{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:18:39Z","timestamp":1788153519075,"version":"build-2803163510"},"reference-count":77,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"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. Aging Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Clinical and epidemiological evidence suggests a link between gut microbiota and ischemic stroke severity as well as outcomes, yet inconsistent findings and unclear mechanisms underscore the need for a systematic synthesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We systematically reviewed and meta-analyzed observational studies linking gut microbiota to ischemic stroke, following PRISMA guidelines. The search covered PubMed, Embase, and the Cochrane Library, with animal studies and\n                      <jats:italic>in vitro<\/jats:italic>\n                      studies excluded. Two reviewers independently screened the literature, extracted data, and assessed study quality via the Newcastle\u2013Ottawa Scale. We conducted random-effects meta-analyses using RevMan 5.3. Heterogeneity was quantified with the\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistic, and publication bias was assessed. Subgroup analyses were conducted to examine influential factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From 17,281 initially identified records, 59 studies involving 7,463 patients were included in the final analysis. Although \u03b1-diversity measures\u2014including Shannon, Chao1, ACE, Simpson index, and observed species richness\u2014did not differ significantly between ischemic stroke patients and controls (all\n                      <jats:italic>p<\/jats:italic>\n                      &amp;gt;\u202f0.05), subgroup analyses indicated that observed species richness (95% CI [\u22120.80, \u22120.13],\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.006) was notably altered in patients with cognitive impairment, and the Chao1 index (95% CI [0.01, 0.37],\n                      <jats:italic>p<\/jats:italic>\n                      = 0.04) was significantly changed in those with mood disorders. Microbial composition analysis revealed no significant differences at the phylum level. However, at the family level, stroke patients exhibited a higher abundance of\n                      <jats:italic>Enterobacteriaceae<\/jats:italic>\n                      and lower levels of\n                      <jats:italic>Lachnospiraceae<\/jats:italic>\n                      and\n                      <jats:italic>Prevotellaceae<\/jats:italic>\n                      . At the genus level, these patients exhibited higher levels of\n                      <jats:italic>Pseudomonas<\/jats:italic>\n                      and\n                      <jats:italic>Streptococcus<\/jats:italic>\n                      , along with reduced abundances of\n                      <jats:italic>Akkermansia<\/jats:italic>\n                      ,\n                      <jats:italic>Bacteroides<\/jats:italic>\n                      ,\n                      <jats:italic>Coprococcus<\/jats:italic>\n                      , and\n                      <jats:italic>Roseburia<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ischemic stroke is characterized by taxonomic gut dysbiosis, whereas a decrease in \u03b1-diversity is observed only in patients who also develop cognitive impairment and mood disorders after stroke. Future multi-omics and large cohort studies should establish causality between gut microbiota and ischemic stroke, identifying therapeutic targets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42024506656<\/jats:ext-link>\n                      , Identifier: CRD42024506656.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnagi.2026.1914614","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:28:55Z","timestamp":1788150535000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The gut microbiota dysbiosis in ischemic stroke: a systematic review and meta-analysis of microbial diversity and taxonomic alterations"],"prefix":"10.3389","volume":"18","author":[{"given":"Heng","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Neurology, Second People\u2019s Hospital of Yibin City-West China Yibin Hospital, Sichuan University","place":["Yibin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Second People\u2019s Hospital of Yibin City-West China Yibin Hospital, Sichuan University","place":["Yibin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Second People\u2019s Hospital of Yibin City-West China Yibin Hospital, Sichuan University","place":["Yibin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Second People\u2019s Hospital of Yibin City-West China