WO2016131640A1 - Medium chain fatty acids and their triglycerides for treating anxiety - Google Patents
Medium chain fatty acids and their triglycerides for treating anxiety Download PDFInfo
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- WO2016131640A1 WO2016131640A1 PCT/EP2016/052079 EP2016052079W WO2016131640A1 WO 2016131640 A1 WO2016131640 A1 WO 2016131640A1 EP 2016052079 W EP2016052079 W EP 2016052079W WO 2016131640 A1 WO2016131640 A1 WO 2016131640A1
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- A—HUMAN NECESSITIES
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- A23V2002/00—Food compositions, function of food ingredients or processes for food or foodstuffs
Definitions
- the present invention relates to the field of treating anxiety and anxiety disorders. BACKGROUND TO THE INVENTION
- Anxiety is an unpleasant state of inner turmoil, often accompanied by nervous behaviour, such as pacing back and forth, somatic complaints and rumination. It is the subjectively unpleasant feelings of dread over anticipated events and may be described as a feeling of fear, worry and uneasiness, usually generalized and unfocused as an overreaction to a situation that is only subjectively seen as menacing.
- anxiety disorders including panic disorder, social anxiety disorder, specific phobias and generalised anxiety disorder.
- Symptoms vary depending of the type of anxiety disorder, but generally include: feelings of panic, fear and uneasiness; problems sleeping; cold or sweaty hands and/or feet; shortness of breath; heart palpitations; dry mouth; numbness or tingling in the hands or feet; nausea; muscle tension and dizziness.
- GABA gamma-aminobutyric acid
- serotonin norepinephrine
- norepinephrine gamma-aminobutyric acid
- Various neuropeptides, hormones and transcription factors have also been implicated in anxiety development and drugs acting on these targets are also used as therapies.
- Anxiety disorders are also commonly treated by psychotherapy, cognitive-behaviour therapy, lifestyle changes and relaxation therapy. Patients suffering from anxiety may be advised to consider modifying their diet. Magnesium deficiency may contribute to anxiety, depression and insomnia, whilst inadequate intake of vitamin B and calcium can exacerbate anxiety symptoms. Other foods or substances which patients suffering from anxiety may be advised to avoid include nicotine, caffeine and stimulant drugs and foods including salt and artificial additives, such as preservatives. Patients may be advised to ensure their daily diet includes foods such as wholegrain cereals, leafy green vegetables and low fat dairy products and to choose fresh, unprocessed foods whenever possible. There is a need for further approaches to treat and prevent anxiety and anxiety disorders.
- the present invention is based on the determination that administration of medium chain triglycerides (MCTs) to a subject can alleviate anxiety.
- MCTs medium chain triglycerides
- the present invention provides a medium chain fatty acid (MCFA) for use in treating and/or preventing anxiety.
- MCFA medium chain fatty acid
- the MCFA may be decanoic acid or octanoic acid.
- the MCFA may be in the form of a medium chain triglyceride (MCT).
- MCT medium chain triglyceride
- Each of the fatty acid moieties of the MCT may comprise the same number of carbons.
- the present invention provides a composition comprising a MCFA as defined in the first aspect of the invention for use in treating and/or preventing anxiety.
- the composition may comprise decanoic acid and octanoic acid.
- the composition may comprise a decanoic acid to octanoic acid ratio of approximately 3:2 wt/wt.
- the composition may be in the form of a food stuff.
- the composition may be in the form of a human food stuff.
- the composition may be in the form of a complete nutritional product.
- the composition may be in a powdered form.
- the composition may be in a spray dried form.
- the composition may be in the form of an oil-in-water emulsion.
- the composition may be in the form of a beverage, mayonnaise, margarine, low fat spread, a dairy product, a cheese spread, processed cheese, a dairy dessert, a flavoured milk, cream, a fermented milk product, cheese, butter, a condensed milk product, an ice cream mix, a soya product, pasteurised liquid egg, a bakery product, a confectionary product, confectionary bar, chocolate bar, high fat bar, liquid emulsion, spray dried powder, freeze dried powder, HUT pudding, Pasteurised pudding, gel, jelly, yoghurt or a food with a fat-based or water-containing filling.
