The theory proposed was that the ketogenic diet alters the gut microbiota, which then influences seizure susceptibility. The team, led by Elaine Hsiao, UCLA assistant professor of integrative biology and physiology, and senior author of the study, studied the effects of the ketogenic diet on two groups of mice. One group was raised in a germ-free, sterile laboratory and the other was treated with antibiotics. In both groups of mice, the ketogenic diet was ineffective in protecting against seizures, suggesting that gut bacteria are necessary for the ketogenic diet to work as therapy against seizures.
Next, they identified specific bacteria that increased with the ketogenic diet, and found two types that played a key role: Akkermansia and Parabacteroides species. In determining the mechanisms underlying their neuroprotective role, they found that enriching diets with both species of bacteria reduced systemic gamma-glutamylated amino acid and increased hippocampal GABA/glutamate levels. “Bacterial cross-feeding decreased gamma-glutamyltranspeptidase activity and inhibited gamma-glutamylation,” promoting seizure protection in vivo.
In summary, this study confirms that the gut microbiota, altered by the ketogenic diet, influences the host metabolism and, therefore, seizure susceptibility.
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