HLP is a metabolic syndrome due to lipid metabolism imbalance, and usually represented as elevated TC and/or TG, as well as a reduction in HDL-C. HLP results in cardiovascular disease and liver injury, which seriously threatens human life (2). Lipid metabolism disorder may attributed to the interaction between genetics and environmental factors, such as irrational dietary habits. For instance, excessive consumption of HCD and high-fat diet (HFD) are potent risk factors for dyslipidemia and atherosclerosis (26, 27).
In the present study, we used HCD to induce HLP disease to evaluate the effect of EM on lipid metabolism disorder. Our results indicated that HLP zebrafish larvae model was successfully established by consuming HCD for 10 days, which was consistent with the previous study (21). As can be seen from the results, HCD promoted obesity of zebrafish larvae, as evidenced by elevated body weight, length and BMI (Fig. 2b-d). However, after EM treatment, this situation were effectively alleviated. The translucency of larval zebrafish until 30 dpf permits observation of vascular lipid accumulation and deposition in real time, which is a unique advantage different from the HLP rodent model. It was reported that excessive lipid particularly cholesterol in the blood vessel may predispose to atherosclerosis (28). Recent evidence suggests that the accumulated lipid in the vascular wall of HLP zebrafish model is similar to the composition of early atherosclerotic plaque of humans (29, 30). Compared with the control group, it was observed that large amounts of red cholesterol tagged with fluorescent cholestery ester accumulated in the green blood vessel (including the caudal artery) in the HCD group (Fig. 4a-c). Intriguingly, EM remarkably improved cholesterol deposition in the area, showing its hypocholesterolemic effect. In addition, neutrophil-regulated inflammatory reaction is essential for early atherosclerosis, and neutrophils, an important immune cell, are recruited in large numbers to the injured sites of endothelial cell layer driving early atherosclerosis and plaque destabilization (31). Our results (Fig. 6a, b) found abundant neutrophils were recruited in the blood vessel of tail in HLP zebrafish larvae, while EM reversed this change. Together, this results suggested that EM reduced vascular cholesterol deposition and improved vascular inflammatory response to inhibit the occurrence of early atherosclerosis in zebrafish larave fed with HCD.
The liver is a center organ for lipid metabolism. When the generated lipid cannot be released into the blood, they are usually accumulated and deposited in hepatocytes in the form of lipid droplets. In the case of hypercholesterolemia, elevated hepatic lipid accumulation contributes to NAFLD and liver injury (32). Transaminases is sensitive to the damage of hepatocytes. ALT and AST are crucial indicators for evaluating liver damage. In this study, compared to the control group, HCD-induced larvae showed that severe lipid accumulation in the liver, hepatic steatosis and abnormal morphology of hepatocytes (Fig. 5a-d). Whereas, the administration of EM prevented the HCD-induced abnormalities in TC, TG, LDL-C and HDL-C levels, as well as the increased activities of ALT and AST (Fig. 3a-f). These results demonstrated that EM could attenuate hepatic lipid accumulation and improve liver function of HLP zebrafish.
Adenosine monophosphate-activated protein kinase (AMPK) is considered as the key molecule that regulates biological energy metabolism and thus has become potential therapeutic target for metabolic diseases. Viollet et al. demonstrated that the improvement of lipid metabolism disorder may be attributed to AMPK activation and its downstream target genes sterol regulatory element binding protein 2 (SREBP-2) (33). The SREBP-2/PCSK9/LDLR signalling pathway is an important and effective pathway that regulates lipid metabolism (34). SREBP-2, a member of SREBPs transcription factors family, regulates the expression of genes required for cholesterol synthesis and uptake (35). Studies have shown that overexpression of SREBP-2 induced by HFD stimulation can dramatically increase genes expression involved in lipid synthesis and metabolism, which may be the cause of diet-induced lipid metabolism disorder (36). LDLR on the surface of hepatocytes is the mediator for uptaking LDL-C in the circulation, leading to decrease LDL-C level. PCSK9 is a serine protease and mainly synthesized in the liver, which is regulated by SREBP-2 (37). It is reported that PCSK9 can triggers LDLR intracellular degradation via attaching to LDLR surface and translocating to lysosomes, resulting in increase both circulating LDL-C and the risk of cardiovascular disease (37). In addition, HMGCR is the key enzyme regulated by the activity of SREBP-2 for cholesterol biosynthesis and an effective target of statins for HLP prevention and treatment (38). Thus, we determined whether EM attenuates lipid accumulation in HCD-induced HLP zebrafish larvae via modulating the AMPK/SREBP-2/PCSK9/LDLR signalling pathway.
In this study, our data (Fig. 7a) showed that EM significantly prevented the HCD-induced decrease of AMPK mRNA in zebrafish. Previous studies have shown that EM activated AMPK signaling pathway and promoted fatty acid oxidation, thereby exerting protective effect in NAFLD zebrafish fed with egg powder (15). Moreover, our results (Fig. 7a) indicated that the expression of SREBP-2 and its target genes involved in PCSK9 and HMGCR was significantly increased, while that of LDLR was decreased in zebrafish with HLP induced by HCD. However, EM reversed the increased expression of SREBP-2, HMGCR and PCSK9, but upregulated the expression of LDLR, which might be the reason of decrease of cholesterol endogenous synthesis and circulated LDL-C content. Reverse cholesterol transport (RCT) process is an effective method to reduce cholesterol in extrahepatic tissues and has been demonstrated to reduce HLP (39). Adenosine triphosphate binding cassette transporter A1 (ABCA1) and adenosine triphosphate binding cassette transporter G1 (ABCG1) both participate in regulating the secretion of cholesterol, which is beneficial to RCT (40). Our research found that EM effectively upregulated the expression of ABCA1 and ABCG1, and promoted the elimination of excess cholesterol.
Collectively, present study revealed that EM can improve obesity, reduce lipid deposition, alleviate inflammation and liver injury on HLP zebrafish larvae fed with HCD through regulating genes expression of lipid metabolism relevant factors and redistributing of lipid in the blood and liver.