The role of the gut microbiome and its metabolites in cerebrovascular diseases

Abstract

The gut microbiome is critically involved in maintaining normal physiological function in the host. Recent studies have revealed that alterations in the gut microbiome contribute to the development and progression of cerebrovascular disease via the microbiota-gut-brain axis (MGBA). As a broad communication network in the human body, MGBA has been demonstrated to have significant interactions with various factors, such as brain structure and function, nervous system diseases, etc. It is also believed that the species and composition of gut microbiota and its metabolites are intrinsically linked to vascular inflammation and immune responses. In fact, in fecal microbiota transplantation (FMT) research, specific gut microbiota and downstream-related metabolites have been proven to not only participate in various physiological processes of human body, but also affect the occurrence and development of cerebrovascular diseases directly or indirectly through systemic inflammatory immune response. Due to the high mortality and disability rate of cerebrovascular diseases, new treatments to improve intestinal dysbacteriosis have gradually attracted widespread attention to better ameliorate the poor prognosis of cerebrovascular diseases in a non-invasive way. This review summarizes the latest advances in the gut microbiome and cerebrovascular disease research and reveals the profound impact of gut microbiota dysbiosis and its metabolites on cerebrovascular diseases. At the same time, we elucidated molecular mechanisms whereby gut microbial metabolites regulate the expression of specific interleukins in inflammatory immune responses. Moreover, we further discuss the feasibility of novel therapeutic strategies targeting the gut microbiota to improve the outcome of patients with cerebrovascular diseases. Finally, we provide new insights for standardized diagnosis and treatment of cerebrovascular diseases.

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“…Substantial evidence has revealed a strong connection between the gut and the brain—referred to as the gut–brain axis—and the composition of the gut microbiota and their derivative OMVs have an important impact on neurological disorders [ 88 , 89 ]. It is reported that, by using mice overexpressing α-synuclein, more α-synuclein aggregates were deposited in the brains of control mice compared to those of germ-free mice, and oral administration of specific bacterial metabolites to germ-free mice enhanced neuroinflammation and motor symptoms, suggesting that the gut microbiota and their secretions in the form of OMVs transmission might be an important contributor to α-synuclein pathology and microglia activation in Parkinson’s disease [ 90 ].…”