Role of the microbiota-gut-heart axis between bile acids and cardiovascular disease

Area of Science:

• Cardiovascular Science
• Microbiology
• Metabolomics

Background:

• Bile acids (BAs) and their receptors are present in cardiovascular cells, highlighting their role in cardiovascular disease (CVD).
• Hydrophobic BAs are cardiotoxic, whereas hydrophilic BAs, like ursodeoxycholic acid, are cardioprotective, as seen in intrahepatic cholestasis of pregnancy.
• Gut microbiota (GM) and its metabolites, particularly secondary BAs, are implicated in various CVDs, including hypertension, atherosclerosis, and heart failure.

Purpose of the Study:

• To elucidate the intricate relationship between cardiovascular disease (CVD) and the gut microbiota (GM) through the lens of bile acid (BA) metabolism.
• To integrate the "microbiota-gut-heart axis" (MGHA) concept with BA signaling in the context of CVD pathogenesis.
• To propose novel therapeutic strategies for CVD based on modulating BA levels within the MGHA framework.

Main Methods:

• Review and synthesis of existing literature on bile acids, gut microbiota, and cardiovascular disease.
• Analysis of the mechanistic links between BA hydrophobicity/hydrophilicity and cardiac function.
• Conceptual integration of the microbiota-gut-heart axis (MGHA) with BA signaling pathways.

Main Results:

• Bile acid receptors are expressed in cardiovascular tissues, mediating BA effects on heart and vasculature.
• A balance of hydrophobic and hydrophilic BAs is critical for cardiovascular health; deviations contribute to cardiac dysfunction.
• Gut microbiota significantly shapes the secondary BA pool, influencing cardiovascular risk factors and disease progression.

Conclusions:

• Bile acids play a dual role in cardiovascular disease, dependent on their hydrophobicity and influenced by gut microbiota metabolism.
• The microbiota-gut-heart axis (MGHA) provides a framework for understanding how gut microbial activity impacts cardiovascular health via bile acids.
• Targeting bile acid metabolism and the gut microbiota presents a promising avenue for novel cardiovascular disease therapies.