US20180000775A1 - Treatment for non-alcoholic fatty liver diseases - Google Patents

Treatment for non-alcoholic fatty liver diseases Download PDF

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US20180000775A1
US20180000775A1 US15/536,252 US201515536252A US2018000775A1 US 20180000775 A1 US20180000775 A1 US 20180000775A1 US 201515536252 A US201515536252 A US 201515536252A US 2018000775 A1 US2018000775 A1 US 2018000775A1
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vitamin
tocopherol
acid
treatment
liver
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Szabolcs Peter
Joseph Schwager
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DSM IP Assets BV
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    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • A23L33/115—Fatty acids or derivatives thereof; Fats or oils
    • A23L33/12—Fatty acids or derivatives thereof
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • A23L33/15—Vitamins
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19—Carboxylic acids, e.g. valproic acid
    • A61K31/20—Carboxylic acids, e.g. valproic acid having a carboxyl group bound to a chain of seven or more carbon atoms, e.g. stearic, palmitic, arachidic acids
    • A61K31/202—Carboxylic acids, e.g. valproic acid having a carboxyl group bound to a chain of seven or more carbon atoms, e.g. stearic, palmitic, arachidic acids having three or more double bonds, e.g. linolenic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/21—Esters, e.g. nitroglycerine, selenocyanates
    • A61K31/215—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
    • A61K31/22—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acyclic acids, e.g. pravastatin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
    • A61K31/35—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having six-membered rings with one oxygen as the only ring hetero atom
    • A61K31/352—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having six-membered rings with one oxygen as the only ring hetero atom condensed with carbocyclic rings, e.g. methantheline 
    • A61K31/353—3,4-Dihydrobenzopyrans, e.g. chroman, catechin
    • A61K31/355—Tocopherols, e.g. vitamin E
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/16—Drugs for disorders of the alimentary tract or the digestive system for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23V—INDEXING SCHEME RELATING TO FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES AND LACTIC OR PROPIONIC ACID BACTERIA USED IN FOODSTUFFS OR FOOD PREPARATION
    • A23V2002/00—Food compositions, function of food ingredients or processes for food or foodstuffs
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23V—INDEXING SCHEME RELATING TO FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES AND LACTIC OR PROPIONIC ACID BACTERIA USED IN FOODSTUFFS OR FOOD PREPARATION
    • A23V2200/00—Function of food ingredients
    • A23V2200/30—Foods, ingredients or supplements having a functional effect on health
    • A23V2200/32—Foods, ingredients or supplements having a functional effect on health having an effect on the health of the digestive tract
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23V—INDEXING SCHEME RELATING TO FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES AND LACTIC OR PROPIONIC ACID BACTERIA USED IN FOODSTUFFS OR FOOD PREPARATION
    • A23V2250/00—Food ingredients
    • A23V2250/18—Lipids
    • A23V2250/186—Fatty acids
    • A23V2250/1882—Polyunsaturated fatty acids
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23V—INDEXING SCHEME RELATING TO FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES AND LACTIC OR PROPIONIC ACID BACTERIA USED IN FOODSTUFFS OR FOOD PREPARATION
    • A23V2250/00—Food ingredients
    • A23V2250/70—Vitamins
    • A23V2250/712—Vitamin E
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K2300/00—Mixtures or combinations of active ingredients, wherein at least one active ingredient is fully defined in groups A61K31/00 - A61K41/00

Definitions

  • the present invention relates to the use of mixtures of vitamin E and polyunsaturated fatty acids (PUFAs) as agents for the prevention, control and/or treatment of conditions associated with excessive fat accumulation in the liver which is not caused by alcohol abuse.
  • PUFAs polyunsaturated fatty acids
  • NAFLD non-alcoholic fatty liver disease
  • NASH non-alcoholic steatohepatitis
  • the present invention relates to the use of such compounds comprising vitamin E and PUFAs as active ingredients in the manufacture of medicaments for the prevention, control and/or treatment of conditions related to NAFLD.
  • the pathophysiology of fatty liver has not yet been fully clarified, a generally accepted mechanism is the “two-hit” theory (Day and James, 1998 Gastroenterology 114:842-845).
