1
|
Firkins SA, Chittajallu V, Flora B, Yoo H, Simons-Linares R. Utilization of Anti-obesity Medications After Bariatric Surgery: Analysis of a Large National Database. Obes Surg 2024; 34:1415-1424. [PMID: 38512645 DOI: 10.1007/s11695-024-07181-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 03/14/2024] [Accepted: 03/14/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE A significant proportion of patients experience insufficient weight loss or weight regain after bariatric surgery. There is a paucity of literature describing anti-obesity medication (AOM) use following bariatric surgery. We sought to identify prevalence and trends of AOM use following bariatric surgery. MATERIALS AND METHODS We utilized the IBM Explorys® database to identify all adults with prior bariatric surgery (Roux-en-Y gastric bypass or sleeve gastrectomy). Those prescribed AOMs (semaglutide, liraglutide, topiramate, phentermine/topiramate, naltrexone/bupropion, orlistat) within 5 years of surgery were further identified. Data was analyzed to characterize AOM utilization among different age, demographic, and comorbid populations. RESULTS A total of 59,160 adults with prior bariatric surgery were included. Among AOMs studies, prevalence of use was highest for topiramate (8%), followed by liraglutide (2.9%), phentermine/topiramate (1.03%), naltrexone/bupropion (0.95%) semaglutide (0.52%), and orlistat (0.17%). Age distribution varied, with the highest utilization among those age 35-39 years for topiramate, 40-44 years for phentermine/topiramate and naltrexone/bupropion, 45-49 years for semaglutide, and 65-69 years for liraglutide and orlistat. African American race was associated with higher utilization across all AOMs. Among comorbidities, hypertension, hyperlipidemia, and diabetes mellitus were most associated with AOM use. CONCLUSION Despite a relatively high incidence of weight regain, AOMs are underutilized following bariatric surgery. It is imperative that barriers to their use be addressed and that AOMs be considered earlier and more frequently in patients with insufficient weight loss or weight regain after bariatric surgery.
Collapse
Affiliation(s)
- Stephen A Firkins
- Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, 44195, USA
| | - Vibhu Chittajallu
- Digestive Health Institute, University Hospitals, Cleveland, OH, USA
| | - Bailey Flora
- Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, 44195, USA
| | - Heesoo Yoo
- Community Care Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Roberto Simons-Linares
- Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, 44195, USA.
| |
Collapse
|
2
|
Hassan YR, El-Shiekh RA, El Hefnawy HM, Mohamed OG, Abu-Elfotuh K, Hamdan AM, Darwish A, Gowifel AMH, Tripathi A, Michael CG. A mechanistic exploration of the metabolome of African mango seeds and its potential to alleviate cognitive impairment induced by high-fat/high-carbohydrate diets: Involvement of PI3K/AKT/GSK-3β/CREB, PERK/CHOP/Bcl-2, and AMPK/SIRT-1/mTOR Axes. J Ethnopharmacol 2024; 324:117747. [PMID: 38218500 DOI: 10.1016/j.jep.2024.117747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 12/15/2023] [Accepted: 01/09/2024] [Indexed: 01/15/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Irvingia gabonensis (Aubry-Lecomte ex O'Rorke) Baill., also known as "African mango" or "bush mango", belonging to family Irvingiaceae, has been mostly used as food and traditional medicine for weight loss and to enhance the health. AIM OF THE STUDY The overconsumption of high-fat and high-carbohydrate (HFHC) food induces oxidative stress, leading to neurological and cognitive dysfunction. Consequently, there is an immediate need for effective treatment. Hence, this study explored the efficacy of orlistat, metformin, and I. gabonensis seeds' total aqueous extract (IG SAE) in addressing HFHC-induced cognitive impairment by mitigating oxidative stress and their underlying mechanistic pathways. MATERIALS AND METHODS Initially, the secondary metabolite profile of IG SAE is determined using high-performance liquid chromatography coupled with a mass detector (UHPLC/MS). The in vivo study involves two phases: an established model phase with control (10 rats on a standard diet) and HFHC diet group (50 rats) for 3 months. In the study phase, HFHC is divided into 5 groups. The first subgroup receives HFHC diet only, while the remaining groups each receive HFHC diet with either Orlistat, metformin, or IG SAE at doses of 100 mg/kg and 200 mg/kg, respectively, for 28 days. RESULTS More than 150 phytoconstituents were characterized for the first holistic approach onto IG metabolome. Characterization of IG SAE revealed that tannins dominate metabolites in the plant. Total phenolics and flavonoids were estimated to standardize our extract (77.12 ± 7.09 μg Gallic acid equivalent/mg extract and 8.039 ± 0.53 μg Rutin equivalent/mg extract, respectively). Orlistat, metformin, and IG SAE successfully reduced the body weight, blood glucose level, lipid profile, oxidative stress and neurotransmitters levels leading to improved behavioral functions as well as histological alternation. Also, IG SAE halted inflammation, apoptosis, and endoplasmic reticulum stress, together with promoting autophagy, via modulation of PI3K/AKT/GSK-3β/CREB, PERK/CHOP/Bcl-2 and AMPK/SIRT-1/m-TOR pathways. CONCLUSION Metformin, orlistat, and IG SAE offer a promising multi-target therapy to mitigate HFHC diet-induced oxidative stress, addressing cognitive function. This involves diverse molecular mechanisms, particularly the modulation of inflammation, ER stress, and both PI3K/AKT/GSK-3β/CREB and AMPK/SIRT-1/m-TOR pathways. Furthermore, the higher dose of IG SAE demonstrated effects comparable to orlistat and metformin across most studied parameters.
Collapse
Affiliation(s)
| | - Riham A El-Shiekh
- Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Cairo, Egypt.
| | - Hala M El Hefnawy
- Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Osama G Mohamed
- Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Cairo, Egypt; Natural Products Discovery Core, Life Sciences Institute, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Karema Abu-Elfotuh
- Clinical Pharmacy Department, Faculty of Pharmacy (Girls), Al-Azhar University, Cairo, Egypt; Al-Ayen Iraqi University, Thi-Qar, 64001, Iraq
| | - Ahmed M Hamdan
- Pharmacy Practice Department, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia
| | - Alshaymaa Darwish
- Biochemistry Department, Faculty of Pharmacy, Sohag University, Sohag, Egypt.
| | - Ayah M H Gowifel
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Modern University for Technology and Information (MTI), Cairo, 11571, Egypt.
| | - Ashootosh Tripathi
- Natural Products Discovery Core, Life Sciences Institute, University of Michigan, Ann Arbor, MI, 48109, USA; Department of Medicinal Chemistry, College of Pharmacy, University of Michigan, Ann Arbor, MI, 48109, USA
| | | |
Collapse
|
3
|
Li Y, Hung V, Ho K, Kavalieratos D, Warda N, Zimmermann C, Quinn KL. The Validity of Patient-Reported Outcome Measures of Quality of Life in Palliative Care: A Systematic Review. J Palliat Med 2024; 27:545-562. [PMID: 37971747 DOI: 10.1089/jpm.2023.0294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Importance: A recent systematic review and meta-analysis found that palliative care was not associated with improvement in quality of life (QOL) in terminal noncancer illness. Among potential reasons for a null effect, it is unclear if patient-reported outcome measures (PROMs) measuring QOL were derived or validated among populations with advanced life-limiting illness (ALLI). Objective: To systematically review the derivation and validation of QOL PROMs from a recent meta-analysis of randomized controlled trials (RCT) of palliative care interventions in people with terminal noncancer illness. Evidence Review: EMBASE, MEDLINE, and PsycINFO were searched from inception to January 8, 2023 for primary validation studies of QOL PROMs in populations with ALLI, defined as adults with a progressive terminal condition and an estimated median survival of less than or equal to one year. The primary outcome was the proportion of PROMs that were derived or validated in ≥1 ALLI population. Findings: Twenty-one unique studies of derivation (n = 13) and validation (n = 11, 3 studies evaluated both) provided data on 9657 participants (mean age 63 years, 50% female) across 15 unique QOL PROMs and subscales. Among studies of validation, 9 were in people with cancer (n = 2289, n = 5 PROMs), 1 in neurodegenerative disease (n = 23, n = 1 PROM), and 1 with mixed diseases (n = 248, n = 1 PROM). Across 15 QOL PROMs and subscales, 47% (n = 7) were derived or validated in an ALLI population. The majority of these seven PROMs were exclusively derived or validated among people with cancer (57%, n = 4). QOL PROMs such as Quality of Life at End of Life, EuroQoL-5 Dimension 5-level, and 36-item Short Form Survey demonstrated validity in more than one terminal noncancer illness. Conclusions: Most QOL PROMs that measured the effect of palliative care on QOL in RCTs were neither derived nor validated in an ALLI population. These findings raise questions about the inferences that palliative care does not improve QOL among people with terminal noncancer illness.
Collapse
Affiliation(s)
- Yifan Li
- Division of Palliative Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vivian Hung
- Department of Medicine, Temmy Latner Centre for Palliative Care, Sinai Health System, Toronto, Ontario, Canada
| | - Kevin Ho
- Department of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Dio Kavalieratos
- Division of Palliative Medicine, Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia, USA
| | - Nahrain Warda
- Department of Medicine, Sinai Health System and University Health Network, Toronto, Ontario, Canada
| | - Camilla Zimmermann
- Division of Palliative Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Supportive Care, University Health Network, Toronto, Ontario, Canada
| | - Kieran L Quinn
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, Temmy Latner Centre for Palliative Care, Sinai Health System, Toronto, Ontario, Canada
- Department of Medicine, Sinai Health System and University Health Network, Toronto, Ontario, Canada
- ICES, Toronto and Ottawa, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
4
|
Jandacek R, Liu M, Tso P. Interactions of Body Weight Loss with Lipophilic Toxin Storage: Commentary. J Nutr 2024; 154:801-803. [PMID: 38244860 PMCID: PMC10942849 DOI: 10.1016/j.tjnut.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/29/2023] [Accepted: 01/12/2024] [Indexed: 01/22/2024] Open
Abstract
A high incidence of obesity and surplus body fat has been observed in wealthy countries for many decades. It is generally recognized that these excesses contribute to serious disease states, including type 2 diabetes and cardiovascular diseases. On the other hand, the adipose tissue stores relatively safely many environmental lipophilic toxins. However, rapid weight loss mobilizes these toxins to the blood to be exposed to vital organs, such as the brain, lungs, and others. With the introduction of potent diabetic drugs causing rapid weight reduction, the question of mobilization of lipophilic toxins to the blood should be considered. In this commentary, we raised this mobilization of adipose tissue toxins to the readers. Also, we discussed how these toxins may be eliminated from the body through the use of nondigestible fat, such as olestra or lipase inhibitors, such as Xenical.
Collapse
Affiliation(s)
- Ronald Jandacek
- Department of Pathology and Laboratory Medicine, University of Cincinnati Medical Center Reading Campus, Cincinnati, OH, United States
| | - Min Liu
- Department of Pathology and Laboratory Medicine, University of Cincinnati Medical Center Reading Campus, Cincinnati, OH, United States
| | - Patrick Tso
- Department of Pathology and Laboratory Medicine, University of Cincinnati Medical Center Reading Campus, Cincinnati, OH, United States.
| |
Collapse
|
5
|
Dehghani A, Binder F, Zorn M, Feigler A, Fischer KI, Felix MN, Happersberger P, Reisinger B. Investigating pH Effects on Enzymes Catalyzing Polysorbate Degradation by Activity-Based Protein Profiling. J Pharm Sci 2024; 113:744-753. [PMID: 37758159 DOI: 10.1016/j.xphs.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/15/2023] [Accepted: 09/15/2023] [Indexed: 10/03/2023]
Abstract
Host cell proteins (HCPs) are process-related impurities that can negatively impact the quality of biotherapeutics. Some HCPs possess enzymatic activity and can affect the active pharmaceutical ingredient (API) or excipients such as polysorbates (PS). PSs are a class of non-ionic surfactants commonly used as excipients in biotherapeutics to enhance the stability of APIs. The enzyme activity of certain HCPs can result in the degradation of PSs, leading to particle formation and decreased shelf life of biotherapeutics. Identifying and characterizing these HCPs is therefore crucial. This study employed the Activity-Based Protein Profiling (ABPP) technique to investigate the effect of pH on the activity of HCPs that have the potential to degrade polysorbates. Two probes were utilized: the commercially available fluorophosphonate (FP)-Desthiobiotin probe and a probe based on the antiobesity drug, Orlistat. Over 50 HCPs were identified, showing a strong dependence on pH-milieu regarding their enzyme activity. These findings underscore the importance of accounting for pH variations in the ABPP method and other investigations of HCP activity. Notably, the Orlistat-based probe (OBP) enabled us to investigate the enzymatic activity of a wider range of HCPs, emphasizing the advantage of using more than one probe for ABPP. Finally, this study led to the discovery of previously unreported active enzymes, including three HCPs from the carboxylesterase enzyme family.
Collapse
Affiliation(s)
- Alireza Dehghani
- Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Strasse 65, Biberach D-88397, Germany
| | - Florian Binder
- Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Strasse 65, Biberach D-88397, Germany
| | - Michael Zorn
- Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Strasse 65, Biberach D-88397, Germany
| | - Andreas Feigler
- Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Strasse 65, Biberach D-88397, Germany
| | - Kathrin Inge Fischer
- Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Strasse 65, Biberach D-88397, Germany
| | - Marius Nicolaus Felix
- Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Strasse 65, Biberach D-88397, Germany
| | - Peter Happersberger
- Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Strasse 65, Biberach D-88397, Germany
| | - Bernd Reisinger
- Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Strasse 65, Biberach D-88397, Germany.
| |
Collapse
|
6
|
Dąbrowski G, Czaplicki S, Szustak M, Korkus E, Gendaszewska-Darmach E, Konopka I. The impact of selected xanthophylls on oil hydrolysis by pancreatic lipase: in silico and in vitro studies. Sci Rep 2024; 14:2731. [PMID: 38302772 PMCID: PMC10834431 DOI: 10.1038/s41598-024-53312-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/30/2024] [Indexed: 02/03/2024] Open
Abstract
Lipase inhibition is one of the directions to control obesity. In vitro assays have confirmed the inhibitory effect of selected xanthophylls, including astaxanthin, fucoxanthinol, fucoxanthin, and neoxanthin. Similarly, an in-silico study also demonstrated the successful inhibition of pancreatic lipase by astaxanthin. Unfortunately, the efficacy of these protocols in the emulsion state typical of lipid digestion remains untested. To address this issue, the current study employed the pH-stat test, which mimics lipid digestion in the gastrointestinal tract, to evaluate native and prepared sea buckthorn and rapeseed oils with varying xanthophyll contents from 0 to 1400 mg/kg oil. Furthermore, a molecular docking of zeaxanthin and violaxanthin (commonly found in plant-based foods), astaxanthin (widely distributed in foods of marine origin) and orlistat (approved as a drug) was performed. The in-silico studies revealed comparable inhibitory potential of all tested xanthophylls (variation from - 8.0 to - 9.3 kcal/mol), surpassing that of orlistat (- 6.5 kcal/mol). Nonetheless, when tested in an emulsified state, the results of pH-stat digestion failed to establish the inhibitory effect of xanthophylls in the digested oils. In fact, lipolysis of native xanthophyll-rich sea buckthorn oil was approximately 22% higher than that of the xanthophyll-low preparation. The key insight derived from this study is that the amphiphilic properties of xanthophylls during the digestion of xanthophyll-rich lipids/meals facilitate emulsion formation, which leads to enhanced fat lipolysis.
