The Link Between Ischemic Stroke and the Gut Microbiome

This review article explores the emerging link between gut microbiome dysbiosis and ischemic stroke pathogenesis. Recent research suggests that microbial metabolites, systemic inflammation, and microbiome-driven thrombotic mechanisms may significantly influence cerebrovascular risk. The article proposes a conceptual "Triple Axis Model" integrating three key pathways: metabolic, neuro-immune, and thrombotic mechanisms. These interconnected processes contribute to endothelial dysfunction, neuroinflammation, platelet activation, and increased susceptibility to ischemic stroke. The review summarizes current evidence on microbiome-derived metabolites such as trimethylamine-N-oxide (TMAO), lipopolysaccharides (LPS), and short-chain fatty acids (SCFAs), and discusses how microbial dysbiosis may contribute to vascular inflammation and thrombosis. Understanding microbiome–brain–vascular interactions may provide new perspectives for stroke prevention, risk assessment, and therapeutic intervention.