  • the first hit corresponds to the accumulation of free fatty acids (FFA) in the liver, which can be related to obesity, or more generally to metabolic syndrome (including diabetes, hypertension and dyslipidemia).
  • the second hit refers to the peroxidation of these fatty acids due to the oxidative stress produced by different factors (Angulo and Lindor, 2001 Gastroenterology 120:1281-1285).
  • the final result of the first hit is an excessive FFA balance, from oversupply and/or failure in lipid beta oxidation, leading to fatty acid accumulation in the liver which gives rise to the first lesions (Charlton et al., 2002 Hepatology 35:898-904). These initial impacts make the liver more vulnerable to aggressive factors of the second hit, which is mediated by oxidative stress and pro-inflammatory cytokines (TNF- ⁇ , TGF- ⁇ , IL-6, IL-8).
  • FFAs increase the expression of cytochrome P450 2E1 (CYP 2E1), a microsomal enzyme which takes part in the ⁇ -oxidation of several FFAs, causing the release of reactive oxygen metabolites (Weltman et al., 1998 Hepatology 27:128-133). Also some FFAs are metabolized by peroxisomal ⁇ -oxidation, generating additional reactive oxygen metabolites (hydrogen peroxide, hydroxyl radicals) (Rao and Reddy, 2001 Semin Liver Dis 21:43-55).
  • CYP 2E1 cytochrome P450 2E1
  • NF- ⁇ B nuclear factor ⁇ B
  • NF- ⁇ B nuclear factor ⁇ B
  • cytokines TGF- ⁇ , TGF- ⁇ , IL-8
  • MDA malondialdehyde
  • 4-hydroxynonenal show chemotactic properties and activate pro-inflammatory cytokines (TNF- ⁇ , TGF- ⁇ , IL-6, IL-8), and stimulate hepatic collagen-producing stellate cells (Pessayre, 2007 J Gastroenterol Hepatol 22 (Suppl 1):S20-S27).
  • the liver-specific Kupffer cells seem to play an important role in the pathogenesis of fatty liver diseases such as, e.g. NASH.
  • Kupffer cells are liver-resident macrophages providing significant protection against endotoxins and harmful exogenous particles from the portal vein.
  • the pathogenesis of NASH may encompass hyperendotoxemia (Creely et al., 2007 Am J Physiol Endocrinol Metab. 292:E740-E747) as a consequence of impaired phagocytotic function of Kupffer cells (Loffreda et al., 1998 FASEB J. 12:57-65). Damaged clearance of bacterial metabolites, endotoxins, lipopolysaccharides etc. might speed up the pathogenesis of liver diseases.
  • Kupffer cells Activation of Kupffer cells leads to additional stress stimuli and may determine the fate of hepatocytes from survival toward apoptosis.
  • overproduction of cytokines e.g. TNF- ⁇ and IL-1 ⁇ occurs.
  • Kupffer cells become more sensitive to these molecules (Diehl, 2002 Am J Physiol Gastrointest Liver Physiol. 282:G1-G5).
  • Inflammatory mediators produced by activated Kupffer cells trigger hepatic stellate cells to synthesize collagen which might result in liver fibrosis and cirrhosis.
  • mediators which are involved in NAFLD or related malfunction of the liver
  • mediators include e.g. eicosanoids (prostaglandins, leukotrienes), cytokines, chemokines, nuclear factors and/or nitric oxide.
  • vitamin E and PUFAs exhibit hepatoprotective effects and are able to synergistically modulate the biosynthesis/overproduction of some pro-inflammatory mediators such as, e.g., cytokines. Therefore, such compounds are useful for the prevention, control and/or treatment of conditions associated with excessive accumulation of fat in the liver, preferably for prevention, control and/or treatment of NAFLD.
  • the present invention relates to the use of a mixture comprising vitamin E and PUFAs for the treatment, control and/or prevention of hepatic inflammation and cell injury in the liver, more preferably prevention, control and/or treatment of NAFLD and related diseases.
  • the present invention relates to the use of vitamin E and PUFAs in the manufacture of a medicament for the prevention, control and/or treatment of conditions requiring modulation of inflammatory responses in liver cells, in particular the treatment and prevention of NAFLD.
