Changes And Their Significance Of Intestinal Flora In Children With Focal Epilepsy Before And After Treatment

Objective: At present,the pathogenesis of epilepsy is not very clear,some studies suggest that the brain-gut axis plays a certain role in its occurrence and development.Our study is aimed to clarify the difference of intestinal flora in children with epilepsy before and after treatment,at the same time,to find the possible role of intestinal flora in occurrence,development and outcome about epilepsy.Methods: In this study,untreated newly diagnosed children with focal epilepsy from April 2020 to October 2020 were selected as the case group,and all of them were treated with oxcarbazepine.Clinical data and fecal samples before and after treatment were collected,and healthy children of the same age group were recruited as control group.The microbial amplicon 16 S r DNA sequencing was carried out after total DNA of fecal samples was extracted,the sequencing results were analyzed by bioinformatics.Results: 1.This study initially included 17 newly diagnosed children with focal epilepsy.After 3 months’ treatment,1 case was ineffective and6 cases were lost.Because there were too few ineffective cases to analyze the data separately,they were not included in the study.Finally,10 children with effective treatment of focal epilepsy were included in the case group,including 5 males(50%)and 5 females(50%),with a median age of 6.35(5.40,9.50)years and a median BMI of 14.41(13.58,15.90).Fourteen healthy children were included in the control group,including 8males(57.10%)and 6 females(42.9%),with a median age of 5.15(3.98,7.90)years and a median BMI of 15.22(14.55,15.62).There was no significant difference in age,sex and BMI between the two groups(P >0.05).2.Shannon index and Simpson index are commonly used to reflectα-diversity.Shannon index and Simpson index of the before treatment group were 3.81(3.64,4.29)and 0.53(0.026,0.063),respectively.Shannon index and Simpson index in the treatment for 3 months group were 3.58(3.30,3.90)and 0.06(0.05,0.10),respectively.Shannon index and Simpson index of control group were 3.05(2.84,3.49)and 0.09(0.07,0.14),respectively.Diversity index analysis showed that Shannon index of the before treatment group and the treatment for 3 months group were significantly higher than that of control group(P < 0.05),while Simpson index of before treatment group was significantly lower than that of control group(P < 0.05).3.There are significant difference bacteria between the the before treatment group and the treatment for 3 months group,as well as between the before treatment group and the control group,and they all increase significantly in the before treatment group(P < 0.05).For example,Actinobacteria(1.65% in before treatment group vs 0.32% in treatment for 3 months group vs 0.33% in control group),Escherichia/Shigella(3.15% vs 0.14% vs 0.15%),Streptococcus(1.49% vs 0.18% vs 0.21%),Romboutsia(1.26%vs0.24% vs 0.20%),Collinsella(1.24% vs 0.25% vs0.11%)and Megamonas(1.91% vs 0.25% vs 0.007%).At the same time,the abundance of Bacteroides,Faecalibacterium and Prevotella increased in the treatment for 3 months group and the control group,and the abundance of Faecalibacterium in the control group increased significantly compared with that before treatment(P < 0.05).4.Compared with the control group,there were significantly fewer bacteria in the treatment for 3 months group.Parabacteroides(3.09% vs1.07%)and Oscillibacter(1.26% vs 0.45%)increased significantly in the treatment for 3 months group,while Anaerostipes(0.26% vs 1.69%)increased significantly in the control group(P < 0.05)Interestingly,the abundance of Megamonas decreased gradually in before treatment group,treatment for 3 months group and control group,and the decrease was statistically significant(P < 0.05).Conclusion: 1.The intestinal flora of children with focal epilepsy has obvious changes accompanied by increased α-diversity compared with healthy children.Faecalibacterium and Prevotella may play a protective role in the currentent of epilepsy,while Collinsella,Escherichia/Shigella,Streptococcus and Megamonas may play the benefit to epilepsy.2.The intestinal flora of children with focal epilepsy changed obviously before and after treatment,and the intestinal flora of those who were effective in treatment changed to healthy children,which suggested that the therapeutic effect might be related to the changes of intestinal flora.