Gut-microbiota-brain axis as a potential source of susceptibility/risk biomarkers for post-traumatic epilepsy: An opinion review.

Both clinical and experimental evidence support the notion that traumatic brain injury (TBI) through the top-down dysregulation of gut-microbiota-brain axis (GMBA) profoundly affects the function and structural integrity of the gut, and that this GMBA dysregulation, in turn may contribute to certain chronic sequelae of TBI, possibly including epilepsy. It is therefore plausible that early post-TBI GMBA perturbations may serve as a source of susceptibility/risk PTE biomarkers derived from TBI-induced intestinal epithelial injury, disruption of intestinal barrier and altered composition and function of gut microbiome. The review particularly focuses on disentangling general biomarkers of TBI-induced intestinal dysfunction from those specifically associated with PTE risk. Although the subject in question is still in its nascent stage, several biomarkers appear promising, such as plasma intestinal fatty acid binding protein, plasma lipopolysaccharide and fecal profiles of gut microbes and their metabolic products, short chain fatty acids. It is concluded that while GMBA-derived biomarkers may not be able alone to stratify PTE risk with high certainty, they may enhance the performance of multimodal predictive models when integrated with other biomarkers in development.