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Influence of intestinal microbiota on the development and course of diseases in patients with chronic kidney disease in combination with cardiovascular pathology
https://doi.org/10.30629/0023-2149-2025-103-8-9-589-595
Abstract
The composition of the intestinal microbiota is associated with the course of diseases such as chronic kidney disease, arterial hypertension and coronary heart disease. Patients with CKD, hypertension and coronary artery disease often experience changes in the composition of the microbiota, which may be associated with an increase in inflammatory processes, metabolic disorders and other factors that contribute to the progression of these diseases. The gut microbiota can change in response to treatment, improving the patient’s condition. This review highlights a uremic toxin produced by the gut microbiota, phenylacetylglutamine (PAG), which may be an excellent indicator of the likelihood of in-stent restenosis or hyperplasia. An increase in the number of bacteria of the genus Lachnospira can lead to postoperative complications after coronary artery bypass grafting.
About the Authors
A. T. Klassova
Stavropol State Medical University of the Ministry of Health of Russia
Россия
Россия
Aigul T. Klassova — Assistant of the Department of Outpatient Therapy
Stavropol
N. V. Agranovich
Stavropol State Medical University of the Ministry of Health of Russia
Россия
Россия
Nadezhda V. Agranovich — Doctor of Medical Sciences, Professor, Head of the Department of Outpatient Therapy
Stavropol
A. S. Anopchenko
Stavropol State Medical University of the Ministry of Health of Russia
Россия
Россия
Alena S. Anopchenko — Candidate of Medical Sciences, Docent of the Department of Outpatient Therapy
Stavropol
A. O. Agranovich
Stavropol State Medical University of the Ministry of Health of Russia
Россия
Россия
Andrey O. Agranovich — Candidate of Medical Sciences, Assistant of the Department of Neurology and Neurorehabilitation
Stavropol
References
1. Miyauchi E. et al. The impact of the gut microbiome on extraintestinal autoimmune diseases. Nat. Rev. Immunol. 2023;23(1):9– 23. DOI: 10.1038/s41577-022-00727-y
2. McCulloch J.A. et al. Intestinal microbiota signatures of clinical response and immune-related adverse events in melanoma patients treated with anti-PD-1. Nat. Med. 2022;28(3):545–556. DOI: 10.1038/s41591-022-01698-2
3. World health statistics 2023: monitoring health for the SDGs, sustainable development goals. [Electronic resource]. URL: https://www.who.int/publications/i/item/9789240074323
4. Sircana A. et al. Gut microbiota, hypertension and chronic kidney disease: Recent advances. Pharmacological Research. 2019;144:390– 408. DOI: 10.1016/j.phrs.2018.01.013
5. Ryabov V.V. et al. Coronary stent technology and the role of inflammation in the atherogenesis: problems and prospects. Bûll. sib. med. 2021;20(1):200–212. DOI: 10.20538/1682-0363-2021-1-200-212
6. Wong J. et al. Expansion of urease- and uricase-containing, indole- and p-cresol-forming and contraction of short-chain fatty acid-producing intestinal microbiota in ESRD. Am. J. Nephrol. 2014;39(3):230–237. DOI: 10.1159/000360010
7. Jiang S. et al. A reduction in the butyrate producing species Roseburia spp. and Faecalibacterium prausnitzii is associated with chronic kidney disease progression. Antonie van Leeuwenhoek. 2016;109(10):1389–1396. DOI: 10.1007/s10482-016-0737-y
8. Yang Z. et al. Gut microbiota and hypertension: association, mechanisms and treatment. Clinical and Experimental Hypertension. 2023;45(1):2195135. DOI: 10.1080/10641963.2023.2195135