Collapse
Affiliation(s)
- Grzegorz Dąbrowski
- Faculty of Food Sciences, Chair of Plant Food Chemistry and Processing, University of Warmia and Mazury in Olsztyn, Pl. Cieszyński 1, 10-726, Olsztyn, Poland.
| | - Sylwester Czaplicki
- Faculty of Food Sciences, Chair of Plant Food Chemistry and Processing, University of Warmia and Mazury in Olsztyn, Pl. Cieszyński 1, 10-726, Olsztyn, Poland
| | - Marcin Szustak
- Faculty of Biotechnology and Food Sciences, Institute of Molecular and Industrial Biotechnology, Lodz University of Technology, Stefanowskiego 2/22, 90-537, Lodz, Poland
| | - Eliza Korkus
- Faculty of Biotechnology and Food Sciences, Institute of Molecular and Industrial Biotechnology, Lodz University of Technology, Stefanowskiego 2/22, 90-537, Lodz, Poland
| | - Edyta Gendaszewska-Darmach
- Faculty of Biotechnology and Food Sciences, Institute of Molecular and Industrial Biotechnology, Lodz University of Technology, Stefanowskiego 2/22, 90-537, Lodz, Poland
| | - Iwona Konopka
- Faculty of Food Sciences, Chair of Plant Food Chemistry and Processing, University of Warmia and Mazury in Olsztyn, Pl. Cieszyński 1, 10-726, Olsztyn, Poland
| |
Collapse
|
7
|
Paulus F, Bauer-Brandl A, Stappaerts J, Holm R. Digestion is a critical element for absorption of cinnarizine from supersaturated lipid-based type I formulations. Eur J Pharm Sci 2024; 192:106634. [PMID: 37951315 DOI: 10.1016/j.ejps.2023.106634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 10/17/2023] [Accepted: 11/08/2023] [Indexed: 11/13/2023]
Abstract
Enabling formulations, such as lipid-based formulations (LBFs), are means to deliver challenging-to-formulate, poorly soluble drugs. LBFs may be composed of lipids, surfactants and/or cosolvents and can be classified depending on the proportions of the components and the hydrophilicity of the surfactant according to the Lipid Formulations Classification System, ranging from type I (very lipophilic) to type IV (hydrophilic). In cases where drug solubility in LBFs does not suffice, e.g. for preclinical toxicity studies, supersaturated LBFs can be used in order to increase the drug load. However, the effect of digestion on drug absorption from supersaturated type I formulations (consisting exclusively of lipids) still remains relatively unexplored and unclear. In the present study, the impact of lipid digestion on absorption of cinnarizine-loaded supersaturated lipid-based formulations of type I was investigated in rats by pre-dosing of the lipase inhibitor orlistat. The lipid chain length and the drug dose were varied by testing medium-chain triglycerides (MCT) and long-chain triglycerides (LCT), both supersaturated and non-supersaturated. Due to the physical instability of supersaturated formulations of cinnarizine, i.e. a potential of precipitation of cinnarizine, the impact of the addition of the amphiphilic polymer Soluplus®, as a potential precipitation inhibitor, was also investigated. The supersaturated systems resulted in a 2.3 - 3.3-fold higher Area Under the Curve (AUC0-24 h, not dose-normalized) and 1.4 - 2.2-fold higher maximum plasma concentration (Cmax, not dose-normalized) than non-supersaturated formulations (statistically significant with p = 0.05), whereas the addition of Soluplus® did not reveal any benefit. Results indicated that lipase inhibition affected the in vivo performance of LBFs: Co-administration of the lipase inhibitor significantly reduced Cmax and AUC0-24 h (both to 33-39 %, not dose-normalized) for the LCT formulations and, though not significant, a similar trend was observed for the AUC0-24 h of the MCT formulations (to 53-87 %), suggesting a higher dependency on lipolysis for LCT. Also, tmax tended to decrease to 20-60 % when compared to the animals not dosed with orlistat but lacking statistical significance. Without lipase inhibition, the LCT in general lead to better absorption of cinnarizine as compared to MCT, with 1.2-1.7-fold higher AUC0-24 h and 1.4-1.8-fold higher Cmax, but without showing statistical significance. Overall, the study revealed that lipolysis plays a major role in drug absorption from supersaturated lipid-based formulations type I.
Collapse
Affiliation(s)
- Felix Paulus
- Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium; Department of Physics, Chemistry and Pharmacy, University of Southern Denmark, Campusvej 55, Odense 5230, Denmark
| | - Annette Bauer-Brandl
- Department of Physics, Chemistry and Pharmacy, University of Southern Denmark, Campusvej 55, Odense 5230, Denmark
| | - Jef Stappaerts
- Janssen Pharmaceutica NV, Turnhoutseweg 30, Beerse 2340, Belgium
| | - René Holm
- Department of Physics, Chemistry and Pharmacy, University of Southern Denmark, Campusvej 55, Odense 5230, Denmark.
| |
Collapse
|
8
|
Leventhal-Perek S, Shani M, Schonmann Y. Effectiveness and persistence of anti-obesity medications (liraglutide 3 mg, lorcaserin, and orlistat) in a real-world primary care setting. Fam Pract 2023; 40:629-637. [PMID: 36477550 DOI: 10.1093/fampra/cmac141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Obesity is a chronic disease with rising prevalence. Guidelines suggest medications for obesity management if lifestyle interventions do not lead to substantial weight loss. Randomized control trials have shown the efficacy of anti-obesity medications in inducing weight loss, but real-world data are lacking. Therefore, our study aims to evaluate anti-obesity medications' effectiveness in reducing weight and improving cardiometabolic parameters and to assess their persistence in a real-world setting. METHODS A historical cohort study using routinely collected data from Clalit Health Services (CHS). We retrieved data on all CHS members aged ≥20 years who initiated anti-obesity medication (orlistat, liraglutide 3 mg, and lorcaserin) between 2018 and 2020. We assessed average weight loss and the percentage of patients that had lost ≥5% and ≥10% of their body weight at 3, 6, and 9 months and compared the effectiveness of these 3 medications. RESULTS We included 5,306 CHS members in our study; most (77.8%) were female, aged 40-59 years (52.4%). Treatment with liraglutide 3 mg and lorcaserin was associated with subsequent weight reduction. The average weight loss at 6 months was 5.6 kg (4.95-6.25, 95% confidence interval [CI]) with liraglutide 3 mg and 1.7 kg (1.2-2.2, 95% CI) with lorcaserin. There was no evidence that treatment with orlistat was associated with subsequent weight loss (-0.18 kg [-0.8 to 0.4, 95% CI]). At 6 months, 38% of the patients with orlistat, 43% with lorcaserin, and 51% with liraglutide 3 mg persisted with their treatments (P < 0.001). CONCLUSION Liraglutide 3 mg was the primary medication associated with clinically significant weight loss and had the highest persistence rate in our real-world study.
Collapse
Affiliation(s)
- Sharon Leventhal-Perek
- Department of Family Medicine, Tel Aviv District, Clalit Health Services, Tel Aviv, Israel
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Shani
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Family Medicine, Central District, Clalit Health Service, Rehovot, Israel
| | - Yochai Schonmann
- Department of Family Medicine, Tel Aviv District, Clalit Health Services, Tel Aviv, Israel
- Department of Quality Measurements and Research, Clalit Health Services, Tel Aviv, Israel
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| |
Collapse
|
9
|
Cheng H, Sun Y, Yu X, Zhou D, Ding J, Wang S, Ma F. FASN promotes gallbladder cancer progression and reduces cancer cell sensitivity to gemcitabine through PI3K/AKT signaling. Drug Discov Ther 2023; 17:328-339. [PMID: 37743521 DOI: 10.5582/ddt.2023.01036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Lipid metabolism plays an important role in the growth and development of tumors. However, the role of lipid metabolism in gallbladder cancer (GBC) has not been clearly clarified. Here, we demonstrated that fatty acid synthase (FASN), a key enzyme in de novo fatty acid biosynthesis, had upregulated expression in GBC samples both at protein and mRNA levels. Analysis of clinical data indicated the association between elevated FASN expression and poorer histology grades. Furthermore, FASN activity impairment through FASN knockdown or treatment with orlistat resulted in the inhibition of cell proliferation and migration, as well as increased sensitivity to gemcitabine. Both FASN knockdown and orlistat treatment induced cell apoptosis. Mechanistically, impairment of FASN activity suppressed the activation of the PI3K/AKT signaling pathway, which led to increased cell apoptosis and sensitivity to gemcitabine. These findings were also validated through nude mouse xenograft models, thus highlighting the potential of targeting FASN as a clinical treatment strategy. Collectively, the present study underscores the crucial role of FASN in the progression of gallbladder cancer via the PI3K/AKT pathway.
Collapse
Affiliation(s)
- Haihong Cheng
- Department of Oncology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuxin Sun
- Department of Oncology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaopeng Yu
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Di Zhou
- Department of Hepatobiliary Surgery, Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Jun Ding
- Department of Biliary and Pancreatic Surgery, Shanghai Shuguang Hospital Affiliated with the Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shouhua Wang
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Ma
- Department of Oncology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
10
|
Stasevich NY, Yagovkina NV, Abdullin II, Sarkisyan AD, Kuznetsova MA, Saprykina AI. [ANALYZING THE IMPACT OF HEALTH-SAVING TECHNOLOGIES ON THE LIFE QUALITY OF THE ELDERLY URBAN POPULATION WITH MULTIMORBIDITY (EXEMPLIFIED BY PATIENTS WITH ACUTE LOWER LIMB ISCHEMIA)]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2023; 31:1219-1224. [PMID: 38069889 DOI: 10.32687/0869-866x-2023-31-s2-1219-1224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/05/2023] [Indexed: 12/18/2023]
Abstract
As the population ages, the prevalence of chronic diseases increases and, accordingly, the probability of simultaneous occurrence of many chronic diseases among the elderly population increases, which affects the dynamics and prognoses of the underlying disease. Prevention of complications of concomitant semantics for the underlying disease seems to be a complex medical problem, the solution to which is aimed at improving the quality of life of patients. Based on the data obtained, the effect of polymorbidity on the course of acute lower limb ischemia (ALLI) was studied in the elderly urban population. The purpose of the study is to analyze the effect of multimorbidity on the life quality of the elderly urban population, exemplified by patients with acute lower limb ischemia. MATERIAL AND METHODS 91 patients with ALLI (n=91) were examined, the mean age equaled to 70±1.2 years, with thromboembolism against the background of arterial occlusion. RESULTS The age of patients is one of the highest risks and must be taken into account when deciding on surgical intervention and further therapy for ALLI. RESEARCH LIMITATIONS The study had no administrative restrictions. CONCLUSION It was found that the value of the comorbidity index in patients with acute lower limb ischemia is associated with the severity of the underlying disease and characterizes the predicted decrease in the probability of a 10-year survival and the risk of death.
Collapse
Affiliation(s)
- N Yu Stasevich
- N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia,
- Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department, 115088, Moscow, Russia
| | | | - I I Abdullin
- N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia
| | - A D Sarkisyan
- N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia
| | - M A Kuznetsova
- N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia
| | - A I Saprykina
- N. A. Semashko National Research Institute of Public Health, 105064, Moscow, Russia
| |
Collapse
|
11
|
Boger BS, Queiroz NL, Noriega PEP, Canuto MC, Stumpf MAM, Cercato C, Mancini MC, de Melo ME. Treatment with Antiobesity Drugs in Weight Regain After Bariatric Surgery: a Retrospective Cohort Study. Obes Surg 2023; 33:2941-2944. [PMID: 37466830 DOI: 10.1007/s11695-023-06736-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Bariatric surgery is the most efficient treatment for obesity. However, in some cases, weight regain can occur. Currently, it is unknown the best antiobesity medication (AOM) for such clinical situation. This study aims to evaluate the effect of AOM in patients with weight regain after bariatric surgery. METHODS A retrospective cohort study from December 2010 to July 2019 with patients submitted to bariatric surgery that had weight regain and received AOM for at least 2 years. RESULTS Of 96 patients that had weight regain in the analyzed period and received AOM, 16 were excluded from the analysis due to non-compliance (n = 7), treatment failure (n = 5), intolerable side effects with all available AOM (n = 2), or interaction with other medications (n = 2). Eighty patients were included in the analysis. The mean age was 59.0 ± 10.1 years, 88.8% were female, 91.2% white, and most of them were submitted to gastric bypass (87.6%). The mean preoperative and nadir weight after surgery were 127.9 ± 25.5 kg and 84.7 ± 22.8 kg, respectively. At the initiation of AOM, the mean baseline weight was 99.4 ± 23.1 kg. After 2 years of follow-up, there was significant weight loss in the groups treated with topiramate-alone (- 3.2 kg), topiramate plus sibutramine (- 6.1kg), and orlistat-alone or in combination (- 3.9kg). No statistical difference was observed in the sibutramine-alone group. CONCLUSION Topiramate (alone or associated with sibutramine) and orlistat (alone or in combination) promoted significant weight loss after 2 years of use in patients submitted to bariatric surgery with weight regain.
Collapse
Affiliation(s)
- Bibiana S Boger
- Unidade de Obesidade, Disciplina de Endocrinologia e Metabologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), R. Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo, SP, 05403-010, Brazil
| | - Nara L Queiroz
- Unidade de Obesidade, Disciplina de Endocrinologia e Metabologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), R. Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo, SP, 05403-010, Brazil
| | - Paulo E P Noriega
- Unidade de Obesidade, Disciplina de Endocrinologia e Metabologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), R. Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo, SP, 05403-010, Brazil
| | - Maicon C Canuto
- Unidade de Obesidade, Disciplina de Endocrinologia e Metabologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), R. Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo, SP, 05403-010, Brazil
| | - Matheo A M Stumpf
- Unidade de Obesidade, Disciplina de Endocrinologia e Metabologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), R. Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo, SP, 05403-010, Brazil.
| | - Cintia Cercato
- Unidade de Obesidade, Disciplina de Endocrinologia e Metabologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), R. Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo, SP, 05403-010, Brazil
| | - Marcio C Mancini
- Unidade de Obesidade, Disciplina de Endocrinologia e Metabologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), R. Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo, SP, 05403-010, Brazil
| | - Maria E de Melo
- Unidade de Obesidade, Disciplina de Endocrinologia e Metabologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), R. Dr. Ovídio Pires de Campos, 225 - Cerqueira César, São Paulo, SP, 05403-010, Brazil
| |
Collapse
|
12
|
Aljamal A, Al Shawabkeh M, Amawi K, Alqadi T, Khwaldeh A. Physiological Effects of Fig Leaf Extract and Orlistat on Obesity, Kidney and Liver of Rats. Pak J Biol Sci 2023; 26:458-462. [PMID: 38044695 DOI: 10.3923/pjbs.2023.458.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
<b>Background and Objective:</b> Obesity is a global health epidemic associated with various health complications. This study investigates the potential effects of ethanolic fig leaf extract and orlistat on obesity, as well as their impact on kidney and liver function in a rat model, aiming to contribute to the development of strategies for managing obesity-related health issues. <b>Materials and Methods:</b> Forty male albino rats with hypercholesterolemia were divided into four groups: Group one served as a control and received a normal diet, group two was a control group that was fed a high-fat diet, group three received a high-fat diet with a daily force-fed ration of 3 g kg<sup></sup><sup>1</sup> b.wt., of fig leaves and group four received a high-fat diet along with daily administration of orlistat at 4 mg kg<sup></sup><sup>1</sup> b.wt. Blood samples were collected from all groups at baseline and after 30 days of treatment. <b>Results:</b> Rats in the high-fat diet group showed a significant increase in body weight by 49%, while rats treated with fig leaf extract showed a significant decrease in body weight by 18% (p<0 .01) and treatment with orlistat resulted in 12% elevation in body weight. Renal function markers creatinine and urea were decreased in the group treated with fig leaves. Liver enzymes AST, ALT and ALP decreased significantly in the group treated with fig leaves and orlistat. Albumin and globulin concentrations decreased more with fig leaf extract than with orlistat. <b>Conclusion:</b> Fig leaves and orlistat reduce body weight and improve kidney and liver function in hypercholesterolemic rats.
Collapse
|
13
|
Wei W, Qin B, Wen W, Zhang B, Luo H, Wang Y, Xu H, Xie X, Liu S, Jiang X, Wang M, Tang Q, Zhang J, Yang R, Fan Z, Lyu H, Lin J, Li K, Lee MH. FBXW7β loss-of-function enhances FASN-mediated lipogenesis and promotes colorectal cancer growth. Signal Transduct Target Ther 2023; 8:187. [PMID: 37202390 PMCID: PMC10195794 DOI: 10.1038/s41392-023-01405-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 02/11/2023] [Accepted: 02/28/2023] [Indexed: 05/20/2023] Open
Abstract
Continuous de novo fatty acid synthesis is required for the biosynthetic demands of tumor. FBXW7 is a highly mutated gene in CRC, but its biological functions in cancer are not fully characterized. Here, we report that FBXW7β, a FBXW7 isoform located in the cytoplasm and frequently mutated in CRC, is an E3 ligase of fatty acid synthase (FASN). Cancer-specific FBXW7β mutations that could not degrade FASN can lead to sustained lipogenesis in CRC. COP9 signalosome subunit 6 (CSN6), an oncogenic marker of CRC, increases lipogenesis via interacting with and stabilizing FASN. Mechanistic studies show that CSN6 associates with both FBXW7β and FASN, and antagonizes FBXW7β's activity by enhancing FBXW7β autoubiquitination and degradation, which in turn prevents FBXW7β-mediated FASN ubiquitination and degradation, thereby regulating lipogenesis positively. Both CSN6 and FASN are positively correlated in CRC, and CSN6-FASN axis, regulated by EGF, is responsible for poor prognosis of CRC. The EGF-CSN6-FASN axis promotes tumor growth and implies a treatment strategy of combination of orlistat and cetuximab. Patient-derived xenograft experiments prove the effectiveness of employing orlistat and cetuximab combination in suppressing tumor growth for CSN6/FASN-high CRC. Thus, CSN6-FASN axis reprograms lipogenesis to promote tumor growth and is a target for cancer intervening strategy in CRC.
