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Darm-Herz-Achse

Wie Darmbakterien kardiovaskuläre Erkrankungen beeinflussen

Gut-heart axis

How gut bacteria influence cardiovascular diseases

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Zusammenfassung

Die Betrachtung des Menschen als einen Holobionten, bestehend aus eukaryotischen Wirtszellen und assoziierten prokaryotischen Lebewesen, hat eine neue Perspektive auf die kardiovaskuläre Pathophysiologie eröffnet. Insbesondere die Bakterien des Darms beeinflussen die Zell- und Organfunktionen ihres Wirts. Darmbakterien stellen eine stoffwechselaktive Gemeinschaft dar, deren Zusammensetzung und Funktion kardiovaskuläre Erkrankungen beeinflussen kann. Die Interaktion zwischen Darmbakterien und Herz erfolgt über Metabolite bakteriellen Ursprungs, welche im Darm resorbiert und über die Zirkulation verteilt werden. Bakterielle Metabolite entstehen aus Nahrungsbestandteilen, was wiederum die Bedeutung der Ernährung unterstreicht. Manche dieser Metabolite, wie z. B. Trimethylamin-N-oxid (TMAO), können kardiovaskuläre Pathologien verstärken. Kurzkettige Fettsäuren wiederum werden als protektive Metabolite betrachtet. Das Immunsystem des Wirts ist dabei ein wichtiger Angriffspunkt für diese Metabolite und erklärt einen großen Teil ihrer Wirkungen. In der Zukunft könnte die gezielte Beeinflussung der Darmbakterien helfen, die Entstehung und Progression von kardiovaskulären Erkrankungen zu verhindern.

Abstract

The view of humans as holobionts consisting of eukaryotic host cells and associated prokaryotic organisms, has opened up a new perspective on cardiovascular pathophysiology. In particular, intestinal bacteria influence the cell and organ functions of the host. Intestinal bacteria represent a metabolically active community whose composition and function can influence cardiovascular health and disease. The interaction between the intestinal microbiota and the heart occurs via metabolites of bacterial origin, which are resorbed in the intestine and distributed via the circulation. Bacterial metabolites are produced from food components, which in turn emphasizes the importance of nutrition. Some of these metabolites, such as trimethylamine N‑oxide (TMAO), can exacerbate cardiovascular pathologies. Short-chain fatty acids (SCFA) in turn are considered to be protective metabolites. The host’s immune system is an important target for these metabolites and explains much of their effects. In the future, the targeted manipulation of intestinal bacteria could help to prevent the development and progression of cardiovascular diseases.

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Förderung

Dr. Nicola Wilck ist Teilnehmer des Clinician Scientist Programms des Berlin Institute of Health (BIH). Seine Nachwuchsgruppe wird durch die Corona-Stiftung im Deutschen Stifterverband gefördert. Er wird durch einen Starting Grant (852796) des European Research Council und im Rahmen des Sonderforschungsbereichs 1365 durch die Deutsche Forschungsgemeinschaft unterstützt.

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  1. Experimental and Clinical Research Center, eine Kooperation von Charité – Universitätsmedizin Berlin und Max-Delbrück-Centrum für Molekulare Medizin, 13125, Berlin, Deutschland

    Hendrik Bartolomaeus, Victoria McParland &  Nicola Wilck

  2. Max-Delbrück-Centrum für Molekulare Medizin in der Helmholtz-Gemeinschaft, 13125, Berlin, Deutschland

    Hendrik Bartolomaeus, Victoria McParland &  Nicola Wilck

  3. DZHK (Deutsches Zentrum für Herz-Kreislauf-Forschung), Partner Site Berlin, Berlin, Deutschland

    Hendrik Bartolomaeus &  Nicola Wilck

  4. Berlin Institute of Health (BIH), Berlin, Deutschland

    Hendrik Bartolomaeus &  Nicola Wilck

  5. Medizinische Klinik mit Schwerpunkt Nephrologie und Internistische Intensivmedizin, Charité – Universitätsmedizin Berlin, 13353, Berlin, Deutschland

    Nicola Wilck

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Bartolomaeus, H., McParland, V. & Wilck, N. Darm-Herz-Achse. Herz 45, 134–141 (2020). https://doi.org/10.1007/s00059-020-04897-0

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