RESUMO
Cardiometabolic affections greatly contribute to the global burden of disease. The susceptibility to obesity, cardiovascular disease, and type-2 diabetes, conditions that add to the cardiometabolic syndrome (CMS), was associated with the ancestral genetic composition and gut microbiota. Studies explicitly testing associations between genetic ancestry and gut microbes are growing. We here examined whether the host genetic ancestry was associated with gut microbiota composition, and distinguished the effects of genetic ancestry and non-genetic factors on human cardiometabolic health. We performed a cross-sectional study with 441 community-dwelling Colombian mestizos from five cities spanning the Andes, Pacific, and Caribbean coasts. We characterized the host genetic ancestry by genotyping 40 ancestry informative markers; characterized gut microbiota through 16S rRNA gene sequencing; assessed diet intake, physical activity, cigarette, and medicament consumption; and measured cardiometabolic outcomes that allowed calculating a CMS risk scale. On average, each individual of our cohort was 67 ± 6% European, 21 ± 5% Native American and 12 ± 5% African. Multivariable-adjusted generalized linear models showed that individuals with higher Native American and African ancestries had increased fasting insulin, body mass index and CMS risk, as assessed by the CMS risk scale. Furthermore, we identified 21 OTUs associated to the host genetic ancestry and 20 to cardiometabolic health. While we highlight novel associations between genetic ancestry and gut microbiota, we found that the effect of intestinal microbes was more likely to explain the variance in CMS risk scale than the contributions of European, Native American and African genetic backgrounds.
Assuntos
Doenças Cardiovasculares/genética , Microbioma Gastrointestinal , Predisposição Genética para Doença/genética , Fatores de Risco , Adulto , Negro ou Afro-Americano/genética , Bactérias/classificação , Bactérias/genética , Bactérias/isolamento & purificação , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/microbiologia , Estudos de Coortes , Estudos Transversais , Dieta , Feminino , Microbioma Gastrointestinal/genética , Microbioma Gastrointestinal/fisiologia , Humanos , Indígenas Sul-Americanos/genética , Estilo de Vida , Masculino , Metagenômica , Pessoa de Meia-Idade , RNA Ribossômico 16S , População Branca/genética , Adulto JovemRESUMO
Oral and fecal microbial biomarkers have previously been associated with cardiometabolic (CM) risk, however, no comprehensive attempt has been made to explore this association in minority populations or across different geographic regions. We characterized gut- and oral-associated microbiota and CM risk in 655 participants of African-origin, aged 25-45, from Ghana, South Africa, Jamaica, and the United States (US). CM risk was classified using the CM risk cut-points for elevated waist circumference, elevated blood pressure and elevated fasted blood glucose, low high-density lipoprotein (HDL), and elevated triglycerides. Gut-associated bacterial alpha diversity negatively correlated with elevated blood pressure and elevated fasted blood glucose. Similarly, gut bacterial beta diversity was also significantly differentiated by waist circumference, blood pressure, triglyceridemia and HDL-cholesterolemia. Notably, differences in inter- and intra-personal gut microbial diversity were geographic-region specific. Participants meeting the cut-points for 3 out of the 5 CM risk factors were significantly more enriched with Lachnospiraceae, and were significantly depleted of Clostridiaceae, Peptostreptococcaceae, and Prevotella. The predicted relative proportions of the genes involved in the pathways for lipopolysaccharides (LPS) and butyrate synthesis were also significantly differentiated by the CM risk phenotype, whereby genes involved in the butyrate synthesis via lysine, glutarate and 4-aminobutyrate/succinate pathways and LPS synthesis pathway were enriched in participants with greater CM risk. Furthermore, inter-individual oral microbiota diversity was also significantly associated with the CM risk factors, and oral-associated Streptococcus, Prevotella, and Veillonella were enriched in participants with 3 out of the 5 CM risk factors. We demonstrate that in a diverse cohort of African-origin adults, CM risk is significantly associated with reduced microbial diversity, and the enrichment of specific bacterial taxa and predicted functional traits in both gut and oral environments. As well as providing new insights into the associations between the gut and oral microbiota and CM risk, this study also highlights the potential for novel therapeutic discoveries which target the oral and gut microbiota in CM risk.
