Gut microbiota and cerebrovascular diseases

Kazuo Yamashiro¹⁾, Takao Urabe²⁾, Nobutaka Hattori¹⁾

¹⁾Department of Neurology, Juntendo University School of Medicine
²⁾Department of Neurology, Juntendo University Urayasu Hospital

The human gut harbors trillions of microbes that affect the host’s health. Accumulating evidence suggests that gut dysbiosis, an imbalance of gut microbiota, is associated with risk factors for cerebrovascular disease, such as hypertension, type 2 diabetes, dyslipidemia, and systemic inflammation. Gut microbiota also directly promotes atherosclerosis through the production of trimethylamine-N-oxide （TMAO）. Furthermore, elevated plasma TMAO levels present an increased risk of cardiovascular complications including stroke. Lately, a special focus has been placed on the gut-brain axis in ischemic stroke pathophysiology. Moreover, gut microbiota has been implicated in ischemic brain injury via the regulation of intestinal T-cells. Stroke causes specific gut microbiota changes by altering the autonomic activity and promotes the translocation and dissemination of bacteria from the host’s gut, leading to post-stroke infection. Targeting gut microbiota might be a novel potential therapeutic strategy to improve outcomes following cerebrovascular diseases.

Address correspondence to Dr. Kazuo Yamashiro, Department of Neurology, Juntendo University School of Medicine （2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan）