Obstructive Sleep Apnea-induced Gut Dysbiosis and Ischaemic Stroke: Mechanism and Research Progress
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摘要: 缺血性脑卒中作为一种高发病率、高死亡率、高致残率、高复发率的脑血管疾病,是导致我国中老年人残疾和死亡的重要原因。因此,识别与缺血性脑卒中相关危险因素并进行有效预防至关重要。有研究表明,阻塞性睡眠呼吸暂停是缺血性脑卒中发生的独立危险因素,但具体机制尚未明确。随着新一代测序技术的发展,研究发现阻塞性睡眠呼吸暂停可引起肠道菌群改变,而肠道菌群可能与缺血性脑卒中密切相关。因此,本文就阻塞性睡眠呼吸暂停诱导肠道菌群失调与缺血性脑卒中的相关机制进行综述,以期为阐明阻塞性睡眠呼吸暂停引起缺血性脑卒中的潜在病理机制提供依据。Abstract: Ischemic stroke, a cerebrovascular disease with high incidence, high mortality, high disability rate and high recurrence rate, is an important cause of death and disability of middle-aged and elderly people in China, and imposes a huge burden to society and families. Therefore, it is essential to identify the risk factors associated with ischemic stroke and effectively prevent them. Studies have shown that obstructive sleep apnea is an independent risk factor for ischemic stroke. However, the exact pathological mechanism of their association has not been clarified. With the development of next-generation sequencing technology, more and more studies have focused on intestinal microbiota. They have found that obstructive sleep apnea can cause intestinal microbiota changes, and intestinal microbiota may be closely related to ischemic stroke. Therefore, this paper attempts to investigate the relationship between intestinal flora and ischemic stroke, so as to reveal the potential pathological mechanism of ischemic stroke caused by obstructive sleep apnea.
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作者贡献:刘苗苗负责论文撰写;岳红梅负责选题设计及论文修订;李雅亭、许金回负责文献收集;武兴东、朱浩斌负责论文修订。利益冲突:所有作者均声明不存在利益冲突
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[1] Pan Z J, Ma T P, Zeng Q H, et al. People's knowledge, attitudes, practice, and healthcare education demand regard-ing OSA: a cross-sectional study among Chinese general populations[J]. Front Public Health, 2023, 11: 1128334. DOI: 10.3389/fpubh.2023.1128334
[2] Javaheri S, Peker Y, Yaggi H K, et al. Obstructive sleep apnea and stroke: the mechanisms, the randomized trials, and the road ahead[J]. Sleep Med Rev, 2022, 61: 101568. DOI: 10.1016/j.smrv.2021.101568
[3] Sanchez O, Adra N, Chuprevich S, et al. Screening for OSA in stroke patients: the role of a sleep educator[J]. Sleep Med, 2022, 100: 196-197. DOI: 10.1016/j.sleep.2022.08.024
[4] Okubo H, Nakatsu Y, Kushiyama A, et al. Gut microbiota as a therapeutic target for metabolic disorders[J]. Curr Med Chem, 2018, 25(9): 984-1001. DOI: 10.2174/0929867324666171009121702
[5] Berding K, Vlckova K, Marx W, et al. Diet and the microbiota-gut-brain axis: sowing the seeds of good mental health[J]. Adv Nutr, 2021, 12(4): 1239-1285. DOI: 10.1093/advances/nmaa181
[6] Badran M, Mashaqi S, Gozal D. The gut microbiome as a target for adjuvant therapy in obstructive sleep apnea[J]. Expert Opin Ther Targets, 2020, 24(12): 1263-1282. DOI: 10.1080/14728222.2020.1841749
[7] Fava F, Rizzetto L, Tuohy K M. Gut microbiota and health: connecting actors across the metabolic system[J]. Proc Nutr Soc, 2019, 78(2): 177-188. DOI: 10.1017/S0029665118002719
[8] Cai Y, Juszczak H M, Cope E K, et al. The microbiome in obstructive sleep apnea[J]. Sleep, 2021, 44(8): zsab061. DOI: 10.1093/sleep/zsab061
[9] Poroyko V A, Carreras A, Khalyfa A, et al. Chronic sleep disruption alters gut microbiota, induces systemic and adipose tissue inflammation and insulin resistance in mice[J]. Sci Rep, 2016, 6: 35405. DOI: 10.1038/srep35405
[10] Xue J, Allaband C, Zhou D, et al. Influence of intermittent hypoxia/hypercapnia on atherosclerosis, gut microbiome, and metabolome[J]. Front Physiol, 2021, 12: 663950. DOI: 10.3389/fphys.2021.663950
[11] Zeng J S, Yang K L, Nie H F, et al. The mechanism of intestinal microbiota regulating immunity and inflammation in ischemic stroke and the role of natural botanical active ingredients in regulating intestinal microbiota: a review[J]. Biomed Pharmacother, 2023, 157: 114026. DOI: 10.1016/j.biopha.2022.114026
[12] Hu W J, Kong X Y, Wang H, et al. Ischemic stroke and intestinal flora: an insight into brain-gut axis[J]. Eur J Med Res, 2022, 27(1): 73. DOI: 10.1186/s40001-022-00691-2
[13] Sharma V, Sharma V, Shahjouei S, et al. At the intersection of gut microbiome and stroke: a systematic review of the literature[J]. Front Neurol, 2021, 12: 729399. DOI: 10.3389/fneur.2021.729399