Yibin Hospital, Sichuan University","place":["Yibin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"He","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Second People\u2019s Hospital of Yibin City-West China Yibin Hospital, Sichuan University","place":["Yibin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiagui","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Second People\u2019s Hospital of Yibin City-West China Yibin Hospital, Sichuan University","place":["Yibin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1177\/15459683241252608","article-title":"Relationship between the gut microbiota and neurological deficits in patients with cerebral ischemic stroke","volume":"38","author":"Bao","year":"2024","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"871720","DOI":"10.3389\/fncel.2022.871720","article-title":"Novel mechanisms and therapeutic targets for ischemic stroke: a focus on gut microbiota","volume":"16","author":"Bao","year":"2022","journal-title":"Front. Cell. Neurosci."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1234","DOI":"10.1038\/s41591-019-0504-5","article-title":"Healthspan and lifespan extension by fecal microbiota transplantation into progeroid mice","volume":"25","author":"B\u00e1rcena","year":"2019","journal-title":"Nat. Med."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"17562864251319870","DOI":"10.1177\/17562864251319870","article-title":"Crosstalk between the gut microbiota and brain network topology in poststroke aphasia patients: perspectives from neuroimaging findings","volume":"18","author":"Cao","year":"2025","journal-title":"Ther. Adv. Neurol. Disord."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"973","DOI":"10.2147\/NDT.S513364","article-title":"Altered gut microbiota and plasma metabolome profiles characterize depression individuals with ischemic stroke: a comparative analysis","volume":"21","author":"Cao","year":"2025","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"10977","DOI":"10.1038\/s41598-021-90463-5","article-title":"Microbiota dysbiosis and functional outcome in acute ischemic stroke patients","volume":"11","author":"Chang","year":"2021","journal-title":"Sci. Rep."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1073113","DOI":"10.3389\/fcimb.2022.1073113","article-title":"Gut microbiota signature as predictors of adverse outcomes after acute ischemic stroke in patients with hyperlipidemia","volume":"12","author":"Chen","year":"2022","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"11776","DOI":"10.1038\/s41598-024-62606-x","article-title":"Uncovering the characteristics of the gut microbiota in patients with ischemic stroke and hemorrhagic stroke","volume":"14","author":"Chen","year":"2024","journal-title":"Sci. Rep."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"157078","DOI":"10.1016\/j.phymed.2025.157078","article-title":"Xiaoyaosan improves depression-like behaviours in mice with post-stroke depression by modulating gut microbiota and microbial metabolism and regulating P2X7R\/NLRP3 inflammasome","volume":"145","author":"Chen","year":"2025","journal-title":"Phytomedicine"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e0130421","DOI":"10.1128\/msystems.01304-21","article-title":"Gut microbial dysbiosis associated with type 2 diabetes aggravates acute ischemic stroke","volume":"6","author":"Chen","year":"2021","journal-title":"mSystems"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1580231","DOI":"10.3389\/fmicb.2025.1580231","article-title":"Alterations in gut microbiota and metabolomic profiles in acute stroke: insights into brain-gut axis dysregulation","volume":"16","author":"Chen","year":"2025","journal-title":"Front. Microbiol."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"2016","DOI":"10.3390\/microorganisms11082016","article-title":"Predicting adverse recanalization therapy outcomes in acute ischemic stroke patients using characteristic gut microbiota","volume":"11","author":"Chou","year":"2023","journal-title":"Microorganisms"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"3416","DOI":"10.1111\/cns.14271","article-title":"Changes of gut microbiota in patients at different phases of stroke","volume":"29","author":"Cui","year":"2023","journal-title":"CNS Neurosci. Ther."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1469339","DOI":"10.1155\/2021\/1469339","article-title":"Distinctive gut microbiota alteration is associated with poststroke functional recovery: results from a prospective cohort study","volume":"2021","author":"Dang","year":"2021","journal-title":"Neural Plast."