Neuroprotective effect of both synbiotics and ketogenic diet in a pentylenetetrazol-induced acute seizure murine model

Microbiota–Gut–Brain Axis and Epilepsy: A Review on Mechanisms and Potential Therapeutics

“…In a recent animal study, the abundance of Firmicutes was increased, and Acetatifactor , Anaerotaenia , Escherichia , Flintibacter , Oscillibacter , and Erysipelatoclostridium were higher in the KD group than in the ND group. The GM with increased abundance was related to the production of SCFAs and GABA ( 21 ). Although KD has specific value in the treatment of epilepsy and neurodegenerative diseases, it increases the risk of glucose and lipid metabolism disorders.…”

“…This study indicated that adjuvant probiotics reduced the frequency of seizures and could be used as a complementary treatment to antiepileptic therapy ( 158 ). In the PTZ-induced chemical kindling mouse model, the probiotic supplementation group did not show full kindling, and GABA increased in mouse brain tissue, which indicated that probiotic supplementation could substantially reduce seizure severity ( 159 ).When treating PTZ-induced seizures in mice with KD, synbiotics or Lactobacillus fermentum MSK 408 could reduce the side effects of KD without disturbing its antiepileptic effects ( 21 , 160 ). Both KD and MSK 408 increase GABA metabolism by regulating the GM ( 160 ).…”

“…After a month of intervention with the classic KD, the total SCFAs were significantly reduced, especially acetate, propionate, and butyrate, which may be due to a reduction in the intake of fermentable carbohydrates or a reduction in fermenting bacteria by KD ( 161 ). Synbiotics can lead to GM enrichment associated with SCFAs ( 21 ). MSK 408 could influence SCFAs and restore serum lipid profile and tight junction protein mRNA expression in the gut and brain independently by modulating the GM ( 160 ).…”

“…Recent advances in sequencing technology have allowed studies on the composition and function of microbiota in neurology. In recent years, some studies have suggested statistical differences in fecal microbial composition between epileptic patients and healthy people, as well as between epileptic patients before and after KD treatment, and in animal models (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). The intestinal microbiota may shape brain function through a variety of pathways and systems, including the central nervous system (CNS), the hypothalamic-pituitaryadrenal (HPA) axis, immune and inflammatory systems, and neuromodulators, and could therefore also be involved in epilepsy (Figure 1).…”

Role of Short Chain Fatty Acids in Epilepsy and Potential Benefits of Probiotics and Prebiotics: Targeting “Health” of Epileptic Patients

“…An analysis of the stool samples of seven patients with DRE showed a 55% reduction of total SCFAs, with a 64% reduction of acetate, 33% of propionate, and 20% of butyrate [ 35 ]. As for the mechanisms behind SCFA decrease in KD, reduced glucose might lead to the utilization of SCFAs for energy, while a higher fat intake might increase the synthesis of polyunsaturated fatty acids instead, and β-hydroxybutyrate production in the gut may require an increased uptake of acetate and butyrate from the gut [ 36 ]. Therefore, to balance out the SCFA decrease, a supplementary diet could be needed.…”