肠道菌群及其代谢产物氧化三甲胺——冠心病治疗的新靶点

Gut microbiota and its metabolite trimethylamine-N-oxide (TMAO): a novel regulator in coronary artery disease

摘要:

冠心病 (Coronary artery disease，CAD) 是全球发病率和死亡率最高的一种心血管疾病，冠心病和肠道菌群失调密切相关，肠道菌群可能是未来冠心病的重要诊断标志物，改善肠道菌群微环境有望成为治疗冠心病的新途径。作为肠道菌群参与合成的活性代谢产物，氧化三甲胺 (Trimethylamine-N-oxide，TMAO) 水平的升高与心血管疾病患病风险、全因死亡率的增加有关；基础研究表明TMAO可能具有促动脉粥样硬化特性；这些研究提示TMAO可作为预防和治疗冠心病的潜在靶点。文中分析了当前调控肠道菌群及其代谢产物TMAO治疗冠心病的临床及基础性研究，以期为冠心病的治疗提供帮助。

Abstract:

Coronary artery disease (CAD) is a chronic disease but causes the highest mortality and morbidity among the cardiovascular diseases worldwide. Correlations between CAD and gut microbiota have been observed. This suggests that the gut microbiota could become a vital diagnostic marker of CAD, and restoring the gut habitat may become a promising strategy for CAD therapy. The elevated level of trimethylamine-N-oxide (TMAO), a gut microbiota-derived metabolite, was found to be associated with the increased risk of cardiovascular disease and the all-cause mortality. Preclinical studies have shown that it has pro-arteriosclerosis properties. It is likely that regulating the production of TMAO by gut microbiota may become a promising strategy for anti-atherosclerosis therapy. This review summarizes the clinical and preclinical researches on the intervention of CAD by regulating the gut microbiota and the microbiota-derived metabolite TMAO, with the aim to provide new target for the therapy of CAD.