ОСЬ КИШЕЧНИК–МОЗГ И РЕЦЕПТОРЫ, АКТИВИРУЕМЫЕ ПЕРОКСИСОМНЫМИ ПРОЛИФЕРАТОРАМИ КАК ФАКТОРЫ РЕГУЛЯЦИИ ЭПИЛЕПТОГЕНЕЗА

Abstract

A large proportion of patients with epilepsy suffer from pharmacoresistant forms of the disease, and this makes the search for new treatments urgent. The possible role of gut-brain interactions in the pathogenesis of epilepsy is widely discussed. Recent experimental and clinical studies show a correlation between the balance of gut microbiota and the severity of epileptogenesis. Various methods to modify the microbiota composition demonstrate its significant impact on the clinical course of epilepsy. Nevertheless, the question remains open as to the basic receptor element of the gut-brain axis, a sort of an interface between the gut microorganisms and the body's regulatory systems. This review aims to analyze the pathways and levels of gut microbiota involvement in the pathogenesis and sanogenesis of epilepsy. Among these pathways, the neural, metabolic, immune, and endocrine pathways are distinguished. Analysis of the data obtained to date shows a significant role for peroxisome proliferator-activated receptors (PPARs) in these processes. The expression of these receptors in the main structures of the gut-brain axis, the presence of their ligands among the metabolites of microbiota, as well as anticonvulsant and/or neuroprotective activities described for some PPAR agonists, allow a hypothesis to be proposed on the role of PPARs as the above-mentioned signaling interface in the gut-brain axis. Separate attention is paid to the therapeutic potential of PPAR agonists in epilepsy treatment.