Probiotics and Phytoantioxidants as Emerging Neuroprotective Strategies: Bridging the Therapeutic Gap in Open Heart Surgery-Induced Brain Injury.

2026-02-26
Biomedicines 14(3)
- Yen Chu
- Kuo-Hsiung Huang
- Chi-Nan Tseng

PubMed: 41898174
DOI: 10.3390/biomedicines14030527

Study Design

Type: Review

Despite its lifesaving role, open heart surgery (OHS) is frequently complicated by neurological injury resulting from cerebral ischemia and reperfusion (I/R) injury, systemic inflammation, and unavoidable oxidative stress. These pathological cascades lead to neuronal death and cognitive decline, which highlights the urgent need for adjunctive neuroprotective strategies. Probiotics and phytoantioxidants have emerged as promising candidates because of their ability to modulate gut-brain axis signaling, reduce oxidative stress, and support vascular repair. Probiotics provide benefits by stabilizing intestinal microbiota, lowering systemic endotoxemia, and enhancing anti-inflammatory cytokine activity, thereby indirectly protecting neural tissue. Phytoantioxidants such as polyphenols directly neutralize I/R-induced reactive oxygen species (ROS), which promote microvascular recovery and neuronal survival. Experimental studies demonstrate the effects of probiotics and phytoantioxidants in reducing excitotoxic neuronal injury and improving neurovascular outcomes, while preliminary clinical observations suggest potential cognitive benefits in surgical populations. Nevertheless, cohort evidence remains scarce, and standardized clinical trials are required to establish optimal dosing, bioavailability, and long-term efficacy. This review emphasizes the translational potential of probiotics and phytoantioxidants as complementary interventions to mitigate brain injury after OHS, addressing a critical therapeutic gap in perioperative neuroprotection.

Research Insights

Bifidobacterium plantarum→Improved Cognitive Function
Experimental studies demonstrate the effects of probiotics and phytoantioxidants in reducing excitotoxic neuronal injury and improving neurovascular outcomes, while preliminary clinical observations suggest potential cognitive benefits in surgical populations.
Effect
Beneficial
Effect size
Small
Bifidobacterium plantarum→Improved Neuronal Survival
Experimental studies demonstrate the effects of probiotics and phytoantioxidants in reducing excitotoxic neuronal injury and improving neurovascular outcomes.
Effect
Beneficial
Effect size
Small
Bifidobacterium plantarum→Improved Neuroprotection
Probiotics and phytoantioxidants have emerged as promising candidates because of their ability to modulate gut-brain axis signaling, reduce oxidative stress, and support vascular repair. Probiotics provide benefits by stabilizing intestinal microbiota, lowering systemic endotoxemia, and enhancing anti-inflammatory cytokine activity, thereby indirectly protecting neural tissue.
Effect
Beneficial
Effect size
Moderate
Bifidobacterium plantarum→Reduced Neuroinflammation
Probiotics provide benefits by stabilizing intestinal microbiota, lowering systemic endotoxemia, and enhancing anti-inflammatory cytokine activity, thereby indirectly protecting neural tissue.
Effect
Beneficial
Effect size
Small
Bifidobacterium plantarum→Reduced Oxidative Stress
Phytoantioxidants such as polyphenols directly neutralize I/R-induced reactive oxygen species (ROS), which promote microvascular recovery and neuronal survival.
Effect
Beneficial
Effect size
Small