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Low-grade inflammation is the cornerstone of many chronic diseases. This type of inflammation increases with age, is common in older individuals, and is known to be a risk factor for cardiovascular disease (CVD). In these cardiovascular conditions, higher plasma levels of proinflammatory mediators, such as TNFα, IL-1, and IL-6, are frequently found. Inflammation is often associated with increased intestinal permeability, with elevated intestinal translocation of proinflammatory mediators of bacterial origin, such as the lipopolysaccharide LPS. A higher cumulative incidence of CVD has previously been 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 their impact on bile acid and cholesterol metabolism. Probiotics primarily help reduce plasma low-density lipoprotein levels and attenuate proinflammatory markers. These beneficial microorganisms contribute to lowering cholesterol levels and producing 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 CVD risk. These findings explain why there is growing interest in developing microbiota-targeted intervention strategies to downregulate 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 host CVD risk factors, such as diabetes. Previous research has demonstrated 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 thus alter the gut microbiota.

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https://onlinelibrary.wiley.com/doi/abs/10.1002/mnfr.202300675 (2024).--

https://link.springer.com/referenceworkentry/10.1007/978-981-99-5575-6_6 (2024).--

https://onlinelibrary.wiley.com/doi/full/10.1002/fsn3.4142 (2024).--

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