Fecal Bile Acid Excretion Research Articles

A combination of Tween 80 with CaCl2 enhances the hypocholesterolemic activity of bile salt hydrolase-active Lactobacillus casei F0422 in rats fed a cholesterol-rich diet

The effects of a Tween 80 and CaCl2 mixture on the hypocholesterolemic activity of bile salt hydrolase (BSH)-active Lactobacillus casei F0422 were investigated in rats fed a cholesterol-rich diet for 3 weeks. This mixture significantly enhanced the hypocholesterolemic activity of strain F0422 in rats. The group administered drinking water supplemented with both strain F0422 and the Tween 80 and CaCl2 mixture had significantly lower levels of total serum cholesterol, low-density lipoprotein cholesterol and total liver cholesterol than did the group administered drinking water supplemented only with strain F0422 or the Tween 80 and CaCl2 mixture. The hypocholesterolemic activity of the combined strain F0422 and Tween 80 and CaCl2 mixture was attributed to the increase in fecal bile acid excretion through enhancement of bile salt tolerance and BSH catalytic activity of strain F0422 by Tween 80 and up-regulation of the adhesion of strain F0422 to intestinal epithelial cells by CaCl2.

Differential impact of hepatic deficiency and total body inhibition of MTP on cholesterol metabolism and RCT in mice

Because apoB-containing lipoproteins are pro-atherogenic and their secretion by liver and intestine largely depends on microsomal triglyceride transfer protein (MTP) activity, MTP inhibition strategies are actively pursued. How decreasing the secretion of apoB-containing lipoproteins affects intracellular rerouting of cholesterol is unclear. Therefore, the aim of the present study was to determine the effects of reducing either systemic or liver-specific MTP activity on cholesterol metabolism and reverse cholesterol transport (RCT) using a pharmacological MTP inhibitor or a genetic model, respectively. Plasma total cholesterol and triglyceride levels were decreased in both MTP inhibitor-treated and liver-specific MTP knockout (L-Mttp(-/-)) mice (each P < 0.001). With both inhibition approaches, hepatic cholesterol as well as triglyceride content was consistently increased (each P < 0.001), while biliary cholesterol and bile acid secretion remained unchanged. A small but significant decrease in fecal bile acid excretion was observed in inhibitor-treated mice (P < 0.05), whereas fecal neutral sterol excretion was substantially increased by 75% (P < 0.001), conceivably due to decreased intestinal absorption. In contrast, in L-Mttp(-/-) mice both fecal neutral sterol and bile acid excretion remained unchanged. However, while total RCT increased in inhibitor-treated mice (P < 0.01), it surprisingly decreased in L-Mttp(-/-) mice (P < 0.05). These data demonstrate that: i) pharmacological MTP inhibition increases RCT, an effect that might provide additional clinical benefit of MTP inhibitors; and ii) decreasing hepatic MTP decreases RCT, pointing toward a potential contribution of hepatocyte-derived VLDLs to RCT.