Collapse
Affiliation(s)
- Wenxia Wei
- Guangdong Provincial Key laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China
| | - Baifu Qin
- Guangdong Provincial Key laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China
| | - Weijie Wen
- Guangdong Provincial Key laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China
| | - Boyu Zhang
- Guangdong Provincial Key laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China
| | - Haidan Luo
- Guangdong Provincial Key laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China
| | - Yuzhi Wang
- Guangdong Provincial Key laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China
| | - Hui Xu
- Guangdong Provincial Key laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China
| | - Xiaoshan Xie
- Guangdong Provincial Key laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China
| | - Sicheng Liu
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China
- Second Department of Medical Oncology, The Third Affiliated Hospital of Kunming Medical University, Kunming, 650118, China
| | - Xin Jiang
- Guangdong Provincial Key laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China
| | - Mengan Wang
- Guangdong Provincial Key laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China
| | - Qin Tang
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Jiayu Zhang
- Guangdong Provincial Key laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China
| | - Runxiang Yang
- Second Department of Medical Oncology, The Third Affiliated Hospital of Kunming Medical University, Kunming, 650118, China
| | - Zongmin Fan
- Guangdong Provincial Key laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China
| | - Haiwen Lyu
- Guangdong Provincial Key laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China
| | - Junzhong Lin
- Department of Colorectal Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Kai Li
- Guangdong Provincial Key laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China.
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China.
| | - Mong-Hong Lee
- Guangdong Provincial Key laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China.
- Guangdong Institute of Gastroenterology, Guangzhou, 510655, China.
- Department of Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China.
| |
Collapse
|
14
|
Blasi F, Ianni F, Mangiapelo L, Pinna N, Cossignani L. In vitro anti-obesity activity by pancreatic lipase inhibition - Simple HPLC approach using EVOO as natural substrate. J Sci Food Agric 2023; 103:2786-2793. [PMID: 36583522 DOI: 10.1002/jsfa.12417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 11/28/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Pancreatic lipase (PL) is a key lipolytic enzyme in humans for the digestion and absorption of dietary fats. Thereby, PL is a well-recognized target in the management of obesity and its inhibition attracts the interest of researchers globally. The screening of new natural PL inhibitors as alternative strategy to the synthesis of chemical ones represents nowadays a hot topic in research. The main challenge in this matter is the lack of a universal analytical method allowing the monitoring of PL activity and the reliable quantification of lipid digestion products. RESULTS The (normal phase)-high-performance liquid chromatography-evaporative light scattering detector [(NP)-HPLC-ELSD] method proposed in this work represents a direct and rapid strategy to simultaneously quantify the products obtained from in vitro PL digestion. As one of the main novelties, the triacylglycerol (TAG) fraction from extra-virgin olive oil was selected as natural substrate. The PL activity was measured by monitoring the levels of remaining TAGs and formed free fatty acids (FFAs), using Orlistat as known inhibitor. The method validation confirmed the adequacy of the analytical method for quantitative purposes, showing high recovery percentage values (between 99% and 103%) and low relative standard deviation (RSD%) values (between 2% and 7%) for triolein and oleic acid standard solutions, as well as appreciably low limit of detection (LOD) and limit of quantification (LOQ) values (respectively 58 and 177 ng mL-1 for triolein; 198 and 602 ng mL-1 for oleic acid). Finally, the developed HPLC-ELSD method was successfully applied to evaluate the inhibitory effect of a polyphenolic extract obtained from apple pomace. The results showed a comparable inhibition degree between a 4.0 mg mL-1 apple pomace solution and a 1.0 μg mL-1 Orlistat solution. CONCLUSION The proposed innovative method reveals highly sensitive and simple to follow the fate of PL digestion, thus opening the way to further investigations in the research of new potentially anti-obesity compounds. © 2022 Society of Chemical Industry.
Collapse
Affiliation(s)
- Francesca Blasi
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - Federica Ianni
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - Luciano Mangiapelo
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - Nicola Pinna
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
| | - Lina Cossignani
- Department of Pharmaceutical Sciences, University of Perugia, Perugia, Italy
- Center for Perinatal and Reproductive Medicine, Santa Maria della Misericordia University Hospital, University of Perugia, Perugia, Italy
| |
Collapse
|
15
|
Valoy A, Alarcón G, Roco J, Zampini C, Isla MI, Jerez S. A Flavonoid-rich Zuccagnia punctata Extract Prevents High Fat Diet-induced Normal Weight Obesity in a Rabbit Model. Planta Med 2023; 89:245-253. [PMID: 35789995 DOI: 10.1055/a-1891-3588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Oral administration of rich in flavonoids hydroalcoholic extract from Zuccagnia punctata (ZpE) improves lipid profile and prevents vascular dysfunction in hypercholesterolemic rabbits. This study aimed to evaluate the ability of ZpE to prevent metabolic and vascular alterations induced by high fat diet (HFD) on a metabolically obese and normal weight rabbit model. The major components of ZpE were analyzed by HPLC method. Rabbits were separated into six groups: 1-fed on standard chow (CD); 2-fed on HFD; 3, 4, 5- fed on HFD and orally administrated 2.5 mg, 5 mg or 10 mg GAE/day of ZpE, respectively (ZpE- HFD); 6- fed on HFD and orally administered 30 mg orlistat/day (Or-HFD). All diets were administrated by 6 weeks. The major compounds of ZpE identified were chalcones: 2',4'-dihydroxy-3'-methoxychalcone and 2',4'-dihydroxychalcone. Oral treatment with ZpE 5 mg GAE/day as well as orlistat prevented the HFD-induced increase of triglycerides, fasting glucose, intraperitoneal glucose test, white cells, and TyG index. Acetylcholine relaxation was reduced in arteries from HFD group and oral administration of ZpE reached this response to CD values. Contractile response to angiotensin II was lower in arteries from rabbits fed on HFD treated with ZpE 5 and 10 mg GAE/day than those of untreated rabbits. Moreover, ZpE could inhibit the activity of pancreatic lipase in vitro and in vivo. In conclusion the ZpE may prevent normal weight obesity by inhibiting the pancreatic lipase. Thus, the use of ZpE as a natural product in the prevention of metabolic syndrome and endothelial dysfunction is very promising.
Collapse
Affiliation(s)
- Agostina Valoy
- Instituto Superior de Investigaciones Biológicas (INSIBIO, UNT-CONICET). San Miguel de Tucumán, Tucumán, Argentina
| | - Gabriela Alarcón
- Instituto Superior de Investigaciones Biológicas (INSIBIO, UNT-CONICET). San Miguel de Tucumán, Tucumán, Argentina
- Facultad de Ciencias Naturales e Instituto Miguel Lillo, Universidad Nacional de Tucumán (UNT). San Miguel de Tucumán, Tucumán, Argentina
| | - Julieta Roco
- Instituto Superior de Investigaciones Biológicas (INSIBIO, UNT-CONICET). San Miguel de Tucumán, Tucumán, Argentina
- Facultad de Ciencias Naturales e Instituto Miguel Lillo, Universidad Nacional de Tucumán (UNT). San Miguel de Tucumán, Tucumán, Argentina
| | - Catiana Zampini
- Facultad de Ciencias Naturales e Instituto Miguel Lillo, Universidad Nacional de Tucumán (UNT). San Miguel de Tucumán, Tucumán, Argentina
- Instituto de Bioprospección y Fisiología Vegetal (INBIOFIV, UNT-CONICET). San Miguel de Tucumán, Tucumán, Argentina
| | - María Ines Isla
- Facultad de Ciencias Naturales e Instituto Miguel Lillo, Universidad Nacional de Tucumán (UNT). San Miguel de Tucumán, Tucumán, Argentina
- Instituto de Bioprospección y Fisiología Vegetal (INBIOFIV, UNT-CONICET). San Miguel de Tucumán, Tucumán, Argentina
| | - Susana Jerez
- Instituto Superior de Investigaciones Biológicas (INSIBIO, UNT-CONICET). San Miguel de Tucumán, Tucumán, Argentina
- Facultad de Ciencias Naturales e Instituto Miguel Lillo, Universidad Nacional de Tucumán (UNT). San Miguel de Tucumán, Tucumán, Argentina
| |
Collapse
|
16
|
Yang J, Deng Y, Zhang M, Feng S, Peng S, Yang S, Liu P, Cai G, Ge G. Construction and Manipulation of Serial Gradient Dilution Array on a Microfluidic Slipchip for Screening and Characterizing Inhibitors against Human Pancreatic Lipase. Biosensors (Basel) 2023; 13:bios13020274. [PMID: 36832040 PMCID: PMC9954273 DOI: 10.3390/bios13020274] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 05/28/2023]
Abstract
Obesity is one of the foremost public health concerns. Human pancreatic lipase (hPL), a crucial digestive enzyme responsible for the digestion of dietary lipids in humans, has been validated as an important therapeutic target for preventing and treating obesity. The serial dilution technique is commonly used to generate solutions with different concentrations and can be easily modified for drug screening. Conventional serial gradient dilution is often performed with tedious multiple manual pipetting steps, where it is difficult to precisely control fluidic volumes at low microliter levels. Herein, we presented a microfluidic SlipChip that enabled formation and manipulation of serial dilution array in an instrument-free manner. With simple slipping steps, the compound solution could be diluted to seven gradients with the dilution ratio of 1:1 and co-incubated with the enzyme (hPL)-substrate system for screening the anti-hPL potentials. To ensure complete mixing of solution and diluent during continuous dilution, we established a numerical simulation model and conducted an ink mixing experiment to determine the mixing time. Furthermore, we also demonstrated the serial dilution ability of the proposed SlipChip using standard fluorescent dye. As a proof of concept, we tested this microfluidic SlipChip using one marketed anti-obesity drug (Orlistat) and two natural products (1,2,3,4,6-penta-O-galloyl-β-D-glucopyranose (PGG) and sciadopitysin) with anti-hPL potentials. The IC50 values of these agents were calculated as 11.69 nM, 8.22 nM and 0.80 μM, for Orlistat, PGG and sciadopitysin, respectively, which were consistent with the results obtained by conventional biochemical assay.
Collapse
Affiliation(s)
- Junqiang Yang
- Department of Anesthesiology, Seventh People’s Hospital of Shanghai University of TCM, Shanghai 200137, China
| | - Yanyan Deng
- Shanghai Frontiers Science Center of TCM Chemical Biology, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Min Zhang
- Shanghai Frontiers Science Center of TCM Chemical Biology, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Key Laboratory of Xinjiang Phytomedicine Resource and Utilization, Ministry of Education, Pharmacy School of Shihezi University, Shihezi 832099, China
| | - Shilun Feng
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
| | - Sheng Peng
- Department of Anesthesiology, Longhua Hospital Shanghai University of TCM, Shanghai 200032, China
| | - Shijia Yang
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
| | - Peirong Liu
- Department of Anesthesiology, Seventh People’s Hospital of Shanghai University of TCM, Shanghai 200137, China
| | - Gaozhe Cai
- State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, Shanghai 200050, China
| | - Guangbo Ge
- Shanghai Frontiers Science Center of TCM Chemical Biology, Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| |
Collapse
|
17
|
Taviano MF, Núñez S, Millán-Laleona A, Condurso C, Verzera A, Merlino M, Ragusa M, Miceli N, López V. Volatile composition, antidiabetic, and anti-obesity potential of Brassica incana leaf and flowering top extracts. Pharm Biol 2022; 60:1994-2001. [PMID: 36219451 PMCID: PMC9559316 DOI: 10.1080/13880209.2022.2128825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
CONTEXT Brassica incana Ten. (Brassicaceae) is an edible plant with very limited available information. Previous studies have demonstrated the polyphenolic profile and the antioxidant and cytotoxic properties of the leaf and flowering top hydroalcoholic extracts. OBJECTIVE The volatile composition and the antidiabetic and anti-obesity potential of B. incana leaf and flowering top extracts have been investigated. MATERIAL AND METHODS The volatile characterization of the extracts was attained by HS-SPME-GC/MS analysis. The antidiabetic and anti-obesity potential was investigated spectrophotometrically in vitro by the ability to modulate pancreatic lipase and α-glucosidase at different concentrations using orlistat and acarbose as reference drugs. The inhibition of advanced glycation end-products (AGEs) was measured with aminoguanidine as reference and the antioxidant activity with the xanthine/xanthine oxidase system and Trolox for comparative purposes. RESULTS Several volatiles belonging to different chemical classes were identified, being sulphur compounds the most abundant in both leaf and flowering top extracts (56.33% and 64.40% of all volatiles). Although the leaf extract showed lower IC50 values in most of the assays (0.968 and 1.921 mg/mL for α-glucosidase; 0.192 and 0.262 mg/mL for AGEs; 0.022 and 0.038 mg/mL for superoxide scavenging), there were no statistically significant differences between both samples. These extracts showed a similar behaviour to Trolox in the xanthine oxidase assay (IC50 values of 0.022 mg/mL for leaf extract; 0.038 mg/mL for flowering top and 0.028 for Trolox). CONCLUSIONS Leaves and flowering tops from B. incana can be used as sources of functional compounds that could act as antidiabetic and anti-obesogenic agents.
Collapse
Affiliation(s)
- Maria Fernanda Taviano
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Sonia Núñez
- Department of Pharmacy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego (Zaragoza), Spain
- Instituto Agroalimentario de Aragón-IA2, CITA-Universidad de Zaragoza, Zaragoza, Spain
| | - Adrián Millán-Laleona
- Department of Pharmacy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego (Zaragoza), Spain
- Instituto Agroalimentario de Aragón-IA2, CITA-Universidad de Zaragoza, Zaragoza, Spain
| | - Concetta Condurso
- Department of Veterinary Sciences, Viale Palatucci, University of Messina, Messina, Italy
| | - Antonella Verzera
- Department of Veterinary Sciences, Viale Palatucci, University of Messina, Messina, Italy
| | - Maria Merlino
- Department of Veterinary Sciences, Viale Palatucci, University of Messina, Messina, Italy
| | - Monica Ragusa
- IRCCS Istituto Ortopedico Rizzoli, Complex Structure of Surgical Sciences and Technologies, Bologna, Italy
| | - Natalizia Miceli
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
- CONTACT Natalizia Miceli University of Messina, Messina, Italy
| | - Víctor López
- Department of Pharmacy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego (Zaragoza), Spain
- Instituto Agroalimentario de Aragón-IA2, CITA-Universidad de Zaragoza, Zaragoza, Spain
- Víctor López Department of Pharmacy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego (Zaragoza), Spain
| |
Collapse
|
18
|
Hasnaoui I, Dab A, Mechri S, Abouloifa H, Saalaoui E, Jaouadi B, Noiriel A, Asehraou A, Abousalham A. Purification, Biochemical and Kinetic Characterization of a Novel Alkaline sn-1,3-Regioselective Triacylglycerol Lipase from Penicillium crustosum Thom Strain P22 Isolated from Moroccan Olive Mill Wastewater. Int J Mol Sci 2022; 23:ijms231911920. [PMID: 36233221 PMCID: PMC9570478 DOI: 10.3390/ijms231911920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 11/20/2022] Open
Abstract
A novel extracellular lipase from a filamentous fungus Ascomycota strain, P22, was isolated from olive mill wastewater, then purified and characterized. This strain was identified as Penicillium crustosum Thom based on sequencing analyses. Penicilliumcrustosum Thom strain P22 lipase (PCrL) was purified 63-fold to homogeneity using ammonium sulfate precipitation and chromatography on a Q-Sepharose Fast Flow column, with a total yield of 34%. The purified PCrL had a molecular mass of 28 kDa, estimated by SDS-PAGE. The 20 NH2-terminal amino-acid residues showed a high degree of homology with those of other Penicillium lipases. The specific activity of PCrL at pH 9 and 37 °C were found to be 5000 and 10,000 U/mg on olive oil and trioctanoin emulsions, respectively. PCrL exhibited clear regioselectivity toward the sn-1 position of the surface-coated triglycerides which were esterified with α-eleostearic acid at the sn-1/3 position. PCrL was completely inhibited by 53 µM of Orlistat, 5 mM of phenylmethylsulfonylfluoride, and 2 mM of diiodopropyl fluorophosphate, suggesting that it belonged to the serine lipase family. PCrL showed high activity and stability in the presence of water-immiscible organic solvents, surfactant, and oxidizing agents, and showed considerable compatibility with commercial laundry detergents. Washing performance analysis revealed that it could effectively remove oil stains. Hence, PCrL has several attractive properties that make it a promising potential candidate for detergent formulations.
