The Role of Fat Reducing Agents on Adipocyte Death and Adipose Tissue Inflammation

Design, synthesis, and biological evaluation of novel quinoline carboxylic acid based styryl/alkyne hybrid molecule as a potent anti-adipogenic and antidyslipidemic agent via activation of Wnt/β-catenin pathway

Obesity has emerged as the root cause for various metabolic disorders worldwide and hence demands for urgent attention. In the same stride, a series of quinoline carboxylic acid-based styryl/alkyne hybrids were designed, synthesized, and evaluated for their anti-adipogenic activity. Based on the structure-activity relationship, functional groups and essential substituents to potentiate the anti-adipogenic activity were identified. The potent compound (E)-6-fluoro-2-(4-(4-methylstyryl)phenyl)quinoline-4-carboxylic acid (5m) suppresses the adipogenesis with IC50 value of 0.330 μM. In vitro studies in 3T3-L1 preadipocytes cell line show that compound 5m prevents adipogenesis by stopping the cell cycle at the early phase of differentiation, which is caused by stimulation of the Wnt3a/β-catenin pathway. Further compound 5m improves the blood lipid profile and reduces adipogenic marker proteins in the epididymal white adipose tissue (eWAT) of dyslipidemic hamster at 100 mg/kg/day oral dose. Treatment with compound 5m reduces the hypertrophied adipose tissue along with the decrease in the levels of adipogenic marker proteins such as PPARγ and CEBPα. The pharmacokinetic result establishes the molecule 5m to be stable with significant oral bioavailability. Henceforth, the present study provides a unique insight into the anti-adipogenic/anti-dyslipidemic properties of a novel styryl-quinoline carboxylic acid scaffold with a scope to enhance the anti-adipogenic potency for therapeutic intervention of obesity.

Impact of Mesotherapy with Sodium Deoxycholate on Liver: Metabolic- and Sex-Specific Insights in Swiss mice

Sodium deoxycholate (DC) mesotherapy is approved for submental fat reduction but lacks evidence for body contouring safety in other body regions. Thus, we studied the systemic and hepatic metabolic effects of DC mesotherapy (50 µg/twice weekly for 4 weeks) in the inguinal white adipose tissue of female and male Swiss mice on a 20% fructose diet (drinking water) for 12 weeks. DC led to adipose tissue hemorrhage, foam cells, and fibrosis, although no body weight and adiposity loss, similar to humans. In males, glucose and hepatic metabolism, hepatic morphology, and protein expression (farnesoid X receptor and fibroblast growth factor-21) did not change by DC, even under fructose feeding. In females, although DC increased hepatic total cholesterol, most changes when detected were due to fructose (e.g., hepatic weight and lipid deposition). In conclusion, chronic DC mesotherapy proved safe for systemic and hepatic metabolism, and when adverse effects are present, they are sex-specific, impacting mostly females, especially under an unhealthy diet. Overall, care must be taken to extrapolate this data to humans since further studies are required to prove its safety in other body systems.

Deoxycholate for Subcutaneous Fat Reduction: A Review of Current Literature and Potential New Delivery Systems

BACKGROUND

Deoxycholate is approved for submental fat reduction due to its ability to lyse cells and reduce fat accumulation, but it is used off-label in aesthetic treatments for subcutaneous fat reduction for several other parts of the body.

OBJECTIVE

Review the clinical evidence supporting using sodium deoxycholate and delivery systems for aesthetic purposes.

MATERIALS AND METHODS

This systematic review explores the clinical evidence for sodium deoxycholate's efficacy and safety in fat reduction, exploring the use of delivery systems to mitigate adverse effects. A comprehensive literature search across Web of Science, Scopus, and PubMed was executed to prepare this review.

RESULTS

Clinical studies confirm that subcutaneous deoxycholate injections effectively reduce submental fat, with long-term results suggesting maintained efficacy up to 3 years post-treatment. However, adverse effects are noted, prompting research into novel delivery systems, which include sustained-release liquid crystal formulations and micro/nanoparticle-based systems, promising to reduce side effects while enhancing efficacy.

CONCLUSION

The findings underscore that deoxycholate is clinically well-established in efficacy and safety, with substantial evidence for treating submental fat. More extensive clinical studies are necessary to establish its safety and effectiveness in larger treatment areas and optimize treatment outcomes using different delivery systems.

