The Role of Gut and Oral Microbiota in the Formation and Rupture of Intracranial Aneurysms: A Literature Review

Abstract

In recent years, there has been a growing interest in the role of the microbiome in cardiovascular and cerebrovascular diseases. Emerging research highlights the potential role of the microbiome in intracranial aneurysm (IA) formation and rupture, particularly in relation to inflammation. In this review, we aim to explore the existing literature regarding the influence of the gut and oral microbiome on IA formation and rupture. In the first section, we provide background information, elucidating the connection between inflammation and aneurysm formation and presenting potential mechanisms of gut-brain interaction. Additionally, we explain the methods for microbiome analysis. The second section reviews existing studies that investigate the relationship between the gut and oral microbiome and IAs. We conclude with a prospective overview, highlighting the extent to which the microbiome is already therapeutically utilized in other fields. Furthermore, we address the challenges associated with the context of IAs that still need to be overcome.

Keywords: bacteria; gut microbiome; intracranial aneurysm; oral microbiome; periodontitis.

Figure 1

Gut–brain interaction. Figure shows a potential mechanism of gut–brain interaction. Gut dysbiosis leads to dysregulation of the gut–blood barrier and LPS translocation to systemic circulation, consecutively activating the immune system. The immune cells enter the intracranial vessels through the systemic circulation and exert stress on the vascular endothelium here through inflammatory mediators. TLR = Toll-like receptor, IL = interleukin, TNF = tumor necrosis factor, iNOS = inducible nitric oxide synthase, IFN = interferon. Created with BioRender.com.