},{"key":"ref15","first-page":"1305","article-title":"Diversity of intestinal microflora in patients with depression after stroke","volume":"36","author":"Fan","year":"2016","journal-title":"Nan Fang Yi Ke Da Xue Xue Bao"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.neuroscience.2025.02.004","article-title":"Multidimensional-based exploration of gut microbial and metabolite differences in patients with recurrent stroke","volume":"572","author":"Fang","year":"2025","journal-title":"Neuroscience"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1007\/s10571-022-01209-4","article-title":"The bridge between ischemic stroke and gut microbes: short-chain fatty acids","volume":"43","author":"Fang","year":"2023","journal-title":"Cell. Mol. Neurobiol."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"966","DOI":"10.12182\/20211160507","article-title":"Dysbiosis of gut microbiota in patients with post-stroke cognitive impairment","volume":"52","author":"Feng","year":"2021","journal-title":"Sichuan Da Xue Xue Bao Yi Xue Ban"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"669322","DOI":"10.3389\/fcimb.2021.669322","article-title":"Roseburia abundance associates with severity, evolution and outcome of acute ischemic stroke","volume":"11","author":"Gu","year":"2021","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"5596924","DOI":"10.1155\/2021\/5596924","article-title":"Gut microbiota-related effects of tanhuo decoction in acute ischemic stroke","volume":"2021","author":"Guo","year":"2021","journal-title":"Oxidative Med. Cell. Longev."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1007\/s12975-020-00863-4","article-title":"Disruptions of anaerobic gut bacteria are associated with stroke and post-stroke infection: a prospective case-control study","volume":"12","author":"Haak","year":"2021","journal-title":"Transl. Stroke Res."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1432958","DOI":"10.3389\/fmicb.2024.1432958","article-title":"The impact of dysbiosis in oropharyngeal and gut microbiota on systemic inflammatory response and short-term prognosis in acute ischemic stroke with preceding infection","volume":"15","author":"He","year":"2024","journal-title":"Front. Microbiol."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1038\/s41392-022-00974-4","article-title":"Microbiota in health and diseases","volume":"7","author":"Hou","year":"2022","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e34764","DOI":"10.1097\/MD.0000000000034764","article-title":"Association between post-stroke cognitive impairment and gut microbiota: a PRISMA-compliant systematic review and meta-analysis","volume":"102","author":"Hu","year":"2023","journal-title":"Medicine (Baltimore)"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1186\/s12866-025-04259-y","article-title":"Metagenomics and metabolomics to evaluate the potential role of gut microbiota and blood metabolites in patients with cerebral infarction","volume":"25","author":"Huang","year":"2025","journal-title":"BMC Microbiol."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"706765","DOI":"10.3389\/fnagi.2021.706765","article-title":"Identification of gut microbiome signatures in patients with post-stroke cognitive impairment and affective disorder","volume":"13","author":"Huang","year":"2021","journal-title":"Front. Aging Neurosci."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1532","DOI":"10.4103\/1673-5374.385846","article-title":"Hemorrhagic transformation in patients with large-artery atherosclerotic stroke is associated with the gut microbiota and lipopolysaccharide","volume":"19","author":"Huang","year":"2024","journal-title":"Neural Regen. Res."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"18849","DOI":"10.1038\/s41598-025-03068-7","article-title":"Association between post-stroke cognitive impairment and gut microbiota in patients with ischemic stroke","volume":"15","author":"Jeng","year":"2025","journal-title":"Sci. Rep."},{"key":"ref29","first-page":"284","article-title":"Ischemic stroke and dysbiosis of gut microbiota: changes to LPS levels and effects on functional outcomes","volume":"29","author":"Jiang","year":"2023","journal-title":"Altern. Ther. Health Med."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1007\/s12031-023-02149-4","article-title":"Analysis of fecal microbiota in patients with hypertension complicated with ischemic stroke","volume":"73","author":"Jiang","year":"2023","journal-title":"J. Mol. Neurosci."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"108001","DOI":"10.1016\/j.jstrokecerebrovasdis.2024.108001","article-title":"Gut microbiome variation in patients with early-stage mild-to-moderate intracerebral hemorrhage: a pilot study exploring therapeutic targets","volume":"33","author":"Jiang","year":"2024","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1224","DOI":"10.29271\/jcpsp.2021.10.1224","article-title":"Correlation between intestinal flora and serum inflammatory factors in post-stroke depression in ischemic stroke","volume":"31","author":"Kang","year":"2021","journal-title":"J. Coll. Physicians Surg. Pak."