Functional recovery outcomes following acute stroke is associated with abundance of gut microbiota related to inﬂammation, butyrate and secondary bile acid

Frontiers in Rehabilitation Sciences, 2022 · DOI: 10.3389/fresc.2022.1017180 · Published: October 26, 2022

Neurology Gastroenterology Rehabilitation

Simple Explanation

This study investigates the connection between gut bacteria and recovery after a stroke. It looks at how the types of bacteria in the gut change in the first three weeks of stroke rehabilitation and how these changes relate to brain function. The study also explores whether having risk factors for stroke affects the types of bacteria in the gut. By understanding these connections, researchers hope to find new ways to help people recover from stroke. The researchers found that stroke is associated with a higher abundance of proinﬂammatory species and a lower abundance of butyrate producers and secondary bile acid producers. These altered microbial communities are associated with poorer functional performances.

Study Duration

Three weeks

Participants

12 stroke participants, 18 controls with risk factors, and 12 controls without risk factors

Evidence Level

Original Research

Key Findings

1
Stroke patients had significantly lower abundances of butyrate producers, secondary bile acid producers, equol producers, and sulfate reducers in their gut.
2
Stroke patients had significantly higher abundances of pro-inflammatory taxa in their gut.
3
The presence of alpha-1-antitrypsin, a marker for intestinal permeability, was inversely associated with several beneficial microbial taxa and positively associated with some pro-inflammatory taxa.

Research Summary

This study measured the gut microbiome in the first three weeks of rehabilitation following stroke and its associations with leaky gut markers, dietary intake, and functional recovery measures. The researchers found significantly lower abundances of butyrate producers, secondary bile acid producers, equol producers, and sulfate reducers in the Stroke group and signiﬁcantly higher abundances of pro-inﬂammatory taxa. The study indicates that the microbiome differences are associated with the stroke itself and not the underlying risk factors and future studies should explore treatments targeting the composition of microbial communities following stroke as a way to boost recovery.

Practical Implications

Targeted Therapies

Future research could focus on developing therapies that manipulate the gut microbiome to optimize stroke rehabilitation and boost recovery.

Dietary Interventions

Dietary interventions aimed at optimizing butyrate, secondary bile acid, and equol producers in the gut may contribute to a rehabilitation environment that boosts recovery.

Personalized Medicine

Understanding the relationship between APOE genotype and gut microbiome characteristics could lead to personalized medicine approaches for stroke recovery.

Study Limitations

1
As a prospective case control study, it cannot definitively say that the associations are causing stroke recovery to be altered.
2
The study did not have access to cognitive status prior to stroke or baseline stroke severity due to the recruitment procedure feasibility.
3
The sample consists largely of older white adults from Kentucky. Larger studies comprising more diverse populations are needed to see whether these associations are generalizable.

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