Microbiota Gut–Brain Axis in Ischemic Stroke: A Narrative Review with a Focus about the Relationship with Inflammatory Bowel Disease

Sinagra, Emanuele; Pellegatta, Gaia; Guarnotta, Valentina; Maida, Marcello; Rossi, Francesca; Conoscenti, Giuseppe; Pallio, Socrate; Alloro, Rita; Raimondo, Dario; Pace, F.; Anderloni, Andrea

doi:10.3390/life11070715

Cited by 19 publications

(11 citation statements)

References 76 publications

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“…Another well-studied clinical example is acute ischaemic stroke, which leads to intestinal ischaemia and dysbiosis, which in turn exacerbate cerebral infarction by enhancing systemic inflammation [ 130 , 131 ]. In addition, dysbiosis is associated with poor outcomes following acute ischaemic stroke as it interacts with the brain through all of the above mechanisms [ 56 , 132 , 133 ].…”

Section: Interaction Of the Gut Microbiota With Key Organs: The Conce...mentioning

confidence: 99%

The central and biodynamic role of gut microbiota in critically ill patients

et al. 2022

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Gut microbiota plays an essential role in health and disease. It is constantly evolving and in permanent communication with its host. The gut microbiota is increasingly seen as an organ, and its failure, reflected by dysbiosis, is seen as an organ failure associated with poor outcomes. Critically ill patients may have an altered gut microbiota, namely dysbiosis, with a severe reduction in “health-promoting” commensal intestinal bacteria (such as Firmicutes or Bacteroidetes) and an increase in potentially pathogenic bacteria (e.g. Proteobacteria). Many factors that occur in critically ill patients favour dysbiosis, such as medications or changes in nutrition patterns. Dysbiosis leads to several important effects, including changes in gut integrity and in the production of metabolites such as short-chain fatty acids and trimethylamine N-oxide. There is increasing evidence that gut microbiota and its alteration interact with other organs, highlighting the concept of the gut–organ axis. Thus, dysbiosis will affect other organs and could have an impact on the progression of critical diseases. Current knowledge is only a small part of what remains to be discovered. The precise role and contribution of the gut microbiota and its interactions with various organs is an intense and challenging research area that offers exciting opportunities for disease prevention, management and therapy, particularly in critical care where multi-organ failure is often the focus. This narrative review provides an overview of the normal composition of the gut microbiota, its functions, the mechanisms leading to dysbiosis, its consequences in an intensive care setting, and highlights the concept of the gut–organ axis.

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Section: Interaction Of the Gut Microbiota With Key Organs: The Conce...mentioning

confidence: 99%

The central and biodynamic role of gut microbiota in critically ill patients

et al. 2022

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“…The main consequences of this immunodepression is infection, to which changes in gut microbiota might contribute by increasing plasma trimethylamine N-oxide levels ( 94 , 95 ). Gut dysbiosis is also a determinant of post-stroke outcomes ( 96 ).…”

Section: The Brain-immune Crosstalk In Ischemic Strokementioning

confidence: 99%

“…Regarding the gastrointestinal system, the sympathetic nervous system may be deleterious, by disrupting production of intestinal mucin, gut permeability ( via noradrenergic-mediated expression of TREM1), and composition of intestinal microbiota ( 78 , 99 ), while the vagal nerve is, on the other hand, more protective. For instance, reducing parasympathetic nerve activity after an acute brain injury stimulates intestinal bacterial proliferation and increases bacterial translocation ( 96 ). It has been recently demonstrated that there are circulating molecular regulators, such as small RNA, that finely control the cholinergic reflex in stroke patients.…”

Section: The Brain-immune Crosstalk In Ischemic Strokementioning

confidence: 99%

Neuro-Inflammatory Response and Brain-Peripheral Crosstalk in Sepsis and Stroke

et al. 2022

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Despite recent therapeutic advances, ischemic stroke is still a leading cause of death and disability. There is renewed attention on peripheral inflammatory signaling as a way of modulating the post-ischemic neuro-inflammatory process. The immune-brain crosstalk has long been the focus for understanding the mechanisms of sickness behavior, which is an adaptive autonomic, neuroendocrine, and behavioral response to a peripheral inflammation. It is mediated by humoral and neural pathways that mainly involve the circumventricular organs and vagal nerve, respectively. In this review we address the question of how sepsis and stroke can dysregulate this adaptive response, notably by impairing the central integration of peripheral signaling, but also by efferent control of the immune response. We highlight the potential role of gut–brain and brain–spleen signaling in stroke.

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“…A review of eighteen studies concluded that aging, inflammation, and different microbial compositions may unequivocally contribute to the development of ischemic stroke ( Lee et al, 2021 ). Older mice with a high Firmicutes / Bacteroidetes ratio were documented to have a higher risk of ischemic stroke and were unable to recover from neurological deficits, contributing to higher mortality ( Spychala et al, 2018 ; Sinagra et al, 2021 ). Aging increases the risk of neurodegenerative, cerebrovascular and cardiovascular diseases and cancer.…”

Section: Agingmentioning

confidence: 99%

Crosstalk between the aging intestinal microflora and the brain in ischemic stroke

Pluta

Jabłoński

Januszewski

et al. 2022

Front. Aging Neurosci.

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Aging is an inevitable phenomenon experienced by animals and humans, and its intensity varies from one individual to another. Aging has been identified as a risk factor for neurodegenerative disorders by influencing the composition of the gut microbiota, microglia activity and cognitive performance. The microbiota-gut-brain axis is a two-way communication path between the gut microbes and the host brain. The aging intestinal microbiota communicates with the brain through secreted metabolites (neurotransmitters), and this phenomenon leads to the destruction of neuronal cells. Numerous external factors, such as living conditions and internal factors related to the age of the host, affect the condition of the intestinal microflora in the form of dysbiosis. Dysbiosis is defined as changes in the composition and function of the gut microflora that affect the pathogenesis, progress, and response to treatment of a disease entity. Dysbiosis occurs when changes in the composition and function of the microbiota exceed the ability of the microflora and its host to restore equilibrium. Dysbiosis leading to dysfunction of the microbiota-gut-brain axis regulates the development and functioning of the host’s nervous, immune, and metabolic systems. Dysbiosis, which causes disturbances in the microbiota-gut-brain axis, is seen with age and with the onset of stroke, and is closely related to the development of risk factors for stroke. The review presents and summarizes the basic elements of the microbiota-gut-brain axis to better understand age-related changes in signaling along the microbiota-gut-brain axis and its dysfunction after stroke. We focused on the relationship between the microbiota-gut-brain axis and aging, emphasizing that all elements of the microbiota-gut-brain axis are subject to age-related changes. We also discuss the interaction between microbiota, microglia and neurons in the aged individuals in the brain after ischemic stroke. Finally, we presented preclinical and clinical studies on the role of the aged microbiota-gut-brain axis in the development of risk factors for stroke and changes in the post-stroke microflora.

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Microbiota Gut–Brain Axis in Ischemic Stroke: A Narrative Review with a Focus about the Relationship with Inflammatory Bowel Disease

Cited by 19 publications

References 76 publications

The central and biodynamic role of gut microbiota in critically ill patients

The central and biodynamic role of gut microbiota in critically ill patients

Neuro-Inflammatory Response and Brain-Peripheral Crosstalk in Sepsis and Stroke

Crosstalk between the aging intestinal microflora and the brain in ischemic stroke

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