Gut microbiome alterations in pulmonary hypertension in highlanders and lowlanders

Abstract

BackgroundAlterations in the gut microbiota have been observed in patients with pulmonary hypertension (PH), though whether the roles of the gut microbiota in PH at different altitudes are the same is unknown. This study aims to evaluate the associations of the gut microbiome with PH in the highlanders and lowlanders.MethodsPH patients and controls were recruited from those who permanently live on the Tibetan plateau (highlanders) or the plains (lowlanders), and underwent transthoracic echocardiography close to their altitude of residence (at 5070 m for highlandersversus6 m for lowlanders). The gut microbiome was profiled using metagenomic shotgun sequencing.ResultsIn total, 13 PH patients (46% highlanders) and 88 controls (70% highlanders) were included. The overall microbial composition was different in PH patients compared to controls (p=0.003). Notably, among lowlanders, a composite microbial score of pro-atherosclerotic trimethylamine-producing species was increased in PH patients compared with that in controls (p=0.028), while among highlanders no such difference was observed (p=0.087). Another composite gut microbial score including eight species ofLactobacillus, which has shown beneficial effects on cardiovascular functions, was higher in highlanders than lowlanders (p<0.01). Furthermore, this score tended to be lower in PH patients than controls among highlanders (p=0.056) but not among lowlanders (p=0.840). In addition, the gut microbiome showed a good performance in distinguishing PH patients from controls in both lowlanders and highlanders.ConclusionsOur study reported differently altered gut microbiome profiles between highland and lowland PH patients, highlighting the distinct microbial mechanism in PH between highlanders and lowlanders.

Microbiota and pulmonary hypertension: a systematic review on human studies

“…The range of accuracy reported by three studies was 80.3-93.8% (17,18,20), while the area under the curve was 0.71 [95% CI, 0.62-0.8] and 0.73 [95% CI, 0.67-0.80] in two studies (16,22). Some species were more predictive of PH including Eubacterium, Roseburia, Parabacteroides, Faecalibacterium, Prevotella, and, Streptococcus (17,18,22) (Table 3).…”

“…The design of all studies was case-control (Table 1). Two articles were focused on pediatric and adolescent populations (15,16), while the rest of the studies were undertaken on adults (17)(18)(19)(20)(21)(22). In the majority of studies, females were more prevalent than men among PH cases (18)(19)(20)(21)(22).…”

“…Most of the included articles reported that the majority of PH patients were receiving treatments such as endothelin receptor Antagonists (ERA) and phosphodiesterase type 5 inhibitors (PDE5-Is) (18-22). Three studies did not report the severity of PH (15,17,18), while in two studies mild to moderate severity was more frequently reported (16, 21). Additionally, the REVEAL score, WHO function class, and, 6-minute walk distance test were reported as severity measures in two, three, and three articles respectively (19)(20)(21)(22).…”

A Prebiotic Diet Containing Galactooligosaccharides and Polydextrose <span aria-describedby="tippy-24">Produces Dynamic and Reproducible Changes in the Gut Microbial Ecosystem in Male Rats

“…The failure to reproduce findings could be due, in part, to multiple bacterial taxonomy databases, ongoing taxonomic revisions, differences in sample storage, DNA extraction and sequencing, and analytic pipelines [15,16]. In addition, commonly overlooked are the influences of environmental factors on the gut microbiome, including geographic location and elevation [17][18][19][20], and animal source [21,22].…”

A Prebiotic Diet Containing Galactooligosaccharides and Polydextrose Produces Dynamic and Reproducible Changes in the Gut Microbial Ecosystem in Male Rats

“…The failure to reproduce findings could be due, in part, to multiple bacterial taxonomy databases, ongoing taxonomic revisions, as well as differences in sample storage, DNA extraction and sequencing, and analytic pipelines [ 14 ]. In addition, commonly overlooked are the influences of environmental factors on the gut microbiome, including geographic location and elevation [ 15 , 16 , 17 , 18 ], and animal source [ 19 , 20 ].…”