Classifications

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  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
  • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
• • A—HUMAN NECESSITIES
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  • A23L—FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES, NOT OTHERWISE PROVIDED FOR; PREPARATION OR TREATMENT THEREOF
  • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
  • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
  • A23L33/105—Plant extracts, their artificial duplicates or their derivatives
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  • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
  • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
  • A23L33/105—Plant extracts, their artificial duplicates or their derivatives
  • A23L33/11—Plant sterols or derivatives thereof, e.g. phytosterols
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  • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
  • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
  • A23L33/14—Yeasts or derivatives thereof
• • A—HUMAN NECESSITIES
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  • A23L—FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES, NOT OTHERWISE PROVIDED FOR; PREPARATION OR TREATMENT THEREOF
  • A23L7/00—Cereal-derived products; Malt products; Preparation or treatment thereof
  • A23L7/10—Cereal-derived products
  • A23L7/104—Fermentation of farinaceous cereal or cereal material; Addition of enzymes or microorganisms
• • A—HUMAN NECESSITIES
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  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
  • A61K31/47—Quinolines; Isoquinolines
  • A61K31/4738—Quinolines; Isoquinolines ortho- or peri-condensed with heterocyclic ring systems
  • A61K31/4741—Quinolines; Isoquinolines ortho- or peri-condensed with heterocyclic ring systems condensed with ring systems having oxygen as a ring hetero atom, e.g. tubocuraran derivatives, noscapine, bicuculline
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
  • A61K31/47—Quinolines; Isoquinolines
  • A61K31/4738—Quinolines; Isoquinolines ortho- or peri-condensed with heterocyclic ring systems
  • A61K31/4745—Quinolines; Isoquinolines ortho- or peri-condensed with heterocyclic ring systems condensed with ring systems having nitrogen as a ring hetero atom, e.g. phenantrolines
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  • A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
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  • A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
  • A61K31/575—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids substituted in position 17 beta by a chain of three or more carbon atoms, e.g. cholane, cholestane, ergosterol, sitosterol
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
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  • A61K36/06—Fungi, e.g. yeasts
• • A—HUMAN NECESSITIES
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  • A61K36/18—Magnoliophyta (angiosperms)
  • A61K36/185—Magnoliopsida (dicotyledons)
  • A61K36/48—Fabaceae or Leguminosae (Pea or Legume family); Caesalpiniaceae; Mimosaceae; Papilionaceae
• • A—HUMAN NECESSITIES
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  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
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  • A61K36/18—Magnoliophyta (angiosperms)
  • A61K36/88—Liliopsida (monocotyledons)
  • A61K36/899—Poaceae or Gramineae (Grass family), e.g. bamboo, corn or sugar cane
• • A—HUMAN NECESSITIES
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  • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
  • A61P1/16—Drugs for disorders of the alimentary tract or the digestive system for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics
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• • A—HUMAN NECESSITIES
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  • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
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• • A—HUMAN NECESSITIES
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• • A—HUMAN NECESSITIES
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  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
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  • A61P3/06—Antihyperlipidemics
• • A—HUMAN NECESSITIES
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  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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• • A—HUMAN NECESSITIES
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  • A61P9/10—Drugs for disorders of the cardiovascular system for treating ischaemic or atherosclerotic diseases, e.g. antianginal drugs, coronary vasodilators, drugs for myocardial infarction, retinopathy, cerebrovascula insufficiency, renal arteriosclerosis
• • A—HUMAN NECESSITIES
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• • A—HUMAN NECESSITIES
  • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
  • A23V—INDEXING SCHEME RELATING TO FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES AND LACTIC OR PROPIONIC ACID BACTERIA USED IN FOODSTUFFS OR FOOD PREPARATION
  • A23V2002/00—Food compositions, function of food ingredients or processes for food or foodstuffs

Definitions

• the present invention relates to medicinal compositions, particularly to combinations of botanical extracts for promoting cardiovascular health.
