Probiotic Bifidobacterium reduces serum TMAO in unstable angina patients via the gut to liver to heart axis.

BACKGROUND AND AIMS

Studies indicate that the gut microbiota and its metabolites are involved in the progression of cardiovascular diseases, and enterohepatic circulation plays an important role in this progression. This study aims to identify potential probiotics for the treatment of unstable angina (UA) and elucidate their mechanisms of action.

METHODS

Initially, the gut microbiota from patients with UA and control was analyzed. To directly assess the effects of supplementation, 10 patients with UA were enrolled and administered (630 mg per intake twice a day for 1 month). The fecal metagenome, serum trimethylamine N-oxide (TMAO) levels, and other laboratory parameters were evaluated before and after supplementation.

RESULTS

After supplementing with for 1 month, there were statistically significant differences ( < 0.05) in TMAO, aspartate aminotransferase, total cholesterol, and low-density lipoprotein compared to before. Additionally, the abundance of increased significantly, although the overall abundance of did not reach statistical significance. The gut microbiota, metabolites, and gut-liver axis are involved in the progression of UA, and potential mechanisms should be further studied.

CONCLUSIONS

Metagenomic analysis demonstrated a reduced abundance of in patients with UA. Supplementation with restored gut dysbiosis and decreased circulating TMAO levels in patients with UA. This study provides evidence that may exert cardiovascular-protective effects through the gut-liver-heart axis.

CLINICAL TRIAL NUMBER

ChiCTR2400093946.