Assuntos
Doenças Cardiovasculares/microbiologia , Microbioma Gastrointestinal , Doenças Metabólicas/microbiologia , Boca/microbiologia , Adulto , Doenças Cardiovasculares/epidemiologia , Feminino , Gana/epidemiologia , Humanos , Jamaica/epidemiologia , Masculino , Doenças Metabólicas/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , África do Sul/epidemiologia , Estados Unidos/epidemiologia , Circunferência da CinturaRESUMO
The gut microbiota, the ecosystem formed by a wide symbiotic community of nonpathogenic microorganisms that are present in the distal part of the human gut, plays a prominent role in the normal physiology of the organism. The gut microbiota's imbalance, gut dysbiosis, is directly related to the origin of various processes of acute or chronic dysfunction in the host. Therefore, the ability to intervene in the gut microbiota is now emerging as a possible tactic for therapeutic intervention in various diseases. From this perspective, evidence is growing that a functional dietary intervention with probiotics, which maintain or restore beneficial bacteria of the digestive tract, represents a promising therapeutic strategy for interventions in cardiovascular diseases and also reduces the risk of their occurrence. In the present work, we review the importance of maintaining the balance of the intestinal microbiota to prevent or combat such processes as arterial hypertension or endothelial dysfunction, which underlie many cardiovascular disorders. We also review how the consumption of probiotics can improve autonomic control of cardiovascular function and provide beneficial effects in patients with heart failure. Among the known effects of probiotics is their ability to decrease the generation of reactive oxygen species and, therefore, reduce oxidative stress. Therefore, in this review, we specifically focus on this antioxidant capacity and its relationship with the beneficial cardiovascular effects described for probiotics.
Assuntos
Doenças Cardiovasculares/prevenção & controle , Suplementos Nutricionais , Disbiose/tratamento farmacológico , Microbioma Gastrointestinal/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Probióticos/uso terapêutico , Doenças Cardiovasculares/microbiologia , Disbiose/fisiopatologia , Trato Gastrointestinal/efeitos dos fármacos , Trato Gastrointestinal/microbiologia , HumanosRESUMO
Westernization and its accompanying epidemiological transitions are associated with changes in gut microbiota. While the extremes of this lifestyle spectrum have been compared (hunter-gatherers, industrialized countries), populations undergoing such shifts have received little attention. To fill the gap of knowledge about the microbiome evolution following broad lifestyle changes and the emergence of disease-associated dysbiosis, we performed a cross-sectional study in which we characterized the microbiota of 441 Colombian adults through 16S rRNA gene sequencing and determined its relationship with demographic, health-related and dietary parameters. We showed that in the gut microbiota of this cohort thrive taxa proper of both hunter-gatherers (Prevotella, Treponema) and citizens of industrialized countries (Bacteroides, Bifidobacterium, Barnesiella); the relative abundances of these taxa differed from those in Western and non-Western populations. We also showed that the Colombian gut microbiota is composed of five consortia of co-abundant microorganisms that are differentially associated with lifestyle, obesity and cardiometabolic disease, and highlighted metabolic pathways that might explain associations between microbiota and host health. Our results give insights into the evolution of the gut microbiota, and underscore the importance of this community to human health. Promoting the growth of specific microbial consortia could help ameliorating physiological conditions associated with Western lifestyles.
