ReviewFrontiers in endocrinology2026
Microbiota-mediated mechanisms of natural products in atherosclerosis: focus on metabolic and inflammatory pathways.
Review in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
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Abstract
Background: Atherosclerosis (AS) is a chronic inflammatory vascular disease characterized by lipid accumulation, endothelial dysfunction, immune dysregulation, and plaque formation. Beyond conventional lipid-related mechanisms, gut microbiota dysbiosis and microbiota-derived metabolites have emerged as important regulators of atherogenesis. Natural products, including polyphenols, flavonoids, alkaloids, fatty acids, polysaccharides, saponins, and terpenoids, may modulate AS by reshaping gut microbial ecology and metabolic outputs. Methods: This narrative review qualitatively synthesized English-language studies published from 2016 to 2026, with emphasis on recent preclinical and emerging clinical evidence. Literature was retrieved from PubMed and Google Scholar using terms related to natural products, gut microbiota, and atherosclerosis. Evidence was integrated across natural product categories, microbial metabolites, host signaling pathways, preclinical models, clinical observations, and translational limitations. Results: Natural products consistently acted on convergent microbiota-dependent pathways rather than isolated mechanisms. They reduced trimethylamine/trimethylamine N-oxide production, promoted short-chain fatty acid generation, remodeled bile acid metabolism, and modulated microbial tryptophan-derived metabolites. These metabolic changes were associated with improved intestinal barrier integrity, suppression of TLR4/NF-κB and NLRP3-mediated inflammation, immune rebalancing, reduced oxidative stress, enhanced cholesterol efflux, and attenuation of plaque-related phenotypes. Polyphenols and berberine showed relatively stronger mechanistic support, whereas polysaccharides, saponins, terpenoids, and complex formulas remain mainly exploratory. Most evidence derives from animal and Conclusions: Natural products provide an integrated framework for targeting the gut microbiota-metabolite-vascular pathology axis in AS. Although current evidence supports their biological plausibility and adjunctive therapeutic potential, standardized preparations, causal microbiome validation, multi-omics-based biomarkers, and well-designed clinical trials with vascular or cardiovascular endpoints are required before clinical translation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.