Commensal Bacteria at the Crossroad Between Cholesterol Homeostasis and Chronic Inflammation. in Atherosclerosis

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Supplementary Information Commensal Bacteria at the Crossroad Between Cholesterol Homeostasis and Chronic Inflammation in Atherosclerosis Kazuyuki Kasahara 1,, Takeshi Tanoue 3, Tomoya Yamashita 1,*, Keiko Yodoi 1, Takuya Matsumoto 1, Takuo Emoto 1, Taiji Mizoguchi 1, Tomohiro Hayashi 1, Naoki Kitano 1, Naoto Sasaki 1, Koji Atarashi 3, Kenya Honda 3,, Ken-ichi Hirata 1 1 Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan Department of Bacteriology, University of Wisconsin-Madison, Madison, USA 3 RIKEN Center for Integrative Medical Sciences (IMS), Yokohama, Japan AMED-CREST, Japan Agency for Medical Research and Development, Tokyo, Japan 1

Relative mrna expression 10 8 0 Apical and internal transporters Mrp Basolateral transporters Ibat Ibabp Mrp3 Osta Ostb Conv GF Supplementary Figure 1. Expression of genes involved in bile acid transporters in the distal ileum from Conv (n=) and GF (n=5) ApoE -/- mice. Mean values ± SEM are plotted; *P<0.05, P<0.01 versus Conv, Mann-Whitney U test. Conv, conventionally raised; GF, germ-free.

A GF Conv B 1 1 IL- TNF-α 3 3 5 5 Pixel density (arbitary units) 150 100 50 0 C5a sicam-1 IL-1ra CXCL-1 CXCL-1 Conv GF TIMP-1 800 pg/ml p=0.0 pg/ml 00 00 00 0 0 Supplementary Figure. (A-B) Cytokine profile in plasma of Conv and GF ApoE -/- mice. (A) The cytokine content in unstimulated plasma from Conv (n=) and GF (n=) ApoE -/- mice was analyzed using the cytokine array kit. Spot intensities were normalized to background and positive controls set to 100% intensity. Presented numbers on membranes mark targets as follows: 1; C5a, ; sicam-1, 3; IL-1ra, ; CXCL-1, 5; CXCL-1, ; TIMP-1. (B) Plasma IL- and TNF-α levels were examined by ELISA. n=5 per group. Mean values ± SEM are plotted; *P<0.05, P<0.01 versus Conv, Mann-Whitney U test. C5a, Complement component 5a; sicam-1, soluble Intracellular Adhesion Molecule 1; IL-1ra, Interleukin 1 receptor antagonist; CXCL, C-X-C motif ligand; TIMP-1, Tissue Inhibitor of Metalloproteinase 1. 3

Liver Cholesterol synthesis AcetylCoA ACC1 HMGCS1 HMGCR Cholesterol CDCA CYPA1 CYP8B1 CA FGFR Malonyl-CoA FAS1 SCD1 Fatty Acids TβMCA TCA Cholesterol catabolism Bile acid synthesis Triglyceride Small intestine Absence of microbiota obstructed the modification of primary BAs and the production of secondary BAs. TβMCA TCA FXR FGF15 Supplementary Figure 3. Proposed model for the role of gut microbiota in the regulation of lipid metabolism. Absence of gut microbiota obstructed deconjugation and production of secondary bile acids, which might lead to the accumulation of TCA and TβMCA in the distal ileum. Altered bile acid composition, especially the increase of conjugated bile acids in the ileum, was associated with increased activity of entero-hepatic FGF15-FGFR axis and suppressed hepatic bile acid synthesis. The

accumulation of liver cholesterol in GF ApoE -/- mice could be explained by decreased conversion from cholesterol to bile acids in the liver, whereas the cholesterol synthesis in the liver was reduced. Lack of microbiota could result in the reduction of hepatic lipogenesis and plasma TG concentration. Red columns mean an increase or an up-regulation, and blue columns mean a reduction or a down-regulation in GF ApoE -/- mice compared to Conv mice. CA, cholic acid; CDCA, chenodeoxycholic acid; TCA, taurine-conjugated cholic acid; TβMCA, taurine-conjugated beta muricholic acid. 5

Supplementary Table 1. The composition of the chow diet used in the study (CMF; Oriental Yeast Co.) Component Composition (g/kg) Water 79 Protein 78 Lipids 83 Minerals Dietary fibre 31 Nitrogen free extract 5 Calcium 118 Phophorus 8.3 Iron 0. Vitamin E 0.3 Vitamin B 1 0.0 Vitamin B 0.01 Niacin 0.13 Choline.8 Folate 0.00

