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CC BY 4.0 · Indian Journal of Neurotrauma
DOI: 10.1055/s-0045-1809656
Original Article

Gut Microbiome Alterations in Patients with Severe Traumatic Brain Injury: A Feasibility Study

Venencia Albert 
1   Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India
,
Arulselvi Subramanian 
1   Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India
,
Deepak Agrawal 
2   Department of Neurosurgery and Gamma-Knife, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations
Funding None.
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Abstract

Introduction

Severe traumatic brain injury (sTBI) is associated with significant morbidity and mortality. Emerging evidence from animal studies suggests a potential role for the gut microbiome in modulating systemic inflammation and neurological outcomes following TBI. However, the association between gut microbiome composition and the clinical course and neurological outcome in sTBI patients has not been extensively studied. This study aims to test the feasibility of exploring the potential association between gut microbiome composition, clinical course, and neurological outcomes in patients with sTBI.

Materials and Methods

A prospective longitudinal pilot study was conducted, recruiting patients with sTBI based on the Glasgow Coma Scale at the emergency department. Fecal samples for microbiota analysis using 16S rRNA gene sequencing with nanopore long-read technology were collected within the first 24 hours after injury and on the 7th day post-injury.

Results

Metagenomic analysis revealed significant alterations in gut microbiome composition following TBI. A marked decrease in beneficial commensals such as Prevotella copri and Lactobacillus was observed, while opportunistic and potentially pathogenic species like Klebsiella pneumoniae and Bacteroides fragilis increased. Alpha and β diversity analyses confirmed a significant shift in microbial diversity, with a distinct separation between pre- and post-injury samples.

Conclusion

This pilot study provides preliminary evidence of gut microbiome alterations following sTBI and supports the feasibility of conducting a larger scale study. The findings highlight the potential of microbiome-targeted interventions in TBI management.

Keywords

traumatic brain injury - gut microbiome - neurological outcomes - pilot study - feasibility

Ethical Approval

This study received approval from the institutional ethics committee prior to initiation [Ref. No.: AIIMSA2919/03.01.2025, RP-38/2025]. Informed consent will be obtained from all participants or their legally authorized representatives.




Publication History

Article published online:
13 June 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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