title: Effects of plant sterols and stanols on intestinal cholesterol metabolism: suggested mechanisms from past to present.
abstract: Plant sterols and stanols are natural food ingredients found in plants. It was already shown in 1950 that they lower serum low-density lipoprotein cholesterol (LDL-C) concentrations. Meta-analysis has reported that a daily intake of 2.5 g plant sterols/stanols reduced serum LDL-C concentrations up to 10%. Despite many studies, the underlying mechanism remains to be elucidated. Therefore, the proposed mechanisms that have been presented over the past decades will be described and discussed in the context of the current knowledge. In the early days, it was suggested that plant sterols/stanols compete with intestinal cholesterol for incorporation into mixed micelles as well as into chylomicrons. Next, the focus shifted toward cellular processes. In particular, a role for sterol transporters localized in the membranes of enterocytes was suggested. All these processes ultimately lowered intestinal cholesterol absorption. More recently, the existence of a direct secretion of cholesterol from the circulation into the intestinal lumen was described. First results in animal studies suggested that plant sterols/stanols activate this pathway, which also explains the increased fecal neutral sterol content and as such could explain the cholesterol-lowering activity of plant sterols/stanols.
authors.affiliation: Department of Human Biology, School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, The Netherlands.
authors.forename: Els
authors.initials: E
authors.lastname: De Smet
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Mensink
authors.forename: Jogchum
authors.initials: J
authors.lastname: Plat
mesh_terms: D018528:ATP-Binding Cassette Transporters / Q000378:metabolism; D000818:Animals; D000924:Anticholesteremic Agents / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000378:metabolism / Q000517:prevention & control; D002784:Cholesterol / Q000378:metabolism*; D020895:Enterocytes / Q000378:metabolism; D055951:Functional Food / Q000032:analysis; D006801:Humans; D007408:Intestinal Absorption; D007413:Intestinal Mucosa / Q000378:metabolism*; D000071518:Liver X Receptors; D008565:Membrane Proteins / Q000378:metabolism; D026901:Membrane Transport Proteins; D008823:Micelles; D057093:Orphan Nuclear Receptors / Q000378:metabolism; D010840:Phytosterols / Q000378:metabolism*; D012855:Sitosterols / Q000378:metabolism*
chemical_list: D018528:ATP-Binding Cassette Transporters; D000924:Anticholesteremic Agents; D000071518:Liver X Receptors; D008565:Membrane Proteins; D026901:Membrane Transport Proteins; D008823:Micelles; C410800:NPC1L1 protein, human; D057093:Orphan Nuclear Receptors; D010840:Phytosterols; D012855:Sitosterols; C407042:plant stanol ester; D002784:Cholesterol