  • Mixtures according to the present invention comprising vitamin E and PUFAs may be used as nutraceutical compositions, i.e. as supplement to dietary compositions, i.e., (fortified) food/feed or beverages, or as compositions in dosage unit form such as pharmaceutical compositions, e.g., tablets, granules, pastes or effervescent formulations which may further comprise pharmaceutically acceptable carriers, excipients or diluents, including, but not limited to, lubricants, colorants, wetting agents, fillers, disintegrants and flavorants.
  • the pastes may be filled into hard or soft gelatine capsules.
  • vitamin E includes both natural and synthetic mixtures of tocopherols, including ⁇ -tocopherol, ⁇ -tocopherol, ⁇ -tocopherol and ⁇ -tocopherol.
  • Tocopherol which is liquid at room temperature, is a group of methylated phenolic compounds of the general formula (I),
  • R1, R3 and R4 are independently from each other hydrogen or methyl groups; and wherein each * represents an individual chiral center.
  • At least one of the substituents R1 and R3 in formula (I) is CH3, more preferably is the use of ⁇ -tocopherol and/or ⁇ -tocopherol.
  • the tocopherols of formula (I) have chiral carbon centers which are indicated by the asterisk (*) in the formula.
  • the configuration at these chiral centers is defined to be either R or S, a concept which is known to the person skilled in the art.
  • the respective tocopherols according to formula (I) exist in 8 different isomers due to these chiral centers (i.e. (2R,4′R,8′R)-, (2R,4′S,8′R)-, (2R,4′R,8′S)-, (2R,4′S,8′S)-, (2S,4′R,8′R)-, (2S,4′S,8′R)-, (2R,4′R,8′S)- and (2S,4′S,8′S)-tocopherol).
  • the tocopherols are either present in the form of mixture of said chiral isomers or isomerically pure.
  • the (2RS, 4′RS, 8′RS) tocopherol is also known as (all-rac)-tocopherol.
  • vitamin E is ⁇ -tocopherol which is used in a mixture with PUFA.
  • PUFAs are classified according to the position of the double bonds in the carbon chain of the molecule as n-9, n-6 or n-3 PUFAs.
  • n-6 PUFAs are linoleic acid (C18:2), arachidonic acid (C20:4), ⁇ -linolenic acid (GLA, C18:13) and dihomo- ⁇ -linolenic acid (DGLA, C20:3).
  • n-3 PUFAs are ⁇ -linolenic acid (C18:13), eicosapentaenoic acid (EPA, C20:5), and docosahexaenoic acid (DHA, C22:6). Especially EPA and DHA have attracted interest of the food industry in recent years. The most available sources of these two fatty acids are fish and the marine oils extracted from them or microalgae.
  • PUFAs refers to a fatty acid having a backbone comprising 16 or more carbon atoms, (for example, 16, 18, 20 or 22 carbon atoms (C16, C18, C20, or C22, respectively), and two or more carbon-carbon double bonds in the backbone.
  • a “long-chain PUFA” refers to a fatty acid having a backbone comprising 18 or more carbon atoms, and two or more carbon-carbon double bonds in the backbone, for example, C18:3n-3 (alpha-linolenic acid or ALA).
  • CA:Bn-X When the notation CA:Bn-X is used for a methylene-interrupted PUFA, the “CA” is the number of carbons (for example C18, C20 or C22), B is the number of double bonds and X is the position of the first double bond counted from the methyl end of the fatty acid chain.
  • PUFAs encompass the free acid forms thereof, as well as salts and esters thereof.
  • ester refers to the replacement of the hydrogen in the carboxylic acid group of a PUFA molecule with another substituent. Examples of common esters include methyl, ethyl, trichloroethyl, propyl, butyl, pentyl, tert butyl, benzyl, nitrobenzyl, methoxybenzyl and benzhydryl. Other esters of PUFAs are described in US 2010-0130608 A1, which is incorporated herein by reference.
  • PUFAs for use with the present invention include omega-3, omega-6, and omega 9 polyunsaturated fatty acids, and oxylipins derived therefrom.
