Naik Shaili S, Ramphall Shivana, Rijal Swarnima, Prakash Vishakh, Ekladios Heba, Mulayamkuzhiyil Saju Jiya, Mandal Naishal, Kham Nang I, Shahid Rabia, Venugopal Sathish
Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Internal Medicine, Surat Municipal Institute of Medical Education and Research (SMIMER) Hospital and Medical College, Surat, IND.
Cureus. 2022 Oct 4;14(10):e29927. doi: 10.7759/cureus.29927. eCollection 2022 Oct.
Hypertension (HTN) is one of the most prevalent and dangerous cardiovascular diseases worldwide. Recently, its direct or indirect association with gut dysbiosis has been an interest of study for many. It also includes the metabolomic and functional gene changes in hypertensives compared with healthy individuals. This systematic review aims to study quantitative and qualitative interactions between the two and re-defining the heart-gut axis. We have strictly followed the (PRISMA), 2020, guidelines. We conducted an in-depth search of databases such as PubMed, PubMed Central (PMC), Medline, and ScienceDirect to find relevant studies for our topic of interest. After the final quality check, we included eight articles in the systematic review. A significant difference in richness and diversity in gut microbiota was observed in hypertensive patients compared with healthy controls. There was an increased abundance of many bacteria such as , , , Enterobacteriaceae, , , , , and , while a decreased abundance of , , spp., and . Alteration of the composition also varied based on diet, age, ethnicity, and severity of HTN. Short-chain fatty acids (SCFAs)-producing bacteria are found to be on the lower side in hypertensives owing to the protective property of SCFAs against inflammation, especially butyric acid. From the perspective of metabolomic changes, harmful metabolites for cardiovascular health such as intestinal fatty acid binding protein (I-FABP), lipopolysaccharides (LPSs), zonulin, sphingomyelins, acylcarnitines, and trimethylamine -oxide (TMAO) were found to be increased in hypertensives. Changes in these biomarkers further establish the relation between gut epithelial health and high blood pressure (BP). Participants affected by diseases have an overall lower rate of acquiring new genes, which results in a low richness of genes in them compared with healthy individuals. There is increased expression of the choline utilization () gene and reduced expression of genes associated with biosynthesis and transport of amino acids in high-BP participants. The unique changes in the composition of the microbiota, functional changes in genes, and metabolome collectively help for a better understanding of the pathogenesis of HTN and also suggest the gut as a promising new therapeutic target for HTN. To establish a further causal relationship between the two, more research is required.
高血压(HTN)是全球最常见且危险的心血管疾病之一。最近,其与肠道菌群失调的直接或间接关联成为许多人研究的热点。这还包括高血压患者与健康个体相比的代谢组学和功能基因变化。本系统评价旨在研究两者之间的定量和定性相互作用,并重新定义心-肠轴。我们严格遵循了2020年的《系统评价和Meta分析的首选报告项目》(PRISMA)指南。我们对PubMed、PubMed Central(PMC)、Medline和ScienceDirect等数据库进行了深入检索,以查找与我们感兴趣主题相关的研究。经过最终质量检查,我们在系统评价中纳入了8篇文章。与健康对照相比,高血压患者的肠道微生物群在丰富度和多样性上存在显著差异。许多细菌的丰度增加,如[具体细菌名称1]、[具体细菌名称2]、[具体细菌名称3]、肠杆菌科、[具体细菌名称4]、[具体细菌名称5]、[具体细菌名称6]、[具体细菌名称7]和[具体细菌名称8],而[具体细菌名称9]、[具体细菌名称10]、[具体细菌名称11]属和[具体细菌名称12]的丰度降低。其组成的改变也因饮食、年龄、种族和高血压严重程度而异。由于短链脂肪酸(SCFAs)具有抗炎保护特性,尤其是丁酸,产生SCFAs的细菌在高血压患者中含量较低。从代谢组学变化的角度来看,高血压患者中发现对心血管健康有害的代谢物如肠脂肪酸结合蛋白(I-FABP)、脂多糖(LPS)、闭合蛋白、鞘磷脂、酰基肉碱和氧化三甲胺(TMAO)增加。这些生物标志物的变化进一步证实了肠道上皮健康与高血压(BP)之间的关系。患病参与者获得新基因的总体比例较低,这导致与健康个体相比,他们体内的基因丰富度较低。高血压参与者中胆碱利用([具体基因名称])基因表达增加,而与氨基酸生物合成和转运相关的基因表达降低。微生物群组成的独特变化、基因的功能变化和代谢组共同有助于更好地理解高血压的发病机制,也表明肠道是高血压一个有前景的新治疗靶点。为了进一步确定两者之间的因果关系,还需要更多的研究。