Assuntos
Doenças Cardiovasculares/microbiologia , Microbioma Gastrointestinal , Doenças Metabólicas/microbiologia , Obesidade/microbiologia , Adolescente , Adulto , Bactérias/classificação , Bactérias/genética , Colômbia , Feminino , Genoma Bacteriano , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
BACKGROUND: The renin-angiotensin system (RAS) is an important enzymatic system responsible for the regulation of biological functions, such as the arterial pressure, hydroelectrolytic control, vascular vasodilatation/vasoconstriction and more recently metabolic functions. OBJECTIVES: The aim of the present review is to discuss the associations between the gut microbiome and the renin-angiotensin system and the influence of their intimate relationship on the cardiovascular health. METHODS: A literature review of the main studies published regarding the relationship among the renin-angiotensin system, gut microbiota and cardiovascular health was performed. RESULTS: The association between the ACE2 and gut microbiota has been discussed. It is shown that the ACE2/Ang 1-7 axis modulates the immune response, influencing the microbiota composition, and thus being one of the causes for some diseases physiophatologies, such as diarrhea and intestinal inflammatory disease. CONCLUSION: The association between RAS and gut microbiota seems to have a strong influence on the genesis of cardiovascular diseases, through direct mechanisms, such as nerve stimulation, or indirectly on metabolic parameters, such as weight, adiposity and lipid profile.
Assuntos
Angiotensina I/metabolismo , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/microbiologia , Microbioma Gastrointestinal/imunologia , Fragmentos de Peptídeos/metabolismo , Peptidil Dipeptidase A/metabolismo , Sistema Renina-Angiotensina/imunologia , Enzima de Conversão de Angiotensina 2 , Animais , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/imunologia , HumanosRESUMO
In some European countries, yogurt consumption is common. However, such consumption is not common in Latin America, particularly in Mexico, partially because of the lack of a cultural tradition of consuming yogurt. Moreover, we also know that little information about the health benefits associated with yogurt consumption has been provided to the Mexican population. Thus, there is an immediate need to provide, at least to the nutrition community in the country, current scientific evidence about the health benefits of yogurt, with the aim that yogurt be included as part of the functional foods recommended to the population. Currently, extensive research has been conducted to investigate the mechanisms through which yogurt generates beneficial effects. Gut microbiota appear to be an important factor that can be modified by dietary prebiotics, as well as probiotics such as yogurt. The prevention or attenuation of gut microbiota dysbiosis is now associated with improvements observed in individuals with metabolic syndrome and cardiovascular disease. Thus, it is important to establish guidelines for the consumption of dairy products, including yogurt. Such guidelines are necessary to increase the consumption of dairy products in Mexico and other countries.
Assuntos
Dieta , Disbiose/prevenção & controle , Alimento Funcional , Microbioma Gastrointestinal , Política Nutricional , Probióticos , Iogurte , Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/microbiologia , Congressos como Assunto , Cultura , Disbiose/complicações , Humanos , Síndrome Metabólica/dietoterapia , Síndrome Metabólica/microbiologia , México , PrebióticosRESUMO
Q fever is an emergent disease in French Guiana. We compared the incidence clinical and serologic profiles between patients from Cayenne, French Guiana and Marseille in metropolitan France during a four-year period. The annual incidence of diagnosed acute Q fever was significantly higher in Cayenne (17.5/100,000) than in Marseille (1.9/100,000) (P = 0.0004), but not the annual incidence of endocarditis (1.29 versus 0.34/100,000). Most patients had fever (97%) and pneumonia (83%) in Cayenne versus 81% and 8% in Marseille (P < 0.0001 and P < 0.0001, respectively) but transaminitis was more common in patients from Marseille (54% versus 32%; P < 0.0001). The proportion of patients with cardiovascular infections was significantly lower in Cayenne (7%) than in Marseille (17%) (P = 0.017), although they showed a stronger immune response with higher levels of phase I IgG (P = 0.024). The differing epidemiology, clinical, and serologic responses of patients from Cayenne and Marseille suggest a different source of infection and a different strain of Coxiella burnetii.
