What Bugs Your Heart?
The Role of Microorganisms in Cardiovascular Health and the Application of Botanicals By: Jocelyn Strand, ND The following article is not endorsed and/or supported by The American Academy of Anti-Aging Medicine. The purposes of this publication do not imply endorsement and/or support of any author, company or theme related to this article.
Cardiovascular disease (CVD) now affects 48% of adults in the US and is the leading cause of death. Within that category, coronary artery disease resulting in myocardial infarction is most prevalent, while stroke comes in second, and is the 5th leading cause of death overall. The good news is that 90% of stroke risk is due to modifiable risk factors. As providers, we can work alongside our patients to alter factors that increase risk of CVD. Hypertension (HTN), the most common form of CVD, is a major modifiable risk factor for many other CVDs, including acute coronary syndrome, cardiomyopathy, congestive heart failure, pulmonary hypertension, and stroke.1,2 Considering the prevalence of CVD and our ability to manage its risk, it is vital that we identify root causes and direct therapeutics accordingly. One potential target lies in the microbiome. The term microbiome describes the microbial composition of a given area on the body and varies depending on habitat. It is diverse, consisting of bacteria, archaea, fungi, protozoa, viruses and their trillions of genomes collectively.3 The oral and the gastrointestinal microbial communities exhibit the greatest diversity and are innately linked to one another. A flourishing, heterogeneous microbial community is essential both for oral and systemic health. 8 These communities are important for human physiology,immune system development, digestion, detoxification reactions and synthesis of micronutrients. In short, they assist us in maintaining health. Alterations in the balance (increased pathogen load, reduced
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commensals, or reduced diversity) of these microorganisms and their functions can result in microbial dysbiosis and has been linked to a host of local and systemic conditions, including cardiovascular disease.3,4,7
DYSBIOSIS CREATES INFLAMMATION A healthy gut epithelium provides a barrier for microorganisms and metabolites. When dysbiosis occurs, pathogens release mediators that disrupt the GI mucosa and its ability to function as a barrier to systemic circulation. One of these metabolites is lipopolysaccharide (LPS). LPS is generated in the cell wall of both commensal and pathological gram-negative bacteria. It binds to LPS binding protein, which is then recognized by innate immune cells (macrophages, neutrophils, and dendritic cells). This initiates activation of toll-like receptor 4 (TLR4) and consequently nuclear factor kappa B (NF-kB). NF-kB is a transcription factor that activates a cascade of events including the release of pro-inflammatory cytokines, chemokines, and adhesion molecules. These chemical messengers result in a chronic inflammatory response mediated by both the innate (macrophage activation) and adaptive (T cell activation) immune systems. The downstream effect is chronic inflammation, platelet aggregation, foam cell formation, and ultimately the production of atherosclerotic plaque.3,4
ANTI-AGING MEDICAL NEWS
• SUMMER 2020
