Exploring the Microbiome in Heart Failure.
Exploring the Microbiome in Heart Failure.
复制标题
探索心力衰竭的微生物组。
DOI：
10.1007/s11897-016-0285-9
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发表时间：
2016-04
影响因子：
--
通讯作者：
Tang WH
中科院分区：
文献类型：
--
作者：
Kitai T;Kirsop J;Tang WH
近年来，人们对肠道微生物区系有了感兴趣的见解，并强调了它对心血管(CV)疾病(包括心力衰竭(HF))的影响日益得到认可。肠道微生物区系组成的变化，称为生物失调，可引发全身炎症，已知这与HF的病理生理学有关。三甲胺N-氧化物(TMAO)是由肠道微生物区系代谢产生的特定膳食营养物质，已成为心血管疾病发病的关键因素。据报道，在心力衰竭和慢性肾脏疾病(CKD)患者中，TMAO水平升高与预后不良有关。肠道微生物区系失调可导致较高水平的TMAO和尿毒症毒素的产生，进而发展为HF和CKD。因此，这种通过肠道微生物区系在心衰和慢性肾脏病之间的双向关系可能成为治疗心肾综合征的新靶点。然而，肠道微生物区系影响心力衰竭发展的机制尚不清楚，TMAO的致病作用以及解释TMAO如何直接或间接促进包括心力衰竭在内的心血管疾病的潜在机制联系仍存在一些问题。TMAO在心肾综合征的病理生理学中的作用以及肾脏对TMAO水平的处理有待进一步研究。
Recent years have brought interesting insights into the human gut microbiota and have highlighted its increasingly recognized impact on cardiovascular (CV) diseases, including heart failure (HF). Changes in composition of gut microbiota, called dysbiosis, can trigger systemic inflammation, which is known to be involved in the pathophysiology of HF. Trimethylamine N-oxide (TMAO), which is derived from gut microbiota metabolites of specific dietary nutrients, has emerged as a key contributor to cardiovascular disease pathogenesis. Elevated TMAO levels have been reported to be associated with poor outcomes in patients with both HF and chronic kidney disease (CKD). Dysbiosis of gut microbiota can contribute to higher levels of TMAO and the generation of uremic toxins, progressing to both HF and CKD. Therefore, this bidirectional relationship between HF and CKD through gut microbiota may be a novel therapeutic target for the cardiorenal syndrome. However, the mechanisms by which gut microbiota could influence the development of heart failure are still unknown, and there are still some questions regarding the causative effects of TMAO and the underlying mechanistic link that explains how TMAO might directly or indirectly promote CV diseases including HF. Further studies are warranted to clarify the function of TMAO on the pathophysiology of cardiorenal syndrome and the handling of TMAO levels by the kidneys.