The Influence of Gut Dysbiosis in the Pathogenesis and Management of Ischemic Stroke
Saravana Babu Chidambaram,
Annan Gopinath Rathipriya,
Arehally M. Mahalakshmi,
Sonali Sharma,
Tousif Ahmed Hediyal,
Bipul Ray,
Tuladhar Sunanda,
Wiramon Rungratanawanich,
Rajpal Singh Kashyap,
M. Walid Qoronfleh,
Musthafa Mohamed Essa,
Byoung-Joon Song,
Tanya M. Monaghan
Affiliations
Saravana Babu Chidambaram
Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru 570015, Karnataka, India
Annan Gopinath Rathipriya
Food and Brain Research Foundation, Chennai 600094, Tamil Nadu, India
Arehally M. Mahalakshmi
Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru 570015, Karnataka, India
Sonali Sharma
Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru 570015, Karnataka, India
Tousif Ahmed Hediyal
Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru 570015, Karnataka, India
Bipul Ray
Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru 570015, Karnataka, India
Tuladhar Sunanda
Department of Pharmacology, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru 570015, Karnataka, India
Wiramon Rungratanawanich
Section of Molecular Pharmacology and Toxicology, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD 20892, USA
Rajpal Singh Kashyap
Research Centre, Dr G. M. Taori Central India Institute of Medical Sciences (CIIMS), Nagpur 440 010, Maharashtra, India
M. Walid Qoronfleh
Q3CG Research Institute (QRI), Research & Policy Division, 7227 Rachel Drive, Ypsilanti, MI 48917, USA
Musthafa Mohamed Essa
Department of Food Science and Nutrition, CAMS, Sultan Qaboos University, Muscat 123, Oman
Byoung-Joon Song
Section of Molecular Pharmacology and Toxicology, Laboratory of Membrane Biochemistry and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, MD 20892, USA
Tanya M. Monaghan
National Institute for Health Research Nottingham Biomedical Research Centre, University of Nottingham, Nottingham NG7 2UH, UK
Recent research on the gut microbiome has revealed the influence of gut microbiota (GM) on ischemic stroke pathogenesis and treatment outcomes. Alterations in the diversity, abundance, and functions of the gut microbiome, termed gut dysbiosis, results in dysregulated gut–brain signaling, which induces intestinal barrier changes, endotoxemia, systemic inflammation, and infection, affecting post-stroke outcomes. Gut–brain interactions are bidirectional, and the signals from the gut to the brain are mediated by microbially derived metabolites, such as trimethylamine N-oxide (TMAO) and short-chain fatty acids (SCFAs); bacterial components, such as lipopolysaccharide (LPS); immune cells, such as T helper cells; and bacterial translocation via hormonal, immune, and neural pathways. Ischemic stroke affects gut microbial composition via neural and hypothalamic–pituitary–adrenal (HPA) pathways, which can contribute to post-stroke outcomes. Experimental and clinical studies have demonstrated that the restoration of the gut microbiome usually improves stroke treatment outcomes by regulating metabolic, immune, and inflammatory responses via the gut–brain axis (GBA). Therefore, restoring healthy microbial ecology in the gut may be a key therapeutic target for the effective management and treatment of ischemic stroke.
