Integrated Omics approach to Explore Gut Microbiome Signature, Gut integrity biomarkers and Short-chain fatty acid profile, predictive tool in Aneurysmal Subarachnoid Hemorrhage

This research proposal outlines a prospective, observational cohort study investigating the role of the gut-brain axis in Aneurysmal Subarachnoid Hemorrhage (aSAH), a life-threatening condition associated with high morbidity and mortality. The study aims to address a critical gap in neurocritical care by exploring how the gut microbiome and its metabolic byproducts influence the disease progression and its further complications, specifically cerebral vasospasm (CV) and delayed cerebral ischemia (DCI). This study adopts an integrated omics approach, combining genomics and metabolomics to provide a holistic view of this complex interaction. A total of 90 participants, 45 aSAH patients and 45 healthy controls will be enrolled, with samples collected within 72 hours of hospital admission. The research methodology includes several key steps such as 16S rRNA gene sequencing will be performed on stool samples to comprehensively profile the gut microbiome signature and identify specific gut bacterial biomarker Simultaneously, plasma levels of short-chain fatty acids (SCFAs), which are vital metabolites known to modulate inflammation and maintain gut barrier integrity, will be quantified using Gas Chromatography-Mass Spectrometry (GC-MS). Furthermore, the study will measure blood levels of key tight-junction proteins, namely Zonulin, Occludin, and Claudin-5, using ELISA to assess the integrity and permeability of the intestinal and blood brain barriers. By establishing a link between gut dysbiosis, altered metabolite profiles, and barrier dysfunction with aSAH outcomes, this research seeks to identify novel biomarkers and create the potential for new diagnostic tools and personalized therapeutic strategies. This groundbreaking study is the first of its kind to be conducted in the Indian population, offering a unique opportunity to understand these mechanisms in a diverse and understudied cohort.