Applications of Strain‐Specific Probiotics in the Management of Cardiovascular Diseases: A Systemic Review

• Published in: Molecular nutrition & food research 2024-04, Vol.68 (8), p.e2300675-n/a
• Main Authors: Khan, Saleha, Ahmad, Firdos, Khalid, Nauman
• Format: Article
• Language: English
• Subjects: Bacteroidetes; bile acids; Cardiovascular diseases; Cholesterol; cholesterol metabolism; CVD biomarkers; digestive tract; Firmicutes; food research; Gastrointestinal system; Gastrointestinal tract; gut dysbiosis; Homeostasis; human health; humans; Inflammation; Lipid metabolism; Lipids; low density lipoprotein; Metabolic disorders; Metabolism; Microorganisms; mortality; nutrition; Probiotics; short‐chain fatty acids
• ISSN: 1613-4125; 1613-4133
• DOI: 10.1002/mnfr.202300675

Cardiovascular diseases (CVDs) are a leading cause of global mortality and novel approaches for prevention and management are needed. The human gastrointestinal tract hosts a diverse microbiota that is crucial in maintaining metabolic homeostasis. The formulation of effective probiotics, alone or in combination, has been under discussion due to their impact on cardiovascular and metabolic diseases. Probiotics have been shown to impact cardiovascular health positively. An imbalance in the presence of Firmicutes and Bacteroidetes has been linked to the progression of CVDs due to their impact on bile acid and cholesterol metabolism. The probiotics primarily help in the reduction of plasma low‐density lipoprotein levels and attenuation of the proinflammatory markers. These beneficial microorganisms contribute to lowering cholesterol levels and produce essential short‐chain fatty acids. The impact of lipid‐regulating probiotic strains on human health is quite significant. However, only a few have been tested for potential beneficial efficacy, and ambiguity exists regarding strain dosages, interactions with confounding factors, and potential adverse effects. Hence, more comprehensive studies and randomized trials are needed to understand the mechanisms of probiotics on CVDs and to ensure human health. This review assesses the evidence and highlights the roles of strain‐specific probiotics in the management of CVDs. The consumption of red meat, sugary processed foods, and saturated fat alters the gut microbiota, and the bacterial alteration leads to an increase in Enterobacter species that release endotoxins in the blood. Choline and carnitine are substrates for trimethylamine (TMA) formation, which undergoes hepatic conversion to trimethylamine N‐oxide (TMAO). The increase in TMAO level results in decreases in BAS and RCT activity while increasing the production of foam cells and inflammation in vessels by inducing Toll‐like receptor 4 (TLR), leading to thrombosis and atherosclerosis.