Spinal cord injury and the human microbiome: Beyond the brain-gut axis

David J. Wallace, Naomi L. Sayre, T. Tyler Patterson, Susannah E. Nicholson, Donald Hilton, Ramesh Grandhi

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


In addition to standard management for the treatment of the acute phase of spinal cord injury (SCI), implementation of novel neuroprotective interventions offers the potential for significant reductions in morbidity and long-term health costs. A better understanding of the systemic changes after SCI could provide insight into mechanisms that lead to secondary injury. An emerging area of research involves the complex interplay of the gut microbiome and the CNS, i.e., a brain-gut axis, or perhaps more appropriately, a CNS-gut axis. This review summarizes the relevant literature relating to the gut microbiome and SCI. Experimental models in stroke and traumatic brain injury demonstrate the bidirectional communication of the CNS to the gut with postinjury dysbiosis, gastrointestinal-associated lymphoid tissue-mediated neuroinflammatory responses, and bacterial-metabolite neurotransmission. Similar findings are being elucidated in SCI as well. Experimental interventions in these areas have shown promise in improving functional outcomes in animal models. This commensal relationship between the human body and its microbiome, particularly the gut microbiome, represents an exciting frontier in experimental medicine.

Original languageEnglish (US)
Article numberE11
JournalNeurosurgical focus
Issue number3
StatePublished - Mar 1 2019


  • Brain-gut axis
  • Microbiome
  • Spinal cord injury

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery


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