Assuntos
Doenças Transmissíveis Emergentes , Doenças Endêmicas , Febre Q/diagnóstico , Febre Q/epidemiologia , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/microbiologia , Coxiella burnetii , DNA Bacteriano/isolamento & purificação , Feminino , França/epidemiologia , Guiana Francesa/epidemiologia , Humanos , Imunoglobulina G/sangue , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Febre Q/imunologia , Febre Q/transmissão , Estudos Retrospectivos , Fatores de Risco , Adulto JovemRESUMO
BACKGROUND: Periodontal disease (PD) is an infectious clinical entity characterized by the destruction of supporting tissues of the teeth as the result of a chronic inflammatory response in a susceptible host. It has been proposed that PD as subclinical infection may contribute to the etiology and to the pathogenesis of several systemic diseases including Atherosclerosis. A number of epidemiological studies link periodontal disease/edentulism as independent risk factor for acute myocardial infarction, peripheral vascular disease, and cerebrovascular disease. Moreover, new randomized controlled clinical trials have shown an improvement on cardiovascular surrogate markers (endothelial function, sICAM, hsPCR level, fibrinogen) after periodontal treatment. Nonetheless, such trials are still limited in terms of external validity, periodontal treatment strategies, CONSORT-based design and results consistency/extrapolation. The current study is designed to evaluate if periodontal treatment with scaling and root planning plus local delivered chlorhexidine improves endothelial function and other biomarkers of cardiovascular disease in subjects with moderate to severe periodontitis. METHODS/DESIGN: This randomized, single-blind clinical trial will be performed at two health centers and will include two periodontal treatment strategies. After medical/periodontal screening, a baseline endothelium-dependent brachial artery flow-mediated dilatation (FMD) and other systemic surrogate markers will be obtained from all recruited subjects. Patients then will be randomized to receive either supragingival/subgingival plaque cleaning and calculus removal plus chlorhexidine (treatment group) or supragingival plaque removal only (control group). A second and third FMD will be obtained after 24 hours and 12 weeks in both treatment arms. Each group will consist of 49 patients (n = 98) and all patients will be followed-up for secondary outcomes and will be monitored through a coordinating center. The primary outcomes are FMD differences baseline, 24 hours and 3 months after treatment. The secondary outcomes are differences in C-reactive protein (hs-CRP), glucose serum levels, blood lipid profile, and HOMA index. DISCUSSION: This RCT is expected to provide more evidence on the effects of different periodontal treatment modalities on FMD values, as well as to correlate such findings with different surrogate markers of systemic inflammation with cardiovascular effects. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Identifier: NCT00681564.
Assuntos
Anti-Infecciosos Locais/administração & dosagem , Doenças Cardiovasculares/prevenção & controle , Clorexidina/administração & dosagem , Periodontite Crônica/terapia , Raspagem Dentária , Endotélio Vascular/fisiopatologia , Antissépticos Bucais/administração & dosagem , Projetos de Pesquisa , Aplainamento Radicular , Adulto , Biomarcadores/sangue , Glicemia/metabolismo , Proteína C-Reativa/metabolismo , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/microbiologia , Doenças Cardiovasculares/fisiopatologia , Periodontite Crônica/sangue , Periodontite Crônica/microbiologia , Periodontite Crônica/fisiopatologia , Colômbia , Terapia Combinada , Feminino , Humanos , Lipídeos/sangue , Masculino , Índice de Gravidade de Doença , Método Simples-Cego , Fatores de Tempo , Resultado do Tratamento , VasodilataçãoRESUMO
This paper aims to find the current level of periodontal med-care knowledge, as well as the possible existence of some oral infection control protocol regarding hospitalized patients. Our sample gathered 110 cardiologists and intensive care units doctors selected from medical teams of five Rio de Janeiro hospitals. Preliminary numbers: 75.4% said to have heard something about Periodontal Medicine, although only 30% out of this group admitted to have read something concerning such subject. On the other side, only 2.7% of the sample informed to do consistent information searching along their patients anamnese, while 58.2% out of this group admitted such procedure conditional to the patient's general state at the due moment. Through such numbers, we tend to come up to the conclusion that, be it either through direct or indirect Periodontal Medicine technical information (and consequently with regards to the absolut importance of preservation and control of oral biofilm and its impact on one's systemic health), the matter has been dimly spread among medical groups. The search also revealed the probability that Rio de Janeiro hospitals lack either units or agents designed for prevention and control of oral infection; consequently, such organizations do not have any kind of protocols, reliable or not, concerned to oral infections.
