OBJECTIVEThis review aimed to summarize the relationship between intestinal microbiota metabolism and cardiovascular disease (CVD) and to propose a novel CVD therapeutic target.

DATA SOURCESThis study was based on data obtained from PubMed and EMBASE up to June 30, 2015. Articles were selected using the following search terms: "Intestinal microbiota", "trimethylamine N-oxide (TMAO)", "trimethylamine (TMA)", "cardiovascular", and "atherosclerosis".

STUDY SELECTIONStudies were eligible if they present information on intestinal microbiota metabolism and atherosclerosis. Studies on TMA-containing nutrients were also included.

RESULTSA new CVD risk factor, TMAO, was recently identified. It has been observed that several TMA-containing compounds may be catabolized by specific intestinal microbiota, resulting in TMA release. TMA is subsequently converted to TMAO in the liver. Several preliminary studies have linked TMAO to CVD, particularly atherosclerosis; however, the details of this relationship remain unclear.

CONCLUSIONSIntestinal microbiota metabolism is associated with atherosclerosis and may represent a promising therapeutic target with respect to CVD management.

Atherosclerosis ; metabolism ; microbiology ; Gastrointestinal Microbiome ; physiology ; Humans ; Methylamines ; metabolism

This study was conducted to investigate the association between Helicobacter pylori (H. pylori) infection and the lipid profile among elderly Koreans. A total of 462 subjects (mean age 66.2 +/- 7.6 yr, 84% males) who underwent health check-up were investigated. Each subject underwent gastroduodenoscopy with gastric mucosal biopsy, and H. pylori infection was determined by histopathological examination using the updated Sydney System score. The presence of H. pylori infection was significantly associated with the elevated serum levels of total cholesterol and low density lipoprotein (LDL) cholesterol (P < 0.05 for each) in univariate analysis. H. pylori infection was not associated with triglyceride and high density lipoprotein (HDL) cholesterol levels (P > 0.05 for each). After controlling confounders, multiple logistic regression analysis showed that the odds ratio of H. pylori infection for high LDL cholesterol level (> 140 mg/dL) was 3.113 (95% confidence interval, 1.364-7.018; P = 0.007). There were no significant associations between the presence of H. pylori infection and elevated total cholesterol levels (> 200 mg/dL) in this model (P = 0.586). The results of this study demonstrate that H. pylori infection is associated with the elevated serum LDL cholesterol levels in elderly Koreans, supporting the hypothesis that H. pylori plays a role in promoting atherosclerosis by modifying lipid metabolism.
Aged ; Aged, 80 and over ; Atherosclerosis/microbiology ; Cholesterol, LDL/*blood ; Endoscopy ; Female ; Gastric Mucosa/anatomy & histology/microbiology ; Gastritis ; Helicobacter Infections/*blood/*epidemiology ; *Helicobacter pylori ; Humans ; Inflammation/microbiology ; Male ; Middle Aged ; Peptic Ulcer ; Republic of Korea/epidemiology

OBJECTIVETo evaluate the relationship between infection burden and coronary atherosclerosis and the plaque feature.

METHODSOne hundred and eighty two patients underwent coronary angiography in Zhongshan Hospital from 2002 - 2003. Atherosclerosis and vulnerable plaque were determined by intravascular ultrasound (IVUS). Seropositivity of cytomegalovirus, helicobacter pylori, chlamydia pneumonia, hepatitis B virus, EB virus, CoxB virus, influenza A virus, influenza B virus and mycobacterium tuberculosis were determined by ELISA. The serum hs-CRP was detected by Dade Behring prospect (Immuno-nehelomitery). Patients were divided into three groups according to the pathogen burden: group A, n or= 6.

RESULTSThe pathogen burden was independent of the C-reactive protein level. Increasing pathogen burden was significantly associated with increasing atherosclerosis risk, the prevalence of atherosclerosis was 44.4%, 70.6% and 76.7% in group A, B and C. The risk associated with elevated pathogen burden was much higher when CRP was also elevated (> 5.0 mg/L) (43.8%, 70.0%, 70.8%) vs (45.5%, 63.7%, 96.8%). The positively of vulnerable plaque increased significantly when the pathogen burden was high (n > 5) (33.3%, 32.4% and 51.7% P < 0.05).

CONCLUSIONOur data suggested that infection burden was associated with prevalence of coronary atherosclerosis, and it was particularly important when C-reactive protein was elevated. The high level infection burden could predict vulnerable plaque.

Aged ; Atherosclerosis ; microbiology ; pathology ; C-Reactive Protein ; analysis ; Chlamydophila pneumoniae ; Cytomegalovirus ; Female ; Helicobacter pylori ; Herpesvirus 4, Human ; Humans ; Influenza B virus ; Male ; Middle Aged ; Viral Load

OBJECTIVEA systematic meta-analysis was performed to explore the role of cytotoxin-associated gene-A (CagA) seropositive strains of Helicobacter pylori (H. pylori) in the pathogenesis of atherosclerotic diseases. Data sources Data from Medline, EMBASE, CBMdisc, CNKI and the Cochrane Collaboration database were searched. Similar search strategies were applied to each of these databases. Study selection The review was restricted to the case-control studies on infective, chronic virulent CagA strains of H. pylori, involving the risk of ischemic stroke and coronary heart disease, ineligible studies were excluded. Two reviewers independently extracted the data and assessed study quality.

RESULTSTotally 26 case-control studies (11 studies on ischemic stroke and 15 studies on coronary heart disease) were retrieved and considered. The combined data revealed that the chronic seropositive virulent strains of H. pylori infection had a trend of increasing the risk of ischemic strokes and coronary heart diseases, yielding pooled ORs of 2.68 (95% CI: 2.20, 3.27) and 2.11 (95% CI: 1.70, 2.62), respectively. We also performed subgroup analyses, dividing the total population into Caucasian and Chinese subgroups. Through the subgroup analysis, no significant difference was found between the subgroups.

CONCLUSIONSOur results support the hypothesis that CagA-seropositive strains infection is significantly associated with susceptibility to ischemic strokes and coronary heart diseases. The magnitude of the association with atherosclerotic diseases needs to be confirmed by prospective studies and the studies on CagA-seropositive strains eradication are more important.

Antibodies, Bacterial ; blood ; Antigens, Bacterial ; immunology ; Atherosclerosis ; etiology ; pathology ; Bacterial Proteins ; immunology ; Helicobacter Infections ; blood ; complications ; microbiology ; Helicobacter pylori ; immunology ; pathogenicity ; Virulence