  • Exemplary omega-3 PUFAs for use with the present invention include, but are not limited to, ⁇ -linolenic acid (C18:3n-3), C18:4n-4, ⁇ -3 eicosapentaenoic acid (20:5n-3) (eicosapentaenoic acid), ⁇ -3 docosapentaenoic acid (docosapentaenoic acid), ⁇ -3 docosahexaenoic acid (22:6n-3), docosatetraenoic acid (22:4n-6), and combinations thereof.
  • Exemplary omega-6 PUFAs for use with the present invention include, but are not limited to, ⁇ linolenic acid, linoleic acid, conjugated linoleic acid, arachidonic acid (20:4n-6), ⁇ -6 docosapentaenoic acid, and combinations thereof.
  • a PUFA oil for use with the present invention is all-cis.
  • the PUFA comprises DHA, also known by its chemical name (all-Z)-4,7,10,13,16,19-docosahexaenoic acid, as well as any salts or derivatives thereof.
  • DHA encompasses DHA ethyl ester (DHA-EE) as well as DHA free fatty acids, phospholipids, other esters, monoglycerides, diglycerides, and triglycerides containing DHA.
  • DHA is an ⁇ -3 PUFA.
  • the PUFA comprises EPA, known by its chemical name (all-Z)-5,8,11,14,17-eicosapentaenoic acid, as well as any salts or derivatives thereof.
  • EPA encompasses the free acid EPA as well as EPA alkyl esters and triglycerides containing EPA.
  • EPA is an ⁇ -3 PUFA.
  • the PUFA oil that is used to make the thermally stable emulsion is substantially free of one or more specific fatty acids.
  • a PUFA oil that contains DHA-EE can be substantially free of EPA.
  • a PUFA oil that contains EPA-EE can be substantially free of DHA.
  • PUFAs suitable for use with the present invention include, but are not limited to, Martek DHATM S Oil (Martek Biosciences Corp., Columbia, Md.), Rosemary-Free Martek DHATM S Oil (Martek Biosciences Corp., Columbia, Md.), Microalgae DHATM Oil (Martek Biosciences Corp., Columbia, Md.), OMEGAPURE® oils (Omega Protein Corp., Houston, Tex.), MARINOL® Oils (Lipid Nutrition, Wormerveer, NL), MEG-3 oils and powders (Ocean Nutrition Corp., Dartmouth, Calif.), Evogel (Symrise AG, Holzminden, Del.), Marine Oil (Arista Industries, Wilton, Conn.), and OMEGASOURCE® oils (Source Food Technology, Inc., Raleigh, N.C.).
  • a particularly useful form of PUFA is ⁇ -3 PUFA which is used in a mixture with vitamin E, in particular ⁇ -tocopherol in accordance with the present invention, i.e. for the treatment, control and/or prevention of conditions associated with excessive fat accumulation in the liver which is not caused by alcohol abuse.
  • PUFA's are preferably used in a concentration so that the daily consumption by a human adult (weighing about 70 kg) is in the range of from 10 mg/day to 4000 mg/day, preferably from 200 mg/day to 600 mg/day, more preferably about 400 mg/day.
  • a food or beverage suitably contains about 5 mg to about 1000 mg of a PUFA per serving.
  • the nutraceutical composition is a pharmaceutical formulation such formulation may contain a PUFA in an amount from about 10 mg to about 1000 mg per dosage unit, e.g., per capsule or tablet, or from about 10 mg per daily dose to about 4000 mg per daily dose of a liquid formulation.
  • Vitamin E or its derivative is preferably used in a concentration so that the daily consumption by a human adult (weighing about 70 kg) is in the range of from 5 mg/day to 2000 mg/day, preferably 15 to 50 IU/day, more preferably 30 IU/day.
  • a food or beverage suitably contains about 2 mg to about 500 mg of vitamin E per serving.
  • the nutraceutical composition is a pharmaceutical formulation such formulation may contain vitamin E in an amount from about 5 mg to about 1000 mg per dosage unit, e.g., per capsule or tablet, or from about 5 mg per daily dose to about 2000 mg per daily dose of a liquid formulation.