- the anxiety may be stranger anxiety, social anxiety disorder, generalised anxiety disorder, general anxiety, phobia, panic disorder, obsessive-compulsive disorder or posttraumatic stress disorder.
- the present invention /elates to the use of a MCFA as defined in the first aspect of the invention in the manufacture of a composition for the treatmerit and/or prevention of anxiety.
- the present invention relates to a method for treating and/or preventing anxiety in a subject comprising administering an effective amount of a MCFA as defined in the first aspect of the invention or a composition as defined in the second aspect of the invention to the subject.
- Figure 1 Elevated plus maze: percentage time spent in open arms. Rats were divided in tertiles of anxiety levels: high anxiety, HA; normal anxiety, NA; low anxiety* LA.
- FIG. 2 Oxygen consumption of nucleus accumbens homogenate in MCT vs control- treated rats divided into tertiles of innate anxiety, high anxiety, HA; normal anxiety, NA; low anxiety, LA; *, p ⁇ 0.05 LA compared to HA
- Figure 3A Light dark box : Percentage time spent in the light compartment in control vs MCT-treated rats *, p ⁇ 0.05
- Figure 3B Light-dark box; Percentage time spent in the light compartment in control vs MCT treated rats were divided in tertiles of innate anxiety levels, high anxiety, HA; normal anxiety, NA; low- anxiety, LA.
- FIG. 5 A) Plasma BHB at 1 and 3 weeks in control vs MCT-treated rats; B) Brain BHB at 3 weeks in control vs MCT-treated rats. The plasma was measured for beta- hydroxybuyrate (BHB) at 7 days after treatment and at sacrifice. BHB where at both 1 and 3 weeks BHB was significantly increased, as were brain 6HB at 3 weeks (P ⁇ 0.05).
- BHB beta- hydroxybuyrate
- Figure 7 Complex I protein expression in rat cortex following a 2 week administration of MCTs
- Figure 8 A) Plasma ketone levels following ingestion of MCT8 or MCT10.
- a medium chain fatty acid refers to a fatty acid composed of 6 to 10, 6 to 11 or 6 to 12 carbon atoms.
- the MCFA may have between 8 and 10 carbon atoms.
- the MCFA may be decanoic acid or octanoic acid.
- Deconoic acid is also known as capric acid and is a saturated fatty acid of formula CH 3 (CH ⁇ )sCOOH. It is also referred to herein as C10.
- Octanoic acid is also known as caprylic acid and is a saturated fatty acid of formula CH 3 (CH2)eCOOH. It is also referred to herein as C8.
- the MCFA may be in the form of triglycerides, diacyl-glycerides, monoacyl-glycerides, phospholipids, lyso-phospholipids, cholesterol and glycolipids.
- the MCFA may be in the form of a triglyceride.
- the MCFA may be in the form of a medium chain triglyceride (MCT). That is, the MCFA may be in the form of a triglyceride in which each of the three fatty acid moieties of the triglyceride is a MCFA.
- the MCFA may be in the form of a MCT in which each of the fatty acid moieties comprises the same number of carbons.
- the MCT may comprise three decanoic acid moieties or three octanoic acid moieties.
- MCTs are present in low amounts in palm oil and coconut oil, for example. Decanoic acid and octanoic acid form around 5 to 8% and 4 to 10% of the fatty acid composition of coconut oil, respectively.
- the present inventors have determined that administration of MCTs to a subject increases Insulin receptor substrate- 1 (IRS-1 ) phosphorylation.
- IRS-1 is an adaptor protein mediating Insulin-like growth factor (IGF) receptor activation of Akt, via PI3K.
- IGF Insulin-like growth factor
- Akt acts as a master switch regulator of energy and metabolic processes such as glucose metabolism, apoptosis and proliferation.
- the MCFAs and MCTs may treat and/or prevent anxiety by altering mitochondrial activity, for example by increasing IRS-1 phosphorylation, in particular phosphorylation of serine 312 of IRS-1 .