583 GpBAR1 Genotype Predicts Bowel Function and Pathophysiology in Diarrhea-Predominant Irritable Bowel Syndrome

Background: Genetic predisposition in irritable bowel syndrome (IBS) is supported by prior association studies (Camilleri et al AJP 302:G1075-G1084, 2012). To date, no single genetic predisposition has been convincingly associated with symptoms and relevant quantitative traits in IBS. Aim: To identify candidate genes predisposing to symptoms, colonic transit, bile acid disturbances, and epithelial permeability in IBS.Methods:We assessed associations of variations in candidate genes controlling bile acid (BA) metabolism (KLB and FGFR4), BA receptor GPBAR1 (or TGR5), serotonin reuptake (5HTTLPR) or immune activation (TNFSF15) with bowel function, BA synthesis and total fecal BA, colonic transit (CT) and intestinal permeability (IP) in 30 healthy volunteers (HV), 30 patients with IBS-C (constipation) and 64 with IBS-D (diarrhea) (by Rome III criteria). Colonic tone and sensation were also measured by barostat in 48 IBS-D patients. Primary endpoints assessed in all participants were: fasting serum C4 (screen for hepatic BA synthesis rate), total fecal BA and fat excretion (per 48h on 100g fat diet), overall CT by scintigraphy (geometric center, GC) at 24h and 48h, intestinal and colonic permeability by urine mannitol excretion at 0-2h and 8-24h following 2-sugar ingestion test. Candidate genotype analysis of blood DNA was conducted using PCR-based methods: rs4795541 (5HTTLPR); rs351855 (FGFR4); rs17618244 (KLB); rs11554825 (GPBAR1); rs4263839 (TNFSF15). Bowel functions, C4, total and individual fecal BA, CT, colonic sensation, and IP were compared in IBS-C, IBS-D and HV. We used Spearman correlation to explore relationships of total fecal BA with CT and IP. The univariate associations of each genotype were assessed in the total set of participants by the KruskalWallis test (2 degrees of freedom general genetic model). Results: There were expected differences in IBS-C, IBS-D and HV groups in number of BMs, stool consistency and ease of passage, CT (GC48h), IP, fecal fat, serum FGF19 and C4, and total fecal BA (table). There were significant associations between total fecal BA and CT GC48 (r=0.43; p<0.001) and IP (r=0.23; p=0.015). There were significant (p<0.05) univariate associations between: a) GPBAR1 and symptom phenotype, gas sensation ratings, total fecal BA excretion, and CT GC48h. There were weaker associations of GPBAR1 variation with BM frequency and gas sensation threshold (both p<0.1); b) 5HTTLPR and stool consistency and ease of passage, postprandial colonic tone, and total fecal BA excretion; c) FGFR4 and IBS symptom phenotype, postprandial colonic tone, pain sensation threshold and serum FGF19 (p=0.06). Variations in TNFSF15 and KLB were not associated with any traits. Conclusion: Genetic control of 5HT reuptake and GPBAR1 receptor predisposes to symptoms and key pathophysiological mechanisms in IBS. Support: NIH DK92179

Lipid Lowering potential of Andrographis paniculata (Nees)

Aim: Atherosclerosis and associated complications is now the major cause of myocardial morbidity and mortality worldwide. Therefore we have selected the Andrographis paniculata for the development of lipid lowering drug. Material and Methods: The lipid lowering activity of mixture of andrographaloides isolated from the leaves of the Andrographis paniculata has been studied in Triton and cholesterol fed hyperlipidemic rats (in vivo). Results: Serum lipids were found to be lowered by andrographaloides (at 50 mg/kg.) in Triton WR-1339 induced hyperlipidemia in experimental animals. Chronic feeding of this mixture of andrographolides (at 25 mg/kg) in animals, simultaneously fed with high fat diet (HFD) for 30 days caused lowering in the lipid and apoprotein levels of very low density (VLDL) and low density lipoproteins (LDL) It has also increased high density lipoprotein (HDL). Andrographaloides activated lipolytic enzymes in plasma and liver lipids. The hypolipidemic activity of the andrographaloides mixture is mediated through increased faecal bile acid excretion and enhanced plasma lecithin-cholesterol acyl transferase activity. Conclusion: Mixture of Andrographolides was found to lower the lipids in experimental animals.

