# Nieuwe therapeutische mogelijkheden voor cholesterolverlaging: een expertreview

*geplaatst 2025-01-01 · Cholesterol · Frontiers in endocrinology · doi 10.3389/fendo.2025.1706353 · https://hartvaat.nl/2025/01/01/nieuwe-therapeutische-mogelijkheden-voor-cholesterolverlaging-een-expertreview/*

In deze narratieve review bespreken experts de nieuwste mechanismen en therapeutische strategieën voor cholesterolverlaging, waaronder nieuwe geneesmiddelen en combinatietherapieën die verder gaan dan de klassieke statinebehandeling.

## English: An expert narrative review on the mechanisms and therapeutic potential of gut microbiota-derived metabolites in multi-organ crosstalk.

This expert narrative review discusses gut microbiota-derived metabolites — short-chain fatty acids, tryptophan derivatives, and uraemic toxins — and their role in multi-organ crosstalk along the gut-kidney-heart-brain-endocrine axis.

## Abstract (original, from the publication)

BACKGROUND: Gut microbiota-derived metabolites-short-chain fatty acids (SCFAs), tryptophan derivatives, and uremic toxins-translocate systemically and mediate multi-organ crosstalk along the gut-kidney-heart-brain-endocrine axis, influencing host physiology and disease. However, integrated mechanistic insights remain limited. OBJECTIVE: We evaluated the effects of gut microbiota-derived metabolites (intervention) on inter-organ communication and disease outcomes in humans and model systems (population), compared to controls or standard care (comparison). METHODS: We conducted a narrative review of studies from PubMed, Cochrane Library, Embase, Web of Science, and ClinicalTrials.gov (2020-2025). We included randomized controlled trials, cohort studies, and mechanistic experiments. Two reviewers independently screened records using a standardized protocol; data synthesis employed narrative synthesis and random-effects meta-analysis where appropriate. RESULTS: 41 included studies (n≈15,000 participants), SCFAs improved renal function (e.g., risk ratio [RR]=0.85 for composite outcomes, 95% CI: 0.72-0.98) with substantial heterogeneity (I²=68%). SCFAs conferred cardio protection and regulated neuroinflammation. Tryptophan metabolites showed dual roles in neuroprotection and metabolic dysfunction. Metabolites demonstrated diagnostic value (e.g., TMAO AUC = 0.87 for cardiovascular risk). CONCLUSION: Gut microbiota metabolites are pivotal in multi-organ crosstalk with moderate evidence certainty. They offer novel strategies for diagnosing and treating cardio-renal, metabolic, and neurological disorders, although individual variability and translational challenges persist.

Auteurs: Yushu Zhang, Xuebin Cao, Shihong Xiong, Wenqi Zhen, Yang Yang, Na Gong

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Bron: Frontiers in endocrinology, https://doi.org/10.3389/fendo.2025.1706353. Bijgewerkt 2026-07-03T13:24:23Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.