Association between oral microbial nitrate metabolism and poor prognosis in acute ischemic stroke patients with a history of hypertension

Background Oral microbes mediate the production of nitric oxide (NO) through the denitrification pathway. This study aimed to investigate the association between oral microbial nitrate metabolism and prognosis in acute ischemic stroke (AIS) patients.Methods This prospective, observational, single-ce...

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Main Authors: Yueran Ren, Jingru Liang, Weike Hu, Jiahui Xie, Yifeng Zheng, Wei Song, Jiajia Zhu, Hongwei Zhou, Qiheng Wu, Yan He, Jia Yin
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Journal of Oral Microbiology
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Online Access:https://www.tandfonline.com/doi/10.1080/20002297.2024.2382620
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author Yueran Ren
Jingru Liang
Weike Hu
Jiahui Xie
Yifeng Zheng
Wei Song
Jiajia Zhu
Hongwei Zhou
Qiheng Wu
Yan He
Jia Yin
author_facet Yueran Ren
Jingru Liang
Weike Hu
Jiahui Xie
Yifeng Zheng
Wei Song
Jiajia Zhu
Hongwei Zhou
Qiheng Wu
Yan He
Jia Yin
author_sort Yueran Ren
collection DOAJ
description Background Oral microbes mediate the production of nitric oxide (NO) through the denitrification pathway. This study aimed to investigate the association between oral microbial nitrate metabolism and prognosis in acute ischemic stroke (AIS) patients.Methods This prospective, observational, single-center cohort study included 124 AIS patients admitted within 24 hours of symptom onset, with 24-hour ambulatory blood pressure data. Oral swabs were collected within 24 hours. Hypertensive AIS patients were stratified by the coefficient of variation (CV) of 24-hour systolic blood pressure. Microbial composition was analyzed using LEfSe and PICRUSt2 for bacterial and functional pathway identification.Results Significant differences in oral microbiota composition were observed between hypertensive AIS patients with varying CVs. Lower CV groups showed enrichment of nitrate-reducing bacteria and “Denitrification, nitrate => nitrogen” pathways. The TAX score of oral nitrate-reducing bacteria, derived from LASSO modeling, independently correlated with 90-day modified Rankin Scale scores, serving as an independent risk factor for poor prognosis. Mediation analyses suggested indirect that the TAX score not only directly influences outcomes but also indirectly affects them by modulating 24-hour systolic blood pressure CV.Conclusions AIS patients with comorbid hypertension and higher systolic blood pressure CV exhibited reduced oral nitrate-reducing bacteria, potentially worsening outcomes.
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spelling doaj-art-64d9e7a3cbbb4161b80ea1301d628f112024-11-26T06:52:11ZengTaylor & Francis GroupJournal of Oral Microbiology2000-22972024-12-0116110.1080/20002297.2024.2382620Association between oral microbial nitrate metabolism and poor prognosis in acute ischemic stroke patients with a history of hypertensionYueran Ren0Jingru Liang1Weike Hu2Jiahui Xie3Yifeng Zheng4Wei Song5Jiajia Zhu6Hongwei Zhou7Qiheng Wu8Yan He9Jia Yin10Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, ChinaDepartment of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, ChinaDepartment of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, ChinaDepartment of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, ChinaDepartment of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, ChinaDepartment of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, ChinaDepartment of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, ChinaMicrobiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, ChinaDepartment of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, ChinaMicrobiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, ChinaDepartment of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, ChinaBackground Oral microbes mediate the production of nitric oxide (NO) through the denitrification pathway. This study aimed to investigate the association between oral microbial nitrate metabolism and prognosis in acute ischemic stroke (AIS) patients.Methods This prospective, observational, single-center cohort study included 124 AIS patients admitted within 24 hours of symptom onset, with 24-hour ambulatory blood pressure data. Oral swabs were collected within 24 hours. Hypertensive AIS patients were stratified by the coefficient of variation (CV) of 24-hour systolic blood pressure. Microbial composition was analyzed using LEfSe and PICRUSt2 for bacterial and functional pathway identification.Results Significant differences in oral microbiota composition were observed between hypertensive AIS patients with varying CVs. Lower CV groups showed enrichment of nitrate-reducing bacteria and “Denitrification, nitrate => nitrogen” pathways. The TAX score of oral nitrate-reducing bacteria, derived from LASSO modeling, independently correlated with 90-day modified Rankin Scale scores, serving as an independent risk factor for poor prognosis. Mediation analyses suggested indirect that the TAX score not only directly influences outcomes but also indirectly affects them by modulating 24-hour systolic blood pressure CV.Conclusions AIS patients with comorbid hypertension and higher systolic blood pressure CV exhibited reduced oral nitrate-reducing bacteria, potentially worsening outcomes.https://www.tandfonline.com/doi/10.1080/20002297.2024.2382620Oral microbiotanitric oxideacute ischemic strokeprognosishypertensionblood pressure
spellingShingle Yueran Ren
Jingru Liang
Weike Hu
Jiahui Xie
Yifeng Zheng
Wei Song
Jiajia Zhu
Hongwei Zhou
Qiheng Wu
Yan He
Jia Yin
Association between oral microbial nitrate metabolism and poor prognosis in acute ischemic stroke patients with a history of hypertension
Journal of Oral Microbiology
Oral microbiota
nitric oxide
acute ischemic stroke
prognosis
hypertension
blood pressure
title Association between oral microbial nitrate metabolism and poor prognosis in acute ischemic stroke patients with a history of hypertension
title_full Association between oral microbial nitrate metabolism and poor prognosis in acute ischemic stroke patients with a history of hypertension
title_fullStr Association between oral microbial nitrate metabolism and poor prognosis in acute ischemic stroke patients with a history of hypertension
title_full_unstemmed Association between oral microbial nitrate metabolism and poor prognosis in acute ischemic stroke patients with a history of hypertension
title_short Association between oral microbial nitrate metabolism and poor prognosis in acute ischemic stroke patients with a history of hypertension
title_sort association between oral microbial nitrate metabolism and poor prognosis in acute ischemic stroke patients with a history of hypertension
topic Oral microbiota
nitric oxide
acute ischemic stroke
prognosis
hypertension
blood pressure
url https://www.tandfonline.com/doi/10.1080/20002297.2024.2382620
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