Objective To explore the effect of enteral nutrition on gut microbiota for ischemic stroke. Methods From March to April, 2017, 121 patients with convalescent ischemic stroke were enrolled. The patients received routine rehabilitation combing with 1-week enteral nutrition. The patients' fresh feces and blood samples were obtained at admission, one week and one month after the enteral nutrition, while nutritional status was assessed with Nutrition Risk Screening (NRS2002). Cytokines, including tumor necrosis factor (TNF) -α, interleukin (IL)-1α, IL-1β, IL-6 and IL-8 were tested with ELISA. Ten patients were tested with 16S rDNA Illumina HiSeq/MiSeq for gut microbiota alterations. Results The scores of NRS2002 decreased (P < 0.05), the level of serum IL-1β and IL-6 raised, while the level of IL-8 dropped one month after enteral nutrition (P < 0.05). In addition, the enteral nutrition altered the dominant bacterial community, and alleviated the diversity and species richness of bacteria, while the difference was statistically significant one week after enteral nutrition. Conclusion Enteral nutrition can alter gut microbiota to facilitate to recover ischemic stroke.
FAN Chun-jiang, LIU Ting-yu, LI Gang, HUANG Jian, CAO Yang, DANG Yi-ni
. Effect of Enteral Nutrition on Intestinal Flora in Patients with Ischemic Stroke[J]. Chinese Journal of Rehabilitation Theory and Practice, 2019
, 25(7)
: 822
-827
.
DOI: 10.3969/j.issn.1006-9771.2019.07.016
1 GoldsteinL B, BushnellC D, AdamsR J, et al. Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association [J]. Stroke, 2011, 42(2): 517-584.
2 GreenA R. Pharmacological approaches to acute ischaemic stroke: reperfusion certainly, neuroprotection possibly [J]. Br J Pharmacol, 2018, 153(Suppl 1): S325-S338.
3 WangY, CuiL, JiX, et al. The China National Stroke Registry for patients with acute cerebrovascular events: design, rationale, and baseline patient characteristics [J]. Int J Stroke, 2011, 6(4): 355-361.
4 王少石,郑天衡,陈真理,等. 早期肠内营养治疗对急性组中近期预后的影响[J]. 中华内科杂志, 2007, 46(5): 366-369.
5 FujishimaI. Rehabilitation for swallowing disorders associated with stroke [M]. 2nd ed. Tokyo: Ishiyaku Publishers Inc., 1998.
6 中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组. 中国急性缺血性脑卒中诊治指南2010[J]. 中华神经科杂志, 2010, 43(2): 146-153.
7 H P JrAdams, del ZoppoG, AlbertsM J, et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists [J]. Circulation, 2007, 115(20): e478-e534.
8 BeamerN B, CoullB M, ClarkW M, et al. Interleukin-6 and interleukin-1 receptor antagonist in acute stroke [J]. Ann Neurol, 1995, 37(6): 800-805.
9 DávalosA, RicartW, Gonzalez-HuixF, et al. Effect of malnutrition after acute stroke on clinical outcome [J]. Stroke, 1996, 27(6): 1028-1032.
10 ClaessonM J, JefferyI B, CondeS, et al. Gut microbiota composition correlates with diet and health in the elderly [J]. Nature, 2012, 488(7410): 178-184.
11 GoyalM S, VenkateshS, MilbrandtJ, et al. Feeding the brain and nurturing the mind: Lingking nutrition and the gut microbiota to brain development [J]. Proc Natl Acad Sci U S A. 2015, 112(46): 14105-14112.
12 SinghV, RothS, LloveraG, et al. Microbiota dysbiosis controls the neuroinflammatory response after stroke [J]. J Neurosci, 2016, 36(28): 7428-7440.
13 KostulasN, Kivis?kkP, HuangY, et al. Ischemic stroke is associated with a systemic increase of blood mononuclear cells expressing interleukin-8 mRNA [J]. Stroke, 1998, 29(2): 462-466.
14 KimJ S. Cytokines and adhesion molecules in stroke and related diseases [J]. J Neurol Sci, 1996, 137(2): 69-78.
15 FassbenderK, RossolS, KammerT, et al. Proinflammatory cytokines in serum of patients with acute cerebral ischemia: kinetics of secretion and relation to the extent of brain damage and outcome of disease [J]. J Neurol Sci, 1994, 122(2): 135-139.