BACKGROUND: Cardiovascular disease, global leading cause of morbi-mortality, deserve a special attention of efficacious and safe treatments. Development of new principles based on the intestinal microbiome has been revealed as a promising approach.

OBJECTIVE: To assess the effects of a combination of three Lactobacillus plantarum strains on low-density lipoprotein cholesterol (LDL-C) and other lipid parameters in hypercholesterolemic adults.

METHODS: In this double-blind, placebo-controlled, randomized trial, 60 patients (mean age 51.8 y, BMI 26.2 kg/m², LDL-C 167.5 mg/dL) not receiving lipid-altering treatment were treated either with a L. plantarum-containing probiotic (LpPRO) or placebo (PLBO) single capsule daily for 12 weeks. Lipid and safety parameters were assessed at screening/baseline, 6 and 12 weeks of treatment, and after a 4-week follow-up period.

RESULTS: At 12 weeks, compared to PLBO, the LpPRO group had significantly (p < 0.001) larger reductions in LDL-C (24.4 vs. 9.8 mg/dL), total-C (33.7 vs. 10.6 mg/dL), LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio (0.8 vs. 0.3), oxidized LDL (7.5 vs. 1.0 U/L) and triglycerides (29.1 vs. 4.1 mg/dL). HDL-C was also significantly (p < 0.001) increased in LpPRO vs. PLBO (2.9 vs. 0.4 mg/dL).

CONCLUSIONS: The L. plantarum combination reduced LDL-C and improved other lipid parameters, suggesting its potential for hypercholesterolemia treatment.