Vascular Cognitive Impairment and the Gut Microbiota

Article type: Review Article

Authors: Li, Sinian^{a; 1} | Shao, Yiming^{b; 1} | Li, Kanglan^{a; 1} | HuangFu, Changmei^c | Wang, Wenjie^d | Liu, Zhou^{a; *} | Cai, Zhiyou^{e; *} | Zhao, Bin^{a; *}

Affiliations: [a] Department of Neurology, Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Institute of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China | [b] The Intensive Care Unit, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China | [c] Department of Gerontology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China | [d] Department of Neurosurgery, The Central Hospital of Longhua District, Shenzhen, China | [e] Department of Neurology, Chongqing General Hospital, Chongqing, China

Correspondence: [*] Correspondence to: Zhou Liu, Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Institute of Neurology, Department of Neurology, Affiliated Hospital of Guangdong Medical University, South 57, Renming Ave, Xiashan District, Zhanjiang, Guangdong, P.R. China. Tel.: +86 7592386949; E-mail: liuzhou@gdmu.edu.cn. Zhiyou Cai, czy000806@163.com; Bin Zhao, WEML binzhaoe@163.com.

Note: [1] These authors contributed equally to this work.

Abstract: Vascular cognitive impairment (VCI), the second most common cause of dementia in elderly people, is a term that refers to all forms of cognitive disorders that can be attributed to cerebrovascular disease such as manifestations of discrete infarctions, brain hemorrhages, and white matter lesions. The gut microbiota (GM) has emerged recently as an essential player in the development of VCI. The GM may affect the brain’s physiological, behavioral, and cognitive functions through the brain-gut axis via neural, immune, endocrine, and metabolic pathways. Therefore, microbiota dysbiosis may mediate or affect atherosclerosis, cerebrovascular disease, and endothelial dysfunction, which are the predominant risk factors for VCI. Moreover, the composition of the GM includes the bacterial component lipopolysaccharides and their metabolic products including trimethylamine-N-oxide and short-chain fatty acids. These products may increase the permeability of the intestinal epithelium, leading to systemic immune responses, low-grade inflammation, and altered signaling pathways that are associated with the pathogenesis of VCI. In this review, we discuss the proposed mechanisms of the GM in the maintenance of VCI and how it is implicated in acquired metabolic diseases, particularly in VCI regulation.

Keywords: Atherosclerosis, cerebrovascular disease, endothelial dysfunction, gut microbiota, lipopolysaccharides, short-chain fatty acids, trimethylamine-N-oxide, vascular cognitive impairment

DOI: 10.3233/JAD-171103

Journal: Journal of Alzheimer's Disease, vol. 63, no. 4, pp. 1209-1222, 2018