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Vascular Cognitive Impairment and the Gut Microbiota
Sinian Li1, Yiming Shao2, Kanglan Li1
1Department of Neurology, Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Institute of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.
Abstract:
Vascular cognitive impairment (VCI), the second most common cause of dementia in elderly people, is a term that refers to all forms of cognitive disorders that can be attributed to cerebrovascular disease such as manifestations of discrete infarctions, brain hemorrhages, and white matter lesions. The gut microbiota (GM) has emerged recently as an essential player in the development of VCI. The GM may affect the brain's physiological, behavioral, and cognitive functions through the brain-gut axis via neural, immune, endocrine, and metabolic pathways. Therefore, microbiota dysbiosis may mediate or affect atherosclerosis, cerebrovascular disease, and endothelial dysfunction, which are the predominant risk factors for VCI. Moreover, the composition of the GM includes the bacterial component lipopolysaccharides and their metabolic products including trimethylamine-N-oxide and short-chain fatty acids. These products may increase the permeability of the intestinal epithelium, leading to systemic immune responses, low-grade inflammation, and altered signaling pathways that are associated with the pathogenesis of VCI. In this review, we discuss the proposed mechanisms of the GM in the maintenance of VCI and how it is implicated in acquired metabolic diseases, particularly in VCI regulation.
Insights
Vascular cognitive impairment (VCI) is linked to gut microbiota changes. Gut bacteria influence brain health via the gut-brain axis, impacting VCI development and progression.
Area of Science:
- Neuroscience
- Microbiology
- Gerontology
Background:
- Vascular cognitive impairment (VCI) is a major cause of dementia in older adults, linked to cerebrovascular diseases.
- The gut microbiota (GM) is increasingly recognized for its role in VCI pathogenesis.
- The brain-gut axis, involving neural, immune, endocrine, and metabolic pathways, mediates GM-brain interactions.
Purpose of the Study:
- To review the proposed mechanisms by which the gut microbiota influences the development and maintenance of VCI.
- To explore the role of gut microbiota dysbiosis in VCI pathogenesis and its connection to metabolic diseases.
Main Methods:
- This review synthesizes current research on the gut microbiota and VCI.
- It examines the impact of bacterial components like lipopolysaccharides and their metabolites (e.g., trimethylamine-N-oxide, short-chain fatty acids) on intestinal permeability and systemic inflammation.
- The review discusses the implications for cerebrovascular disease and endothelial dysfunction, key VCI risk factors.
Main Results:
- Gut microbiota dysbiosis can contribute to atherosclerosis, cerebrovascular disease, and endothelial dysfunction, all risk factors for VCI.
- Bacterial products can increase intestinal permeability, triggering systemic inflammation and altered signaling pathways involved in VCI.
- The GM plays a significant role in acquired metabolic diseases that impact VCI regulation.
Conclusions:
- The gut microbiota is a critical factor in VCI development and progression.
- Targeting the gut microbiota presents a potential therapeutic strategy for managing VCI and related metabolic disorders.
- Further research into the gut-brain axis mechanisms is crucial for understanding and treating VCI.
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