TMAO: how gut microbiota contributes to heart failure

An increasing amount of evidence reveals that the gut microbiota is involved in the pathogenesis and progression of various cardiovascular diseases. In patients with heart failure (HF), splanchnic hypoperfusion causes ischemia and intestinal edema, allowing bacterial translocation and bacterial meta...

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Published in	Translational research : the journal of laboratory and clinical medicine Vol. 228; pp. 109 - 125
Main Authors	Zhang, Yixin, Wang, Yuan, Ke, Bingbing, Du, Jie
Format	Journal Article
Language	English
Published	United States Elsevier Inc 01.02.2021
Subjects	Gastrointestinal Microbiome Heart Failure - metabolism Humans Intestinal Mucosa - metabolism Methylamines - metabolism CHF TMAO RCT BNP LVEF LV HFpEF DASH HFrEF TNF LPS LVAD NF-κB NT-proBNP DMB DMA NLRP3 FMC IMC IL DIM FMO PKC TMA FMT SOD2 ER SCFA SIRT3 VCAM TML TCA TGF-β1 CVDs HF γBB AHF
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Abstract	An increasing amount of evidence reveals that the gut microbiota is involved in the pathogenesis and progression of various cardiovascular diseases. In patients with heart failure (HF), splanchnic hypoperfusion causes ischemia and intestinal edema, allowing bacterial translocation and bacterial metabolites to enter the blood circulation via an impaired intestinal barrier. This results in local and systemic inflammatory responses. Gut microbe-derived metabolites are implicated in the pathology of multiple diseases, including HF. These landmark findings suggest that gut microbiota influences the host's metabolic health, either directly or indirectly by producing several metabolites. In this review, we mainly discuss a newly identified gut microbiota-dependent metabolite, trimethylamine N-oxide (TMAO), which appears to participate in the pathologic processes of HF and can serve as an early warning marker to identify individuals who are at the risk of disease progression. We also discuss the potential of the gut–TMAO–HF axis as a new target for HF treatment and highlight the current controversies and potentially new and exciting directions for future research.
AbstractList	An increasing amount of evidence reveals that the gut microbiota is involved in the pathogenesis and progression of various cardiovascular diseases. In patients with heart failure (HF), splanchnic hypoperfusion causes ischemia and intestinal edema, allowing bacterial translocation and bacterial metabolites to enter the blood circulation via an impaired intestinal barrier. This results in local and systemic inflammatory responses. Gut microbe-derived metabolites are implicated in the pathology of multiple diseases, including HF. These landmark findings suggest that gut microbiota influences the host's metabolic health, either directly or indirectly by producing several metabolites. In this review, we mainly discuss a newly identified gut microbiota-dependent metabolite, trimethylamine N-oxide (TMAO), which appears to participate in the pathologic processes of HF and can serve as an early warning marker to identify individuals who are at the risk of disease progression. We also discuss the potential of the gut-TMAO-HF axis as a new target for HF treatment and highlight the current controversies and potentially new and exciting directions for future research. An increasing amount of evidence reveals that the gut microbiota is involved in the pathogenesis and progression of various cardiovascular diseases. In patients with heart failure (HF), splanchnic hypoperfusion causes ischemia and intestinal edema, allowing bacterial translocation and bacterial metabolites to enter the blood circulation via an impaired intestinal barrier. This results in local and systemic inflammatory responses. Gut microbe-derived metabolites are implicated in the pathology of multiple diseases, including HF. These landmark findings suggest that gut microbiota influences the host's metabolic health, either directly or indirectly by producing several metabolites. In this review, we mainly discuss a newly identified gut microbiota-dependent metabolite, trimethylamine N-oxide (TMAO), which appears to participate in the pathologic processes of HF and can serve as an early warning marker to identify individuals who are at the risk of disease progression. We also discuss the potential of the gut-TMAO-HF axis as a new target for HF treatment and highlight the current controversies and potentially new and exciting directions for future research.An increasing amount of evidence reveals that the gut microbiota is involved in the pathogenesis and progression of various cardiovascular diseases. In patients with heart failure (HF), splanchnic hypoperfusion causes ischemia and intestinal edema, allowing bacterial translocation and bacterial metabolites to enter the blood circulation via an impaired intestinal barrier. This results in local and systemic inflammatory responses. Gut microbe-derived metabolites are implicated in the pathology of multiple diseases, including HF. These landmark findings suggest that gut microbiota influences the host's metabolic health, either directly or indirectly by producing several metabolites. In this review, we mainly discuss a newly identified gut microbiota-dependent metabolite, trimethylamine N-oxide (TMAO), which appears to participate in the pathologic processes of HF and can serve as an early warning marker to identify individuals who are at the risk of disease progression. We also discuss the potential of the gut-TMAO-HF axis as a new target for HF treatment and highlight the current controversies and potentially new and exciting directions for future research.
Author	Wang, Yuan Ke, Bingbing Zhang, Yixin Du, Jie
Author_xml	– sequence: 1 givenname: Yixin surname: Zhang fullname: Zhang, Yixin organization: Beijing Anzhen Hospital, Capital Medical University, Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Collaborative Innovation Center for Cardiovascular Disorders, Beijing, China – sequence: 2 givenname: Yuan surname: Wang fullname: Wang, Yuan organization: Beijing Anzhen Hospital, Capital Medical University, Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Collaborative Innovation Center for Cardiovascular Disorders, Beijing, China – sequence: 3 givenname: Bingbing surname: Ke fullname: Ke, Bingbing organization: Beijing Anzhen Hospital, Capital Medical University, Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Collaborative Innovation Center for Cardiovascular Disorders, Beijing, China – sequence: 4 givenname: Jie surname: Du fullname: Du, Jie email: jiedu@ccmu.edu.cn organization: Beijing Anzhen Hospital, Capital Medical University, Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Collaborative Innovation Center for Cardiovascular Disorders, Beijing, China
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/32841736$$D View this record in MEDLINE/PubMed
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Keywords	CHF TMAO RCT BNP LVEF LV HFpEF DASH HFrEF TNF LPS LVAD NF-κB NT-proBNP DMB DMA NLRP3 FMC IMC IL DIM FMO PKC TMA FMT SOD2 ER SCFA SIRT3 VCAM TML TCA TGF-β1 CVDs HF γBB AHF
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PublicationDateYYYYMMDD	2021-02-01
PublicationDate_xml	– month: 02 year: 2021 text: February 2021
PublicationDecade	2020
PublicationPlace	United States
PublicationPlace_xml	– name: United States
PublicationTitle	Translational research : the journal of laboratory and clinical medicine
PublicationTitleAlternate	Transl Res
PublicationYear	2021
Publisher	Elsevier Inc
Publisher_xml	– name: Elsevier Inc
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Snippet	An increasing amount of evidence reveals that the gut microbiota is involved in the pathogenesis and progression of various cardiovascular diseases. In...
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SubjectTerms	Gastrointestinal Microbiome Heart Failure - metabolism Humans Intestinal Mucosa - metabolism Methylamines - metabolism
Title	TMAO: how gut microbiota contributes to heart failure
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