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炎症性肠病与心血管疾病:聚焦肠道微生物群的综合综述

Inflammatory Bowel Disease and Cardiovascular Disease: An Integrative Review With a Focus on the Gut Microbiome.

作者信息

Sanchez Cruz Camila, Rojas Huerta Anahi, Lima Barrientos Jesus, Rodriguez Cristina, Devani Aarfa, Boosahda Vanessa, Rasagna Mareddy Naga S, Briceno Silva Gabriela, Del Castillo Miranda Jose C, Reyes Gochi Kevin A, Reyes Gochi Mario D, Alvarez Samantha, Ghattas Hasbun Patricia E

机构信息

General Practice, Universidad Nacional Autonoma de Mexico, Mexico City, MEX.

General Practice, Benemérita Universidad Autónoma de Puebla, Puebla, MEX.

出版信息

Cureus. 2024 Jul 22;16(7):e65136. doi: 10.7759/cureus.65136. eCollection 2024 Jul.

Abstract

Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, is a chronic inflammatory condition of the gastrointestinal tract. Recent research indicates a significant link between IBD and cardiovascular disease (CVD), the leading cause of global morbidity and mortality. This review examines the association between IBD and CVD, emphasizing the role of the gut microbiome in this relationship. IBD patients have a higher risk of cardiovascular events, such as coronary artery disease, heart failure, and cerebrovascular incidents, primarily due to chronic systemic inflammation, genetic factors, and gut microbiota imbalance (dysbiosis). Dysbiosis in IBD increases intestinal permeability, allowing bacterial products to enter the bloodstream, which promotes inflammation and endothelial dysfunction, contributing to CVD. Understanding the gut microbiome's role in IBD and CVD suggests new therapeutic interventions. Modulating the microbiome through diet, probiotics, and fecal microbiota transplantation (FMT) are promising research avenues. These interventions aim to restore a healthy gut microbiota balance, potentially reducing inflammation and improving cardiovascular outcomes. Additionally, the review emphasizes the importance of regular cardiovascular risk assessments and personalized preventive measures in managing IBD patients. Such measures include routine monitoring of cardiovascular health, tailored lifestyle modifications, and early intervention strategies to mitigate cardiovascular risk. By integrating current knowledge, this review aims to improve understanding and management of the interconnected pathophysiology of IBD and CVD. This approach will ultimately enhance patient outcomes and provide a foundation for future research and clinical practice guidelines in this area.

摘要

炎症性肠病(IBD)包括克罗恩病和溃疡性结肠炎,是一种胃肠道的慢性炎症性疾病。最近的研究表明,IBD与心血管疾病(CVD)之间存在显著联系,而心血管疾病是全球发病和死亡的主要原因。本综述探讨了IBD与CVD之间的关联,强调了肠道微生物群在这种关系中的作用。IBD患者发生心血管事件的风险较高,如冠状动脉疾病、心力衰竭和脑血管事件,主要是由于慢性全身炎症、遗传因素和肠道微生物群失衡(生态失调)。IBD中的生态失调会增加肠道通透性,使细菌产物进入血液,从而促进炎症和内皮功能障碍,导致CVD。了解肠道微生物群在IBD和CVD中的作用提示了新的治疗干预措施。通过饮食、益生菌和粪便微生物群移植(FMT)调节微生物群是有前景的研究途径。这些干预措施旨在恢复健康的肠道微生物群平衡,可能减轻炎症并改善心血管结局。此外,该综述强调了在管理IBD患者时进行定期心血管风险评估和个性化预防措施的重要性。这些措施包括常规监测心血管健康、量身定制的生活方式改变以及减轻心血管风险的早期干预策略。通过整合现有知识,本综述旨在增进对IBD和CVD相互关联的病理生理学的理解和管理。这种方法最终将改善患者结局,并为该领域未来的研究和临床实践指南奠定基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cfb/11338650/6dd36ac1aed3/cureus-0016-00000065136-i01.jpg

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