- the MCFA, MCT or composition is not administered in combination with arginine and/or fish oil.
- the present invention provides a composition comprising a MCFA as defined in the first aspect of the invention for use in treating and/or preventing anxiety.
- the composition may comprise a plurality of MCFAs as defined in the first aspect of the present invention.
- the composition may comprise fatty acids composed of 6 to 10, 6 to 1 1 or 6 to 12 carbon atoms.
- the composition may comprise MCFAs composed of 8 to 10 carbon atoms.
- the composition may be in a form suitable for delivering a dosage of at least about 5g/l to 150g/l decanoic acid per day.
- the dosage may be about 5g/l, 10g/I, 15g/l, 20g/l, 30g/l, 40g/l, 50g/l, 60g/l, 70g/l, 80g/l, 90g/l, 100g/l, 1 10g/l, 120g/l, 130g/l, 140g/l, 150g/l, 175g/l, 200g/l, 225g/l, 250g/l or 500g/l decanoic acid per day.
- the composition may be in a form suitable for delivering a dosage of at least about 5g/l to 150g/l octanoic acid per day.
- the dosage may be about 5g/l, 10g/I, 15g/l, 20g/l, 30g/l, 40g/l, 50g/l, 60g/l, 70g/l, 80g/l, 90g/l, 100g/l, 1 10g/l, 120g/l, 130g/l, 140g/l, 150g/l, 175g/l, 200g/l, 225g/l or 250g/l octanoic acid per day.
- the present inventors have determined that administering octanoic acid in the form of MCTs results in a rapid increase in plasma and brain ketone levels.
- the inventors have also determined that administering decanoic acid in the form of MCTs results prolonged increase in plasma and brain ketone levels. Without wishing to be bound by theory, the inventors consider that this may be because octanoic acid is more rapidly metabolised in vivo.
- composition may comprise decanoic acid and octanoic acid.
- the composition may comprise an approximately equal ratio of decanoic acid and octanoic acid.
- the ratio of decanoic acid to octanoic acid may be approximately 1 :1 wt/wt.
- the composition may comprise a higher ratio of decanoic acid to octanoic acid.
- the ratio of decanoic acid to octanoic acid may be approximately 2:1 , 3:1 , 4:1 , 5:1 or 10:1 wt/wt.
- the ratio of decanoic acid to octanoic acid may be approximately 3:2 wt/wt.
- the composition may be free from or substantially free from mono- or poly-unsaturated fatty acids.
- the composition may have a ketogenic ratio of 0.2 to 0.3:1. In other embodiments, the ratio may be 0.5:1 or 1 :1 to 5:1.
- Ketogenic ratio refers to the weight of lipid to the sum of weights of carbohydrate and protein.
- the composition may be in the form of a tablet, dragees, capsule, gel cap, powder, granule, solution, emulsion, suspension, coated particle, spray-dried particle or pill.
- the composition may be usable for reconstitution in water.
- the composition may be an oil-in-water emulsion.
- the composition may be inserted or mixed into a food substance.
- the composition may be in the form of a food stuff, for example a human food stuff.
- the composition may be in the form of a nutritional supplement.
- a nutritional supplement refers to a product which is intended to supplement the general diet of a subject.
- the composition may be in the form of a complete nutritional product.
- a complete nutritional product refers to a product which is intended to be the sole item or meal or diet consumed by a subject.
- the composition may be in the form of a beverage, mayonnaise, margarine, low fat spread, a dairy product, a cheese spread, processed cheese, a dairy dessert, a flavoured milk, cream, a fermented milk product, cheese, butter, a condensed milk product, an ice cream mix, a soya product, pasteurised liquid egg, a bakery product, a confectionary product, confectionary bar, chocolate bar, high fat bar, liquid emulsion, spray dried powder, freeze dried powder, HUT pudding, Pasteurised pudding, gel, jelly, yoghurt or a food with a fat-based or water-containing filling.
- composition may be an infant formula.