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.3390\/brainsci13081217","article-title":"The potential of gut microbiota in prediction of stroke-associated pneumonia","volume":"13","author":"Li","year":"2023","journal-title":"Brain Sci."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"e0276598","DOI":"10.1371\/journal.pone.0276598","article-title":"Uncovering the characteristics of the gut microbiota in patients with acute ischemic stroke and phlegm-heat syndrome","volume":"17","author":"Li","year":"2022","journal-title":"PLoS One"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1186\/s12866-019-1552-1","article-title":"Change of intestinal microbiota in cerebral ischemic stroke patients","volume":"19","author":"Li","year":"2019","journal-title":"BMC Microbiol."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"857","DOI":"10.12182\/20220960105","article-title":"Correlations between gut microbiota changes and cognitive function in patients with post-stroke cognitive impairment in the early stage","volume":"53","author":"Li","year":"2022","journal-title":"Sichuan Da Xue Xue Bao Yi Xue Ban"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1515\/tnsci-2020-0117","article-title":"Dysbiosis characteristics of gut microbiota in cerebral infarction patients","volume":"11","author":"Li","year":"2020","journal-title":"Transl. Neurosci."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1444793","DOI":"10.3389\/fcimb.2025.1444793","article-title":"Gut microbiota of patients with post-stroke depression in Chinese population: a systematic review and meta-analysis","volume":"15","author":"Li","year":"2025","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"5413","DOI":"10.1007\/s12035-024-04618-2","article-title":"Functional outcome prediction of acute ischemic stroke based on the oral and gut microbiota","volume":"62","author":"Liang","year":"2025","journal-title":"Mol. Neurobiol."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1996","DOI":"10.1007\/s12975-025-01363-z","article-title":"Gut microbiota improve the prediction of stroke-associated pneumonia risk and outcomes in acute ischemic stroke","volume":"16","author":"Lin","year":"2025","journal-title":"Transl. Stroke Res."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"511562","DOI":"10.3389\/fnagi.2020.511562","article-title":"Gut microbiome signatures are biomarkers for cognitive impairment in patients with ischemic stroke","volume":"12","author":"Ling","year":"","journal-title":"Front. Aging Neurosci."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"1595","DOI":"10.3233\/JAD-200315","article-title":"Structural change of gut microbiota in patients with post-stroke comorbid cognitive impairment and depression and its correlation with clinical features","volume":"77","author":"Ling","year":"","journal-title":"J. Alzheimer\u2019s Dis"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1810501","DOI":"10.3389\/fcimb.2026.1810501","article-title":"Robot-assisted gait training alleviates the symptoms of acute ischemic stroke via regulating gut microbiota composition and function","volume":"16","author":"Liu","year":"2026","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1455","DOI":"10.3233\/JAD-191066","article-title":"The association of post-stroke cognitive impairment and gut microbiota and its corresponding metabolites","volume":"73","author":"Liu","year":"2020","journal-title":"J. Alzheimer\u2019s Dis"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"e70265","DOI":"10.1111\/ene.70265","article-title":"Influence of the gut microbiota on acute ischemic stroke functional outcomes at three months","volume":"32","author":"Lled\u00f3s","year":"2025","journal-title":"Eur. J. Neurol."},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1257317","DOI":"10.3389\/fcimb.2023.1257317","article-title":"Gut microbiota as predictors of the occurrence of high on-treatment platelet reactivity in acute ischemic stroke patients","volume":"13","author":"Lou","year":"2024","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref47","doi-asserted-by":"publisher","first-page":"e26651","DOI":"10.1016\/j.heliyon.2024.e26651","article-title":"Unveiling the negative association of Faecalibacterium prausnitzii with ischemic stroke severity, impaired prognosis and pro-inflammatory markers","volume":"10","author":"Luo","year":"2024","journal-title":"Heliyon"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1080\/1028415X.2023.2242121","article-title":"The gut microbial signatures of patients with lacunar cerebral infarction","volume":"27","author":"Ma","year":"2024","journal-title":"Nutr. Neurosci."