Review Article by npj | biofilms and microbiomes
The oral-gut microbiota axis plays a crucial role in cardiometabolic health. This review explores the interactions between these microbiomes through enteric, hematogenous, and immune pathways, resulting in disruptions in microbial balanceandmetabolicprocesses. Thesedisruptionscontributeto systemic inflammation, metabolic disorders, and endothelial dysfunction, which are closely associated with cardiometabolic diseases. Understanding these interactions provides insights for innovative therapeutic strategies to prevent and manage cardiometabolic diseases.
The human body hosts trillions of microorganisms that inhabit various ecological niches such as the gut, mouth, and skin, forming a symbiotic relationship crucial for maintaining health1. Among these habitats, the intestinal tract harbors the highest density of microorganisms, including bacteria, fungi, viruses, and archaea. This microbiota plays significant roles in digestion, absorption, immune system development, and metabolic regulation2,3. Due to its extensive functions, the intestinal microecology has garnered increasing attention4.
Similarly, the oral microecology is essential for maintaining oral health and physiology5. There is significant connection between the oral and intestinal microecologies. The oral cavity is considered an endogenous reservoir for intestinal microorganisms6,7, and the translocation of oral bacteria to the intestinal may negatively impact health8. Cardiometabolic diseases, which refer to cardiovascular diseases driven by metabolic risk factors, have become a major health concern globally9,10. Recent research has highlighted the crucial role of microecology in human health. In particular, the oral-gut microbiota axis, have important implications for cardiometabolic health.
This review examines how the oral gut microbiota axis influences cardiometabolic health, offering valuable insights for future research and clinical practice. Microbial distribution in the oral cavity and intestinal tract In the oral cavity, the core microbiome primarily comprises the phyla Actinomycetota, Bacteroidota, Bacillota, Fusobacteriota, Pseudomonadota, Saccharibacteria and Spirochaetota11. Actinomycetota mainly consists of the genera Corynebacterium, Rothia, and Actinomyces. Bacteroidota include Prevotella and Capnocytophaga. Fusobacteria mainly include Fusobacterium12,13. Bacillota mainly include the family Veillonellaceae, the genus Streptococcus and Granulicatella, while Pseudomonadota includes Neisseria and Haemophilus.
The gut microbiota is dominated by Bacillota, Bacteroidota, Actinomycetota, Fusobacteriota, Pseudomonadota, Verrucomicrobiota, and Cyanobacteriota14. Among these, Bacteroidota and Bacillota account for over 90%. Bacillota encompasses key genera such as Lactobacillus, Bacillus, and Clostridium15, while Bacteroidota comprise significant genera like Bacteroides, Parabacteroides, Prevotella,andPorphyromonas16 (Fig. 1). The Human Microbiome Project showed that approximately 45% of participants had overlapping oral and gut microbiota17, with more than half of the shared species belonging to the phylum Firmicutes, class Clostridia, and order Clostridiales18. This overlap suggests a complex interaction between oral and intestinal microecology, where oral bacteria can colonize the gut, significantly influencing various pathophysiological processes.
