In Nature Reviews Cardiology, DZHK researchers shed light on various mechanisms in the interaction between the gut microbiome and thromboses. This could lead to new approaches for the prevention and treatment of thrombosis and associated cardiovascular diseases.
A new scientific review in Nature Reviews Cardiology shows that the gut microbiome influences the development of thrombosis in several ways. In addition to the production of trimethylamine-N-oxide (TMAO), various bacterial metabolites and inflammatory processes contribute to thrombus formation. One example is the bacterial conversion of choline and carnitine from foods such as red meat into TMAO, which is known to promote platelet activation.
In addition, studies show that the gut microbiota influences the integrity of the intestinal barrier (Commensal bacteria weaken the intestinal barrier by suppressing epithelial neuropilin-1 and Hedgehog signalling | Nature Metabolism). When this barrier is disrupted, endotoxic substances can enter the bloodstream and trigger inflammatory reactions that contribute to thrombosis formation. This leads to an increased systemic level of inflammation, which also increases the blood's tendency to clot.
Microbial metabolites and new therapeutic approaches
In addition, short-chain fatty acids (SCFAs), which are produced by certain intestinal bacteria, play a role in regulating inflammation and stabilising the endothelium, which in turn can modulate the coagulation processes. Another example is the bacterial influence on bile acids, which alters liver metabolism and blood lipid levels. Imbalances in these mechanisms could increase the risk of cardiovascular complications such as thrombosis.
‘Our results show that the gut microbiome has a far-reaching influence on the vascular system and thrombosis. Understanding the microbial mechanisms that promote thrombosis opens up promising possibilities for preventive therapies targeting microbial diversity and influencing microbial metabolites,’ explains Christoph Reinhardt, last author of the study from the Center for Thrombosis and Haemostasis (CTH) at the University Medical Center Mainz.
These research results open up new perspectives for therapeutic measures, including targeted probiotics, prebiotic nutrition or drugs that could regulate the influence of specific bacteria and their metabolites on the coagulation system. These new approaches could help to fundamentally improve the prevention and treatment of thrombosis and related cardiovascular diseases.
Original publication: The gut microbiota in thrombosis. My Phung Khuu, Nadja Paeslack, Olga Dremova, Corinne Benakis, Klytaimnistra Kiouptsi & Christoph Reinhardt, Nature Reviews Cardiology (2024)
Scientific contact: Prof. Christoph Reinhardt, Center for Thrombosis and Haemostasis (CTH) of the University Medical Center Mainz, Christoph.Reinhardt@unimedizin-mainz.de
