School of Medicine, Patras University, Patras, Greece.
Department of Psychiatry, Aiginiteio University Hospital, Athens, Greece.
Curr Med Chem. 2022;29(23):4050-4077. doi: 10.2174/0929867328666211213112949.
The gut microbiome interacts with host physiology through various mechanisms, including the cardiovascular (CV) system. A healthy microbiome has the ability to process and digest complex carbohydrates into short-chain fatty acids (SCFA). These SCFA function as signaling molecules, immune-modulating molecules, and energy sources. However, when the microbiome is altered, it produces gut dysbiosis with overgrowth of certain bacteria that may lead to overproduction of trimethylamine-N-oxide (TMAO) from the metabolism of phosphatidylcholine, choline, and carnitine; dysbiosis also leads to increased intestinal permeability allowing the microbiome-derived lipopolysaccharide (LPS), a bacterial endotoxin, to enter the blood circulation, triggering inflammatory responses. An altered gastrointestinal (GI) tract environment and microbiome- derived metabolites are associated with CV events. Disrupted content and function of the microbiome leading to elevated TMAO and LPS levels, altered bile acid metabolism pathways, and SCFA production are associated with an increased risk of CV diseases (CVD), including atherosclerosis, myocardial infarction, thrombosis, arrhythmias, and stroke. Therapeutic interventions that may favorably influence a dysbiotic GI tract profile and promote a healthy microbiome may benefit the CV system and lead to a reduction of CVD incidence in certain situations. These issues are herein reviewed with a focus on the spectrum of microbiota-related CVD, the mechanisms involved, and the potential use of microbiome modification as a possible therapeutic intervention.
肠道微生物组通过多种机制与宿主生理学相互作用，包括心血管 (CV) 系统。健康的微生物组能够将复杂的碳水化合物加工和消化成短链脂肪酸 (SCFA)。这些 SCFA 作为信号分子、免疫调节分子和能量来源发挥作用。然而，当微生物组发生改变时，它会产生肠道菌群失调，某些细菌过度生长，这可能导致从磷脂酰胆碱、胆碱和肉碱代谢中产生过多的氧化三甲胺 (TMAO)；菌群失调还会导致肠道通透性增加，使微生物组衍生的脂多糖 (LPS)，一种细菌内毒素，进入血液循环，引发炎症反应。改变的胃肠道 (GI) 环境和微生物组衍生的代谢物与 CV 事件有关。微生物组的内容和功能被破坏，导致 TMAO 和 LPS 水平升高、胆汁酸代谢途径改变和 SCFA 产生，这与 CV 疾病 (CVD) 的风险增加有关，包括动脉粥样硬化、心肌梗死、血栓形成、心律失常和中风。可能对肠道菌群失调产生有利影响并促进健康微生物组的治疗干预可能有益于 CV 系统，并在某些情况下降低 CVD 的发病率。本文重点讨论了与微生物组相关的 CVD 的范围、涉及的机制以及微生物组修饰作为一种潜在治疗干预的可能性。
