Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
Department of General Medicine, Shaoxing People's Hospital, Zhejiang University, Shaoxing, China.
Front Immunol. 2023 Apr 17;14:1171898. doi: 10.3389/fimmu.2023.1171898. eCollection 2023.
Stroke is a common group of cerebrovascular diseases that can lead to brain damage or death. Several studies have shown a close link between oral health and stroke. However, the oral microbiome profiling of ischemic stroke (IS) and its potential clinical implication are unclear. This study aimed to describe the oral microbiota composition of IS, the high risk of IS, and healthy individuals and to profile the relationship between microbiota and IS prognosis.
This observational study recruited three groups: IS, high-risk IS (HRIS), and healthy control (HC) individuals. Clinical data and saliva were collected from participants. The modified Rankin scale score after 90 days was used to assess the prognosis of stroke. Extracted DNA from saliva and performed 16S ribosomal ribonucleic acid (rRNA) gene amplicon sequencing. Sequence data were analyzed using QIIME2 and R packages to evaluate the association between the oral microbiome and stroke.
A total of 146 subjects were enrolled in this study according to the inclusion criteria. Compared with HC, HRIS and IS demonstrated a progressive increase trend in Chao1, observed species richness, and Shannon and Simpson diversity index. On the basis of permutational multivariate analysis of variance, the data indicate a great variation in the saliva microbiota composition between HC and HRIS (F = 2.40, P < 0.001), HC and IS (F = 5.07, P < 0.001), and HRIS and IS (F = 2.79, P < 0.001). The relative abundance of , , , , and was higher in HRIS and IS compared with that in HC. Furthermore, we constructed the predictive model by differential genera to effectively distinguish patients with IS with poor 90-day prognoses from those with good (area under the curve = 79.7%; 95% CI, 64.41%-94.97%; p < 0.01).
In summary, the oral salivary microbiome of HRIS and IS subjects have a higher diversity, and the differential bacteria have some predictive value for the severity and prognosis of IS. Oral microbiota may be used as potential biomarkers in patients with IS.
中风是一组常见的脑血管疾病，可导致脑损伤或死亡。几项研究表明，口腔健康与中风之间存在密切联系。然而，缺血性中风（IS）的口腔微生物组谱及其潜在的临床意义尚不清楚。本研究旨在描述 IS、高危 IS（HRIS）和健康个体的口腔微生物群落组成，并分析微生物群与 IS 预后之间的关系。
本观察性研究招募了三组参与者：IS、HRIS 和健康对照组（HC）。从参与者中采集临床数据和唾液。采用 90 天后改良 Rankin 量表评分评估中风预后。从唾液中提取 DNA，进行 16S 核糖体核糖核酸（rRNA）基因扩增子测序。使用 QIIME2 和 R 包分析序列数据，以评估口腔微生物组与中风之间的关联。
根据纳入标准，共有 146 名符合条件的受试者入组本研究。与 HC 相比，HRIS 和 IS 的 Chao1、观察到的物种丰富度、Shannon 和 Simpson 多样性指数呈逐渐增加的趋势。基于置换多元方差分析，数据表明 HC 和 HRIS（F=2.40，P<0.001）、HC 和 IS（F=5.07，P<0.001）以及 HRIS 和 IS（F=2.79，P<0.001）之间唾液微生物群落组成存在很大差异。与 HC 相比，HRIS 和 IS 中相对丰度较高的菌属包括 、 、 、 和 。此外，我们构建了基于差异属的预测模型，能够有效区分 90 天预后不良和良好的 IS 患者（曲线下面积=79.7%；95%置信区间，64.41%-94.97%；p<0.01）。
总之，HRIS 和 IS 患者的口腔唾液微生物组多样性较高，差异细菌对 IS 的严重程度和预后具有一定的预测价值。口腔微生物组可能作为 IS 患者的潜在生物标志物。
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