Figure 1.

Levels of Serum Cholesterol Are Important for Human Health and Can Be Modulated by a Variety of Factors, Including the Potential Metabolism of Cholesterol by the Gut Microbiota

Intestinal cholesterol levels are influenced by both dietary and host-derived cholesterol. Intervention by changes in diet or use of statins both affect levels of intestinal cholesterol, while the use of ezetimibe blocks uptake of intestinal cholesterol. Gut microbial metabolism of cholesterol may also serve to reduce cholesterol absorption in the intestine, resulting in lower serum cholesterol levels. The proposed pathway for microbial conversion of cholesterol (1) to coprostanol (4) in the microbiota involves the intermediates cholestenone (2) and coprostanone (3).