Cholesterol-induced colorectal cancer progression and its mitigation through gut microbiota remodeling and simvastatin treatment

BMC Cancer. 2025 Jun 1;25(1):977. doi: 10.1186/s12885-025-14379-3.

Abstract

Background: Elevated serum cholesterol levels are linked to an increased risk of colorectal adenomas and colorectal cancer (CRC), yet the role of serum low-density lipoprotein (LDL) in CRC development remains unclear. This study explores the impact of cholesterol on tumor growth and the potential therapeutic effects of Lactobacillus and Simvastatin.

Methods: We utilized a cecal tumor xenograft mouse model with Ldlr-/- mice to assess the effects of high cholesterol levels on tumor growth. Additionally, the role of gut microbiota remodeling and cholesterol-lowering strategies was investigated using Lactobacillus supplementation and Simvastatin treatment.

Results: Ldlr-/- mice on a high-cholesterol diet developed significantly larger tumors (P < 0.05) and exhibited exacerbated malignancy, as indicated by HE and Ki-67 staining. Lactobacillus supplementation reduced tumor growth (P < 0.05), lowered serum cholesterol levels, and altered the gut microbiota composition, increasing the relative abundance of beneficial bacterial taxa. Simvastatin treatment reduced PD-L1 expression in CRC cells by lowering cholesterol levels, which was associated with decreased CRC proliferation, reduced serum LDL levels, and enhanced T cell infiltration in the tumor microenvironment.

Conclusion: Elevated serum cholesterol promotes CRC progression, while gut microbiota remodeling through Lactobacillus supplementation and cholesterol-lowering interventions, such as Simvastatin, show potential in mitigating tumor growth and enhancing antitumor immune responses. These findings highlight the importance of cholesterol management in CRC treatment strategies.

Keywords: Lactobacillus; Colorectal cancer; Gut microbiota; Low-density lipoprotein; Simvastatin.

MeSH terms

  • Animals
  • Cell Line, Tumor
  • Cell Proliferation / drug effects
  • Cholesterol* / adverse effects
  • Cholesterol* / blood
  • Colorectal Neoplasms* / drug therapy
  • Colorectal Neoplasms* / etiology
  • Colorectal Neoplasms* / microbiology
  • Colorectal Neoplasms* / pathology
  • Disease Models, Animal
  • Disease Progression
  • Gastrointestinal Microbiome* / drug effects
  • Humans
  • Lactobacillus
  • Male
  • Mice
  • Mice, Knockout
  • Receptors, LDL / genetics
  • Simvastatin* / pharmacology
  • Simvastatin* / therapeutic use
  • Tumor Microenvironment / drug effects
  • Xenograft Model Antitumor Assays

Substances

  • Simvastatin
  • Cholesterol
  • Receptors, LDL