Development of a novel transgenic rice with hypocholesterolemic activity via high-level accumulation of the α′ subunit of soybean β-conglycinin

Soybean 7S globulin, known as β-conglycinin, has been shown to regulate human plasma cholesterol and triglyceride levels. Furthermore, the α' subunit of β-conglycinin has specifically been shown to possess low-density lipoprotein (LDL)-cholesterol-lowering activity. Therefore, accumulation of the α' subunit of β-conglycinin in rice seeds could lead to the production of new functional rice that could promote human health. Herein, we used the low-glutelin rice mutant 'Koshihikari' (var. a123) and suppressed its glutelins and prolamins, the major seed storage proteins of rice, by RNA interference. The accumulation levels of the α' subunit in the lines with suppressed glutelin and prolamin levels were >20mg in 1g of rice seeds, which is considerably higher than those in previous studies. Oral administration of the transgenic rice containing the α' subunit exhibited a hypocholesterolemic activity in rats; the serum total cholesterol and LDL cholesterol levels were significantly reduced when compared to those of the control rice (var. a123). The cholesterol-lowering action by transgenic rice accumulating the α' subunit induces a significant increase in fecal bile acid excretion and a tendency to increase in fecal cholesterol excretion. This is the first report that transgenic rice exhibits a hypocholesterolemic activity in rats in vivo by using the β-conglycinin α' subunit.

Microbiota Modification with Probiotics Induces Hepatic Bile Acid Synthesis via Downregulation of the Fxr-Fgf15 Axis in Mice

Gut microbiota influences host health status by providing trophic, protective, and metabolic functions, including bile acid (BA) biotransformation. Microbial imprinting on BA signature modifies pool size and hydrophobicity, thus contributing to BA enterohepatic circulation. Microbiota-targeted therapies are now emerging as effective strategies for preventing and/or treating gut-related diseases. Here, we show that gut microbiota modulation induced by VSL#3 probiotics enhances BA deconjugation and fecal excretion in mice. These events are associated with changes in ileal BA absorption, repression of the enterohepatic farnesoid X receptor-fibroblast growth factor 15 (FXR-FGF15) axis, and increased hepatic BA neosynthesis. Treatment with a FXR agonist normalized fecal BA levels in probiotic-administered mice, whereas probiotic-induced alterations in BA metabolism are abolished upon FXR and FGF15 deficiency. Our data provide clear in vivo evidence that VSL#3 probiotics promote ileal BA deconjugation with subsequent fecal BA excretion and induce hepatic BA neosynthesis via downregulation of the gut-liver FXR-FGF15 axis.

Effects of isoflavone supplementation on disturbances in lipid metabolism and antioxidant system due to exogenous cholesterol oxidation products in rats

Dietary cholesterol oxidation products (COP) cause disturbances in lipid metabolism and antioxidant system. Here we investigated if isoflavone supplementation ameliorated COP-induced disturbances in lipid metabolism and antioxidant system. Male Sprague–Dawley rats (4weeks of age) were fed diets containing 0.2% COP supplemented with or without 0.15% isoflavone aglycones for 3weeks. Isoflavone supplementation significantly ameliorated the dietary COP-induced decrease in hepatic cholesterol 7α-hydroxylase activity. Isoflavone supplementation also promoted faecal bile acid excretion, restored the decrease in plasma triacylglycerol levels in COP-fed rats, and suppressed COP-induced oxidative stress. Thus, isoflavone supplementation may ameliorate COP-induced deleterious effects by activating hepatic cholesterol 7α-hydroxylase and decreasing COP levels in the body.

Effects of a farnesoid X receptor antagonist on hepatic lipid metabolism in primates

