Altered composition of the gut microbiome in patients with drug-resistant epilepsy

•Subjects with drug-resistant epilepsy showed an altered gut microbiota.•Numerous rare flora increased in patients with drug-resistant epilepsy.•Patients with four seizures per year or less showed an increase of Bifidobacteria and Lactobacillus.•Restoring the gut microbial community may be a novel therapeutic method for drug-resistant epilepsy. The relationship between the gut microbiota and the central nervous system has been gradually recognized while whether microbiome plays a role in the pathogenesis of drug-resistant epilepsy is still unknown. The aim of our work was to explore whether dysbiosis is involved in the mechanism of drug-resistant epilepsy. Patients with epilepsy attending West China Hospital of Sichuan University were enrolled from March to May 2017. Patients were grouped into drug-resistant (n = 42) and drug-sensitive (n = 49) groups, another 65 healthy controls were from the same families of the patients. The fecal samples were collected and the microbiome composition was analyzed by high-throughout sequencing of the 16s ribosomal DNA. We found that the gut microbial community of drug-resistant epilepsy was significantly altered with an abnormal increased abundance of rare flora. While the gut microbiome composition of drug-sensitive epilepsy was similar with that of healthy controls. Specifically, patients with four seizures per year or fewer showed an increase of Bifidobacteria and Lactobacillus than those with more than four seizures per year. Dysbiosis may be involved in the mechanism of drug-resistant epilepsy and restoring the gut microbial community may be a novel therapeutic method for drug-resistant epilepsy.