  • subject as used herein includes, all higher animals wherein inflammatory events are known.
  • a subject is a mammal, including animals or humans.
  • a “fatty liver” or “excessive fat accumulation” associated with NAFDL or NASH means that the liver contains more than about 5 to about 10 wt % of fat.
  • the compounds according to the present invention have hepatoprotective properties and are useful for the prevention, control and/or treatment of conditions involved in NAFLD or related malfunction of the liver. They can also be used as an adjunct to the treatment of a variety of diseases or disorders caused by excessive non-alcoholic fat accumulation in the liver via modulation of biosynthesis/overproduction of inflammatory mediators in the liver cells.
  • the compounds of the present invention are used for the prevention, control and/or treatment of conditions associated with excessive fat accumulation in the liver which is not caused by alcohol abuse, preferably prevention, control and/or treatment of NAFLD and NASH.
  • the present invention is particularly directed to the use of a combination of vitamin E and PUFAs as defined above (in the manufacture of a medicament/composition) for the prevention, control and/or treatment of conditions requiring modulation of inflammatory response associated with accumulation of fat in the liver which is not caused by consumption/abuse of alcohol, especially of those conditions mentioned above.
  • compounds/mixtures of the present invention may be used in combination with other nutraceutical compositions or therapeutic agents known to those skilled in the art for treatment, control and/or prevention of inflammatory disorders in the liver by administration prior to, simultaneously with or following the administration of the compound(s) as disclosed herein.
  • compounds/mixtures according to the present invention consist substantially of vitamin E and PUFA—i.e. being the main active ingredients—with furthermore addition of binders, fillers, carriers, excipients including water, glycerol, etc. known to the skilled person.
  • the ratio of vitamin E and polyunsaturated fatty acids which is administered might be in the range of about 1:1 to about 1:5, such as e.g., 1:2, or in the range of about 4:1 or about 5:1 to about 20:1, calculated as weight ratio.
  • the vitamin E is calculated as ⁇ -tocopherol.
  • Useful ratios might be In an embodiment, the polyunsaturated fatty acid and vitamin E calculated as a weight ratio of 0.2:1, 0.4:1, 0.6:1, 1:1, 2:1, 3:1, 4:1, 5:1, 6:1, 8:1, 10:1, 12:1, 14:1, 16:1, 18:1, 20:1, 25:1 or 30:1, wherein the vitamin E is calculated as ⁇ -tocopherol.
  • the anti-inflammatory effect of a combined therapy with vitamin E and PUFAs can be demonstrated in stimulated macrophages including Kupffer cells by determining the inhibition of the synthesis of cytokines that reflect the inflammatory response.
  • Kupffer cells i.e. liver-resident macrophages
  • a test substance such as mixtures of vitamin E and PUFA according to the present invention.
  • murine macrophages RAW264.7 or even monocyte/macrophages present in peripheral blood cells can be used appropriate surrogate models (Raptis et al. J Hepatology 60, 625-632, 2014).
  • LPS lipopolysaccharide
  • DMSO fetal sulfate
  • Culture supernatants may be harvested after appropriate periods of time (e.g. 24 hours).
  • Cytokines and interleukins can be measured by appropriate ELISA-based multiplex assays. The percentage of inhibition of the mentioned inflammatory mediators present in the liver-specific cells at a given concentration of the test substances (compared to maximal production by LPS-stimulated cells) is calculated and the putative synergistic effect of the test substance computed (see below).
  • Leukocytes are obtained from healthy donors. Mononuclear cells (MNC) are purified by Ficoll-Isopaque gradient centrifugation. Cells (at 3-8 ⁇ 106 cells/mL) are cultured in phenol-red free RPMI 1640, supplemented with 0.25% FBS, 0.1 mM NEAA, 50 U/mL penicillin, 50 ⁇ g/mL streptomycin and 5 ⁇ 10-5 M 2-mercaptoethanol. Cells are stimulated with LPS (100 ng/mL) and IFN- ⁇ (20 U/mL) for 2-24 h.
