Coronary artery disease (CAD) is the most common health problem worldwide and remains the leading cause of morbidity and mortality. Over the past decade, it has become clear that the inhabitants of our gut, the gut microbiota, play a vital role in human metabolism, immunity, and reactions to diseases, including CAD. Although correlations have been shown between CAD and the gut microbiota, demonstration of potential causal relationships is much more complex and challenging. In this review, we will discuss the potential direct and indirect causal roots between gut microbiota and CAD development via microbial metabolites and interaction with the immune system. Uncovering the causal relationship of gut microbiota and CAD development can lead to novel microbiome-based preventative and therapeutic interventions. However, an interdisciplinary approach is required to shed light on gut bacterial-mediated mechanisms (e.g., using advanced nanomedicine technologies and incorporation of demographic factors such as age, sex, and ethnicity) to enable efficacious and high-precision preventative and therapeutic strategies for CAD.

中文翻译：

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肠道微生物群与心血管疾病：机遇与挑战。

冠状动脉疾病（CAD）是全世界最常见的健康问题，并且仍然是发病和死亡的主要原因。在过去的十年中，我们已经清楚地认识到，我们肠道的居民——肠道微生物群，在人类新陈代谢、免疫和对疾病（包括 CAD）的反应中发挥着至关重要的作用。尽管 CAD 和肠道微生物群之间已显示出相关性，但潜在因果关系的证明要复杂得多且更具挑战性。在这篇综述中，我们将通过微生物代谢物以及与免疫系统的相互作用来讨论肠道菌群与 CAD 发展之间潜在的直接和间接因果关系。揭示肠道微生物群与 CAD 发展的因果关系可以带来基于微生物组的新型预防和治疗干预措施。然而，需要采用跨学科方法来阐明肠道细菌介导的机制（例如，使用先进的纳米医学技术并结合年龄、性别和种族等人口因素），以实现有效且高精度的 CAD 预防和治疗策略。