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Stroke - disturbance of intestinal mucosal barrier function

Darina Georgieva-Hristova


The incidence of sudden death after stroke varies from 2% to 6%, and two leading non-neurological causes are heart function disorders and infections. Acute brain injury induces various autonomic, neuro-endocrine and inflammatory changes which are manifested in certain organs in the body, leading to immunosuppression and development of inflammatory complications.
The intestinal microbiota plays a key role in the maintenance of homeostasis, such as distortions in its regulation may result in severe inflammatory diseases. Immune depression following stroke, affects the intestinal mucosa and lead to distortion of its barrier function, which can lead to increased bacterial translocation, septicemia and systemic infections. It is believed to be a cytokine-mediated anti-inflammatory response to pathogenic factor in the development of infections after stroke. Peptococcaceae levels in stroke, increasing more than three times. These changes in colonic microflora associated with increased levels of norepinephrine and noradrenergic innervation.


stroke, gut, inflammation, microbiota.

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Dorrance AM, Fink G. Effects of Stroke on the Autonomic Nervous System.Compr Physiol. 2015 Jul 1;5(3):1241-63

Manea MM, Comsa M, Minca A, Dragos D- Popa Constantin Brain-heart axis - Review Article Journal of Medicine and Life Vol. 8, Issue 3, July-September 2015, pp.266-271

Nichols M, Townsend N, Luengo-Fernandez R, Leal J, Gray A, Scarborough P, Rayner M. European Cardiovascular Disease Statistics. 2012, European Heart Network, Brussels, European Society of Cardiology, Sophia Antipolis, 10

De Raedt S, De Vos A, De Keyser J Autonomic dysfunction in acute ischemic stroke: an underexplored therapeutic area? J Neurol Sci. 2015 Jan 15;348(1-2):24-34

Boehme, A.K., Kumar, A.D., Dorsey, A.M., Siegler, J.E., Aswani, M.S., Lyerly, M.J. et al, Infections present on admission compared with hospital-acquired infections in acute ischemic stroke patients. J Stroke Cerebrovasc Dis. 2013;22:e582-e589.

Ionita, C.C., Siddiqui, A.H., Levy, E.I., Hopkins, L.N., Snyder, K.V., Gibbons, K.J. Acute ischemic stroke and infections. J Stroke Cerebrovasc Dis. 2011;20:1-9.

Chamorro, A., Urra, X., Planas, A.M. Infection after acute ischemic stroke: a manifestation of brain-induced immunodepression. Stroke. 2007;38:1097-1103

Prass, K., Meisel, C., Höflich, C., Braun, J., Halle, E., Wolf, T. et al, Stroke-induced immunodeficiency promotes spontaneous bacterial infections and is mediated by sympathetic activation reversal by poststroke T helper cell type 1-like immunostimulation. J Exp Med. 2003;198:725-736.

Schulte-Herbrüggen, O., Quarcoo, D., Meisel, A., Meisel, C. Differential affection of intestinal immune cell populations after cerebral ischemia in mice. Neuroimmunomodulation. 2009;16:213-218.

Tascilar, N., Irkorucu, O., Tascilar, O., Comert, F., Eroglu, O., Bahadir, B. et al, Bacterial translocation in experimental stroke: what happens to the gut barrier?. Bratisl Lek Listy. 2010;111:194-199.

Flint, H.J., Scott, K.P., Louis, P., Duncan, S.H., 2012. The role of the gut microbiota in nutrition and health. Nat. Rev. Gastroenterol. Hepatol. 9, 577-589.

Wu, G.D. et al., 2011. Linking long-term dietary patterns with gut microbial enterotypes. Science (80-) 334, 105-108.

Spor, A., Koren, O., Ley, R., 2011. Unravelling the effects of the environment and host genotype on the gut microbiome. Nat. Rev. Microbiol. 9, 279-290.

Ganal, S.C. et al., 2012. Priming of natural killer cells by nonmucosal mononuclear phagocytes requires instructive signals from commensal microbiota. Immunity 37, 171-186.

