Department of Neurology, the Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China.
Department of Interventional Neurology, the Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China.
Front Cell Infect Microbiol. 2023 Jul 11;13:1231541. doi: 10.3389/fcimb.2023.1231541. eCollection 2023.
Cerebral small vessel disease (CSVD) is a cluster of microvascular disorders with unclear pathological mechanisms. The microbiota-gut-brain axis is an essential regulatory mechanism between gut microbes and their host. Therefore, the compositional and functional gut microbiota alterations lead to cerebrovascular disease pathogenesis. The current study aims to determine the alteration and clinical value of the gut microbiota in CSVD patients.
Sixty-four CSVD patients and 18 matched healthy controls (HCs) were included in our study. All the participants underwent neuropsychological tests, and the multi-modal magnetic resonance imaging depicted the changes in brain structure and function. Plasma samples were collected, and the fecal samples were analyzed with 16S rRNA gene sequencing.
Based on the alpha diversity analysis, the CSVD group had significantly decreased Shannon and enhanced Simpson compared to the HC group. At the genus level, there was a significant increase in the relative abundances of Parasutterella, Anaeroglobus, Megasphaera, Akkermansia, Collinsella, and Veillonella in the CSVD group. Moreover, these genera with significant differences in CSVD patients revealed significant correlations with cognitive assessments, plasma levels of the blood-brain barrier-/inflammation-related indexes, and structural/functional magnetic resonance imaging changes. Functional prediction demonstrated that lipoic acid metabolism was significantly higher in CSVD patients than HCs. Additionally, a composite biomarker depending on six gut microbiota at the genus level displayed an area under the curve of 0.834 to distinguish CSVD patients from HCs using the least absolute shrinkage and selection operator (LASSO) algorithm.
The evident changes in gut microbiota composition in CSVD patients were correlated with clinical features and pathological changes of CSVD. Combining these gut microbiota using the LASSO algorithm helped identify CSVD accurately.
脑小血管病（CSVD）是一组微血管疾病，其病理机制尚不清楚。微生物群-肠-脑轴是肠道微生物与其宿主之间的重要调节机制。因此，肠道微生物组成和功能的改变导致了脑血管病的发病机制。本研究旨在确定 CSVD 患者肠道微生物群的变化及其临床价值。
本研究纳入了 64 名 CSVD 患者和 18 名匹配的健康对照者（HCs）。所有参与者均接受神经心理学测试，多模态磁共振成像描绘了脑结构和功能的变化。采集血浆样本，并对粪便样本进行 16S rRNA 基因测序分析。
基于 alpha 多样性分析，CSVD 组的 Shannon 指数显著降低，Simpson 指数增强。在属水平上，CSVD 组中 Parasutterella、Anaeroglobus、Megasphaera、Akkermansia、Collinsella 和 Veillonella 的相对丰度显著增加。此外，CSVD 患者中具有显著差异的这些属与认知评估、血脑屏障/炎症相关指标的血浆水平以及结构/功能磁共振成像变化显著相关。功能预测表明，CSVD 患者的硫辛酸代谢明显高于 HCs。此外，基于 6 个属水平的肠道微生物组合的复合生物标志物，使用最小绝对收缩和选择算子（LASSO）算法，区分 CSVD 患者和 HCs 的曲线下面积为 0.834。
CSVD 患者肠道微生物组成的明显变化与 CSVD 的临床特征和病理变化相关。使用 LASSO 算法结合这些肠道微生物有助于准确识别 CSVD。
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