Dysbiosis—An Etiological Factor for Cardiovascular Diseases and the Therapeutic Benefits of Gut Microflora

Abstract

The human gut is colonized by a variety of microorganisms especially bacteria. There are multiple evidences that gut microflora dysbiosis is a novel risk factor for development of various intestine-related diseases such as irritable bowel syndrome and inflammatory bowel disease as well as nonintestinal diseases including obesity, type II diabetes, and cardiovascular diseases. A mutual relationship among the host’s immune system and the metabolites produced by the gut microflora, including trimethylamine N-oxide (TMAO), short-chain fatty acids (SCFAs), and bile acids, is present. Alterations in the host-microbial interaction lead to impaired homeostasis and thus contribute towards the activation of several pathways that causes progression of cardiovascular diseases. This review summarizes the role of gut microflora dysbiosis in the development and progression of atherosclerosis, coronary artery disease, and hypertension. Dysbiosis has been implicated in the pathogenesis of atherosclerosis by TLR activation, intracellular Ca2+ release, FXR-induced signalling, and decreased removal of cholesterol from peripheral macrophages, while in hypertension the mechanism involved is prolonged haemodynamic effects of angiotensin-II and oxLDL-induced hypertension. In fact, CVDs are the leading cause of mortality across the globe; thus, targeting the gut microflora in the treatment of these diseases along with the conventional therapy can markedly reduce the cardiovascular disease burden. The gut microbiota-targeted treatment including prebiotics, probiotics, and postbiotics can be therapeutically beneficial. In future, the heart-gut axis can be presented as a novel and clinically relevant area for research.