目的 本研究旨在探讨冠状动脉微血管疾病(Coronary microvascular disease，CM VD)患者口腔菌群的微生物群落特征，并评估特定菌株通过炎症途径对内皮细胞功能的影响。方法 选取2023年3月至2024年3月期间确诊为CMVD的100例患者，采集其口腔菌群样本。通过16S rRNA基因测序分析口腔菌群样本中的微生物群落多样性和结构特征。进一步采用体外实验，使用人冠状动脉内皮细胞(HCAEC)评估选定菌株(Bacteroides、Prevotella、Ruminococcus、Lactobacillus和Enterococcus)的感染对炎症因子(TNF-α、IL-6、IL-1β)表达水平和细胞活力的影响。结果 16S rRNA基因测序结果显示，CMVD患者口腔菌群样本中存在丰富的微生物多样性，主要由Bacteroides(9。96±3。04)％、Prevotella(9。61±2。98)％、Ruminococcus(10。77±3。08)％、Lactobacillus(9。94±3。13)％和 Enterococcus(9。67±3。07)％等10种菌群组成。体外实验结果表明，Bacteroides感染显著提高了TNF-a(750。32±50。68 pg/mL vs 299。84±19。87 pg/mL，P＜0。01)、IL-6(820。45±59。87 pg/mL vs 259。78±30。25 pg/mL，P＜0。01)和 IL-1β(899。87±69。45 pg/mL vs 309。90±24。78 pg/mL，P＜0。01)的表达水平，并显著降低了HCAEC 的细胞活力(65。34％±5。68％vs 92。45％±3。45％，P＜0。01)。Prevotella和Ruminococcus感染组也显示出类似的炎症反应和细胞活力下降(P＜0。01)，而Lactobacillus和Enterococcus感染组对炎症因子表达水平和细胞活力的影响较小，差异无统计学意义(P＞0。05)。结论 本研究揭示了CMVD患者口腔菌群的微生物群落特征，并为Bacteroides、Prevotella和Ruminococcus菌株通过诱导炎症反应显著影响内皮细胞功能提供了证据。口腔菌群可能在CMVD的发病机制中发挥重要作用，为该疾病的诊断和治疗提供了新的思路。
The role of bacterial strains in coronary microvascular disease and their relationship with inflammatory response
Objective To explore the microbial community characteristics of the oral flora in patients with coronary microvascular disease(CMVD)and evaluate the impact of specific strains on endothelial cell function through inflammatory pathways.Methods 100 patients diagnosed with CMVD between March 2023 and March 2024 were selected,and their oral flora samples were collected.The diversity and structural characteristics of microbial communities in oral flora samples were analyzed by 16S rRNA gene sequencing.Further in vitro experiments were performed using human coronary artery endothelial cells(HCAEC)to evaluate the effects of infection with selected strains(Bacteroides,Prevotella,Ruminococcus,Lactobacillus and Enterococcus)on the expression levels of inflammatory factors(TNF-α,IL-6,IL-1β)and Effect on cell viability.Results The 16S rRNA gene sequencing results showed that there was rich microbial diversity in the oral flora samples of CMVD patients,mainly composed of Bacteroides(9.96±3.04)％,Prevotella(9.61±2.98)％,Ruminococcus(10.77±3.08)％,Lactobacillus(It consists of 10 species of bacteria including 9.94±3.13％and Enterococcus(9.67±3.07)％.In vitro experimental results showed that Bacteroides infection significantly increased TNF-α(750.32±50.68 pg/mL vs 299.84±19.87 pg/mL,P＜0.01),IL-6(820.45±59.87 pg/mL vs 259.78±30.25 pg/mL,P＜0.01)and IL-1β(899.87±69.45 pg/mL vs 309.90±24.78 pg/mL,P＜0.01)expression levels,and significantly reduced the cell viability of HCAEC(65.34％5.68％vs 92.45％3.45％,P＜0.01).The Prevotella and Ruminococcus infection groups also showed similar inflammatory responses and decreased cell viability(P＜0.01),while the Lactobacillus and Enterococcus infection groups had less impact on the expression levels of inflammatory factors and cell viability,and the difference was not statistically significant(P＞0.05).Conclusion This study reveals the microbial community characteristics of the oral flora of patients with CMVD and provides evidence that Bacteroides,Prevotella,and Ruminococcus strains significantly affect endothelial cell function by inducing inflammatory responses.Oral flora may play an important role in the pathogenesis of CMVD,providing new ideas for the diagnosis and treatment of this disease.
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