Pathogenetic relationship of microbiome and metabolic disorders on the background of hypertension and gout: Potential targets of pharmacotherapy

Cardiometabolic diseases are one of the urgent problems of modern medicine. Currently, much attention is being paid to the study of the common pathogenesis of diabetes mellitus, gout and hypertension. One of the pharmacological targets is the correction of the intestinal microbiome and dysbiosis, as an integral link in the development of systemic inflammation and endotoxinemia, leading to the development of these pathologies. The article presents the results of scientific research devoted to the study of the effect of the intestinal microbiome on the development of cardiometabolic diseases. The main goal of the research is to find a rational pharmacological therapy of intestinal dysbiosis for the treatment of comorbid patients. It has been proved that, together with standard drug therapy, taking into account the pathogenetic features of the development of cardiometabolic diseases, it is advisable to use drugs that affect the intestinal microbiome. The main classical approach is the use of probiotic drugs containing live bacteria. The use of probiotics in combination with probiotic drugs to support the growth of intestinal normoflora has become a promising direction. However, this approach requires a long period of correction of the microflora, which prompted the idea of using postbiotics – signaling molecules – products of the vital activity of the microflora for a more targeted and rapid effect on pathological processes, both in the intestine and on the organ system as a whole. This approach promotes the beginning of the development of synbiotics, a complex of microorganisms, growth factors and metabolites that made it possible to more effectively influence on dysbiotic processes in various pathologies, including dyslipidemia and cardiovascular diseases. Correction of intestinal barrier permeability disorders will help prevent the development of systemic complications associated with chronic pathologies. The article also presents the author’s scheme of the pathogenesis of cardiometabolic diseases, based on the study of current scientific research.