FROM GUT TO PLAQUE: GUT MICROBIOME'S IMPACT ON ATHEROSCLEROSIS DEVELOPMENT AND PROGRESSION. LITERATURE REVIEW

Background. Atherosclerosis remains the leading cause of cardiovascular mortality worldwide. This review examines the emerging role of the gut microbiome in atherosclerosis pathogenesis. Recent advances in sequencing technologies have enabled deeper examination of complex interactions between intestinal microbial communities and cardiovascular health. Methods. This review followed MOOSE guidelines, searching PubMed, Scopus, Web of Science, and Embase databases through March 2024. Search terms included "gut microbiome," "atherosclerosis," and related concepts. Studies examining relationships between gut microbiome composition and AS were included, with data extracted using standardized forms and organized into four categories for qualitative synthesis. Results. Research reveals atherosclerosis patients exhibit reduced bacterial diversity and altered Firmicutes to Bacteroidetes ratios. Specific taxonomic signatures include increased Enterobacteriaceae and decreased butyrate-producing bacteria. Key microbial metabolites influence atherosclerosis development: short-chain fatty acids demonstrate anti-inflammatory properties; trimethylamine-N-oxide enhances macrophage cholesterol accumulation; bile acids modulate lipid metabolism; and lipopolysaccharides trigger inflammatory cascades involved in plaque formation. Conclusion. Understanding gut microbiome contributions to atherosclerosis pathogenesis offers new possibilities for prevention and treatment through microbiota modulation or targeting specific microbial metabolites, representing a paradigm shift toward personalized approaches considering interactions between genetics, environment, and microbiome.