Traumatic Brain Injury Clinical Trial
Official title:
The Clinical Research on the Relationship Between Circadian Rhythm and Gut Microbiota in TBI Patients
Microbiome studies may be highlighted as crucial in the development of sleep disorder for TBI patients. The microbiota-gut-brain connection may further provide an opportunity for microbiota manipulation to treat the TBI patients with sleep disorders.This study is to investigate whether exist the relationship between sleep disorder and circadian rhythm of patients with TBI or not and focus the study on the potential of the host-microbiota interaction in regulating sleep disorder.
Neuroscientists are probing the connections between intestinal microbes and brain
development. The general scaffolding of the brain-gut-enteric microbiota axis includes the
central nervous system (CNS), the neuroendocrine and neuroimmune systems, the sympathetic
and parasympathetic arms of the autonomic nervous system (ANS), the enteric nervous system
(ENS), and of course the intestinal microbiota. These components interact to form a complex
reflex network with afferent fibers that project to integrative CNS structures and efferent
projections to the smooth muscle. Gut microbiota regulates intestinal and extraintestinal
homeostasis. Accumulating evidence suggests that the gut microbiota may also regulate brain
function and behavior. Results from animal models indicate that disturbances in the
composition and functionality of some microbiota members are associated with
neurophysiological disorders, strengthening the idea of a microbiota-gut-brain axis and the
role of microbiota as a "peacekeeper" in the brain health. It is now clear that the
gut-brain communication is bidirectional. On one hand, changes in the microbial community
affect behavior. On the other hand, perturbations in behavior alter the composition of the
gut microbiota. Since changes in the composition of the gut microbiota are associated with
the behavioral and cognitive alterations, a healthy microbiota community is essential for a
normal regulation of the microbiota-gut-brain axis. Among the potential factors regulating
the axis, microbial metabolites may be the major mediators.
Seven million traumatic brain injuries (TBIs) occur each year in the many countries. One of
the most common sequelae in patients exposed to TBI is disrupted sleep, which is especially
common following mild TBI. And another one is intestinal function disorder.
Sleep is governed by the intricate interplay between sleep wake homeostasis and circadian
rhythms in the body. These rhythms are largely controlled by the suprachiasmatic nucleus
(SCN) of the anterior hypothalamus. Clock genes form the molecular machinery of this
circadian system, operating via autoregulatory feedback loops.
Among the vertebrate peripheral tissues that express circadian rhythms is the
gastrointestinal system, which exhibit circadian rhythms in gene expression (including clock
genes), motility and secretion in vivo and in vitro. These rhythms depend upon a patent
molecular clock and they are also coordinated by SCN input via the sympathetic nervous
system.
The emerging role of the gut microbiome as an important modulator of gastrointestinal
function has recently included the role of circadian rhythms. Recent studies have suggested
that microbial signaling plays a critical role in homeostatic maintenance of intestinal
function along with the host circadian mechanism.
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