Therapeutic potential of atorvastatin in ischemic stroke: an investigation into its anti-inflammatory effect by targeting the gut-brain axis

Abstract Background Recent studies have highlighted the vital role of gut microbiota in the pathogenesis of Ischemic stroke (IS). However, the effects and underlying mechanisms of atorvastatin on IS via regulating gut-brain axis remain unclear. Thus, this study aimed to explore the relationship betw...

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Main Authors: Liuzhu Chen, Linpei Zhuo, Jie Zheng, Xiaoyun Sun, Jing Sun, Jiaming Liu
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Journal of Translational Medicine
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Online Access:https://doi.org/10.1186/s12967-025-06803-w
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author Liuzhu Chen
Linpei Zhuo
Jie Zheng
Xiaoyun Sun
Jing Sun
Jiaming Liu
author_facet Liuzhu Chen
Linpei Zhuo
Jie Zheng
Xiaoyun Sun
Jing Sun
Jiaming Liu
author_sort Liuzhu Chen
collection DOAJ
description Abstract Background Recent studies have highlighted the vital role of gut microbiota in the pathogenesis of Ischemic stroke (IS). However, the effects and underlying mechanisms of atorvastatin on IS via regulating gut-brain axis remain unclear. Thus, this study aimed to explore the relationship between atorvastatin, gut microbiota and IS through animal experiments, clinical trials and Mendelian randomization (MR) analysis. Methods Male mice were induced with bilateral common carotid artery occlusion (BCCAO) to establish an IS animal model, and then intragastrically treated with atorvastatin. Neurological deficits, microglia activation, and the levels of NLRP3 inflammasome and NF-κB pathway-related proteins were detected. Meanwhile, gut microbiota composition and intestinal barrier integrity were evaluated. In this prospective study, we recruited IS patients undergoing atorvastatin treatment, evaluated their functional outcomes, collected fecal samples, and assessed gut microbiota functions. Moreover, the causal relationships between specific bacteria, inflammation and IS were assessed via MR analysis. Results Our results showed that atorvastatin treatment significantly improved neurobehavioral deficits, suppressed activation of microglia, and inhibited NF-κB pathway as well as the formation of the NLRP3 inflammasome, reduced the release of inflammatory cytokines, including IL-1β and IL-18, which were reversed by antibiotics treatment. We further identified an increase in the genus Lachnospiraceae NK4A136 in atorvastatin-treated mice. Subsequent clinical experiments were conducted to explore the effects by analyzing the characteristic bacteria, such as Ruminococcus torques and Lachnospiraceae NK4A136. The higher abundances of Ruminococcus torques and Lachnospiraceae NK4A136 were associated with a good outcome in atorvastatin-treated IS patients. MR analysis further revealed that these microbes were negatively correlated with inflammatory factor levels, and showed inhibitory effects on the Akt/NF-κB/NLRP3 pathway and PLA2G7 gene expression. Conclusion These findings demonstrated the roles of atorvastatin in regulating Akt/NF-κB/NLRP3 pathway to inhibit neuroinflammation through specific bacteria, which implied a novel way for IS treatment.
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spelling doaj-art-9f218b70ba6746228823c2615f9b51e72025-08-20T03:43:30ZengBMCJournal of Translational Medicine1479-58762025-07-0123111810.1186/s12967-025-06803-wTherapeutic potential of atorvastatin in ischemic stroke: an investigation into its anti-inflammatory effect by targeting the gut-brain axisLiuzhu Chen0Linpei Zhuo1Jie Zheng2Xiaoyun Sun3Jing Sun4Jiaming Liu5Department of Neurology, the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityDepartment of Neurology, the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityDepartment of Preventive Medicine, School of Public Health, Wenzhou Medical UniversityDepartment of Neurology, Zhuji Affiliated Hospital of Wenzhou Medical UniversityDepartment of Neurology, the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityDepartment of Preventive Medicine, School of Public Health, Wenzhou Medical UniversityAbstract Background Recent studies have highlighted the vital role of gut microbiota in the pathogenesis of Ischemic stroke (IS). However, the effects and underlying mechanisms of atorvastatin on IS via regulating gut-brain axis remain unclear. Thus, this study aimed to explore the relationship between atorvastatin, gut microbiota and IS through animal experiments, clinical trials and Mendelian randomization (MR) analysis. Methods Male mice were induced with bilateral common carotid artery occlusion (BCCAO) to establish an IS animal model, and then intragastrically treated with atorvastatin. Neurological deficits, microglia activation, and the levels of NLRP3 inflammasome and NF-κB pathway-related proteins were detected. Meanwhile, gut microbiota composition and intestinal barrier integrity were evaluated. In this prospective study, we recruited IS patients undergoing atorvastatin treatment, evaluated their functional outcomes, collected fecal samples, and assessed gut microbiota functions. Moreover, the causal relationships between specific bacteria, inflammation and IS were assessed via MR analysis. Results Our results showed that atorvastatin treatment significantly improved neurobehavioral deficits, suppressed activation of microglia, and inhibited NF-κB pathway as well as the formation of the NLRP3 inflammasome, reduced the release of inflammatory cytokines, including IL-1β and IL-18, which were reversed by antibiotics treatment. We further identified an increase in the genus Lachnospiraceae NK4A136 in atorvastatin-treated mice. Subsequent clinical experiments were conducted to explore the effects by analyzing the characteristic bacteria, such as Ruminococcus torques and Lachnospiraceae NK4A136. The higher abundances of Ruminococcus torques and Lachnospiraceae NK4A136 were associated with a good outcome in atorvastatin-treated IS patients. MR analysis further revealed that these microbes were negatively correlated with inflammatory factor levels, and showed inhibitory effects on the Akt/NF-κB/NLRP3 pathway and PLA2G7 gene expression. Conclusion These findings demonstrated the roles of atorvastatin in regulating Akt/NF-κB/NLRP3 pathway to inhibit neuroinflammation through specific bacteria, which implied a novel way for IS treatment.https://doi.org/10.1186/s12967-025-06803-wAtorvastatinIschemic strokeGut microbiotaNeuroinflammationNLRP3 inflammasomeNF-κB pathway
spellingShingle Liuzhu Chen
Linpei Zhuo
Jie Zheng
Xiaoyun Sun
Jing Sun
Jiaming Liu
Therapeutic potential of atorvastatin in ischemic stroke: an investigation into its anti-inflammatory effect by targeting the gut-brain axis
Journal of Translational Medicine
Atorvastatin
Ischemic stroke
Gut microbiota
Neuroinflammation
NLRP3 inflammasome
NF-κB pathway
title Therapeutic potential of atorvastatin in ischemic stroke: an investigation into its anti-inflammatory effect by targeting the gut-brain axis
title_full Therapeutic potential of atorvastatin in ischemic stroke: an investigation into its anti-inflammatory effect by targeting the gut-brain axis
title_fullStr Therapeutic potential of atorvastatin in ischemic stroke: an investigation into its anti-inflammatory effect by targeting the gut-brain axis
title_full_unstemmed Therapeutic potential of atorvastatin in ischemic stroke: an investigation into its anti-inflammatory effect by targeting the gut-brain axis
title_short Therapeutic potential of atorvastatin in ischemic stroke: an investigation into its anti-inflammatory effect by targeting the gut-brain axis
title_sort therapeutic potential of atorvastatin in ischemic stroke an investigation into its anti inflammatory effect by targeting the gut brain axis
topic Atorvastatin
Ischemic stroke
Gut microbiota
Neuroinflammation
NLRP3 inflammasome
NF-κB pathway
url https://doi.org/10.1186/s12967-025-06803-w
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