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Hello {{First Name|there}},
You’ve heard of the gut–brain axis.
What about the gut–vascular axis?
For years, scientists have explored how the gut microbiome communicates with the brain, shaping mood, cognition, and neurological disease. New research now reveals that this same microbial ecosystem speaks directly to our blood vessels, influencing when new vessels grow, when they stabilize, and when angiogenesis becomes harmful.
A 2024 review highlights this idea, describing a complex gut–vascular axis that links diet, inflammation, microbial metabolism, and endothelial signaling. Understanding this connection helps explain why everyday lifestyle choices can quietly shape long-term vascular health.
The Gut–Vascular Axis Explained
The gut microbiota is not confined to the intestine. Microbial metabolites enter the bloodstream influencing endothelial cells, immune signaling, and angiogenic pathways in distant organs including the heart, brain, liver, skin, and eyes.
Key mechanisms include:
Inflammation as a mediator → Microbial signals can amplify or suppress inflammatory cytokines such as IL-6, TNF-α, and IL-1β, all of which directly regulate angiogenic signaling.
Endothelial signaling → Gut-derived metabolites influence VEGF, HIF-1α, NF-κB, and PI3K–AKT pathways, which determine whether vessels grow, stabilize, or become leaky.
Barrier integrity → Dysbiosis can impair the intestinal barrier, allowing bacterial components to enter circulation and trigger pathological angiogenesis.
In early life, the gut microbiota is essential for normal vascular development. In adulthood, shifts in microbial composition can tilt angiogenesis toward repair or disease.
Microbial Metabolites That Shape Blood Vessels
Short-Chain Fatty Acids (SCFAs) ✅
Produced when gut bacteria ferment dietary fiber, SCFAs such as butyrate, acetate, and propionate are among the most protective microbial metabolites.
Reduce endothelial inflammation by inhibiting NF-κB signaling
Improve endothelial function via G-protein coupled receptors (GPR41/43)
Suppress pathological angiogenesis in cancer by downregulating VEGF and HIF-1α
At physiological levels, SCFAs support vascular stability and controlled vessel growth.
Trimethylamine N-oxide (TMAO) ⚠️
TMAO is a gut microbiota–derived metabolite produced when certain gut bacteria convert dietary choline and carnitine into trimethylamine (TMA), which the liver then oxidizes into TMAO.
It becomes problematic when levels are chronically elevated, particularly in the setting of dysbiosis and inflammation.
TMAO activates inflammatory pathways, including NF-κB, MAPK, and STAT3, increasing cytokine release and VEGF activity. Diets high in animal-based foods, including red and processed meats, favor TMAO-producing gut microbes.
Bile Acids and Indole Derivatives 🦠
Gut microbes may transform bile acids into signaling molecules that can either promote or suppress angiogenesis. Some bile acids reduce pathological vessel growth in retinal disease and cancer, while others may exacerbate inflammation when dysregulated.
The Gut, Angiogenesis, and Disease
Gut microbiome imbalance has been implicated in pathological angiogenesis across multiple conditions:
Cardiovascular disease → Pro-inflammatory byproducts of the microbiome promote vascular inflammation and plaque instability.
Metabolic disease → Altered angiogenesis contributes to insulin resistance and impaired wound healing.
Cancer → Certain microbes stimulate tumor angiogenesis and metastasis, while others inhibit vessel growth and improve immune surveillance.
Eye and brain health → Microbial signals influence retinal neovascularization and blood–brain barrier integrity.
Diet and Lifestyle: Practical Levers for Vascular Health
Because the gut microbiota responds rapidly to lifestyle factors, everyday choices can meaningfully influence angiogenesis.
Eat to Support Beneficial Metabolites
Increase dietary fiber → Vegetables, legumes, whole grains, nuts, and seeds fuel good SCFA production.
Diversify plant foods → Greater microbial diversity from a diversified diet supports balanced angiogenic signaling.
Limit excess red and processed meats → Reduces TMAO production and vascular inflammation.
Support the Gut Barrier
Polyphenol-rich foods → Berries, olive oil, green tea, and spices help maintain barrier integrity and reduce oxidative stress.
Fermented foods → Yogurt, kefir, miso, and fermented vegetables may support beneficial microbial signaling.
Lifestyle Factors That Matter
Regular physical activity → Improves gut microbial diversity and promotes healthy angiogenesis.
Sleep and stress management → Chronic stress and sleep disruption increase inflammatory signaling that drives pathological vessel growth.
The Bottom Line
Angiogenesis does not operate in isolation. It is shaped by the microbes we host, the foods we eat, and the environment we create. By understanding the gut–vascular axis, we gain new insight into how nutrition and lifestyle can quietly influence blood vessel health across the lifespan.
Future therapies may target microbial metabolites directly. But today, diet and daily habits remain powerful tools for supporting healthy angiogenesis from the inside out.
Check out this weeks youtube video to see our mascot Dr. Angio bringing complex health and research topics to life.
Best wishes,
- The Angiogenesis Foundation
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