Zehn Skin and Health

Sayols-Baixeras S, Dekkers KF, Baldanzi G, et al. Streptococcus Species Abundance in the Gut Is Linked to Subclinical Coronary Atherosclerosis in 8973 Participants From the SCAPIS Cohort. Circulation. 2023;148(6):459-472. doi:10.1161/CIRCULATIONAHA.123.063914

The human gut microbiome, a complex ecosystem of trillions of microorganisms, plays a vital role in various aspects of health, including digestion, immunity, and even cardiovascular health. Recent research has highlighted the connection between gut microbiota composition and the development of atherosclerosis, the buildup of plaque in the arteries that can lead to heart attacks and strokes. The SCAPIS (Swedish Cardiopulmonary Bioimage Study) cohort study, involving 8,973 participants, provides valuable insights into this connection, particularly highlighting the role of Streptococcus species.  

Key Findings and Second-Order Implications

• Streptococcus Species and Atherosclerosis: The study found a strong association between the abundance of certain Streptococcus species in the gut and increased coronary artery calcium score (CACS), a measure of subclinical atherosclerosis. These species, including Streptococcus anginosus and Streptococcus oralis subsp. oralis, are commonly found in the oral cavity. This finding suggests a potential link between oral health and heart health, with the gut microbiome acting as a mediator.
  • Second-order implication: S. oralis has been associated with periodontal disease, further supporting the link between oral health and cardiovascular health.  
• Gut Microbiota and Systemic Inflammation: The study also found associations between gut microbiota composition and markers of systemic inflammation, such as hsCRP (high-sensitivity C-reactive protein) and neutrophil counts. This suggests that gut bacteria may contribute to inflammation, a key driver of atherosclerosis.
  • Second-order implication: Chronic inflammation is a hallmark of many chronic diseases, including cardiovascular disease. By influencing inflammation, the gut microbiome may have broader implications for overall health and disease risk.  
• Gut-Oral Microbiome Connection: The study found correlations between the abundance of certain Streptococcus species in the gut and their presence in saliva samples. This further strengthens the connection between oral and gut microbiota and suggests that oral bacteria may translocate to the gut, potentially influencing gut health and systemic inflammation.
  • Second-order implication: This finding highlights the importance of maintaining good oral hygiene not only for oral health but also for overall health, including cardiovascular health.

Lifestyle and Medicinal Interventions to Reduce Pathogenic Bacteria

• Maintain good oral hygiene: Brush and floss regularly, and visit the dentist for regular checkups and cleanings.  
• Consume a healthy diet: A diet rich in fruits, vegetables, and whole grains has been shown to promote a healthy gut microbiome. Tennert et al compared the oral microbiome between healthy and standard diet groups, finding a reduction in harmful bacteria for those on a healthy diet.
  • Healthy diet = low carbohydrate, high in omega-3, Vit C/D, antioxidants, fiber.
• Consume probiotics: multiple studies highlight positive alteration or regulation of the oral microbiota with consumption of probiotic-containing foods, such as probiotic yogurt and fermented milk.

Conclusion

This study provides insight into the complex relationship between gut microbiota, oral health, and heart health. The findings suggest that maintaining a healthy gut microbiome, including reducing the abundance of potentially pathogenic Streptococcus species, may be important for preventing and managing atherosclerosis. By adopting a healthy lifestyle and seeking appropriate medical advice, individuals can take proactive steps towards improving their gut and heart health.