- administration of the composition may be by an oral route or another route into the gastro-intestinal tract, for example the administration may also be by gastric tube feeding.
- the composition may be enriched with a MCFA.
- the composition may be enriched with octanoic acid and/or decanoic acid.
- MCFA has been added to the composition.
- the MCFA may be spiked (i.e. added within or into) the composition.
- enriched with a MCFA means that the enriched food or food extract comprises a greater amount of the MCFA than occurs natively in the food or food extract.
- an enriched composition, food or food extract may comprise at least 1 .5-, at least 2-, at least 5-, at least 10-, at least 20-, at least 50- or at least 100-fold more MCFA than an equivalent native composition, food or food extract which has not been enriched.
- the present invention also provides the use of a MCFA as defined herein in the manufacture of a composition for the treatment and/or prevention of anxiety.
- the invention relates to the use of a MCFA in the manufacture of a medicament for the treatment and/or prevention of anxiety
- the medicament may comprise one or more suitable pharmaceutically acceptable carriers excipients.
- the present invention also provides a composition comprising a decanoic acid to octanoic acid ratio of about 3:2 wt/wt.
- the decanoic acid and octanoic acid may be in the form of MCTs.
- the fatty acid moieties of the MCTs may comprise the same number of carbons.
- a composition may be in a form defined herein.
- Anxiety is an unpleasant state of inner turmoil, often accompanied by nervous behaviour, such as pacing back and forth, somatic complaints and rumination. It is the subjectively unpleasant feelings of dread over anticipated events and as such may be described as a feeling of fear, worry and uneasiness, usually generalized and unfocused as an overreaction to a situation that is only subjectively seen as menacing.
- anxiety disorders There are several recognised types of anxiety disorders, including panic disorder, social anxiety disorder, specific phobias and generalised anxiety disorder. Symptoms vary depending of the type of anxiety disorder, but generally include: feelings of panic, fear and uneasiness; problems sleeping; cold or sweaty hands and/or feet; shortness of breath; heart palpitations; dry mouth; numbness or tingling in the hands or feet; nausea; muscle tension and dizziness.
- Anxiety is commonly tested via validated questionnaires.
- the General Health Questionnaire consists of sixty questions about mild somatic and anxiety symptoms. Thirty- and 12-item questionnaires are also commonly used.
- Clinicians usually diagnose anxiety via short interviews, asking about specific anxiety- generating environments and responses. These are used to classify anxiety into subtypes such as social anxiety, general anxiety disorder, panic disorder or phobic disorder.
- the anxiety may be stranger anxiety, social anxiety disorder, generalised anxiety disorder, general anxiety, phobia, panic disorder, obsessive-compulsive disorder or posttraumatic stress disorder.
- Stranger anxiety is a form of distress that children experience when exposed to people unfamiliar to them. Symptoms may include: getting quiet and staring at the stranger, verbally protesting by cries or other vocalizations, and hiding behind a parent.
- Social anxiety disorder is a persistent fear about social situations and being around people. It is one of the most common anxiety disorders.
- GAD Generalised anxiety disorder
- Individuals often exhibit a variety of physical symptoms, including fatigue, fidgeting, headaches, nausea, numbness in hands and feet, muscle tension, muscle aches, difficulty swallowing, bouts of difficulty breathing, difficulty concentrating, trembling, twitching, irritability, agitation, sweating, restlessness, insomnia, hot flashes, and rashes and inability to fully control the anxiety.
- the Diagnostic and Statistical Manual of Mental Disorders (2013) defines GAD by the following criteria: A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).
- the anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months):
- the anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- the disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism).
- Phobia phobic anxiety
- Phobia includes all cases in which fear and anxiety is triggered by a specific stimulus or situation.
- Panic disorder is when a person suffers from brief attacks of intense terror and apprehension, often marked by trembling, shaking, confusion, dizziness, nausea, and/or difficulty breathing. These panic attacks arise abruptly and peak in less than ten minutes, although they can last for several hours. Attacks can be triggered by stress, fear, or even exercise; the specific cause is not always apparent.
