Bile Acids: The Contribution of the Gut Microbiota to Atherosclerosis

Emerging evidence has implicated the gut microbiota in the pathogenesis and progression of numerous cardiovascular diseases. Atherosclerosis is a major pathological process that leads to many severe cardiovascular complications. Meanwhile, atherosclerosis patients may experience local and systemic inflammatory responses, with structural changes in the intestinal microbiota and increased mucosal permeability. Currently, the role of gut microbiota-derived metabolites in atherosclerosis pathology is of great concern. Relevant findings have highlighted the potential direct or indirect impacts of gut microbiota on the metabolic health of the host via the production of various metabolites. Thus, this review places an emphasis on bile acids (BAs), metabolites derived from and regulated by the gut microbiota. BAs can delay the pathological processes associated with atherosclerosis, underscoring the significance of these metabolites as an early marker for disease progression risk. In addition, we explore the potential of BA-related gut metabolites as novel therapeutic targets for atherosclerosis, and propose several promising directions for future research.