We aimed to elucidate the mechanism underlying the anti-dyslipidemic effect of compound-T3, a farnesoid X receptor antagonist, by investigating its effects on hepatic lipid metabolism in non-human primates. We administered lipid-lowering drugs for 7 days to cynomolgus monkeys receiving a high-fat diet, and subsequently measured the levels of lipid parameters in plasma, feces, and hepatic tissue fluids. Compound-T3 (0.3 and 3mg/kg p.o.) significantly decreased the plasma levels of non-high-density lipoprotein (non-HDL) cholesterol and apolipoprotein B in a dose-dependent manner. It also decreased the mRNA levels of hepatic small heterodimer partner-1, induced the mRNA expression of hepatic cholesterol 7α-hydroxylase, reduced hepatic cholesterol and triglyceride levels, increased fecal bile acid excretion, and upregulated the expression of hepatic low-density lipoprotein (LDL) receptor. Furthermore, compound-T3 significantly increased plasma HDL cholesterol and apolipoprotein A-I levels. The mRNA expression levels of hepatic apolipoprotein A-I tended to increase after compound-T3 treatment. Compound-T3 also induced accumulation of hepatic bile acids and decreased the mRNA expression levels of the hepatic bile acid export pump. The effects of cholestyramine (300mg/kg p.o.) on the plasma and hepatic lipid parameters were similar to those of compound-T3, and it increased fecal bile acid levels without causing accumulation of hepatic bile acids. These findings suggest that LDL receptor-mediated hepatic LDL incorporation due to cholesterol catabolism catalyzed by cholesterol 7α-hydroxylase decreases plasma non-HDL cholesterol levels. Upregulation of hepatic apolipoprotein A-I mRNA expression may partially contribute to the increase in HDL cholesterol levels mediated by compound-T3.

Effects of Porcine Hemoglobin on Serum Lipid Content and Fecal Lipid Excretion in Rats

The purpose of this study was to elucidate the effects of dietary hemoglobin on serum and liver lipid contents in rats, and the ability of hemoglobin hydrolysates to disrupt lipid absorption. After rats had been fed on casein- or porcine hemoglobin-containing diets for 4 weeks, their serum and liver lipid contents and fecal cholesterol, bile acid, and nitrogen excretion were measured. To elucidate the mechanism of lipid absorption by dietary hemoglobin, we also examined lipase activity, micellar solubility of cholesterol, and bile acid binding activity in the presence of hemoglobin hydrolysates. Dietary hemoglobin decreased serum and liver triglyceride and cholesterol contents and increased fecal fatty acid, cholesterol, and bile acid excretion. In addition, hemoglobin hydrolysates inhibited lipase activity compared with casein hydrolysates in an in vitro study. These results suggested that the hypolipidemic effect of hemoglobin is mediated by increased fecal lipid excretion, and that decreased lipase activity by hemoglobin is at least partially responsible for this result. The observed effects were documented with an 8 g/kg hemoglobin diet, which is lower than in other studies; therefore. hemoglobin may be useful in the prevention of lifestyle-related diseases.

Cooperation between hepatic cholesteryl ester hydrolase and scavenger receptor BI for hydrolysis of HDL-CE

Liver is the sole organ responsible for the final elimination of cholesterol from the body either as biliary cholesterol or bile acids. High density lipoprotein (HDL)-derived cholesterol is the major source of biliary sterols and represents a mechanism for the removal of cholesterol from peripheral tissues including artery wall-associated macrophage foam cells. Via selective uptake through scavenger receptor BI (SR-BI), HDL-cholesterol is thought to be directly secreted into bile, and HDL cholesteryl esters (HDL-CEs) enter the hepatic metabolic pool and need to be hydrolyzed prior to conversion to bile acids. However, the identity of hepatic CE hydrolase (CEH) as well as the role of SR-BI in bile acid synthesis remains elusive. In this study we examined the role of human hepatic CEH (CES1) in facilitating hydrolysis of SR-BI-delivered HDL-CEs. Over-expression of CEH led to increased hydrolysis of HDL-[³H]CE in primary hepatocytes and SR-BI expression was required for this process. Intracellular CEH associated with BODIPY-CE delivered by selective uptake via SR-BI. CEH and SR-BI expression enhanced the movement of [³H]label from HDL-[³H]CE to bile acids in vitro and in vivo. Taken together, these studies demonstrate that SR-BI-delivered HDL-CEs are hydrolyzed by hepatic CEH and utilized for bile acid synthesis.

