Related Experiment Video
Updated: May 15, 2026
Isolation and Flow Cytometric Assessment of Neuroimmune Interactions in a Mini-Stroke Murine Model
Published on: June 20, 2025
Diagnostic value of gut microbiota profiling and circulating biomarkers to predict post-stroke infection in acute
Weny Rinawati1,2, Aryati Aryati3,4, Abdulloh Machin4,5,6
1Doctoral Program in Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Background:
Post-stroke infection (PSI), particularly pneumonia and urinary tract infection, is a common and serious complication after acute ischemic stroke (AIS). Current diagnostic biomarkers provide limited accuracy when used in isolation. This study aimed to evaluate the diagnostic value of circulating biomarkers and gut microbiota profiling, both individually and in combination, to predict PSI in AIS patients.
Methods:
We conducted a prospective observational study at Prof. Dr. dr. Mahar Mardjono National Brain Center Hospital, Jakarta. A total of 80 AIS patients admitted within 24 h of onset were enrolled and followed for 7 days to assess PSI. Blood samples were analyzed for NMDAR, butyrate, TMAO, RANKL, iFABP, and LPS. Stool samples were collected for 16S rRNA sequencing. Diagnostic performance was evaluated using ROC curves, with AUC, sensitivity, and specificity calculated. Multivariate logistic regression models were constructed to assess independent predictors and combined diagnostic accuracy.
Results:
PSI occurred in 37/80 patients (46.3%). NMDAR showed the highest diagnostic performance (AUC 0.911; sensitivity 86.5%; specificity 90.7), followed by iFABP (AUC 0.894), LPS (AUC 0.896), RANKL (AUC 0.881), butyrate (AUC 0.866), and TMAO (AUC 0.865). Gut microbiota analysis revealed reduced evenness and dominance imbalance in infected patients, with enrichment of pathogenic taxa (Escherichia coli, Salmonella enterica) and depletion of SCFA-producing commensals (Faecalibacterium prausnitzii, Roseburia intestinalis). Multivariate models integrating microbiota features and biomarkers improved predictive accuracy compared with single-domain approaches.
Conclusion:
Integrating circulating biomarkers with gut microbiota profiling significantly enhances early prediction of PSI in AIS. These findings highlight the role of the gut-brain-immune axis in post-stroke complications and support combined biomarker-microbiota models for risk stratification and preventive strategies.
Insights
Predicting post-stroke infection (PSI) in acute ischemic stroke (AIS) patients is improved by combining circulating biomarkers with gut microbiota analysis. This integrated approach enhances early risk stratification for better preventive strategies.
Area of Science:
- Neurology
- Infectious Diseases
- Microbiome Research
Background:
- Post-stroke infection (PSI) is a common complication after acute ischemic stroke (AIS).
- Existing diagnostic biomarkers for PSI have limited accuracy when used alone.
- Early prediction of PSI is crucial for timely intervention and improved patient outcomes.
Purpose of the Study:
- To evaluate the diagnostic value of circulating biomarkers for PSI in AIS patients.
- To assess the role of gut microbiota profiling in predicting PSI.
- To determine the combined diagnostic accuracy of biomarkers and microbiota for PSI prediction.
Main Methods:
- Prospective observational study of 80 AIS patients.
- Analysis of circulating biomarkers including NMDAR, butyrate, TMAO, RANKL, iFABP, and LPS.
- Gut microbiota profiling using 16S rRNA sequencing and diagnostic performance evaluation via ROC curves.
Main Results:
- Post-stroke infection (PSI) occurred in 46.3% of patients.
- NMDAR demonstrated the highest diagnostic performance (AUC 0.911), followed by other biomarkers.
- Gut microbiota analysis revealed dysbiosis with enrichment of pathogenic taxa and depletion of beneficial bacteria in infected patients.
Conclusions:
- Integrating circulating biomarkers with gut microbiota profiling significantly enhances early prediction of PSI in AIS.
- These findings underscore the importance of the gut-brain-immune axis in post-stroke complications.
- Combined biomarker-microbiota models offer potential for improved risk stratification and preventive strategies.
