Probiotics, Prebiotics and Synbiotics—A Promising Strategy in Prevention and Treatment of Cardiovascular Diseases?

Abstract

Recent evidence suggests that probiotics, prebiotics and synbiotics may serve as important dietary components in the prevention (especially) and treatment of cardiovascular diseases (CVD), but the recommendations for their use are often based on brief reports and small clinical studies. This review evaluates the current literature on the correlation between CVD and probiotics, prebiotics and synbiotics. Although research on probiotics, prebiotics and synbiotics has grown exponentially in recent years, particularly regarding the effect of probiotics on CVD, their mechanisms have not been clearly defined. It has been proposed that probiotics lower cholesterol levels, and may protect against CVD, by increasing bile salt synthesis and bile acid deconjugation. Similar effects have also been observed for prebiotics and synbiotics; however, probiotics also appear to have anti-oxidative, anti-platelet and anti-inflammatory properties. Importantly, probiotics not only have demonstrated effects in vitro and in animal models, but also in humans, where supplementation with probiotics decreases the risk factors of CVD. In addition, the properties of commercial probiotics, prebiotics and synbiotics remain undetermined, and further experimental research is needed before these substances can be used in the prevention and treatment of CVD. In particular, well-designed clinical trials are required to determine the influence of probiotics on trimethylamine-N-oxide (TMAO), which is believed to be a marker of CVDs, and to clarify the long-term effects, and action, of probiotic, prebiotic and synbiotic supplementation in combination with drug therapy (for example, aspirin). However, while it cannot be unequivocally stated whether such supplementation yields benefits in the prevention and treatment of CVDs, it is important to note that clinical studies performed to date have not identified any side-effects to use.

Role of Gut Microbiota, Probiotics and Prebiotics in the Cardiovascular Diseases

“…Cardiovascular diseases involve the heart or blood vessels, the most well-known being coronary artery disease, stroke, hypertensive heart disease, cardiomyopathy, venous thrombosis, arrhythmia, and thromboembolic disease. CVD is a growing global health problem [7][8][9]. In 2015, 18 million deaths were attributed to cardiovascular diseases, accounting for approximately one-third of all-cause deaths and representing an increase of 12.5% from 2005.…”

“…Prebiotics represent substances most used to maintain a normal gut microbiota and restore its equilibrium when homeostasis is affected [53][54][55]. Prebiotics contain only substances which stimulate microorganism growth; there are no bacteria in their composition [9]. These substances can be obtained from various sources, including soybeans, raw oats.…”

“…These substances can be obtained from various sources, including soybeans, raw oats. and honey [9,56]. However, the most popular prebiotics are plant oligosaccharides [51].…”

“…Tenorio-Jimenez et al [72] reported that a 12-week administration of L. reuteri V3401 was associated, beyond a reduced risk of CVD, with lower levels of inflammation biomarkers, such as TNF-α, IL-6, IL-8, and soluble intercellular adhesion molecule-1, in obese adults aged 18 to 65 years with metabolic syndrome. However, although some studies demonstrated that probiotics can decrease the production of proinflammatory cytokines, their underlying mechanism remains unclear [9].…”

Gut Microbiota and Atherosclerosis—Focusing on the Plaque Stability

“…Some studies focused (153)(154)(155). Besides, adherence to Mediterranean diet also can modulate intima-media thickness and atherosclerotic plaques (156)(157)(158)(159). Some scientists have found that MeDiet acted on the atherosclerotic inflammatory process by downregulating proinflammatory biomarkers and upregulating biomarkers associated with the stability of plaque.…”