Cholesterol lowering and inhibition of sterol absorption by Lactobacillus reuteri NCIMB 30242: a randomized controlled trial

• Published in: European journal of clinical nutrition Vol. 66; no. 11; pp. 1234 - 1241
• Main Authors: Jones, M L, Martoni, C J, Prakash, S
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.11.2012; Nature Publishing Group
• Subjects: 692/699/317; 692/700/459/1994; Absorption; Adult; Anticholesteremic agents; Apolipoprotein A-I - blood; Apolipoprotein B-100 - blood; Bile acids; Bile Acids and Salts - blood; Biological and medical sciences; C-reactive protein; C-Reactive Protein - metabolism; Cardiology. Vascular system; Care and treatment; Cholesterol; Cholesterol - analogs & derivatives; Cholesterol - blood; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Clinical Nutrition; Coronary heart disease; Double-Blind Method; Epidemiology; Feeding. Feeding behavior; Female; Fibrinogen; Fibrinogen - metabolism; Fundamental and applied biological sciences. Psychology; Heart; High density lipoprotein; Humans; Hydrolase; Hypercholesterolemia; Hypercholesterolemia - blood; Hypercholesterolemia - drug therapy; Internal Medicine; Intestinal Absorption; Lactobacillus reuteri; Low density lipoprotein; Male; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; original-article; Physiological aspects; Phytosterols - blood; Placebos; Probiotics; Public Health; Sitosterols - blood; Sterols; Stigmasterol - blood; Triglycerides; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Canada; coronary artery disease; LDL-cholesterol; bile salt hydrolase; cholesterol absorption; supplement capsule; Cardiovascular disease; L. reuteri; Hypocholesterolemic agent; Randomization; Absorption; Bacteria; Lactobacillaceae; Clinical trial; Inhibition; Supplementation; Lactobacillus; Choloylglycine hydrolase; Enzyme; Cholesterol LDL; Metabolic diseases; Capsule; Coronary heart disease; Hydrolases; Antilipemic agent; Sterol
• ISSN: 0954-3007; 1476-5640; 1476-5640
• DOI: 10.1038/ejcn.2012.126

Background/Objectives: The percentage of hypercholesterolemic individuals not reaching their LDL-cholesterol (LDL-C) goal remains high and additional therapeutic strategies should be evaluated. The objective of this study was to evaluate the cholesterol-lowering efficacy and mechanism of action of bile salt hydrolase-active Lactobacillus reuteri NCIMB 30242 capsules in hypercholesterolemic adults. Subjects/Methods: A total of 127 subjects completed a randomized, double-blind, placebo-controlled, parallel-arm, multicenter study. Subjects were randomized to consume L. reuteri NCIMB 30242 capsules or placebo capsules over a 9-week intervention period. The primary outcome was LDL-C relative to placebo at the study end point. Results: L. reuteri NCIMB 30242 capsules reduced LDL-C by 11.64% ( P <0.001), total cholesterol by 9.14%, ( P <0.001), non-HDL-cholesterol (non-HDL-C) by 11.30% ( P <0.001) and apoB-100 by 8.41% ( P =0.002) relative to placebo. The ratios of LDL-C/HDL-cholesterol (HDL-C) and apoB-100/apoA-1 were reduced by 13.39% ( P =0.006) and 9.00% ( P =0.026), respectively, relative to placebo. Triglycerides and HDL-C were unchanged. High-sensitivity C-reactive protein and fibrinogen were reduced by 1.05 mg/l ( P =0.005) and 14.25% ( P =0.004) relative to placebo, respectively. Mean plasma deconjugated bile acids were increased by 1.00 nmol/l ( P =0.025) relative to placebo, whereas plasma campesterol, sitosterol and stigmasterol were decreased by 41.5%, 34.2% and 40.7%, respectively. Conclusions: The present results suggest that the deconjugation of intraluminal bile acids results in reduced absorption of non-cholesterol sterols and indicate that L. reuteri NCIMB 30242 capsules may be useful as an adjunctive therapy for treating hypercholesterolemia.