Abstract TMP95: A Role for Gut Dysbiosis in the Progression of Cerebral Small Vessel Disease

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Robert M Bryan ◽  
James W Nelson ◽  
David J Durgan
2018 ◽  
Vol 32 (S1) ◽  
Author(s):  
James Willard Nelson ◽  
Priya Ganesh ◽  
Nadim Ajami ◽  
Robert Bryan ◽  
David Durgan

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
James W Nelson ◽  
David Durgan ◽  
Nadim Ajami ◽  
Joseph Petrosino ◽  
Robert Bryan

The importance of a healthy gut microbiota on host physiology is becoming increasingly evident. Recent studies suggest that alterations to the microbiota can have adverse effects beyond the GI tract, and has been linked to hypertension and stroke. Thus we hypothesized that gut dysbiosis could contribute to the development of cerebral small vessel disease (CSVD). Giving merit to this hypothesis, we found that the microbiota of the spontaneously hypertensive stroke prone rat (SHRSP) is significantly different than that of WKY controls. Using 16s rRNA sequencing of bacterial DNA we found that SHRSP animals had decreases in measures of bacterial richness (p=.005) and diversity (p=.028), indicative of gut dysbiosis. Phenotypically, CSVD includes vessel remodeling, BBB breakdown and neuroinflammation. Gut dysbiosis is often associated with a leaky gut barrier that allows bacteria to enter the systemic circulation. We observed significantly greater permeability of the SHRSP colon barrier when compared to WKY (p=.026). We next sought to determine if impaired colon barrier function in SHRSP could lead to increased bacterial translocation to the periphery and ultimately to the brain. Brains were harvested from 24 week old SHRSP and WKY animals and qRT-PCR of the 16s rRNA gene was performed to detect the presence of bacteria in the brain. We discovered that SHRSP animals displayed a 50% increase in bacterial 16S rRNA load in the brain compared to WKY animals (p=.0063) confirming that bacteria are not only present in CSVD rats, but also in greater abundance than WKYs. Similarly, we found that SHRSP animals displayed a near 2-fold increase of the bacterial endotoxin LPS in the brain, as compared to WKY brain LPS levels (p=.01). Finally, to further confirm the presence of bacterial components in the brain we used immunofluorescence imaging to visualize peptidoglycan (PG), a molecule found solely in bacterial cell walls. We discovered that we could visualize the presence of PG in the brains of SHRSP animals, and note that PG was commonly observed inside microglia. We conclude from this study that SHRSP rats exhibit gut dysbiosis, gut barrier breakdown, and bacterial products in the brain. Further studies will examine how this bacterial presence contributes to the CSVD phenotypes.


2019 ◽  
Vol 33 (S1) ◽  
Author(s):  
James Nelson ◽  
Priya Ganesh ◽  
Nadim Ajami ◽  
David Durgan ◽  
Robert Bryan

2020 ◽  
Vol 5 (2) ◽  
pp. 128-137
Author(s):  
Huimin Chen ◽  
Yuesong Pan ◽  
Lixia Zong ◽  
Jing Jing ◽  
Xia Meng ◽  
...  

BackgroundThe effect of cerebral small vessel disease (CSVD) and intracranial arterial stenosis (ICAS) on stroke outcomes remains unclear.MethodsData of 1045 patients with minor stroke or transient ischaemic attack (TIA) were obtained from 45 sites of the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial. We assessed the associations of burdens of CSVD and ICAS with new strokes and bleeding events using multivariate Cox regression models and those with modified Rankin Scale (mRS) scores using ordinal logistic regression models.ResultsAmong the 1045 patients, CSVD was present in 830 cases (79.4%) and ICAS in 460 (44.0%). Patients with >1 ICAS segment showed the highest risk of new strokes (HR 2.03, 95% CI 1.15 to 3.56, p=0.01). No association between CSVD and the occurrence of new strokes was found. The presence of severe CSVD (common OR (cOR) 2.01, 95% CI 1.40 to 2.89, p<0.001) and >1 ICAS segment (cOR 2.15, 95% CI 1.57 to 2.93, p<0.001) was associated with higher mRS scores. Severe CSVD (HR 10.70, 95% CI 1.16 to 99.04, p=0.04), but not ICAS, was associated with a higher risk of bleeding events. Six-point modified CSVD score improved the predictive power for bleeding events and disability.InterpretationCSVD is associated with more disability and bleeding events, and ICAS is associated with an increased risk of stroke and disability in patients with minor stroke and TIA at 3 months. CSVD and ICAS may represent different vascular pathologies and play distinct roles in stroke outcomes.Trial registration numberNCT00979589


2021 ◽  
pp. 0271678X2199262
Author(s):  
Shuai Jiang ◽  
Tian Cao ◽  
Yuying Yan ◽  
Tang Yang ◽  
Ye Yuan ◽  
...  

Recent subcortical infarction (RSI) in the lenticulostriate artery (LSA) territory with a non-stenotic middle cerebral artery is a heterogeneous entity. We aimed to investigate the role of LSA combined with neuroimaging markers of cerebral small vessel disease (CSVD) in differentiating the pathogenic subtypes of RSI by whole-brain vessel-wall magnetic resonance imaging (WB-VWI). Fifty-two RSI patients without relevant middle cerebral artery (MCA) stenosis on magnetic resonance angiography were prospectively enrolled. RSI was dichotomized as branch atheromatous disease (BAD; a culprit plaque located adjacent to the LSA origin) (n = 34) and CSVD-related lacunar infarction (CSVD-related LI; without plaque or plaque located distal to the LSA origin) (n = 18). Logistic regression analysis showed lacunes (odds ratio [OR] 9.68, 95% confidence interval [CI] 1.71–54.72; P = 0.010) and smaller number of LSA branches (OR 0.59, 95% CI 0.36–0.96; P = 0.034) were associated with of BAD, whereas severe deep white matter hyperintensities (DWMH) (OR 0.11, 95% CI 0.02–0.71; P = 0.021) was associated with CSVD-related LI. In conclusion, the LSA branches combined with lacunes and severe DWMH may delineate subtypes of SSI. The WB-VWI technique could be a credible tool for delineating the heterogeneous entity of SSI in the LSA territory.


2021 ◽  
pp. 1-4
Author(s):  
Oscar H. Del Brutto ◽  
Robertino M. Mera

A total of 590 older adults of Amerindian ancestry living in rural Ecuador received anthropometric measurements and a brain magnetic resonance imaging to estimate the total cerebral small vessel disease (cSVD) score. A fully adjusted ordinal logistic regression model, with categories of the total cSVD score as the dependent variable, disclosed significant associations between the waist circumference, the waist-to-hip, and the waist-to-height ratios – but not the body mass index (BMI) – and the cSVD burden. Indices of abdominal obesity may better correlate with severity of cSVD than the BMI in Amerindians. Phenotypic characteristics of this population may account for these results.


Sign in / Sign up

Export Citation Format

Share Document