WO2018118196A1 - Healthier aging in domesticated animals - Google Patents

Healthier aging in domesticated animals Download PDF

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Publication number
WO2018118196A1
WO2018118196A1 PCT/US2017/056682 US2017056682W WO2018118196A1 WO 2018118196 A1 WO2018118196 A1 WO 2018118196A1 US 2017056682 W US2017056682 W US 2017056682W WO 2018118196 A1 WO2018118196 A1 WO 2018118196A1
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mitochondrial
testosterone
animal
composition
metabolism
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PCT/US2017/056682
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French (fr)
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Richard Postrel
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Richard Postrel
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/0012Galenical forms characterised by the site of application
    • A61K9/0019Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/185Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19Carboxylic acids, e.g. valproic acid
    • A61K31/195Carboxylic acids, e.g. valproic acid having an amino group
    • A61K31/197Carboxylic acids, e.g. valproic acid having an amino group the amino and the carboxyl groups being attached to the same acyclic carbon chain, e.g. gamma-aminobutyric acid [GABA], beta-alanine, epsilon-aminocaproic acid or pantothenic acid
    • A61K31/198Alpha-amino acids, e.g. alanine or edetic acid [EDTA]
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/505Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A61K31/519Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings
    • A61K31/525Isoalloxazines, e.g. riboflavins, vitamin B2
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/56Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
    • A61K31/565Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids not substituted in position 17 beta by a carbon atom, e.g. estrane, estradiol
    • A61K31/568Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids not substituted in position 17 beta by a carbon atom, e.g. estrane, estradiol substituted in positions 10 and 13 by a chain having at least one carbon atom, e.g. androstanes, e.g. testosterone
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K33/00Medicinal preparations containing inorganic active ingredients
    • A61K33/06Aluminium, calcium or magnesium; Compounds thereof, e.g. clay
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K33/00Medicinal preparations containing inorganic active ingredients
    • A61K33/24Heavy metals; Compounds thereof
    • A61K33/32Manganese; Compounds thereof
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00Medicinal preparations containing peptides
    • A61K38/04Peptides having up to 20 amino acids in a fully defined sequence; Derivatives thereof
    • A61K38/06Tripeptides
    • A61K38/063Glutathione
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00Medicinal preparations containing peptides
    • A61K38/04Peptides having up to 20 amino acids in a fully defined sequence; Derivatives thereof
    • A61K38/12Cyclic peptides, e.g. bacitracins; Polymyxins; Gramicidins S, C; Tyrocidins A, B or C
    • A61K38/13Cyclosporins

Definitions

  • the present invention enhances health and well being of "man's best friend” with the beneficial result of a longer and stronger bond between human pet owners or pet companions and the recognized positive outcomes on the human's health.
  • the level of normal or maximal activity is strengthened or maintained. This allows the individual to build or maintain more robust interactions with others, including others of different species, such as a canine human bond.
  • the human population especially in developed countries, has been seeing an increase in average age. Especially in the United States, and even more remarkable in Japan, the " baby boom" generation is drifting to retirement. A good number of these boomers have seen their children mature and move out to take on their own lives and responsibilities and to continue the human cycle with another generation. As members of the population age the aging process is associated with a decline in activities and with general social interactions. Social interaction and a feeling of being needed can give a purpose to life and improve attitudes in the aging population.
  • This emotional bond increases the importance of increasing the time span of the bond (increasing the num ber of years a pet remains healthy) and also improving health and activity levels of the animals whose importance to human well-being is growing.
  • the present invention recognizes the increased importance of non-human companions, and the benefits that these pets or companion animals provide to emotional and physical well- being of human involved with caring for or companioning these animals. Both the humans and animals can benefit physically and emotionally from this positive interspecies interaction. While not wishing to be bound by possible mechanisms underlying benefits to individuals and society from the optimized animal outlook, one possibility is that many mammals, including humans and canines, have evolved mechanisms that internally reward the organism, possibly releasing a hormone or neurotransmitter substance that binds to a satisfaction or happiness center within the brain. Accordingly, both the psyche and physicality of the select animal that the present invention may target can be expected to experience improvement. Other animals in contact with the select animal, most preferably humans interacting with said select animal, will share in increased sensations of general well being, higher interspecies engagement levels with positive internal reward response, and just generally a more positive demeanor.
  • One important factor involved in the present invention is that as the animals age androgenic influences of endogenous hormone, especially testosterone, continuously wanes.
  • total testosterone refers to the total amount of testosterone in the blood serum, that is, the combined amount of protein-bound testosterone and free testosterone.
  • the typical half-life of "testosterone" in the blood serum ranges from 10 to 100 minutes.
  • Testosterone is metabolized into dihydrotestosterone in the body by way of the 5-alpha reductase (5AR) enzyme (this means that dihydrotestosterone is a metabolite of testosterone), and furthermore, nandrolone is a byproduct of the aromatization
  • 5AR 5-alpha reductase
  • Testosterone itself is the principal male sex hormone. Hormones are defined and classified as chemical messengers of the human body, which means that hormones are what carry messages to different cells and tissues in the body to tell those cells and tissues what to do (grow muscle tissue, heal and repair, manufacture important components, perform a specific job, etc.). Without hormones of all different types, all functions within the human body will proceed unregulated and out of control. How much testosterone the average male produces is dependent on many different factors, which include: individual genetics, age, lifestyle habits, nutritional habits, and activity levels. On average, it has been determined that the median level of testosterone production among 30 year old males is between 50 - 70 mg weekly. Where any given individual might land within that range is dependent on the aforementioned factors.