• Cardiovascular disease including coronary heart disease, atherosclerosis, stroke, myocardial infarction, sudden death syndrome, is the number one cause of death in most developed countries all over the world. Also, in developing countries, the prevalence of CVD is on the increase and appears to be linked to people adopting a more Westernized (North American) diet (high fat) and lifestyle (sedentary). Elevated circulating cholesterol levels, in particular low-density-lipoprotein cholesterol (LDL-cholesterol) levels, have been well established as one of the major risk factors for the development and progression of CVD. A high level of circulating triglycerides is also a critical risk factor in the increased incidence of CVD.
• LDL-cholesterol low-density-lipoprotein cholesterol
• reducing total cholesterol and/or triglyceride levels is advised to high risk patients to reduce cardiovascular-related risk factors that are known and demonstrated to be associated with a higher incidence of morbidity and mortality.
• Subjects with obesity, diabetes and hyperlipidemia are three major subgroups of the population that are adversely affected by high cholesterol and triglyceride levels.
• statin drugs reduce blood cholesterol through suppressing the activity of HMG-CoA reductase, the rate-limiting enzyme in cholesterol synthesis, but this class of compounds has little or no effect on lowering triglycerides.
• statin or statin-like compounds The major drawback of statin or statin-like compounds is that the synthesis of an important mitochondrial enzyme called Q10 is inhibited, depending on HMG-CoA reductase to be intact and functional.
• statins Blockage of HMG-CoA reductase by statins causes reduced coenzyme Q10 levels and this is thought to underlie the cause of a number of statin-associated muscle-related myopathies reported, such as muscle soreness, muscle weakness, muscle tenderness, intense muscle pain, peripheral neuropathy and muscle protein breakdown called rhabdomylosis and may underlie other side effects that are dependent on the presence of normal physiological levels of coenzyme Q10.
• rhabdomylosis can be both a serious and a life threatening side effect clearly associated with the use of statin drugs where the muscle breakdown causes major organ damage to both the liver and kidney that has resulted in many reported deaths.
• the all-cause discontinuation rate of statin use was about 10% and discontinuation because of adverse events was about 4%.
• Plant sterols and their different analogues inhibit cholesterol absorption and thus reduce cholesterol concentration in the plasma. However, when blood cholesterol concentration is reduced through the inhibition of cholesterol absorption, cholesterol synthesis increases simultaneously as a compensation mechanism to counteract the reduced absorption of dietary and biliary cholesterol. Plant sterols and their different analogues have not previously been shown to have any significant effect in reducing serum triglyceride levels.
• a blood lipid lowering agent that functions through a same mechanism as berberine and a blood lipid lowering agent that functions through a different mechanism than berberine act synergistically to improve blood lipid profiles.
• Such improvements may be manifested, for example, in lowering blood lipids such as total cholesterol (T-C), low-density-lipoprotein cholesterol (LDL-C) or non-high-density- lipoprotein cholesterol (nonHDL-C), and/or triglycerides (TG), and/or in increasing the ratio of high-density-lipoprotein cholesterol (HDL-C) to LDL-C or nonHDL-C.
• Blood lipid modulations (e.g. the lowering effects) of the two administered in combination are more than the sum of the two administered separately.
• a blood lipid level lowering composition comprising a blood lipid lowering agent that functions through a same mechanism as berberine, and a blood lipid lowering agent that functions through a different mechanism than berberine.
• a blood lipid lowering agent that functions through a same mechanism as berberine and a blood lipid lowering agent that functions through a different mechanism than berberine for lowering blood lipid levels in a mammal.
• a blood lipid lowering agent that functions through a same mechanism as berberine and a blood lipid lowering agent that functions through a different mechanism than berberine for manufacturing a medicament for lowering blood lipid levels in a mammal.
• a commercial package comprising a blood lipid lowering agent that functions through a same mechanism as berberine and a blood lipid lowering agent that functions through a different mechanism than berberine together with instructions for use in lowering blood lipid levels in a mammal.
• a method comprising administering a blood lipid lowering agent that functions through a same mechanism as berberine and a blood lipid lowering agent that functions through a different mechanism than berberine to a mammal to result in the lowering of blood lipid levels.
• a blood lipid lowering agent that functions through a same mechanism as berberine for controlling weight of a mammal.
• the blood lipid lowering agent that functions through a same mechanism as berberine may be from a naturally occurring source or from a synthetic or semi-synthetic source.
