Medication-resistant epilepsy is associated with a unique gut microbiota signature


Riva A., Sahin E., Volpedo G., Catania N. T., Venara I., Biagioli V., ...Daha Fazla

Epilepsia, 2025 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1111/epi.18367
  • Dergi Adı: Epilepsia
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, EMBASE, International Pharmaceutical Abstracts, MEDLINE, Veterinary Science Database
  • Anahtar Kelimeler: epilepsy, gut microbiota signature, microbiota–gut–brain axis, pediatrics
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet

Özet

Objective: Dysfunction of the microbiota–gut–brain axis is emerging as a new pathogenic mechanism in epilepsy, potentially impacting on medication response and disease outcome. We investigated the composition of the gut microbiota in a cohort of medication-resistant (MR) and medication-sensitive (MS) pediatric patients with epilepsy. Methods: Children with epilepsy of genetic and presumed genetic etiologies were evaluated clinically and subgrouped into MR and MS. Age-matched healthy controls (HCs) were also recruited. A food diary was used to evaluate nutritional habits, and the Rome IV questionnaire was used to record gastrointestinal symptoms. The microbiota composition was assessed in stool samples through 16S rRNA. α-Diversity (AD) and β-diversity (BD) were calculated, and differential abundance analysis was performed using linear multivariable models (significance: p.adj <.05). Results: Forty-one patients (MR:MS = 20:21) with a mean age of 7.2 years (±4.6 SD) and 27 age-matched HCs were recruited. No significant differences in AD were found when comparing patients and HCs. Significant positive correlation was found between AD and age (Chao1 p.adj =.0004, Shannon p.adj =.0004, Simpson p.adj =.0028). BD depicted a different bacterial profile in the epilepsy groups compared to HCs (MS vs. HC: Bray–Curtis F = 1.783, p =.001; Jaccard F = 1.24, p =.001; MR vs. HC: Bray–Curtis F = 2.24, p =.001; Jaccard F = 1.364, p =.001). At the genus level, the epilepsy groups were characterized by a significant increase in Hungatella (MS vs. HC: +4.95 log2 change; MR vs. HC: +6.72 log2 change); the [Eubacterium] siraeum group changed between the MR and MS subgroups. Significance: Epileptic patients display unique gut metagenomic signatures compared to HCs. Moreover, a different ratio of the butyrate-producing [Eubacterium] siraeum group suggests dissimilarities between patients based on the response to antiseizure medications.