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Stuivenberg et al. Microbiome Res Rep 2025;4:11 Microbiome Research
DOI: 10.20517/mrr.2024.22
Reports

Review Open Access

Potential effects of probiotics on atherosclerosis

1,2
1,2
Gerrit A. Stuivenberg 1,2 , Annabel Poon , Jeremy P. Burton , J. David Spence 3
1
Microbiology and Immunology, Western University, London N6A 3K7, Canada.
2
The Canadian Centre for Human Microbiome and Probiotic Research, Lawson Health Research Institute, London N6A 4V2,
Canada.
3
Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute, Western University, London N6G 2V4,
Canada.
Correspondence to: Prof. J. David Spence, Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute,
Western University, 1400 Western Road, London N6G 2V4, Canada. E-mail: dspence@robarts.ca
How to cite this article: Stuivenberg GA, Poon A, Burton JP, Spence JD. Potential effects of probiotics on atherosclerosis.
Microbiome Res Rep 2025;4:11. https://dx.doi.org/10.20517/mrr.2024.22

Received: 20 Mar 2024 First Decision: 26 Sep 2024 Revised: 29 Nov 2024 Accepted: 11 Dec 2024 Published: 21 Dec 2024
Academic Editor: Marco Ventura Copy Editor: Pei-Yun Wang Production Editor: Pei-Yun Wang

Abstract
The rising global incidence of atherosclerosis highlights the inadequacies in our understanding of the
pathophysiology and treatment of the disease. Increasing evidence outlines the importance of the intestinal
microbiome in atherosclerosis, wherein gut-derived uremic toxins (GDUTs) may be of concern. Plasma levels of
the GDUTs trimethylamine n-oxide (TMAO), p-cresyl sulfate, and indoxyl sulfate are associated with accelerated
renal function decline and increased cardiovascular risk. Thus, reducing the amount of GDUTs in circulation is
expected to benefit patients with atherosclerosis. Because some beneficial bacteria can clear GDUTs in vitro and in
vivo, orally administered probiotics targeting the intestinal tract represent a promising way to bring about these
changes. Atherosclerosis such, this perspective reviews the potential use of probiotics to treat atherosclerosis,
particularly in patients with non-traditional risk factors and/or impaired renal function.

Keywords: Probiotics, atherosclerosis, uremic toxins, gut microbiota

INTRODUCTION
Atherosclerosis is a chronic inflammatory disease characterized by the thickening of arteries due to plaque
accumulation, and narrowing of arteries due to plaque rupture and thrombosis. Atherosclerosis progression
is strongly dependent on dyslipidemia, hypertension, and inflammatory responses, and thus, traditional risk

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