• BBR in a naturally occurring source may be used "as is", for example, plant material containing the BBR may be used directly.
• BBR from any source may be subject to one or more isolation or concentration steps (e.g. extraction, crystallization, filtration) to provide a purer and/or more concentrated form of the BBR.
• BBR is used as a crude extract from a natural source, as a concentrated extract from a natural source, as a partially purified extract from a natural source, or in a substantially pure form from a natural, synthetic or semi-synthetic source.
• BBR may be available commercially from a number of suppliers.
• BBR may comprise, for example, berberine, one or more berberine derivatives or analogs, one or more pharmacologically acceptable salts thereof, or a mixture thereof.
• Berberine is an isoquinoline alkaloid of formula (I):
• Berberine, berberine derivatives or analogs, salts thereof or mixtures thereof may be found in a variety plants, for example Coptis chinensis rhizomes (huanglian, coptis, goldthread), goldenseal, goldthread, Phellodendron amurense bark, Berberis sargentiana, Berberis thunbergii, Berberis vulgaris (Barberry), Berberis aquifolium (Oregon grape), Hydrastis Canadensis (goldenseal), and Berberis aristata (tree turmeric).
• Coptis chinensis rhizomes honey, coptis, goldthread
• goldenseal goldthread
• Phellodendron amurense bark Berberis sargentiana
• Berberis thunbergii Berberis vulgaris (Barberry)
• Berberis aquifolium Olegon grape
• Hydrastis Canadensis goldenseal
• Berberis aristata tre
• Berberine, berberine derivatives or analogs, and salts thereof may be prepared synthetically or semi-synthetically by a variety of chemical and/or enzymatic methods known in the art, for example, as described in United States patent publication 2006/0223838 published October 5, 2006, the disclosure of which is herein incorporated by reference.
• the BBR comprises berberine, one or more pharmacologically acceptable salts of berberine or a mixture thereof.
• Preferred pharmacologically acceptable salts of berberine include, for example, acid addition salts, e.g. chlorides, sulfates, carbonates, phosphates, citrates and acetates. Acid addition salts may be produced by reacting berberine with an appropriate acid.
• the blood lipid lowering agent that functions through a different mechanism than berberine may be, for example, a plant sterol (phytosterol), a plant stanol (phytostanol), a statin, an isoflavone, a natural product containing one or more of the above and/or other blood lipid lowering agents, a derivative thereof or a mixture thereof.
• a plant sterol, a plant stanol, an ester of a plant sterol, an ester of a plant stanol or a mixture thereof provide surprisingly synergistic effects when used in conjunction with BBR.
• Plant sterols comprise alcoholic derivatives of cyclopentanoperhydrophenanthrenes.
• Plant stanols are saturated forms of the sterols.
• Some representative examples of plant sterols are beta-sitosterol, campesterol and stigmasterol.
• Some representative examples of plant stanols are sitostanol and campestanol.
• esters of plant sterols or plant stanols are esters with unsaturated fatty acids, for example omega-3 fatty acids (e.g. docosahexaenoic acid (DHA), docosapentaenoic acid (DPA), eicosapentaenoic acid (EPA) and alpha-linolenic acid (ALA)), and esters with any other acids that are suitable for consumption and/or that benefit health (e.g. ascorbic acid).
• DHA docosahexaenoic acid
• DPA docosapentaenoic acid
• EPA eicosapentaenoic acid
• ALA alpha-linolenic acid
• Plant sterols and plant stanols are found in legumes, fruits, vegetables, trees and other plants as well as in fungi and other microorganisms.
• Plant material containing plant sterols and/or stanols may be used directly, or the plant sterols and/or stanols may be extracted from the plant material and used in a more purified and/or concentrated form.
• plant sterols and plant stanols are extracted from plant or other phytosterol/phytostanol-containing materials.
• plant materials include, for example, soybean oil, tall (pine tree) oil, wood pulp, leaves, nuts, vegetable oils, corn and rice. Plant sterols and plant stanols are available commercially from a number of suppliers.
• Red Yeast Rice contains several different naturally-occurring statins, including lovastatin, which are naturally produced during the fermentation process involved with producing Red Yeast Rice.
