[The microbiota-gut-brain axis and its great projections]. / El eje microbiota-intestino-cerebro y sus grandes proyecciones.

INTRODUCTION: The microbiota is the set of millions of microorganisms that coexist in a symbiotic way in our body. It is mainly located in the digestive tract, being distributed in function of the chemical properties and the functions of the different organs. The factors that influence its composition are multiple (diet, individual habits, diseases or drugs). It also participates in several functions of the organism such as metabolism, immunity or even the function of the central nervous system. DEVELOPMENT: This last interrelationship is called: gut-brain axis. For years the relationship between the microbiota and the central nervous system has been known and how they influence one over the other. It is postulated that communication occurs through three systems: the vagus nerve, the systemic pathway (with the release of hormones, metabolites and neurotransmitters) and the immune system (by the action of cytokines). CONCLUSIONS: There are still many unknowns to be clarified in this field, but this microbiota-intestine-brain relationship is postulated as a possible pathogenic basis for neurological diseases of great health impact such as Alzheimer, Parkinson or multiple sclerosis. There are currently studies with probiotics with hopeful results in patients with Alzheimer's disease.

TITLE: El eje microbiota-intestino-cerebro y sus grandes proyecciones.Introduccion. Se denomina microbiota al conjunto de millones de microorganismos que conviven de manera simbiotica en nuestro organismo. Este conjunto bacteriano, que se localiza principalmente en el tracto digestivo, se distribuye a lo largo de los diferentes organos en funcion de las propiedades quimicas. Los factores que influyen en su composicion son multiples (dieta, habitos individuales, farmacos). La microbiota colabora en varias funciones, como pueden ser el metabolismo o la inmunidad. Desarrollo. En los ultimos años se ha puesto de relieve el papel bidireccional de la microbiota del tracto digestivo y del sistema nervioso central, es el denominado eje intestino-cerebro. En lo que a este eje se refiere, se cree que la 'comunicacion' se produce a traves de tres vias: el nervio vago, la via sistemica (mediante la liberacion de hormonas, metabolitos y neurotransmisores) y el sistema inmune (por la accion de las citocinas). Conclusiones. Aunque aun quedan muchas incognitas por esclarecer, este eje se postula como una posible base patogena para numerosos trastornos neurologicos de gran impacto sanitario, como la enfermedad de Alzheimer, la enfermedad de Parkinson o la esclerosis multiple. En el momento actual se estan llevando a cabo estudios que intentan evaluar el impacto de los probioticos sobre algunas de estas enfermedades neurologicas.

The beneficial effect of probiotics as a supplementary treatment in drug-resistant epilepsy: a pilot study.

Epilepsy is a neurological disease with high global prevalence. Despite the range of drug-based treatments currently available to control the condition, one in 3 patients experiences epileptic seizures. Therapeutic alternatives for these patients include the ketogenic diet, surgery or the cerebral implantation of neurostimulators; however these are benefits with limits. The target of this study is to find a new complementary treatment for these patients, studying the effectiveness of probiotics for controlling epileptic seizures in patients with drug-resistant epilepsy. A prospective study was designed in which a group of patients with drug-resistant epilepsy was administered a probiotic mixture for 4 months. Patients were assessed before and after taking the probiotics; among other variables, number of seizures and patients' quality of life (QOLIE-10) were monitored. Levels of cD-14, interleukin 6, and γ-aminobutyric acid were also analysed throughout the study. 45 patients were included in the study. In an intention-to-treat analysis, 28.9% of all patients displayed a greater than 50% reduction in the number of seizures (the parameter required in clinical trials). A significant improvement was also observed in patients' quality of life. We found that probiotics may be an option for supplementary therapy. Since the use of probiotics is safe, they may contribute to improving seizure control, and therefore quality of life, in patients with drug-resistant epilepsy. The study has been registered in https://clinicaltrials.gov with number NCT03403907.