02/11/2024
Lipopolysaccharide (LPS) and the Incidence of Cardiovascular Disease
Greg Millar DC CPFM CCEP
Member Alabama Board of Chiropractic Examiners
Arteriosclerosis and atherosclerosis are often confused and sometimes used to mean the same thing, but there's a difference between the two terms.
ARTERIOSCLEROSIS occurs when the blood vessels that carry oxygen and nutrients from the heart to the rest of the body (arteries) become thick and stiff — sometimes restricting blood flow to the organs and tissues. Healthy arteries are flexible and elastic. But over time, the walls in the arteries can harden, a condition commonly called hardening of the arteries.
ATHEROSCLEROSIS is a specific type of arteriosclerosis. Atherosclerosis is the buildup of fats, cholesterol and other substances in and on the artery walls. This buildup is called plaque. The plaque can cause arteries to narrow, blocking blood flow. The plaque can also burst, leading to a blood clot.
Although ATHEROSCLEROSIS is often considered a heart problem, it can affect arteries anywhere in the body. Atherosclerosis can be treated. Healthy lifestyle habits can help prevent atherosclerosis.
Mounting scientific evidence over decades has established that atherosclerosis is a chronic inflammatory disorder. Although a variety of inflammatory markers (ie, C-reactive protein) have been associated with atherosclerosis and its consequences, it is important to identify principal mediators of the inflammatory responses.
Among the potentially critical sources of vascular inflammation during atherosclerosis are the components of pathogenic bacteria, especially one that's hard to say but very potent, lipopolysaccharide (LPS). One potentially important source of inflammation is endotoxin (lipopolysaccharide [LPS]).
What is Lipopolysaccharide (LPS):
Lipopolysaccharide (LPS) is a component of the surface membrane of gram-negative bacteria found in the gastrointestinal tract. Gram-negative bacteria include: Escherichia coli, Salmonella, Shigella, Pseudomonus, Helicobactor, Legionella, Wolbachia.
This endotoxin promotes the upregulation of pro-inflammatory cytokines eliciting a strong immune response. The detection of antibodies against LPS indicates infiltration of macromolecule-sized endotoxins into the intestinal barrier and the systemic circulation which is known to contribute to atherosclerosis.
LPS and Leaky Gut:
LPS is one marker among seven markers for increased intestinal permeability aka: Leaky Gut. The additional markers include Zonulin, Anti-Zonulin IgG, Anti-Zonulin IgA, Anti-Actin IgG, Anti-Actin IgA, Anti-LPS IgA and Anti-LPS (IgG + IgM)
Numerous studies clearly demonstrated that elevated serum LPS levels were associated with the development of atherosclerosis.
Treatment Strategy to Eradicate and Lessen the effects of LPS on Cardiovascular Health:
Remember that old saying "To do the same thing and expect a different result is the definition of insanity." That means we have to change a few things like our lifestyle.
The science of functional medicine it has been well established that the following protocol incorporating a program using a simple acronym of the 6Rs: remove, replace, reinoculate, repair, rebalance and re-test has been significantly effective in eradicating the LPS. When applied to various health conditions including atherosclerosis the 6R program can lead to a dramatic improvement in symptoms and sometimes even complete resolution.
The elements of the 6R program are described briefly here:
1: Remove
Remove stressors. Get rid of things that negatively affect your GI tract, including foods (in some cases, gluten) you are sensitive to, parasites, and potential problematic bacteria or yeast. This might involve using an elimination diet to find out what foods are triggering GI symptoms. It may also involve taking medications or herbs to get rid of an infection.
2: Replace
Replace digestive enzymes. Add back things like digestive enzymes, bile acids, and hydrochloric acid that are required for proper digestion and that may be compromised by diet, medications, diseases, aging, or other factors.
3: Reinoculate
Aid beneficial bacteria flourish by eating probiotic-rich foods or taking supplements that contain “good” bacteria, such as Bifidobacteria and Lactobacillus species, and by eating high-fiber foods that supply prebiotics to nourish good microbes.
Include a rich supply of prebiotics are foods. These foods will stimulate the growth of beneficial microorganisms already in the large intestine.
Prebiotics are available in many foods that contain a fiber called inulin, including artichokes, garlic, leeks, onions, chicory, tofu, and other soy products. Grains and seeds such as barley, oats flaxseeds, and chia seeds are also good sources of prebiotics. Another prebiotic source is a supplement ingredient called fructooligosaccharides (FOS).
4: Repair
Help the lining of the GI tract repair itself by supplying key nutrients that heal a compromised gut, such as zinc, antioxidants (such as vitamins A, C, and E), omega-3 fish oils, and the amino acid glutamine.
5: Rebalance
It is important to pay attention to lifestyle choices. Sleep, exercise, and stress can all affect the GI tract. Managing and balancing those factors helps promote optimal digestive tract health.
6: Re-test
Once one applies the therapeutic principles of effective treatment, re-testing is highly recommended to determine if the LPS is no longer present in the systemic circulation.
References:
https://www.sciencedirect.com/.../abs/pii/S1050173821000992
https://www.nature.com/articles/s41569-022-00737-2
https://link.springer.com/article/10.1007/s12265-021-10109-9
https://www.ahajournals.org/doi/10.1161/JAHA.119.013628
https://lipidworld.biomedcentral.com/.../1476-511X-11-139
https://www.ahajournals.org/.../01.ATV.0000147534.69062.dc
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5669181/
** Always consult with a physician or healthcare practitioner with significant integrative or functional medicine training before starting any of the above recommendations.
The information in this post is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Millar and the functional medicine community. Dr. Millar encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. Dr Millar practices functional medicine at Millar Functional Medicine. (256) 513-4888. www.millarfunctionalmedicine.com
