Hypertension Research Laboratory, School of Biological Sciences, Monash University, Melbourne, Victoria, Australia.
Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
Acta Physiol (Oxf). 2024 Aug;240(8):e14193. doi: 10.1111/apha.14193. Epub 2024 Jun 20.
The gut-immune axis is a relatively novel phenomenon that provides mechanistic links between the gut microbiome and the immune system. A growing body of evidence supports it is key in how the gut microbiome contributes to several diseases, including hypertension and cardiovascular diseases (CVDs). Evidence over the past decade supports a causal link of the gut microbiome in hypertension and its complications, including myocardial infarction, atherosclerosis, heart failure, and stroke. Perturbations in gut homeostasis such as dysbiosis (i.e., alterations in gut microbial composition) may trigger immune responses that lead to chronic low-grade inflammation and, ultimately, the development and progression of these conditions. This is unsurprising, as the gut harbors one of the largest numbers of immune cells in the body, yet is a phenomenon not entirely understood in the context of cardiometabolic disorders. In this review, we discuss the role of the gut microbiome, the immune system, and inflammation in the context of hypertension and CVD, and consolidate current evidence of this complex interplay, whilst highlighting gaps in the literature. We focus on diet as one of the major modulators of the gut microbiota, and explain key microbial-derived metabolites (e.g., short-chain fatty acids, trimethylamine N-oxide) as potential mediators of the communication between the gut and peripheral organs such as the heart, arteries, kidneys, and the brain via the immune system. Finally, we explore the dual role of both the gut microbiome and the immune system, and how they work together to not only contribute, but also mitigate hypertension and CVD.
肠道-免疫轴是一种相对较新的现象，它为肠道微生物组与免疫系统之间提供了机制联系。越来越多的证据支持它是肠道微生物组如何导致多种疾病的关键，包括高血压和心血管疾病（CVDs）。过去十年的证据支持肠道微生物组与高血压及其并发症（包括心肌梗死、动脉粥样硬化、心力衰竭和中风）之间存在因果关系。肠道内稳态的紊乱，如菌群失调（即肠道微生物组成的改变），可能会引发免疫反应，导致慢性低度炎症，最终导致这些疾病的发生和发展。这并不奇怪，因为肠道拥有体内数量最多的免疫细胞之一，但在代谢紊乱的情况下，这一现象尚未完全被理解。在这篇综述中，我们讨论了肠道微生物组、免疫系统和炎症在高血压和 CVD 中的作用，并综合了目前关于这种复杂相互作用的证据，同时强调了文献中的空白。我们重点讨论了饮食作为肠道微生物组的主要调节剂之一，并解释了关键的微生物衍生代谢物（例如，短链脂肪酸、三甲胺 N-氧化物）如何通过免疫系统作为肠道和外周器官（如心脏、动脉、肾脏和大脑）之间通讯的潜在介质。最后，我们探讨了肠道微生物组和免疫系统的双重作用，以及它们如何共同作用，不仅导致高血压和 CVD，而且减轻其影响。
