Zhai Taiyu, Zou Xueyang, Zhang Zichen, Wang Yifei, Shi Lin, Ren Wenbo, Huang Jing
Department of Clinical Laboratory, The First Hospital of Jilin University, Changchun, China.
College of Medical Technology, Beihua University, Jilin, China.
Gut Microbes. 2025 Dec;17(1):2532703. doi: 10.1080/19490976.2025.2532703. Epub 2025 Jul 12.
The stability of atherosclerotic plaques constitutes the fundamental pathological basis for acute cardiovascular events, and their circadian rhythm characteristics highlight the essential role of dynamic interactions between the host and microorganisms. This review systematically elucidates the multifaceted mechanisms by which disruptions in the circadian rhythm of the gut microbiota contribute to plaque destabilization. Specifically, the microbiota modulates endothelial function, immune homeostasis, and vascular inflammation via rhythmic variations in metabolites. Perturbations in this rhythm compromise the structural integrity of plaques through a synergistic "metabolic-immune-vascular" network. Furthermore, the review unveils the bidirectional regulation between the host's circadian clock and the microbiota's rhythm. Innovatively, we propose "Chronotherapy-based Microbiome Modulation (CMM)," a strategy that reestablishes synchrony between the host and microbiota rhythms through time-restricted feeding, time-specific probiotics, and drugs targeting the circadian clock, thereby, it is possible to improve plaque stability by regulating the host's gut microbiota. The clinical translation of these findings requires overcoming technical challenges, such as personalized time window prediction and microbiota ecological risk assessment, and integrating multi-omics dynamic monitoring with AI modeling and optimization strategies. This review presents a novel perspective on the regulation of plaque stability.
动脉粥样硬化斑块的稳定性是急性心血管事件的基本病理基础，其昼夜节律特征凸显了宿主与微生物之间动态相互作用的重要作用。本综述系统地阐明了肠道微生物群昼夜节律紊乱导致斑块不稳定的多方面机制。具体而言，微生物群通过代谢产物的节律性变化调节内皮功能、免疫稳态和血管炎症。这种节律的紊乱通过协同的“代谢-免疫-血管”网络损害斑块的结构完整性。此外，本综述揭示了宿主生物钟与微生物群节律之间的双向调节。创新性地，我们提出了“基于时辰疗法的微生物群调节（CMM）”，这是一种通过限时进食、特定时间的益生菌和靶向生物钟的药物来重新建立宿主与微生物群节律同步的策略，从而有可能通过调节宿主的肠道微生物群来改善斑块稳定性。这些发现的临床转化需要克服技术挑战，如个性化时间窗口预测和微生物群生态风险评估，并将多组学动态监测与人工智能建模和优化策略相结合。本综述为斑块稳定性的调节提供了一个新的视角。
