Effects of Xinglou Chengqi decoction on central and peripheral immune inflammation in mice with AIS are correlated with intestinal flora

To explore the effect of Xinglou Chengqi decoction (XCD) on the brain-gut axis in mice with acute ischemic stroke. A cerebral ischemia-reperfusion model identified as phlegm-heat and fu-organ excess pattern was established by reforming the Longa method and based on the diagnostic criteria of traditional Chinese medicine. Sixty specific-pathogen free male C57BL/6 mice were randomly divided into five groups, and 36 antibiotic-treated (ABX) mice were randomly divided into three groups. Cecum norepinephrine (NE) and motilin (MTL) were detected by enzyme-linked immunosorbent assay, cecum tyrosine hydroxylase (TH) protein expression level was detected by immunohistochemistry, Iba-1 and glial fibrillary acidic protein (GFAP) expression levels were detected by immunofluorescence, and serum inflammatory factor contents were detected using the flow multifactor technique. Compared to the sham group, a significant increase in TH expression level was observed in the cecum in the middle cerebral artery occlusion (MCAO) group (P = .015). MTL levels were significantly increased in the MCAO group compared with the sham group (P < .001) and significantly decreased in the XCD and nimodipine (Nim) groups compared with the MCAO group (P = .003 and P = .007, respectively). Astrocytes and microglia were markedly activated in the MCAO group, whereas activation was decreased in the XCD group compared to the MCAO group. Antibiotic-treated (ABX) mice astrocytes and microglia were obviously activated in the ABX-MCAO group, and activation tended to be lower in the ABX-XCD group. Interleukin-22 level significantly increased in the ABX-XCD group compared with the ABX-MCAO (P = .021). XCD has a significant regulatory effect on the immune pathway of the brain-gut axis in mice with acute ischemic stroke, while the removal of the gut microbiota attenuates the effect considerably.