局灶性癫痫患儿治疗前后肠道菌群的变化及意义

Change in intestinal flora after treatment in children with focal epilepsy

摘要:

目的 研究局灶性癫痫患儿与健康儿童肠道菌群是否不同，以及癫痫患儿治疗前后肠道菌群的变化。 方法 招募未经治疗的初诊局灶性癫痫患儿10例为病例组，且均用单药奥卡西平治疗。收集患儿临床资料，以及治疗前和治疗3个月后的粪便标本；另招募相同年龄段的健康儿童14例为对照组。提取粪便标本中细菌总DNA，进行16S rDNA测序，并行生物信息学分析。 结果 病例组经奥卡西平治疗3个月后癫痫发作频率减少>50％。门水平方面，治疗前组放线菌门丰度高于治疗后组和对照组（P<0.05）；属水平方面，治疗前组埃希菌/志贺菌属、链球菌属、柯林斯菌属和巨单胞菌属丰度高于对照组（P<0.05），经治疗后其丰度降低（P<0.05）。 结论 与健康儿童相比，局灶性癫痫患儿的肠道菌群存在显著差异；奥卡西平可以显著改善癫痫症状，重塑癫痫患儿的肠道菌群。

Abstract:

Objective To study the difference in intestinal flora between children with focal epilepsy and healthy children and the change in intestinal flora after treatment in children with epilepsy. Methods A total of 10 children with newly diagnosed focal epilepsy were recruited as the case group and were all treated with oxcarbazepine alone. Their clinical data were recorded. Fecal specimens before treatment and after 3 months of treatment were collected. Fourteen aged-matched healthy children were recruited as the control group. Total bacterial DNA was extracted from the fecal specimens for 16S rDNA sequencing and bioinformatics analysis. Results After 3 months of carbamazepine treatment, the seizure frequency was reduced by >50% in the case group. At the phylum level, the abundance of Actinobacteria in the case group before treatment was significantly higher than that in the control group (P<0.05), and it was reduced after treatment (P<0.05). At the genus level, the abundances of Escherichia/Shigella, Streptococcus, Collinsella, and Megamonas in the case group before treatment were significantly higher than those in the control group (P<0.05), and the abundances of these bacteria decreased significantly after treatment (P<0.05). Conclusions There is a significant difference in intestinal flora between children with focal epilepsy and healthy children. Oxcarbazepine can significantly improve the symptoms and intestinal flora in children with epilepsy.