A review on preventive role of ketogenic diet (KD) in CNS disorders from the gut microbiota perspective

Rawat, Kajal; Singh, Neha; Kumari, Puja; Saha, Lekha

doi:10.1515/revneuro-2020-0078

Cited by 42 publications

(32 citation statements)

References 116 publications

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“…164 Ketone (medium chain triglyceride) supplements have also been shown to improve the cognitive functions in MCI subjects. 317,318 to act on the microbiome by restoring its equilibrium, but more importantly by reducing the activation of the inflammasome which is one of the contributors to neuroinflammation. Recently, several case studies have been published on the use of ketogenic diet in APOE4 allele carrying MCI and mild AD individuals with a significant increase in their cognitive performance such as the significant increase of their score of MoCA test.…”

Section: Specific Dietary Componentsmentioning

confidence: 99%

Targeting Impaired Antimicrobial Immunity in the Brain for the Treatment of Alzheimer’s Disease

Fülöp¹,

Tripathi²,

Rodrigues³

et al. 2021

NDT

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Alzheimer’s disease (AD) is the most common form of dementia and aging is the most common risk factor for developing the disease. The etiology of AD is not known but AD may be considered as a clinical syndrome with multiple causal pathways contributing to it. The amyloid cascade hypothesis, claiming that excess production or reduced clearance of amyloid-beta (Aβ) and its aggregation into amyloid plaques, was accepted for a long time as the main cause of AD. However, many studies showed that Aβ is a frequent consequence of many challenges/pathologic processes occurring in the brain for decades. A key factor, sustained by experimental data, is that low-grade infection leading to production and deposition of Aβ, which has antimicrobial activity, precedes the development of clinically apparent AD. This infection is chronic, low grade, largely clinically silent for decades because of a nearly efficient antimicrobial immune response in the brain. A chronic inflammatory state is induced that results in neurodegeneration. Interventions that appear to prevent, retard or mitigate the development of AD also appear to modify the disease. In this review, we conceptualize further that the changes in the brain antimicrobial immune response during aging and especially in AD sufferers serve as a foundation that could lead to improved treatment strategies for preventing or decreasing the progression of AD in a disease-modifying treatment.

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Section: Specific Dietary Componentsmentioning

confidence: 99%

Targeting Impaired Antimicrobial Immunity in the Brain for the Treatment of Alzheimer’s Disease

Fülöp¹,

Tripathi²,

Rodrigues³

et al. 2021

NDT

View full text Add to dashboard Cite

show abstract

“…Specialized and restricted dietary regimens may affect positively or negatively the microbiota composition and, therefore, influence host physiology and disease evolution and outcome. Several studies investigated the effect of diet on neurological disorders, from epilepsy (62) to neurodegenerative diseases (63). Different kinds of diet are associated with a different gut microbiota signature, immune response, and effect on the mucus intestinal layer (64).…”

Section: Gut Microbiome Gut-brain Axis and Kd: A Broadband Connection Still To Explorementioning

confidence: 99%

A Root in Synapsis and the Other One in the Gut Microbiome-Brain Axis: Are the Two Poles of Ketogenic Diet Enough to Challenge Glioblastoma?

et al. 2021

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Glioblastoma is the most frequent and aggressive brain cancer in adults. While precision medicine in oncology has produced remarkable progress in several malignancies, treatment of glioblastoma has still limited available options and a dismal prognosis. After first-line treatment with surgery followed by radiochemotherapy based on the 2005 STUPP trial, no significant therapeutic advancements have been registered. While waiting that genomic characterization moves from a prognostic/predictive value into therapeutic applications, practical and easy-to-use approaches are eagerly awaited. Medical reports on the role of the ketogenic diet in adult neurological disorders and in glioblastoma suggest that nutritional interventions may condition outcomes and be associated with standard therapies. The acceptable macronutrient distribution of daily calories in a regular diet are 45–65% of daily calories from carbohydrates, 20–35% from fats, and 10–35% from protein. Basically, the ketogenic diet follows an approach based on low carbohydrates/high fat intake. In carbohydrates starvation, body energy derives from fat storage which is used to produce ketones and act as glucose surrogates. The ketogenic diet has several effects: metabolic interference with glucose and insulin and IGF-1 pathways, influence on neurotransmission, reduction of oxidative stress and inflammation, direct effect on gene expression through epigenetic mechanisms. Apart from these central effects working at the synapsis level, recent evidence also suggests a role for microbiome and gut-brain axis induced by a ketogenic diet. This review focuses on rationales supporting the ketogenic diet and clinical studies will be reported, looking at future possible perspectives.

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“…Changes in microbiome in PD are increasingly characterized with decreased alpha diversity, a scalar ranging from 0 to infinity referring to the number of species/taxonomic units per sample, thereby quantifying species richness; increased lipid polysaccharide (LPS); decreased production of short chain fatty acids (SCFA); and activation of the inflammasome [95][96][97] as reviewed [98]. SCFA are key components of maintaining integrity of the gut epithelial barrier and preventing bacterial overgrowth from occurring.…”

Section: The Impact Of Nutritional Ketosis On Parkinson's Disease Functional Domainsmentioning

confidence: 99%

Nutritional Ketosis in Parkinson's Disease — a Review of Remaining Questions and Insights

2021

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Nutritional ketosis has promise for treating Parkinson’s disease. Three previous studies explored the use of a ketogenic diet in cohorts with Parkinson’s disease, and, while not conclusive, the data suggest non-motor symptom benefit. Before the ketogenic diet can be considered as a therapeutic option, it is important to establish with greater certainty that there is a reliable symptomatic benefit: which symptoms or groups of symptoms are impacted (if non-motor symptoms, which ones, and by which mechanism), what timescale is needed to obtain benefit, and how large an effect size can be achieved? To accomplish this, further investigation into the disease mechanisms based on pre-clinical data and hints from the clinical outcomes to date is useful to understand target engagement and gauge which mechanism could lead to a testable hypothesis. We review research pertaining to ketogenic diet, exogenous ketones, fasting, clinical studies, and theoretical review papers regarding therapeutic mechanisms from direct ketone body signaling and indirect metabolic effects. Through discussion of these findings and consideration of whether the ketogenic diet can be regarded as therapeutically useful for adjunctive therapy for Parkinson’s disease, we identify remaining questions for the clinician to consider prior to recommending this diet.

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A review on preventive role of ketogenic diet (KD) in CNS disorders from the gut microbiota perspective

Cited by 42 publications

References 116 publications

Targeting Impaired Antimicrobial Immunity in the Brain for the Treatment of Alzheimer’s Disease

Targeting Impaired Antimicrobial Immunity in the Brain for the Treatment of Alzheimer’s Disease

A Root in Synapsis and the Other One in the Gut Microbiome-Brain Axis: Are the Two Poles of Ketogenic Diet Enough to Challenge Glioblastoma?

Nutritional Ketosis in Parkinson's Disease — a Review of Remaining Questions and Insights

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