• statins including lovastatin
• the active lipid lowering components in Red Yeast Rice are not solely statins since the amount of statins obtained from Red Yeast Rice consumption is much lower than the dose of statin drug.
• the lipid lowering effect of Red Yeast Rice is more likely a result of the combination of lovastatin with other different statins and isoflavones found in Red Yeast Rice extracts.
• Red Yeast Rice is a fermented rice product that has been used in Chinese cuisine and as a medicinal food to promote blood circulation for centuries, without significant side effects that occurs after statin drug supplementation.
• Blood lipid levels may include, for example, triglyceride (TG) levels, total cholesterol (T-C) levels and non-high-density-lipoprotein cholesterol (nonHDL-C) levels (e.g. very low-density lipoprotein cholesterol (VLDL-C) levels, intermediate-density lipoprotein cholesterol (IDL-C) levels and/or low-density-lipoprotein cholesterol (LDL-C) levels).
• VLDL-C very low-density lipoprotein cholesterol
• IDL-C intermediate-density lipoprotein cholesterol
• LDL-C low-density-lipoprotein cholesterol
• Compositions, uses and methods of the present invention may lower one or more of these levels in the blood. The lowering of blood lipid levels may be measured in whole blood, blood plasma and/or blood serum.
• BBR and BLLA are used in amounts effective to provide a daily dose of the combination of ingredients that lowers blood lipid levels.
• the daily dose of each ingredient may in some cases be 5 mg or more per kg of body weight of a subject. In other cases, doses of each ingredient of 10 mg or more per kg of body weight may be appropriate. In yet other cases, doses of each ingredient of 50 mg or more per kg of body weight may be appropriate. For an 80 kg subject, a dose of each ingredient of 10 mg or more per kg of body weight is about 0.8 grams or more of each ingredient per day. Daily dosages can be given all at once in a single dose or can be given incrementally in several smaller dosages. Thus, the composition of the present invention can be formulated such that the recommended daily dose is achieved by the administration of a single dose or by the administration of several smaller doses.
• BBR and BLLA may be used for any suitable length of time to reduce blood lipid levels in the subject.
• BBR and BLLA are used for at least two weeks. Longer periods of usage can provide greater reduction in blood lipid levels and are envisaged as continued use of all known lipid control therapeutic approaches is required to effectively control or maintain lower lipid levels in the long term. For example, discontinuation of statin therapy results in blood lipid profiles returning to pre-intervention levels.
• BBR and BLLA may be formulated in a dosage form.
• Dosage forms include powders, tablets, capsules, softgels, solutions, suspensions, emulsions and other forms that are readily appreciated by one skilled in the art.
• the compositions may be administered orally, parenterally, intravenously or by any other convenient method. Oral administration is preferred.
• BBR and BLLA may be administered simultaneously or within a short period of time of one another. Preferably, BBR and BLLA are administered simultaneously. If they are administered within a short period of time of one another, the period time should not be so long that the synergistic effect of BBR and BLLA is not realized.
• BBR and BLLA may be formulated together with other pharmacologically acceptable ingredients typically used in the nutraceutical and/or pharmaceutical compositions, for example antiadherents, binders (e.g.
• starches sugars, cellulose, hydroxypropyl cellulose, ethyl cellulose, lactose, xylitol, sorbitol and maltitol
• coatings e.g. cellulose, synthetic polymers, corn protein zein and other polysaccharides
• disintegrants e.g. starch, cellulose, cross-linked polyvinyl pyrrolidone, sodium starch glycolate and sodium carboxymethyl cellulose
• fillers/diluents e.g.
• BBR and BLLA may also be admixed with a food or beverage and taken orally in such a manner.
• Fortified foods and beverages may be made by adding BBR and BLLA during the manufacturing of the food or beverage.
• the consumer may add BBR and BLLA to the food or beverage near the time of consumption.
• Each ingredient may be added to the food or beverage together with the other ingredients or separately from the other ingredients. Examples of foods and beverages are, but not limited to, cereals, snack bars, dairy products, fruit juices, powdered food and dry powder beverage mixes.
• BBR and BLLA may be packaged together in a commercial package together with instructions for their use.