Abt, M.C. et al., 2012. Commensal bacteria calibrate the activation threshold of innate antiviral immunity. Immunity 37, 158-170.

Ayres, J.S., Trinidad, N.J., Vance, R.E., 2012. Lethal inflammasome activation by a multidrug-resistant pathobiont upon antibiotic disruption of the microbiota. Nat. Med. 18, 799-806.

Dupont, A.W., Dupont, H.L., 2011. The intestinal microbiota and chronic disorders of the gut. Nat. Rev. Gastroenterol. Hepatol. 8, 523-531.

Le Chatelier, E. et al., 2013. Richness of human gut microbiome correlates with metabolic markers. Nature 500, 541-546.

Yoshimoto, S. et al., 2013. Obesity-induced gut microbial metabolite promotes liver cancer through senescence secretome. Nature 499, 97-101

Kang, D.-W. et al., 2013. Reduced incidence of Prevotella and other fermenters in intestinal microflora of autistic children. PLoS One 8, e68322

Hsiao, E.Y. et al., 2013. Microbiota modulate behavioral and physiological abnormalities associated with neurodevelopmental disorders. Cell 155, 1451-1463.

Luczynski, P. et al., 2016. Growing up in a bubble: using germ-free animals to assess the influence of the gut microbiota on brain and behaviour. Int. J. Neuropsychopharmacol., pyw020 101093/ijnp/pyw020.

Dirnagl, U. et al., 2007. Stroke-induced immunodepression: experimental evidence and clinical relevance. Stroke 38, 770-773.

Hetze, S. et al., 2013. Superiority of preventive antibiotic treatment compared with standard treatment of poststroke pneumonia in experimental stroke: a bed to bench approach. J. Cereb. Blood Flow Metab. 33, 846-854

de Jonge, W.J., 2013. The gut`s little brain in control of intestinal immunity. ISRN Gastroenterol. 2013 630159

Denes, A., Thornton, P., Rothwell, N.J., Allan, S.M., 2010. Inflammation and braininjury: acute cerebral ischaemia, peripheral and central inflammation. Brain Behav. Immun. 24, 708-723.

A. Houlden , M. Goldrick , D. Brough , E.S. Vizi , N. Lénárt , B. Martinecz , I.S. Roberts A. Denes Brain injury induces specific changes in the caecal microbiota of mice via altered autonomic activity and mucoprotein production, Behavior and Immunity 57 (2016) 10-20

Gu, S. et al., 2013. Bacterial community mapping of the mouse gastrointestinal tract. PLoS One 8, e74957,

Mejía-León, M.E., Petrosino, J.F., Ajami, N.J., Domínguez-Bello, M.G., de la Barca, A.M.C., 2014. Fecal microbiota imbalance in Mexican children with type 1 diabetes.Sci. Rep. 4, 3814.

Lyte, M., Bailey, M.T., 1997. Neuroendocrine-bacterial interactions in a neurotoxininduced model of trauma. J. Surg. Res. 70, 195-201

Millen, J.E., Glauser, F.L., Fairman, R.P., 1985. A comparison of physiologicalresponses to percussive brain trauma in dogs and sheep. J. Neurosurg. 62, 587-591

O`Mahony, S.M. et al., 2009. Early life stress alters behavior, immunity, and microbiota in rats: implications for irritable bowel syndrome and psychiatric illnesses. Biol. Psychiatry 65, 263-267.

Kim, Y.S., Ho, S.B., 2010. Intestinal goblet cells and mucins in health and disease: recent insights and progress. Curr. Gastroenterol. Rep. 12, 319-330

Korpelainen, J.T., Sotaniemi, K.A., Myllylä, V.V., 1999. Autonomic nervous system disorders in stroke. Clin. Auton. Res. 9, 325-333

Hilz, M.J. et al., 2011. High NIHSS values predict impairment of cardiovascular autonomic control. Stroke 42, 1528-1533.



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