PREBIOTICS FOR ACUTE ISCHEMIC STROKE

Abstract

There is two-way communication between the gut and the brain. The condition of the quality and quantity of microbiota in the gut greatly affects the communication process or commonly known as the microbiota-gut-brain axis. Acute ischemic stroke can affect the quality and quantity of microbiota in the gut, which leads to intestinal dysbiosis. Thus, it might produce an inflammatory response that can change immune homeostatic. This can lead to poor clinical outcomes and neurologic function and an increase in mortality. Dysbiosis is a condition where there are qualitative and quantitative changes in the composition, distribution, and metabolic activity of intestinal microbiota which have a detrimental effect on human health, in other words, there is a decrease in the number of probiotic bacteria in the gut, which provide health benefits. The conditions for a good probiotic are that the probiotics have to be kept alive in the digestive tract to obtain health benefits. The approach taken to keep these bacteria alive is the use of prebiotics. Prebiotics are components of food that cannot be digested by the digestive tract enzymatically. Thus, they are fermented by microbiota in the large intestine to produce metabolites, one of which is short-chain fatty acids (SCFA) as a product of fermentation. SCFA (Short Chain Fatty Acid) or short-chain fatty acids play a neuroprotective role, synthesizing neurotransmitters and modulating the immune system. Therefore, this review explains how stroke affects the quantity and quality of microbiota in the gut in the communication process of the microbiota-gut-brain axis and the role of prebiotics in improving dysbiosis. Hence, it can provide better post-stroke clinical outcomes.