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Gut fungal signatures predict disease status in acute ischemic stroke
Qi Yan1, Lixia Pu2, Shuai Yuan3
1Department of Neurology, Second Hospital and Clinical Medical School, Lanzhou University, Lanzhou, China.
Abstract:
The role of gut fungi in acute ischemic stroke (AIS) remains poorly understood. To characterize the gut mycobiome in AIS and explore its association with disease severity and prognosis. We profiled the gut mycobiome of an AIS cohort (n = 117) with longitudinal disease estimation via ITS2 sequencing. The gut mycobiome of patients with AIS differed significantly from that of healthy individuals, featured by shift of enterotypes, marked alterations of core genera such as Aspergillus, Candida, and Geotrichum. AIS exhibited stronger interkingdom correlations and higher node degrees in the co-occurrence network. Random Forest classifiers, based on features marked by Geotrichum and yeast, were effective to distinguish patients with AIS from healthy controls (AUC = 0.95) and predicting disease severity (AUC = 0.955) in the cross-sectional data, and reliably indicated AIS outcomes in a prospective data (AUC = 0.775). These findings suggest that gut fungi may have potential as predictors of AIS status and prognosis.
Insights
Gut fungi differ in acute ischemic stroke (AIS) patients compared to healthy individuals. Specific fungi like Geotrichum show potential for predicting AIS and its outcomes.
Area of Science:
- Microbiology
- Neurology
- Gastroenterology
Background:
- The gut mycobiome's role in acute ischemic stroke (AIS) is largely unknown.
- Understanding gut fungal communities may offer new insights into stroke pathogenesis and progression.
Purpose of the Study:
- To characterize the gut mycobiome in AIS patients.
- To investigate the association between gut fungi, AIS severity, and prognosis.
Main Methods:
- ITS2 sequencing was used to profile the gut mycobiome in 117 AIS patients.
- Co-occurrence network analysis explored interkingdom correlations.
- Random Forest models were developed to predict AIS status, severity, and outcomes.
Main Results:
- AIS patients displayed distinct gut mycobiomes compared to healthy controls, with altered enterotypes and genera (e.g., Aspergillus, Candida, Geotrichum).
- The gut fungal network in AIS showed increased complexity.
- Models utilizing Geotrichum and yeast features accurately distinguished AIS patients and predicted disease severity (AUC > 0.95) and outcomes (AUC = 0.775).
Conclusions:
- Gut fungi composition is significantly altered in AIS.
- Specific gut fungal markers, particularly Geotrichum, show promise as non-invasive biomarkers for AIS detection and prognosis.
