Improvement of neurological function, immune function and inflammatory response in patients with severe cerebral hemorrhage by probiotic low-fat enteral nutrition

Bei Yuan; Qiannan Qi; Xulei Li; Kai Wang

doi:10.36721/PJPS.2025.38.6.REG.14125.1

Author(s)

Bei Yuan Department of General Internal Medicine Ward 2, Affiliated Hospital of Hebei University,Baoding, Hebei,China

Qiannan Qi Department of Neurology, Affiliated Hospital of Hebei University,Baoding, Hebei,China

Xulei Li Department of Neurology, Affiliated Hospital of Hebei University,Baoding, Hebei,China

Kai Wang Department of General Internal Medicine Ward 2, Affiliated Hospital of Hebei University,Baoding, Hebei,China

Abstract

After the occurrence of cerebral hemorrhage (CH), patients generally develop neurological disorders and dysphagia, requiring enteral nutrition support. In this study, the research team explored the impact of predictive management-assisted probiotic low-fat nutritional supplements on CH patients. A total of 114 CH patients admitted to our hospital from August 2022 to June 2024 were selected as the study subjects. They were divided into a control group (n=57) using low-fat nutritional supplements and an experimental group (n=57) using probiotic combined with low-fat nutritional supplements. After treatment, the NIHSS of the experimental group was found to be lower than that of the control group, while the ADL was higher than that of the control group (p<0.05). In addition, glutamate (Glu), aspartic acid (Asp), CD8+ and inflammatory factors were lower in the experimental group than in the control group after treatment, whereas glycine (Gly), gamma-aminobutyric acid (GABA), cluster of differentiation (CD)3+, CD4+, CD4+/CD8+ were higher than in the control group (P< 0.05). In conclusion, probiotic low-fat nutrition combined with predictive management significantly improves neurological function.

Publication Details

Page(s) 2401-2408

DOI 10.36721/PJPS.2025.38.6.REG.14125.1

Published Journal: Pakistan Journal of Pharmaceutical Sciences, Volume: 38, Issue: 6, Year: 2025

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Keywords

Cerebral hemorrhage, inflammatory factors, T lymphocyte subsets, Neurotransmitters, Enteral nutrition support, Low-fat enteral nutrition

References

Aghamohammad S,Hafezi A,Rohani M .2023 .Probiotics as functional foods: How probiotics can alleviate the symptoms of neurological disabilities. BioMed, 163 : 114816.

Al-Kawaz MN,Hanley DF,Ziai W .2020 .Advances in therapeutic approaches for spontaneous intracerebral hemorrhage. , 17(4) : 1757-1767.

Alemseged F,Rocco A,Arba F,Schwabova JP,Wu T,Cavicchia L,Ng F,Ng JL,Zhao H,Williams C,Sallustio F,Balabanski AH,Tomek A,Parson MW,Mitchell PJ,Diomedi M,Yassi N,Churilov L,Davis SM,Campbell BCV,Management (BATMAN) Collaboration Investigators BCV .2022 .Posterior national institutes of health stroke scale improves prognostic accuracy in posterior circulation stroke. Stroke., 53(4) : 1247-1255.

Blackman I,Mudd A .2023 .An empirical analysis of the constructs of fundamentals of care framework using structural equation modelling. J. Adv. Nurs., 79(3) : 1139-1151.

Chen X,Liu J,He Y,Wei L,Deng M,Zhang R,Song H,Yang Y .2025 .Predicting poor self-management behaviors in adults with newly diagnosed COPD: Based on the information-motivation-behavioral skills model. BMC, 25(1) : 1384.

Cheng M,Li T,Hu E,Yan Q,Li H,Wang Y,Luo J,Tang T .2024 .A novel strategy of integrating network pharmacology and transcriptome reveals antiapoptotic mechanisms of Buyang Huanwu Decoction in treating intracerebral hemorrhage. J. Ethnopharmacol., 319 : 117123.

Cho H,Jo M,Oh H,Lee Y,Park Y Y .2023 .Synergistic antidepressant-like effect of n-3 polyunsaturated fatty acids and probiotics through the brain-gut axis in rats exposed to chronic mild stress. J. Nutr, 116 : 109326.

Deng S,Liu S,Jin P,Feng S,Tian M,Wei P,Zhu H,Tan J,Zhao F,Gong Y .2021 .Albumin reduces oxidative stress and neuronal apoptosis via the ERK/Nrf2/HO-1 pathway after intracerebral hemorrhage in Rats. Oxid. Med, : 8891373.

Garg A,Ortega-Gutierrez S,Farooqui M,Nagaraja N M .2022 .Recurrent intracerebral hemorrhage in patients with cerebral amyloid angiopathy: A propensitymatched case-control study. J. Neurol., 269(4) : 2200-2205.

Hao J,Jiang K,Wu M,Yu J,Zhang X .2020 .The effects of music therapy on amino acid neurotransmitters: Insights from an animal study. Physiol. Behav, 224 : 113024.

Wang Huang Z,Y Huang Z .2022 .Perioperative enteral immunonutrition with probiotics favors the nutritional, inflammatory and functional statuses in digestive system surgery. Asia. Pac. J. Clin. Nutr, 31(1) : 78-86.

