ORIGINAL RESEARCH

Taxonomic dysbiosis of gut microbiota and serum biomarkers reflect severity of central nervous system injury

Chernevskaya EA, Meglei AYu, Buyakova IV, Kovaleva NYu, Gorshkov KM, Zakharchenko VE, Beloborodova NV
About authors

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia

Correspondence should be addressed: Ekaterina A. Chernevskaya
Petrovka, 25, s. 2, Moscow, 127051; ur.rrcknf@ayaksvenrehce

About paper

Compliance with ethical standards: the study was approved by the Ethics Committee of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology (Protocol № 2/19/2 dated June 20, 2019). Informed consent was obtained from all study participants or their legal representatives.

Author contribution: Chernevskaya EA, Meglei AYu — taxonomic microbiota profiling, serum biomarker tests, data analysis, manuscript preparation; Beloborodova NV — study design, final version of the manuscript; Buyakova IV, Kovaleva NYu, Gorshkov KM — patient recruitment and treatment, clinical data collection; ZakharchenkoVE — sample collection, final version of the manuscript. All authors read and approved the final version of the manuscript.

Received: 2020-08-20 Accepted: 2020-09-03 Published online: 2020-09-16
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The term “chronic critical illness” (CCI) refers to patients with prolonged dependence on intensive care. In most patients, CCI is triggered by severe brain injury. Ever more studies researching the microbiota in pathologic conditions are published every year, but a lot is yet to be elucidated about the composition of the gut microbiota in CCI. The aim of this study was to investigate possible correlations between changes in the taxonomic abundance of the gut microbiota, levels of proinflammatory and neurological serum biomarkers and the severity of central nervous system injury in patients with CCI. Our prospective observational pilot study included 29 patients with CCI. Using real-time PCR allowed us to detected changes in the taxonomic abundance of the gut microbiota. The correlation analysis of serum biomarkers and the taxonomic composition of the gut microbiota revealed statistically significant correlations between cortisol levels and the abundance of F. prausnitzii (r = ‒0.62; p < 0.05) and B. thetaiotaomicron (r = ‒0.57; p < 0.05) in vegetative state patients; between the CRP/albumin ratio and the abundance of S. aureus (r = 0.72; p < 0.05); between the abundance of B. fragilis group/F. prausnitzii and S100 levels (r = 0.45; p <0.05) in conscious patients; between Glasgow coma scale scores and the abundance of Enterococcus spp. (r = ‒0.77; p <0.05) in both groups. Thus, the association between the changes in the taxonomic composition of the gut microbiota and the severity of neurologic deficit can be evaluated using PCR-based diagnostic techniques and blood serum biomarkers. This approach will help to optimize antibacterial treatment regimens and/or develop alternative strategies to minimize the aggressive effect of antibiotics on the gut microbiota.

Keywords: cortisol, gut microbiota, real-time PCR, biomarkers, gut-brain axis, chronic critical illness, procalcitonin, CRP/albumin ratio, Feacalibacterium prausnitzii, Bacteroides thetaiotaimicron, Enterococcus spp.

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