Classification of intestinal inflammation driven by gut microbiota metabolites: a new paradigm for precision treatment of cardiovascular diseases

The global burden of cardiovascular disease continues to increase, and there is an urgent need to revolutionize traditional prevention and treatment strategies. In recent years, in-depth research on the “gut axis” has revealed the core role of gut microbiota and its metabolites in regulating cardiovascular health through intestinal inflammation. However, the heterogeneity of intestinal inflammation limits its clinical treatment and translational efficacy. In this review, we propose a classification system for intestinal inflammation based on the “microbiota metabolite immune disease” axis, which decomposes the general concept of “intestinal inflammation” into five operable molecular subtypes: trimethylamine N-oxide-driven, lipopolysaccharide imbalance, short-chain fatty acid imbalance, aryl hydrocarbon receptor ligand-regulated, and bile acid metabolic disorder types. Each subtype has a unique microbial composition, characteristic metabolite profile, specific receptors, and signaling pathways. Based on this classification, we constructed a personalized and precise treatment approach, with “dietary intervention as the basis, microbial preparations as the core, and drug intervention as the supplement.” In response to the common phenomenon of multiple overlapping subtypes in clinical practice, we propose a personalized adjustment principle of “core contradiction priority, collaborative measures, and taboo avoidance.”