Intestinal flora influences effect of cholesterol-lowering drugs

Atorvastatin: cholesterol-lowering effect is influenced by intestinal flora

A new study has shown that the cholesterol-lowering effect of the drug atorvastatin is influenced by the intestinal flora. The observations could explain why cholesterol-lowering drugs work very differently individually.

Diet and medication

According to health experts, about every third German citizen has high cholesterol. An elevated cholesterol level can lead to diseases of the vessels, with possible consequences such as a heart attack or stroke. In order to lower the cholesterol, a change in diet is usually recommended. The many years of warnings about eggs and butter are, according to many health experts, but no longer here. Frequently, cholesterol-lowering drugs are also used. However, these drugs are not fully recommended for all patients. In addition, they act individually very different. Researchers have now come up with a possible explanation for why that is.

Some people whose cholesterol is too high take cholesterol lowering drugs. But these drugs are not the same for all patients. This could have something to do with the intestinal microbiome being different in individuals. (Image: jarun011 / fotolia.com)

Try with mice

As reported by the German Society for Cardiology - Cardiovascular Research e.V. (DGK) in a communication published by the Informationsdienst Wissenschaft (idw), the cholesterol-lowering effect of a certain statin is influenced by the intestinal flora.

According to the experts, the atorvastatin cholesterol-lowering drug is less effective in mice with no natural gut microbiome receiving high-fat foods than those on low-fat diets.

This has a study of a research team around Friedericke Zimmermann and PD Dr. Arash Haghikia from the Department of Cardiology at Campus Benjamin Franklin of the Berlin Charité, which was presented at the German Heart Day in Berlin.

Intestinal microbiome differs between individuals

"The intestinal microbiome seems to be involved in the LDL-cholesterol-lowering effect of atorvastatin," says study author Friedericke Zimmermann.

"Because the gut microbiota differs between individuals due to genetic factors, diet and other environmental factors, the observations from our work may help understand the individually variable cholesterol-lowering effects of statins."

The Berlin-based research team is currently investigating molecular mechanisms underlying the microbiome-dependent regulation of statin action.

In the experimental study published in the journal "Clinical Research in Cardiology", the researchers compared mice with intact intestinal flora to gnotobiotic animals, ie mice that have no germ colonization in the gut.

The animals were fed a standard diet or high-cholesterol diet, in part they also received atorvastatin.

Comparison of bacterial strains

According to the researchers, the LDL-lowering effect of atorvastatin after high-cholesterol diet was significantly lower in mice without microbiome than in the control group.

In the animals with microbiome, a comparison of the bacterial strains of mice with high-fat diets and those with standard diet showed differences, those fed high-fat had more bacteria of Firmicutus phylum and less of Bacteroides phylum.

This change was reversed by treatment with atorvastatin.

As stated in the communication, the new observations may explain why cholesterol-lowering drugs individually work very differently in different ways. (Ad)