[14] Nam H S. Gut microbiota and ischemic stroke: the role of trimethylamine N-oxide[J]. J Stroke, 2019, 21(2): 151-159. DOI: 10.5853/jos.2019.00472
[15] Zhu W F, Gregory J C, Org E, et al. Gut microbial metabolite TMAO enhances platelet hyperreactivity and thrombosis risk[J]. Cell, 2016, 165(1): 111-124. DOI: 10.1016/j.cell.2016.02.011
[16] El Hage R, Al-Arawe N, Hinterseher I. The role of the gut microbiome and trimethylamine oxide in atherosclerosis and age-related disease[J]. Int J Mol Sci, 2023, 24(3): 2399. DOI: 10.3390/ijms24032399
[17] Zhang J L, Wang L K, Cai J L, et al. Gut microbial metabolite TMAO portends prognosis in acute ischemic stroke[J]. J Neuroimmunol, 2021, 354: 577526. DOI: 10.1016/j.jneuroim.2021.577526
[18] Mirzaei R, Bouzari B, Hosseini-Fard S R, et al. Role of microbiota-derived short-chain fatty acids in nervous system disorders[J]. Biomed Pharmacother, 2021, 139: 111661. DOI: 10.1016/j.biopha.2021.111661
[19] Tan C H, Wu Q H, Wang H D, et al. Dysbiosis of gut microbiota and short-chain fatty acids in acute ischemic stroke and the subsequent risk for poor functional outcomes[J]. JPEN J Parenter Enteral Nutr, 2021, 45(3): 518-529. DOI: 10.1002/jpen.1861
[20] Lee J, D'Aigle J, Atadja L, et al. Gut microbiota-derived short-chain fatty acids promote poststroke recovery in aged mice[J]. Circ Res, 2020, 127(4): 453-465. DOI: 10.1161/CIRCRESAHA.119.316448
[21] Li P, Dong Z Y, Chen W H, et al. Causal relations between obstructive sleep apnea and stroke: a mendelian randomiza-tion study[J]. Nat Sci Sleep, 2023, 15: 257-266. DOI: 10.2147/NSS.S398544
[22] Zhao L N, Yang L J, Guo Y Y, et al. New insights into stroke prevention and treatment: gut microbiome[J]. Cell Mol Neurobiol, 2022, 42(2): 455-472. DOI: 10.1007/s10571-021-01047-w
[23] Xue J, Zhou D, Poulsen O, et al. Intermittent hypoxia and hypercapnia accelerate atherosclerosis, partially via trimethylamine-oxide[J]. Am J Respir Cell Mol Biol, 2017, 57(5): 581-588. DOI: 10.1165/rcmb.2017-0086OC
[24] Wang Z N, Klipfell E, Bennett B J, et al. Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease[J]. Nature, 2011, 472(7341): 57-63. DOI: 10.1038/nature09922
[25] Ding L, Chang M R, Guo Y, et al. Trimethylamine-N-oxide (TMAO)-induced atherosclerosis is associated with bile acid metabolism[J]. Lipids Health Dis, 2018, 17(1): 286. DOI: 10.1186/s12944-018-0939-6
[26] Xia W Y, Huang Y H, Peng B, et al. Relationship between obstructive sleep apnoea syndrome and essential hypertension: a dose-response meta-analysis[J]. Sleep Med, 2018, 47: 11-18. DOI: 10.1016/j.sleep.2018.03.016
[27] Munir S S, Sert Kuniyoshi F H, Singh P, et al. Is the gut microbiome implicated in the excess risk of hypertension associated with obstructive sleep apnea? A contemporary review[J]. Antioxidants (Basel), 2023, 12(4): 866. DOI: 10.3390/antiox12040866
[28] Durgan D J. Obstructive sleep apnea-induced hypertension: role of the gut microbiota[J]. Curr Hypertens Rep, 2017, 19(4): 35.
[29] Jiao Y, Li W X, Zhang Q Y, et al. Gut microbiota and hypertension: a bibliometric analysis of recent research (2014—2023)[J]. Front Nutr, 2023, 10: 1253803. DOI: 10.3389/fnut.2023.1253803
[30] Liu J, Li T X, Wu H, et al. Lactobacillus rhamnosus GG strain mitigated the development of obstructive sleep apnea-induced hypertension in a high salt diet via regulating TMAO level and CD4+ T cell induced-type Ⅰ inflammation[J]. Biomed Pharmacother, 2019, 112: 108580.
[31] 伍娟, 杨眉峰, 楼莹, 等. 肠道微生物与阻塞性睡眠呼吸暂停低通气综合征及其并发症的相关性研究进展[J]. 江西中医药大学学报, 2019, 31(6): 117-121. https://www.cnki.com.cn/Article/CJFDTOTAL-XYXB201906036.htm Wu J, Yang M F, Lou Y, et al. Research progress of correlation between intestinal microorganism and OSAHS and its complications[J]. J Jiangxi Univ Tradit Chin Med, 2019, 31(6): 117-121. https://www.cnki.com.cn/Article/CJFDTOTAL-XYXB201906036.htm
[32] Khalyfa A, Ericsson A, Qiao Z H, et al. Circulating exosomes and gut microbiome induced insulin resistance in mice exposed to intermittent hypoxia: effects of physical activity[J]. EBioMedicine, 2021, 64: 103208.
[33] Pack A I. Gut microbiome: role in insulin resistance in obstructive sleep apnea[J]. EBioMedicine, 2021, 65: 103278.
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