Yan Chuming, Si Tong, Zheng Wancheng, Huang Liyuan, Wen Lulu, Shen Huixin, Qu Miao
Neurology Department, Xuanwu Hospital of Capital Medical University, Beijing, People's Republic of China.
Neurology Department, Beijing Shijitan Hospital, Beijing, People's Republic of China.
Neuropsychiatr Dis Treat. 2025 Mar 4;21:477-489. doi: 10.2147/NDT.S494035. eCollection 2025.
The changes in gut microbiota and plasma metabolites have been proposed to play a key role in post stroke depression (PSD), but clinical study based on combined omics is still in lack. This study aimed to investigate the characteristics of gut microbiota and plasma metabolites in patients 3 months after the onset of acute ischemic stroke (AIS), compare PSD and non-PSD groups, and explore possible diagnostic biomarkers.
Seventy patients with stroke were included at 3 months after AIS onset. Plasma and fecal samples were collected. Gut microbiome was examined using 16S rRNA sequencing, and plasma metabolites were assessed via targeted liquid chromatography-mass spectrometry.
Of the 70 patients with ischemic stroke, 25 (35.71%) were diagnosed with PSD. At the genus level, patients with PSD had increased abundance of , and , and decreased levels of the group and . In patients with PSD, 12 plasma metabolites were altered, with cortisol and pyroglutamic acid levels increased, while 2-phosphoglyceric acid, 3-phosphoglycerate, phosphorylcholine, tryptophan, caffeine, N-methylalanine, ornithine, serotonin, theophylline, and vanillic acid were decreased. Enriched metabolic pathways included glutathione, tryptophan, and caffeine metabolism. Furthermore, significant correlations were observed between gut microbial dysregulation and major plasma metabolite alterations. The areas under the curve values of gut microbiota, plasma metabolites, and the combined dataset for PSD diagnosis were 0.704, 0.875, and 0.940, respectively.
This study identified the characteristics of gut microbiota and plasma metabolites as well as a panel of combined biomarkers in 3-month PSD, possibly providing a new theoretical framework for diagnosis and treatment.
肠道微生物群和血浆代谢物的变化被认为在中风后抑郁症（PSD）中起关键作用，但基于组学联合的临床研究仍然缺乏。本研究旨在调查急性缺血性中风（AIS）发病3个月后患者的肠道微生物群和血浆代谢物特征，比较PSD组和非PSD组，并探索可能的诊断生物标志物。
纳入70例AIS发病3个月后的中风患者。收集血浆和粪便样本。使用16S rRNA测序检测肠道微生物群，并通过靶向液相色谱-质谱法评估血浆代谢物。
在70例缺血性中风患者中，25例（35.71%）被诊断为PSD。在属水平上，PSD患者的 、 和 的丰度增加，而 组和 的水平降低。在PSD患者中，12种血浆代谢物发生改变，皮质醇和焦谷氨酸水平升高，而2-磷酸甘油酸、3-磷酸甘油酸、磷酸胆碱、色氨酸、咖啡因、N-甲基丙氨酸、鸟氨酸、血清素、茶碱和香草酸降低。富集的代谢途径包括谷胱甘肽、色氨酸和咖啡因代谢。此外，观察到肠道微生物失调与主要血浆代谢物改变之间存在显著相关性。肠道微生物群、血浆代谢物以及PSD诊断的联合数据集的曲线下面积值分别为0.704、0.875和0.940。
本研究确定了3个月PSD中肠道微生物群和血浆代谢物的特征以及一组联合生物标志物，可能为诊断和治疗提供新的理论框架。
