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卒中后认知障碍与肠道微生物群及其相关代谢物的关联。

The Association of Post-Stroke Cognitive Impairment and Gut Microbiota and its Corresponding Metabolites.

机构信息

Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China.

Clinical Medical College, Nanjing Medical University, Nanjing, China.

出版信息

J Alzheimers Dis. 2020;73(4):1455-1466. doi: 10.3233/JAD-191066.

Abstract

BACKGROUND

Post-stroke cognitive impairment (PSCI) is an important factor causing disabilities after acute ischemic stroke (AIS). Emerging evidence suggested that gut microbiota play an important role in cognitive impairment.

OBJECTIVE

This study aimed to explore the association between PSCI and gut microbiota.

METHOD

65 patients with newly diagnostic AIS finished the fecal collection on admission and cognitive assessment 3 months later in the clinic. Fecal samples were subjected to 16SrRNA gene sequencing and gas chromatography-mass spectrometry analysis. Additionally, we enrolled new 18 AIS patients, whose treatment was supplemented by probiotics, to assess the potential of microbial treatment in PSCI.

RESULTS

PSCI patients were characterized by the significantly decreased alpha-diversity, disturbed microbial composition, and corresponding metabolites compared with non-PSCI patients. Increased Fusobacterium and deficiency of microbial metabolized short-chain fatty acids (SCFAs) were significantly associated with PSCI. A model based on gut microbiota and SCFAs could predict 3 months or longer PSCI early and accurately after stroke onset. While traditional probiotic administration had little effect on PSCI, it could ameliorate patients' mood, including depression and anxiety in the 3 months after stroke.

CONCLUSION

Our study revealed the association between PSCI and gut microbiota and its corresponding metabolites for the first time, suggesting the potential for applying microbiota and its corresponding metabolites to early clinical diagnosis and treatment of PSCI.

摘要

背景

卒中后认知障碍(PSCI)是急性缺血性卒中(AIS)后导致残疾的重要因素。新出现的证据表明,肠道微生物群在认知障碍中起着重要作用。

目的

本研究旨在探讨 PSCI 与肠道微生物群之间的关系。

方法

65 例新诊断的 AIS 患者在入院时完成粪便采集,并在 3 个月后在诊所进行认知评估。粪便样本进行 16SrRNA 基因测序和气相色谱-质谱分析。此外,我们还招募了 18 例新的 AIS 患者,其治疗补充了益生菌,以评估微生物治疗在 PSCI 中的潜力。

结果

与非 PSCI 患者相比,PSCI 患者的 alpha 多样性显著降低,微生物组成和相应代谢物受到干扰。梭菌丰度增加和微生物代谢的短链脂肪酸(SCFAs)缺乏与 PSCI 显著相关。基于肠道微生物群和 SCFAs 的模型可以在卒中后早期准确预测 3 个月或更长时间的 PSCI。虽然传统益生菌治疗对 PSCI 影响不大,但它可以改善患者的情绪,包括卒中后 3 个月的抑郁和焦虑。

结论

本研究首次揭示了 PSCI 与肠道微生物群及其相应代谢物之间的关联,提示应用微生物群及其相应代谢物对 PSCI 进行早期临床诊断和治疗的潜力。

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