-0.50[-0.84，-0.17]，p=0.003）、布劳特氏菌属（SMD=-0.40[-0.73，-0.06]，p=0.022）和戴阿利斯特菌属（SMD=-0.40[-0.74，-0.07]，p=0.018）在癫痫患者中的丰度显著较低。
我们的研究结果表明癫痫患者的肠道微生物群组成发生了显著变化。促进神经炎症的细菌属在癫痫中升高。我们的研究揭示了肠道微生物群破坏与癫痫发生之间的相互关系，但纳入结果之间的异质性较高，鼓励进一步研究。