Collapse
Affiliation(s)
- Ismail Hasnaoui
- Univ Lyon, Université Lyon 1, Institut de Chimie et de Biochimie Moléculaires et Supramoléculaires (ICBMS), UMR 5246 CNRS, Génie Enzymatique, Membranes Biomimétiques et Assemblages Supramoléculaires (GEMBAS), Bât Raulin, 43 Bd du 11 Novembre 1918, CEDEX, F-69622 Villeurbanne, France
- Laboratoire de Bioressources, Biotechnologie, Ethnopharmacologie et Santé (LBBES), Faculté des Sciences d’Oujda (FSO), Université Mohammed Premier (UMP), Bd Mohamed VI, BP 717, Oujda 60000, Morocco
| | - Ahlem Dab
- Univ Lyon, Université Lyon 1, Institut de Chimie et de Biochimie Moléculaires et Supramoléculaires (ICBMS), UMR 5246 CNRS, Génie Enzymatique, Membranes Biomimétiques et Assemblages Supramoléculaires (GEMBAS), Bât Raulin, 43 Bd du 11 Novembre 1918, CEDEX, F-69622 Villeurbanne, France
- Laboratoire de Biotechnologie Microbienne et d’Ingénierie des Enzymes (LBMIE), Centre de Biotechnologie de Sfax (CBS), Université de Sfax, Route de Sidi Mansour Km 6, BP 1177, Sfax 3018, Tunisia
| | - Sondes Mechri
- Laboratoire de Biotechnologie Microbienne et d’Ingénierie des Enzymes (LBMIE), Centre de Biotechnologie de Sfax (CBS), Université de Sfax, Route de Sidi Mansour Km 6, BP 1177, Sfax 3018, Tunisia
| | - Houssam Abouloifa
- Laboratoire de Bioressources, Biotechnologie, Ethnopharmacologie et Santé (LBBES), Faculté des Sciences d’Oujda (FSO), Université Mohammed Premier (UMP), Bd Mohamed VI, BP 717, Oujda 60000, Morocco
- Research Unit of Microbiology, Biomolecules and Biotechnology, Laboratory of Chemistry Physics and Biotechnology of Molecules and Materials, Faculty of Sciences and Techniques Mohammedia, Hassan II University of Casablanca, Mohammedia 28806, Morocco
| | - Ennouamane Saalaoui
- Laboratoire de Bioressources, Biotechnologie, Ethnopharmacologie et Santé (LBBES), Faculté des Sciences d’Oujda (FSO), Université Mohammed Premier (UMP), Bd Mohamed VI, BP 717, Oujda 60000, Morocco
| | - Bassem Jaouadi
- Laboratoire de Biotechnologie Microbienne et d’Ingénierie des Enzymes (LBMIE), Centre de Biotechnologie de Sfax (CBS), Université de Sfax, Route de Sidi Mansour Km 6, BP 1177, Sfax 3018, Tunisia
| | - Alexandre Noiriel
- Univ Lyon, Université Lyon 1, Institut de Chimie et de Biochimie Moléculaires et Supramoléculaires (ICBMS), UMR 5246 CNRS, Génie Enzymatique, Membranes Biomimétiques et Assemblages Supramoléculaires (GEMBAS), Bât Raulin, 43 Bd du 11 Novembre 1918, CEDEX, F-69622 Villeurbanne, France
| | - Abdeslam Asehraou
- Laboratoire de Bioressources, Biotechnologie, Ethnopharmacologie et Santé (LBBES), Faculté des Sciences d’Oujda (FSO), Université Mohammed Premier (UMP), Bd Mohamed VI, BP 717, Oujda 60000, Morocco
- Correspondence: (A.A.); (A.A.)
| | - Abdelkarim Abousalham
- Univ Lyon, Université Lyon 1, Institut de Chimie et de Biochimie Moléculaires et Supramoléculaires (ICBMS), UMR 5246 CNRS, Génie Enzymatique, Membranes Biomimétiques et Assemblages Supramoléculaires (GEMBAS), Bât Raulin, 43 Bd du 11 Novembre 1918, CEDEX, F-69622 Villeurbanne, France
- Correspondence: (A.A.); (A.A.)
| |
Collapse
|
19
|
Yin Y, Kong X, Li M, Wang J, Dai X, Zhang Y, Lin W. Development of an esterase fluorescent probe based on naphthalimide-benzothiazole conjugation and its applications for qualitative detection of esterase in orlistat-treated biosamples. Anal Chim Acta 2022; 1190:339248. [PMID: 34857133 DOI: 10.1016/j.aca.2021.339248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 11/17/2022]
Abstract
Esterase is a large hydrolysis family, and widely distributed in many kinds of cells. It is responsible for multiple physiological and pathological functions including metabolism, gene expression. While abnormality of esterase is associated with many pathological activities in obesity, Wolman's disease, and cancer. Thereby, it is essential to design an effective tool for esterase in situ detection in biological systems. Herein, a novel fluorescent probe Y-1 for monitoring esterase in living cells was rationally designed. Probe Y-1 was synthesized by the conjugation between an acetylation of 4-hydroxy naphthalimide and benzothiazole group. Benzothiazole moiety is a typical Excited-state intramolecular proton transfer (ESIPT) controller. Acetate group was selected as the responsive site and ESIPT initiator. As the acetate group could block the ESIPT effect, the probe emits no fluorescence under the excitation of 455 nm. When binding with esterase, Y-1 shows distinct fluorescence with the peak at 560 nm with short time when ESIPT is on. Y-1 displays high sensitivity (LOD is 0.216 × 10-3 U/mL), fast response (within 5 min), high selectivity and photostability towards esterase. Furthermore, the %RSD (relative standard deviation) of within-day and day-to-day precision was no more than 13.0% and the accuracy ranged from -6.5 to -12.3%. Kinetics performance of Y-1 indicates that esterase has high affinity and hydrolysis to Y-1. For biological applications, our probe is a time-dependent visualizing esterase in living HepG2 and CoLo205 cells within 15 min. After the treatment of orlistat (1 and 5 μM) for inhibiting the activity of esterase, the bright fluorescence has also been detected using our probe. Furthermore, it has been successful in monitoring the esterase in zebrafish, the data were consistent with cellular phenomena. Therefore, all these findings indicate that the robust probe Y-1 is a useful qualitative tool for detecting esterase in biological systems.
Collapse
Affiliation(s)
- Yaguang Yin
- Institute of Fluorescent Probes for Biological Imaging, School of Chemistry and Chemical Engineering, University of Jinan, Jinan, Shandong, 250022, PR China
| | - Xiuqi Kong
- Institute of Fluorescent Probes for Biological Imaging, School of Chemistry and Chemical Engineering, University of Jinan, Jinan, Shandong, 250022, PR China
| | - Min Li
- Institute of Fluorescent Probes for Biological Imaging, School of Chemistry and Chemical Engineering, University of Jinan, Jinan, Shandong, 250022, PR China
| | - Jingchao Wang
- Institute of Fluorescent Probes for Biological Imaging, School of Chemistry and Chemical Engineering, University of Jinan, Jinan, Shandong, 250022, PR China
| | - Xiaoyu Dai
- Institute of Fluorescent Probes for Biological Imaging, School of Chemistry and Chemical Engineering, University of Jinan, Jinan, Shandong, 250022, PR China
| | - Yunyan Zhang
- Institute of Fluorescent Probes for Biological Imaging, School of Chemistry and Chemical Engineering, University of Jinan, Jinan, Shandong, 250022, PR China
| | - Weiying Lin
- Institute of Fluorescent Probes for Biological Imaging, School of Chemistry and Chemical Engineering, University of Jinan, Jinan, Shandong, 250022, PR China; Guangxi Key Laboratory of Electrochemical Energy Materials, Institute of Optical Materials and Chemical Biology, School of Chemistry and Chemical Engineering, Guangxi University, Nanning, Guangxi, 530004, PR China.
| |
Collapse
|
20
|
Zhao YX, Wang LJ, Gong FY, Pan H, Miao H, Duan L, Yang HB, Zhu HJ. [Effects of orlistat and metformin on metabolism and gonadal function in overweight or obese patients with polycystic ovary syndrome]. Zhonghua Nei Ke Za Zhi 2021; 60:1165-1168. [PMID: 34856689 DOI: 10.3760/cma.j.cn112138-20210302-00171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The aim of this study was to assess the effects of orlistat or metformin treatment on lipid and glucose metabolism, and gonadal function in obese/overweight women with polycystic ovary syndrome (PCOS). A total of 39 patients diagnosed with PCOS were randomly (digital table method) divided into orlistat treatment group (20 cases) and metformin treatment group (19 cases). Compared with those before, treatment with either orlistat or metformin significantly reduced body weight, body mass index (BMI), hip circumferences, and serum insulin levels of the PCOS patients both at the end of 3 months and 6 months (P<0.05). No significant differences could be viewed between orlistat and metformin treated subjects. Moreover, orlistat treatment significantly lowered the levels of low-density lipoprotein cholesterol, total cholesterol, fasting blood glucose, and homeostasis model assessment-insulin resistance (HOMA-IR) (P<0.05), while there were no significant changes in above parameters with metformin treatment. The improvement of menstrual cycle was observed after 6-month treatment in both groups (P<0.05). However, changes in polycystic ovarian morphology by ultrasound were only observed in orlistat treated group. In conclusion, orlistat is comparable with metformin in weight loss and improvement of insulin resistance and menstrual cycle, and is superior to metformin in improvement of lipid metabolism in overweight/obese PCOS patients.
Collapse
Affiliation(s)
- Y X Zhao
- Key Laboratory of Endocrinology of National Health Commission, State Key Laboratory of Complex Severe and Rare Diseases,Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - L J Wang
- Key Laboratory of Endocrinology of National Health Commission, State Key Laboratory of Complex Severe and Rare Diseases,Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - F Y Gong
- Key Laboratory of Endocrinology of National Health Commission, State Key Laboratory of Complex Severe and Rare Diseases,Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - H Pan
- Key Laboratory of Endocrinology of National Health Commission, State Key Laboratory of Complex Severe and Rare Diseases,Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - H Miao
- Key Laboratory of Endocrinology of National Health Commission, State Key Laboratory of Complex Severe and Rare Diseases,Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - L Duan
- Key Laboratory of Endocrinology of National Health Commission, State Key Laboratory of Complex Severe and Rare Diseases,Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - H B Yang
- Key Laboratory of Endocrinology of National Health Commission, State Key Laboratory of Complex Severe and Rare Diseases,Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - H J Zhu
- Key Laboratory of Endocrinology of National Health Commission, State Key Laboratory of Complex Severe and Rare Diseases,Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| |
Collapse
|
21
|
Noori S, Mirzababaei A, Amini MR, Clark CCT, Mirzaei K. Effect of orlistat on serum uric acid level in adults: A systematic review and meta-analysis of randomised controlled trials. Int J Clin Pract 2021; 75:e14674. [PMID: 34324762 DOI: 10.1111/ijcp.14674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/26/2021] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE Hyperuricemia increases the risk of gout and cardiovascular diseases. Obesity increases the risk of hyperuricemia while weight loss (>5 kg) has been reported to decrease urate. The effects of orlistat on serum uric acid (SUA) are still controversial. The aim of this meta-analysis was to evaluate the influence of orlistat on SUA levels in adults. METHODS Relevant studies, published up to May 2020, were searched systematically through PubMed/Medline, Scopus and Google Scholar. All relevant randomised controlled clinical trials were included. Meta-analysis was performed using random-effect model. Subgroup analysis, sensitivity analysis and meta-regression were also carried out. RESULTS Overall 7 trials (9 datasets) that enrolled 1786 subjects were included. Orlistat showed in a significant change in SUA level (Difference in means: -17.661 μmol, 95% CI: -31.615 to -3.707, P = .01). A low heterogeneity observed across the studies (I2 = 25.119%). After categorising studies on the basis of duration and sample size, the effect of orlistat on SUA was significant. The results of meta-regression were showed that significant relationships were not found between orlistat and SUA in the duration of intervention. CONCLUSION We found a significant reduction in SUA following orlistat therapy in adults.
Collapse
Affiliation(s)
- Soheila Noori
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mohammad Reza Amini
- Department of Clinical Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| |
Collapse
|
22
|
Khan SS, Sudasinghe TD, Landgraf AD, Ronning DR, Sucheck SJ. Total Synthesis of Tetrahydrolipstatin, Its Derivatives, and Evaluation of Their Ability to Potentiate Multiple Antibiotic Classes against Mycobacterium Species. ACS Infect Dis 2021; 7:2876-2888. [PMID: 34478259 PMCID: PMC8630808 DOI: 10.1021/acsinfecdis.1c00283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Tetrahydrolipstatin (THL, 1a) has been shown to inhibit both mammalian and bacterial α/β hydrolases. In the case of bacterial systems, THL is a known inhibitor of several Mycobacterium tuberculosis hydrolases involved in mycomembrane biosynthesis. Herein we report a highly efficient eight-step asymmetric synthesis of THL using a route that allows modification of the THL α-chain substituent to afford compounds 1a through 1e. The key transformation in the synthesis was use of a (TPP)CrCl/Co2(CO)8-catalyzed regioselective and stereospecific carbonylation on an advanced epoxide intermediate to yield a trans-β-lactone. These compounds are modest inhibitors of Ag85A and Ag85C, two α/β hydrolases of M. tuberculosis involved in the biosynthesis of the mycomembrane. Among these compounds, 10d showed the highest inhibitory effect on Ag85A (34 ± 22 μM) and Ag85C (66 ± 8 μM), and its X-ray structure was solved in complex with Ag85C to 2.5 Å resolution. In contrast, compound 1e exhibited the best-in-class MICs of 50 μM (25 μg/mL) and 16 μM (8.4 μg/mL) against M. smegmatis and M. tuberculosis H37Ra, respectively, using a microtiter assay plate. Combination of 1e with 13 well-established antibiotics synergistically enhanced the potency of few of these antibiotics in M. smegmatis and M. tuberculosis H37Ra. Compound 1e applied at concentrations 4-fold lower than its MIC enhanced the MIC of the synergistic antibiotic by 2-256-fold. In addition to observing synergy with first-line drugs, rifamycin and isoniazid, the MIC of vancomycin against M. tuberculosis H37Ra was 65 μg/mL; however, the MIC was lowered to 0.25 μg/mL in the presence of 2.1 μg/mL 1e demonstrating the potential of targeting mycobacterial hydrolases involved in mycomembrane and peptidoglycan biosynthesis.
Collapse
Affiliation(s)
- Saniya S Khan
- Department of Chemistry & Biochemistry, University of Toledo, Toledo, Ohio 43606, United States
| | - Thanuja D Sudasinghe
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, Nebraska 68198, United States
| | - Alexander D Landgraf
- Department of Chemistry & Biochemistry, University of Toledo, Toledo, Ohio 43606, United States
| | - Donald R Ronning
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, Nebraska 68198, United States
| | - Steven J Sucheck
- Department of Chemistry & Biochemistry, University of Toledo, Toledo, Ohio 43606, United States
| |
Collapse
|
23
|
Shang C, Li Y, He T, Liao Y, Du Q, Wang P, Qiao J, Guo H. The prognostic miR-532-5p-correlated ceRNA-mediated lipid droplet accumulation drives nodal metastasis of cervical cancer. J Adv Res 2021; 37:169-184. [PMID: 35499057 PMCID: PMC9040090 DOI: 10.1016/j.jare.2021.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 12/15/2022] Open
Abstract
The prognostic miR-532-5p inhibited epithelial-mesenchymal transition and lymphangiogenesis by regulating lipid droplets accumulation. miR-532-5p-correlated ceRNA network in which LINC01410 directly bound to miR-532-5p effectively functioned as a sponge for miR-532-5p to disinhibit its target gene-FASN. Combined therapy with miR-532-5p and FASN inhibitor-orlistat blocked lymph node metastasis and tumor growth.
