{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T15:28:13Z","timestamp":1792250893699,"version":"4.4.0"},"reference-count":62,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Emerging evidence implicates gut microbiota dysbiosis in exacerbating stroke pathogenesis via the gut\u2010brain axis, suggesting novel therapeutic targets. While electroacupuncture (EA) demonstrates anti\u2010inflammatory effects through vagus nerve activation, its neuroprotective mechanisms via vagus nerve\u2013microbiota crosstalk remain unexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Rats with middle cerebral artery occlusion received daily ST36 (Acupoint Zusanli) EA for 1 to 7\u2009days postischemia. Subdiaphragmatic vagotomy and fecal microbiota transplant were implemented to validate pathway specificity. Multimodal assessments included longitudinal neurological scoring, infarct volume, systemic\/neuroinflammatory profiling (enzyme\u2010linked immunosorbent assay, immunohistochemistry), intestinal fucosylation dynamics (quantitative polymerase chain reaction, lectin staining), and 16S ribosomal RNA sequencing of gut microbiota.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      EA significantly improved neurological outcomes and reduced infarct volumes at 3 to 7\u2009days after middle cerebral artery occlusion (versus controls), which was abolished by vagotomy. Mechanistically, EA restored gut barrier integrity through vagus\u2010dependent upregulation of fucosyltransferase 2 (Fut2)\u2010driven epithelial \u03b11,2\u2010fucosylation, enhancing mucin 2+ goblet cell density and tight junction protein expression (ZO\u20101\/occludin\/claudin\u20101). Concurrent microbiota shifts included Lactobacillales\/Bacteroidales enrichment (linear discriminant analysis &gt;4.0) and pathobiont suppression, which was reversed by vagotomy. Crucially, fecal microbiota transplant from EA\u2010treated donors replicated neuroprotection in germ\u2010free recipients, achieving 33% infarct reduction and 30% survival improvement (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.012), whereas fecal microbiota transplant from vagotomized donors showed no therapeutic benefits.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">EA at ST36 produced neuroprotection through activating vagal efferent pathways to orchestrate intestinal mucosal repair via Fut2\u2010mediated fucosylation, which reshape microbial ecosystems and attenuate neuroinflammation. These findings establish a previously unrecognized vagus nerve\u2010gut\u2010brain axis mechanism for stroke recovery, positioning microbiota\u2010directed neuromodulation by EA as a translatable therapeutic strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.045929","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T11:20:01Z","timestamp":1762773601000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Electroacupuncture Alleviates Brain Injury Through Vagus Nerve Activation and Gut Microbiota in a Rat Model of Ischemic Stroke"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6130-6115","authenticated-orcid":false,"given":"Qian\u2010Kun","family":"Zhao","sequence":"first","affiliation":[{"name":"General Hospital of Northern Theater Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1805-8705","authenticated-orcid":false,"given":"Yue\u2010Xin","family":"Ning","sequence":"additional","affiliation":[{"name":"General Hospital of Northern Theater Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5855-8426","authenticated-orcid":false,"given":"Tian\u2010Ce","family":"Xu","sequence":"additional","affiliation":[{"name":"General Hospital of Northern Theater Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zi\u2010Ai","family":"Zhao","sequence":"additional","affiliation":[{"name":"General Hospital of Northern Theater Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2372-3343","authenticated-orcid":false,"given":"Yi\u2010Feng","family":"Pei","sequence":"additional","affiliation":[{"name":"General Hospital of Northern Theater Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing\u2010Yuan","family":"Niu","sequence":"additional","affiliation":[{"name":"General Hospital of Northern Theater Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5351-6457","authenticated-orcid":false,"given":"Xian\u2010Dong","family":"Li","sequence":"additional","affiliation":[{"name":"General Hospital of Northern Theater Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7486-1992","authenticated-orcid":false,"given":"Hui\u2010Sheng","family":"Chen","sequence":"additional","affiliation":[{"name":"General Hospital of Northern Theater Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00252-0"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102758"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01410-7"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2024.2500"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.122.038466"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.064053"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(16)00114-9"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.122.319983"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.121.036800"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-023-00890-0"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-323263"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1038\/nm.4068"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chom.2021.05.002"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-136-5-200203050-00010"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-023-36448-6"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.4103\/1673-5374.230272"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2024.108040"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-411545-3.00008-0"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/nm.3479"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2020.07.015"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-021-04290-9"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chom.2022.09.001"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.659656"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.26.4.627"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0024-3205(99)00038-7"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.17.3.472"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btr507"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1038\/nmeth.2276"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btr381"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jams.2013.06.013"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2017.03.023"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1142\/S0192415X15500883"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2021.03.022"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-med-042320-014032"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/procel\/pwad026"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.212704"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1306070110"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.1254009"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature13823"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1038\/ni.3587"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00338-20"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(19)30356-4"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-022-00581-2"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2024.1327630"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2024.1358525"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.935681"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1107559"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1142\/S0192415X22500409"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2012.32"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00018-021-03812-y"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature18848"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2006.08.019"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.celrep.2023.112754"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jep.2022.115281"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.123.044249"},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41577-024-01014-8"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12974-025-03419-1"},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41522-024-00556-y"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12974-022-02435-9"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-022-00737-2"},{"key":"e_1_3_2_62_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2022.1018371"},{"key":"e_1_3_2_63_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.119.316448"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.045929","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T10:52:33Z","timestamp":1779792753000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.045929"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,6]]},"references-count":62,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,6]]}},"alternative-id":["10.1161\/JAHA.125.045929"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.045929","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,6]]},"assertion":[{"value":"2025-08-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e045929"}}