High blood pressure (also called hypertension) ranks among the most prevalent non-communicable diseases worldwide. Large epidemiological studies have identified hypertension as the leading global risk factor for non-communicable diseases. Persistent hypertension causes organ damage to vessels, brain and retina, heart, and kidneys. Accordingly, hypertension poses enormous challenges to our society and healthcare systems, as inadequately treated hypertension leads to chronic disease with the need for ongoing medical treatment, loss of quality of life, and premature mortality. Hypertension also plays a prominent role globally from a socioeconomic perspective.
A variety of anti-hypertensive drugs are available since decades. It should be noted, however, that these drugs have been developed decades ago and do not incorporate recent key mechanistic findings regarding the pathophysiology of hypertension. This applies to inflammation in hypertension, whose role has been recognized recently but is insufficiently addressed by today's drugs. The identification of novel treatments targeting inflammation in hypertension is essential to close the treatment gap. While inflammation is now recognized as a hallmark of hypertension and subsequent organ damage, treatment of this chronic inflammation is a challenge. Severe side effects of long-term broad immunosuppression prevented its application in clinical routine.
Instead, the microbiome is a promising target for the prevention and the treatment of inflammation in hypertension. Hypertension and chronic hypertensive kidney damage are associated with an alteration of the microbiome. The effect of the microbiome on the host can in large parts be attributed to the interaction with the immune system, localized near the intestinal barrier and the gut-associated lymphoid tissue (GALT). Many diet-dependent microbial metabolites (e.g. short-chain fatty acids (SCFA), tryptophan metabolites) can modulate the function of specific immune cells.
The overall goal of HyperBiota is to explore the potential of microbiome-guided immunonutrition for anti-inflammatory immunomodulation and thus organ protection in hypertension and CKD. First, we aim to understand the dynamics of the intestinal bacterial ecosystem, the associated inflammatory response in hypertension, and the influence of specific dietary interventions. We then will utilize this knowledge to design personalized dietary interventions based upon the composition and function of the microbial ecosystem in the gut, moving away from generalized recommendations towards a personalized and disease-specific nutrition.