Department of Physiology and Pharmacology, UT Microbiome Consortium, Center for Hypertension and Precision Medicine, College of Medicine and Life Sciences, University of Toledo, OH.
Hypertension. 2022 Oct;79(10):2138-2147. doi: 10.1161/HYPERTENSIONAHA.122.19826. Epub 2022 Jul 20.
Microbiota colonization begins at birth and continuously reshapes throughout the course of our lives, resulting in tremendous interindividual heterogeneity. Given that the gut microbiome, similar to the liver, houses many categories of catalytic enzymes, there is significant value in understanding drug-bacteria interactions. The discovery of this link could enhance the therapeutic value of drugs that would otherwise have a limited or perhaps detrimental effect on patients. Resistant hypertension is one such subset of the hypertensive population that poorly responds to antihypertensive medications, resulting in an increased risk for chronic cardiovascular illnesses and its debilitating effects that ultimately have a detrimental impact on patient quality of life. We recently demonstrated that the gut microbiota is involved in the metabolism of antihypertensive drugs and thus contributes to the pathophysiology of resistant hypertension. Due to a lack of knowledge of the mechanisms, novel therapeutic approaches that account for the gut microbiota may allow for better therapeutic outcomes in resistant hypertension. Therefore, the purpose of this review is to summarize our current, albeit limited, understanding of how the gut microbiota may possess particular enzymatic activities that influence the efficacy of antihypertensive drugs.
微生物组定植始于出生，并在我们的一生中持续重塑，导致个体间存在巨大的异质性。鉴于肠道微生物组与肝脏一样，拥有许多类别的催化酶，因此了解药物-细菌相互作用具有重要意义。发现这种联系可以提高药物的治疗价值，否则这些药物对患者的影响有限，甚至可能有害。耐药性高血压就是高血压人群中的一个亚组，对降压药物反应不佳，导致慢性心血管疾病风险增加及其致残影响，最终对患者的生活质量产生不利影响。我们最近表明，肠道微生物群参与了抗高血压药物的代谢，从而导致耐药性高血压的病理生理学发生。由于对机制缺乏了解，考虑肠道微生物群的新型治疗方法可能会使耐药性高血压的治疗效果更好。因此，本综述的目的是总结我们目前对肠道微生物群如何具有特定酶活性从而影响抗高血压药物疗效的有限认识。