Assuntos
Cardiologia , Doenças Cardiovasculares/microbiologia , Doenças Cardiovasculares/prevenção & controle , Cuidados Críticos , Conhecimentos, Atitudes e Prática em Saúde , Controle de Infecções/métodos , Pacientes Internados , Doenças Periodontais/microbiologia , Doenças Periodontais/prevenção & controle , Padrões de Prática Médica , Doenças Cardiovasculares/etiologia , Unidades de Cuidados Coronarianos , Humanos , Unidades de Terapia Intensiva , Doenças Periodontais/complicaçõesRESUMO
O objetivo do presente estudo foi verificar o grau de conhecimento médico sobre medicina periodontal e verificar a existência de algum protocolo de controle de infecção da cavidade oral em pacientes internados em hospitais. Para tal, 110 médicos cardiologistas e intensivistas lotados em cinco hospitais no município do Rio de Janeiro foram entrevistados. Dentre os indivíduos, 75,4 por cento afirmaram ter conhecimento sobre o termo medicina periodontal; entretanto, apenas 30 por cento declararam já ter lido algo a respeito. Apenas 2,7 por cento dos médicos possuem o hábito de coletar informações sobre a história odontológica de seus pacientes e 58,2 por cento afirmaram que essa conduta é condicional ao quadro apresentado pelo paciente. Com base nos dados obtidos, pode-se concluir que o conhecimento sobre medicina periodontal e, consequentemente, sobre a importância do controle do biofilme oral na manutenção da saúde sistêmica, apresenta-se pouco difundido entre a classe médica. Verificou-se não haver setor ou pessoa responsável pelo controle de infecção oral dentro dos hospitais avaliados e, consequentemente, a não existência de qualquer protocolo, eficaz ou não, de controle de infecção oral nessas unidades.
This paper aims to find the current level of periodontal med-care knowledge, as well as the possible existence of some oral infection control protocol regarding hospitalized patients. Our sample gathered 110 cardiologists and intensive care units doctors selected from medical teams of five Rio de Janeiro hospitals. Preliminary numbers: 75.4 percent said to have heard something about Periodontal Medicine, although only 30 percent out of this group admitted to have read something concerning such subject. On the other side, only 2.7 percent of the sample informed to do consistent information searching along their patients anamnese, while 58.2 percent out of this group admitted such procedure conditional to the patient's general state at the due moment. Through such numbers, we tend to come up to the conclusion that, be it either through direct or indirect Periodontal Medicine technical information (and consequently with regards to the absolut importance of preservation and control of oral biofilm and its impact on one's systemic health), the matter has been dimly spread among medical groups. The search also revealed the probability that Rio de Janeiro hospitals lack either units or agents designed for prevention and control of oral infection; consequently, such organizations do not have any kind of protocols, reliable or not, concerned to oral infections.
