Persistent gut microbiota alterations after ischemic stroke are modifiable by probiotic intervention
- 1Institute for Stroke and Dementia Research (ISD), LMU University Hospital, LMU Munich
Abstract
The gut-brain axis has emerged as a critical modulator in neurological diseases, including stroke. While acute post-stroke dysbiosis is well established, it remains unclear whether these alterations persist long-term and can be therapeutically modulated. This study addresses this gap through integrated metagenomic and metabolomic profiling in two independent clinical stroke cohorts, complemented by experimental models. Experimental stroke induced persistent changes in gut microbiota composition and altered short-chain fatty acid profiles. In patients, microbiota composition remained distinct from controls up to three months after ischemic stroke or transient ischemic attack (TIA), accompanied by persistent reductions in propionic and valeric acid and reduced abundance of Prevotella-associated microbial signatures. We performed a randomized, double-blind interventional trial (PRISE) testing a multispecies probiotic versus placebo, using household members as additional controls. Probiotic intervention led to microbiome compositional changes with increased abundance of beneficial taxa and significantly improved functional recovery. The tested probiotic strains showed anti-inflammatory and antioxidant effects in vitro. These findings suggest that targeted modulation of the microbiome represents a promising therapeutic avenue to improve chronic stroke recovery, warranting validation in larger Phase III clinical trials.
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BibTeX
@misc{melton2026persistent,
title = {{Persistent gut microbiota alterations after ischemic stroke are modifiable by probiotic intervention}},
author = {P. Melton and A. Sorbie and V. T. E. Aho and C. Haslinger and M. Zimmermann and W. Marut and C. Jaeger and P. Wilmes and C. Benakis and A. Liesz},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.15.26365107},
url = {https://www.medrxiv.org/content/10.64898/2026.10.15.26365107v1},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - Persistent gut microbiota alterations after ischemic stroke are modifiable by probiotic intervention
AU - P. Melton
AU - A. Sorbie
AU - V. T. E. Aho
AU - C. Haslinger
AU - M. Zimmermann
AU - W. Marut
AU - C. Jaeger
AU - P. Wilmes
AU - C. Benakis
AU - A. Liesz
PY - 2026
DA - 2026/10/15
PB - medRxiv
DO - 10.64898/2026.10.15.26365107
UR - https://www.medrxiv.org/content/10.64898/2026.10.15.26365107v1
AB - The gut-brain axis has emerged as a critical modulator in neurological diseases, including stroke. While acute post-stroke dysbiosis is well established, it remains unclear whether these alterations persist long-term and can be therapeutically modulated. This study addresses this gap through integrated metagenomic and metabolomic profiling in two independent clinical stroke cohorts, complemented by experimental models. Experimental stroke induced persistent changes in gut microbiota composition and altered short-chain fatty acid profiles. In patients, microbiota composition remained distinct from controls up to three months after ischemic stroke or transient ischemic attack (TIA), accompanied by persistent reductions in propionic and valeric acid and reduced abundance of Prevotella-associated microbial signatures. We performed a randomized, double-blind interventional trial (PRISE) testing a multispecies probiotic versus placebo, using household members as additional controls. Probiotic intervention led to microbiome compositional changes with increased abundance of beneficial taxa and significantly improved functional recovery. The tested probiotic strains showed anti-inflammatory and antioxidant effects in vitro. These findings suggest that targeted modulation of the microbiome represents a promising therapeutic avenue to improve chronic stroke recovery, warranting validation in larger Phase III clinical trials.
ER -