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Low-grade inflammation is the cornerstone of many chronic diseases. This type of inflammation increases with age, being common in elderly people, and is known to be a risk factor for cardiovascular diseases (CVD). Higher plasma levels of proinflammatory mediators, such as TNFα, IL1, and IL6, are frequently found in these cardiovascular conditions. Inflammation is often related to increased intestinal permeability, with elevated intestinal translocation of proinflammatory mediators of bacterial origin, such as LPS liposaccharides. A higher cumulative incidence of CVD was previously observed with higher serum levels of LPS-binding protein. LPS and other components of the bacterial cell membrane are recognized by several receptors on endothelial cells. LPS binding directly induces adhesion molecules, such as ICAM-1 and P-selectin on endothelial cells, which are important for interactions with leukocytes.

Probiotics have been shown to have a positive impact on cardiovascular health. An imbalance in the presence of Firmicutes and Bacteroidetes has been linked to the progression of CVD due to its impact on bile acid and cholesterol metabolism. Probiotics mainly help reduce plasma levels of low-density lipoproteins and attenuate pro-inflammatory markers. These beneficial microorganisms help reduce cholesterol levels and produce short-chain essential fatty acids. The impact of lipid-regulating probiotic strains on human health is quite significant.

The aforementioned data highlight the potential role of the gut microbiota in controlling intestinal permeability and endotoxemia and, therefore, the development of chronic low-grade inflammation and the risk of CVD. These findings explain why there is growing interest in developing intervention strategies targeting the microbiota to achieve downregulation of low-grade inflammation as a way to prevent CVD. Therefore, foods and ingredients, such as probiotics and prebiotics, represent promising tools for dietary management of CVD risk. In particular, dysbiosis is directly associated with many CVD risk factors in the host, such as diabetes. Previous research has shown a strong correlation between dysbiosis and the development of CVD. Probiotics, prebiotics and synbiotics are considered important regulators of microbiota imbalances, as they increase the colonization of beneficial bacteria and therefore alter the gut microbiota

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