arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2024-2359DXUNEAarthyper-2359Research ArticleСтатьиArticlesРоль кишечной микробиоты в развитии артериальной гипертензии: механизмы и терапевтические мишениThe role of intestinal microbiota in the development of arterial hypertension: mechanisms and therapeutic targetshttps://orcid.org/0000-0003-3096-9747БорщевЮ. Ю.BorshchevYu. Yu.

Борщев Юрий Юрьевич — кандидат биологических наук, ведущий научный сотрудник, заведующий научно-исследовательским отделом токсикологии 

Санкт-Петербург

Yury Yu. Borshchev, PhD in Biological Sciences, Leading Researcher, Department of Toxicology

St Petersburg

borshchev_yuyu@almazovcentre.ruhttps://orcid.org/0000-0003-1705-7217СонинД. Л.SoninD. L.

Сонин Дмитрий Леонидович — кандидат медицинских наук, ведущий научный сотрудник, руководитель научно-исследовательского отдела микроциркуляции и метаболизма миокарда 

Санкт-Петербург

Dmitry L. Sonin, MD, PhD, Leading Researcher, Research Department of Microcirculation and Myocardial Metabolism

St Petersburg

sonin_dl@almazovcentre.ruhttps://orcid.org/0000-0001-6382-5286МинасянС. М.MinasianS. M.

Минасян Саркис Минасович — кандидат медицинских наук, ведущий научный сотрудник

Санкт-Петербург

Sarkis M. Minasian, MD, PhD, Senior Researcher, Research Department of Microcirculation and Myocardial Metabolism

St Petersburg

carkis@yandex.ruhttps://orcid.org/0000-0002-9217-9890ПроцакЕ. С.ProtsakE. S.

Процак Егор Сергеевич — младший научный сотрудник научно-исследовательского отдела токсикологии

Санкт-Петербург

Egor S. Protsak,   MD,   Junior   Researcher,   Department of Toxicology

St Petersburg

egor-protsak@yandex.ruhttps://orcid.org/0000-0003-4069-0678СеменоваН. Ю.SemenovaN. Yu.

Семенова Наталья Юрьевна — кандидат биологических наук, старший научный сотрудник научно-исследовательского отдела патоморфологии 

Санкт-Петербург

Natalia Yu. Semenova, PhD in Biological Sciences, Senior Researcher, Department of Patomorphology

St Petersburg

semenova_nyu@almazovcentre.ruhttps://orcid.org/0000-0001-5129-9944ГалагудзаМ. М.GalagudzaM. M.

Галагудза Михаил Михайлович — доктор медицинских наук, профессор, член-корреспондент РАН, главный научный сотрудник научно-исследовательского отдела микроциркуляции и метаболизма миокарда, директор Института экспериментальной медицины 

ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Mikhail M. Galagudza, MD, DSc, Professor, Corresponding Member of the Russian Academy of Sciences, Chief Researcher, Research Department of Microcirculation and Myocardial Metabolism, Director of the Institute of Experimental Medicine

2 Akkuratov str., St Petersburg, 197341

galagudza_mm@almazovcentre.ruФедеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской ФедерацииРоссияAlmazov National Medical Research CentreRussian Federation202407112023302159173Copyright © Борщев Ю.Ю., Сонин Д.Л., Минасян С.М., Процак Е.С., Семенова Н.Ю., Галагудза М.М., 20242024Борщев Ю.Ю., Сонин Д.Л., Минасян С.М., Процак Е.С., Семенова Н.Ю., Галагудза М.М.Borshchev Y.Y., Sonin D.L., Minasian S.M., Protsak E.S., Semenova N.Y., Galagudza M.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/2359

Кишечная микробиота не только опосредует влияние на организм ряда факторов риска сердечно-сосудистых заболеваний, но и может играть активную роль в регуляции артериального давления (АД) за счет изменения проницаемости кишечного эпителиального барьера и продукции вазоактивных метаболитов. При этом изучение молекулярных механизмов, лежащих в основе влияния кишечной микробиоты на уровень АД, находится на начальном этапе. В обзоре проведен анализ научной литературы, посвященной роли кишечной микробиоты в развитии артериальной гипертензии (АГ), описаны ключевые механизмы прогипертензивного действия метаболитов кишечной микробиоты и представлены данные о новых подходах к лечению АГ, основанных на воздействии на состав и функцию кишечной микрофлоры. На уровень АД влияют молекулы, концентрация которых в крови прямо или опосредованно связана с активностью кишечной микрофлоры. Эти биоактивные молекулы могут быть разделены на две группы — образующиеся клетками иммунной системы человека в результате стимуляции со стороны микробиоты и образующиеся ферментативным путем в результате метаболической активности самой микробиоты. К первой группе относятся молекулярные механизмы, связанные с активацией иммунитета и системной воспалительной реакцией, а ко второй — короткоцепочечные жирные кислоты, триметиламин-N-оксид, желчные кислоты, уремические токсины и биогенные амины. АГ сопровождается специфическими изменениями состава кишечной микробиоты, причем в последние годы исследователями установлены причинно-следственные отношения между определенными энтеротипами и развитием АГ. Более того, сформировавшаяся АГ сама по себе является причиной изменений профиля кишечного микробиома. Более глубокое понимание молекулярных механизмов, опосредующих влияние микробиоты на АД, может послужить основой для разработки новых подходов к лечению АГ.

The intestinal microbiota not only mediates the influence of a number of risk factors for cardiovascular diseases on the body, but can also play an active role in the regulation of blood pressure (BP) by changing the permeability of the intestinal epithelial barrier and the production of vasoactive metabolites. At the same time, the study of the molecular mechanisms underlying the influence of intestinal microbiota on BP levels is at an early stage. The review analyzes the scientific literature on the role of intestinal microbiota in the development of arterial hypertension (HTN), describes the key mechanisms of the prohypertensive action of intestinal microbiota metabolites, and presents data on new approaches to the treatment of HTN based on effects on the composition and function of intestinal microflora. BP levels are affected by molecules whose concentration in the blood is directly or indirectly related to the activity of intestinal microflora. These bioactive molecules can be divided into two groups — those formed by cells of the human immune system as a result of stimulation by the microbiota and those formed enzymatically as a result of the metabolic activity of the microbiota itself. The first group includes molecular mechanisms associated with immune activation and systemic inflammatory response, and the second group includes short-chain fatty acids, trimethylamine-N-oxide, bile acids, uremic toxins and biogenic amines. HTN is accompanied by specific changes in the composition of the intestinal microbiota, and in recent years, researchers have established cause-and-effect relationships between certain enterotypes and the development of HTN. Moreover, established HTN itself causes changes in the intestinal microbiome profile. A deeper understanding of the molecular mechanisms mediating the influence of microbiota on BP may serve as the basis for the development of new approaches to the treatment of HTN.

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The authors declare that there are no conflicts of interest present.