Identification of a resistant protein from scallop shell extract and its bile acid-binding activity

In this study, we showed that feeding rats the organic extract of scallop shells (scallop shell extract) caused a decrease in the weights of white adipose tissues in rats fed a high-fat diet. In addition, the cholesterol concentration in the serum of rats that received a diet containing scallop shell extract was significantly lower than that in the serum of rats on the control diet. Feeding this scallop shell extract to rats increased the fecal weight as well as the fecal excretion of bile acids. The amino acid composition of the feces from rats fed the scallop shell extract was different from that of feces from rats fed the control diet, and treatment of the extract with pepsin and pancreatin identified a protein with a molecular weight of 90 kDa (90-kDa protein) as one of the indigestible proteins. Interestingly the 90-kDa protein was found to be identical to a free radical-scavenging protein we previously identified and showed the ability to bind bile acids. These results suggest that indigestible proteins (resistant proteins) in the scallop shell extract, including the 90-kDa protein, inhibit the absorption of bile acid by binding to it and cause increased excretion of fecal bile acid, which subsequently may decrease the serum cholesterol level.

Peptides Identified in Soybean Protein Increase Plasma Cholesterol in Mice on Hypercholesterolemic Diets

The in vitro micellar cholesterol displacement assay has been used to identify peptides that may potentially reduce cholesterol in vivo. Two of these peptides, LPYPR and WGAPSL, derived from soybean protein (SP) that have been reported to displace cholesterol from micelles were tested by feeding them as a part of a hypercholesterolemic diet to mice for 3 weeks. Except reduction of very low-density lipoprotein cholesterol (VLDL-C) and triglyceride contents, the peptide-containing diets increased plasma cholesterol content with the increasing dose of the peptides. Mice fed diets supplemented with the peptides also had lower fecal bile acid excretion. Negative correlations between fecal bile acid excretion and plasma total cholesterol content (r = -0.876, P = 0.062) and non-HDL-C content (r = -0.831, P = 0.084) were observed. The mRNA levels of the genes for cholesterol and bile acid metabolism, CYP51, LDLR, CYP7A1, and LPL, were up-regulated in mice fed diets supplemented with peptides except the group fed the low dose of WGAPSL. The results suggested that higher plasma total cholesterol content possibly due to lower fecal steroid excretion as well as lower VLDL-C and triglyceride contents might due to the up-regulated expression levels of the genes CYP51, LDLR, and LPL.

Medium-Chain Fatty Acids Enhanced the Excretion of Fecal Cholesterol and Cholic Acid in C57BL/6J Mice Fed a Cholesterol-Rich Diet

The objective of the present study was to investigate the cholesterol-reducing effect of medium-chain fatty acids (MCFAs) completed by elevated excretion of fecal neutral steroids and/or bile acids. Blood and liver lipid profiles, fecal neutral steroids, bile acids, and mRNA and protein expression of the genes relevant to cholesterol homeostasis were measured and analyzed in C57BL/6J mice fed a cholesterol-rich diet with 2% caprylic acid or capric acid for 12 weeks. Blood total cholesterol and low-density lipoprotein cholesterol (LDL-c) levels were reduced significantly as compared to diet with palmitic acid or stearic acid. Caprylic acid promoted the excretion of fecal neutral steroids, especially cholesterol. The excretion of fecal bile acids, mainly in the form of cholic acid was enhanced and accompanied by elevated expression of mRNA and the protein of hepatic cholesterol 7α-hydroxylase (CYP7A1). These results indicate that MCFAs can reduce blood cholesterol by promoting the excretion of fecal cholesterol and cholic acid.