Supplementary Table. Primers for RT-PCR Primer Name Gapdh-F Gapdh-R Cyp7a1-F Cyp7a1-R Cyp8b1-F Cyp8b1-R Cyp7b1-F Cyp7b1-R Cyp7a1-F Cyp7a1-R Mrp-F Mrp-R Mrp3-F Mrp3-R Hmgcs1-F Hmgcs1-R Hmgcr-F Hmgcr-R Npc1l1-F Npc1l1-R Abcg5-F Abcg5-R Sequence TGTGTCCGTCGTGGATCTGA TTGCTGTTGAAGTCGCAGGAG AGCAACTAAACAACCTGCCAGTACTA GTCCGGATATTCAAGGATGCA GGCTGGCTTCCTGAGCTTATT ACTTCCTGAACAGCTCATCGG TAGCCCTCTTTCCTCCACTCATA GAACCGATCGAACCTAAATTCCT GCCTCACCTATGGGATCTTCA TCAAAGCCTGACGCAGATG GGATGGTGACTGTGGGCTGAT GGCTGTTCTCCCTTCTCATGG TCCCACTTTTCGGAGACAGTAAC ACTGAGGACCTTGAAGTCTTGGA GTGGCACCGGATGTCTTTG ACTCTGACCAGATACCACGTT AGCTTGCCCGAATTGTATGTG TCTGTTGTGAACCATGTGACTTC GCTTCTTCCGCAAGATATACACTCCC GAGGATGCAGCAATAGCCACATAAGAC TCTCCGCGTCCAGAACAAC CATTGAGCATGCCGGTGTAT 7

Abcg8-F Abcg8-R Acc1-F Acc1-R Fas1-F Fas1-R Scd1-F Scd1-R Srebf1-F Srebf1-R Fgfr-F Fgfr-R Ldlr-F Ldlr-R Lxr-F Lxr-R Srebf-F Srebf-R Abca1-F Abca1-R Abcg1-F Abcg1-R Fxr-F Fxr-R GACAGCTTCACAGCCCACAA GCCTGAAGATGTCAGAGCGA GCCTCTTCCTGACAAACGAG TGACTGCCGAAACATCTCTG TGGTGAATTGTCTCCGAAAAGA CACGTTCATCACGAGGTCATG GCGATACACTCTGGTGCTCA CCCAGGGAAACCAGGATATT TAGAGCATATCCCCCAGGTG GGTACGGGCCACAAGAAGTA GCCTCCGACAAGGATTTGGCA GAGTGCAGACACCCAGCAGGT CGCGGATCTGATGCGTCGCT CGGCCCTGGCAGTTCTGTGG GCGTCCATTCAGAGCAAGTGT TCACTCGTGGACATCCCAGAT GTGGAGCAGTCTCAACGTCA TGGTAGGTCTCACCCAGGAG GGTTTGGAGATGGTTATACAATAGTTGT CCCGGAAACGCAAGTCC TCACCCAGTTCTGCATCCTCTT GCAGATGTGTCAGGACCGAGT TGTGAGGGCTGCAAAGGTTT ACATCCCCATCTCTCTGCAC 8

Shp-F Shp-R Fgf15-F Fgf15-R Ibat-F Ibat-R Ibabp-F Ibabp-R Osta-F Osta-R Ostb-F Ostb-R IL-1β-F IL-1β-R IL--F IL--R TNF-α-F TNF-α-R CGATCCTCTTCAACCCAGATG AGGGCTCCAAGACTTCACACA GAGGACCAAAACGAACGAAATT ACGTCCTTGATGGCAATCG ACCACTTGCTCCACACTGCTT CGTTCCTGAGTCAACCCACAT CAGGAGACGTGATTGAAAGGG GCCCCCAGAGTAAGACTGGG TGTTCCAGGTGCTTGTCATCC CCACTGTTAGCCAAGATGGAGAA GATGCGGCTCCTTGGAATTA GGAGGAACATGCTTGTCATGAC TGTAATGAAAGACGGCACACC TCTTCTTTGGGTATTGCTTGG CCACTTCACAAGTCGGAGGCTTA GCAAGTGCATCATCGTTGTTCATAC ATGAGCACAGAAAGCATGATC TACAGGCTTGTCACTCGAATT 9