Intestinal flora changes in patients with ischemic stroke and correlations with prognosis and Th1/Th2 immune cell balance
Objective To study intestinal flora changes in patients with ischemic stroke,and to explore their correlations with prognosis and T helper cell type 1/T helper cell type 2(Th1/Th2)immune cell balance.Methods One hundred and six patients with ischemic stroke admitted to our hospital between January 2020 and March 2022 were enrolled and received intravenous thrombolytic therapy.After discharge,the prognosis of patients was evaluated using the Modified Rankin Scale(mRS)after 90-day follow-up.These patients were divided into the good group(mRS score≤2,n=71)and poor group(3＜mRS score＜6,n=35)according to the mRS score.The intestinal flora composition and levels of Th1/Th2 and related cytokines were compared between the two groups.Pearson correlation analysis was conducted to reveal the correlations between the relative abundance of intestinal flora and the levels of Th1/Th2 and related cytokines in these patients.Results Chaol index and Shannon index were lower in the poor group than in the good group(t=7.025,5.033,all P＜0.001).The abundance of Firmicutes and Prevotella was decreased in the poor group(t=11.475,6.514,all P＜0.001),while the abundance of Bacteroides and Escherichia was increased compared with the good group(t=19.289,7.826,all P＜0.001).The poor group had elevated serum levels of interleukin-2(IL-2)and interferon-γ(IFN-γ)(t=12.685,25.814,all P＜0.001)but decreased levels of Th1/Th2,IL-4 and IL-5 compared with the good group(t=5.066,12.793,11.476,all P＜0.001).The results of Pearson correlation analysis suggested that Bacteroidetes and Escherichia were negatively correlated with Th1/Th2,IL-4,and IL-5(r=-0.604～-0.376,P＜0.05),but positively with IL-2 and IFN-γ(r=0.439～0.623,all P＜0.05).Firmicutes,Prevotella,Chao1 index,and Shannon index were positively correlated with Th1/Th2,IL-4,and IL-5(r=0.428～0.623,P＜0.05),but negatively with IL-2 and IFN-γ(r=-0.584～-0.397,P＜0.05).Conclusion Changes in intestinal flora in patients with ischemic stroke are associated with poor prognosis and levels of Th1/Th2 and related cytokines.
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