Gut Microbiota and Coronary Artery Disease: Current Therapeutic Perspectives

Abstract

The human gut microbiota is the community of microorganisms living in the human gut. This microbial ecosystem contains bacteria beneficial to their host and plays important roles in human physiology, participating in energy harvest from indigestible fiber, vitamin synthesis, and regulation of the immune system, among others. Accumulating evidence suggests a possible link between compositional and metabolic aberrations of the gut microbiota and coronary artery disease in humans. Manipulating the gut microbiota through targeted interventions is an emerging field of science, aiming at reducing the risk of disease. Among the interventions with the most promising results are probiotics, prebiotics, synbiotics, and trimethylamine N-oxide (TMAO) inhibitors. Contemporary studies of probiotics have shown an improvement of inflammation and endothelial cell function, paired with attenuated extracellular matrix remodeling and TMAO production. Lactobacilli, Bifidobacteria, and Bacteroides are some of the most well studied probiotics in experimental and clinical settings. Prebiotics may also decrease inflammation and lead to reductions in blood pressure, body weight, and hyperlipidemia. Synbiotics have been associated with an improvement in glucose homeostasis and lipid abnormalities. On the contrary, no evidence yet exists on the possible benefits of postbiotic use, while the use of antibiotics is not warranted, due to potentially deleterious effects. TMAO inhibitors such as 3,3-dimethyl-1-butanol, iodomethylcholine, and fluoromethylcholine, despite still being investigated experimentally, appear to possess anti-inflammatory, antioxidant, and anti-fibrotic properties. Finally, fecal transplantation carries conflicting evidence, mandating the need for further research. In the present review we summarize the links between the gut microbiota and coronary artery disease and elaborate on the varied therapeutic measures that are being explored in this context.

Interactions between Mediterranean Diet Supplemented with Dairy Foods and the Gut Microbiota Influence Cardiovascular Health in an Australian Population

“…Recent studies suggest that blood pressure can be influenced by an increased inflammatory state and intestinal permeability [ 58 ]. Beneficial effects on immune regulation and intestinal permeability can be mediated by bacterial metabolites, such as SCFAs, while other bacterial-derived metabolites and components, such as trimethylamine (TMA) and lipopolysaccharide, respectively, are associated with inflammatory properties [ 59 ]. Reduced levels of Butyricicoccus , a SCFA producer, have been associated with chronic gastrointestinal and kidney diseases [ 60 , 61 ].…”

Bergamot Polyphenolic Extract Combined with Albedo and Pulp Fibres Counteracts Changes in Gut Microbiota Associated with High-Fat Diet: Implications for Lipoprotein Size Re-Arrangement

“…Evidence has been accumulated showing that cardiovascular disease states, including myocardial infarction, hypertension, stroke and peripheral vascular diseases, may be affected by alterations of gut microbiota [ 1 , 2 ]. The pathophysiological basis of these correlations is still unknown.…”