Well-cared for intestine, the heart thanks you

Changes in the gut microbiome have been linked to several conditions, such as type 2 diabetes, obesity, and inflammatory bowel disease. Now, a team of researchers from the Broad Institute of the Massachusetts Institute of Technology (MIT) and Harvard, in the United States, in collaboration with Massachusetts General Hospital, has discovered that microorganisms present in the intestine may also play a role in cardiovascular problems. Published yesterday in the journal Cell, the study identified specific bacteria that consume cholesterol and help reduce fat levels and the risk of heart disease.

Researchers analyzed metabolites and microbial genomes from more than 1,400 participants in the Framingham Heart Study, a project focused on risk factors for cardiovascular disease. The group discovered that a bacteria called Oscillibacter is capable of absorbing and metabolizing cholesterol from the intestinal environment, and individuals with higher levels of this microorganism tend to have lower amounts of fat.

Researchers have identified the mechanism by which these bacteria break down cholesterol, indicating that interventions targeting the microbiome could potentially reduce fat. According to the article, these findings also lay the groundwork for further investigation into how changes in the microbiome affect health.

“Our research integrates clinical findings with experimental validation to ensure we obtain actionable mechanistic insights that can serve as a starting point for improving cardiovascular health,” said Ramnik Xavier, trial leader and professor at Harvard Medical School, in a statement.

Old target

Over the past decade, other researchers have discovered connections between the composition of the gut microbiome and elements of cardiovascular disease, such as triglycerides and blood sugar levels after a meal. However, understanding of these links has been limited by the lack of complete knowledge of intestinal metabolic pathways.

Fernando Faglioni Ribas, cardiologist at Beneficência Portuguesa, in São Paulo, highlights that the type of intestinal flora also promotes greater or lesser glucose metabolism. “There is enormous potential to increase the availability of bacteria that metabolize bad cholesterol or even reduce the availability, for example, of glucose in patients who have excess blood glucose levels, all of which can greatly help the patient in controlling their risk. cardiovascular.”

“It’s a challenge. To analyze the microbiota, a lot of structure is needed, it is necessary to study in depth everything that the patient has in their intestinal microbiota. It is difficult to know the exact proportion to modify each microorganism in that person. Knowing what side effects are related to Exposing a patient to an excess of some of the germs of the intestinal microbiota is also important. This research is very early, I think there is a long way to go”, pondered the specialist.

The new trial gained a more detailed look at the impact of gut microbes on metabolism. Combining DNA sequencing with metabolomics — the study of metabolites — stool samples from the Framingham Heart Study were meticulously evaluated. The approach revealed more than 16,000 associations between microorganisms and metabolic characteristics, highlighting the role of bacteria of the Oscillibacter genus in reducing cholesterol levels.

The researchers also identified another bacterial species, Eubacterium coprostanoligenes, which contributes to lower cholesterol levels. “Our work highlights the need for a deeper understanding of gut ecology and microbial interactions to develop more effective therapeutic strategies,” explained postdoctoral researcher Chenhao Li, co-author of the work. “There are many new discoveries to be made that bring us closer to a mechanistic understanding of how microbes interact with their host.”

No clutter

Ricardo Cals, cardiologist at Santa Lúcia hospital, in Brasília, emphasizes that the discovery opens the way for new treatments. “New molecules have been created to influence cholesterol metabolism. The more medication options we have to lower cholesterol, the better. However, there are challenges in manipulating the microbiota, removing this balance that it naturally has, which is bacteria that does not cause disease in humans, but perhaps with a much larger number of its members it will begin to be pathogenic.”

For Ricardo Teixeira Leal, cardiologist at Hospital do Coração do Brasil, Rede D’Or, also in Brasília, discovering how to stimulate certain bacterial enzymes and suppress others without unbalancing the body is just as important as the results of the trial. According to him, in addition to cholesterol, other inflammatory substances are released and metabolized in the intestine.

“This pro-inflammatory environment worsens diseases such as hypertension, diabetes, fibromyalgia, rheumatological diseases, among others. Reducing inflammation through modulation of mediators would have unimaginable benefits in the treatment of all these issues.”

Other conditions

This topic has been very relevant nowadays and intestinal modulation has shown to be a promising approach in the treatment of inflammatory bowel diseases, diabetes, hypertension, obesity, dyslipidemia, autoimmune diseases and neuropsychiatric diseases. The choice of patients must be individualized, through evaluation by a gastroenterologist and a good clinical history. It is known that inflammatory bowel disease (IBD) has multiple triggering factors, with the intestinal microbiota being one of these triggers. Furthermore, there is scientific evidence that diseases with chronic inflammation increase patients’ cardiovascular risk. More studies focusing on changes in the intestinal microbiota would provide alternative treatments, leading patients to remission of IBD and reducing the associated risk.

Daniela Carvalho, gastroenterologist at the Gastrocentro clinic, in Brasília