epilepsiaEpilepsy and paroxysmal conditionsЭпилепсия и пароксизмальные состояния2077-83332311-4088IRBIS LLC10.17749/2077-8333/epi.par.con.2024.190epilepsia-1050Research ArticleSCIENTIFIC SURVEYSНАУЧНЫЕ ОБЗОРЫA relationship between intestinal microbiome and epilepsy: potential treatment options for drug-resistant epilepsyВзаимосвязь кишечного микробиома и эпилепсии: потенциальные возможности терапии фармакорезистентной эпилепсииhttps://orcid.org/0009-0002-1493-4528ЧередниченкоА. С.CherednichenkoA. S.

Чередниченко Алина Сергеевна 

ул. Куйбышева, д. 136, Батайск 346880, Ростовская обл.

Alina S. Cherednichenko 

136 Kuibyshev Str., Bataysk 346880, Rostov Region

https://orcid.org/0009-0001-8483-6336МоздорП. В.MozdorP. V.

Моздор Павел Владимирович

ул. Просвещения, д. 59, корп. 3, ст-ца Полтавская 353800, Красноармейский р-н, Краснодарский край

Pavel V. Mozdor 

59 corp. 3 Prosveshcheniya Str., Poltavskaya 353800, Krasnoarmeysky District, Krasnodar Territory

p.mozdor@mail.ruhttps://orcid.org/0009-0005-8441-5928ОлейниковаТ. К.OleynikovaT. K.

Олейникова Татьяна Константиновна

ул. Карла Маркса, д. 3, Курск 305000

Tatyana K. Oleynikova 

3 Karl Marx Str., Kursk 305000

https://orcid.org/0009-0009-7295-2290ХатамП. А.KhatamP. A.

Хатам Псэнэф Абдуллах

ул. Первомайская, д. 191, Майкоп 385000, Республика Aдыгея

Psenef A. Khatam 

191 Pervomayskaya Str., Maykop 385000, Republic of Adygea

https://orcid.org/0009-0001-4038-143XНастуеваФ. М.NastuevaF. M.

Настуева Фарида Мухарбиевна

ул. Мира, д. 310, Ставрополь 355017

Farida M. Nastueva 

310 Mira Str., Stavropol 355017

https://orcid.org/0009-0001-2163-4788КоваленковК. О.KovalenkovK. O.

Коваленков Кирилл Олегович

ул. Мира, д. 310, Ставрополь 355017

Kirill O. Kovalenkov 

310 Mira Str., Stavropol 355017

https://orcid.org/0009-0001-3833-380XСердиноваА. С.SerdinovaA. S.

Сердинова Анастасия Сергеевна

Нахичеванский пер., д. 29, Ростов-на-Дону 344022

Anastasia S. Serdinova 

29 Nakhichevan Passage, Rostov-on-Don 344022

https://orcid.org/0009-0005-4716-4904ОсмаеваА. Х.OsmaevaA. Kh.

Осмаева Амина Хусайновна

Нахичеванский пер., д. 29, Ростов-на-Дону 344022

Amina Kh. Osmaeva 

29 Nakhichevan Passage, Rostov-on-Don 344022

https://orcid.org/0009-0009-8904-562XРовчакА. И.RovchakA. I.

Ровчак Анна Игоревна

Нахичеванский пер., д. 29, Ростов-на-Дону 344022

Anna I. Rovchak 

29 Nakhichevan Passage, Rostov-on-Don 344022

https://orcid.org/0009-0005-8573-5210ЕсиковаЮ. Ю.EsikovaYu. Yu.

Есикова Юлия Юрьевна

Нахичеванский пер., д. 29, Ростов-на-Дону 344022

Yulia Yu. Esikova 

29 Nakhichevan Passage, Rostov-on-Don 344022

https://orcid.org/0009-0002-1562-4505ШогеноваМ. Х.ShogenovaM. Kh.

Шогенова Мадина Хасановна

ул. Долгоруковская, д. 4, Москва 127006

Madina Kh. Shogenova 

4 Dolgorukovskaya Str., Moscow 127006

https://orcid.org/0009-0003-5871-7792АхмедовК. И.AkhmedovK. I.

Ахмедов Курбанмагомед Икрамович

ул. Долгоруковская, д. 4, Москва 127006

Kurbanmagomed I. Akhmedov 

4 Dolgorukovskaya Str., Moscow 127006

https://orcid.org/0009-0001-1668-6583АмиргамзаевМ. Р.AmirgamzaevM. R.

Амиргамзаев Магнидин Ризванович

ул. Пушкинская, д. 40, Владикавказ 362019, Республика Северная Осетия – Алания

Magnidin R. Amirgamzaev 

40 Pushkinskaya Str., Vladikavkaz 362019, Republic of North Ossetia – Alania

https://orcid.org/0009-0009-8204-0615БатыршинаЭ. Р.BatyrshinaE. R.

