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26.08.2023 | Secondary Hypertension: Nervous System Mechanisms (M Wyss, Section Editor)

Gut Microbiota and Its Role in the Brain-Gut-Kidney Axis in Hypertension

verfasst von: Natalia G. Vallianou, Dimitris Kounatidis, Fotis Panagopoulos, Angelos Evangelopoulos, Vassilios Stamatopoulos, Anastasios Papagiorgos, Eleni Geladari, Maria Dalamaga

Erschienen in: Current Hypertension Reports | Ausgabe 11/2023

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Abstract

Purpose of Review

The role of the gut microbiota in modulating blood pressure is increasingly being recognized, currently. The purpose of this review is to summarize recent findings about the mechanisms involved in hypertension with regard to the phenomenon of “gut dysbiosis.”

Recent Findings

Gut dysbiosis, i.e., the imbalance between the gut microbiota and the host, is characterized by a disruption of the tight junction proteins, such as occludins, claudins, and JAMs (junctional adhesion molecules), resulting in increased gut permeability or the so called “leaky gut.” Due to the influence of genetic as well as environmental factors, various metabolites produced by the gut microbiota, such as indole and p-cresol, are increased. Thereby, uremic toxins, such as indoxyl sulfates and p-cresol sulfates, accumulate in the blood and the urine, causing damage in the podocytes and the tubular cells. In addition, immunological mechanisms are implicated as well. In particular, a switch from M2 macrophages to M1 macrophages, which produce pro-inflammatory cytokines, occurs. Moreover, a higher level of Th17 cells, releasing large amounts of interleukin-17 (IL-17), has been reported, when a diet rich in salt is consumed. Therefore, apart from the aggravation of uremic toxins, which may account for direct harmful effects on the kidney, there is inflammation not only in the gut, but in the kidneys as well. This crosstalk between the gut and the kidney is suggested to play a crucial role in hypertension. Notably, the brain is also implicated, with an increasing sympathetic output. The brain-gut-kidney axis seems to be deeply involved in the development of hypertension and chronic kidney disease (CKD).

Summary

The notion that, by modulating the gut microbiota, we could regulate blood pressure is strongly supported by the current evidence. A healthy diet, low in animal protein and fat, and low in salt, together with the utilization of probiotics, prebiotics, synbiotics, or postbiotics, may contribute to our fight against hypertension.

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Titel: Gut Microbiota and Its Role in the Brain-Gut-Kidney Axis in Hypertension
verfasst von: Natalia G. Vallianou
Dimitris Kounatidis
Fotis Panagopoulos
Angelos Evangelopoulos
Vassilios Stamatopoulos
Anastasios Papagiorgos
Eleni Geladari
Maria Dalamaga
Publikationsdatum: 26.08.2023
Verlag: Springer US
Erschienen in: Current Hypertension Reports / Ausgabe 11/2023
Print ISSN: 1522-6417
Elektronische ISSN: 1534-3111
DOI: https://doi.org/10.1007/s11906-023-01263-3

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