},{"key":"ref49","doi-asserted-by":"publisher","first-page":"359","DOI":"10.2147\/CLEP.S66677","article-title":"Quality assessment of observational studies in a drug-safety systematic review, comparison of two tools: the Newcastle-Ottawa scale and the RTI item bank","volume":"6","author":"Margulis","year":"2014","journal-title":"Clin. Epidemiol."},{"key":"ref50","doi-asserted-by":"publisher","first-page":"1962","DOI":"10.3390\/cells13231962","article-title":"Vascular cognitive impairment-the molecular basis and potential influence of the gut microbiota on the pathological process","volume":"13","author":"Olejnik","year":"2024","journal-title":"Cells"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"1788","DOI":"10.1161\/STROKEAHA.121.036800","article-title":"Gut microbiota and their metabolites in stroke: a double-edged sword","volume":"53","author":"Peh","year":"2022","journal-title":"Stroke"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"14046","DOI":"10.1038\/s41598-025-97432-2","article-title":"Association of gut microbiota and immunometabolic profiles with ischemic stroke severity","volume":"15","author":"Pilon","year":"2025","journal-title":"Sci. Rep."},{"key":"ref53","doi-asserted-by":"publisher","first-page":"2667","DOI":"10.3390\/microorganisms11112667","article-title":"Association analysis of gut microbiota and prognosis of patients with acute ischemic stroke in basal ganglia region","volume":"11","author":"Shi","year":"2023","journal-title":"Microorganisms"},{"key":"ref9001","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.3390\/ijms27031289","article-title":"Butyrate-producing bacteria as a keystone species of the gut microbiome: A systemic review of dietary impact on gut-brain and host health","volume":"27","author":"Snodgrass","year":"2026","journal-title":"Int. J. Mol. Sci."},{"key":"ref54","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1038\/nm.4194","article-title":"Translocation and dissemination of commensal bacteria in post-stroke infection","volume":"22","author":"Stanley","year":"2016","journal-title":"Nat. Med."},{"key":"ref55","doi-asserted-by":"publisher","first-page":"799222","DOI":"10.3389\/fneur.2021.799222","article-title":"Gut microbiota dysbiosis in acute ischemic stroke associated with 3-month unfavorable outcome","volume":"12","author":"Sun","year":"2022","journal-title":"Front. Neurol."},{"key":"ref56","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1002\/jpen.1861","article-title":"Dysbiosis of gut microbiota and short-chain fatty acids in acute ischemic stroke and the subsequent risk for poor functional outcomes","volume":"45","author":"Tan","year":"2021","journal-title":"JPEN J. Parenter. Enteral Nutr."},{"key":"ref57","doi-asserted-by":"publisher","first-page":"e12805","DOI":"10.1097\/MD.0000000000012805","article-title":"The characteristics analysis of intestinal microecology on cerebral infarction patients and its correlation with apolipoprotein E","volume":"97","author":"Wang","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"e3318","DOI":"10.1002\/brb3.3318","article-title":"Identification of disordered profiles of gut microbiota and functional component in stroke and poststroke epilepsy","volume":"13","author":"Wei","year":"2023","journal-title":"Brain Behav."},{"key":"ref59","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1186\/s12967-024-05800-9","article-title":"Gut commensal Parabacteroides distasonis exerts neuroprotective effects in acute ischemic stroke with hyperuricemia via regulating gut microbiota-gut-brain axis","volume":"22","author":"Wei","year":"2024","journal-title":"J. Transl. Med."},{"key":"ref60","doi-asserted-by":"publisher","DOI":"10.2174\/011570159X390349250818115524","article-title":"The role of gut bacteria and plasma metabolites in predicting post-stroke depression in patients with acute ischemic stroke","author":"Wen","year":"2025","journal-title":"Curr. Neuropharmacol."},{"key":"ref61","doi-asserted-by":"publisher","first-page":"2407","DOI":"10.3389\/fmicb.2019.02407","article-title":"Rarefaction, alpha diversity, and statistics","volume":"10","author":"Willis","year":"2019","journal-title":"Front. Microbiol."},{"key":"ref62","doi-asserted-by":"publisher","first-page":"965","DOI":"10.2147\/NDT.S507156","article-title":"Potential inflammatory biomarkers and differential gut microbiota in cognitive impairment after ischemic stroke","volume":"21","author":"Wu","year":"2025","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref63","doi-asserted-by":"publisher","first-page":"1624987","DOI":"10.3389\/fnins.2025.1624987","article-title":"Risk of occult gastrointestinal bleeding with increased gut enterococcus and staphylococcus for poor outcomes in ischemic stroke patients","volume":"19","author":"Xia","year":"2025","journal-title":"Front. Neurosci."