Abstract

An effective way to reduce LDL cholesterol, the primary risk factor of atherosclerotic cardiovascular disease, is to increase cholesterol excretion from the body. Our group and others have recently found that cholesterol excretion can be facilitated by both hepatobiliary and transintestinal pathways. However, the lipoprotein that moves cholesterol through the plasma to the small intestine for transintestinal cholesterol efflux (TICE) is unknown. To test the hypothesis that hepatic very low-density lipoproteins (VLDL) support TICE, antisense oligonucleotides (ASO) were used to knockdown hepatic expression of microsomal triglyceride transfer protein (MTP), which is necessary for VLDL assembly. While maintained on a high cholesterol diet, Niemann-Pick C1-like 1 hepatic transgenic (L1Tg) mice, which predominantly excrete cholesterol via TICE, and wild type (WT) littermates were treated with control ASO or MTP ASO. In both WT and L1Tg mice, MTP ASO decreased VLDL triglyceride (TG) and cholesterol secretion. Regardless of treatment, L1Tg mice had reduced biliary cholesterol compared to WT mice. However, only L1Tg mice treated with MTP ASO had reduced fecal cholesterol excretion. Based upon these findings, we conclude that VLDL or a byproduct such as LDL can move cholesterol from the liver to the small intestine for TICE.

Highlights

  • Atherosclerotic coronary vascular disease (ASCVD) remains the number one killer of Americans [1]

  • Because antisense oligonucleotides (ASO) are cleared more efficiently by the liver compared to the small intestine [26], we anticipated that knockdown of microsomal triglyceride transfer protein (MTP) expression would be significantly greater in liver versus small intestine, which requires MTP for assembly and secretion of chylomicrons [18]

  • Since MTP is required for efficient efflux of hepatic lipids on apolipoprotein B (apoB)-containing lipoproteins, liver lipid accumulation was dramatically increased in mice treated with MTP ASO

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Summary

Introduction

Atherosclerotic coronary vascular disease (ASCVD) remains the number one killer of Americans [1]. One way to reduce LDLc, the primary risk factor of ASCVD, is to increase cholesterol excretion from the body [2]. Biliary cholesterol secretion is the primary mechanism by which excess cholesterol is moved into the lumen of the small intestine and subsequently excreted from the body [3]. When biliary cholesterol secretion is absent or dramatically reduced in mice and humans, normal cholesterol excretion can be maintained by TICE [7,11,12,13]. Mice deficient in ABCB4 (ABCB42/2) and mice with transgenic expression of Niemann-Pick C1-Like 1 in hepatocytes (L1Tg) have a ,90% decrease in biliary cholesterol but normal fecal neutral sterol excretion presumably due to increased TICE [7,8,13,14,15]. It has been shown that TICE can be pharmacologically stimulated with LXR agonist in ABCB42/2 and L1Tg mice [7,13,14]

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