2023 Volume 11 Pages 156-170
Probiotics are beneficial live microorganisms because they provide health benefits to the host after being consumed in sufficient amounts, primarily by increasing the proliferation of native digestive microflora. Hypercholesterolemia is a condition in which cholesterol serum concentration is elevated significantly (exceeds 200 mg/dL). Hypercholesterolemia is characterized by high plasma levels of low-density lipoprotein (LDL) and low plasma concentration of high-density lipoprotein (HDL). This review aims to examine the mechanism of action of probiotics in preventing the risk of hypercholesterolemia and reducing LDL cholesterol levels in the human body. The mechanism of cholesterol-lowering effect of probiotic bacteria can be classified into four basic principles such as 1) the conversion of cholesterol to coprostanol, 2) the deconjugation of cholesterol by probiotics’ bile salt hydrolase enzyme, 3) the alteration of protein expression related to cholesterol synthesis, and 4) the production of Short Chain Fatty Acids (SCFA) by probiotics. Cholesterol converted to coprostanol is not absorbed by the small intestine and is directly excreted with the feces. The deconjugated cholesterol is easily precipitated and thus not absorbed by the small intestine. It also induces the assimilation of cholesterol into the probiotic membrane. Finally, the SCFAs, produced by probiotics fermentation within host digestive tract, can upregulate the synthesis of HDL apolipoprotein.