Introduction The prognosis for cervical cancer (CC) patients with lymph node metastasis (LNM) is extremely poor. Lipid droplets (LDs) have a pivotal role in promoting tumor metastasis. The crosstalk mechanism between LDs and LNM modulated in CC remains largely unknown. Objectives This study aimed to construct a miRNA-dependent progonostic model for CC patients and investigate whether miR-532-5p has a biological impact on LNM by regualting LDs accumulation. Methods LASSO-Cox regression was applied to establish a prognostic prediction model. miR-532-5p had the lowest P-value in RNA expression (P < 0.001) and prognostic prediction (P < 0.0001) and was selected for further study. The functional role of the prognostic miR-532-5p-correlated competing endogenous RNA (ceRNA) network was investigated to clarify the crosstalk between LDs and LNM. The underlying mechanism was determined using site-directed mutagenesis, dual luciferase reporter assays, RNA immunoprecipitation assays, and rescue experiments. A xenograft LNM model was established to evaluate the effect of miR-532-5p and orlistat combination therapy on tumor growth and LNM. Results A novel 5-miRNAs prognostic signature was constructed to better predict the prognosis of CC patient. Further study demonstrated that miR-532-5p inhibited epithelial-mesenchymal transition and lymphangiogenesis by regulating LDs accumulation. Interestingly, we also found that LDs accumulation promoted cell metastasis in vitro. Mechanistically, we demonstrated a miR-532-5p-correlated ceRNA network in which LINC01410 was bound directly to miR-532-5p and effectively functioned as miR-532-5p sponge to disinhibit its target gene-fatty acid synthase (FASN). Combined therapy with miR-532-5p and FASN inhibitor-orlistat further inhibited tumor growth and LNM in vivo. Conclusion Our findings highlight a LD accumulation-dependent mechanism of miR-532-5p-modulated LNM and support treatment with miR-532-5p/orlistat as novel strategy for treating patients with LNM in CC.
Collapse
Affiliation(s)
- Chunliang Shang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, 100191 Beijing, China
| | - Yuan Li
- Department of Obstetrics and Gynecology, Peking University Third Hospital, 100191 Beijing, China
| | - Tianhui He
- Department of Obstetrics and Gynecology, Peking University Third Hospital, 100191 Beijing, China
| | - Yuandong Liao
- Department of Obstetrics and Gynecology, The First Affliated Hospital, Sun Yat-sen University, 510080 Guangzhou, China
| | - Qiqiao Du
- Department of Obstetrics and Gynecology, The First Affliated Hospital, Sun Yat-sen University, 510080 Guangzhou, China
| | - Pan Wang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, 100191 Beijing, China
| | - Jie Qiao
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, 100191 Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, 100191 Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, 100191 Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, 100191 Beijing, China
- Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, 100191 Beijing, China
- Corresponding authors at: Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University Third Hospital, Key Laboratory of Assisted, Beijing 100191, China (J. Qiao).
| | - Hongyan Guo
- Department of Obstetrics and Gynecology, Peking University Third Hospital, 100191 Beijing, China
- Corresponding authors at: Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University Third Hospital, Key Laboratory of Assisted, Beijing 100191, China (J. Qiao).
| |
Collapse
|
24
|
Harapko TV, Mateshuk-Vatseba LR. MORPHOMETRIC AND ELECTRON MICROSCOPIC CHANGES OF STRUCTURAL COMPONENTS OF LYMPH NODES DURING CORRECTION OF THE ACTION OF SODIUM GLUTAMATE WITH ORLISTAT. Wiad Lek 2021; 74:2060-2065. [PMID: 34725276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The aim: To study morphometric and electron microscopic changes in the parenchyma of rat lymph nodes under the action of sodium glutamate and its correction by orlistat. PATIENTS AND METHODS Materials and methods: The article presents and analyzes the data of an experimental study conducted on 66 white male rats and females of reproductive age. Experimental animals are divided into 4 groups. RESULTS Results: After six weeks of exposure to monosodium glutamate, there was a significant decrease in the relative area of the cortical substance in the lymph nodes of white male and female rats by 11.95% and 9.31% and, respectively, an increase in the relative area of the medullary substance by 18.76% and 14.7% in compared with an intact group of animals. After six weeks of sodium glutamate and the next six weeks of the standard diet of vivarium and orlistat, the relative area of the cortical substance in the lymph node parenchyma was 2.55% and 0.38% more than the parameters of the intact group of animals, respectively. Accordingly, the relative area of the medullary substance decreased and was 4.01% and 0.59% less compared to the intact group of animals. CONCLUSION Conclusions: Electron microscopic examination showed that monosodium glutamate causes changes in the parenchyma of the lymph nodes as in a high-calorie diet. The introduction of orlistat (xenical) leads to a partial restoration of the structural organization, and hence the function of this organ.
Collapse
|
25
|
Marounek M, Volek Z, Taubner T, Czauderna M. Metabolic Effects of a Hydrophobic Alginate Derivative and Tetrahydrolipstatin in Rats Fed a Diet Supplemented with Palm Fat and Cholesterol. Folia Biol (Praha) 2021; 67:143-149. [PMID: 35151239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The effects of octadecylamide of alginic acid (amidated alginate) and tetrahydrolipstatin on serum and hepatic cholesterol, and the faecal output of fat and sterols, were investigated in rats. Amidated alginate is a sorbent of lipids, tetrahydrolipstatin is an inhibitor of pancreatic lipase. Rats were fed diets containing cholesterol and palm fat at 10 and 70 g/kg, respectively. Palm fat was provided by coconut meal. Amidated alginate at 40 g/kg diet significantly decreased serum total cholesterol, low-density lipoprotein and hepatic cholesterol, and hepatic lipids and increased the faecal output of fat and coprostanol. Tetrahydrolipstatin at 300 mg/kg diet significantly decreased low-density lipoprotein cholesterol and hepatic lipids and increased the faecal output of fat. The intake of feed was not significantly influenced; however, the weight gains in rats fed amidated alginate were lower than in rats of the control group. Both amidated alginate and tetrahydrolipstatin modified the fatty acid profile in excreta lipids. Concentrations of saturated fatty acids were decreased and those of unsaturated fatty acids increased. Despite different modes of action, amidated alginate and tetrahydrolipstatin were equally efficient in removing the dietary fat from the body.
Collapse
Affiliation(s)
- M Marounek
- Department of Nutrition Physiology and Animal Product Quality, Institute of Animal Science, Prague, Czech Republic
- Department of Microbiology, Nutrition and Dietetics, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences, Prague, Czech Republic
| | - Z Volek
- Department of Nutrition Physiology and Animal Product Quality, Institute of Animal Science, Prague, Czech Republic
- Department of Microbiology, Nutrition and Dietetics, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences, Prague, Czech Republic
| | - T Taubner
- Department of Nutrition Physiology and Animal Product Quality, Institute of Animal Science, Prague, Czech Republic
| | - M Czauderna
- The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, Jablonna, Poland
| |
Collapse
|
26
|
Abstract
Obesity is among the leading causes of morbidity and mortality worldwide and its prevalence continues to increase globally. Because obesity is a chronic, complex, and heterogeneous disease influenced by genetic, developmental, biological, and environmental factors, it is necessary to approach obesity with an integrated and comprehensive treatment strategy. As it is difficult to achieve and sustain successful long-term weight loss in most patients with obesity through lifestyle modifications (e.g., diet, exercise, and behavioral therapy), pharmacological approaches to the treatment of obesity should be considered as an adjunct therapy. Currently, four drugs (orlistat, naltrexone extended-release [ER]/bupropion ER, phentermine/topiramate controlled-release, and liraglutide) can be used long-term (>12 weeks) to promote weight loss by suppressing appetite or decreasing fat absorption. Pharmacotherapy for obesity should be conducted according to a proper assessment of the clinical evidence and customized to individual patients considering the characteristics of each drug and comorbidities associated with obesity. In this review, we discuss the mechanisms of action, efficacy, and safety of these available long-term anti-obesity drugs and introduce other potential agents under investigation. Furthermore, we discuss the need for research on personalized obesity medicine.
Collapse
Affiliation(s)
- Jang Won Son
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sungrae Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
27
|
Khedr NF, Ebeid AM, Khalil RM. New insights into weight management by orlistat in comparison with cinnamon as a natural lipase inhibitor. Endocrine 2020; 67:109-116. [PMID: 31721089 DOI: 10.1007/s12020-019-02127-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 10/30/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Orlistat which is taken by obese patients may present some therapeutic assistance through its inhibition of lipase activity. Otherwise, a natural lipase inhibitor as cinnamon is widely used traditional medicine to decrease cholesterol and body weight. The current study aimed to investigate the weight management of orlistat in comparison with cinnamon through different obesity related targets. METHODS Subjects were divided into: Group 1: subjects received cinnamon capsules for 60 days. Group 2: subjects were received orlistat twice daily for 30 days, then once daily for another 30 days. Blood samples were collected at baseline and after 2 months. RESULTS Both orlistat and cinnamon groups showed a significant reduction in BMI, lipid profile, and lipase activity compared with baseline. Orlistat group showed significant elevation (p < 0.001) in glucagon, insulin-degrading enzyme (IDE) and dopamine level concomitant with the decrease of serum glutamate compared with baseline level of the same group and cinnamon group. However, cinnamon reduced serum insulin level and insulin resistance (IR) compared with baseline level of the same group and orlistat group. CONCLUSIONS Orlistat can be used in weight management not only for its pancreatic lipase inhibition but also, due to its indirect appetite reduction effect through elevated glucagon, IDE and dopamine levels and its inhibitory effect on glutamate neurotransmitter, whereas, cinnamon improves BMI and glycaemic targets.
Collapse
Affiliation(s)
- Naglaa F Khedr
- Biochemistry Department, Faculty of Pharmacy, Tanta University, Tanta, Egypt.
| | - Abla M Ebeid
- Clinical Pharmacy Department, Faculty of Pharmacy, Delta University for Science and Technology, Gamasaa, Egypt
| | - Rania M Khalil
- Biochemistry Department, Faculty of Pharmacy, Delta University for Science and Technology, Gamasaa, Egypt
| |
Collapse
|
28
|
Shirai K, Fujita T, Tanaka M, Fujii Y, Shimomasuda M, Sakai S, Samukawa Y. Efficacy and Safety of Lipase Inhibitor Orlistat in Japanese with Excessive Visceral Fat Accumulation: 24-Week, Double-Blind, Randomized, Placebo-Controlled Study. Adv Ther 2019; 36:86-100. [PMID: 30535651 PMCID: PMC6318260 DOI: 10.1007/s12325-018-0835-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Indexed: 11/30/2022]
Abstract
Introduction Orlistat is an inhibitor of pancreatic lipase and is used as an anti-obesity drug in many countries. However, there are no data available regarding the effects of orlistat on visceral fat accumulation in Japanese subjects. Therefore, this comparative, placebo-controlled, double-blind, randomized study aimed to evaluate the efficacy and safety of orlistat in Japanese participants with excessive visceral fat accumulation and without dyslipidemia, diabetes mellitus, and hypertension (“metabolic diseases”). Methods The study population included Japanese participants with excessive visceral fat accumulation (waist circumference ≥ 85 cm in males and ≥ 90 cm in females, which corresponds to a visceral fat area of 100 cm2) and without metabolic diseases. Following a 12-week observation term, participants were randomized to the orlistat 60 mg group (n = 100) or placebo group (n = 100). Both drugs were administered orally three times daily for 24 weeks. Participants were also counseled to improve their diet and to maintain exercise throughout the study. Visceral fat area, subcutaneous fat area, waist circumference, body weight, body mass index, adverse reactions, laboratory tests, and blood pressure were regularly assessed. Results Visceral fat area, waist circumference, and body weight were significantly reduced in the orlistat group (mean ± standard error, − 13.50 ± 1.52%, − 2.51 ± 0.25%, and − 2.79 ± 0.30%, respectively) compared to the placebo group (− 5.45 ± 1.50%, − 1.55 ± 0.26%, and − 1.22 ± 0.28%, respectively) at the last assessment. The main adverse reactions were defecation-related symptoms including oily spotting and flatus with discharge, resulting from the pharmacological effects of orlistat. Most adverse reactions were mild, and none were serious or severe. Conclusion Orlistat administration reduced visceral fat area, waist circumference, and body weight in Japanese participants with excessive visceral fat and without metabolic diseases. In addition, safety was confirmed with a tolerable profile. Orlistat may be useful to reduce excessive visceral fat accumulation when used in combination with diet and exercise. Trial Registration Japan Pharmaceutical Information Center identifier, JapicCTI-184005. Funding Taisho Pharmaceutical Co., Ltd. Electronic Supplementary Material The online version of this article (10.1007/s12325-018-0835-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Kohji Shirai
- Department of Internal Medicine, Mihama Hospital, Chiba, Japan
| | - Toru Fujita
- Taisho Pharmaceutical Co., Ltd., Tokyo, Japan.
| | | | - Yuka Fujii
- Taisho Pharmaceutical Co., Ltd., Tokyo, Japan
| | | | | | | |
Collapse
|
29
|
Bedhiafi T, Charradi K, Azaiz MB, Mahmoudi M, Msakni I, Jebari K, Bouziani A, Limam F, Aouani E. Supplementation of grape seed and skin extract to orlistat therapy prevents high-fat diet-induced murine spleen lipotoxicity. Appl Physiol Nutr Metab 2018; 43:782-794. [PMID: 29514007 DOI: 10.1139/apnm-2017-0743] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2023]
Abstract
Spleen is the largest lymphoid organ and obesity is related to an elevated risk of immunity dysfunction. The mechanism whereby fat adversely affects the spleen is poorly understood. This study was designed to assess the effectiveness of grape seed and skin extract (GSSE) and orlistat (Xenical, Xe) on high-fat diet (HFD)-induced spleen lipotoxicity. Obese rats were treated either with GSSE (4 g/kg body weight) or Xe (2 mg/kg body weight) or GSSE+Xe and monitored for weight loss for 3 months. Animals were then sacrificed and their spleen used for the evaluation of lipotoxicity-induced oxidative stress and inflammation as well as the putative protection afforded by GSSE and Xe treatment. HFD induced body weight gain and glycogen accumulation into the spleen; ectopic deposition of cholesterol and triglycerides and an oxidative stress characterized by increased lipoperoxidation and carbonylation; inhibition of antioxidant enzyme activities, such as catalase, glutathione peroxidase, and superoxide dismutase; depletion of zinc and copper; and a concomitant increase in calcium. HFD also increased plasma pro-inflammatory cytokines, such as interleukin (IL)-6, IL-17A, tumour necrosis factor alpha, and C-reactive protein, and decreased plasma IL-10 and adiponectin. Importantly, GSSE counteracted all the deleterious effects of HFD on spleen (i.e., lipotoxicity, oxidative stress, and inflammation) and the best protection was obtained when combining Xe+GSSE. Combining GSSE with Xe prevented against fat-induced spleen lipotoxicity, oxidative stress, and inflammation; this combination may be beneficial in other diseases related to the spleen.
Collapse
Affiliation(s)
- Takwa Bedhiafi
- a Faculty of Sciences of Bizerte, University of Carthage, 7021 Jarzouna, Tunisia
- b Laboratory of Bioactive Substances, Center of Biotechnology of Borj Cedria, BP 901, 2050 Hammam Lif, Tunisia
| | - Kamel Charradi
- a Faculty of Sciences of Bizerte, University of Carthage, 7021 Jarzouna, Tunisia
- b Laboratory of Bioactive Substances, Center of Biotechnology of Borj Cedria, BP 901, 2050 Hammam Lif, Tunisia
| | - Mouna Ben Azaiz
- c Immunology Department, Military Hospital of Tunis, Tunis, 1008, Tunisia
| | - Mohamed Mahmoudi
- a Faculty of Sciences of Bizerte, University of Carthage, 7021 Jarzouna, Tunisia
- b Laboratory of Bioactive Substances, Center of Biotechnology of Borj Cedria, BP 901, 2050 Hammam Lif, Tunisia
| | - Issam Msakni
- d Anatomy and Cyto-Pathology Department, Military Hospital, Mont-Fleury, Tunis, 1008, Tunisia
| | - Khawla Jebari
- a Faculty of Sciences of Bizerte, University of Carthage, 7021 Jarzouna, Tunisia
- b Laboratory of Bioactive Substances, Center of Biotechnology of Borj Cedria, BP 901, 2050 Hammam Lif, Tunisia
| | - Ammar Bouziani
- d Anatomy and Cyto-Pathology Department, Military Hospital, Mont-Fleury, Tunis, 1008, Tunisia
| | - Ferid Limam
- b Laboratory of Bioactive Substances, Center of Biotechnology of Borj Cedria, BP 901, 2050 Hammam Lif, Tunisia
| | - Ezzedine Aouani
- a Faculty of Sciences of Bizerte, University of Carthage, 7021 Jarzouna, Tunisia
- b Laboratory of Bioactive Substances, Center of Biotechnology of Borj Cedria, BP 901, 2050 Hammam Lif, Tunisia
| |
Collapse
|
30
|
Song J, Ruan X, Gu M, Wang L, Wang H, Mueck AO. Effect of orlistat or metformin in overweight and obese polycystic ovary syndrome patients with insulin resistance. Gynecol Endocrinol 2018; 34:413-417. [PMID: 29172796 DOI: 10.1080/09513590.2017.1407752] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The aim of this study was to evaluate the effect of orlistat or metformin combined with Diane-35 on anthropometric, hormonal and metabolic parameters in overweight and obese polycystic ovary syndrome (PCOS) patients with insulin resistance (fasting insulin > 10 mIU/L). A total of 240 PCOS women were randomly allocated to orlistat plus Diane-35(OD group), metformin plus Diane-35(MD group), orlistat plus metformin plus Diane-35(OMD group) or Diane-35 (D group). Body weight, BMI, waist and hip circumference, blood pressure, endocrine profile, lipid profile and insulin resistance were assessed at baseline and after 3 months. Significant reductions in waist and hip circumference, serum LH, total testosterone and uric acid were observed in all groups compared with baseline. TG and TC significantly decreased in the OD group. Homeostasis model assessment insulin resistance (HOMA-IR) index was reduced in the OD (p = .015), MD (p = .001) and OMD (p = .004) groups. Body weight, BMI, systolic BP and HDL-C significantly changed in the OD and OMD group compared with the D group (p < .05). Side effects were less with orlistat than metformin. This study demonstrated that orlistat is more effective in reducing weight and lipid profile than metformin. Besides, orlistat has mild side-effects and is better tolerated compared with metformin.
