Ligustrum robustum Alleviates Atherosclerosis by Decreasing Serum TMAO, Modulating Gut Microbiota, and Decreasing Bile Acid and Cholesterol Absorption in Mice

Scope Atherosclerosis (AS) is closely related to gut microbiota. Previous studies demonstrates that Ligustrum robustum (LR), a flavonoid-rich tea like plant, can mitigate several AS-related risk factors and modulate gut microbiota in animal models and human subjects. But its anti-AS effect and mechanisms remain unclear. Therefore, in this study, impacts of LR on AS development are investigated and the potential underlying mechanisms in C57BL/6J and Apoe(-/-) mice are explored. Methods and Results Female C57BL/6J and Apoe(-/)(-) mice are fed a chow diet or high-choline diet, supplemented with vehicle (water) or LR water extract (700 mg kg(-1)) by gavage for 17 weeks. It is found that LR attenuates diet-induced AS by reducing serum trimethylamine and trimethylamine-N-oxide (TMAO) levels likely by modulating gut microbiota. Moreover, LR increases the abundance of the genus Bifidobacterium, which generates bile salt hydrolase, and thus presumably enhances bile acid (BA) deconjugation and increases fecal BA excretion. Meanwhile, LR increases fecal cholesterol excretion, decreases the levels of serum and hepatic cholesterol, but did not affect short-chain fatty acids in feces. Conclusion LR attenuates AS development presumably by decreasing serum TMAO levels and increasing fecal BA excretion likely via gut microbial modulation. These effects are accompanied by increases in fecal cholesterol excretion and decreases in serum and hepatic cholesterol.