• packages are known to one skilled in the art and include, for example, bottles, jars, blister packs, boxes, etc.
• BBR and BLLA may be used to treat or reduce the chance of contracting or the progression of a number of diseases or conditions in a subject.
• Diseases or conditions include, for example, cardiovascular disease, hyperlipidemia, atherosclerosis, coronary heart disease, angina, cerebrovascular disease, stroke, overweight or obesity, diabetes, insulin resistance, hyperglycemia, hypertension, arrhythmia, diseases of the central nervous system, diseases of the peripheral nervous system and inflammation.
• BBR and BLLA are particularly effective at preventing cardiovascular diseases, for example, coronary heart disease, atherosclerosis, stroke, arrhythmia, myocardial infarction and sudden death syndrome.
• BBR and BLLA may also be used to control weight in a subject.
• Subjects are humans and animals with blood circulatory systems, particularly mammals, for example, humans, dogs, cats, horses and rodents (e.g. hamsters, mice and rats).
• BBR and BLLA Without being held to any particular mechanism of action, synergy between BBR and BLLA is thought to arise by affecting two or more blood lipid control mechanisms to achieve a blood lipid-lowering efficacy greater than the additive effect.
• BBR and BLLA also provide an anti-inflammatory effect that provides additional health benefits and protection, especially to the cardiovascular system.
• BBR and BLLA may simultaneously affect three independent pathways to synergistically lower serum cholesterol levels, lower triglycerides and reduce or down-regulate chronic inflammatory mechanism.
• Circulating cholesterol concentration is a function of input from absorption (dietary and biliary cholesterol) and de novo synthesis relative to clearance through hepatic and non-hepatic removal mechanisms as well as cholesterol elimination through excretion.
• absorption dietary and biliary cholesterol
• de novo synthesis relative to clearance through hepatic and non-hepatic removal mechanisms as well as cholesterol elimination through excretion.
• Many of the available natural products that lower body cholesterol target a single distinct pathway and either show limited efficacy or require a high dose level to control cholesterol.
• Embodiments of the present invention can meet this demand.
• Fig. 1 is a graph depicting effect of berberine chloride and plant stands on circulating cholesterol levels in hamsters fed an atherogenic control diet and the atherogenic control diet supplemented with berberine chloride and/or plant stanols for 4 weeks (for each lipid parameter, values with different superscripts (a, b, c or d) are significantly different); [0037] Fig.
• FIG. 2 is a graph depicting effect of berberine chloride and plant stands on plasma triglyceride concentration in hamsters fed an atherogenic control diet and the atherogenic control diet supplemented with berberine chloride and/or plant stanols for 4 weeks (values with different superscripts (a or b) are significantly different);
• Fig. 3 is a graph depicting percent changes of plasma cholesterol and triglyceride concentration in hamsters fed an atherogenic control diet and the atherogenic control diet supplemented with berberine chloride and/or plant stanols;
• Fig. 4 is a graph depicting effect of berberine chloride and plant stanols on liver cholesterol concentration in hamsters fed an atherogenic control diet and the atherogenic control diet supplemented with berberine chloride and/or plant stanols for 4 weeks (values with different superscripts (a, b or c) are significantly different);
• Fig. 5 is a graph depicting effect of berberine chloride and plant stanols on the weekly body weight in hamsters fed an atherogenic control diet and the atherogenic control diet supplemented with berberine chloride and/or plant stanols for 4 weeks;
• Fig. 6 is a graph depicting effect of berberine chloride and plant stanols on average daily feed intake in hamsters fed an atherogenic control diet and the atherogenic control diet supplemented with berberine chloride and/or plant stanols for 4 weeks;
• Fig. 7a is a graph depicting effect of berberine chloride and plant stanols on intestinal ABCG5 mRNA expression in hamsters fed an atherogenic control diet and the atherogenic control diet supplemented with berberine chloride and/or plant stanols for 4 weeks (values with different superscripts (a or b) are significantly different);
• Fig. 7b is a graph depicting effect of berberine chloride and plant stanols on intestinal ABCG8 mRNA expression in hamsters fed an atherogenic control diet and the atherogenic control diet supplemented with berberine chloride and/or plant stanols for 4 weeks (values with different superscripts (a or b) are significantly different);
• Fig. 8a is a graph depicting effect of berberine chloride and plant stanols on liver HMG-CoA reductase mRNA expression in hamsters fed an atherogenic control diet and the atherogenic control diet supplemented with berberine chloride and/or plant stanols for 4 weeks (values with different superscripts (a or b) are significantly different);
• Fig. 8b is a graph depicting effect of berberine chloride and plant stanols on liver CYP7A1 mRNA expression in hamsters fed an atherogenic control diet and the atherogenic control diet supplemented with berberine chloride and/or plant stanols for 4 weeks; and,
• Fig. 8c is a graph depicting effect of berberine chloride and plant stanols on liver CYP27A1 mRNA expression in hamsters fed an atherogenic control diet and the atherogenic control diet supplemented with berberine chloride and/or plant stanols for 4 weeks.
