MINI REVIEW article
Front. Immunol.
Sec. Nutritional Immunology
Probiotics in Atherosclerosis: Mechanisms, Efficacy and Future Directions — A Review Study
Provisionally accepted
Yue Cai1*
Xinwei Huang2- 1Kunming University of Science and Technology, Kunming, China
- 2Shanghai University, Shanghai, China
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Background: Atherosclerosis (AS), the pathological basis of cardiovascular diseases, is a major cause of global mortality. Gut microbiota dysbiosis contributes to AS progression via trimethylamine N-oxide (TMAO), inflammation, and vascular dysfunction. Probiotics have emerged as a potential strategy against AS. Objective: To systematically review the mechanisms, efficacy, and future perspectives of probiotics in atherosclerosis. Methods: Preclinical and clinical evidence was summarized, focusing on gut microbiota, TMAO, short-chain fatty acids, lipid metabolism, inflammation, and vascular function. Results: Probiotics exert anti-atherosclerotic effects by restoring gut microbiota composition, reducing TMAO, increasing short-chain fatty acids, improving lipid profiles, alleviating inflammation, and protecting endothelial function. Clinical trials support beneficial effects on metabolic and vascular risk factors but are limited by small sample sizes and short durations. Conclusions: Probiotics are a promising and safe approach for AS intervention. Future large-scale, long-term trials and optimized probiotic designs are required to facilitate clinical application.
Keywords: Atherosclerosis, Gut Microbiota, Probiotics, short-chain fatty acids, Trimethylamine N-oxide, Vascular function
Received: 20 Oct 2025; Accepted: 10 Feb 2026.
Copyright: © 2026 Cai and Huang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yue Cai
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