Effects of Buyang Huanwu Decoction on Intestinal Barrier, Intestinal Flora, and Trimethylamine Oxide in Rats with Heart Failure

Objective: To explore the mechanisms of Buyang Huanwu Decoction(BYHWD) modulating the gut microbiome and trimethylamine oxide(TAMO) to exert cardioprotective effects. Methods: Ligation of the left anterior descending coronary artery was performed in rats to induce heart failure(HF). Except for the shamoperation group(n=10), 36 operation-induced models were randomized into 3 groups using a random number table(n=12 in each group): the model group, the BYHWD group(15.02 g/kg BYHWD), and the positive group(4.99 g/kg metoprolol succinate). After 4-week treatment(once daily by gavage), echocardiography was applied to evaluate the cardiac function and the Tei index(the ratio of ventricular isovolumic contraction time(IVCT)and isovolumic diastolic time(IVRT) to ejection time(ET)) was calculated;hematoxylin-eosin(HE) staining was observed to characterize the pathology of the myocardium and small intestinal villi. D-lactic acid was detected by an enzyme-linked immunosorbent assay(ELISA). Expressions of occludin, claudin-1, and zonula occludens(ZO-1) were detected by Western blot. 16S ribosomal ribonucleic acid(16S rRNA) sequencing was used to explore the changes in the intestinal flora. TMAO was detected via liquid chromatography-tandem mass spectrometry(LC-MS/MS). Results: In the echocardiography, the Tei index was considerably lower in the positive and BYHWD groups compared with the model group(P<0.05). Besides, BYHWD improved the pathology of myocardium and small intestine of HF rats and lowered the D-lactic acid content in the serum, when compared with the model group(P<0.05). BYHWD also improved the expression of occludin and claudin-1(P<0.05);in the gut microbiota analysis, BYHWD slowed down modifications in the structure distribution of gut microbiota and regulated the diversity of intestinal flora in HF rats. The content of TMAO in the serum was significantly lowered by BYWHT compared with the model group(P<0.05). Conclusion: BYHWD may delay progression of HF by enhancing the intestinal barrier structure, and regulating intestinal flora and TAMO.

Heart failure symptom burden,dietary intake,and inflammation:An integrative review of the literature

Heart failure(HF)is characterized by high symptom burden including,but not limited to fatigue,dyspnea,and edema.Up to 21.5%of HF patients experience significant depressive symptoms,much higher than 7.1%in adults without HF.Diet,metabolites,and other inflammatory mechanisms have gained notable attention in recent studies for contributions to symptoms in HF.Symptoms for black adults(B/As)with HF are often influenced by lifestyle factors,which may influence their higher mortality rates;few studies address these factors.Distinguishing the links between key elements with diet,inflammation,and symptoms may bring clarity for new dietary strategies in HF clinical care.The purpose of this integrative review is to examine the existing literature regarding relationships among physiologic pathways in HF along with physical and emotional symptoms in the context of inflammation,dietary intake,tumor necrosis factor‑alpha(TNF‑a),a biomarker of inflammation,and trimethylamine‑N‑Oxide(TMAO).Based on available evidence,inflammation may be a key link between physical symptoms,diet,depression,TMAO,and TNF‑a in persons with HF and warrants further examination to clarify pathological links to solidify evidence for better guidance with dietary modifications.The literature reviewed in this study demonstrates that more work is needed to examine dietary planning,social support,and differences between men and women in the B/A community.Results of this literature review call attention to the essential,personalized care needs related to symptom monitoring and dietary planning which is expected to decrease symptom burden in the HF population.

Potential efficacy and mechanism of eight mild-natured and bitterflavored TCMs based on gut microbiota:A review

The mild-natured and bitter-flavored traditional Chinese medicines(MB-TCMs)are an important class of TCMs that have been widely used in clinical practice and recognized as safe long-term treatments for chronic diseases.However,as an important class of TCMs,the panorama of pharmacological effects and the mechanisms of MB-TCMs have not been systemically reviewed.Compelling studies have shown that gut microbiota can mediate the therapeutic activity of TCMs and help to elucidate the core principles of TCM medicinal theory.In this systematic review,we found that MB-TCMs commonly participated in the modulation of metabolic syndrome,intestinal inflammation,nervous system disease and cardiovascular system disease in association with promoting the growth of beneficial bacteria Bacteroides,Akkermansia,Lactobacillus,Bifidobacterium,Roseburia as well as inhibiting the proliferation of harmful bacteria Helicobacter,Enterococcus,Desulfovibrio and Escherichia-Shigella.These alterations,correspondingly,enhance the generation of protective metabolites,mainly including short-chain fatty acids(SCFAs),bile acid(BAs),5-hydroxytryptamine(5-HT),indole and gamma-aminobutyric acid(GABA),and inhibit the generation of harmful metabolites,such as proinflammatory factors trimethylamine oxide(TAMO)and lipopolysaccharide(LPS),to further exert multiplicative effects for the maintenance of human health through several different signaling pathways.Altogether,this present review has attempted to comprehensively summarize the relationship between MB-TCMs and gut microbiota by establishing the TCMs-gut microbiota-metabolite-signaling pathway-diseases axis,which may provide new insight into the study of TCM medicinal theories and their clinical applications.

Role of gut microbiota in ischemic stroke:A narrative review of human and animal studies

The high incidence,mortality,and disability associated with ischemic stroke pose a significant threat to human health.The intestinal microbiota significantly influences the onset,progression,and prognosis of ischemic stroke.Gut flora plays a pivotal role in brain-gut interactions.The reflection of changes in the gut and brain caused by gut microbes faciltates the investigation of early warning biomarkers and potential therapeutic targets for ischemic stroke.In this narrative review of the relationship between gut microbiota and ischemic stroke,we primarily discuss three topics,grounded in real-world human and animal studies.First,we examined the relationship between ischemic stroke and intestinal microbiota and its metabolites,delineate the overall characteristics of intestinal microbiota dysregulation in ischemic stroke,and assess the potential clinical value,prevailing research controversies,and unique phenomena of intestinal microbiota metabolites such as trimethylamine N-oxide and short-chain fatty acids in ischemic stroke.Second,we explored the potential communication pathways between intestinal flora and ischemic stroke based on the brain-gut axis,encompassing metabolic pathways,immune pathways,and neural pathways.Finally,we encapsulated the factors influencing the severity of ischemic stroke via intestinal flora,the pharmacological and nonpharmacological interventions that modulate intestinal flora in treating ischemic stroke,and the current research landscape of intestinal flora in the context of ischemic stroke sequelae.