Totum-070, a nutritional combination of plant extracts, prevents hypercholesterolemia in high fat diet-fed hamsters by inhibiting intestinal cholesterol absorption

Atherosclerotic cardiovascular disease is the leading cause of mortality worldwide. Hypercholesterolemia is a risk factor of atherosclerosis. This study evaluated the effects of three doses of Totum-070 (3.5%, 4.25% and 5% of diet for 12 weeks; HFD-Totum-070 groups), a plant-based polyphenol-rich supplement, in hamsters with high-fat diet (HFD)-induced dyslipidemia (HFD group). Several functional tests were performed in vivo to characterize the effect of Totum-070 on lipoprotein metabolism. Molecular mechanisms of action were explored using human Caco2 enterocytes. Totum-070 supplementation reduced total cholesterol (-41%), non-HDL cholesterol (-47%) and triglycerides (-46%) in a dose-dependent manner, compared with HFD, without any effects on food intake or body weight. HFD-induced steatosis also was significantly decreased. Gene expression analysis in liver and intestine highlighted Totum-070 effects on metabolic pathways and a strong anti-inflammatory effect. Upon challenge with olive oil gavage, post-prandial lipemia was strongly reduced. Sterol excretion in the feces was increased in the HFD-Totum-070 groups compared with the HFD group. The dual isotope cholesterol absorption test confirmed the reduction of intestinal cholesterol absorption in Totum-070 supplemented hamsters. These effects were confirmed in Caco2 cells where incubation with Totum-070 inhibited cholesterol uptake and apolipoprotein B secretion. Furthermore, metagenomic analysis of gut microbiota revealed a strong effect of Totum-070 on alpha and beta diversity measures. Compared with the HFD group, the Firmicutes to Bacteroidetes ratio was beneficially reduced in the HFD-hamsters supplemented with Totum-070 groups. Altogether, these findings indicate that Totum-070-mediated inhibition of intestinal cholesterol absorption limits the rise in blood cholesterol in high-fat fed hamsters. Overall design: Comparative gene expression profiling analysis of RNA-seq data for hamster livers from 3 experimental groups: hamsters fed with a Normal Diet (ND), hamsters fed with a High Fat Diet (HFD) and hamsters fed with HFD supplemented with Totum-070 (HFD-T070 5%)