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Regulation of Gut Microbiota in Acute Ischemic Stroke Patients
Yildiz Arslan1, Ali Çayir2, Özlem Kocabiyik1
1İzmir Bakirçay University Çiğli Education and Research Hospital Neurology Clinic.
Objectives:
There is a bidirectional relationship between stroke and infection, with stroke increasing susceptibility to infections and contributing to poorer clinical outcomes and higher mortality rates. Stroke-induced dysmotility, impaired gut barrier integrity, and systemic dissemination of resident gut microbiota have recently been implicated in the pathogenesis of poststroke infections. We hypothesize that early modulation of the gut microbiota within the first week of acute stroke may help prevent or mitigate post-stroke infections, mortality, and morbidity.
Methods:
This prospective study was conducted between 2020 and 2024 and included patients with moderate-to-severe acute stroke who were monitored in the intensive care unit (ICU) for at least 4 weeks. Probiotic agents containing Saccharomyces Boulardii were administered to the study group either orally or through a nasogastric tube. National Institutes of Health Stroke Scale (NIHSS) scores, patient survival rates, and poststroke infections were recorded during the first month and compared with those of the control group, who were not given probiotics.
Results:
The study group had significantly lower rates of poststroke infection and mortality ( P= 0.010 and P= 0.023, respectively). In addition, NIHSS scores were significantly higher in the control group ( P =0.032). Laboratory analyses revealed significantly higher neutrophil and platelet counts, C-reactive protein (CRP), and total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels were also significantly higher in the control group ( P <0.05).
Conclusion:
This study demonstrated that probiotic administration may reduce the risk of poststroke infections, improve functional outcomes, and decrease both mortality and morbidity in patients with acute ischemic stroke.
Insights
Early probiotic use in acute stroke patients significantly reduced infections and mortality. Saccharomyces Boulardii administration improved outcomes, highlighting the gut microbiota
Area of Science:
- Neurology
- Microbiology
- Immunology
Background:
- Stroke increases susceptibility to infections, leading to poor outcomes and mortality.
- Post-stroke infections are linked to gut dysbiosis, impaired gut barrier, and microbial translocation.
- Early gut microbiota modulation is hypothesized to prevent post-stroke complications.
Purpose of the Study:
- To investigate the efficacy of early probiotic administration in preventing post-stroke infections, mortality, and morbidity.
- To assess the impact of Saccharomyces Boulardii on clinical outcomes in acute stroke patients.
Main Methods:
- Prospective study (2020-2024) of moderate-to-severe acute stroke patients in ICU for ≥4 weeks.
- Intervention group received Saccharomyces Boulardii probiotics (oral or nasogastric).
- Comparison with a control group; data collected included National Institutes of Health Stroke Scale (NIHSS) scores, survival rates, and infection rates.
Main Results:
- Significantly lower rates of post-stroke infection (P=0.010) and mortality (P=0.023) in the probiotic group.
- The control group exhibited significantly higher NIHSS scores (P=0.032).
- Elevated neutrophil and platelet counts, CRP, and lipid profiles (cholesterol, LDL, HDL) were observed in the control group (P<0.05).
Conclusions:
- Probiotic administration, specifically Saccharomyces Boulardii, may reduce post-stroke infections.
- Early probiotic use appears to improve functional outcomes and decrease mortality and morbidity in acute ischemic stroke patients.