9. Yang T. et al. The gut microbiota and the brain–gut–kidney axis in hypertension and chronic kidney disease. Nat. Rev. Nephrol. 2018;14(7):442–456. DOI: 10.1038/s41581-018-0018-2
10. Li J. et al. Gut microbiota dysbiosis contributes to the development of hypertension. Microbiome. 2017;5(1):14. DOI: 10.1186/s40168-016-0222-x
11. Dinakis E. et al. Association Between the Gut Microbiome and Their Metabolites With Human Blood Pressure Variability. Hypertension. 2022;79(8):1690–1701. DOI: 10.1161/HYPERTENSIONAHA.122.19350
12. Mushtaq N. et al. Molecular characterization of alterations in the intestinal microbiota of patients with grade 3 hypertension. Int. J. Mol. Med. 2019. DOI: 10.3892/ijmm.2019.4235
13. Larabi A., Barnich N., Nguyen H.T.T. New insights into the interplay between autophagy, gut microbiota and inflammatory responses in IBD. Autophagy. 2020;16(1):38–51. DOI: 10.1080/15548627.2019.1635384
14. Sircana A. et al. Gut microbiota, hypertension and chronic kidney disease: Recent advances. Pharmacological Research. 2019;144:390–408. DOI: 10.1016/j.phrs.2018.01.013
15. Wilck N. et al. Salt-responsive gut commensal modulates TH17 axis and disease. Nature. 2017;551(7682):585–589. DOI: 10.1038/nature24628
16. Yan X. et al. Intestinal Flora Modulates Blood Pressure by Regulating the Synthesis of Intestinal-Derived Corticosterone in High SaltInduced Hypertension. Circulation Research. 2020;126(7):839–853. DOI: 10.1161/CIRCRESAHA.119.316394
17. Zhu Q. et al. Dysbiosis signatures of gut microbiota in coronary artery disease. Physiological Genomics. 2018;50(10):893–903. DOI: 10.1152/physiolgenomics.00070.2018
18. Fan Y. et al. Microbiota-related metabolites fueling the understanding of ischemic heart disease. Imeta. 2023;2(2):e94. DOI: 10.1002/imt2.94
19. Yoshida N., Yamashita T., Hirata K. Gut Microbiome and Cardiovascular Diseases. Diseases. 2018;6(3):56. DOI: 10.3390/diseases6030056
20. Jin M. et al. The role of intestinal microbiota in cardiovascular disease. J. Cell. Mol. Med. 2019;23(4):2343–2350. DOI: 10.1111/jcmm.14195
21. Horvath A. et al. Effects of a multispecies synbiotic on glucose metabolism, lipid marker, gut microbiome composition, gut permeability, and quality of life in diabesity: a randomized, double-blind, placebo-controlled pilot study. Eur. J. Nutr. 2020;59(7):2969–2983. DOI: 10.1007/s00394-019-02135-w
22. Robles‐Vera I. et al. Changes to the gut microbiota induced by losartan contributes to its antihypertensive effects. British J. Pharmacology. 2020;177(9):2006–2023. DOI: 10.1111/bph.14965
23. Pribylova N.N. et al. Endothelial dysfunction, vascular stiffness and their correction with perindopril, losartan in patients with ischemic heart disease, arterial hypertension and chronic kidney disease after coronary stenting. Humans and their Health. 2022;25(3):15–23. DOI: 10.21626/vestnik/2022-3/02
24. Santisteban M.M. et al. Hypertension-Linked pathophysiological alterations in the gut. Circulation Research. 2017;120(2):312–323. DOI: 10.1161/CIRCRESAHA.116.309006
25. Yoo H.H. et al. Effects of orally administered antibiotics on the bioavailability of amlodipine: gut microbiota-mediated drug interaction. Journal of Hypertension. 2016;34(1):156–162. DOI: 10.1097/HJH.0000000000000773
26. Song Y. et al. Gut microbiota-dependent phenylacetylglutamine in cardiovascular disease: current knowledge and new insights. Front. Med. 2024;18(1):31–45. DOI: 10.1007/s11684-024-1055-9
