The Role and Mechanism of Intestinal Flora in Blood Pressure Regulation and Hypertension Development
The Role and Mechanism of Intestinal Flora in Blood Pressure Regulation and Hypertension Development
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肠道菌群在血压调节和高血压发展中的作用和机制
DOI：
10.1089/ars.2020.8104
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发表时间：
2020-05-14
影响因子：
6.6
通讯作者：
Cai, Jun
中科院分区：
文献类型：
--
作者：
Li, Jing;Yang, Xinchun;Cai, Jun
意义：高血压(HTN)具有复杂的病因，具有遗传和环境因素的特点。它已成为全球健康负担，导致心血管疾病和肾脏疾病，最终发展为过早死亡。越来越多的证据表明，肠道微生物群与代谢紊乱和炎症密切相关，与HTN密切相关。近年来，利用细菌基因组分析和粪便微生物区系移植以及大量精液证据的研究表明，肠道微生物群异常与HTN密切相关。HTN患者和动物的肠道微生物群落均表现为细菌多样性降低，微生物结构和功能紊乱，发酵产物发生改变。肠道微生物区系的代谢产物和肠道微生物区系的代谢产物在血压控制中起着重要作用，因此它们与HTN的发生有关。关键问题：本研究的目的在于了解肠道细菌的作用以及引起血压升高并导致HTN发病的病理环境的机制的最新进展。总结了旨在纠正肠道菌群失调以促进HTN发展的潜在干预策略。未来方向：应从HTN参与者那里进行更多的粪便移植，以检查随着肠道微生物组的替换，血压变化的幅度。所提出的肠道调节BP的机制仍有待验证。使用益生菌、饮食干预、噬菌体和粪便移植的干预策略对HTN患者是否可行仍有待探索。
Significance: Hypertension (HTN) has a complex etiology that is characterized by genetic and environmental factors. It has become a global health burden leading to cardiovascular diseases and kidney diseases, ultimately progressing to premature death. Accumulating evidence indicated that gut microbiome was associated with metabolic disorders and inflammation, which were closely linked to HTN.Recent Advances: Recent studies using bacterial genomic analysis and fecal microbiota transplantation as well as many lines of seminal evidence demonstrated that aberrant gut microbiome was significantly associated with HTN. The intestinal microbiome of both patients and animals with HTN had decreased bacterial diversity, disordered microbial structure and functions, and altered end products of fermentation. Gut dysbiosis and metabolites of the gut microbiota play an important role in blood pressure (BP) control, and they are therefore responsible for developing HTN.Critical Issues: This study aimed at focusing on the recent advances in understanding the role played by gut bacteria and the mechanisms underlying the pathological milieu that induced elevated BP and led to HTN pathogenesis. Potential intervention strategies targeting the correction of gut dysbiosis to improve HTN development were summarized.Future Directions: Larger numbers of fecal transplants from participants with HTN should be carried out to examine the magnitude of BP changes with the replacement of the gut microbiome. The proposed mechanisms for the gut in regulating BP remain to be verified. Whether intervention strategies using probiotics, dietary interventions, bacteriophages, and fecal transplants are feasible for individuals with HTN remains to be explored.