Collapse
Affiliation(s)
- Jinghua Song
- a Department of Gynecological Endocrinology Beijing Obstetrics and Gynecology Hospital , Capital Medical University , Beijing , China
- b Department of Obstetrics and Gynecology , Beijing Anzhen Hospital, Capital Medical University , Beijing , China
| | - Xiangyan Ruan
- a Department of Gynecological Endocrinology Beijing Obstetrics and Gynecology Hospital , Capital Medical University , Beijing , China
- c Department of Women's Health , University Hospitals of Tuebingen , Tuebingen , Germany
| | - Muqing Gu
- a Department of Gynecological Endocrinology Beijing Obstetrics and Gynecology Hospital , Capital Medical University , Beijing , China
| | - Lijuan Wang
- a Department of Gynecological Endocrinology Beijing Obstetrics and Gynecology Hospital , Capital Medical University , Beijing , China
| | - Husheng Wang
- a Department of Gynecological Endocrinology Beijing Obstetrics and Gynecology Hospital , Capital Medical University , Beijing , China
| | - Alfred Otto Mueck
- a Department of Gynecological Endocrinology Beijing Obstetrics and Gynecology Hospital , Capital Medical University , Beijing , China
- c Department of Women's Health , University Hospitals of Tuebingen , Tuebingen , Germany
| |
Collapse
|
31
|
Abstract
Obesity is a major cause of type 2 diabetes and may complicate type 1 diabetes. Weight loss for obese individuals with diabetes has many health benefits, often leads to improvement in glucose control and sometimes, in type 2 diabetes, near normalisation of abnormal glucose metabolism. Weight loss is difficult to maintain and attempts to lose weight may be undermined by some diabetes treatments such as sulfonylureas, thiazolidinediones and insulin. Whilst lifestyle support should be the primary approach to aid individuals who wish to lose weight, pharmacological approaches can also be considered. These include choosing glucose-lowering drugs or drug combinations that are weight neutral or result in weight loss or prescribing drugs that are specifically approved as anti-obesity medication. Given that some of the newer glucose-lowering medications that cause weight loss, such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2i), are also being used or considered for use as anti-obesity drugs, it seems that the distinction between glucose-lowering medication and weight loss medication is becoming blurred. This review discusses the main pharmacological approaches that can be used to support weight loss in individuals with diabetes.
Collapse
Affiliation(s)
- John P H Wilding
- Obesity and Endocrinology Research, Institute of Ageing and Chronic Disease, Clinical Sciences Centre, University of Liverpool, Longmoor Lane, Liverpool, L9 7AL, UK.
| |
Collapse
|
32
|
Abstract
Although diet, physical activity, and behavioral modifications are the cornerstones of weight management, weight loss achieved by lifestyle modifications alone is often limited and difficult to maintain. Pharmacotherapy for obesity can be considered if patients have a body mass index (BMI) of 30 kg/m2 or greater or BMI of 27 kg/m2 or greater with weight-related comorbidities. The 6 most commonly used antiobesity medications are phentermine, orlistat, phentermine/topiramate extended release, lorcaserin, naltrexone sustained release (SR)/bupropion SR, and liraglutide 3.0 mg. Successful pharmacotherapy for obesity depends on tailoring treatment to patients' behaviors and comorbidities and monitoring of efficacy, safety, and tolerability.
Collapse
Affiliation(s)
- Katherine H Saunders
- Comprehensive Weight Control Center, Division of Endocrinology, Diabetes, and Metabolism, Weill Cornell Medicine, 1165 York Avenue, New York, NY 10065, USA.
| | - Devika Umashanker
- Comprehensive Weight Control Center, Division of Endocrinology, Diabetes, and Metabolism, Weill Cornell Medicine, 1165 York Avenue, New York, NY 10065, USA
| | - Leon I Igel
- Comprehensive Weight Control Center, Division of Endocrinology, Diabetes, and Metabolism, Weill Cornell Medicine, 1165 York Avenue, New York, NY 10065, USA
| | - Rekha B Kumar
- Comprehensive Weight Control Center, Division of Endocrinology, Diabetes, and Metabolism, Weill Cornell Medicine, 1165 York Avenue, New York, NY 10065, USA
| | - Louis J Aronne
- Comprehensive Weight Control Center, Division of Endocrinology, Diabetes, and Metabolism, Weill Cornell Medicine, 1165 York Avenue, New York, NY 10065, USA
| |
Collapse
|
33
|
Zaid AN, Zohud N, E’layan B, Aburadi T, Jaradat N, Ali I, Hussein F, Ghanem M, Qaddomi A, Abu Zaaror Y. Pharmacodynamic testing and new validated HPLC method to assess the interchangeability between multi-source orlistat capsules. Drug Des Devel Ther 2017; 11:3291-3298. [PMID: 29200824 PMCID: PMC5701567 DOI: 10.2147/dddt.s138926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Orlistat is an irreversible inhibitor of the lipase enzyme that prevents trigylcerides from being digested, thereby inhibiting triglyceride hydrolysis and absorption. The resultant reduced calorie uptake enables a positive effect on weight control. Systemic absorption of the drug is, therefore, not necessary for its mode of action. An alternative in vitro study (pharmacodynamic) has been introduced for this drug, as in vivo bioavailability studies are irrelevant with regard to the achievement of the product's intended purposes. OBJECTIVES To develop a new validated high-performance liquid chromatography (HPLC) method for the analysis of orlistat and to assess the potency and equivalence of three orlistat formulations using the pharmacodynamic method as a surrogate indicator of pharmaceutical interchangeability. METHODS A new HPLC method was developed for the analysis and for the dissolution studies of orlistat in capsules. Pancreatic lipase activity was measured for three different capsule products: Orlislim®, Slimcare®, and Xenical®, G1, G2, and the brand, respectively. Porcine pancreatic lipase and p-nitrophenyl butyrate (PNPB) were placed in a pH 7.4 reaction buffer at 37°C, and substrate hydrolysis was monitored by measuring absorbance changes at 410 nm; this was repeated on six capsules of each product. The inhibition was expressed by the concentration of product, which inhibited 50% of the activity of pancreatic lipase (IC50). RESULTS The new analytical method was suitable for orlistat analysis. Values of IC50 from regression lines and equations were 6.14, 8.43, and 7.80 μg/mL for Orlislim®, Xenical®, and Slimcare®, respectively. CONCLUSION Pharmacodynamic studies of lipase inhibition could be used to support in vitro dissolution, which demonstrates interchangeability between generic and branded orlistat capsules. Moreover, it could be suggested as an alternative tool to bioequivalence studies for orlistat oral products.
Collapse
Affiliation(s)
| | | | | | | | | | - Iyad Ali
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus
| | | | | | | | - Yara Abu Zaaror
- Department of Research and Development Pharmacare PLC, Ramallah, Palestine
| |
Collapse
|
34
|
Abstract
PURPOSE Adiponectin and chemerin have been reported their associations with insulin resistance and chronic inflammation. However, the relationship between adiponectin and chemerin themselves has not been fully elucidated. Therefore, we investigated the effects of changes in adiponectin and chemerin levels after a weight intervention. MATERIALS AND METHODS We recruited 136 healthy overweight or obese subjects from 2006 to 2009 and provided all participants lifestyle modification therapy with diet consultations over 16 weeks. We assigned the participants to take orlistat or sibutramine or to a no prescription group. We analyzed the data using paired t-tests, Pearson's partial correlation analysis, and stepwise multiple linear regression analysis. RESULTS ∆ in chemerin was positively correlated with ∆ in adiponectin (r = 0.29, p < 0.01), and these trends were similar in the insulin-resistant (r = 0.35, p = 0.03) and insulin-sensitive (r = 0.27, p < 0.01) groups. In multiple regression analyses, Δadiponectin, ΔQUICKI (quantitative insulin-sensitivity check index), Δglucose, and ΔDBP were significantly associated with Δchemerin in the insulin-resistant group, and initial chemerin level, ΔQUICKI, ΔBMI (body mass index), and taking orlistat were associated with Δchemerin in the insulin-sensitive group. CONCLUSIONS Changes in chemerin levels were positively associated with changes in adiponectin levels. The association between these changes might be related to chemerin's dual inflammatory and anti-inflammatory effects or insulin resistance and insulin sensitivity enhancing effects, depending on the metabolic conditions. Additional studies are needed to clarify the mechanisms that underlie the effects of adiponectin and chemerin.
Collapse
Affiliation(s)
- Hyun-Young Shin
- a Department of Family Medicine, Myongji Hospital, Seonam University, College of Medicine , Gyeonggi-do Republic of Korea
| | - Sohee Park
- b Department of Biostatistics, Graduate School of Public Health, Yonsei University , Seoul , Korea
| | - Ji Won Lee
- c Department of Family Medicine, Gangnam Severance Hospital, University College of Medicine , Seoul , Korea
| |
Collapse
|
35
|
Merola N, Castillo J, Benavente-García O, Ros G, Nieto G. The Effect of Consumption of Citrus Fruit and Olive Leaf Extract on Lipid Metabolism. Nutrients 2017; 9:E1062. [PMID: 28954421 PMCID: PMC5691679 DOI: 10.3390/nu9101062] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/30/2017] [Accepted: 09/19/2017] [Indexed: 11/25/2022] Open
Abstract
Citrus fruit and olive leaves are a source of bioactive compounds such as biophenols which have been shown to ameliorate obesity-related conditions through their anti-hyperlipidemic and anti-inflammatory effect, and by regulating lipoproteins and cholesterol body levels. Citrolive™ is a commercial extract which is obtained from the combination of both citrus fruit and olive leaf extracts; hence, it is hypothesised that Citrolive™ may moderate metabolic disorders that are related to obesity and their complications. Initially, an in vitro study of the inhibition of pancreatic lipase activity was made, however, no effect was found. Both preliminary and long-term evaluations of Citrolive™ on lipid metabolism were conducted in an animal model using Wistar rats. In the preliminary in vivo screening, Citrolive™ was tested on postprandial plasma triglyceride level after the administration of an oil emulsion, and a significant reduction in postprandial triacylglycerol (TAG) levels was observed. In the long-term study, Citrolive™ was administered for 60 days on Wistar rats that were fed a high-fat diet. During the study, several associated lipid metabolism indicators were analysed in blood and faeces. At the end of the experiment, the livers were removed and weighed for group comparison. Citrolive™ treatment significantly reduced the liver-to-body-weight ratio, as supported by reduced plasma transaminases compared with control, but insignificantly reduced plasma low density lipoprotein (LDL) and postprandial TAG plasma levels. In addition, faecal analysis showed that the treatment significantly increased total cholesterol excretion. On the other hand, no effect was found on faecal TAG and pancreatic lipase in vitro. In conclusion, treatment ameliorates liver inflammation symptoms that are worsened by the effects of high fat diet.
Collapse
Affiliation(s)
- Nicola Merola
- Department of Food Technology, Nutrition and Food Science, Veterinary Faculty University of Murcia, Campus de Espinardo, 30100 Espinardo, Murcia, Spain.
| | - Julián Castillo
- Research and Development Department of Nutrafur-Frutarom Group, Camino Viejo de Pliego s/n, 80320 Alcantarilla, Murcia, Spain.
| | - Obdulio Benavente-García
- Research and Development Department of Nutrafur-Frutarom Group, Camino Viejo de Pliego s/n, 80320 Alcantarilla, Murcia, Spain.
| | - Gaspar Ros
- Department of Food Technology, Nutrition and Food Science, Veterinary Faculty University of Murcia, Campus de Espinardo, 30100 Espinardo, Murcia, Spain.
| | - Gema Nieto
- Department of Food Technology, Nutrition and Food Science, Veterinary Faculty University of Murcia, Campus de Espinardo, 30100 Espinardo, Murcia, Spain.
| |
Collapse
|
36
|
Sun S, Jin M, Zhou X, Ni J, Jin X, Liu H, Wang Y. The Application of Quantitative ¹H-NMR for the Determination of Orlistat in Tablets. Molecules 2017; 22:molecules22091517. [PMID: 28891958 PMCID: PMC6151513 DOI: 10.3390/molecules22091517] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 09/07/2017] [Accepted: 09/08/2017] [Indexed: 01/01/2023] Open
Abstract
A quantitative nuclear magnetic resonance (qNMR) method to measure the content of Orlistat in tablets was studied and found to be efficient, accurate, reliable, and simple. In this paper, phloroglucinolanhydrous and dimethylsulfoxide-d6 (DMSO-d6) served as the internal standard and solvent, respectively. The qNMR methodology, including the linearity, range, the limit of detection (LOD) and quantification (LOQ), stability, precision, and accuracy, was validated seriatim, and the results were very favorable. The content determination results of three batches of Orlistat in tablets were almost identical upon comparing the qNMR method and the high-performance liquid chromatography (HPLC) method. The recommended method authentically compensated the deficiencies of the current HPLC method for determining Orlistat content, and proved to be a method complementary to traditional analysis for the purity measurement of Orlistat in some pharmaceutical preparations.
