Bile acid coordinates microbiota homeostasis and systemic immunometabolism in cardiometabolic diseases

Cardiometabolic disease (CMD), characterized with metabolic disorder triggered cardiovascular events, is a leading cause of death and disability. Metabolic disorders trigger chronic low-grade inflammation, and actually, a new concept of metaflammation has been proposed to define the state of metabolism connected with immunological adaptations. Amongst the continuously increased list of systemic metabolites in regulation of immune system, bile acids (BAs) represent a distinct class of metabolites implicated in the whole process of CMD development because of its multifaceted roles in shaping systemic immunometabolism. BAs can directly modulate the immune system by either boosting or inhibiting inflammatory responses via diverse mechanisms. Moreover, BAs are key determinants in maintaining the dynamic communication between the host and microbiota. Importantly, BAs via targeting Farnesoid X receptor (FXR) and diverse other nuclear receptors play key roles in regulating metabolic homeostasis of lipids, glucose, and amino acids. Moreover, BAs axis per se is susceptible to inflammatory and metabolic intervention, and thereby BAs axis may constitute a reciprocal regulatory loop in metaflammation. We thus propose that BAs axis represents a core coordinator in integrating systemic immunometabolism implicated in the process of CMD. We provide an updated summary and an intensive discussion about how BAs shape both the innate and adaptive immune system, and how BAs axis function as a core coordinator in integrating metabolic disorder to chronic inflammation in conditions of CMD.

Using herbal medicine to target the "microbiota-metabolism-immunity" axis as possible therapy for cardiovascular disease.

The gut microbiota harvests nutrients from the host while making possible the digestion of complex nutrients and regulating and balancing the immune and metabolic functions. The microbiota itself, and the dysbiosis of the gut flora, are correlated to the onset and progress of diabetes, obesity, and atherosclerosis. Herbal medicine (HM) plays a role in modulating gut microbiota and is widely used in the prevention and treatment of cardiovascular disease (CVD) and its associated conditions, such as diabetes, obesity, and hyperlipidemia. In this review, we focus on the relationship between the microbiota-metabolism-immunity (MMI) axis and CVD (including its risk factors) and the beneficial effects of HM to regulate this crosstalk. The insights may redefine our understanding of how HM works and spark a revolution in HM-based drug discovery.