Imbalance of Microbacterial Diversity Is Associated with Functional Prognosis of Stroke
Xintong Zhang, Xiangyu Wang, Hong Zhao, Risheng Cao, Yini Dang, Binbin Yu
Abstract
Objectives. There is mounting evidence to suggest that the pathophysiology of stroke is greatly influenced by the microbiota of the gut and its metabolites, in particular short-chain fatty acids (SCFAs). The primary purpose of the study was to evaluate whether the levels of SCFAs and the gut microbiota are altered in poststroke patients and to examine the relationship between these alterations and the physical condition, intestinal health, pain, or nutritional status of patients. Methods. Twenty stroke patients and twenty healthy controls were enrolled in the current study, and their demographics were matched. Gas chromatography was used to determine the fecal SCFAs, and 16S rRNA gene sequencing was used to evaluate their fecal microbiota. Microbial diversity and richness were examined using the diversity indices alpha and beta, and taxonomic analysis was utilized to determine group differences. The relationships between the gut microbiome and fecal SCFAs, discriminant bacteria, and poststroke clinical outcomes were analyzed. Results. Less community richness (ACE and Chao) was observed in the poststroke patients ( <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mi>P</a:mi> <a:mo><</a:mo> <a:mn>0.05</a:mn> </a:math> ), but the differences between the poststroke group and the healthy control group in terms of species diversity (Shannon and Simpson) were not statistically significant. The makeup of the poststroke gut microbiota was distinct from that of the control group, as evidenced by beta diversity. Then, the relative abundances of the taxa in the poststroke and control groups were compared in order to identify the specific microbiota changes. At the level of phylum, the poststroke subjects showed a significant increase in the relative abundances of Akkermansiaceae, Fusobacteriota, Desulfobacterota, Ruminococcaceae, and Oscillospirales and a particularly noticeable decrease in the relative abundance of Acidobacteriota compared to the control subjects ( <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"> <c:mi>P</c:mi> <c:mo><</c:mo> <c:mn>0.05</c:mn> </c:math> ). In regard to SCFA concentrations, lower levels of fecal acetic acid ( <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"> <e:mi>P</e:mi> <e:mo>=</e:mo> <e:mn>0.001</e:mn> </e:math> ) and propionic acid ( <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"> <g:mi>P</g:mi> <g:mo>=</g:mo> <g:mn>0.049</g:mn> </g:math> ) were found in poststroke subjects. Agathobacter was highly correlated with acetic acid level ( <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M5"> <i:mi>r</i:mi> <i:mo>=</i:mo> <i:mn>0.473</i:mn> </i:math> , <k:math xmlns:k="http://www.w3.org/1998/Math/MathML" id="M6"> <k:mi>P</k:mi> <k:mo>=</k:mo> <k:mn>0.002</k:mn> </k:math> ), whereas Fusobacteria ( <m:math xmlns:m="http://www.w3.org/1998/Math/MathML" id="M7"> <m:mi>r</m:mi> <m:mo>=</m:mo> <m:mo>−</m:mo> <m:mn>0.371</m:mn> </m:math> , <o:math xmlns:o="http://www.w3.org/1998/Math/MathML" id="M8"> <o:mi>P</o:mi> <o:mo>=</o:mo> <o:mn>0.018</o:mn> </o:math> ), Flavonifractor ( <q:math xmlns:q="http://www.w3.org/1998/Math/MathML" id="M9"> <q:mi>r</q:mi> <q:mo>=</q:mo> <q:mo>−</q:mo> <q:mn>0.334</q:mn> </q:math> , <s:math xmlns:s="http://www.w3.org/1998/Math/MathML" id="M10"> <s:mi>P</s:mi> <s:mo>=</s:mo> <s:mn>0.034</s:mn> </s:math> ), Desulfovibrio ( <u:math xmlns:u="http://www.w3.org/1998/Math/MathML" id="M11"> <u:mi>r</u:mi> <u:mo>=</u:mo> <u:mo>−</u:mo> <u:mn>0.362</u:mn> </u:math> , <w:math xmlns:w="http://www.w3.org/1998/Math/MathML" id="M12"> <w:mi>P</w:mi> <w:mo>=</w:mo> <w:mn>0.018</w:mn> </w:math> ), and Akkermansia ( <y:math xmlns:y="http://www.w3.org/1998/Math/MathML" id="M13"> <y:mi>r</y:mi> <y:mo>=</y:mo> <y:mo>−</y:mo> <y:mn>0.321</y:mn> </y:math> , <ab:math xmlns:ab="http://www.w3.org/1998/Math/MathML" id="M14"> <ab:mi>P</ab:mi> <ab:mo>=</ab:mo> <ab:mn>0.043</ab:mn> </ab:math> ) were negatively related to acetic acid levels. Additionally, the findings of the correlation analysis revealed that Akkermansia ( <cb:math xmlns:cb="http://www.w3.org/1998/Math/MathML" id="M15"> <cb:mi>r</cb:mi> <cb:mo>=</cb:mo> <cb:mo>−</cb:mo> <cb:mn>0.356</cb:mn> </cb:math> , <eb:math xmlns:eb="http://www.w3.org/1998/Math/MathML" id="M16"> <eb:mi>P</eb:mi> <eb:mo>=</eb:mo> <eb:mn>0.024</eb:mn> </eb:math> ), Desulfovibrio ( <gb:math xmlns:gb="http://www.w3.org/1998/Math/MathML" id="M17"> <gb:mi>r</gb:mi> <gb:mo>=</gb:mo> <gb:mo>−</gb:mo> <gb:mn>0.316</gb:mn> </gb:math> , <ib:math xmlns:ib="http://www.w3.org/1998/Math/MathML" id="M18"> <ib:mtext>P</ib:mtext> <ib:mo>=</ib:mo> <ib:mn>0.047</ib:mn> </ib:math> ), and Alloprevotella ( <kb:math xmlns:kb="http://www.w3.org/1998/Math/MathML" id="M19"> <kb:mi>r</kb:mi> <kb:mo>=</kb:mo> <kb:mo>−</kb:mo> <kb:mn>0.366</kb:mn> </kb:math> , <mb:math xmlns:mb="http://www.w3.org/1998/Math/MathML" id="M20"> <mb:mi>P</mb:mi> <mb:mo>=</mb:mo> <mb:mn>0.020</mb:mn> </mb:math> ) were significantly negatively correlated with high-density lipoprotein cholesterol. In addition, the Neurogenic Bowel Dysfunction score ( <ob:math xmlns:ob="http://www.w3.org/1998/Math/MathML" id="M21"> <ob:mi>r</ob:mi> <ob:mo>=</ob:mo> <ob:mn>0.495</ob:mn> </ob:math> , <qb:math xmlns:qb="http://www.w3.org/1998/Math/MathML" id="M22"> <qb:mi>P</qb:mi> <qb:mo>=</qb:mo> <qb:mn>0.026</qb:mn> </qb:math> ), Barthel index ( <sb:math xmlns:sb="http://www.w3.org/1998/Math/MathML" id="M23"> <sb:mi>r</sb:mi> <sb:mo>=</sb:mo> <sb:mo>−</sb:mo> <sb:mn>0.531</sb:mn> </sb:math> , <ub:math xmlns:ub="http://www.w3.org/1998/Math/MathML" id="M24"> <ub:mi>P</ub:mi> <ub:mo>=</ub:mo> <ub:mn>0.