Батыршина Эндже Ривалевна

ул. Блюхера, д. 3, Уфа 450075, Республика Башкортостан

Endzhe R. Batyrshina 

3 Blucher Str., Ufa 450075, Republic of Bashkortostan

Государственное бюджетное учреждение Ростовской области «Центральная городская больница»РоссияCentral City HospitalRussian FederationГосударственное бюджетное учреждение здравоохранения «Красноармейская центральная районная больница»РоссияKrasnoarmeyskaya Central District HospitalRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Курский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияKursk State Medical UniversityRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Майкопский государственный технологический университет»РоссияMaikop State Technological UniversityRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Ставропольский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияStavropol State Medical UniversityRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Ростовский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияRostov State Medical UniversityRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Российский университет медицины» Министерства здравоохранения Российской ФедерацииРоссияRussian University of MedicineRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Северо-Осетинская государственная медицинская академия» Министерства здравоохранения Российской ФедерацииРоссияNorth Ossetian State Medical AcademyRussian FederationГосударственное бюджетное учреждение здравоохранения Республики Башкортостан «Городская клиническая больница № 18»РоссияCity Clinical Hospital No. 18Russian Federation202406082024163250265Copyright © Cherednichenko A.S., Mozdor P.V., Oleynikova T.K., Khatam P.A., Nastueva F.M., Kovalenkov K.O., Serdinova A.S., Osmaeva A.K., Rovchak A.I., Esikova Y.Y., Shogenova M.K., Akhmedov K.I., Amirgamzaev M.R., Batyrshina E.R., 20242024Чередниченко А.С., Моздор П.В., Олейникова Т.К., Хатам П.А., Настуева Ф.М., Коваленков К.О., Сердинова А.С., Осмаева А.Х., Ровчак А.И., Есикова Ю.Ю., Шогенова М.Х., Ахмедов К.И., Амиргамзаев М.Р., Батыршина Э.Р.Cherednichenko A.S., Mozdor P.V., Oleynikova T.K., Khatam P.A., Nastueva F.M., Kovalenkov K.O., Serdinova A.S., Osmaeva A.K., Rovchak A.I., Esikova Y.Y., Shogenova M.K., Akhmedov K.I., Amirgamzaev M.R., Batyrshina E.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.epilepsia.su/jour/article/view/1050Background

Background. According to the World Health Organization, about 50 million people worldwide suffer from epilepsy. Almost 1/3 of patients are diagnosed with drug-resistant epilepsy (DRE). A relationship between intestinal microbiome (IM) and the central nervous system carried out throughout life via bidirectional dynamic network exists. It has been evidenced that IM profile becomes altered in patients with DRE.

Objective

Objective: to summarize the current literature data on the role for microbiome-gut-brain axis in DRE, as well as to assess an importance of IM composition changes as a prognostic marker for developing DRE.

Material and methods

Material and methods. The authors conducted a search for publications in the electronic databases PubMed/MEDLINE and eLibrary, as well as Google Scholar search engine. The evaluation of the articles was carried out in accordance with the PRISMA recommendations. Based on the search, 4,158 publications were retrieved from PubMed/MEDLINE database, 173 – from eLibrary, and 1,100 publications found with  Google Scholar. After the selection procedure, 121 studies were included in the review.

Results

Results. The review provides convincing evidence about a correlation between IM and DRE demonstrating overt differences in IM composition found in patients with epilepsy related to drug sensitivity. IM dysbiosis can be corrected by exogenous interventions such as ketogenic diet, probiotic treatment and fecal microbiota transplantation subsequently resulting in altered brain neurochemical signaling and, therefore, alleviating epileptic activity.

Conclusion

Conclusion. A ketogenic diet, probiotics and antibiotics may have some potential to affect epilepsy by correcting IM dysbiosis, but the current studies provide no proper level of evidence. Future clinical multicenter trials should use standardized protocols and a larger-scale patient sample to provide more reliable evidence. Moreover, further fundamental investigations are required to elucidate potential mechanisms and therapeutic targets.

Актуальность

Актуальность. По данным Всемирной организации здравоохранения, около 50 млн человек во всем мире страдают эпилепсией. Почти у 1/3 пациентов диагностируется фармакорезистентная эпилепсия (ФРЭ). Между кишечным микробиомом (КМБ) и центральной нервной системой существует взаимосвязь, которая осуществляется на протяжении всей жизни через двунаправленную динамическую сеть. Имеются данные, что КМБ изменяется у пациентов с ФРЭ.

Цель

Цель:  обобщить современные литературные данные, посвященные роли оси «микробиом – кишечник – мозг» в ФРЭ, а также определить ценность изменения состава КМБ в качестве прогностического маркера формирования ФРЭ.

Материал и методы

Материал и методы. Проведен поиск публикаций в электронных базах данных PubMed/MEDLINE и eLibrary, а также в поисковой системе Google Scholar. Оценку статей проводили в соответствии с рекомендациями PRISMA. В результате поиска было извлечено 4158 публикаций из базы PubMed/MEDLINЕ, 173 публикации из eLibrary и 1100 публикаций, найденных с помощью Google Scholar. После процедуры отбора в обзор было включено 121 исследование.

Результаты

Результаты. В обзоре представлены убедительные доказательства корреляции между КМБ и ФРЭ. Выявлены различия в составе микробиоты кишечника у пациентов с эпилепсией в зависимости от чувствительности к лекарственным препаратам. Дисбактериоз кишечной микробиоты может быть скорректирован с помощью экзогенных вмешательств, таких как кетогенная диета, лечение пробиотиками и трансплантация фекальной микробиоты, что впоследствии приводит к изменениям в нейрохимической передаче сигналов в головном мозге и, следовательно, способствует снижению эпилептической активности.

Заключение

Заключение. Кетогенная диета, пробиотики и антибиотики могут иметь определенный потенциал в отношении влияния на эпилепсию через коррекцию дисбактериоза кишечной микробиоты, но имеющиеся на сегодняшний день исследования не обеспечивают должного уровня доказательности. В будущих клинических многоцентровых исследованиях следует использовать стандартизированные протоколы и большую выборку, чтобы обеспечить более надежные доказательства. Кроме того, необходимы дальнейшие фундаментальные исследования для выяснения потенциальных механизмов и терапевтических мишеней.

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The authors declare that there are no conflicts of interest present.