Lalbaay

Food for special medical purposes, intended for the dietary treatment of drug-resistant epilepsies .

The microbiota controls the metabolism of Tryptophan (TRP) : an altered microbiota has been reported in epileptic patients, caused by a deficiency of TRP. Therefore, restoring a correct microbiota allows not only to increase plasma TRP but also to restore its correct metabolism and its cerebral uptake, in order to favor correct production of serotonin .

Confirming the role of serotonin, A reduced ability to obtain TRP from the diet has been reported in epileptic patients (nutritional vulnerability), which may also depend on its altered metabolism with a greater production of indole catabolites, which carry out reinforcing actions on the intestinal membrane. In particular, a reduction of one third in the rate of brain serotonin synthesis compared to controls has been estimated in epileptic patients.

In the 1990s we witnessed the reversal of the role of serotonin in epilepsy: mistakenly believed to be pro-convulsant, it was found to be anti-convulsant.

Given that serotonin is synthesized starting from TRP, an essential amino acid (which derives only from the diet), which competes with the other Large Neutral Amino Acids (LNAAs) both for cerebral uptake and for intestinal absorption, nutritional strategies are useful aimed at increasing both plasma TRP and its cerebral uptake.

Oral intakes of the serum protein alpha-lactalbumin were found to be capable of increasing the plasma TRP/LNAAs ratio, but, in the presence of an altered metabolism of TRP, this increase does not automatically correspond to an increase in its cerebral uptake (less than 1% of the TRP plasma is available for cerebral uptake) and therefore to an increase in cerebral synthesis of serotonin.

Thanks to its specific actions on the digestive system, alpha-lactalbumin she turned out to be capable of both modify the microbiota both of also increase the rate of synthesis of brain serotonin fivefold . Alpha-lactalbumin it was also found capable of increasing the neuropeptide Y , which has been defined to be a powerful endogenous anticonvulsant.

Furthermore, nourishing the cells of the digestive system well facilitates their response to the stimulation of alpha-lactalbumin. The specific nutrients of these cells are i short chain fats (Short Chain Fatty Acids, SCFAs) which carry out an anti-inflammatory action , are able to improve the metabolism of the precursors of tryptophan and serotonin and regulate the functionality of the intestine-brain axis at 360 degrees. Butyric acid , one of the most widespread SCFAs, contributes to the correct functioning of the intestinal mucosa , positively influences the ecosystem of the gastro-intestinal tract and has been proven to have anticonvulsant effects in various experimental models of epilepsy, positively influencing both the frequency of the crises themselves that aspects related to neuropsychiatric disorders .

The patented synergistic association between alpha-lactalbumin and butyric acid led to the development of Lalbaay, the first food for special medical purposes studied in Italy by reference centers in the field of epilepsy, to provide an effective and useful tool for the dietary management of drug-resistant epilepsies.