Gut microbiota dysbiosis and neurological function recovery after intracerebral hemorrhage: an analysis of clinical samples
Authors: Wang Yan , Bing Hailong , Jiang Conghui , Wang Jie , Wang Xuan , Xia Zhengyuan , Chu Qinjun 
Published: September 2024

ABSTRACT

We aimed to investigate the microbial community composition in patients with intracerebral hemorrhage (ICH) and its effect on prognosis. We designed two clinical cohort studies to explore the gut dysbiosis after ICH and their relationship with neurological function prognosis. First, fecal samples from patients with ICH at three time points: T1 (within 24 h of admission), T2 (3 days after surgery), and T3 (7 days after surgery), and healthy volunteers were subjected to 16S rRNA sequencing using Illumina high-throughput sequencing technology. When differential gut microbiota was identified, the correlation between clinical indicators and microbiotas was analyzed. Subsequently, the patients with ICH were categorized into GOOD and POOR groups based on their Glasgow Outcome Scale Extended (GOS-E) score, and the disparities in gut microbiota between the two groups were assessed. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors. The composition and diversity of the gut microbiota in patients with ICH were different from those in the control group and changed dynamically with the extension of the course of cerebral hemorrhage. The abundances of
Enterococcaceae
,
Clostridiales incertae sedis XI
, and
Peptoniphilaceae
were significantly increased in patients with ICH, whereas
Bacteroidaceae
,
Ruminococcaceae
,
Lachnospiraceae
, and
Veillonellaceae
were significantly reduced. The relative abundance of
Enterococcus
gradually increased with the extension of the duration of ICH after surgery, and the abundance of
Bacteroides
gradually decreased. The abundance of
Enterococcus
before surgery was found to be negatively associated with patient neurological function prognosis. The original ICH score and
Lachnospiraceae
status were independent risk factors for predicting the prognosis of neurological function in patients with ICH (
P
< 0.05). Changes in the gut microbiota diversity in patients with ICH were related to prognosis.
Lachnospiraceae
may have a protective effect on prognosis.

IMPORTANCE

Acute central nervous system injuries like hemorrhagic stroke are major global health issues. While surgical hematoma removal can alleviate brain damage, severe cases still have a high 1-month mortality rate of up to 40%. Gut microbiota significantly impacts health, and treatments like fecal microbiota transplantation (FMT) and probiotics can improve brain damage by correcting gut microbiota imbalances caused by ischemic stroke. However, few clinical studies have explored this relationship in hemorrhagic stroke. This study investigated the impact of cerebral hemorrhage on the composition of gut microbiota, and we found that
Lachnospiraceae
were the independent risk factors for poor prognosis in intracerebral hemorrhage (ICH). The findings offer potential insights for the application of FMT in patients with ICH, and it may improve the prognosis of patients.