Indraswari ADW,Aisyiyah U,Kurniawan K,Surboyo MDC .2024 .Prediction pressure ulcers in high care unit patients: Evaluating risk factors and predictive scale using a prospective cross-sectional study. Avicenna. J. Med, 14(1) : 39-44.

Jiang Y,Lam SM,Zhang S,Miao H,Zhou Y,Zhang Q,Zhou T,Feng H,Ding N,Wang H,Luo R,Yin Y,Feng H,Shui G,Hu R .2025 .CSF multi-omics of intracerebral hemorrhage from onset to reperfusion underscores lipid metabolism in functional outcome. Sci. Bull, 70(2) : 162-166.

Jiang H,Zeng W,Zhu F,Zhang X,Cao D,Peng A,Wang H A .2025 .Exploring the associations of gut microbiota with inflammatory and the early hematoma expansion in intracerebral hemorrhage: From change to potential therapeutic objectives. Front. Cell. Infect. Microbiol., 15 : 1462562.

Juan Z,Chen J,Ding B,Yongping L,Liu K,Wang L,Le Y,Liao Q,Shi J,Huang J,Wu Y,Ma D,Ouyang W,Tong J .2022 .Probiotic supplement attenuates chemotherapy-related cognitive impairment in patients with breast cancer: A randomised, double-blind and placebo-controlled trial. Eur. J. Cancer., 161 : 10-22.

Kang T,Xue Y,Yang Q,Lei Q .2023 .Analysis of the effect of early nutritional support on clinical treatment and prognosis of emergency patients with severe intracerebral hemorrhage. Panminerva. Med, 65(3) : 424-425.

Karakan T,Ozkul C,Kupeli Akkol E,Bilici S,SobarzoSanchez E,Capasso R .2021 .Gut-brain-microbiota axis: Antibiotics and functional gastrointestinal disorders. , 13(2) : 389.

Kase CS,Hanley DF CS .2021 .Intracerebral hemorrhage: Advances in emergency care. Neurol. Clin., 39(2) : 405-418.

Li L,Liu T,Gu Y,Wang X,Xie R,Sun Y,Wang B,Cao H B .2022 .Regulation of gut microbiota-bile acids axis by probiotics in inflammatory bowel disease. Front. Immunol., 13 : 974305.

Li R,Zhang X,Gu L,Yuan Y,Luo X,Shen W .2023 .CDGSH iron sulfur domain 2 over-expression alleviates neuronal ferroptosis and brain injury by inhibiting lipid peroxidation via AKT/mTOR pathway following intracerebral hemorrhage in mice. J. Neurochem., 165(3) : 426-444.

Magid-Bernstein J,Girard R,Polster S,Srinath A,Romanos S,Awad IA,Sansing LH .2022 .Cerebral hemorrhage: Pathophysiology, treatment and future directions. Circ. Res., 130(8) : 1204-1229.

Montano A,Hanley DF,Hemphill JC .2021 .Hemorrhagic stroke. Handb. Clin. Neurol, 176 : 229-248.

Morkl S,Narrath M,Schlotmann D,Sallmutter MT,Putz J,Lang J,Brandstatter A,Pilz R,Karl Lackner H,Goswami N,Steuber B,Tatzer J,Lackner S,Holasek S,Painold A,Jauk E,Wenninger J,Horvath A,Spicher N,Barth A,Butler MI,Wagner-Skacel J .2025 .Multispecies probiotic supplement enhances vagal nerve function - results of a randomized controlled trial in patients with depression and healthy controls. Gut, 17(1) : 2492377.

Naomi R,Embong H,Othman F,Ghazi HF,Maruthey N,Bahari H N .2021 .Probiotics for alzheimer's disease: A systematic review. Nutrients., 14(1) : 20.

Rubin DJ,Shah AA .2021 .Predicting and preventing acute care re-utilization by patients with diabetes. Curr. Diab. Rep, 21(9) : 34.

Wan Y,Holste KG,Hua Y,Keep RF,Xi G .2023 .Brain edema formation and therapy after intracerebral hemorrhage. Neurobiol. Dis., 176 : 105948.

Zhang C,Zhang S,Yin Y,Wang L,Li L,Lan C,Shi J,Jiang Z,Ge H,Li X,Ao Z,Hu S,Chen J,Feng H,Hu R H .2024 .Clot removAl with or without decompressive craniectomy under ICP monitoring for supratentorial intracerebral hemorrhage (CARICH): A randomized controlled trial. Int. J. Surg., 110(8) : 4804-4809.

Zhang Y,Xiong Y,Yu Q,Shen S,Chen L,Lei X .2021 .The activity of daily living (ADL) subgroups and health impairment among Chinese elderly: A latent profile analysis. BMC. Geriatr., 21(1) : 30.

Zheng L,Chen Y,Lin X,Deng S,Sun B,Zheng J,Zeng F,Xue Y .2024 .Relationship between fetal-type posterior cerebral artery and basilar artery atherosclerosis. Front, 16 : 1533281.