fig1

Figure 1. The microbiota–gut–brain axis in epilepsy. The gut microbiome could affect epilepsy through several mechanisms. For example, an eubiotic microbiota produces metabolites, such as SCFAs and serotonin, which are known to have a possible inhibitory activity on epilepsy occurrence. On the other hand, a dysbiotic layout could be associated with increased gastrointestinal permeability and the production of epilepsy-promoting metabolites, such as proinflammatory factors, which could disrupt the host GABA/glutamate ratio inducing epilepsy events. The interaction between the gut microbiota and the enteric/vagus nervous system, and HPA axis are also potentially involved in the manifestation of epileptic events. BAs: Bile acids; GABA: γ-aminobutyric acid; HPA: hypothalamic-pituitary-adrenal; LPS: lipopolysaccharide; PGN: peptidoglycan; SCFAs: short-chain fatty acids; TMAO: trimethylamine N-oxide.