  • MNC Mononuclear cells
  • Multiparametric kits for determination of cytokines and chemokines are purchased from BIO-RAD Laboratories (Hercules, Calif.) and used in the LiquiChip Workstation IS 200 (Qiagen, Hilden, Germany). The data are evaluated with the LiquiChip Analyser software (Qiagen).
  • LPS lipoprotein sulfate suppression protein
  • cytokines interleukins and chemokines
  • cytokines interleukins and chemokines
  • LPS induces a massive increase of the secretion of inflammatory mediators such as TNF-alpha.
  • inflammatory mediators are secreted.
  • These parameters are modulated by pre-incubating cells with ⁇ -tocopherol or ⁇ -3 PUFA prior to the stimulation with LPS.
  • the pro-inflammatory cytokine TNF- ⁇ is reduced by 29% and 64%, respectively (Table 1a).
  • IL-1beta and CCL4/MIP-1b are also significantly reduced by the two substances (Tables 1b, 1c).
  • the substances reduces the extent of the inflammatory stress in cells that respond to inflammatory stimuli.
  • Soft gelatin capsules are prepared by conventional procedures providing a dose of vitamin E of 5 to 1000 mg (e.g. ⁇ -tocopherol), such as e.g. 50 mg, and at least one compound selected from the group of PUFAs as defined above of 10 to 1000 mg (e.g. DHA), such as e.g. 200 mg, wherein the amounts are the recommended daily doses.
  • vitamin E e.g. ⁇ -tocopherol
  • DHA e.g. 200 mg
  • Other ingredients to be added glycerol. Water, gelatine, vegetable oil.
  • Hard gelatin capsules are prepared by conventional procedures providing a dose of vitamin E of 5 to 1000 mg (e.g. ⁇ -tocopherol) and at least one compound selected from the group of PUFAs as defined above of 10 to 1000 mg (e.g. DHA), wherein the amounts are the recommended daily doses.
  • Other ingredients to be added fillers, such as, e.g., lactose or cellulose or cellulose derivatives q.s.; lubricant, such as, e.g., magnesium stearate if necessary (0.5%).
  • Tablets are prepared by conventional procedures providing as active ingredient 5 to 1000 mg of vitamin E (e.g. ⁇ -tocopherol), such as e.g. 20 mg, per tablet and at least one compound selected from the group of PUFAs as defined above of 10 to 1000 mg (e.g. DHA), and as excipients microcrystalline cellulose, silicone dioxide (SiO2), magnesium stearate, crospovidone NF (which is a disintegratent agent) ad 500 mg.
  • vitamin E e.g. ⁇ -tocopherol
  • PUFAs as defined above of 10 to 1000 mg
  • An orange juice drink colored with beta-Carotene 10% CWS and with vitamin E (e.g. ⁇ -tocopherol) and at least one compound selected from the group of PUFAs as defined above (e.g. DHA) may be prepared according to Table 2 and 3.
  • sodium benzoate is dissolved in water whilst stirring. Stirring is continued and sugar syrup, ascorbic acid, citric acid, pectin solution and juice compound are added one after the other. Do not use a high speed mixer.
  • the bottling syrup is diluted with (carbonated) water to one liter of beverage.
  • deionized water is first added to the juice concentrates with gently stirring to allow the juice concentrates to hydrate. Then, the oily flavor and beta-carotene 10% CWS stock solution are added and pre-emulsified in a rotor-stator-homogenizer. Homogenization is performed in a high-pressure homogenizer at 200 bar.
  • Typical serving of a soft drink can be 240 ml, with an amount in Vitamin E (e.g. ⁇ -tocopherol) which is about 5-100 mg/serving and an amount in PUFA (e.g. DHA) which is about 5-500 mg/serving
  • Vitamin E e.g. ⁇ -tocopherol
  • PUFA e.g. DHA
  • Adherent cells i.e. Kupffer cells
  • liver tissue i.e., Immonological Letters 158, 52-56, 2014 or according to any method known in the art.
  • These cells are treated with compounds as described above (see Example 1).
  • These cells will be activated with an inflammatory stimulus and the effect of substances and combination thereof on the reduction of the inflammatory response is determined. With this set-up, identical effects as those described for blood cell derived macrophages (see Ex. 1) are obtained.

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