肠道微生态在儿童难治性癫痫发病及治疗中的研究进展

Gut microbiota in pathogenesis and treatment of refractory epilepsy in children:research progress

儿童难治性癫痫是一种常见的儿科神经系统疾病。许多临床前及临床证据表明儿童难治性癫痫患者体内优势菌群与健康人相比存在显著差异;抗癫痫干预后难治性癫痫儿童体内肠道菌群分布发生改变;动物粪菌移植实验进一步证实肠道菌群的改变与癫痫发病及抗癫痫疗效存在因果关系。临床上益生菌的添加可能增强抗癫痫疗效,抗生素的使用往往也影响临床的抗癫痫疗效。肠道微生态可能通过内源性机制(如改变神经递质含量等)及外源性机制(如感染和损伤等)改变儿童难治性癫痫患者的代谢、遗传、免疫和感染等。本综述通过总结近年来国内外肠道微生态与儿童癫痫发病和抗癫痫效果的相关研究,阐述肠道微生态在儿童癫痫发病及治疗中的作用并对其可能的作用机制进行探讨。

Refractory epilepsy in children is a neurological disease with high prevelence.Many clinical and preclinical evidences directly or indirectly suggested that gut microbiota play an important role in the pathogenesis and treatment of the disease in children.Some studies on fecal microbiota transplantation showed a causal link between the microbiota and the pathogenesis and treatment of infant epilepsy.Clinical use of probiotics may enhance the anti-epileptic effect,while the use of antibiotics often has an impact on clinical anti-epileptic effect.The gut microbiome may change the metabolism,genetics,immunity and infection of the children with refractory epilepsy through endogenous mechanisms such as changing the content of neurotransmitters,and exogenous mechanisms such as infection and injury.By summarizing the researches on the correlation between intestinal microbiota and epileptic onset and antiepileptic effect in the children in recent years,this review elaborated the role of intestinal microecology in the pathogenesis and treatment of childhood epilepsy,and discussed its possiblemechanisms,