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以腸道微生物群為標的作為心血管疾病的治療方法

Targeting the Gut Microbiome as a Treatment for Cardiovascular Diseases

摘要


人體和動物實驗證實,腸道微生物群失衡(dysbiosis),會造成細菌感染,啟動免疫系統引起有害的發炎反應,或產生內毒素前驅物及代謝物,藉由不同信號路徑影響宿主生理,間接導致心血管疾病(cardiovascular disease,CVD)的發病;微生物群也可以藉由改變膽固醇代謝,影響動脈粥樣硬化,加速心血管疾病的進展。另外腸道微生物群會對心血管疾病藥物治療造成影響。近年來,許多研究開始發展以腸道微生物群為治療目標的方法。腸道菌相失衡會導致心血管疾病的加劇,因此調節腸道菌群可做為心血管疾病治療的理論機制,除了控制飲食是預防或降低心血管疾病進程的基本方法外,使用抗生素和益生菌、糞菌移植、內毒素吸附以及藥物,干預目標菌群和其相關代謝途徑等,均是與腸道菌群相關的治療手段。未來改變腸道微生物群,可能會成為一種減少疾病危險因子、改善病徵嚴重程度和降低併發症的治療方法。

並列摘要


Accumulating evidence has indicated that intestinal microbiota is involved in the development of various human diseases, including cardiovascular diseases (CVDs). Recently, both human and animal experiments have revealed that gut microflora dysbiosis can accelerate the progression of CVDs due to inducing a chronic inflammatory state by endotoxaemia and upregulating gut permeability. Additionally, several dietary-related effects of the gut microbiota contribute to the pathogenesis of CVD, which affects the host physiological processes by activation of numerous signaling pathways. Thus, the intestinal microbiome provides a new potential therapeutic target for the treatment of CVDs. Besides controlling diet, application of antibiotics, probiotics, fecal microbiota transplant and endotoxin absorbent could be therapeutic approaches for CVDs. Modulation of the gut microbiota is an area of growing interest as a means of altering the pathogenesis and complications of cardiac disorders. Altering the gut microbiota may become an attractive method for reducing risk factors and minimising the severity and complications associated with these disorders.

參考文獻


Yeh CF, Chen YH, Liu SF, et al. Mutual Interplay of Host Immune System and Gut Microbiota in the Immunopathology of Atherosclerosis. Int J Mol Sci 2020;21:8729.
Koren O, Spor A, Felin J, et al. Human oral, gut, and plaque microbiota in patients with atherosclerosis. Proc Natl Acad Sci 2011;108(S1):4592-8.
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