中风是一种毁灭性疾病,是全球第二大死亡和残疾原因。多项研究表明,上呼吸道感染(PI)与急性缺血性中风(AIS)密切相关。然而,临床意义和潜在的病理机制仍不清楚.
■在这项研究中,16SrRNA基因测序用于比较有或没有PI的AIS患者和正常对照(NCs;每个30例)的口咽和肠道菌群的结构特征。并检测全身炎症标志物,以探讨上呼吸道感染(URTIs)与随后卒中严重程度和功能转归之间的关系及潜在机制.
■我们发现AIS-PI患者血清白细胞升高,NE,CRP,和Hcy水平,以及更高的90天mRS评分。口咽和肠道菌群分析表明,AIS和AIS-PI患者依次表现出微生物丰富度增加。微生物群的主坐标分析表明,三组之间的微生物群组成存在显着差异。在AIS-PI患者中,Megamonas,Megasphaera,RuminoccaceaeUCG004,Rothia,和链球菌在肠道中显著富集。机会性病原体,包括Thermus,未培养的Veillonellasp.,和东方细菌,被发现在口咽中明显富集。失调的微生物群与全身炎症标志物呈正相关。中风严重程度,预后不良。相比之下,产生短链脂肪酸的细菌艾森伯氏菌,细菌NLAE,镰刀菌,Ruminocycaceae,和粪杆菌在NC中富集。它们的丰度与全身炎症标志物呈负相关,卒中严重程度和预后不良。
■我们的研究结果表明,上呼吸道的PI可能通过引起口咽和肠道微生物群的紊乱并促进全身炎症水平的升高,从而导致AIS患者的短期功能预后不良。
UNASSIGNED: Stroke is a devastating disease and ranks as the second leading cause of death and disability globally. Several studies have shown that preceding infection (PI) of upper respiratory tract are strongly associated with acute ischemic stroke (AIS). However, the clinical implications and underlying pathological mechanisms remain unclear.
UNASSIGNED: In this study, 16S rRNA gene sequencing was employed to compare the structural characteristics of oropharyngeal and gut microbiota in AIS patients with or without PI and normal controls (NCs; 30 cases each), and systemic inflammatory markers were detected to explore the relationship between upper respiratory tract infections (URTIs) and subsequent stroke severity and functional outcome and the potential mechanism.
UNASSIGNED: We found that patients with AIS-PI exhibited elevated serum WBC, NE, CRP, and Hcy levels, as well as a higher 90-day mRS score. Oropharyngeal and gut microbiota analysis showed that AIS and AIS-PI patients exhibited increased microbial richness in sequence. Principal coordinate analysis of the microbiota demonstrated significant differences in microbiota composition among the three groups. In AIS-PI patients, Megamonas, Megasphaera, Ruminococcaceae UCG 004, Rothia, and Streptococcus were significantly enriched in the gut. Opportunistic pathogens, including Thermus, uncultured Veillonella sp., and Oribacterium sinu, were found to be significantly enriched in the oropharynx. The dysregulated microbiota were positively correlated with systemic inflammatory markers, stroke severity, and poor prognosis. In contrast, short-chain fatty acid-producing bacteria Eisenbergiella, bacterium NLAE, Fusicatenibacter, Ruminococcaceae, and Faecalibacterium were enriched in NCs. Their abundances were negatively correlated with systemic inflammatory markers, stroke severity and poor prognosis.
UNASSIGNED: Our findings suggest that PIs of the upper respiratory tract may contribute to poor short-term functional outcome in AIS patients by causing disturbance of the oropharyngeal and gut microbiota and promoting elevated systemic inflammation levels.