Can Intestinal Microbiota and Circulating Microbial Products Contribute to Pulmonary Arterial Hypertension?

Can Intestinal Microbiota and Circulating Microbial Products Contribute to Pulmonary Arterial Hypertension? Am J Physiol Heart Circ Physiol. 2019 Sep 06;: Authors: Thenappan T, Khoruts A, Chen Y, Weir EK Abstract Pulmonary arterial hypertension (PAH) is a fatal disease with a median survival of only 5-7 years. PAH is characterized by remodeling of the pulmonary vasculature causing reduced pulmonary arterial compliance (PAC) and increased pulmonary vascular resistance (PVR), ultimately resulting in right ventricular failure and death. Better therapies for PAH will require a paradigm shift in our understanding of the early pathophysiology. PAC decreases before there is an increase in the PVR. Unfortunately, current treatment has little effect on PAC. The loss of compliance correlates with extracellular matrix remodeling and fibrosis in the pulmonary vessels, which has been linked to chronic perivascular inflammation and immune dysregulation. However, what initiates the perivascular inflammation and immune dysregulation in PAH is unclear. Alteration of the gut microbiota composition and function underlies the level of immunopathogenic involvement in several diseases, including atherosclerosis, obesity, diabetes mellitus and depression, among others. In this review, we discuss evidence that raises the possibility of an etiologic role for changes in the gut and circulating microbiome in the initiation of perivascular inflammation in the e...
Source: American Journal of Physiology. Heart and Circulatory Physiology - Category: Physiology Authors: Tags: Am J Physiol Heart Circ Physiol Source Type: research