- Obsessive-compulsive disorder is an anxiety disorder characterized by intrusive thoughts that produce uneasiness, apprehension, fear or worry (obsessions), repetitive behaviours aimed at reducing the associated anxiety (compulsions), or a combination of such obsessions and compulsions.
- Posttraumatic stress disorder may develop after a person is exposed to one or more traumatic events, such as sexual assault, warfare, serious injury, or threats of imminent death.
- the diagnosis may be given when a group of symptoms, such as disturbing recurring flashbacks, avoidance or numbing of memories of the event, and hyperarousal, continue for more than a month after the occurrence of a traumatic event.
- the anxiety treated and/or prevented according to the present invention is not associated with age-related cognitive decline.
- TREATING AND/OR PREVENTING To “treat” means to administer a MCFA or composition as described herein to a subject having existing anxiety in order to lessen, reduce or improve at least one symptom associated with the anxiety and/or to slow down, reduce or block the progression of the anxiety.
- To “prevent” means to administer a MCFA or composition as described herein to a subject is not showing any symptoms of to reduce or prevent development of at least one symptom associated with the anxiety.
- Symptoms of anxiety may be determined using questionnaires and interviews as described above.
- the subject may be, but is not limited to, mammals such as bovine, canine, caprine, cervine, equine, feline, human, ovine, porcine and primates.
- mammals such as bovine, canine, caprine, cervine, equine, feline, human, ovine, porcine and primates.
- the subject is a human.
- the subject may be a child or an infant.
- the subject may have, or be suspected of or at risk of, anxiety.
- HA high anxiety
- NA normal anxiety
- LA low anxiety
- MCTs (C8:C10) had no effect on nucleus accumbens oxygen consumption compared to control diet, while strong differences were seen between the anxiety phenotypes (HA vs LA) (see Figure 2). Two weeks of MCTs improved anxiety levels in unstressed rats, mainly in the low anxiety group.
- Example 2 Differing temporal dynamics of plasma and brain ketone levels following octanoic acid or decanoic acid administration Plasma ketone levels increased more rapidly after octanoic acid ingestion compared to deconaoic acid ingestion (see Figure 8A). Plasma ⁇ - ⁇ showed similar kinetics to brain ⁇ - ⁇ , with ingestion of octanoic acid causing a more rapid increase and ingestion of decanoic acid providing a longer-lasting increase (see Figure 8B).
- One hundred male Wistar rats were housed individually in standard rat cages enriched with a cardboard tube and tissue and ad libitum food and water. After acclimatization of 1 week all rats were weighed, then tested for baseline anxiety using the elevated plus maze test.
- the elevated plus maze (EPM) apparatus consists of four arms, two are open while others are closed on the sides and at the end. Each arm has a length of 50cm.
- EPM elevated plus maze
- the rat was placed on the centre of the maze at a low level of lighting (15 lux on the open arms and 5 lux in the closed) and its behaviour was observed for 5 min.
- the parameters evaluated include: the time spent by rats in the open arms in the closed arms and in the central part of the maze.
- Various behaviors such as grooming, immobility and stretch-attend postures were also measured.
- Rats were separated into 3 groups according to anxiety: high, normal and low. High, normal and low anxiety rats were further subdivided into feeding groups. Sixteen each of high, normal and low anxiety rats were given a diet of 5% medium chain triglycerides (40:60 of octanoic acid triglyceride and decanoic triglyceride) and fifteen each were given control diet (5% sunflower oil) via specially formulated animal chow for 15 days. The diet was in the form of animal chow with normal fat, carbohydrate and protein ratios as standard chow diets.
- medium chain triglycerides 40:60 of octanoic acid triglyceride and decanoic triglyceride
- control diet 5% sunflower oil
- mice were evaluated for emotional behaviour using the following sequence of tests with two day intervals of rest in between: light-dark box test, social interaction test, and social dominance test. Rats were weighed every week to ensure weight maintenance. After 15 days the rats were sacrificed by decapitation and brains collected for RNA and protein analyses.
- the light dark box is composed of a three-chambered apparatus in the shape of a long rectangle.
