{
  "abstract": "Background Refractory epilepsy remains a global clinical challenge. This first-in-humans cohort study aimed to evaluate the efficacy and safety of washed microbiota transplantation (WMT) in the treatment of epilepsy.Methods A prospective, single-center, open-label study of WMT in patients with epilepsy was conducted from November 2016 to November 2023. The primary outcome was the clinical response rate (≥ 50% reduction in seizure frequency) at one month post-WMT. Parallel experiments using a pentylenetetrazole-induced epileptic mouse model were performed to validate clinical findings and investigate the role of specific core bacterial species.Results Among 21 patients (mean age, 18.9 years), including 18 with refractory epilepsy, the clinical response rates were 43% (9/21), 57% (12/21), and 38% (8/21) at one, three, and six months post-WMT, respectively (IDDF2026-ABS-0422 Figure 1. Washed microbiota transplantation ameliorates seizure frequency and constipation in patients with epilepsy). A second maintenance WMT course at three months was associated with a higher response rate at six months compared to no maintenance therapy (OR > 999, 95% CI [1.12, +infinity], P = 0.08) (IDDF2026-ABS-0422 Figure 1. Washed microbiota transplantation ameliorates seizure frequency and constipation in patients with epilepsy). WMT significantly increased Akkermansia muciniphila (A. muciniphila) levels in responders (P = 0.038) (IDDF2026-ABS-0422 Figure 2. Baseline predictors of a clinical response to washed microbiota transplantation in patients with epilepsy). Higher baseline A. muciniphila ­abundance was associated with improved clinical outcomes (Z = 3.28, P = 0.001) (IDDF2026-ABS-0422 Figure 3. Washed microbiota transplantation modulates gut microbial function and enriches A. muciniphila in responders among patients with epilepsy). The preclinical study confirmed that A. muciniphila augmented the effects of WMT against seizures, significantly reducing seizure severity and duration, and prolonging seizure latency (IDDF2026-ABS-0422 Figure 4. Augmented washed microbiota transplantation protects against epileptic seizures, IDDF2026-ABS-0422 Figure 5. Targeting the gut microbiota reconstructed the composition of the gut microbiota in epileptic mice).Conclusions Integrating clinical and preclinical findings, this study demonstrates that A. muciniphila synergistically enhances the effects of WMT against epileptic seizures. This study provides evidence for a new concept of microbiome-based therapeutics in epilepsy treatment.Abstract IDDF2026-ABS-0422 Figure 1Abstract IDDF2026-ABS-0422 Figure 2Abstract IDDF2026-ABS-0422 Figure 3Abstract IDDF2026-ABS-0422 Figure 4Abstract IDDF2026-ABS-0422 Figure 5",
  "authors": [
    {
      "affiliations": [
        "The Second Affiliated Hospital of Nanjing Medical University, China"
      ],
      "name": "Qianqian Li"
    },
    {
      "affiliations": [
        "State Key Laboratory of Animal Biodiversity Conservation and Integrated Pest Management, Institute of Zoology, Chinese Academy of Sciences, China"
      ],
      "name": "Ruiqiao He"
    },
    {
      "affiliations": [
        "The Second Affiliated Hospital of Nanjing Medical University, China"
      ],
      "name": "Xianglu Wang"
    },
    {
      "affiliations": [
        "State Key Laboratory of Animal Biodiversity Conservation and Integrated Pest Management, Institute of Zoology, Chinese Academy of Sciences, China"
      ],
      "name": "Fangqing Zhao"
    },
    {
      "affiliations": [
        "The Second Affiliated Hospital of Nanjing Medical University, China"
      ],
      "name": "Faming Zhang"
    },
    {
      "affiliations": [
        "Department of General Practice, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China"
      ],
      "name": "Chuyan Long"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, Nanjing, China"
      ],
      "name": "Zhi He"
    }
  ],
  "title": "IDDF2026-ABS-0422 Akkermansia muciniphila enhances washed microbiota transplantation in the treatment of epilepsy",
  "uid": "025e4f46-d399-5d1d-9bf2-0f7bec2ff4f1"
}