Cardiovascular diseases
Impression of the publications on the relevance of the microbiome
It may not be natural for everyone to place cardiovascular disease under the heading of metabolic disease. The reason for this classification is that the risk of cardiovascular disease and its associated risk factors play an important role in the metabolic syndrome and are therefore referred to as cardiometabolic diseases (1). There are several factors related to cardiovascular disease, including high blood pressure, an impaired lipid profile in the blood, atherosclerosis (arteriosclerosis), and systemic inflammation, and there are several indications that suggest a relationship with the microbiome. For example, patients with so-called inflammatory bowel disease have a greater risk of cardiovascular events, despite the fact that they are less likely to have ‘classic’ risk factors for cardiovascular disease, indicating a link between gut and heart (2). It is also known that inflammatory responses are involved in atherosclerosis and that the microbiome influences this (3,4), and that in patients with established atherosclerosis, the composition of the microbiome was more pro-inflammatory compared to healthy subjects (3). Such inflammatory reactions are attributed, among other things, to bacterial substances that inadvertently end up in the blood, which can be the result of an increased permeability of the intestinal wall (the so-called ‘leaky gut’). In this light, it is striking that in a study in the blood of patients with various cardiovascular diseases, more bacterial and viral DNA was found than in healthy controls (5). In patients with high blood pressure, the composition and diversity of the microbiome also appears to differ from healthy persons (6). In addition, a ‘poo transplant’ from those patients to laboratory animals results in a much higher blood pressure in the laboratory animals than a ‘poo transplant’ from healthy persons (6). Studies with probiotic supplementation have found an improved lipid profile and lowered blood pressure in patients (1,4,7). Finally, in addition to the gut microbiome, the mouth microbiome is also an interesting factor in cardiovascular disease. For example, there is a known correlation between periodontal disease and cardiovascular disease, and several studies show that probiotics can positively influence the oral microbiome and, for example, dental plaque, potentially helping to lower the risk of cardiovascular disease (7).
References
1. Mazidi M, Rezaie P, Kengne AP, Mobarhan MG, Ferns GA. Gut microbiome and metabolic syndrome. Diabetes Metab Syndr. 2016; 10: S150-157.
2. Singh V, Yeoh BS, Vijay-Kumar M. Gut Microbiome as a Novel Cardiovascular Therapeutic Target. Curr Opin Pharmacol. 2016; 27: 8–12.
3. Yamashita T, Kasahara K, Emoto T, Matsumoto T, Mizoguchi T, Kitano N, Sasaki N, Hirata K. Intestinal Immunity and Gut Microbiota as Therapeutic Targets for Preventing Atherosclerotic Cardiovascular Diseases. Circ J. 2015; 79: 1882–90.
Lau K, Srivatsav V, Rizwan A, Nashed A, Liu R, Shen R, Akhtar M. Bridging the Gap between Gut Microbial Dysbiosis and Cardiovascular Diseases. Nutrients [Internet]. 2017 [cited 2018 Feb 27]; 9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579652/
5. Dinakaran V, Rathinavel A, Pushpanathan M, Sivakumar R, Gunasekaran P, Rajendhran J. Elevated Levels of Circulating DNA in Cardiovascular Disease Patients: Metagenomic Profiling of Microbiome in the Circulation. PLoS ONE [Internet]. 2014 [cited 2018 Mar 25]; 9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4136842/
6. Li J, Zhao F, Wang Y, Chen J, Tao J, Tian G, Wu S, Liu W, Cui Q, Geng B, et al. Gut microbiota dysbiosis contributes to the development of hypertension. Microbiome [Internet]. 2017 [cited 2018 Mar 25]; 5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5286796/
7. Ettinger G, MacDonald K, Reid G, Burton JP. The influence of the human microbiome and probiotics on cardiovascular health. Gut Microbes. 2014; 5: 719–28.
1. Mazidi M, Rezaie P, Kengne AP, Mobarhan MG, Ferns GA. Gut microbiome and metabolic syndrome. Diabetes Metab Syndr. 2016; 10: S150-157.
2. Singh V, Yeoh BS, Vijay-Kumar M. Gut Microbiome as a Novel Cardiovascular Therapeutic Target. Curr Opin Pharmacol. 2016; 27: 8–12.
3. Yamashita T, Kasahara K, Emoto T, Matsumoto T, Mizoguchi T, Kitano N, Sasaki N, Hirata K. Intestinal Immunity and Gut Microbiota as Therapeutic Targets for Preventing Atherosclerotic Cardiovascular Diseases. Circ J. 2015; 79: 1882–90.
Lau K, Srivatsav V, Rizwan A, Nashed A, Liu R, Shen R, Akhtar M. Bridging the Gap between Gut Microbial Dysbiosis and Cardiovascular Diseases. Nutrients [Internet]. 2017 [cited 2018 Feb 27]; 9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5579652/
5. Dinakaran V, Rathinavel A, Pushpanathan M, Sivakumar R, Gunasekaran P, Rajendhran J. Elevated Levels of Circulating DNA in Cardiovascular Disease Patients: Metagenomic Profiling of Microbiome in the Circulation. PLoS ONE [Internet]. 2014 [cited 2018 Mar 25]; 9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4136842/
6. Li J, Zhao F, Wang Y, Chen J, Tao J, Tian G, Wu S, Liu W, Cui Q, Geng B, et al. Gut microbiota dysbiosis contributes to the development of hypertension. Microbiome [Internet]. 2017 [cited 2018 Mar 25]; 5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5286796/
7. Ettinger G, MacDonald K, Reid G, Burton JP. The influence of the human microbiome and probiotics on cardiovascular health. Gut Microbes. 2014; 5: 719–28.