Kardiyovasküler hastalıklarda barsak mikrobiyotasının rolü

Abstract

Barsak mikrobiyotası, gastrointestinal sistemde yaşayan organizmaların tamamı olarak tanımlanmaktadır. Barsak mikrobiyotası çok komplekstir ve barsak mikrobiyotasında başlıca bakteri ve arkebakteri olmak üzere virüs, mantar ve birçok ökaryotik mikroorganizma yer almaktadır. Bu organizmaların çoğu kalın barsakta yer almakta ve yaşamın sürdürülmesinde önemli fizyolojik rol oynamaktadır. Barsak mikrobiyotası dinamiktir ve beslenme alışkanlıkları, yaşam tarzı, antibiyotikler ve genetik geçmiş ile düzenlenmektedir. Barsak mikrobiyotası besinlerden çeşitli metabolitlerin üretilmesinde önemli role sahiptir. Mikrobiyota vücuda alınan besinlere göre farklı metabolitler oluşturmaktadır. Bu metabolitlerin bazıları karbon ve enerji kaynağı olarak konak tarafından kullanılmakta ve obezite, iştah ve kolonik inflamasyonun modülasyonu üzerinde faydalı etkiler göstermekte, bazıları ise olumsuz etkiler meydana getirmektedir. Mikrobiyota ile hastalık risklerinin önceden tespit edilebileceği öngörülmektedir. Yapılan çalışmalarda, barsak mikrobiyotası bileşimi gastrointestinal sistem hastalıkları, obezite, diyabet, kanser ve depresyon, otizm, anksiyete ve Parkinson hastalığı gibi hemen hemen tüm hastalıklarla ilişkilendirilmiştir. Barsak mikrobiyotasının; barsak immunitesi ve barsak motilitesinin düzenlenmesi, besinlerin sindirilmesi, enerji üretimi, intestinal bariyerin ve barsak vasküler sistemin düzenlenmesi gibi barsakla ilgili etkileri iyi bilinmektedir fakat ekstra intestinal etkileri hakkındaki kesin bilgiler henüz sınırlıdır. Mikrobiyota ve metabolitlerin pek çok sistem üzerine ekstra intestinal etkileri araştırılıyorken özellikle kardiyovasküler sistem üzerine etkileri dikkat çekmektedir. Örneğin en sık görülen kardiyovasküler hastalıklardan kalp krizi, inme ve periferal damar hastalıkları gibi çoğunlukla tromboemboliye ikincil gelişen hastalıklarda barsak mikrobiyotasının rolü olduğu düşünülmektedir. Kardiyovasküler hastalıklarda barsak mikrobiyotasının rolü hakkında en ilginç kanıtlar, kardiyovasküler risk ile ilişkili yeni metabolitlerin ve yolakların tanımlanması ve plazma örneklerinin metabolik analizleri sonucu elde edilmesidir. Ancak bu hastalıklarda mikrobiyotanın oluşturduğu etkinin mekanizmaları hala net olarak anlaşılmış değildir. Dünya Sağlık Örgütü’ne göre batı ülkelerinde meydana gelen ölümlerin ana nedenlerinden biri kardiyovasküler hastalıklardır ve her yıl 20 milyon ölüm kardiyovasküler hastalıklardan meydana gelmektedir. Bu kadar fazla ölümün görüldüğü kardiyovasküler hastalıklarda, mikrobiyotanın rolünün gösterilmesi bu tür yaygın hastalıkların tedavisinde güncel tedavi yaklaşımlarından farklı, umut verici, yeni tedavi seçenekleri sağlayabilir. Bu nedenle, kardiyovasküler hastalıklarda terapötik strateji olarak barsak mikrobiyotasının düzenlenmesi üzerine ilgi giderek artmaktadır. Bu derlemede, barsak mikrobiyotası ile kardiyovasküler hastalıkların ilişkisi üzerine yapılmış son çalışmalara ve bu hastalıkları kontrol etmek için barsak mikrobiyotasını düzenleyecek olası yollara odaklanılmıştır

Keywords

• gastrointestinal mikrobiyom, kalp ve damar hastalıkları, ateroskleroz, inflamasyon, probiyotikler, prebiyotikler, kısa zincirli yağ asitleri, kolin

The role of gut microbiota in cardiovascular diseases

Abstract

The gut microbiota is defined as the all of the organism living in the gastrointestinal tract. The gut microbiota is very complex, and contains mainly bacteria and archebacteria, viruses, fungi and many eukaryotic microorganisms. Many of these organisms located in the large intestine and plays an important physiological role in the maintaining of life. Gut microbiota is dynamic and is regulated by dietary habits, lifestyle, antibiotics and genetic background. The gut microbiota has an important role in the production of various metabolites from nutrients. Microbiota produces different metabolites according to the nutrients. Some of these metabolites are used by the host as a source of carbon and energy and have beneficial effects on the modulation of obesity, appetite and colonic inflammation, while others cause adverse effects. It is predicted that disease risks can be estimated with microbiota. Gut microbiota was associated with almost all diseases such as gastrointestinal tract diseases, obesity, diabetes, cancer and depression, autism, anxiety and Parkinson’s disease. Intestine-related effects of gut microbiota such as intestine immunity and intestinal motility regulation, digestion of nutrients, energy production, intestinal barrier and regulation of the intestinal vascular system are well known, but exact information about extra intestinal effects is still limited. While microbiota and its metabolites are being investigated for extra intestinal effects on many systems, the effects on the cardiovascular system are noteworthy. For example, it is thought that gut microbiota plays a role in diseases that are secondary to thromboembolism such as heart attack, stroke and peripheral vascular diseases. The most interesting evidence about the role of gut microbiota in cardiovascular diseases is the identification of new metabolites and pathways associated with cardiovascular risk and the metabolic analysis of plasma samples. However, the mechanism of action of microbiota in these diseases is still unclear. According to the World Health Organization, cardiovascular diseases are one of the main cause of deaths in Western countries. Every year, 20 million deaths occur in cardiovascular diseases. The demonstration of the role of microbiotia in cardiovascular diseases where mortalite is high may provide new, promising, and different treatment options than current treatment approaches. Therefore, interest in regulation of gut microbiota as a therapeutic strategy in cardiovascular diseases is increasing. This review focuses on recent studies on the relationship between gut microbiota and cardiovascular disease and possible ways to regulate gut microbiota to control of these diseases.

Keywords

• gastrointestinal microbiome, cardiovascular diseases, atherosclerosis, inflammation, probiotics, prebiotics, volatile fatty acids, choline

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