Cholesterol-to-Coprostanol Conversion by the Gut Microbiota: What We Know, Suspect, and Ignore

Every day, up to 1 g of cholesterol, composed of the unabsorbed dietary cholesterol, the biliary cholesterol secretion, and cholesterol of cells sloughed from the intestinal epithelium, enters the colon. All cholesterol arriving in the large intestine can be metabolized by the colonic bacteria. Cholesterol is mainly converted into coprostanol, a non-absorbable sterol that is excreted in the feces. Interestingly, cholesterol-to-coprostanol conversion in human populations is variable, with a majority of high converters and a minority of low or inefficient converters. Two major pathways have been proposed, one involving the direct stereospecific reduction of the Δ5 double bond direct while the indirect pathway involves the intermediate formation of 4-cholelesten-3-one and coprostanone. Despite the fact that intestinal cholesterol conversion was discovered more than a century ago, only a few cholesterol-to-coprostanol-converting bacterial strains have been isolated and characterized. Moreover, the responsible genes were mainly unknown until recently. Interestingly, cholesterol-to-coprostanol conversion is highly regulated by the diet. Finally, this gut bacterial metabolism has been linked to health and disease, and recent evidence suggests it could contribute to lower blood cholesterol and cardiovascular risks.

Phytosterols and Cardiovascular Disease

Purpose of Review Coronary heart disease is the leading cause of mortality worldwide. Elevated blood cholesterol levels are not only the major but also the best modifiable cardiovascular risk factor. Lifestyle modifications which include a healthy diet are the cornerstone of lipid-lowering therapy. So-called functional foods supplemented with plant sterols lower blood cholesterol levels by about 10–15%. Recent Findings In the recent revision of the ESC/EAS dyslipidemia guideline 2019, plant sterols are recommended for the first time as an adjunct to lifestyle modification to lower blood cholesterol levels. However, the German Cardiac Society (DGK) is more critical of food supplementation with plant sterols and calls for randomized controlled trials investigating hard cardiovascular outcomes. An increasing body of evidence suggests that plant sterols per se are atherogenic. Summary This review discusses this controversy based on findings from in vitro and in vivo studies, clinical trials, and genetic evidence.

Is Simvastatin Associated with Oral Lichenoid Drug Reaction?

Currently, various drugs have been found to induce many oral lesions. Some medications used to treat systemic diseases can affect the oral mucosa and induce lesions known as oral lichenoid drug reaction (OLDR). The diagnosis is made when the oral lesion errupted after the patient took a specific medication. However, diagnosis is challenging when a patient takes multiple medications and the onset of the eruption is unclear. OLDRs commonly cause severe pain in the oral cavity and affect the quality of life. Statins are widely used by patients with cardiovascular disease (CVD) to lower blood cholesterol levels, decreasing the risk of heart attack or stroke. This review will focus the side effects of a hypolipidemic drug group (statins) in the oral cavity. From previous experience, simvastatin may be related to severe oral ulcerations, dysplasia, and carcinoma in situ in the oral mucosa. Moreover, simvastatin combined with amlodipine can induce more severe oral lesions that are very difficult to treat. Therefore, the beneficial effect of these drugs and their side effects should be considered carefully, because simvastatin significantly affects oral and general health.

Anti-hypercholesterolemia effects and quality of eel (Anguilla bicolor) oil

<p class="Abstract">Eel (<em>Anguilla bicolor</em>) is a general fish consumption in many countries. Besides its vitamin rich, eel oil is also known to contain fatty acids like oleic acid and palmitic acid. That is necessary for traditional medicine and as food a supplement. It is known that polyunsaturated fatty acids are recognized to lower blood cholesterol. In this study, fresh eels were extracted using reflux methods. The study was conducted on rat test animals given high-fat diet and PTU (Propylthiouracil). Treatment was given eel fish oil with dose 0.5 ml / kg BW; 1 ml / KgBW and 2 ml / KgBW. The results of eel extraction showed that the metal content is undetectable except Zn metal 11.72 ppm. Eel fish oil affects the total cholesterol decrease at each dose (h &lt;0.05). Known percent increase in total cholesterol after 14 days at a dose of 0.5 ml / kg body weight (-14.10%); 1 ml / kg BW (2.12%) and 2 ml / kg BW (11.37%).</p>

Pengaruh Pemberian Ekstrak Buah Kelor (Moringa oleifera) Terhadap Penurunan Kadar Kolestrol Pada Darah Hewan Mencit (Mus musculus)

This study aimed to identify bioactive compounds of moringa (moringa oleifera) extracts and determine the effective concentration on lowering blood cholesterol levels of mice. The animals used were 15 male mice induced by propylthiouracil and fat food diet. The mice were divided randomly into 5 groups with different treatment groups. The first, the second, and the third treatments were given moringa extracts each with a concentration of 10, 20% and 40%. The fourth treatment group was given food fat diet and propiltiorasil as a positive control, and the fifth treatment was given standard food and distilled water as a negative control. Data were analyzed using a statistical analysis of variance (ANOVA) test followed by Duncan test. The results showed that moringa fruit extract contains alkaloids, saponins, flavonoids, and tannins. Moringa fruit extract can lower blood cholesterol levels of mice with the most effective concentration of 10%.

PENGARUH AIR REBUSAN DAUN MAMPELAS (Teteracera indica) TERHADAP KADAR KOLESTEROL DARAH MENCIT

Tetracera indica Merr. locally known as Mampelas is commonly used in traditional remedies. It believed to have the potential to cure hypercholesterolemia. The potential use of this plant to lower blood cholesterol level was understudied; therefore this study aimed to determine the effect of the infusion of fresh leaves of Tetracera indica to the blood cholesterol levels of mice. This research was true experimental design, a post-test only design with nonequivalent (control) groups. This study used 25 male mice divided into five categories, i.e., P0 mice were administered with 0 g of infusion, P1 mice with 2 g infusion, P2 mice with 5 g infusion, P3 mice with 10 g infusion, and P4 mice without Tetracera indica infusion but 10 mg of simvastatin. The treatment in all categories were given continuously for seven days. The results showed the mean of the blood cholesterol levels were 169.4 ± 59.37 mg/dL in P0, 121.8 ± 7.62 mg/dL in P1, 136.2 ± 15.69 mg/dL in P2, 110.6 ± 37 , 01 mg/dL in P3 , and 179,0 ± 35,24 mg/dL in P4. Kruskal Wallis test was calculated to determine the difference of blood cholesterol level among all groups, and it reported p < 0.05. The results of this study showed that infusion of Tetracera indica leaf was significantly lowered the level of blood cholesterol in mice.