Phase 1 study of AYP-101 (soybean phosphatidylcholine): safety, pharmacokinetics, and lipid profile effects for reducing submental fat

BACKGROUND

Excessive submental fat under the chin is a known aesthetic concern because of its negative impact on facial appearance and psychological well-being. AYP-101 is a newly developed injectable agent containing 93% soybean phosphatidylcholine (SPC) designed to reduce submental fat. We conducted a phase 1 study to evaluate the safety, pharmacokinetic (PK), and lipid profile effects of AYP-101.

METHODS

This study was a randomized, double-blind, placebo-controlled, single-dose, two-cohort trial. Participants were randomized into groups receiving 250 mg of AYP-101, 500 mg of AYP-101, or placebo at a 9:9:8 ratio across both cohorts. Safety was assessed through standard clinical evaluations. Blood samples were collected up to 144 h postdose in cohort 1 and up to 48 h postdose in cohort 2. The PK parameters were calculated via noncompartmental analysis.

RESULTS

All 26 randomized subjects completed the study. A total of 72 solicited adverse drug reactions (ADRs) were reported by 24 subjects, all of which were mild. The most common ADRs were injection site pain and bruising. There were 29 ADR cases in the 250 mg group; 26 cases in the 500 mg group; and 18 cases in the placebo group, indicating that there were no clinically significant differences in the safety profiles between the groups. All the dose groups presented similar PK profiles, with Cmax values of 12.86, 13.44, and 13.61 µg/L and AUC0-24 h values of 278.06, 274.79, and 267.63 µg*h/L, respectively. No clinically significant differences in PK or lipid profiles were observed between the postdose group and the baseline group for any of the dose groups.

CONCLUSIONS

AYP-101 appears to be a safe candidate for treating submental fat, with localized reactions and no systemic exposure at single subcutaneous doses of up to 500 mg.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05476094.

Synergistic Fat-Reducing Effect of Deoxycholic Acid and Rhein in Lipid-Based Nanoparticles with Reduced Toxicity for Obesity Treatment

Purpose

Injectable deoxycholic acid (DA) has been approved for removing excess submental fat and is off-label for local adipose tissue reduction. Conventional DA injections fail to control fat reduction and generate severe adverse effects in adjacent non-adipose tissues. We designed squarticles as lipid-based nanoparticles for DA delivery to reduce fat accumulation.

Methods

The liquid lipid phase of the squarticles was composed of squalene, which was previously reported to sequester the toxicity of overdosed drugs. Rhein, a natural anti-adipogenic compound, was incorporated into the squarticles for combined fat-lowering.

Results

The squarticles had an average diameter of 93 nm and high rhein encapsulation (96%). The nanoparticles were easily internalized into mature adipocytes and were located in the lysosomes. DA induces adipocyte death via apoptosis and necrosis; however, nanoencapsulation can decrease cell death. Compared to free DA, squarticles showed superior mitigation of cytotoxicity against non-targeted cells (skin fibroblasts). Oil Red O staining indicated that squarticles loaded with DA or rhein alone inhibited lipid droplets by 42% and 17%, respectively. DA and rhein worked together in squarticles to further suppress fat accumulation by 50%. Dual administration of DA and rhein to the nanocarriers downregulated adipokines. The intraperitoneal administration of squarticles loaded with DA and rhein significantly decreased body weight, total cholesterol, and adipokine release. Histological analysis revealed that squarticles reduced adipocyte hypertrophy in the groin and epididymis by 11% and 53%, respectively. We examined the toxicity of the combination of DA+rhein in healthy rats that received a dose three-fold higher than that used in the pharmacological assessment. The survival rate of the overdosed DA+rhein increased from 50% to 100% after nanoencapsulation. Free compounds induce ascites, liver size reduction, AST/ALT elevation (1.5-fold), and potassium imbalance in rats. Nanoencapsulation significantly reduced these adverse effects.

Conclusion

Our findings highlight the potential of squarticles for treating obesity.

The effect of quercetin on adipogenesis, lipolysis, and apoptosis in 3T3-L1 adipocytes: The role of SIRT1 pathways

Background

Lipotoxicity, caused by adipocyte triglyceride over-accumulation, contributes to obesity-related comorbidities such as hypertension, type 2 diabetes, coronary heart disease, respiratory dysfunction, and osteoarthritis. This study focuses on determining how sirtuin-1 (SIRT-1) mediates quercetin's (QCT) effect on 3T3-L1 adipocytes. Key aspects of this study include preventing adipogenesis, inducing lipolysis, and stimulating adipocyte apoptosis.