  • Testosterone governs many different functions within the body. The nature of hormones in the circulation is to govern systemic functions remotely around the body, and testosterone is no exception to this.
  • Androgens such as testosterone and DHT bind to androgen receptors (ARs) in cells.
  • ARs androgen receptors
  • the resulting androgen-receptor complex regulates gonadotropin secretion and
  • spermatogenesis The androgen-receptor complex is responsible also for external vinilization and for most androgen actions during sexual maturation and adult life. DHT is an especially potent androgen because it binds with greater affinity to androgen receptors than testosterone does.
  • Testosterone production in intact mammals is stimulated by luteinizing hormone (LH). It is understood that follicle stimulating hormone (FSH) stimulates testosterone production also.
  • Testosterone concentrations in the blood serum are regulated in part by a negative-feedback pathway in which testosterone inhibits the formation and/or secretion of luteinizing hormone-releasing hormone (LHRH).
  • LH RH acts to stimulate secretion of LH by the pituitary gland. Testosterone acts also by regulating the sensitivity of the pituitary gland to LHRH.
  • the present invention provides improved health and longevity for the animal component of the relationships humans are finding more and more significant.
  • the invention preferably includes a second approach wherein in conjunction with androgen balancing as an anti-aging measure that optimizes activities additional improvement may be obtained by also optimizing mitochondrial activity, metabolism and performance.
  • Common diseases in the aging dog include: arthritis, which reduces activity levels and may make the animal more irritable or reclusive; obesity, which can acerbate arthritis and other diseases such as cardiomyopathy and usually reduces animal activity levels; joint dysplasia, which reduces animal comfort and activity; gum disease; diabetes; blindness of various etiologies; dementia; and other diseases of aging familiar in humans.
  • Metabolic functions may be impaired, for example, adipose tissue may experience accelerated or location improper deposition and/or aberrant utilization, glucose metabolism and metabolism of other sugars may be altered though diabetic effects and compensating metabolic shifts. For example in humans both free testosterone and total testosterone have been documented in their decline as a male ages.
  • testosterone levels may be important factors with regard to depression, activity level and general sense of well-being.
  • a testosterone supplement may improve activity levels and maintain a leaner body.
  • Low testosterone levels in human females have been associated with lack of motivation and a sense of fatigue.
  • the common weight gain and increased adipose tissue deposition in women starting approximately 10 years prior to menopause coincides with a commonly observed decreased level of circulating hormones
  • testosterone This suggests an important component of the present invention relating to maintaining testosterone balance will benefit both male and female canines.
  • testosterone is used as an example throughout this discussion since testosterone is an inexpensive and commonly reported androgen that has been used and abused by male and female humans. As testosterone replacement or testosterone level augmentation raises testosterone levels up to or possibly slightly exceeding previous normal range it has a high success rate of alleviating many conditions associated with aging that have been found to compromise human and animal health and general well being.
  • Testosterone and analogues have successfully treated or managed female breast cancer, hereditary angioedema, anemia, multiple muscle wasting diseases including HIV/AI DS, severe burns, acute and chronic wounds, general caloric wasting, muscular atrophy, osteoporosis, male infertility, adolescent growth failure, osteoporosis, female libido problems, Turner and Klinefelter Syndrome, menopause, chronic dysfunctional uterine bleeding (menorrhagia), endometriosis, and many others.
  • Recent reports suggest that testosterone has an import effect in strengthening connective tissues such as ligaments, for example the anterior cruciate ligament (ACL) in the knee.
  • ACL anterior cruciate ligament
  • Androgenic compound abusers have contributed to testosterone's and other androgenic hormones' shocking disparagement in general news media through reports of sometimes violent activities and severe health outcomes such as brain tumor, but perhaps partly related to publicity from these mainstream press warnings about androgenic use and "over manliness", a buse continues in a significant segment of the population. Though serious abuse may present long term problems for the individual and society, society in general can understand that the abuse is a result of testosterone's positive effects.
  • the present invention seeks to avoid these problems by monitoring, either through behavioral observation, or more preferably by measuring blood, saliva, urine, or skin androgen or androgenic activity. Even minor undesired elevation above a targeted amount, perhaps resulting from metabolic differences, change in food, or a mistake in dosing or formulation can be properly corrected. Long term effects seen over decades may not be a problem at all in shorter lived species. But age may be considered as a factor.
  • the natural testosterone molecule is poorly available to a mammals circulation when it is delivered by oral administration and absorbed across the intestinal wall into the hepatic portal system. Liver metabolizes most ingested testosterone before it can enter general circulation. An attempt to surmount this obstacle by alkylating (methylating) the c-17 a position of the molecule has been essentially abandoned for human use because of toxic effects on the liver. Testosterone undecanoate is not modified at the c-17 a position and appears to avoid this toxicity issue perhaps because its absorption is not through the portal system.