27. Liu M. et al. Cardiovascular disease and its relationship with chronic kidney disease. Eur. Rev. Med. Pharmacol. Sci. 2014;18(19):2918– 2926. PMID: 25339487
28. Hsu C.-N., Tain Y.-L. Chronic kidney disease and gut microbiota: what is their connection in early life? Int. J. Mol. Sci. 2022;23(7):3954. DOI: 10.3390/ijms23073954
29. Liu Y. et al. Phenylacetylglutamine is associated with the degree of coronary atherosclerotic severity assessed by coronary computed tomographic angiography in patients with suspected coronary artery disease. Atherosclerosis. 2021;333:75–82. DOI: 10.1016/j.atherosclerosis.2021.08.029
30. Ottosson F. et al. The gut microbiota-related metabolite phenylacetyl glutamine associates with increased risk of incident coronary artery disease. Journal of Hypertension. 2020;38(12):2427–2434. DOI: 10.1097/HJH.0000000000002569
31. Menni C. et al. Gut microbial diversity is associated with lower arterial stiffness in women. European Heart Journal. 2018;39(25):2390– 2397. DOI: 10.1093/eurheartj/ehy226
32. Yu F. et al. Phenylacetylglutamine, a Novel Biomarker in Acute Ischemic Stroke. Front. Cardiovasc. Med. 2021;8:798765. DOI: 10.3389/fcvm.2021.798765
33. Azab S.M. et al. Serum metabolic signatures of chronic limb-threatening ischemia in patients with peripheral artery disease. JCM. 2020;9(6):1877. DOI: 10.3390/jcm9061877
34. Liu Y. et al. Phenylacetylglutamine is associated with the degree of coronary atherosclerotic severity assessed by coronary computed tomographic angiography in patients with suspected coronary artery disease. Atherosclerosis. 2021;333:75–82. DOI: 10.1016/j.atherosclerosis.2021.08.029
35. Fu Y. et al. Prognostic value of plasma phenylalanine and gut microbiota-derived metabolite phenylacetylglutamine in coronary in-stent restenosis. Y. Fu et al. Front. Cardiovasc. Med. 2022;9:944155. DOI: 10.3389/fcvm.2022.944155
36. Fang C. et al. Dysbiosis of gut microbiota and metabolite phenylacetylglutamine in coronary artery disease patients with stent stenosis. Front. Cardiovasc. Med. 2022;9:832092. DOI: 10.1111/jcmm.15959
37. Li J. et al. Shifts in gut microbiome and metabolome are associated with risk of recurrent atrial fibrillation. J. Cellular. Molecular. Medi. 2020;24(22):13356–13369. DOI: 10.3389/fcvm.2022.832092
38. Zuo K. et al. Disordered gut microbiota and alterations in metabolic patterns are associated with atrial fibrillation. GigaScience. 2019;8(6):giz058. DOI: 10.1093/gigascience/giz058
39. Fujimoto D. et al. The relationship between unique gut microbiome-derived lipid metabolites and subsequent revascularization in patients who underwent percutaneous coronary intervention. Atherosclerosis. 2023;375:1–8. DOI: 10.1016/j.atherosclerosis.2023.05.001
40. Wang Y. et al. Gut microbiota in patients with postoperative atrial fibrillation undergoing off-pump coronary bypass graft surgery. J. Clin. Med. 2023;12(4):1493. DOI: 10.3390/jcm12041493
41. Liu Y. et al. Gut microbiota metabolism disturbance is associated with postoperative atrial fibrillation after coronary artery bypass grafting. J. Cardiovasc. Health. 2024;1(1):5. DOI: 10.1038/s44325-024-00003-z
Review
For citations:
Klassova A.T., Agranovich N.V., Anopchenko A.S., Agranovich A.O. Influence of intestinal microbiota on the development and course of diseases in patients with chronic kidney disease in combination with cardiovascular pathology. Clinical Medicine (Russian Journal). 2025;103(8-9):589-595. (In Russ.) https://doi.org/10.30629/0023-2149-2025-103-8-9-589-595
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