Bidirectional regulatory mechanisms and targeted therapeutic strategies of the microbiota in ischemic stroke.

Ischemic stroke (IS) is not only one of the leading causes of various degrees of dysfunction and disability worldwide, but also the third leading cause of death after heart disease and cancer. Due to the short treatment window and limited efficacy, current treatments face significant challenges, highlighting the urgent need for new neuroprotective therapeutic strategies. The microbiota is regarded as a virtual organ of the body, which is divided into microbiota of the intestines, oral cavity, respiratory tract, and reproductive tract according to the colonization site. In recent years, both basic experiments and clinical studies have emphasized the important relationship between microbiota and IS. For many years, the impact of dysbiosis on IS has become an important and active research direction in the fields of biology and medicine. In this review, we focus on the relationship between the microbiota of the intestines, oral cavity, and other related parts and IS, and emphasize the bidirectional mechanism of action between them. In addition, we discuss potential strategies for treating IS that target the microbiota in different parts, aiming to provide new ideas for disease prevention, diagnosis, and treatment.