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Cardiovascular Endocrinology

MON-296 - Enterocloster-Derived Conjugated Bile Acids Drive Gut Microbiota-Bile Acid Signaling in Metabolic Syndrome-Related Hypertension

Monday, June 15, 2026
9:00 AM - 2:00 PM CT
Location: ENDOExpo; Poster Floor
Disclosure(s):
Raffaella Maria Gadaleta, PhD: No financial relationships to disclose
Antonio MOSCHETTA: No financial relationships to disclose
Arterial hypertension (AH) is a major endocrine-metabolic complication of metabolic syndrome (MS), yet mechanisms beyond classical hormonal regulation remain incompletely defined. Growing evidence implicates the gut microbiota-bile acid axis in metabolic and vascular homeostasis1. To investigate microbiota-associated mechanisms underlying AH in MS, we performed 16S rRNA gene sequencing on fecal samples from 94 MS patients undergoing comprehensive metabolic and endocrine phenotyping. Patients were stratified according to individual MS components, and microbial diversity and taxonomic composition were compared across subgroups. Among MS criteria, AH uniquely associated with significant alterations in both a- and ß-diversity. Hypertensive MS patients exhibited a distinct microbial signature, with 35 differentially abundant taxa, including 25 genera. Normotensive individuals displayed an enrichment in Actinobacteriota (including Clavibacter) and Bacillales_A (Rummeliibacillus), whereas hypertensive patients showed increased abundance of CAG-485, Ruminococcus_F, Aphodomorpha, Brochothrix, Psychrobacter, Lentilactobacillus, and Negativibacillus. The bile acid-modifying genus Enterocloster was significantly depleted in hypertensive patients and showed the lowest association with AH in LEfSe analysis. Within this genus, Enterocloster bolteae abundance was reduced by more than 50% in hypertensive patients, as confirmed by digital PCR. Enterocloster bolteae produces short-chain fatty acids (SCFAs) and microbially conjugated bile acids (MCBAs)2, which may indirectly affect the cardiovascular system, including blood pressure, through regulation of inflammatory pathways, fluid homeostasis, and vascular function. MCBAs modulate bile acid receptor signaling, including FXR- and TGR5-dependent pathways, which are critical regulators of metabolic homeostasis and vascular tone. The selective loss of Enterocloster, particularly Enterocloster bolteae, supports a mechanistic link between impaired microbial metabolite production and blood pressure dysregulation. These findings identify the gut microbiota-MCBA axis as a novel endocrine pathway contributing to AH in MS and suggest Enterocloster as a potential biomarker and therapeutic target. Ongoing studies aim to validate these associations in an independent cohort.

1) The gut microbiome and hypertension. Joanne A. O'Donnell, et al., Nature Reviews Nephrology (2023)

2) Global Chemical Impact of the Microbiome Includes Novel Bile Acid Conjugations. Robert Quinn et al. (2020)

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