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A synbiotic combination consisting of the prebiotic Puerariae lobatae Radix-resistant starch (PRS) and the probiotic *Akkermansia muciniphila* (AKK). This combination is being investigated for the treatment of ischemic stroke by modulating the gut-brain axis. PRS selectively enriches AKK, which produces the metabolite indole lactic acid (ILA). ILA acts as a ligand for the aryl hydrocarbon receptor (AhR) and activates the Nrf2 signaling pathway. This activation leads to the upregulation of ferroptosis-inhibiting proteins, specifically SLC7A11 and GPX4, thereby reducing neuronal damage and intestinal injury following an ischemic stroke. Preclinical studies in rat models have shown that this synbiotic approach is more effective than either component alone in alleviating stroke-induced damage.
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