Assuntos
Humanos , Cardiologia , Doenças Cardiovasculares/microbiologia , Doenças Cardiovasculares/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Controle de Infecções/métodos , Pacientes Internados , Cuidados Críticos , Doenças Periodontais/microbiologia , Doenças Periodontais/prevenção & controle , Padrões de Prática Médica , Doenças Cardiovasculares/etiologia , Unidades de Cuidados Coronarianos , Unidades de Terapia Intensiva , Doenças Periodontais/complicaçõesRESUMO
Sepsis and septic shock are the major causes of morbidity and mortality in critically ill patients. During the onset of sepsis, a massive inflammatory reaction involving chemical mediators such as cytokines and chemokines and inflammatory cells such as the polymorphonuclear neutrophil and macrophage takes place. In addition to this systemic inflammatory process, sepsis and septic shocks cause a profound decrease in the peripheral vasomotor tone leading to a great decrease in the peripheral resistance. This event is central to derangement of hemodynamic and perfusion parameters. Nitric oxide (NO) is produced by several cell types and has been implicated in a wide range of physiological and pathological processes, with both detrimental and beneficial effects. There is a wealth of data implicating NO as a key player in all cardiac, vascular, renal and pulmonary derangements of sepsis and septic shock. Clinical assays trying to improve sepsis by inhibiting NO formation by NO synthases have met with failure, probably due to the lack of selectivity of inhibitors towards NOS isoforms. Notwithstanding the search for selective inhibitors, a better understanding of the NO molecular effector mechanisms may provide new opportunities for therapy development. Some of these NO effector mechanisms are discussed, including guanylate cyclase, nitrosothiols, potassium channels, reactive oxygen species and gene expression in the context of sepsis. Thus, more research on the relationship between NO and sepsis is clearly needed and warranted and may provide new therapeutic targets to treat sepsis and septic shock.
Assuntos
Doenças Cardiovasculares/fisiopatologia , Óxido Nítrico/fisiologia , Sepse/fisiopatologia , Animais , Doenças Cardiovasculares/enzimologia , Doenças Cardiovasculares/imunologia , Doenças Cardiovasculares/microbiologia , Humanos , Óxido Nítrico/imunologia , Óxido Nítrico/metabolismo , Sepse/sangue , Sepse/imunologia , Sepse/microbiologiaRESUMO
Bactérias da placa dental alcançam a corrente sangüínea nas doenças periodontais, nas interveçöes odontológicas e mesmo durante a mastigaçäo e escovaçäo dos dentes.Muitas doenças sistêmicas eram atribuídas às batérias da boca e, comumente, era sugerido a extraçäo de dentes como prevençäo e tratamento destas doenças.Posteriormente, apenas a endocardite continuou sendo associada a bactérias da boca, e pacientes com problemas valvulares rececbem antibiocoterapia antes de intervençöes odontológicas invasivas. recentemente a importância das infecçöes bucais em doenças sistêmicas voltou a ser intensivamente discutida. Trabalhos epidemiológicos indicam que as bactérias da boca podem ser importantes näo apenas na endocardite, mas em várias outras doenças como diabetes, ,ateroesclerose, infarto e partos prematuros. Embora as evidências ainda näo sejam conclusivas, uma perspectiva nova e ampla está abrindo-se para odontologia e medicina, ou seja,de que a saúde bucal é imoprtante na prevençäo de doenças sistêmicas graves e freqüentes. Se atéo momento o objetivo da Odontologia foi a preservaçäo dos dentes, atualmente os horizontes säo mais amplos, ,objetivando a manutençäo da saúde bucal e sistêmica. Esta afirmativa é válida näo apenas para os indivíduos com deficiências dos mecanismos ded dedfesa, como idosos e imunocomprometidos, mas para toda populaçäo. Esta filosofia vai permitir também uma melhor integraçäo entre a dontologia e a Medicina. Esta integraçäo já é evidenete em pacientes portadores de doenças mucocutâneas, discrasias sagüineas, transplantados, diabéticos e doenças infecciosas como a Aids.
Assuntos
Humanos , Masculino , Feminino , Doenças Cardiovasculares/microbiologia , Doenças da Boca/complicações , Doenças da Boca/diagnóstico , Doenças da Boca/epidemiologia , Doenças Periodontais/epidemiologia , Endocardite Bacteriana , Saúde BucalRESUMO
Como patógeno respiratorio, C. pneumoniae ha sido asociada con crisis de asma bronquial como uno de varios factores desencadenantes. Las evidencias seroepidemiológicas, histopatológicas y de biología molecular que relacionan además la infección por C. penumonaie con la producción de angiopatía coronaria van en aumento. Se revisan los antecedentes que han permitido encontrar esta relación, incluyendo nuestra propia experiencia, aunque se desconoce el grado de responsabilidad atribuible a la infección en esta afección degenerativa