Ricci, Veronica (2021) Effects of changing dietary habits on the fecal microbiome as an innovative approach for the development of integrated strategies of prevention and control of global cardiovascular risk in the Salerno area. [Tesi di dottorato]

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Item Type:	Tesi di dottorato
Resource language:	English
Title:	Effects of changing dietary habits on the fecal microbiome as an innovative approach for the development of integrated strategies of prevention and control of global cardiovascular risk in the Salerno area.
Creators:	Creators Email Ricci, Veronica veronica.ricci@unina.it
Date:	10 December 2021
Number of Pages:	106
Institution:	Università degli Studi di Napoli Federico II
Department:	Medicina Clinica e Chirurgia
Dottorato:	Terapie avanzate biomediche e chirurgiche
Ciclo di dottorato:	34
Coordinatore del Corso di dottorato:	nome email Di Minno, Giovanni diminno@unina.it
Tutor:	nome email Di Minno, Giovanni UNSPECIFIED
Date:	10 December 2021
Number of Pages:	106
Keywords:	mediterranean diet; gut microbiome; cardiovascular prevention; coronary artery disease
Settori scientifico-disciplinari del MIUR:	Area 06 - Scienze mediche > MED/09 - Medicina interna Area 06 - Scienze mediche > MED/11 - Malattie dell'apparato cardiovascolare Area 06 - Scienze mediche > MED/49 - Scienze tecniche dietetiche applicate
Date Deposited:	21 Dec 2021 13:11
Last Modified:	28 Feb 2024 11:38
URI:	http://www.fedoa.unina.it/id/eprint/14315

Collection description

According to the World Health Organization, coronary artery disease (CAD) is the leading cause of morbidity and mortality in the world with an estimated 17.9 million deaths each year. Several risk factors are involved in the onset and progression of this disease and among them, in recent years, dietary habits and gut microbiota composition have been shown to have a relevant impact. There are many scientific evidences showing the protective role of the Mediterranean diet (MD) in cardiovascular disease especially in CAD primary prevention while less is recognized in secondary prevention. Moreover, alterations in the gut microbiota have been reported as factors responsible for several diseases. Because the mechanisms underlying the protective role of MD have not been fully elucidated, recent attention has focused on the modulation of the gut microbiota by MD in a "protective direction" for the cardiovascular system. Aim: The main aim of this study was to improve the knowledge of the mechanisms underlying the beneficial role of MD on the cardiovascular system. In particular, we sought to elucidate the relationship between this dietary pattern and the gut microbiota in CAD patients. Subsequently, in order to carry out a technological transfer from the “Centro Cardiologico Monzino” in Milan to the Check-up Center in Salerno, we conducted the same analysis on a group of healthy subjects or in primary prevention for CVD residing in the Salerno area, who presented a high adherence to DM already at the baseline. Finally, we preliminarily studied the effects of DM on the whole blood transcriptome in CAD patients. Materials and methods: This study is included in a parallel-group, randomized, open-label, interventional trial to assess the effects of the MD compared to a low-fat diet (LFD) on CAD patients. 103 CAD patients have been enrolled and randomized into the two groups (MD vs LFD). Sequencing experiments were performed in order to evaluate diets effects on microbiota composition before (T0), three months after the dietary treatments (T3), and after 1 year (T4) of free diet. Dietary effects have been also evaluated on transcriptome by performing whole blood RNA sequencing on a subgroup of patients at T0 and T3. Results: The study of the intestinal microbiome of patients included in secondary prevention programs for CAD revealed, already after 3 months of treatment, an increase of several bacterial species producing butyrate, a SCFA with different beneficial effects on the cardiovascular system. In addition, we observed a reduction of bacterial genera such as Escherichia and Klebsiella, associated with cardiovascular disease and atherosclerotic plaque formation in several studies. These correlations were maintained also after 1 year at the start of study. The validation analysis between the centers in Milan and Salerno confirmed the efficiency of the techniques used in this work. Furthermore, sequencing of healthy subjects living in a Mediterranean area such as Salerno, again revealed a positive correlation between MD adherence and butyrate-producing bacteria. Preliminary transcriptomic results showed several genes with different expression between T0 and T3 and a correlation of 39 genes with MD-modulated bacteria. Conclusions and relevance: These data emphasize a positive effect of MD on modulation of the gut microbiome. In particular, finding some beneficial bacterial species positively correlated with MD adherence in both CAD patients and healthy subjects, suggests that, a wider diffusion of the Mediterranean diet should be recommended as a lifestyle change parallel to drug therapy both in primary and in secondary prevention of CAD.

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