{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T10:09:11Z","timestamp":1780567751157,"version":"3.54.1"},"reference-count":100,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Microbiome studies in post-stroke cognitive impairment (PSCI) have focused on the gut, while upstream oral dysbiosis and oral\u2013gut axis signatures remain undercharacterized. We profiled paired oral and gut microbiota in PSCI to assess coordinated alterations and cross-site associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center cross-sectional study enrolled 133 post-stroke participants (64 PSCI). Paired tongue-coating and fecal samples underwent 16S rRNA gene sequencing. We compared \u03b1\/\u03b2 diversity, taxonomic composition, and predicted functional pathways at both sites, quantified within-individual oral\u2013gut dissimilarity and the gut fraction of oral\u2013gut shared microbiota, and adapted an oral enrichment score (OES) to index gut \u201coralization\u201d. Differential microbiota, predicted pathways, and MMSE\/MoCA scores were integrated into a multi-layer association framework. Machine-learning models were built using oral features, gut features, and combined oral\u2013gut features, with SHAP for interpretability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PSCI showed reduced oral richness (ACE\/Chao1) and reduced gut diversity\/evenness (Shannon\/Simpson), with significant \u03b2-diversity differences at both sites. Oral commensals (\n                      <jats:italic>Leptotrichia<\/jats:italic>\n                      ,\n                      <jats:italic>Neisseria<\/jats:italic>\n                      ) were depleted, whereas opportunistic taxa (\n                      <jats:italic>Pseudomonas<\/jats:italic>\n                      ,\n                      <jats:italic>Alloprevotella<\/jats:italic>\n                      ,\n                      <jats:italic>Streptococcus<\/jats:italic>\n                      ) were enriched. In the gut, SCFA-associated microbiota (\n                      <jats:italic>Coprococcus<\/jats:italic>\n                      ,\n                      <jats:italic>Faecalibacterium<\/jats:italic>\n                      ,\n                      <jats:italic>Ruminococcus<\/jats:italic>\n                      ) decreased, while Gram-negative potential pathogens (\n                      <jats:italic>Enterobacter<\/jats:italic>\n                      ,\n                      <jats:italic>Pseudomonas<\/jats:italic>\n                      ,\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      ) increased. Tax4Fun2-based inference suggested predicted gut functional alterations involving lipopolysaccharide biosynthesis potential and tryptophan metabolism-related pathways. Oral\u2013gut metrics supported stronger oral\u2013gut association in PSCI, including lower paired dissimilarity, a higher shared-genera fraction, and elevated OES (median 0.0368 vs 0.0142), mainly driven by oral-dominant microbiota (\n                      <jats:italic>Streptococcus<\/jats:italic>\n                      ,\n                      <jats:italic>Fusobacterium<\/jats:italic>\n                      ,\n                      <jats:italic>Veillonella and Haemophilus<\/jats:italic>\n                      ). Combined oral\u2013gut features showed the most favorable exploratory test-set performance (XGBoost AUC 0.945; average precision 0.943).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PSCI was associated with coordinated oral and gut dysbiosis, characterized by loss of commensals, enrichment of opportunistic or Gram-negative taxa, and a stronger gut oralization signal reflected by reduced oral\u2013gut dissimilarity and elevated OES. Tax4Fun2 suggested predicted functional potential related to lipopolysaccharide biosynthesis and tryptophan metabolism, while combined oral\u2013gut features showed favorable exploratory internal discrimination of PSCI. These findings require validation in larger longitudinal multi-omics cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1851811","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T09:50:44Z","timestamp":1780566644000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Oral and gut microbiota dysbiosis with strengthened oral\u2013gut connectivity in post-stroke cognitive impairment"],"prefix":"10.3389","volume":"17","author":[{"given":"Xuetong","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Shijiazhuang People\u2019s Hospital","place":["Shijiazhuang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanping","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Traditional Chinese Medicine Hospital of Shijiazhuang","place":["Shijiazhuang, 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