Table 1.
Selected preclinical and clinical studies of gut microbiome modulation demonstrating the effect of interventions in experimental, surrogate, or clinical markers of atherosclerosis.
| Study | Year | Population | Intervention | Outcome |
|---|---|---|---|---|
| Probiotics | ||||
| Malik et al. [42] | 2018 | Male CAD patients | Lactobacillus plantarum | ↓Inflammatory markers ↑Endothelial function No change in TMAO |
| Moludi et al. [43] | 2021 | CAD patients | Lactobacillus rhamnosus | ↓Body weight ↓Inflammatory markers |
| Koppinger et al. [44] | 2020 | LDLr−/− mice with ischemia/reperfusion injury | Lactobacillus reuteri | ↓Infarct size |
| Sun et al. [45] | 2022 | CAD patients | Bifidobacterium lactis Probio-M8 | Improvement in anginal, anxiety, and depressive symptoms ↓Inflammatory markers ↓TMAO ↓Proatherogenic aminoacids |
| Yoshida et al. [46] | 2018 | Female Wistar rats on a HFD |
Bacteroides vulgatus
Bacteroides dorei |
Prevention of atherosclerotic plaque formation |
| O’Morain et al. [47] | 2021 | Male LDLr−/− mice on a HFD |
Lactobacillus acidophilus Bifidobacterium bifidum Bifidobacterium animalis subsp. Lactis Lactobacillus plantarum |
↓Aortic root occlusion Atherosclerotic plaque stabilization ↓Inflammatory-, extracellular matrix remodeling-, and apoptosis-related gene expression |
| Prebiotics | ||||
| Aarsaether et al. [48] | 2006 | Patients scheduled for CABG | Β-1,3/1,6 glucan | ↓CK-MB and cTnT |
| Merino-Aguilar et al. [49] | 2014 | Obese male Wistar rats | Fructooligosaccharides | ↓Body weight ↓Inflammatory markers Improved lipid profile |
| Dehghan et al. [50] | 2016 | Female patients with DM | Oligofructose-enriched inulin | ↓Inflammatory markers ↓Blood pressure Improved lipid profile |
| Parnell et al. [51] | 2009 | Overweight patients | Oligofructose | ↓Body weight |
| Synbiotics | ||||
| Tajabadi-Ebrahimi et al. [52] | 2017 | Diabetic patients with CAD |
Lactobacillus acidophilus 2 × 109 CFU/g Lactobacillus casei 2 × 109 CFU/g Bifidobacterium bifidum 2 × 109 CFU/g 800 mg inulin |
Improved insulin-glucose homeostasis Improved lipid profile |
| TMAO Inhibitors | ||||
| Wang et al. [53] | 2015 | ApoE−/− mice | DMB | ↓Foam cell formation ↓Atherosclerotic lesion development |
| Chen et al. [54] | 2022 | Wild type mice with partial carotid artery ligation | DMB | ↓Vascular remodeling ↓NLRP3 inflammasome expression ↓Endoplasmic reticulum stress ↓Reactive oxygen species formation |
| Organ et al. [55] | 2020 | Wild type mice with transient aortic constriction | Iodomethylcholine | ↓Adverse cardiac remodeling ↓Inflammation, fibrosis, and extracellular matrix remodeling |
| Witkowski et al. [56] | 2021 | Mouse model of arterial injury | Fluoromethylcholine | ↓Tissue factor expression |
| Fecal Transplantation | ||||
| Smits et al. [57] | 2018 | Male patients with MetSy | Fecal transplantation from vegan donors | No alterations in TMAO or vascular inflammation |
CAD: coronary artery disease, TMAO: trimethylamine N-oxide, LDL: low-density lipoprotein, HFD: high-fat diet, CABG: coronary artery bypass grafting, CK-MB: creatine kinase-myocardial bound, cTnT: cardiac troponin T, DM: diabetes mellitus, CFU: colony-forming unit, DMB: 3,3-dimethyl-1-butanol, MetSy: metabolic syndrome, ↓: decreased, ↑ increased.