Collapse
Affiliation(s)
- Shanshan Sun
- State Key Laboratory for Bioactive Substances and Functions of Natural Medicines and Beijing Key Laboratory of New Drug Mechanisms and Pharmacological Evaluation Study, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Xiannongtan Street, Beijing 100050, China.
| | - Mengxia Jin
- State Key Laboratory for Bioactive Substances and Functions of Natural Medicines and Beijing Key Laboratory of New Drug Mechanisms and Pharmacological Evaluation Study, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Xiannongtan Street, Beijing 100050, China.
| | - Xia Zhou
- State Key Laboratory for Bioactive Substances and Functions of Natural Medicines and Beijing Key Laboratory of New Drug Mechanisms and Pharmacological Evaluation Study, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Xiannongtan Street, Beijing 100050, China.
| | - Jinghua Ni
- State Key Laboratory for Bioactive Substances and Functions of Natural Medicines and Beijing Key Laboratory of New Drug Mechanisms and Pharmacological Evaluation Study, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Xiannongtan Street, Beijing 100050, China.
| | - Xiangju Jin
- State Key Laboratory for Bioactive Substances and Functions of Natural Medicines and Beijing Key Laboratory of New Drug Mechanisms and Pharmacological Evaluation Study, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Xiannongtan Street, Beijing 100050, China.
| | - Hongyue Liu
- State Key Laboratory for Bioactive Substances and Functions of Natural Medicines and Beijing Key Laboratory of New Drug Mechanisms and Pharmacological Evaluation Study, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Xiannongtan Street, Beijing 100050, China.
| | - Yinghong Wang
- State Key Laboratory for Bioactive Substances and Functions of Natural Medicines and Beijing Key Laboratory of New Drug Mechanisms and Pharmacological Evaluation Study, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Xiannongtan Street, Beijing 100050, China.
| |
Collapse
|
37
|
Dawson AJ, Kilpatrick ES, Coady AM, Elshewehy AMM, Dakroury Y, Ahmed L, Atkin SL, Sathyapalan T. Endocannabinoid receptor blockade reduces alanine aminotransferase in polycystic ovary syndrome independent of weight loss. BMC Endocr Disord 2017; 17:41. [PMID: 28705172 PMCID: PMC5512818 DOI: 10.1186/s12902-017-0194-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 07/09/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Evidence suggests that endocannabinoid system activation through the cannabinoid receptor 1 (CB1) is associated with enhanced liver injury, and CB1 antagonism may be beneficial. The aim of this study was to determine the impact of rimonabant (CB1 antagonist) on alanine aminotransferase (ALT), a hepatocellular injury marker, and a hepatic inflammatory cytokine profile. METHODS Post hoc review of 2 studies involving 50 obese women with PCOS and well matched for weight, randomised to weight reducing therapy; rimonabant (20 mg od) or orlistat (120 mg tds), or to insulin sensitising therapy metformin, (500 mg tds), or pioglitazone (45 mg od). No subject had non-alcoholic fatty liver disease (NAFLD). RESULTS Treatment with rimonabant for 12 weeks reduced both ALT and weight (p < 0.01), and there was a negative correlation between Δ ALT and Δ HOMA-IR (p < 0.001), but not between Δ ALT and Δ weight. There was a significant reduction of weight with orlistat (p < 0.01); however, orlistat, metformin and pioglitazone had no effect on ALT. The free androgen index fell in all groups (p < 0.05). The inflammatory marker hs-CRP was reduced by pioglitazone (p < 0.001) alone and did not correlate with changes in ALT. The inflammatory cytokine profile for IL-1β, IL-6, IL-7, IL-10, IL12, TNF-α, MCP-1 and INF-γ did not differ between groups. None of the interventions had an effect on biological variability of ALT. CONCLUSION Rimonabant through CB1 receptor blockade decreased serum ALT that was independent of weight loss and hepatic inflammatory markers in obese women with PCOS without NAFLD. TRIAL REGISTRATION ISRCTN58369615 (February 2007; retrospectively registered) ISRCTN75758249 (October 2007; retrospectively registered).
Collapse
Affiliation(s)
- Alison J. Dawson
- Department of Diabetes and Endocrinology, University of Hull, Hull, UK
| | - Eric S. Kilpatrick
- Department of Clinical Biochemistry, Sidra Medical and Research Centre, Doha, Qatar
| | - Anne-Marie Coady
- Department of Obstetric Ultrasound, Hull & East Yorkshire Women’s & Children’s Hospital, Hull, UK
| | | | - Youssra Dakroury
- Weill Cornell Medicine Qatar, Research Department, PO Box 24144, Doha, Qatar
| | - Lina Ahmed
- Weill Cornell Medicine Qatar, Research Department, PO Box 24144, Doha, Qatar
| | - Stephen L. Atkin
- Weill Cornell Medicine Qatar, Research Department, PO Box 24144, Doha, Qatar
| | | |
Collapse
|
38
|
O'Connor EA, Evans CV, Burda BU, Walsh ES, Eder M, Lozano P. Screening for Obesity and Intervention for Weight Management in Children and Adolescents: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2017. [PMID: 28632873 DOI: 10.1001/jama.2017.0332] [Citation(s) in RCA: 308] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Obesity is common in children and adolescents in the United States, is associated with negative health effects, and increases the likelihood of obesity in adulthood. OBJECTIVE To systematically review the benefits and harms of screening and treatment for obesity and overweight in children and adolescents to inform the US Preventive Services Task Force. DATA SOURCES MEDLINE, PubMed, PsycINFO, Cochrane Collaboration Registry of Controlled Trials, and the Education Resources Information Center through January 22, 2016; references of relevant publications; government websites. Surveillance continued through December 5, 2016. STUDY SELECTION English-language trials of benefits or harms of screening or treatment (behavior-based, orlistat, metformin) for overweight or obesity in children aged 2 through 18 years, conducted in or recruited from health care settings. DATA EXTRACTION AND SYNTHESIS Two investigators independently reviewed abstracts and full-text articles, then extracted data from fair- and good-quality trials. Random-effects meta-analysis was used to estimate the benefits of lifestyle-based programs and metformin. MAIN OUTCOMES AND MEASURES Weight or excess weight (eg, body mass index [BMI]; BMI z score, measuring the number of standard deviations from the median BMI for age and sex), cardiometabolic outcomes, quality of life, other health outcomes, harms. RESULTS There was no direct evidence on the benefits or harms of screening children and adolescents for excess weight. Among 42 trials of lifestyle-based interventions to reduce excess weight (N = 6956), those with an estimated 26 hours or more of contact consistently demonstrated mean reductions in excess weight compared with usual care or other control groups after 6 to 12 months, with no evidence of causing harm. Generally, intervention groups showed absolute reductions in BMI z score of 0.20 or more and maintained their baseline weight within a mean of approximately 5 lb, while control groups showed small increases or no change in BMI z score, typically gaining a mean of 5 to 17 lb. Only 3 of 26 interventions with fewer contact hours showed a benefit in weight reduction. Use of metformin (8 studies, n = 616) and orlistat (3 studies, n = 779) were associated with greater BMI reductions compared with placebo: -0.86 (95% CI, -1.44 to -0.29; 6 studies; I2 = 0%) for metformin and -0.50 to -0.94 for orlistat. Groups receiving lifestyle-based interventions offering 52 or more hours of contact showed greater improvements in blood pressure than control groups: -6.4 mm Hg (95% CI, -8.6 to -4.2; 6 studies; I2 = 51%) for systolic blood pressure and -4.0 mm Hg (95% CI, -5.6 to -2.5; 6 studies; I2 = 17%) for diastolic blood pressure. There were mixed findings for insulin or glucose measures and no benefit for lipids. Medications showed small or no benefit for cardiometabolic outcomes, including fasting glucose level. Nonserious harms were common with medication use, although discontinuation due to adverse effects was usually less than 5%. CONCLUSIONS AND RELEVANCE Lifestyle-based weight loss interventions with 26 or more hours of intervention contact are likely to help reduce excess weight in children and adolescents. The clinical significance of the small benefit of medication use is unclear.
Collapse
Affiliation(s)
- Elizabeth A O'Connor
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Portland, Oregon
| | - Corinne V Evans
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Portland, Oregon
| | - Brittany U Burda
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Portland, Oregon
| | - Emily S Walsh
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Portland, Oregon
| | - Michelle Eder
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Portland, Oregon
| | - Paula Lozano
- Kaiser Permanente Research Affiliates Evidence-based Practice Center, Group Health Research Institute, Seattle, Washington
| |
Collapse
|
39
|
Zhu M, Harshbarger WD, Robles O, Krysiak J, Hull KG, Cho SW, Richardson RD, Yang Y, Garcia A, Spiegelman L, Ramirez B, Wilson CT, Yau JA, Moore JT, Walker CB, Sacchettini JC, Liu WR, Sieber SA, Smith JW, Romo D. A strategy for dual inhibition of the proteasome and fatty acid synthase with belactosin C- orlistat hybrids. Bioorg Med Chem 2017; 25:2901-2916. [PMID: 28236510 PMCID: PMC5522751 DOI: 10.1016/j.bmc.2017.01.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 01/13/2017] [Indexed: 11/21/2022]
Abstract
The proteasome, a validated cellular target for cancer, is central for maintaining cellular homeostasis, while fatty acid synthase (FAS), a novel target for numerous cancers, is responsible for palmitic acid biosynthesis. Perturbation of either enzymatic machine results in decreased proliferation and ultimately cellular apoptosis. Based on structural similarities, we hypothesized that hybrid molecules of belactosin C, a known proteasome inhibitor, and orlistat, a known inhibitor of the thioesterase domain of FAS, could inhibit both enzymes. Herein, we describe proof-of-principle studies leading to the design, synthesis and enzymatic activity of several novel, β-lactone-based, dual inhibitors of these two enzymes. Validation of dual enzyme targeting through activity-based proteome profiling with an alkyne probe modeled after the most potent inhibitor, and preliminary serum stability studies of selected derivatives are also described. These results provide proof of concept for dual targeting of the proteasome and fatty acid synthase-thioesterase (FAS-TE) enabling a new approach for the development of drug-candidates with potential to overcome resistance.
Collapse
Affiliation(s)
- Mingzhao Zhu
- Department of Chemistry & Biochemistry and CPRIT Synthesis and Drug-Lead Discovery Laboratory, Baylor University, Waco, TX 76706, USA
| | - Wayne D Harshbarger
- Department of Biochemistry & Biophysics, Texas A&M University, College Station, TX 77840, USA
| | - Omar Robles
- Department of Chemistry, Texas A&M University, College Station, TX 77842, USA
| | - Joanna Krysiak
- Department of Chemistry, Technische Universität München, Lichtenbergstr. 4, 85747 Garching, Germany
| | - Kenneth G Hull
- Department of Chemistry & Biochemistry and CPRIT Synthesis and Drug-Lead Discovery Laboratory, Baylor University, Waco, TX 76706, USA
| | - Sung Wook Cho
- Department of Chemistry, Texas A&M University, College Station, TX 77842, USA
| | | | - Yanyan Yang
- Department of Chemistry, Texas A&M University, College Station, TX 77842, USA
| | - Andres Garcia
- Department of Chemistry, Texas A&M University, College Station, TX 77842, USA
| | - Lindsey Spiegelman
- Department of Chemistry, Texas A&M University, College Station, TX 77842, USA
| | - Bianca Ramirez
- Department of Chemistry, Texas A&M University, College Station, TX 77842, USA
| | | | - Ju Anne Yau
- Department of Chemistry, Texas A&M University, College Station, TX 77842, USA
| | - James T Moore
- Department of Chemistry, Texas A&M University, College Station, TX 77842, USA
| | - Caitlen B Walker
- Department of Chemistry, Texas A&M University, College Station, TX 77842, USA
| | - James C Sacchettini
- Department of Biochemistry & Biophysics, Texas A&M University, College Station, TX 77840, USA
| | - Wenshe R Liu
- Department of Chemistry, Texas A&M University, College Station, TX 77842, USA
| | - Stephan A Sieber
- Department of Chemistry, Technische Universität München, Lichtenbergstr. 4, 85747 Garching, Germany
| | - Jeffrey W Smith
- Sanford Burnham Medical Research Institute, La Jolla, CA, USA
| | - Daniel Romo
- Department of Chemistry & Biochemistry and CPRIT Synthesis and Drug-Lead Discovery Laboratory, Baylor University, Waco, TX 76706, USA.
| |
Collapse
|
40
|
Larsson I, Sandqvist M, Werling M, Wiklund M, Bergh C, Eliasson B. [Energy restriction and adherence required for weight loss without surgery]. Lakartidningen 2017; 114:EFF9. [PMID: 28440846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Energy restriction and adherence required for weight loss without surgery Non-surgical weight loss treatment has not been shown to reduce mortality or cardiovascular morbidity, but can prevent diabetes mellitus and improves cardiovascular risk factors. For weight loss, energy restriction is fundamental and can lead to an average 2 to 20 kg loss over 6 to 12 months. Pharmacological treatment, behaviour therapy, physical activity and weight loss advice through web sites and smartphone applications and combinations in addition to energy restriction can contribute to further, but relatively limited weight loss up to 30 months. Adherence to the treatment is necessary for both weight loss and long-term weight loss maintenance.
Collapse
Affiliation(s)
| | - Madeléne Sandqvist
- Regionalt Obesitascentrum - Göteborg, Sweden Regionalt Obesitascentrum - Göteborg, Sweden
| | - Malin Werling
- Sahlgrenska universitetssjukhuset - Goteborg, Sweden Sahlgrenska universitetssjukhuset - Goteborg, Sweden
| | - Malin Wiklund
- Vastra Gotalandsregion - Koncernstab Hälso- och sjukvård, Koncernkontoret Göteborg, Sweden Vastra Gotalandsregion - Koncernstab Hälso- och sjukvård, Koncernkontoret Göteborg, Sweden
| | - Christina Bergh
- Institute of Clinical Sciences - Department of Obstetrics and Gynecology Gothenburg, Sweden Institute of Clinical Sciences - Department of Obstetrics and Gynecology Gothenburg, Sweden
| | - Björn Eliasson
- Regionalt Obesitascentrum - Göteborg, Sweden - Göteborg, Sweden
| |
Collapse
|
41
|
Choi J, Kim KJ, Koh EJ, Lee BY. Gelidium elegans Regulates the AMPK-PRDM16-UCP-1 Pathway and Has a Synergistic Effect with Orlistat on Obesity-Associated Features in Mice Fed a High-Fat Diet. Nutrients 2017; 9:E342. [PMID: 28358328 PMCID: PMC5409681 DOI: 10.3390/nu9040342] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 03/28/2017] [Indexed: 12/14/2022] Open
Abstract
The incidence of obesity is rising at an alarming rate throughout the world and is becoming a major public health concern with incalculable social and economic costs. Gelidium elegans (GENS), also previously known as Gelidium amansii, has been shown to exhibit anti-obesity effects. Nevertheless, the mechanism by which GENS is able to do this remains unclear. In the present study, our results showed that GENS prevents high-fat diet (HFD)-induced weight gain through modulation of the adenosine monophosphate-activated protein kinase (AMPK)-PR domain-containing16 (PRDM16)-uncoupling protein-1 (UCP-1) pathway in a mice model. We also found that GENS decreased hyperglycemia in mice that had been fed a HFD compared to corresponding controls. We also assessed the beneficial effect of the combined treatment with GENS and orlistat (a Food and Drug Administration-approved obesity drug) on obesity characteristics in HFD-fed mice. We found that in HFD-fed mice, the combination of GENS and orlistat is associated with more significant weight loss than orlistat treatment alone. Moreover, our results demonstrated a positive synergistic effect of GENS and orlistat on hyperglycemia and plasma triglyceride level in these animals. Thus, we suggest that a combination therapy of GENS and orlistat may positively influence obesity-related health outcomes in a diet-induced obese population.
Collapse
Affiliation(s)
- Jia Choi
- Department of Food Science and Biotechnology, College of Life Science, CHA University, Seongnam, Kyeonggi 463-400, Korea.
| | - Kui-Jin Kim
- Department of Food Science and Biotechnology, College of Life Science, CHA University, Seongnam, Kyeonggi 463-400, Korea.
| | - Eun-Jeong Koh
- Department of Food Science and Biotechnology, College of Life Science, CHA University, Seongnam, Kyeonggi 463-400, Korea.
| | - Boo-Yong Lee
- Department of Food Science and Biotechnology, College of Life Science, CHA University, Seongnam, Kyeonggi 463-400, Korea.
| |
Collapse
|
42
|
Rajjo T, Mohammed K, Alsawas M, Ahmed AT, Farah W, Asi N, Almasri J, Prokop LJ, Murad MH. Treatment of Pediatric Obesity: An Umbrella Systematic Review. J Clin Endocrinol Metab 2017; 102:763-775. [PMID: 28359101 DOI: 10.1210/jc.2016-2574] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 10/14/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Multiple interventions are available to reduce excess body weight in children. We appraised the quality of evidence supporting each intervention and assessed the effectiveness on different obesity-related outcomes. METHODS We conducted a systematic search for systematic reviews of randomized controlled trials evaluating pediatric obesity interventions applied for ≥6 months. We assessed the quality of evidence for each intervention using GRADE (Grading of Recommendation, Assessment, Development, and Evaluation) approach. RESULTS From 16 systematic reviews, we identified 133 eligible randomized controlled trials. Physical activity interventions reduced systolic blood pressure and fasting glucose (low to moderate quality of evidence). Dietary interventions with low-carbohydrate diets had a similar effect to low-fat diets in terms of body mass index (BMI) reduction (moderate quality of evidence). Educational interventions reduced waist circumference, BMI, and diastolic blood pressure (low quality of evidence). Pharmacological interventions reduced BMI (metformin, sibutramine, orlistat) and waist circumference (sibutramine, orlistat) and increased high-density lipoprotein cholesterol (sibutramine) but also raised systolic and diastolic blood pressure (sibutramine). Surgical interventions (laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass, sleeve gastrectomy) resulted in the largest BMI reduction (moderate quality of evidence). Combined interventions consisting of dietary modification, physical activity, behavioral therapy, and education significantly reduced systolic and diastolic blood pressure, BMI, and triglycerides. Combined parent-child interventions and parent-only interventions had similar effects on BMI (low quality of evidence). CONCLUSIONS Several childhood obesity interventions are effective in improving metabolic and anthropometric measures. A comprehensive multicomponent intervention, however, appears to have the best overall outcomes.