노팔 복합물이 II형 당뇨생쥐에서 지질대사에 미치는 효과

This study investigated the effects of Opuntia ficus-indica and other natural resources (OF) in db/db and C57 mice. Plasma triglycerides, cholesterol, alanine aminotransferase (ALT) activity, aspartate aminotransferase (AST) activity, fecal bile acid excretion, the histopathological appearance of the liver, and cholesterol-related mRNA expression were determined. Mice (12 db/db mice and 12 C57 mice) were assigned to diabetic-control (db-C), diabetic-OF treatment (db-OF), normal-control (C57-C), and normal-OF treatment (C57-OF) groups. Animals in the control group were fed an AIN-76 recommended diet and animals in the OF group were fed an experimental diet containing 5% of OF for 4 weeks. Concentrations of total plasma cholesterol, triglyceride, low density lipoprotein (LDL)-cholesterol, and very low density lipoprotein (VLDL)-cholesterol decreased with the administration of OF. In contrast, high density lipoprotein (HDL)-cholesterol levels were minimally affected by the experimental diet. Plasma AST and ALT showed lower activities in the db-OF group, and the fecal excretion of bile acid was reduced in the db-OF group. Histopathological analysis of the liver showed that fatty liver conditions in the db-OF group were more improved than db-C. Low-density lipoprotein receptor (LDL-R) and cholesterol 7-hydroxylase (CYP7A1) mRNA expression were increased in the db-OF group as well. However, 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMG-CoA-R) mRNA expression was lower in the db-OF group. These results provide experimental evidence about improved lipid metabolism of the OF feeding in the db/db mice.

A Mechanism-based Pharmacological Evaluation of Efficacy of Trigonella foenum graecum (Fenugreek) Seeds in Regulation of Dyslipidemia and Oxidative Stress in Hyperlipidemic Rats

: Alcoholic extract of Trigonella foenum graecum seeds [fenugreek seed extract (FSE)] was studied in triton-induced and high-fat diet-induced hyperlipidemia to evaluate antidyslipidemic effect. Plasma cholesterol (26.19%) and triglycerides (36.6%) were found to be lowered by FSE maximum at a dose of 200 mg/kg body weight in triton-treated hyperlipidemic rats. Chronic feeding of FSE (200 mg/kg body weight) caused lowering in plasma and hepatic lipid levels by activating lecithin-cholesterol acyltransferase (47%), postheparin lipolytic activity (35%), triglyceride lipase (34%), lipoprotein lipase (20.8%), and increased excretion of fecal bile acids (36%-45%). The FSE shows potent antioxidant activity in both in vitro and in vivo systems. It inhibited generation of superoxide anion and hydroxyl free radicals in both enzymatic and nonenzymatic systems significantly at 200 µM concentration. Furthermore, FSE normalizes the activities of antioxidant enzymes, that is, superoxide dismutase and catalase, and reduces plasma lipid peroxidation (33.9%), hepatic 4-hydroxynonenal (27%), and isoprostanes (28%). Data of the present study demonstrated that the T. foenum graecum seed extract has both antidyslipidemic and antioxidant properties.

Metabolic adaptation allows Amacr-deficient mice to remain symptom-free despite low levels of mature bile acids

Bile acids play multiple roles in the physiology of vertebrates; they facilitate lipid absorption, serve as signaling molecules to control carbohydrate and lipid metabolism, and provide a disposal route for cholesterol. Unexpectedly, the α-methylacyl-CoA racemase (Amacr) deficient mice, which are unable to complete the peroxisomal cleavage of C27-precursors to the mature C24-bile acids, are physiologically asymptomatic when maintained on a standard laboratory diet. The aim of this study was to uncover the underlying adaptive mechanism with special reference to cholesterol and bile acid metabolism that allows these mice to have a normal life span. Intestinal cholesterol absorption in Amacr−/− mice is decreased resulting in a 2-fold increase in daily cholesterol excretion. Also fecal excretion of bile acids (mainly C27-sterols) is enhanced 3-fold. However, the body cholesterol pool remains unchanged, although Amacr-deficiency accelerates hepatic sterol synthesis 5-fold. Changes in lipoprotein profiles are mainly due to decreased phospholipid transfer protein activity. Thus Amacr-deficient mice provide a unique example of metabolic regulation, which allows them to have a normal lifespan in spite of the disruption of a major metabolic pathway. This metabolic adjustment can be mainly explained by setting cholesterol and bile acid metabolism to a new balanced level in the Amacr-deficient mouse.

