Exploring the Role of Gut Microbiota in Atherosclerosis and Novel Therapeutics to Mitigate the Disease Process—A Comprehensive Review of Current Literature

Atherosclerosis is an inflammatory process affecting the blood vessels, mainly the arteries. It is an established cause of a range of vascular disorders. Under homeostatic conditions, gut microbiota interacts with the host to affect its physiology and perform functions such as maintaining the integrity of the gut–epithelial barrier and immune regulation required for host survival. The gut microbial signature of an individual is a significant factor serving as a determinant of developing atherosclerotic diseases. Several factors, including the administration of antibiotics and consumption of a diet rich in processed saturated fats and carbohydrates, are known to eliminate the commensal microbes colonizing the gut, resulting in disrupted microbial ecology or dysbiosis. The gut microbiome synthesizes a range of metabolites implicated in atherosclerotic plaque formation. Dysbiosis impedes the metabolic processes and disrupts the gut–epithelial barrier that permeates the translocation of such gut metabolites and microbial endotoxins into the circulation where it interacts with the host immune cells and triggers inflammation. The current understanding regarding the integral role of the gut microbiome and its metabolites in atherosclerosis has paved the way toward discovering and applying novel nonpharmacological therapeutical interventions targeting to improve gut microbial diversity and neutralizing the effect of proinflammatory metabolites released by it. This review aims to provide a comprehensive account of the intricacies of the link existing between the human gut microbiome and atherosclerosis. Additionally, it explores novel therapeutics that carry the potential to mitigate the risk of developing atherosclerotic disorders via diverse mechanisms.