Methods

3T3-L1 adipocytes underwent treatment with varying QCT doses, lipopolysaccharide (LPS), and the SIRT-1 inhibitor EX-527, followed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide [MTT] assay for cell viability assessment. Furthermore, quantitative real-time polymerase chain reaction measured mRNA expression levels of adipogenesis markers (fatty acid synthase [FASN] and peroxisome proliferator-activated receptor gamma [PPARγ]), lipolysis markers (adipose triglyceride lipase [ATGL] and hormone-sensitive lipase [HSL]), and apoptosis markers (B-cell lymphoma2 [Bcl-2], Bcl-2 Associated -X-protein [BAX] and Caspase-3).

Results

The data showed that LPS + QCT significantly reduced cell viability in a dose- and time-dependent manner, unaffected by LPS + QCT + EX-527. Treatment with LPS + QCT did not affect FASN and PPARγ expression but significantly increased ATGL and HSL mRNA expression compared with LPS alone. Interestingly, EX-527 reversed the effects of LPS + QCT on lipogenesis and lipolysis markers completely. QCT enhanced apoptosis in a SIRT-1 independent pattern.

Conclusion

The data suggest that QCT suppresses adipogenesis while increasing lipolysis via SIRT-1. However, QCT's effects on apoptosis appear to be independent of SIRT-1. These findings provide further evidence for QCT's effects on adipocytes, particularly its interaction with SIRT-1.

Chenodeoxycholic Acid-Loaded Nanoparticles Are Sufficient to Decrease Adipocyte Size by Inducing Mitochondrial Function

Excess fat accumulation is not only associated with metabolic diseases but also negatively impacts physical appearance and emotional well-being. Bile acid, the body's natural emulsifier, is one of the few FDA-approved noninvasive therapeutic options for double chin (submental fat) reduction. Synthetic sodium deoxycholic acid (NaDCA) causes adipose cell lysis; however, its side effects include inflammation, bruising, and necrosis. Therefore, we investigated if an endogenous bile acid, chenodeoxycholic acid (CDCA), a well-known signaling molecule, can be beneficial without many of the untoward effects. We first generated CDCA-loaded nanoparticles to achieve sustained and localized delivery. Then, we injected them into the subcutaneous fat depot and monitored adipocyte size and mitochondrial function. Unlike NaDCA, CDCA did not cause cytolysis. Instead, we demonstrate that a single injection of CDCA-loaded nanoparticles into the subcutaneous fat reduced the adipocyte size by promoting fat burning and mitochondrial respiration, highlighting their potential for submental fat reduction.

Lipolytic agents for submental fat reduction: Review

RESULT

The review delves into the realm of reducing submental fat, presenting a comprehensive analysis of various lipolytic agents used in plastic surgery and dermatology. The introduction establishes the context by defining the key indicators of a youthful neck and emphasizing the significant influence of fat in the aging process, particularly in the submental area. The usage of aminophylline involves subcutaneous injections, facilitating fat breakdown by increasing cyclic adenosine monophosphate and inhibiting adenosine receptors. Hypotonic pharmacologic lipo-dissolution induces fat dissolution via injected compounds under pressure, while lipolytic lymphatic drainage employs hyaluronidase to reduce tissue viscosity, aiding fat circulation. Glycerophosphorylcholine containing choline alfoscerate claims to activate fat metabolism, whereas the utilization of phosphatidylcholine combined with deoxycholate lacks cosmetic approval due to safety concerns. Deoxycholic acid has FDA approval for submental fat reduction, yet its mechanisms remain incompletely understood. Understanding the complex anatomy and mechanisms of lipolytic agents is essential for safe and effective submental fat reduction, despite evolving practices and off-label utilization. Clinical guidelines and references support this discussion, offering insights for safer applications.

