Characteristics And Theirs Significance Of Intestinal Flora In Children With Different Seizure Types Of Epilepsy

Objective: Epilepsy is one of the most common central nervous system disorders in children,but at present epilepsy pathogenesis is not fully defined.Studies have shown differences between the intestinal flora of children with epilepsy and normal children,and the intestinal flora is involved in the pathogenesis of epilepsy through multiple pathways.The purpose of this study was to detect intestinal flora of children with different seizure types of epilepsy and healthy children by 16 S rDNA high-throughput sequencing:(1)to compare the intestinal flora among children with focal seizure epilepsy,children with full-blown seizure epilepsy and healthy children;(2)To compare the differences of intestinal flora between children with Benign childhood epilepsy with centrotemporal spikes(BECT)and children without BECT,to understand the relationship between alterations in intestinal flora and epilepsy,and to open new ideas for the study of the pathogenesis of epilepsy.Methods: Children with epilepsy who were first diagnosed and met the entry criteria(case group)at the Department of Neurology of a provincial tri forme children’s Hospital in southern China between April 2020 and December 2020 were selected as the study subjects,while healthy children who were examined in the Department of child health care of the hospital were recruited as the control group.The case group was divided into focal seizure group and comprehensive seizure group according to seizure type.The focal seizure group was subdivided into BECT and non BECT groups.Stool samples were collected and DNA was extracted,high-throughput sequencing was performed using the novaseq 6000 platform after PCR amplification of DNA from the region of interest as well as statistical analysis,and finally gut flora differences were compared between children with focal onset epilepsy,between children with generalized onset epilepsy and normal children,and between BECT and non BECT childrenResults: 1.A total of 37 children with epilepsy and 14 healthy children were included in this study.There were 28 children with focal epilepsy and 9children with generalized epilepsy,and 9 children with focal epilepsy on BECT and 19 children without BECT.2.The Chao1 index,ACE index,and Shannon index in the focal seizure group were 302.44(248.19,410.77),308.25(244.95,413.14),and 3.33(2.97,3.53),respectively,and those in the control group were 279.32(247.88,349.52),299.75(256.25,365.90),and 3.45(3.11,3.52),respectively,in the global seizure group221.18(186.0,1286.71),222.75(189.0,3270.27),2.51(2.33,2.81),respectively.The Chao1 index,ACE index,and Shannon index of the focal seizure and generalized seizure groups were greater than those of the control group,and the differences were statistically significant(P < 0.05),whereas the Chao1 index,ACE index,and Shannon index between the focal seizure and generalized seizure groups were not statistically significant(P >0.05).3.The Chao1 index,ACE index,and Shannon index in the BECT group were 313.09(185.03,366.67),311.16(191.65,373.39),3.39(2.94,3.77),respectively,and the Chao1 index,ACE index,and Shannon index in the non BECT group were 334.69(284.13,403.10),317.83(270.67,416.19),3.34(2.98,To 3.41),respectively,the Chao1 index,ACE index,and Shannon index were not significantly different between the BECT and non BECT groups(P >0.05).4.PCA plots showed relatively diffuse distributions of all samples between focal onset,generalized onset,and control groups,as well as between the BECT and non BECT groups,indicating low similarity in the composition of the bacterial flora between samples.5.Lefse analysis revealed species with significant differences in relative abundance between focal onset,generalized onset,and control groups at all taxonomic levels,with the greatest differences in relative abundances of clostridiales,bacteroidales,and Bacteroidetes genera in focal onset,generalized onset,and control groups,respectively(P < 0.05).6.Lefse analysis revealed species with significant differences in relative abundance between the BECT and non BECT groups at the order level,family level,and genus level,with Bacteroides Marseille,Streptococcus spp＿gallolyticus＿Ucn34 had the greatest difference in relative abundance(P <0.05).7.Metastas statistical analysis at phylum level,genus level as well as species level revealed Firmicutes,Actinobacteria,Ruminococcus,lachnospiracea in the focal onset group compared to the control group＿incertae＿The abundance of sedis,Escherichia Shigella,macromonas,Gemella,Streptococcus,rombutzia,Escherichia K12,and Clostridium increased and the abundance of Bacteroidetes,Bacteroidetes,faecalibacterium,and faecalibacterium prausnitzii decreased in the full-blown group(P < 0.05).The abundance of Bacteroidetes,Streptococcus,dorea,Collins,Klebsiella,rombutzia,Escherichia coli K12,Collins aerogenes,Clostridium increased and the abundance of Bacteroidetes,Bacteroidetes,faecalibacterium,faecalibacterium prausnitzii decreased,all of which were statistically significant(P < 0.05).Compared with the focal seizure group,the abundance of intestinal flora was not significantly different at phylum level and genus level(P > 0.05),while the abundance of common Bacteroidetes was increased at species level with a significant difference(P < 0.05).8.Metastas statistical analysis at the phylum level,genus level,as well as at the species level revealed that the abundance of Proteobacteria was decreased in the BECT group compared with the non BECT group,while the abundance of Coxiella spp.Conclusions: 1.Compared with healthy children,the intestinal microflora of children with focal epilepsy and generalized epilepsy were significantly changed,accompanied by increased diversity of intestinal microflora.Firmicutes,actinobacteria,ruminococcus,Streptococcus,Clostridiaceae bacterium and dorea may be involved in the occurrence and development of epilepsy,while Bacteroidetes and Bacteroides play a protective role in epilepsy.2.Compared with children with generalized epilepsy,the intestinal flora of children with focal epilepsy changed,but the diversity of intestinal flora did not change significantly.3.Compared with the non BECT children,the intestinal flora of BECT children was changed,and the degree of disorder was lower,but the diversity of intestinal flora had no significant change.