• An objective of the following examples was to show that a combination of BBR and BLLA results in a synergistic improvement in blood lipid profile than each intervention on its own, toward positive health benefits to the cardiovascular system, cerebrovascular vasculature, liver, and body weight.
• Table 1 lists materials used in the following examples.
• Plant stanols consist of 10% campestanols and 82% sitostanols, with overall 92% of plant stanols.
• This example provides data for the combination of berberine chloride (BBRCI) with plant stanols (PS) to improve blood lipid profiles toward positive health benefits to the cardiovascular system, cerebrovascular system, vasculature, liver, and body weight.
• BBRCI berberine chloride
• PS plant stanols
• BBRCI control diet containing 100 mg/kg-d of BBRCI
• PS control diet containing 1% (w/w) PS
• BBRCI+PS control diet containing 100 mg/kg-d BBRCI and 1% (w/w) PS
• BBRCI and PS were introduced into the diet by blending.
• the primary endpoint at the end of the study was to determine the effects of each intervention on circulating blood lipids including total cholesterol (T-C), high-density-lipoprotein cholesterol (HDL-C), nonHDL-C (which is indicative of LDL-C levels) and triglyceride (TG) profiles. All lipids were measured by the standard enzymatic method.
• the hamster has been established as a good model for studying human cholesterol metabolism and was used to examine the effects of BBRCI and plant stanols each alone and in combination on circulating blood lipid levels. As well, tissues were collected to determine the associated biochemical and molecular mechanisms that are activated, induced or augmented by the experimental interventions tested.
• Table 3 summarizes the effect of BBRCI and plant stanols on the percent tissue weight relative to body weight. For each tissue weight to body weight parameter in Table 3, values with different superscripts (a or b) are significantly different. The results suggest beneficial effects to the liver and liver function as BBRCI and PS alone and especially BBRCI and PS in combination markedly reduced the appearance of fatty liver, and significantly lowered organ weight compared to the livers of the control animals.
• Fig. 4 shows the effect of BBRCI and PS alone and in combination the cholesterol content in the liver. Dietary supplementation of BBRCI and PS either alone or combined together dramatically reduced cholesterol concentration in the liver of hamsters. This observation, together with lower liver weight, implies that either BBRCI or PS or combination of either can be used to treat fatty liver.
• Table 4 and Figs. 7a-7b summarize the effect of BBCI and PS alone or in combination on intestinal ABCG5 (Fig. 7a) and ABCG8 (Fig. 7b) mRNA expression.
• BBRCI and PS alone did not affect ABCG5 and ABCG8 mRNA expression.
• the mRNA expression of both genes was significantly reduced in a synergistic mode.
• the function of ABCG5 and ABCG8 in the intestine is to transport cholesterol out of enterocytes and back to the intestine for elimination via the feces.
• Recent observations have demonstrated that the mRNA expression of ABCG5 and ABCG8 is closely and positively associated with blood cholesterol levels. When a strong action occurs on cholesterol reduction, the expressions of these two genes are down-regulated.
• Table 4 summarize the effect of BBCI and PS alone or in combination on intestinal ABCG5 (Fig. 7a) and ABCG8 (Fig. 7b) mRNA expression.
• Table 5 and Fig. 8a summarize the effect of BBRCI and PS alone or in combination on liver HMG-CoA reductase.
