Marzullo Paolo, Di Renzo Laura, Pugliese Gabriella, De Siena Martina, Barrea Luigi, Muscogiuri Giovanna, Colao Annamaria, Savastano Silvia
Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy.
Division of General Medicine, IRCCS Istituto Auxologico Italiano, 28923 Piancavallo, Verbania Italy.
Int J Obes Suppl. 2020 Jul;10(1):35-49. doi: 10.1038/s41367-020-0017-1. Epub 2020 Jul 20.
The co-existence of humans and gut microbiota started millions of years ago. Until now, a balance gradually developed between gut bacteria and their hosts. It is now recognized that gut microbiota are key to form adequate immune and metabolic functions and, more in general, for the maintenance of good health. Gut microbiota are established before birth under the influence of maternal nutrition and metabolic status, which can impact the future metabolic risk of the offspring in terms of obesity, diabetes, and cardiometabolic disorders during the lifespan. Obesity and diabetes are prone to disrupt the gut microbiota and alter the gut barrier permeability, leading to metabolic endotoxaemia with its detrimental consequences on health. Specific bacterial sequences are now viewed as peculiar signatures of the metabolic syndrome across life stages in each individual, and are linked to pathogenesis of cardiovascular diseases (CVDs) via metabolic products (metabolites) and immune modulation. These mechanisms have been linked, in association with abnormalities in microbial richness and diversity, to an increased risk of developing arterial hypertension, systemic inflammation, nonalcoholic fatty liver disease, coronary artery disease, chronic kidney disease, and heart failure. Emerging strategies for the manipulation of intestinal microbiota represent a promising therapeutic option for the prevention and treatment of CVD especially in individuals prone to CV events.
人类与肠道微生物群的共存始于数百万年前。到目前为止，肠道细菌与其宿主之间逐渐形成了一种平衡。现在人们认识到，肠道微生物群是形成适当免疫和代谢功能的关键，更广泛地说，对维持良好健康至关重要。肠道微生物群在出生前受母体营养和代谢状态的影响而建立，这可能会影响后代在整个生命周期中肥胖、糖尿病和心血管代谢紊乱方面未来的代谢风险。肥胖和糖尿病容易破坏肠道微生物群并改变肠道屏障通透性，导致代谢性内毒素血症及其对健康的有害后果。特定的细菌序列现在被视为个体生命各阶段代谢综合征的特殊标志，并通过代谢产物（代谢物）和免疫调节与心血管疾病（CVD）的发病机制相关联。这些机制与微生物丰富度和多样性异常相关，会增加患动脉高血压、全身炎症、非酒精性脂肪性肝病、冠状动脉疾病、慢性肾病和心力衰竭的风险。操纵肠道微生物群的新兴策略是预防和治疗CVD的一种有前景的治疗选择，特别是对于易发生心血管事件的个体。
