Monacolin K (MK) is the principal active substance in Monascus-fermentation products (e.g. red yeast rice). MK is effective in reducing cholesterol levels in humans and has been widely used as a lipid-lowering drug. The mechanism for this is through a high degree of competitive inhibition of the rate-limiting enzyme HMG-CoA reductase (HMGR) in the cholesterol synthesis pathway. In addition to lowering blood lipid levels, MK also prevents colon cancer, acute myeloid leukemia and neurological disorders such as Parkinson's disease and type I neurofibromatosis. The aim of this manuscript is to comprehensively review the progress in the study of the biological activity of MK and its imechanism of action in reducing blood lipid concentration, prevention of cancer and its neuroprotective, anti-inflammatory and antibacterial properties. This review provides a reference for future applications of MK in functional foods and medicine.
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