skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Investigating intestinal permeability and gut microbiota roles in acute coronary syndrome patients

Journal Article · · Human Microbiome Journal

Acute Coronary Syndrome (ACS) is a prime cause of morbidity and mortality. Perturbed gutmicrobiota (dysbiosis) and increased intestinal permeability (leaky-gut) with translocation of bacterial antigens, play critical role in obesity and metabolic syndrome, which are also major ACS risk factors. Additionally, Trimethylamine-N-Oxide (TMAO), a metabolite produced by phylum Proteobacteria in gut is implicated in developing ACS. As Proteobacteria is a major source of translocated antigen lipopolysaccharides (LPS), we hypothesized that ACS patients have leaky-gut condition characterized by dysbiosis with increased Proteobacteria, leading to elevated blood levels of TMAO and LPS. Methods: In a pilot case-control study, we enrolled 19 ACS patients (within 72-h of cardiac events) and 19 healthy-controls. Gut barrier function was determined using lactulose-to-mannitol urinary excretion ratio (L/M ratio). Stool microbiome composition was examined using 16S sequencing and predictive functional analysis for LPS biosynthesis pathway by PICRUSt tool. Serum TMAO and LPS levels were measured. ACS patients had increased Gammaproteobacteria compared to controls:1.8 ± 3.0 vs. 0.2 ± 0.4% (P=0.04). Though Proteobacteria level was increased but not statistically significant: 4.1 ± 3.8 vs. 2.1 ± 1.7% (P=0.056). L/M-ratio was three times higher in ACS patients; 0.06 ± 0.07 vs 0.023 ± 0.02, (P=0.014). Interestingly, there was no difference in the mean serum LPS or TMAO levels. Yet, PICRUSt analysis indicated increased Proteobacteria population increasingly contributed to LPS biosynthesis in ACS patients only. ACS patients likely to have leaky-gut and perturbed gut microbiota. Further studies are required to precisely define the role of dysbiosis in ACS.

Research Organization:
Los Alamos National Lab. (LANL), Los Alamos, NM (United States)
Sponsoring Organization:
USDOE National Nuclear Security Administration (NNSA); Clinical and Translational Science Center (CTSC)
Grant/Contract Number:
20160340ER; 20170671PRD2; 89233218CNA000001
OSTI ID:
1545182
Alternate ID(s):
OSTI ID: 1558047
Report Number(s):
LA-UR-18-26913; LA-UR-19-31930; S2452231719300107; 100059; PII: S2452231719300107
Journal Information:
Human Microbiome Journal, Journal Name: Human Microbiome Journal Vol. 13 Journal Issue: C; ISSN 2452-2317
Publisher:
ElsevierCopyright Statement
Country of Publication:
Country unknown/Code not available
Language:
English

References (29)

The heart and the gut journal July 2013
Intestinal permeability parameters in obese patients are correlated with metabolic syndrome risk factors journal October 2012
Gut Microbiota in Human Adults with Type 2 Diabetes Differs from Non-Diabetic Adults journal February 2010
Lipopolysaccharide Causes an Increase in Intestinal Tight Junction Permeability in Vitro and in Vivo by Inducing Enterocyte Membrane Expression and Localization of TLR-4 and CD14 journal February 2013
The Human Intestinal Microbiome in Health and Disease journal December 2016
Increased Intestinal Permeability in Patients with Crohn's Disease and Their Relatives: A Possible Etiologic Factor journal December 1986
Modulating the innate immune response by combinatorial engineering of endotoxin journal January 2013
Risk of Cerebrovascular Accidents and Ischemic Heart Disease in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-analysis journal March 2014
Association of endotoxemia with carotid atherosclerosis and cardiovascular disease journal December 1999
Expression of the Lipopolysaccharide-Modifying Enzymes PagP and PagL Modulates the Endotoxic Activity of Bordetella pertussis journal October 2006
Dysbiosis of Gut Microbiota With Reduced Trimethylamine‐N‐Oxide Level in Patients With Large‐Artery Atherosclerotic Stroke or Transient Ischemic Attack journal October 2015
CD14 C(-260)T promoter polymorphism and prevalence of acute coronary syndromes journal February 2005
Intestinal Microbial Metabolism of Phosphatidylcholine and Cardiovascular Risk journal April 2013
Human oral, gut, and plaque microbiota in patients with atherosclerosis journal October 2010
Intra-individual variation of plasma trimethylamine-N-oxide (TMAO), betaine and choline over 1 year journal January 2017
The Human Microbiome Project journal October 2007
Automated enzymatic assays for the determination of intestinal permeability probes in urine. 1. Lactulose and lactose journal February 1990
Variation in Microbiome LPS Immunogenicity Contributes to Autoimmunity in Humans journal May 2016
Blood Microbiota Dysbiosis Is Associated with the Onset of Cardiovascular Events in a Large General Population: The D.E.S.I.R. Study journal January 2013
Toll-like Receptor 4 Polymorphisms and Atherogenesis journal July 2002
Leaky gut and diabetes mellitus: what is the link?: Leaky gut in diabetes journal March 2011
The Long-Term Stability of the Human Gut Microbiota journal July 2013
The Treatment-Naive Microbiome in New-Onset Crohn’s Disease journal March 2014
Proteobacteria: microbial signature of dysbiosis in gut microbiota journal September 2015
The gut microbiome in atherosclerotic cardiovascular disease journal October 2017
Microbial Enterotypes, Inferred by the Prevotella-to-Bacteroides Ratio, Remained Stable during a 6-Month Randomized Controlled Diet Intervention with the New Nordic Diet journal December 2013
Dysbiosis gut microbiota associated with inflammation and impaired mucosal immune function in intestine of humans with non-alcoholic fatty liver disease journal February 2015
Intestinal microbiota metabolism of l-carnitine, a nutrient in red meat, promotes atherosclerosis journal April 2013
Microbial conversion of choline to trimethylamine requires a glycyl radical enzyme journal November 2012

Figures / Tables (5)