Novakovic Marko, Rout Amit, Kingsley Thomas, Kirchoff Robert, Singh Amteshwar, Verma Vipin, Kant Ravi, Chaudhary Rahul
Department of Internal Medicine, Sinai Hospital of Baltimore, Baltimore, MD 21215, United States.
Department of Internal Medicine, Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN 55905, United States.
World J Cardiol. 2020 Apr 26;12(4):110-122. doi: 10.4330/wjc.v12.i4.110.
The human gut is colonized by a community of microbiota, primarily bacteria, that exist in a symbiotic relationship with the host. Intestinal microbiota-host interactions play a critical role in the regulation of human physiology. Deleterious changes to the composition of gut microbiota, referred to as gut dysbiosis, has been linked to the development and progression of numerous diseases, including cardiovascular disease (CVD). Imbalances in host-microbial interaction impair homeostatic mechanisms that regulate health and can activate multiple pathways leading to CVD risk factor progression. Most CVD risk factors, including aging, obesity, dietary patterns, and a sedentary lifestyle, have been shown to induce gut dysbiosis. Dysbiosis is associated with intestinal inflammation and reduced integrity of the gut barrier, which in turn increases circulating levels of bacterial structural components and microbial metabolites, including trimethylamine-N-oxide and short-chain fatty acids, that may facilitate the development of CVD. This article reviews the normal function and composition of the gut microbiome, mechanisms leading to the leaky gut syndrome, its mechanistic link to CVD and potential novel therapeutic approaches aimed towards restoring gut microbiome and CVD prevention. As CVD is the leading cause of deaths globally, investigating the gut microbiota as a locus of intervention presents a novel and clinically relevant avenue for future research.
人类肠道被一群微生物群落定殖,主要是细菌,它们与宿主存在共生关系。肠道微生物群与宿主的相互作用在人类生理调节中起着关键作用。肠道微生物群组成的有害变化,即肠道生态失调,与包括心血管疾病(CVD)在内的多种疾病的发生和发展有关。宿主与微生物相互作用的失衡会损害调节健康的稳态机制,并能激活导致心血管疾病危险因素进展的多种途径。大多数心血管疾病危险因素,包括衰老、肥胖、饮食模式和久坐不动的生活方式,已被证明会诱发肠道生态失调。生态失调与肠道炎症和肠道屏障完整性降低有关,这反过来又会增加细菌结构成分和微生物代谢产物的循环水平,包括氧化三甲胺和短链脂肪酸,这些可能会促进心血管疾病的发展。本文综述了肠道微生物群的正常功能和组成、导致肠道渗漏综合征的机制、其与心血管疾病的机制联系以及旨在恢复肠道微生物群和预防心血管疾病的潜在新治疗方法。由于心血管疾病是全球死亡的主要原因,将肠道微生物群作为一个干预靶点进行研究为未来研究提供了一条新的、具有临床相关性的途径。