Differential regulation of bile acid and cholesterol metabolism by the farnesoid X receptor in Ldlr−/− mice versus hamsters

Modulating bile acid synthesis has long been considered a good strategy by which to improve cholesterol homeostasis in humans. The farnesoid X receptor (FXR), the key regulator of bile acid synthesis, was, therefore, identified as an interesting target for drug discovery. We compared the effect of four, structurally unrelated, synthetic FXR agonists in two fat-fed rodent species and observed that the three most potent and selective agonists decreased plasma cholesterol in LDL receptor-deficient (Ldlr (-/-)) mice, but none did so in hamsters. Detailed investigation revealed increases in the expression of small heterodimer partner (Shp) in their livers and of intestinal fibroblast growth factor 15 or 19 (Fgf15/19) in mice only. Cyp7a1 expression and fecal bile acid (BA) excretion were strongly reduced in mice and hamsters by all four FXR agonists, whereas bile acid pool sizes were reduced in both species by all but the X-Ceptor compound in hamsters. In Ldlr (-/-) mice, the predominant bile acid changed from cholate to the more hydrophilic β-muricholate due to a strong repression of Cyp8b1 and increase in Cyp3a11 expression. However, FXR agonists caused only minor changes in the expression of Cyp8b1 and in bile acid profiles in hamsters. In summary, FXR agonist-induced decreases in bile acid pool size and lipophilicity and in cholesterol absorption and synthesis could explain the decreased plasma cholesterol in Ldlr (-/-) mice. In hamsters, FXR agonists reduced bile acid pool size to a smaller extent with minor changes in bile acid profile and reductions in sterol absorption, and consequently, plasma cholesterol was unchanged.

Bowel Functions, Fecal Unconjugated Primary and Secondary Bile Acids, and Colonic Transit in Patients With Irritable Bowel Syndrome

There is an unclear relationship among bowel symptoms, excretion of unconjugated fecal bile acid (UBA), and colonic transit in irritable bowel syndrome (IBS). We measured total and main individual UBA in fecal samples of patients with IBS and assessed relationships among stool frequency or consistency, fecal UBA (total and individual), and colonic transit. In this study 30 healthy volunteers (controls), 31 subjects with IBS with diarrhea (IBS-D), and 30 with IBS with constipation (IBS-C) were placed on 4-day diets containing 100 g fat; we measured stool characteristics, total fecal UBA and fat levels, and overall colonic transit. We assessed univariate associations of total and individual levels of fecal UBA with phenotype (controls, IBS-D, IBS-C) by using the Kruskal-Wallis test; associations between end points were assessed by using Spearman correlations. With response surface regression models, we assessed relationships between stool, colonic transit, and fecal total and secretory UBA. There was a significant association between total fecal UBA and phenotype (P= .029); the association was greater for IBS-D than IBS-C, compared with controls. Fecal levels of primary UBAs (cholic and chenodeoxycholic acids) were higher in subjects with IBS-D, compared with controls (both P < .01). Levels of fecal secretory UBAs (chenodeoxycholic acid, P= .019; deoxycholic acid, P= .025) were lower in subjects with IBS-C compared with controls, whereas levels of the nonsecretory UBA, lithocholic acid, were higher (P= .020). There were significant univariate associations between stool number and form and total fecal UBA (including percentages of lithocholic acid, chenodeoxycholic acid and cholic acid), fecal fat, and colonic transit at 24 and 48 hours after eating. In the regression models, the relative contribution of colonic transit was consistently greater and largely independent of the contribution of bile acids. Measurements of individual UBAs identify changes associated with stool characteristics in patients with IBS; these effects are independent of the effects of colonic transit.

