Microbiome and its impact on cardiovascular and renal health

Abstract

The human microbiome, comprising various microorganisms, is crucial in health preservation and disease development. Recent technological advancements have revealed the microbiome's pervasive presence, challenging traditional notions of bodily sterility. While the microbiome inhabits various body parts, the intestinal tract emerges as a hotspot, hosting over a thousand bacterial species, with Firmicutes and Bacteroidetes dominating the landscape. Dysbiosis, disruptions in this delicate balance, is linked to various pathological intestinal and extraintestinal conditions, including cardiovascular or chronic kidney disease. This article explores the association between the gut microbiome and cardiovascular and renal pathology development. Cardiovascular diseases, a global health challenge, involve atherosclerosis influenced by inflammation. The gut microbiome contributes to inflammation by producing uremic toxins, causing "leaky gut", impacting metabolic health and triglyceride metabolism in the liver. The focus then shifts to specific uremic toxins, such as indoxyl sulfate, P-cresyl sulfate, and trimethylamine-N-oxide, exploring their origins, mechanisms of toxicity, and clinical implications. These toxins have been linked to renal dysfunction, cardiovascular morbidity, and atherosclerotic progression. The article discusses potential therapeutic options, including oral adsorbents, sulfotransferase inhibitors, and gut microbiome modulation. While promising, these interventions require further investigation through large-scale, randomized studies to elucidate their efficacy and safety. Understanding the intricate interplay between the gut microbiome, cardiovascular health, and uremic toxin synthesis is crucial for developing personalized therapeutic approaches to manage these toxins and mitigate their impact on cardiovascular and renal health.