• BBRCI and PS alone did not affect HMG-CoA reductase mRNA expression. However, when they were combined, the mRNA expression of HMG-CoA reductase was increased by 7-fold.
• HMG-CoA reductase is a rate-limiting enzyme in cholesterol biosynthesis. A large body of evidence has indicated that cholesterol synthesis is altered reciprocally with cholesterol absorption. When a strong action occurs on cholesterol reduction through inhibiting cholesterol absorption, cholesterol biosynthesis is increased as compensatory response to the cholesterol loss due to the reduced absorption.
• the powerful synergistic action of BBRCI and PS on HMG-CoA reductase mRNA expression implies that the combination of these materials may act synergistically to reduce blood cholesterol, possibly by inhibiting cholesterol absorption.
• FIG. 8b and Fig. 8c summarize the effect of BBRCI and PS on the mRNA expression of CYP7A1 and CYP27A1 in the liver.
• BBRCI and PS alone tended to increase mRNA expression of both genes.
• CYP7A1 and CYP27A1 are two rate-limiting enzymes controlling bile acid synthesis, which is one mechanism through which the body removes cholesterol by converting it into bile acids.
• BBRCI and PS were combined, a synergistic action appeared to happen. This result implies that BBRCI and PS reduce blood cholesterol by affecting cholesterol catabolism in the liver through a synergistic action mode.
• Example 1 There is a balance between synthesis and clearance of cholesterol in the body. Despite efficient clearance of cholesterol, the body will compensate to try to maintain a certain baseline cholesterol level.
• the strong action of the combination of BBRCI and PS may have reduced cholesterol levels to a near minimum or base level. In such a case, no observable synergistic effect is expected even though a synergistic action was implied by the gene expressions. For this reason, a synergistic action on cholesterol reduction was not detected in Example 1 as a maximum or near maximum reduction in blood lipids was achieved.
• BBRCI control diet containing 100 mg/kg.d of BBRCI
• PS control diet containing 1 % (w/w) PS
• BBRCI+PS control diet containing 100 mg/kg-d BBRCI and 1 % (w/w) PS
• One objective of this example was to determine the effects of each intervention on circulating blood lipids including total cholesterol (T-C), high-density- lipoprotein cholesterol (HDL-C), nonHDL-C (which is indicative of LDL-C levels) and triglyceride (TG) profiles when hamsters were fed a diet containing a higher concentration of cholesterol, for example, 0.25% by weight in the diet.
• T-C total cholesterol
• HDL-C high-density- lipoprotein cholesterol
• TG triglyceride
• Table 7 summarizes the effect on tissue weight to body weight ratio (values are means ⁇ SD). Data were analyzed by one-way ANOVA followed by Tukey test when a significant treatment effect was detected. A significant difference was indicated by a p ⁇ 0.05. Values with different superscripts (a, b or c) for each tissue weight to body weight parameter within a tissue group are significantly different. The average liver weight was statistically lower in the PS group compared to the Control group but was not significantly lower when comparing the BBRCI group with Control. The combination of BBRCI and PS (BBRCI+PS), however, reduced the average liver weight in a strong, statistically significant, and synergistic manner compared to liver weights in the BBRCI and PS groups. The BBRCI+PS induced effect on the average liver weight was also significantly lower than in Control. Table 7
• BBRCI control diet containing 100 mg/kg-d of BBRCI
• PS control diet containing 0.5% (w/w) PS
• BBRCI+PS control diet containing 100 mg/kg*d BBRCI and 0.5% (w/w) PS
• T-C total cholesterol
• HDL-C high-density- lipoprotein cholesterol
• TG triglyceride
• BBRCI- 1 control diet containing 100 mg/kg-d of BBRCI
• PS control diet containing 1% (w/w) PS
• BBRCI-1 +PS control diet containing 100 mg/kg-d BBRCI and 1% (w/w) PS
• BBRCI-2 control diet containing 200 mg/kg-d of BBRCI
• BBRCI-2+PS control diet containing 200 mg/kg*d BBRCI and 1% (w/w) PS
• One objective of this example was to determine the effects of each intervention on plasma cholesterol levels in a different animal model.

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