Decreased abundance of Akkermansia muciniphila after adrenocorticotropic hormone therapy in patients with West syndrome

Abstract

Background West syndrome (WS) is a severe epileptic encephalopathy of infancy. The high degree of effectiveness of adrenocorticotropic hormone (ACTH) therapy indicates that the hypothalamic-pituitary-adrenal (HPA) axis may be involved in WS, and there is substantial evidence that the gut microbiota (GM) communicates with the brain via the HPA axis. The aims of this study were to determine and compare the diversity of the GM in infants with WS and healthy infants, and in patients with WS before and after ACTH therapy. Results A total of 19 infants with WS and 24 healthy infants in the same age range (3–13 months) were enrolled. Fecal samples were collected and DNA was extracted and sequenced on the Illumina HiSeq platform. The between-group differences in Chao1 index (α diversity) and the abundances of GM genera were analyzed using the Wilcoxon signed-rank test; graphs were plotted using R software. There were no significant differences in the top four dominant GM genera between patients with WS and healthy infants; however, the abundance of the species Akkermansia muciniphila was significantly (P = 0.017) higher in the WS group than in healthy infants. After 2 weeks of ACTH therapy, the abundance of this bacteria was significantly (P = 0.022) and dramatically decreased. Conclusion The abundance of A. muciniphila was significantly higher in patients with WS than healthy infants. Further research is needed to clarify the relationship between A. muciniphila and WS pathogenesis.