- One chamber is light with a solid floor.
- Another is dark, with a grid floor.
- Animals were placed into a three-chambered apparatus and given the choice between investigating an object or a contained juvenile for 10 minutes.
- the juveniles were between the ages of PND25-32 to avoid eliciting any aggression from the experimental animal.
- Juveniles were habituated to the apparatus and the chamber one day prior to testing to reduce their stress and anxiety levels.
- subjects were placed in the middle chamber without access to the other two chambers to habituate to the environment for 5 minutes. The doors were then removed and animals were allowed free access to the two chambers for 10 minutes.
- the time spent investigating the juvenile compared to the object was recorded and scored by an observer blind to the treatment and converted to a percentage. Animals were designated as having a social preference when this time exceeds 50%.
- Plasma samples were analysed for beta-hydroxybutyrate using a colorimetric kit (Cayman, US).
- sample preparation involved liquid/liquid extraction of 50 ⁇ brain tissue supernatant (pH 2), and extract derivatization with MSTFA (silylation). Analysis of BHB was performed via GC/MS, int.
- Tissues were homogenized in 200 mL Tris buffer (pH 7.4) containing 10% sucrose and protease inhibitors sonicated, and kept at -80°C until use. Protein amounts were evaluated using the BCA assay diluted and then separated on gels. Proteins were transferred to nitrocellulose membranes, which were then saturated (5% BSA) and incubated with primary (rabbit PSD-95) and secondary antibodies.
- Protein extracts were prepared from homogenates of striatum tissue. Kits containing antibodies to IRS-1 and phosphorylated IRS-1 (pS312) (Life Technologies) were used to probe total protein content vs phosphorylated protein via sandwich ELISA.
- Control rats received oral gavage of sunflower oil, as described above.
- MCT8 and MCT10 received oral gavage of octanoic acid or decanoic acid, respectively. Rats were sacrificed and trunk blood, portal vein blood and brain, pancreas and liver were collected as indicated.
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EP0948963B1 (en) * | 1998-01-21 | 2003-05-07 | Fideline | Pig appeasing pheromones to decrease stress, anxiety and aggressiveness |
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GB201210699D0 (en) | 2012-06-15 | 2012-08-01 | Vitaflo Ltd | Nutritional food |
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2016
- 2016-02-01 US US15/551,094 patent/US10596137B2/en active Active
- 2016-02-01 WO PCT/EP2016/052079 patent/WO2016131640A1/en active Application Filing
- 2016-02-01 JP JP2017539441A patent/JP6669761B2/ja active Active
- 2016-02-01 AU AU2016221929A patent/AU2016221929A1/en not_active Abandoned
- 2016-02-01 EP EP16703463.6A patent/EP3259029B1/en active Active
- 2016-02-01 CN CN201680010905.4A patent/CN107427485B/zh active Active
- 2016-02-01 ES ES16703463T patent/ES2832777T3/es active Active
- 2016-02-01 CA CA2974867A patent/CA2974867A1/en not_active Abandoned
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AKIHISA MAKINO ET AL: "Anxiolytic-like effect of trans-2-decenoic acid ethyl ester in stress-induced anxiety-like model mice", BIOMEDICAL RESEARCH., vol. 34, no. 5, 1 January 2013 (2013-01-01), JP, pages 259 - 267, XP055205614, ISSN: 0388-6107, DOI: 10.2220/biomedres.34.259 * |
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Also Published As
Publication number | Publication date |
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US10596137B2 (en) | 2020-03-24 |
CN107427485A (zh) | 2017-12-01 |
AU2016221929A1 (en) | 2017-07-13 |
US20180028479A1 (en) | 2018-02-01 |
EP3259029A1 (en) | 2017-12-27 |
ES2832777T3 (es) | 2021-06-11 |
EP3259029B1 (en) | 2020-10-21 |
JP6669761B2 (ja) | 2020-03-18 |
CN107427485B (zh) | 2021-06-18 |
CA2974867A1 (en) | 2016-08-25 |
JP2018511558A (ja) | 2018-04-26 |
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