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The Role of Endothelial Dysfunction in the Connection Between Gut Microbiota, Vascular Injury, and Arterial Hypertension

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Gut Microbiome, Microbial Metabolites and Cardiometabolic Risk

Part of the book series: Endocrinology ((ENDOCR))

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Abstract

The management of arterial hypertension, as recently defined by the European Society of Hypertension, is far from being completely achieved, and further studies are required both in the area of pathophysiology of elevated blood pressure and in developing novel and more effective therapeutic strategies. Recent studies highlighted the primary role of vascular endothelial cells (ECs) played in regulating vascular tone (mostly via nitric oxide release) and counteracting atherothrombosis. On the other hand, endothelial dysfunction, which occurs early in disease states characterized by metabolic disorders (diabetes mellitus, Metabolic Syndrome, dyslipidemias, etc.), represents the key mechanism underlying the loss of the capacity to modulate blood pressure and inhibit smooth cell proliferation as a consequence of a chronic inflammatory condition and oxidative stress. Mounting evidence suggests that there is a substantial contribution to this process accompanying altered microbiota. This occurs via an enhanced endotoxin migration from the epithelial intestinal barrier (LPS in particular), which leads to low-grade endotoxemia. This, in turn, is associated with increased cytokine release, dysregulation of NO synthases, and COX-2 activation, leading to impaired vascular control and elevation of blood pressure. Moreover, the reduced production of antihypertensive metabolites (Short Chain Fatty Acids; SCFA) and the increased production of toxic substances (TMAO), as a consequence of dysbiosis, further potentiate the role of altered microbiota in the development of cardiovascular impairment and arterial hypertension. This chapter aims to assess the pathophysiological mechanisms underlying dysbiosis as a central mechanism associated with vascular impairment and high blood pressure.

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Acknowledgments

The authors declare that no conflict of interest exists in the data included in the manuscript. All authors have read and agreed to the published version of the manuscript.

The work was supported by public resources from the Italian Ministry of Research: PON-MIUR 03PE000_78_1 and PONMIUR 03PE000_78_2. POR Calabria FESR FSE 2014–2020 Asse 12-Azioni 10.5.6 e 10.5.12. and Agrinfra Project granted by Regione Calabria (Italy).

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  1. Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy

    Rocco Mollace

  2. Department of Health Sciences, University “Magna Graecia” of Catanzaro, Catanzaro, Italy

    Jessica Maiuolo & Vincenzo Mollace

  3. Fondazione Dulbecco, Lamezia Terme, Italy

    Vincenzo Mollace

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  1. Rocco Mollace
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  2. Jessica Maiuolo
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Correspondence to Rocco Mollace .

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  1. Department of Systems Medicine, University of Tor Vergata, Rome, Italy

    Massimo Federici

  2. Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy

    Rossella Menghini

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Mollace, R., Maiuolo, J., Mollace, V. (2024). The Role of Endothelial Dysfunction in the Connection Between Gut Microbiota, Vascular Injury, and Arterial Hypertension. In: Federici, M., Menghini, R. (eds) Gut Microbiome, Microbial Metabolites and Cardiometabolic Risk. Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-031-35064-1_21

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