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脑卒中后并发认知障碍和抑郁患者的肠道菌群结构变化及其与临床特征的相关性。

Structural Change of Gut Microbiota in Patients with Post-Stroke Comorbid Cognitive Impairment and Depression and Its Correlation with Clinical Features.

机构信息

Department of Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.

Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China.

出版信息

J Alzheimers Dis. 2020;77(4):1595-1608. doi: 10.3233/JAD-200315.

Abstract

BACKGROUND

Post-stroke comorbid cognitive impairment and depression (PSCCID) is a severe neuropsychiatric complication after acute stroke. Gut microbiota dysbiosis is associated with many psychiatric disorders. Alterations in the composition of gut microbiota may serve as a critical role in patients with PSCCID.

OBJECTIVE

We aimed to characterize the microbial profiles of patients with PSCCID.

METHOD

A total of 175 stroke patients were recruited in the study. The composition of gut bacterial communities of patients was determined by 16S ribosomal RNA Miseq sequencing, and Phylogenetic Investigation of Communities by Reconstruction of Unobserved States was used to demonstrate the functional alterations of gut microbiota. We further identified the characteristic gut microbiota of PSCCID using linear discriminant analysis effect size.

RESULTS

Patients with PSCCID exhibited an increased abundance of Proteobacteria, including Gammaproteobacteria, Enterobacteriales, and Enterobacteriaceae, and a decreased abundance of several short-chain fatty acids-producing bacteria compared with non-PSCCID patients. The abundance of Gammaproteobacteria and Enterobacteriaceae showed negative correlations with the MoCA score. Moreover, the Kyoto Encyclopedia of Genes and Genomes results demonstrated the enriched orthologs of glycan biosynthesis and metabolism and decreased orthologs of amino acid metabolism in PSCCID patients. Importantly, the characteristic gut microbiota was identified and achieved an area under the curve of 0.847 between the two groups.

CONCLUSION

In this study, we characterized the gut microbiota of PSCCID patients, and revealed the correlations of the altered gut microbiota with clinical parameters, which took a further step towards non-invasive diagnostic biomarkers for PSCCID from fecal samples.

摘要

背景

卒中后共病认知障碍和抑郁(PSCCID)是急性卒中后的一种严重神经精神并发症。肠道微生物群落失调与许多精神疾病有关。肠道微生物群落组成的改变可能在 PSCCID 患者中起着关键作用。

目的

我们旨在描述 PSCCID 患者的微生物特征。

方法

本研究共纳入 175 例卒中患者。通过 16S 核糖体 RNA Miseq 测序确定患者肠道细菌群落的组成,并用重建未观察状态的群落系统发育分析来展示肠道微生物群落的功能改变。我们进一步通过线性判别分析效应大小来鉴定 PSCCID 的特征肠道微生物群。

结果

与非 PSCCID 患者相比,PSCCID 患者的厚壁菌门、包括γ变形菌门、肠杆菌目和肠杆菌科的丰度增加,而几种产生短链脂肪酸的细菌的丰度降低。γ变形菌门和肠杆菌科的丰度与 MoCA 评分呈负相关。此外,京都基因与基因组百科全书的结果表明,PSCCID 患者中糖生物合成和代谢的同源物丰富,而氨基酸代谢的同源物减少。重要的是,我们鉴定了特征肠道微生物群,两组间的曲线下面积为 0.847。

结论

在这项研究中,我们描述了 PSCCID 患者的肠道微生物群,并揭示了改变的肠道微生物群与临床参数的相关性,这为从粪便样本中寻找 PSCCID 的非侵入性诊断生物标志物迈出了一步。

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