肠道菌群及其代谢产物对心肌纤维化影响与治疗的研究进展

Gut microbiota and its metabolites affect and help to treat myocardial fibrosis

摘要:

心肌纤维化是多种心血管疾病,如冠心病、心肌梗死和心力衰竭等的终末期表现和主要致病因素。研究发现,免疫和炎症过程在心肌纤维化的发病机制中起决定性作用。近年来,人们发现肠道微生物在心肌纤维化的发病机制和发展中起着至关重要的作用。肠道菌群的失调可导致微生物的代谢产物转移到血液循环中,如短链脂肪酸、脂多糖和氧化三甲胺等。这些代谢物直接或间接地诱导组织损伤免疫和激活全身炎症反应,进而影响心肌纤维化。如何改变肠道菌群来改善心肌纤维化已成为当前的研究重点,包括饮食干预、使用抗生素、补充益生菌和益生元,以及粪便微生物群移植等。本综述旨在回顾肠道菌群及其代谢产物与心肌纤维化的相互作用,介绍通过干预肠道菌群改善心肌纤维化的研究进展,为心肌纤维化的治疗提供新思路。

Abstract:

Myocardial fibrosis is the end-stage manifestation and main pathogenic factor of a variety of cardiovascular diseases, such as coronary heart disease, myocardial infarction, and heart failure. Immune and inflammatory processes play a decisive role in the pathogenesis of myocardial fibrosis. Recent studies have demonstrated that gut microbiota plays a crucial role in the pathogenesis and development of myocardial fibrosis. The dysregulation of gut microbiota can lead to the transfer of microbial metabolites, such as short-chain fatty acids, lipopolysaccharides, and trimethylamine oxide into the blood circulation. These metabolites directly or indirectly induce immune responses to tissue damage and systemic activation of inflammatory responses which then affect myocardial fibrosis. How to mitigate myocardial fibrosis by modifying gut microbiota has become the focus of current research, and the measures include dietary interventions, antibiotics, probiotics, prebiotics, and fecal microbiota transplantation. This paper reviews the interactions of gut microbiota and its metabolites with myocardial fibrosis and introduces the research progress in alleviating myocardial fibrosis by modulating gut microbiota, providing new ideas for the treatment of myocardial fibrosis.