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

Authors：

LIN Chuhui ¹ , ZENG Ting ¹ , WU Qianyi ^2,3 , CAO Dezhi ⁴ , LI Bingmei ^2,3 ,  DENG Yuhong ^1,2,3

1. Department of Clinical Nutrition , the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China;
2. Institute of Neuroscience and Department of Neurology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China;
3. Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou 510260, China;
4. Department of Neurology, Shenzhen Children’s Hospital, Shenzhen 5180038, China;

Corresponding author：

DENG Yuhong, Email: 1376708863@qq.com

Keywords：

Epilepsy; Bacteroides fragilis 839; Microbiota; Autoimmune-associated epilepsy

DOI：

10.7507/2096-0247.202204008

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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.

Citation： LIN Chuhui, ZENG Ting, WU Qianyi, CAO Dezhi, LI Bingmei, DENG Yuhong. Assessing the effect of early use of bacteroides fragilis 839 in the treatment of “possible autoimmune-related epilepsy”. Journal of Epilepsy, 2022, 8(4): 298-304. doi: 10.7507/2096-0247.202204008 Copy

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1. Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: Position paper of the ILAE Commission forClassification and Terminology. Epilepsia, 2017, 58(4): 512-521.
2. Steriade C, Britton J, Dale RC, et al. Acute symptomatic seizures secondary to autoimmune encephalitis and autoimmuneassociated epilepsy: conceptual definitions. Epilepsia, 2020, 61(7): 1341-1351.
3. Levite M. Autoimmune epilepsy. Nat Immunol, 2002, 3(6): 500.
4. 邓宇虹, 林楚慧, 操德智. 脆弱拟杆菌(BF839)辅助治疗难治性癫痫有效性的初步临床研究. 癫痫杂志, 2021, 7(4): 288-295.
5. Husari KS, Dubey D. Autoimmune Epilepsy. Neurotherapeutics, 2019, 16(3): 685-702.
6. Chen ZB, Brodie MJ, Liew D, et al. Treatment outcomes in patients with newly diagnosed epilepsy treated with established and new antiepileptic drugs: a 30-year longitudinal cohort study. JAMA Neurol, 2018, 75(3): 279-286.
7. Kwan P, Brodie MJ. Effectiveness of first antiepileptic drug. Epilepsia, 2001, 42(10): 1255-1260.
8. Toledano M, Britton JW, McKeon A, et al. Utility of an immunotherapy trial in evaluating patients with presumed autoimmune epilepsy. Neurology, 2014, 82(18): 1578-1586.
9. Husari KS, Cervenka MC. Therapy for the treatment of post-encephalitic and autoimmune-associated epilepsies. Front Neurol, 2021, 12: 624202.
10. 罗向阳, 李平甘, 李栋方, 等. 免疫球蛋白治疗儿童癫痫的疗效及机制分析. 中华神经医学杂志. 2010, 9(3): 299-303, 307.
11. 许继平, 李玉莲, 苗丰莲, 等. 免疫球蛋白治疗儿童难治性癫痫的近、远期疗效与体液免疫功能的研究. 中国免疫学杂志, 2003, 19(9): 649-650.
12. John FC, O'Riordan KJ, Cowan CSM, et al. The Microbiota-Gut-Brain Axis. Physiological Reviews, 2019, 99(4): 1877-2013.
13. He Z, Cui BT, Zhang T, et al. Fecal microbiota transplantation cured epilepsy in a case with Crohn’s disease: Thefirst report. World J Gastroenterol, 2017, 23(19): 3565-3568.
14. Gómez-Eguílaz M, Ramón-Trapero JL, Pérez-Martínez L, et al. The beneficial effect of probiotics as a supplementary treatment indrug-resistant epilepsy: a pilot study. Benef Microbes, 2018, 9(6): 875-888.

Journal of Epilepsy

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

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