脆弱拟杆菌839治疗新诊断“可能的自身免疫相关癫痫”的疗效

Assessing the effect of early use of bacteroides fragilis 839 in the treatment of“possible autoimmune-related epilepsy”

目的对单独服用脆弱拟杆菌839(Bacteroides fragilis 839,BF839)以治疗“可能的自身免疫相关癫痫”的患者进行回顾性分析,以寻找新方法治疗癫痫。方法15例新诊断且未经规范抗癫痫发作药物治疗的患者,诊断考虑“可能的自身免疫相关癫痫”,给予单独口服BF839启动治疗,回顾这部分患者的发作变化、共患病及脑电图改变、不良反应等信息。结果在14~33个月的随访期间,73.33%(11/15)的患者在随访期达到了1年缓解,7例患者的缓解时间>24个月,4例患者的缓解时间>30个月。73.33%(11/15)的患者自我报告共患病改善,脑电图好转率为57.14%(4/7),无患者由于不良反应导致退出,12个月的保留率为73.33%(11/15)。结论首次报道早期单独应用肠道菌群制剂可有效治疗“可能的自身免疫相关癫痫”,由于其较低的不良反应及对共患病的改善,还可作为诊断性治疗工具使用。这不仅对显著提高自身免疫相关癫痫的早期诊断率和缓解率、避免患者发展成难治性癫痫具有重要意义,还刷新了我们对癫痫病因的认知。

Objective To retrospectively analyze patients taking Bacteroides fragilis(BF839)alone for their"possible autoimmune-related epilepsy"to find new treatments for epilepsy.Methods 15 newly diagnosed patients who were not treated with standard Anti-seizure medications were diagnosed with"possible autoimmune-related epilepsy"and were given oral BF839 to initiate treatment.Seizure changes,self-reported improvement of comorbidities,EEG,adverse reactions and other information were reviewed.Results During the follow-up period of 14~33 months,73.33%(11/15)patients achieved 1-year remission during the follow-up period,7 patients had a remission time of more than 24 months,and 4 patients had a remission time of more than 30 months.73.33%(11/15)of the patients reported that their comorbidities improved,and the EEG improvement rate was 57.14%(4/7).No patients withdrew due to adverse reactions,and the 12-month retention rate was 73.33%(11/15).Conclusion It is the first report that the early application of intestinal flora preparation alone can effectively treat“possible autoimmune-related epilepsy”,and it can also be used as a diagnostic treatment tool due to its lower adverse reactions and improvement of comorbidities.This is not only of great significance to significantly improve the early diagnosis rate and remission rate of autoimmune-related epilepsy,and to prevent patients from developing refractory epilepsy,but also refreshes our understanding of the etiology of epilepsy.