Tu2057 Assessment of Bowel Symptoms, Colonic Transit, and the Relationship to Fecal Bile Acid (BA) Excretion in Health and Irritable Bowel Syndrome (IBS)

Background: Idiopathic bile acid malabsorption (BAM) causes chronic diarrhea and BA deficiency may cause constipation. BA supplementation and an ileal BA transporter inhibitor, elobixibat, accelerate colonic transit (CT). Rectal infusion of BA (e.g. chenodeoxycholate) induces colonic propulsive motility. Up to 50% of patients with IBS-D have accelerated CT; 20% of patients with IBS-C have delayed CT. The relationship between fecal BA excretion, CT, and bowel symptoms in IBS is unclear and may be relevant to selecting optimal therapy. Aim: To assess stool frequency (number) and consistency (form) in relation to CT and fecal BA excretion in healthy participants and patients with IBS-C and IBS-D. Methods: In a prospective study of 92 participants (31 healthy, 30 IBS-C and 31 IBS-D by Rome III criteria), we measured total and individual fecal BA and fecal fat (on 100g fat diet), overall CT by validated scintigraphy (geometric center, GC at 24 and 48h) and stool characteristics by a 14 day bowel pattern diary including Bristol stool form scale. Univariate associations between endpoints were assessed using Spearman correlation (rs). Relationships between stool characteristics, CT and fecal BA excretion were assessed using response surface multiple regression models (which included BMI as a covariate and linear, quadratic and cross product terms for the CT and BA measurements). Results: 1. There were significant univariate associations (table showing rs) between stool number and stool form and total fecal BA (including % LCA, % CDCA, and % CA), fecal fat, and GC24 and 48. 2. The response surface model for stool number (figure left panel) with total fecal BA and CT (GC24 ) explained 29% of the variation (r=0.54, p,0.001); similarly, the model for stool form (figure middle panel) with fecal BA and CT (GC24) explained 20% of the variation (r=0.45, p=0.021). Using total secretory BA (CA+DCA+CDCA), the response surface model for stool form (figure right panel) explained 23% of the variation (r=0.49, p=0.006). In these models, the relative contribution of CT was consistently greater than that for BA, with the coefficients corresponding to CT being statistically significant (p,0.05), while those for BA were borderline (e.g. p=0.073 for the coefficient for secretory BA and stool form, and p=0.227 for stool number). Conclusion: Relative to fecal BA, colonic transit is the greater determinant of stool number and stool form; increased total and secretory fecal BA enhance the effects of colon transit on stool characteristics, but are not independently significant factors. Funding:NIHDK92179

Hypolipidemic Activity of Okra is Mediated Through Inhibition of Lipogenesis and Upregulation of Cholesterol Degradation

Little is known about the hypolipidemic activity of okra; therefore, we investigated the hypolipidemic activity of okra and its interaction with gene expression of several key components involved in lipid homeostasis. Male C57BL/6 mice were randomly divided into three groups and fed with hyperlipidemic diet or two hyperlipidemic diets supplemented with 1% or 2% okra powder for eight weeks. Results demonstrated that okra dose-dependently decreased serum and hepatic total cholesterol and triglyceride, and enhanced fecal excretion of bile acids. Gene expression analysis revealed that okra upregulated cholesterol 7α-hydroxylase (CYP7A1) expression, downregulated expression of sterol regulatory element-binding protein 1c (SREBP1c) and fatty acid synthase (FAS), with no effect on sterol regulatory element-binding protein 2 (SREBP2), 3-hydroxy-3-methylglutaryl-CoA reductase (HMGR), low-density lipoprotein receptor (LDLR) and carnitine palmitoyltransferase-1A (CPT1A). It was suggested that hypolipidemic activity of okra was mediated most likely by upregulation of cholesterol degradation through CYP7A1 and by inhibition of lipogenesis through SREBP1c and FAS. Okra raw and fractionated polysaccharide showed strong bile acid binding capacity in vitro, which may contribute to the hypolipidemic activity observed. In conclusion, okra has potential application in the management of hyperlipidemia and its associated metabolic disorders.