Gut Microbiota and CardioVascular Disease (CVD)

 

1. INTRODUCTION

        According to the World Health Organization (WHO), Cardiovascular Disease (CVD) is still a cause of death in western countries. Obesity, Hypertension, Type-II Diabetes are the common risk factors for cardiovascular disease (Zamparelli, et al., 2016). While heart failure is a cause of high morbidity and mortality. Other risk factors include Lifestyle choices like Smoking, Lack of exercise, and poor dietary health. Recently there has been developing interest in studies primarily focused on the linkage between gut Microbiota and CVD. Metagenomic and Genomic Sequencing analyses show that the presence of gut Microbiota has beneficial effects on CVD.

2. COMPONENTS   AND   PHYSIOLOGICAL   ACTIVITIES   OF   THE   GUT MICROBES

        When your body continuously exposed to the environment after birth, the gut is rapidly colonized by trillions of non-pathogenic bacteria. In healthy individuals, the composition of gut Microbiota remains stable for example Bacteriodetes, Proteobacteria, Actinobacteria, and fimicutes However, there is also a variation in Bacterial Diversity among individuals due to genetic factors, diet, drug, and environmental effects. Interaction between the gut Microbiota and intestinal cells controls barrier functions, continuously stimulating the immune system to defend against pathogens For example Structural components of the Microbiota such as lipopolysaccharide (LPS) and Peptidoglycan, can directly contact with host intestinal cells. Some other gut microbes also affect the absorption of many oral drugs. Vitamin synthesis and metabolic regulation in the intestine. On the other hand many metabolic molecules including bile acid and short-chain fatty acid Overall, emerging evidence supports the concept that the composition of the Gut Microbiota and its fundamental functions alters physiological responses related to the cardio-metabolic health of the host.

3. INTERACTIONS BETWEEN THE GUT MICROBIOTA AND CVD

HYPERTENSION: Hypertension is the most prevalent risk factor associated with CVD and also a cause of death in developed countries. Emerging evidence implicates the gut Microbiota in blood pressure (BP) regulation and abnormal bacterial communities are associated with hypertension. High salt intake promotes the development of hypertension. Since absorption of sodium mainly occurs in the intestine the gut Microbiota is involved in the salt sensitivity associated with hypertension. A study conducted in mince reported that maternal gut microbial modulating protected the adult male offspring against hypertension, but consuming of a high-fat diet in long term manner affects the adult offspring’s gut Microbiota Short-chain fatty acids (SCFAs) are a major class of Bacterial metabolites that are mainly produced in the colon via Bacterial fermentation of dietary fibers. SCFAs such as Acetate and Propionate, are generated mainly by Bacteriodetes while butyrate is typically generated by Fimicutes. Several studies have suggested that antihypertensive medication may lower BP but effects on the gut Microbiota Captopril (CAP) is an Angiotensin-converting enzyme in inhibitor used clinically in Antihypertensive applications and increased Allobaculum level can maintain a sustained antihypertensive effect even after CAP.
HEART FAILURE AND CARDIOMYOPATHY: Heart failure (HF) includes a large body of complex clinical complications that result in damage to the function or structure of the heart (Xu, H. et al., 2020). The gut hypothesis infers that decreased cardiac output and elevated systematic congestion can lead to Edema, leading to increased bacterial shifting and increased circulating endotoxin that can contribute to the underlying inflammation observed in patients with heart failure (Tang, et al., 2017). The role of Gut Microbiota in inflammatory and immune response drawn attention to the link between the gut Micro-flora and HF Bacteria and fungi were tested in a feces sample of HF patient and healthy controls, the result showed that patient with chronic heart failure (CHF) were effect by more pathogenic Bacteria than the control patient Shigella, Candida and Compylobacteria species were proven to be positively correlated with the severity of disease The data also suggested that HF can disturb the balance of intestinal Micro-flora (Jin, et al., 2019).
DIABETES: Akkermansia muciniphila, a single species of the human gut microbe has gained considerable attention since reductions in its abundance are closely linked to insulin resistance and diabetes.in coronary artery disease patients with Type 2 diabetes mellitus (T2DM), have a low abundance of beneficial bacteria and increases in the presence of pathogens. Many molecules like GLP-1, MyD88, and dipeptidyl peptidase-4 (DPP-4) interact closely with the gut microbiota to modulate the secretion of insulin and Diabetes-related metabolic effects (Xu, H. et al., 2020).

4. PREVENTIONS

ANTIBIOTICS: Antibiotics are mostly used in cardiovascular experiments, targeting Gut Microbiota for example neomycin, minocycline, and vancomycin.

PROBIOTICS & PREBIOTICS: Probiotics can stimulate the activity of one or more than one beneficial bacteria and produce beneficial effects for the host and become a novel target for the prevention of CVD. Common Probiotics are Lactobacillus, Lactococcus, Streptococcus, and Bifidobacterium. Common Prebiotics are fruit, vegetables, and cereals.
DIET & EXERCISE: It is essential for patients to make an adjustment for their diet and also daily exercise. To prevent CVD.
OTHER THERAPIES: Chemicals that inhibit microbiota metabolic process are for example 3, 3 dimethyl-1-butanol reduced the accumulation of lipids by decreases the level of Trimethylamine N-oxide (TMAO) (Jin, et al., 2019).

5. CONCLUDING REMARKS

        Gut microbiota can influence host health and disease. A complex relationship exists between the gut Microbiota and CVD and they both influence each other via metabolic changes and immune responses. Diet including probiotics, prebiotics, and exercise is the natural medication for every individual for the prevention of CVD. Future investigation should focus on identifying at a mechanic level Microbial technologies related to the combination of microbial omics with phenotype could help to obtain desirable outcomes which will be promising strategies to compose and modulate gut microbiome for CVD prevention and therapeutics.

By: Fatima Khursheed

REFERENCES

1. Jin, M., Qian, Z., Yin, J., Xu, W., & Zhou, X. (2019). The role of intestinal microbiota in cardiovascular disease. Journal of Cellular and Molecular Medicine, 23(4), 2343-2350. https://doi.org/10.1111/jcmm.14195
2. Tang, W. W., Kitai, T., & Hazen, S. L. (2017). Gut Microbiota in Cardiovascular Health
3. and Disease. Circulation Research, 120(7), 1183-1196. https://doi.org/10.1161/circresaha.117.309715
4. Xu, H., Wang, X., Feng, W., Liu, Q., Liu, Q., & Cai, L. (2020). The gut microbiota and its interactions with cardiovascular disease. Microbial Biotechnology, 13(3), 637-656. https://doi.org/10.1111/1751-7915.13524
5. Zamparelli, M.s., Compare, D., Coccoli, P., Rocco, A., Nardone, O., Gasbarrini, A.,…Miele, L. 2016). The Metabolic Role of Gut Microbiota in the Development of Nonalcoholic Fatty Liver Disease and Cardiovascular Disease. International Journal of Molecular Sciences, 17(8), 1225. https://doi.org/10.3390/ijms17081225