Collapse
Affiliation(s)
- Tamim Rajjo
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
- Department of Family Medicine
| | - Khaled Mohammed
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
- Division of Preventive, Occupational and Aerospace Medicine, and
| | - Mouaz Alsawas
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
- Division of Preventive, Occupational and Aerospace Medicine, and
| | - Ahmed T Ahmed
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
| | - Wigdan Farah
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
- Division of Preventive, Occupational and Aerospace Medicine, and
| | - Noor Asi
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
- Division of Preventive, Occupational and Aerospace Medicine, and
| | - Jehad Almasri
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
- Division of Preventive, Occupational and Aerospace Medicine, and
| | - Larry J Prokop
- Library Public Services, Mayo Clinic, Rochester, Minnesota 55905
| | - Mohammad Hassan Murad
- Evidence-Based Practice Center, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery
- Division of Preventive, Occupational and Aerospace Medicine, and
| |
Collapse
|
43
|
Curry SA. Obesity Epidemic: Pharmaceutical Weight Loss. R I Med J (2013) 2017; 100:18-20. [PMID: 28246654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Obesity is a chronic disease universally defined as an excess of adipose tissue resulting in body mass index (BMI) > 30.0 kg/m2. Over the past few years, the concept of prevention has gained increased awareness, thus leading to the development of additional pharmaceutical options for the treatment of obesity since 2012. Treating obesity revolves around an individualized, multi-disciplinary approach with additional focus on a healthy and supportive lifestyle to maintain the weight loss. [Full article available at http://rimed.org/rimedicaljournal-2017-03.asp].
Collapse
Affiliation(s)
- Stephanie A Curry
- Division of Endocrinology, Diabetes and Metabolism, CharterCARE Medical Associates, Providence RI
| |
Collapse
|
44
|
Bourns L, Shiau J. Should family physicians prescribe medication for obesity? YES. Can Fam Physician 2017; 63:102-103. [PMID: 28209667 PMCID: PMC5395373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Laura Bourns
- Family physician completing her residency in Public Health and Preventive Medicine at the University of Ottawa in Ontario.
| | - Judy Shiau
- Medical Director of the LEAF Weight Management Clinic and Assistant Professor and Bariatric Medicine Fellowship Program Director at the University of Ottawa
| |
Collapse
|
45
|
Shaw E. Should family physicians prescribe medication for obesity? NO. Can Fam Physician 2017; 63:103-105. [PMID: 28209668 PMCID: PMC5395374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Elizabeth Shaw
- Family physician and Professor of Family Medicine at McMaster University in Hamilton, Ont.
| |
Collapse
|
46
|
Lee PC, Dixon J. Pharmacotherapy for obesity. Aust Fam Physician 2017; 46:472-477. [PMID: 28697290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Obesity is a serious, chronic, relapsing disease of energy regulation, with strong genetic and early-life environmental determinants. Pharmacotherapy can be a useful adjunct to lifestyle intervention in effecting and maintaining clinically meaningful weight loss. OBJECTIVE The aim of this article is to discuss the role of pharmacotherapy in obesity management. The efficacy, side effects and contraindications of available weight-loss medications are reviewed. DISCUSSION Long-term pharmacotherapy options, which can be effective in providing moderate weight loss, are available to treat obesity. Pharma-cotherapy should be considered an adjunct to lifestyle intervention in those with a body mass index (BMI) >30 kg/m30 kg/m2, or in those with a BMI of 27-30 kg/m2 and obesity-related complications. Safety and efficacy should be monitored closely on commencement, and the medication should be discontinued if there are safety or tolerability issues, or if.
Collapse
|
47
|
Conde K, Fabelo C, Krause WC, Propst R, Goethel J, Fischer D, Hur J, Meza C, Ingraham HA, Wagner EJ. Testosterone Rapidly Augments Retrograde Endocannabinoid Signaling in Proopiomelanocortin Neurons to Suppress Glutamatergic Input from Steroidogenic Factor 1 Neurons via Upregulation of Diacylglycerol Lipase-α. Neuroendocrinology 2017; 105:341-356. [PMID: 27871072 PMCID: PMC5839320 DOI: 10.1159/000453370] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 11/12/2016] [Indexed: 01/09/2023]
Abstract
Testosterone exerts profound effects on reproduction and energy homeostasis. Like other orexigenic hormones, it increases endocannabinoid tone within the hypothalamic feeding circuitry. Therefore, we tested the hypothesis that testosterone upregulates the expression of diacylglycerol lipase (DAGL)α in the hypothalamic arcuate nucleus (ARC) to increase energy intake via enhanced endocannabinoid-mediated retrograde inhibition of anorexigenic proopiomelanocortin (POMC) neurons. Energy intake, meal patterns, and energy expenditure were evaluated in orchidectomized, male guinea pigs treated subcutaneously with testosterone propionate (TP; 400 μg) or its sesame oil vehicle (0.1 mL). TP rapidly increased energy intake, meal size, O2 consumption, CO2 production, and metabolic heat production, all of which were antagonized by prior administration of the DAGL inhibitor orlistat (3 μg) into the third ventricle. These orlistat-sensitive, TP-induced increases in energy intake and expenditure were temporally associated with a significant elevation in ARC DAGLα expression. Electrophysiological recordings in hypothalamic slices revealed that TP potentiated depolarization-induced suppression of excitatory glutamatergic input onto identified ARC POMC neurons, which was also abolished by orlistat (3 μM), the CB1 receptor antagonist AM251 (1 μM), and the AMP-activated protein kinase inhibitor compound C (30 μM) and simulated by transient bath application of the dihydrotestosterone mimetic Cl-4AS-1 (100 nM) and testosterone-conjugated bovine serum albumin (100 nM). Thus, testosterone boosts DAGLα expression to augment retrograde, presynaptic inhibition of glutamate release onto ARC POMC neurons that, in turn, increases energy intake and expenditure. These studies advance our understanding of how androgens work within the hypothalamic feeding circuitry to affect changes in energy balance.
Collapse
Affiliation(s)
- Kristie Conde
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA
| | - Carolina Fabelo
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA
| | - William C. Krause
- Department of Cellular and Molecular Pharmacology, University of California, San Francisco, CA, USA
| | - Robert Propst
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA
| | - Jordan Goethel
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA
| | - Daniel Fischer
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA
| | - Jin Hur
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA
| | - Cecilia Meza
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA
| | - Holly A. Ingraham
- Department of Cellular and Molecular Pharmacology, University of California, San Francisco, CA, USA
| | - Edward J. Wagner
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA
| |
Collapse
|
48
|
Abstract
Ostalactones A-C (1-3), three new β- and ε-lactone natural products, were isolated from the culture broth of the basidiomycete Stereum ostrea. The structures were elucidated by interpretation of HRFABMS and 1D and 2D NMR data. The structures of 1 and 2 are characterized by the presence of a β-lactone containing a fused 4/5 bicyclic core structure. Compound 3 possesses a 2-oxepinone ring system, which is likely to be a biosynthetic precursor of compounds 1 and 2. Ostalactones A (1) and B (2) displayed potent inhibitory activity against human pancreatic lipase.
Collapse
Affiliation(s)
- Hahk-Soo Kang
- Department of Bio-industrial Technologies, Konkuk University , Seoul 05029, Korea
| | - Jong-Pyung Kim
- Korea Research Institute of Bioscience and Biotechnology (KRIBB) , Cheongju, Chungbuk 28116, Korea
| |
Collapse
|
49
|
Axon E, Atkinson G, Richter B, Metzendorf M, Baur L, Finer N, Corpeleijn E, O'Malley C, Ells LJ. Drug interventions for the treatment of obesity in children and adolescents. Cochrane Database Syst Rev 2016; 11:CD012436. [PMID: 27899001 PMCID: PMC6472619 DOI: 10.1002/14651858.cd012436] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Child and adolescent obesity has increased globally, and can be associated with significant short- and long-term health consequences. OBJECTIVES To assess the efficacy of drug interventions for the treatment of obesity in children and adolescents. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PubMed (subsets not available on Ovid), LILACS as well as the trial registers ICTRP (WHO) and ClinicalTrials.gov. Searches were undertaken from inception to March 2016. We checked references and applied no language restrictions. SELECTION CRITERIA We selected randomised controlled trials (RCTs) of pharmacological interventions for treating obesity (licensed and unlicensed for this indication) in children and adolescents (mean age under 18 years) with or without support of family members, with a minimum of three months' pharmacological intervention and six months' follow-up from baseline. We excluded interventions that specifically dealt with the treatment of eating disorders or type 2 diabetes, or included participants with a secondary or syndromic cause of obesity. In addition, we excluded trials which included growth hormone therapies and pregnant participants. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial quality and extracted data following standard Cochrane methodology. Where necessary we contacted authors for additional information. MAIN RESULTS We included 21 trials and identified eight ongoing trials. The included trials evaluated metformin (11 trials), sibutramine (six trials), orlistat (four trials), and one trial arm investigated the combination of metformin and fluoxetine. The ongoing trials evaluated metformin (four trials), topiramate (two trials) and exenatide (two trials). A total of 2484 people participated in the included trials, 1478 participants were randomised to drug intervention and 904 to comparator groups (91 participants took part in two cross-over trials; 11 participants not specified). Eighteen trials used a placebo in the comparator group. Two trials had a cross-over design while the remaining 19 trials were parallel RCTs. The length of the intervention period ranged from 12 weeks to 48 weeks, and the length of follow-up from baseline ranged from six months to 100 weeks.Trials generally had a low risk of bias for random sequence generation, allocation concealment and blinding (participants, personnel and assessors) for subjective and objective outcomes. We judged approximately half of the trials as having a high risk of bias in one or more domain such as selective reporting.The primary outcomes of this review were change in body mass index (BMI), change in weight and adverse events. All 21 trials measured these outcomes. The secondary outcomes were health-related quality of life (only one trial reported results showing no marked differences; very low certainty evidence), body fat distribution (measured in 18 trials), behaviour change (measured in six trials), participants' views of the intervention (not reported), morbidity associated with the intervention (measured in one orlistat trial only reporting more new gallstones following the intervention; very low certainty evidence), all-cause mortality (one suicide in the orlistat intervention group; low certainty evidence) and socioeconomic effects (not reported).Intervention versus comparator for mean difference (MD) in BMI change was -1.3 kg/m2 (95% confidence interval (CI) -1.9 to -0.8; P < 0.00001; 16 trials; 1884 participants; low certainty evidence). When split by drug type, sibutramine, metformin and orlistat all showed reductions in BMI in favour of the intervention.Intervention versus comparator for change in weight showed a MD of -3.9 kg (95% CI -5.9 to -1.9; P < 0.00001; 11 trials; 1180 participants; low certainty evidence). As with BMI, when the trials were split by drug type, sibutramine, metformin and orlistat all showed reductions in weight in favour of the intervention.Five trials reported serious adverse events: 24/878 (2.7%) participants in the intervention groups versus 8/469 (1.7%) participants in the comparator groups (risk ratio (RR) 1.43, 95% CI 0.63 to 3.25; 1347 participants; low certainty evidence). A total 52/1043 (5.0%) participants in the intervention groups versus 17/621 (2.7%) in the comparator groups discontinued the trial because of adverse events (RR 1.45, 95% CI 0.83 to 2.52; 10 trials; 1664 participants; low certainty evidence). The most common adverse events in orlistat and metformin trials were gastrointestinal (such as diarrhoea, mild abdominal pain or discomfort, fatty stools). The most frequent adverse events in sibutramine trials included tachycardia, constipation and hypertension. The single fluoxetine trial reported dry mouth and loose stools. No trial investigated drug treatment for overweight children. AUTHORS' CONCLUSIONS This systematic review is part of a series of associated Cochrane reviews on interventions for obese children and adolescents and has shown that pharmacological interventions (metformin, sibutramine, orlistat and fluoxetine) may have small effects in reduction in BMI and bodyweight in obese children and adolescents. However, many of these drugs are not licensed for the treatment of obesity in children and adolescents, or have been withdrawn. Trials were generally of low quality with many having a short or no post-intervention follow-up period and high dropout rates (overall dropout of 25%). Future research should focus on conducting trials with sufficient power and long-term follow-up, to ensure the long-term effects of any pharmacological intervention are comprehensively assessed. Adverse events should be reported in a more standardised manner specifying amongst other things the number of participants experiencing at least one adverse event. The requirement of regulatory authorities (US Food and Drug Administration and European Medicines Agency) for trials of all new medications to be used in children and adolescents should drive an increase in the number of high quality trials.
Collapse
Affiliation(s)
- Emma Axon
- University of NottinghamCochrane Skin GroupNottinghamUKNG7 2NR
| | - Greg Atkinson
- Teesside UniversityHealth and Social Care InstituteMiddlesbroughUKTS1 3BA
| | - Bernd Richter
- Institute of General Practice, Medical Faculty of the Heinrich‐Heine‐University DüsseldorfCochrane Metabolic and Endocrine Disorders GroupPO Box 101007DüsseldorfGermany40001
| | - Maria‐Inti Metzendorf
- Institute of General Practice, Medical Faculty of the Heinrich‐Heine‐University DüsseldorfCochrane Metabolic and Endocrine Disorders GroupPO Box 101007DüsseldorfGermany40001
| | - Louise Baur
- The University of SydneyDepartment of Paediatrics and Child HealthLocked Bag 4001WestmeadAustraliaNSW 2145
| | - Nicholas Finer
- UCL Institute of Cardiovascular ScienceNational Centre for Cardiovascular Prevention and Outcomes170 Tottenham Court RoadLondonUKW1T 7HA
- Novo Nordisk A/SGlobal Medical Affairs ManagementCopenhagenDenmark
| | - Eva Corpeleijn
- University Medical Centre GroningenDepartment of EpidemiologyHanzeplein 1GroningenNetherlands9713 GZ
| | - Claire O'Malley
- Durham UniversityDepartment of Sport and Exercise SciencesDurhamUKDH1 3HN
| | - Louisa J Ells
- Teesside UniversitySchool of Health and Social CareParkside West OfficesMiddlesbroughUKTS1 3BA
| | | |
Collapse
|
50
|
Anderson JW, Schwartz SM, Hauptman J, Boldrin M, Rossi M, Bansal V, Hale CA. Obesity: Low-Dose Orlistat Effects on Body Weight of Mildly to Moderately Overweight Individuals: A 16 Week, Double-Blind, Placebo-Controlled Trial. Ann Pharmacother 2016; 40:1717-23. [PMID: 16940406 DOI: 10.1345/aph.1h234] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Lifestyle measures are considered the first line of therapy for treating overweight individuals, but many are unable to achieve a meaningful weight loss. Objective: To determine the efficacy and safety of orlistat 60 mg, given 3 times daily, for weight loss in mildly to moderately overweight individuals. Methods: A multicenter, 16 week, randomized, double-blind, placebo-controlled study was conducted in 391 overweight subjects at 20 US centers. The main outcome measure was change in weight from baseline to week 16; secondary measures included changes in body mass index, waist circumference, blood pressure, and fasting lipoprotein and glucose levels. Results: Subjects in both groups lost weight over the treatment period; however, orlistat-treated subjects lost significantly more weight than placebo-treated subjects beyond 2 weeks of treatment. Weight loss from baseline to week 16 was significantly greater in participants receiving orlistat versus those receiving placebo (3.05 vs 1.90 kg; p < 0.001, intent-to-treat analysis). Orlistat-treated subjects who completed 16 weeks of treatment lost 4.8 ± 0.35% (mean ± SE) of baseline weight compared with 3.1 ± 0.38% for the placebo group (p < 0.001). Orlistat-treated subjects, compared with those receiving placebo, also demonstrated a greater relative reduction in total (–4.4% vs 0.0%; p = 0.004) and low-density lipoprotein cholesterol (–7.2% vs -0.6%; p = 0.005) and both diastolic (-3.9% vs -0.5%; p = 0.001) and systolic blood pressure (-4.7% vs -1.8%; p = 0.004). Both groups showed a similar safety profile; gastrointestinal events were significantly more common in the orlistat-treated subjects. Conclusions: The use of orlistat 60 mg by mildly to moderately overweight individuals produced significant weight loss in conjunction with a reduced calorie diet and self-instructional materials. This amount of weight loss was associated with improvements in several weight-related risk factors. Orlistat 60 mg may be a useful adjunct to lifestyle measures and has the potential to contribute significantly to weight and risk factor improvement for overweight individuals.
Collapse
Affiliation(s)
- James W Anderson
- Endocrine Division, University of Kentucky, Lexington, KY 40506-0298, USA.
| | | | | | | | | | | | | |
Collapse
|