},{"key":"ref64","doi-asserted-by":"publisher","first-page":"715475","DOI":"10.3389\/fcimb.2021.715475","article-title":"Dysbiosis of gut microbiota is an independent risk factor of stroke-associated pneumonia: a Chinese pilot study","volume":"11","author":"Xia","year":"2021","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref65","doi-asserted-by":"publisher","first-page":"587284","DOI":"10.3389\/fcimb.2020.587284","article-title":"Gut microbiotic features aiding the diagnosis of acute ischemic stroke","volume":"10","author":"Xiang","year":"2020","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref66","doi-asserted-by":"publisher","first-page":"1486","DOI":"10.1136\/gutjnl-2020-323263","article-title":"Rapid gut dysbiosis induced by stroke exacerbates brain infarction in turn","volume":"70","author":"Xu","year":"2021","journal-title":"Gut"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"3434","DOI":"10.1016\/j.numecd.2021.08.045","article-title":"Compositional and functional alterations of gut microbiota in patients with stroke","volume":"31","author":"Xu","year":"2021","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref68","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1007\/s00203-025-04494-x","article-title":"Multi-omics profiling reveals key microbial and metabolic variations in ischemic stroke: insights into gut and oral microbiota","volume":"207","author":"Yao","year":"2025","journal-title":"Arch. Microbiol."},{"key":"ref69","doi-asserted-by":"publisher","first-page":"1116065","DOI":"10.3389\/fnagi.2023.1116065","article-title":"Predictive microbial feature analysis in patients with depression after acute ischemic stroke","volume":"15","author":"Yao","year":"2023","journal-title":"Front. Aging Neurosci."},{"key":"ref70","doi-asserted-by":"publisher","first-page":"e002699","DOI":"10.1161\/JAHA.115.002699","article-title":"Dysbiosis of gut microbiota with reduced trimethylamine-N-oxide level in patients with large-artery atherosclerotic stroke or transient ischemic attack","volume":"4","author":"Yin","year":"2015","journal-title":"J. Am. Heart Assoc."},{"key":"ref71","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1007\/s41999-025-01159-2","article-title":"Systemic inflammation is associated with gut microbiota diversity in post-stroke patients","volume":"16","author":"Yoshimura","year":"2025","journal-title":"Eur. Geriatr. Med."},{"key":"ref72","doi-asserted-by":"publisher","first-page":"1451968","DOI":"10.3389\/fnagi.2024.1451968","article-title":"Specific gut microbiome signatures predict the risk of acute ischemic stroke","volume":"16","author":"Yu","year":"2024","journal-title":"Front. Aging Neurosci."},{"key":"ref73","doi-asserted-by":"publisher","first-page":"1334581","DOI":"10.3389\/fcimb.2024.1334581","article-title":"Role of the gut microbiota in complications after ischemic stroke","volume":"14","author":"Zhang","year":"2024","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref74","doi-asserted-by":"publisher","first-page":"2023","DOI":"10.1155\/2023\/6297653","article-title":"Imbalance of microbacterial diversity is associated with functional prognosis of stroke","author":"Zhang","year":"2023","journal-title":"Neural Plast."},{"key":"ref75","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1186\/s12967-022-03669-0","article-title":"Pivotal interplays between fecal metabolome and gut microbiome reveal functional signatures in cerebral ischemic stroke","volume":"20","author":"Zhao","year":"2022","journal-title":"J. Transl. Med."},{"key":"ref76","doi-asserted-by":"publisher","first-page":"836820","DOI":"10.3389\/fimmu.2022.836820","article-title":"Gut dysbiosis is associated with the severity of cryptogenic stroke and enhanced systemic inflammatory response","volume":"13","author":"Zheng","year":"2022","journal-title":"Front. Immunol."}],"container-title":["Frontiers in Aging Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnagi.2026.1914614\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:28:59Z","timestamp":1788150539000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnagi.2026.1914614\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":77,"alternative-id":["10.3389\/fnagi.2026.1914614"],"URL":"https:\/\/doi.org\/10.3389\/fnagi.2026.1914614","relation":{},"ISSN":["1663-4365"],"issn-type":[{"value":"1663-4365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,31]]},"article-number":"1914614"}}