Abstract
With improved standards of living, the incidence of multiple metabolic disorders has increased year by year, especially major risk factors for cardiovascular disease such as hyperglycemia and hyperlipidemia, continues to increase. Emerging epidemiological data and clinical trials have shown the additional protective effects of some metabolic therapy drugs against cardiovascular diseases. A series of studies have found that these drugs may work by modulating the composition of gut microbiota. In this review, we provide a brief overview of the contribution of the gut microbiota to both metabolic disorders and cardiovascular diseases, as well as the response of gut microbiota to metabolic therapy drugs with cardiovascular benefits. In this manner, we link the recent advances in microbiome studies on metabolic treatment drugs with their cardiovascular protective effects, suggesting that intestinal microorganisms may play a potential role in reducing cardiovascular risk factors. We also discuss the potential of microorganism-targeted therapeutics as treatment strategies for preventing and/or treating cardiovascular disease and highlight the need to establish causal links between therapeutics for metabolic diseases, gut microbiota modulation, and cardiovascular protection.
Highlights
Human dietary habits and lifestyle have changed greatly over time with the development of society (Chauveau et al, 2013)
A clinical study involving 106 patients with newly diagnosed type 2 diabetes mellitus (T2DM) found that acarbose treatment can significantly change the gut microbiota composition compared to glipizide, especially increasing the abundance of species possessing high bile salt hydrolase (BSH) activity, such as Lactobacillus gasseri and Bifidobacterium longum, while depleting putrefactive species of Bacteroides, Alistipes and Clostridium, thereby changing the relative abundance of microbial genes involved in Bile acids (BAs) metabolism and contributing to beneficial effects on the host metabolism (Gu et al, 2017)
Another study confirmed this result (Su et al, 2015), which found that acarbose can reduce the level of LPS in the blood by increasing the number of Bifidobacterium and reducing the number of Enterococcus faecalis (Kikuchi et al, 2018), and alleviate chronic low-level inflammation in patients. These results indicate that changes in the gut microbiota after acarbose treatment can bring greater cardiovascular benefits to diabetic patients
Summary
Human dietary habits and lifestyle have changed greatly over time with the development of society (Chauveau et al, 2013). A clinical study involving 106 patients with newly diagnosed T2DM found that acarbose treatment can significantly change the gut microbiota composition compared to glipizide, especially increasing the abundance of species possessing high BSH activity, such as Lactobacillus gasseri and Bifidobacterium longum, while depleting putrefactive species of Bacteroides, Alistipes and Clostridium, thereby changing the relative abundance of microbial genes involved in BA metabolism and contributing to beneficial effects on the host metabolism (Gu et al, 2017). An animal study reported that simvastatin treatment increased the abundance of Bacteroidetes, reduced Firmicutes and Actinobacteria, as well as altering the serum metabolic and bile acids profiles of HFD feeding mice It found that gut microbiota modulation resulting from oral antibiotics attenuated the hypolipidemic effect of simvastatin and suggested that this might be related to the suppression on hepatic CYP7A1, CYP7B1, and FXR proteins that regulate bile acids synthesis from cholesterol by gut microbiota modulation (He et al, 2017)
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