Dysbiosis of Gut microbiota in patients with Large-Artery Atherosclerotic Stroke: a pilot study

Introduction Increasing data demonstrate an association between gut microbiome in brain diseases via the gut-brain axis. However, few studies have evaluated the association between gut microbiome and large-artery atherosclerotic ischemic stroke patients. Method A cross-sectional pilot study was conducted among 15 patients with large-artery atherosclerotic ischemic stroke and 15 asymptomatic persons. Large-artery atherosclerotic stroke were diagnosed using TOAST classification. The control group was selected based on age- and sex-match with the patient group. Participants provided a stool sample profiled by 16S-ribosomal gene-specific methods Next-generation sequencing. The Mann-Whitney U test was used to compare the differences in gut microbiota profile between stroke and control groups. Alpha (Shannon diversity index) and beta diversity (Bray-Curtis dissimilarity) were used to evaluate gut microbial diversity. Generalized linear mixed effects models were used to relate gut microbial genus and stroke which were adjusted for age, BMI, underlying disease (diabetes, hypertension and dyslipidemia), and alcohol use. Result The average age of stroke patients was 61.1±7.1 and 59.2±8.2 in the control group. Beta-diversity (Bray-Curtis dissimilarity) of the gut microbiome was statistically significant in order, family and genus level (P-value=0.017, 0.011 and 0.003, respectively) between stroke and control groups; however, there was no statistically significant difference in alpha-diversity (Shannon diversity index; P-value=0.852). The relative abundance of Class Bacteriodia increased in stroke group. Using generalized linear mix effect model, we found 6 genera was significantly associated with stroke after multivariate adjustment. Ruminococcus spp .(P-value=0.017), Streptococcus spp .(P-value=0.019), Actinomyces spp .(P-value=0.02) and Dorea spp .(P-value=0.021) showed positive association while Bifidobacterium spp .(P-value=0.04) and Faecalibacterium spp .(P-value=0.041) showed negatively association with stroke. Conclusion Patients with large-artery atherosclerotic stroke had a decreased microbiome beta-diversity and certain gut microbiota genera may be related to large-artery atherosclerotic stroke. Future implications of this study could include the development of targeted interventions to modulate gut microbiota in order to improve outcomes for patients with large-artery atherosclerotic stroke.