A nanoemulsion targeting adipose hypertrophy and hyperplasia shows anti-obesity efficiency in female mice

Obesity often leads to severe medical complications. However, existing FDA-approved medications to combat obesity have limited effectiveness in reducing adiposity and often cause side effects. These medications primarily act on the central nervous system or disrupt fat absorption through the gastrointestinal tract. Adipose tissue enlargement involves adipose hyperplasia and hypertrophy, both of which correlate with increased reactive oxygen species (ROS) and hyperactivated X-box binding protein 1 (XBP1) in (pre)adipocytes. In this study, we demonstrate that KT-NE, a nanoemulsion loaded with the XBP1 inhibitor KIRA6 and α-Tocopherol, simultaneously alleviates aberrant endoplasmic reticulum stress and oxidative stress in (pre)adipocytes. As a result, KT-NE significantly inhibits abnormal adipogenic differentiation, reduces lipid droplet accumulation, restricts lipid droplet transfer, impedes obesity progression, and lowers the risk of obesity-associated non-alcoholic fatty liver disease in female mice with obesity. Furthermore, diverse administration routes of KT-NE impact its in vivo biodistribution and contribute to localized and/or systemic anti-obesity effectiveness.

Interference of gut-brain-gonad axis originating from triclocarban exposure to parent zebrafish induces offspring embryonic development abnormality by up-regulation of maternal circSGOL1

Triclocarban (TCC) is a widely used antibacterial ingredient possessing acute toxicity effects; however, its chronic toxicity and underlying molecular mechanisms remain uncertain. Herein, we demonstrated that chronic TCC exposure affects the growth and development of adult zebrafish through inducing an intestinal flora disorder in the gut. The imbalance of intestinal flora caused functional barriers within the intestinal-brain-gonadal axis. This resulted in a series of anomalous nerve and motor behaviors, and reproductive toxicity as reflected in pathological damage to parental gonads and F1-larval developmental malformations. Abnormal development of F1 larvae was attributed to apoptosis induced by the up-regulation of circSGOL1. This up-regulation affected the activity and localization of the hnRNP A1 protein, which then promoted overexpression of pro-apoptotic related genes that ultimately lead to apoptosis during early embryonic development. Overall, these novel findings systematically elucidated the TCC toxicity mechanism in parent-offspring dyads, and provide important theoretical guidance for early risk warning and control of chronic TCC toxicity.

Success Rate of Buccal Fat Pad Removal in Cases of Previous Injection Lipolysis of the Cheeks: A Comparative Analysis

Background

Although buccal fat pad removal for facial slimming has a high success rate, fibrosis in patients with a history of cheek injection lipolysis may pose challenges. Therefore, we evaluated the success rate and procedure-related complications of buccal fat pad removal in patients with a history of cheek injection lipolysis.

Methods

Patients who underwent buccal fat pad removal between September 2016 and February 2020 were categorized according to a history of lipolysis (injection lipolysis group versus control group). The primary and secondary outcomes were the success rate of buccal fat pad removal and the incidence of procedure-related complications, respectively.

Results

The study sample comprised 100 patients (14 men; 86 women; mean age, 27.49 ± 6.26 years; mean follow-up duration, 7.41 months), with 61 patients (nine men; 52 women) in the injection lipolysis group and 39 patients (five men; 34 women) in the control group. The mean buccal fat pad weight did not differ significantly between the two groups. However, the success rate was 91.8% (56/61 patients) and 100% (39/39 patients) in the injection lipolysis and control groups, respectively. Complications were exclusively observed in the injection lipolysis group [8/122 cheeks (6.6%); control group, 0/78 cheeks (0%)].

Conclusions

Buccal fat pad removal effectively enhances the aesthetic appearance of the lower face. However, in patients with a history of cheek injection lipolysis, the success rate of buccal fat pad removal is lower, and the incidence of complications is significantly higher. Consequently, caution should be exercised when performing this procedure in specific patient populations.

Gut microbiota controlling radiation-induced enteritis and intestinal regeneration

Cancer remains the second leading cause of mortality, with nearly 10 million deaths worldwide in 2020. In many cases, radiotherapy is used for its anticancer effects. However, radiation causes healthy tissue toxicity as a side effect. In intra-abdominal and pelvic malignancies, the healthy bowel is inevitably included in the radiation field, causing radiation-induced enteritis and dramatically affecting the gut microbiome. This condition is associated with significant morbidity and mortality that impairs cancer patients' and survivors' quality of life. This Review provides a critical overview of the main drivers in modulating the gut microenvironment in homeostasis, disease, and injury, focusing on gut microbial metabolites and microorganisms that influence epithelial regeneration upon radiation injury.