Inhibiting Cholesterol Absorption During Lactation Programs Future Intestinal Absorption of Cholesterol in Adult Mice

Gastroenterology. 2017 Aug;153(2):382-385.e3. doi: 10.1053/j.gastro.2017.04.019. Epub 2017 Apr 22.


In nematodes, the intestine senses and integrates early life dietary cues that lead to lifelong epigenetic adaptations to a perceived nutritional environment-it is not clear whether this process occurs in mammals. We aimed to establish a mouse model of reduced dietary cholesterol availability from maternal milk and investigate the consequences of decreased milk cholesterol availability, early in life, on the metabolism of cholesterol in adult mice. We blocked intestinal absorption of cholesterol in milk fed to newborn mice by supplementing the food of dams (for 3 weeks between birth and weaning) with ezetimibe, which is secreted into milk. Ezetimibe interacts with the intestinal cholesterol absorption transporter NPC1l1 to block cholesterol uptake into enterocytes. Characterization of these offspring at 24 weeks of age showed a 27% decrease in cholesterol absorption (P < .001) and reduced levels of Npc1l1 messenger RNA and protein, but not other cholesterol transporters, in the proximal small intestine. We observed increased histone H3K9me3 methylation at positions -423 to -607 of the proximal Npc1l1 promoter in small intestine tissues from 24-week-old offspring fed ezetimibe during lactation, compared with controls. These findings show that the early postnatal mammalian intestine functions as an environmental sensor of nutritional conditions, responding to conditions such as low cholesterol levels by epigenetic modifications of genes. Further studies are needed to determine how decreased sterol absorption for a defined period might activate epigenetic regulators; the findings of our study might have implications for human infant nutrition and understanding and preventing cardiometabolic disease.

Keywords: Breast Milk; Development; Lipoproteins; Neonate.

MeSH terms

  • Adaptation, Physiological*
  • Animals
  • Anticholesteremic Agents / pharmacology
  • Biological Availability
  • Biological Transport
  • Cholesterol / metabolism*
  • Cholesterol, Dietary / metabolism*
  • Enterocytes / metabolism
  • Epigenesis, Genetic
  • Ezetimibe / pharmacology
  • Female
  • Histones / metabolism
  • Intestinal Absorption / drug effects
  • Intestinal Absorption / physiology*
  • Intestinal Mucosa / metabolism*
  • Intestine, Small / metabolism
  • Intestines / cytology
  • Lactation / physiology
  • Membrane Transport Proteins / drug effects
  • Membrane Transport Proteins / genetics
  • Mice
  • Milk / chemistry
  • Models, Animal
  • RNA, Messenger / metabolism


  • Anticholesteremic Agents
  • Cholesterol, Dietary
  • Histones
  • Membrane Transport Proteins
  • Npc1l1 protein, mouse
  • RNA, Messenger
  • Cholesterol
  • Ezetimibe