Gut-microbiota-directed strategies to treat epilepsy: clinical and experimental evidence

• Published in: Seizure (London, England) Vol. 90; pp. 80 - 92
• Main Authors: Mejía-Granados, Diana Marcela, Villasana-Salazar, Benjamín, Lozano-García, Lucas, Cavalheiro, Esper A., Striano, Pasquale
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.08.2021
• Subjects: Drug-resistant epilepsy; Epilepsy; Microbiota; Microbiota-gut-brain axis; Non-pharmacological treatments; Seizures; FXR; Microbiota-gut-brain axis; BBB; Epilepsy; CNS; LTP; AHR; TNF; IECs; NF-κB; Microbiota; ALAC; fEPSP; TRP; 2Bas; PTZ; NMDA; KD; CA; Seizures; GF; CDCA; KYN; 4AP; IL; rRNA; IAA; MGB; Non-pharmacological treatments; FMT; Drug-resistant epilepsy; GABA; CPE; GPCR; SCFAs; MES; IPA; IDO1
• ISSN: 1059-1311; 1532-2688
• DOI: 10.1016/j.seizure.2021.03.009

•People with epilepsy exhibit altered gut microbiota composition.•Bottom-up signals affect neurotransmission, neuroendocrine, metabolic, and neuroimmune pathways.•Integrating omics may expand the current knowledge linking the microbiome to epilepsy.•Targeting the human gut microbiome could shift treatment paradigms for epilepsy. A growing appreciation that the intestinal microbiota might exert changes on the central nervous system via the gut-brain has emerged as a new research frontier in neurological disorders. Moreover, new approaches for studying and manipulating the gut microbiome, including metabolomics and faecal microbiota transplantation, have highlighted the tremendous potential that microbes have on neuroinflammation, metabolic, and neuroendocrine signaling pathways. Despite the large proliferation of studies in animal models examining the linkage between microbial disequilibrium and epilepsy, intestinal profiles at a functional level in humans have remained scarce. We reviewed the scientific evidence on gut microbiota's role in epilepsy, both in clinical and experimental studies, to better understand how targeting the gut microbiota could serve as a diagnostic or prognostic research tool. Likewise, translating microbial molecular mechanisms to medical settings could fill the gaps related to alternative therapies for patients with epilepsy, mainly in cases with refractory phenotypes.