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Review
. 2022 Nov 14;4(1):57.
doi: 10.1186/s42466-022-00222-8.

The gut-brain axis in ischemic stroke: its relevance in pathology and as a therapeutic target

Corinne Benakis  1 , Arthur Liesz  2   3
Affiliations
Review

The gut-brain axis in ischemic stroke: its relevance in pathology and as a therapeutic target

Corinne Benakis et al. Neurol Res Pract. .

Abstract

The gut contains the largest reservoir of microorganisms of the human body, termed as the gut microbiota which emerges as a key pathophysiological factor in health and disease. The gut microbiota has been demonstrated to influence various brain functions along the "gut-brain axis". Stroke leads to intestinal dysmotility and leakiness of the intestinal barrier which are associated with change of the gut microbiota composition and its interaction with the human host. Growing evidence over the past decade has demonstrated an important role of these post-stroke changes along the gut-brain axis to contribute to stroke pathology and be potentially druggable targets for future therapies. The impact of the gut microbiota on brain health and repair after stroke might be attributed to the diverse functions of gut bacteria in producing neuroactive compounds, modulating the host's metabolism and immune status. Therefore, a better understanding on the gut-brain axis after stroke and its integration in a broader concept of stroke pathology could open up new avenues for stroke therapy. Here, we discuss current concepts from preclinical models and human studies on the bi-directional communication along the microbiota-gut-brain axis in stroke.

Keywords: Brain ischemia; Gut; Inflammation; Metabolites; Microbiota; Stroke.

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Conflict of interest statement

A.L. is Principal Investigator of the PRISE study (NCT04954846) and received speaker honoraria from Institut AllergoSan and Nestle regarding research on microbiota in stroke. Beyond these, the authors declare that they have no competing financial interests regarding the work presented in this manuscript.

Figures

Fig. 1
Fig. 1
Microbiome-Gut-Brain axis in stroke. Current concept of the main pathways along the bidirectional gut-brain interaction. Here depicted are the 3 main pathways of brain to gut communication: (1) immune cells via the blood circulation, (2) vagus nerve axis and (3) systemically circulating bacterial metabolites released by the intestinal microbiota
Fig. 2
Fig. 2
Potential use of microbiota-targeted therapies for post-stroke recovery. The scheme highlights the potential use of microbiota-targeted therapies such as probiotic therapies as supplementary therapeutic strategies to improve recovery during the chronic phase after stroke. Despite promising preclinical results and first clinical trials, current data is not yet sufficient to prove efficacy of such interventions and to suggest specific compounds or treatment regimens
See this image and copyright information in PMC

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