PŘEHLEDOVÉ ČLÁNKY Mikrobióm pri srdcovom zlyhávaní a aortálnej stenóze | E9 / Vnitř Lék 2022;68(2):E4-E10 / VNITŘNÍ LÉKAŘSTVÍ www.casopisvnitrnilekarstvi.cz Budúce smerovanie Vzhľadom na zložitosť a veľkosť ČM a jeho metabolitov, ako aj na potenciálne prínosy a riziká ovplyv ovania ČM u vysokorizikových pacientov, je potrebný multidisciplinárny prístup. Do budúcna je potrebné rozsiahlejšie aplikovať úplné metagenomické sekvenovanie na lepšie definovanie funkčných zmien v ČM u pacientov s kardiovaskulárnymi ochoreniami. Takéto metódy sú drahé, ale poskytujú rozlíšenie na úrovni druhu, ako aj funkčný potenciál mikróbov v čreve na hostiteľa. Existuje široké spektrum možností ovplyv ovania ČM a v súčasnosti prebieha výskum jednotlivých modalít pri kardiovaskulárnych ochoreniach. Zatiaľ nie je známe, ktorá metóda je najvhodnejšia na ovplyvnenie črevnej mikroflóry. Farmakologické zacielenie TMA‑lyázy a modifikácia stravy predstavujú prijateľné stratégie na zmiernenie prejavov a progresie SZ. Najbezpečnejšou a najsľubnejšou možnosťou však môže byť zmena stravy. Na hlbšie pochopenie a následné terapeutické zacielenie osi črevá ‑srdce bude potrebná úzka spolupráca medzi špecializovanými lekármi a výskumnými skupinami zameranými na mikrobióm s kapacitou pre analýzu produktov mikrobiálnej aktivity (metabolomické a/alebo proteomické analýzy), metagenomiku a viacúrov ovú bioinformatiku. Záver Podľa súčasných poznatkov sa na funkciu mikrobiómu pozerá ako na „endokrinný“ orgán, ktorý svojimi metabolitmi ovplyv uje ľudskú fyziológiu. Črevný mikrobióm je prepojený s vývojom jednotlivých ochorení. Zatiaľ ostáva neisté, do akej miery ovplyv uje vývoj a priebeh chorôb. Upresnenie úlohy mikrobiómu pri patogenéze je cieľom výskumu. 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