Altered gut microbiota and short-chain fatty acid in acute ischaemic stroke with active cancer

Q: What was the main aim of the study?

To investigate gut microbiota composition and short-chain fatty acid (SCFA) levels in patients with acute ischaemic stroke (AIS) and active cancer.

Q: How were gut microbiota profiles and SCFAs measured?

Gut microbiota profiles were characterized using 16S rRNA sequencing, while faecal SCFAs were quantified by gas chromatography-mass spectrometry.

Q: What did the study find about gut microbiota and outcomes?

Patients with concurrent AIS and active cancer showed taxonomic alterations, reduced SCFA production, markers of intestinal barrier dysfunction, and worse 180-day functional outcomes.

Sep 22, 2026

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Acute ischaemic stroke (AIS) occurring with active cancer has distinct etiological drivers and is linked to worse clinical outcomes. While gut microbiota dysbiosis is studied separately in stroke and cancer, gut microbial profiles and short-chain fatty acid (SCFA) alterations in patients with both conditions remain unclear. This prospective observational study evaluates 16S rRNA gut composition, faecal SCFAs, intestinal barrier biomarkers, and 180-day functional outcomes.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

What is already known on this topic

What this study adds

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Open access Original research Altered gut microbiota and short-chain fatty acid in acute ischaemic stroke with active cancer Wei Song ,1 Xiaofei Lin ,1 Genghong Xia ,2 Yueran Ren ,1 Xuxuan Gao ,1 Linling Shen ,1 Qiheng Wu ,1 Jia Yin 1 To cite: Song W, Lin X, Xia G, et al. Altered gut microbiota and short-chain fatty acid in acute ischaemic stroke with active cancer. Stroke & Vascular Neurology 2025;0 . doi:10 . 1136/ svn-2025-004217 ► Additional supplemental material is published online only. To view, please visit the journal online ([https://doi.org/10.1136/](https://doi.org/10.1136/)[ ](https://doi.org/10.1136/)[svn-2025-004217](svn-2025-004217)) . WS and XL are joint first authors. Received 6 March 2025 Accepted 16 July 2025 © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. 1Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China 2Department of Neurology, Zengcheng Branch of Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China Correspondence to Dr Jia Yin; [yinj@smu.edu.cn](yinj@smu.edu.cn) ABSTRACT Background Acute ischaemic stroke (AIS) in patients with active cancer presents unique etiological factors and correlates with worse outcomes. Although gut microbiota dysbiosis has been separately documented in stroke pathophysiology and cancer progression, gut microbial profiles in patients with concurrent conditions remain unexplored. We investigated gut microbiota composition and short-chain fatty acid (SCFA) levels in patients with AISand active cancer. Methods In this prospective observational study, we analysed consecutive patients with AIS admitted between 2018 and 2023. Gut microbiota profiles were characterised using 16S rRNA sequencing. Faecal SCFAs were quantified by gas chromatography-mass spectrometry, and serum biomarkers of intestinal barrier function were measured. Functional outcomes were assessed using the modified Rankin Scale (mRS) at 180 days poststroke. Results Among 942 consecutive AIS patients, 156 met inclusion criteria: 42 with active cancer and 114 matched controls. Patients with concurrent AIS and cancer demonstrated significant taxonomic alterations, characterised by elevated Firmicutes-to-Bacteroidetes ratio (F/B: 1.2 vs 0 .6; p=0 .010) and Clostridiales-toBacteroidales ratio (C/B: 1.1 vs 0 .6; p=0 .008) compared with controls. These patients exhibited enrichment of inflammation-associated bacteria, depletion of SCFAproducing microbes, reduced faecal SCFA levels and elevated markers of intestinal barrier dysfunction (all p<0 .05) . The abundance of inflammation-associated genera Erysipelotrichaceae and Dorea correlated with elevated D-dimer levels and worse 180-day mRS scores. Multivariate analysis identified Clostridiales abundance, F/Band C/B ratios as independent predictors of poor functional outcomes (mRS≥3) at 180 days. Conclusions Patients with concurrent AIS and active cancer demonstrate distinct gut microbiota profiles and reduced SCFA production, associated with compromised intestinal barrier function and poor outcomes. These observations suggest perturbed gut–brain axis function and motivate exploratory research into microbiota-targeted approaches for this high-risk population. INTRODUCTION Stroke and cancer are major public health challenges that frequently coexist in clinical practice. Cancer patients have more than twice the stroke risk compared with WHAT IS ALREADY KNOWN ON THIS TOPIC | ⇒ Active cancer is associated with increased risk and worse outcomes in acute ischaemic stroke (AIS) .
⇒ Gut microbiota dysbiosis has been separately documented in stroke and cancer but remains unexplored in concurrent conditions.
WHAT THIS STUDY ADDS | | --- | | ⇒ AIS patients with cancer show distinct gut dysbiosis characterised by enriched inflammation-associated bacteria, depleted s

FAQs

What was the main aim of the study?

To investigate gut microbiota composition and short-chain fatty acid (SCFA) levels in patients with acute ischaemic stroke (AIS) and active cancer.

How were gut microbiota profiles and SCFAs measured?

Gut microbiota profiles were characterized using 16S rRNA sequencing, while faecal SCFAs were quantified by gas chromatography-mass spectrometry.

What did the study find about gut microbiota and outcomes?

Patients with concurrent AIS and active cancer showed taxonomic alterations, reduced SCFA production, markers of intestinal barrier dysfunction, and worse 180-day functional outcomes.

Sep 22, 2026

Uploaded by Aditya