Research advances with regards to clinical outcome and potential mechanisms of the cholesterol-lowering effects of probiotics

Probiotics are living microorganisms that, upon ingestion in high amounts, exert health effects beyond inherent basic nutrition. To date, some studies have shown that dietary intake of probiotics is effective at lowering plasma cholesterol. The aim of this article is to summarize the current knowledge on the underlying mechanism(s) that affect(s) the cholesterol-lowering action of probiotics. The accepted mechanism responsible for the cholesterol-lowering effect of probiotics is the inhibition of intestinal cholesterol absorption and the suppression of bile acid reabsorption. Recent research has indicated that several sites within the cholesterol metabolism, such as the NPCILI protein, 3-hydroxy-3-methylglutaryl-CoA reductase and 7 alpha and 27 alpha-hydroxylase, have been suggested where regulation may take place after oral administration of probiotics, but these mechanisms are still imperfectly understood. Human metagenomic studies examining the possible mechanisms by which probiotic ingestion can be used to treat hypercholesterolemia should be carried out in the future.