  • testosterone can be bound, packaged or complexed in a less natural manner to enhance absorption of the active molecule, through a non-portal pathway, for example, through the lymph system.
  • Complexing testosterone with a form of sex hormone binding globulin (SHBG), which carries the hydrophobic (lipid based) hormone in the circulatory system may be one important means for delivering testosterone through the general circulation.
  • SHBG sex hormone binding globulin
  • Liposomes and other hydrophobic carrier systems are possible delivery agents.
  • a coating or packaging that protects the testosterone carrier from gastric acid and enzymes may be designed for removal in the small intestine to permit testosterone to be carried into the lymph system.
  • compositions that might be used in practicing the present invention is a hormonal compound complexed or packaged in a chew toy.
  • Direct supplementation using an androgen or testosterone molecule in food is not without its downsides.
  • Testosterone in its native state or in chemically modified form has positive and negative consequences from use. Accordingly, use of the compositions is preferably in conjunction with repeated monitoring of androgen, e.g., testosterone, balance to minimize or avoid undesired effects while benefiting from the desired effects.
  • Circulating testosterone may be increased to a degree using compounds such as vitamins to stimulate production or to inhibit breakdown.
  • vitamin D has been shown to protect the liver from viral and chemical toxicity. Accordingly, vitamin may be coadministered with an androgen to help protect the liver from toxic response to the androgen.
  • Vitamin D has a second beneficial attribute in that it is lipophilic as are the cholesterol derived sex hormones such as androgens like testosterone.
  • Vitamin D can serve as a lipid carrier for other lipid molecules such as testosterone. When co-administered with testosterone Vitamin D both serves as a delivery vehicle until the SH BG and testosterone are able to associate. The testosterone androgen is circulating to find its target(s) and the vitamin D can migrate to the liver to exert its protective effect there.
  • Other lipid vitamins, such as vitamin A, vitamin E and/or vitamin K may also serve as lipid carriers to hold lipophilic androgen in circulation until it is able to be gathered by circulating SBHG.
  • testosterone balance can benefit from the presence of lipid vitamins and from inducing expression of SBHG using one or more means known in the art.
  • Sub-dermal identity chips are popular with pet owners in the United States and are growing in popularity worldwide. This illustrates that pet owners are receptive to "foreign" bodies being inserted into their animals. Similarly several forms of female birth control in humans make use of an implanted rod or stick that slowly dispenses a sex hormone. This acceptance suggests that many pet owners may welcome androgen supplementation in this manner to avoid risks, for example of hepatic toxicity.
  • Such device implanted in an animal might use any of the available delivery options. Shorter lasting implant (several months might use an osmotic pumping mechanism.
  • implant might use controlled solubility or diffusion where the androgen is part of a slowly dissolving matrix or is incorporated within a barrier that controls androgen diffusion into the bloodstream.
  • implanted devices will help ensure better hormonal balancing because of the required visits to the veterinary clinic where a technician or veterinarian can assay circulating androgen and refresh the implant.
  • Testosterone activity is mediated trough androgen receptors that are found in a multitude of tissues throughout the body.
  • the testosterone molecule crosses the cell membrane and binds to an intracellular receptor (AR) present in the cytosol of many cells.
  • AR intracellular receptor
  • the testosterone-receptor complex then migrates into the nucleus where it can bind specific deoxyribonucleic acid (DNA) segments to control gene expression by activating synthesis of specific messenger ribonucleic acid (mRNA) segment molecules to increase transcription (copying the targeted DNA) and processing the copy to empowerate protein synthesis controlled by the targeted segment of DNA; which, for example, in muscle cells, may increase production of the proteins actin and myosin.
  • DNA deoxyribonucleic acid
  • mRNA messenger ribonucleic acid
  • testosterone-receptor complex dissociates and the receptor is recycled along with the hormone to repeat this process multiple times.
  • Androgenic receptors including some responsive to testosterone metabolic products or metabolites such as dihydroxytestosterone (DHT) have been observed throughout the body in various tissues including, but not limited to: skin, scalp, prostate, thyroid, muscle fiber cells, muscle stem cells, pancreas, bladder, bone marrow, stromal cells, endothelial cells, macrophages, myeloblasts, myelocytes, neutrophils, megakaryocytes, corneal cells, lens cells, iris cells, cilliary body cells, adrenal cells and adipose (fat) cells.
  • DHT dihydroxytestosterone
  • the present invention recognizes that decreased testosterone levels such as those occurring during the aging process may result in diminished or suboptimal function of at least one and probably many organ systems in the body.
  • controlled restoration of testosterone presence and activity can have profound beneficial effect with regard to multiple physiologic functions. I mproving at least one of these functions, and preferably several can result in a general improvement in the animal's physiology and well-being.
  • Administration of testosterone to restore normal physiological levels can help to restore to a more youthful state and improve the function of many of the different systems where testosterone's effects on the cellular level are accomplished. This includes, for example, action in the bone marrow that increases red blood cell count, which translates to increased endurance, improvement in energy, well-being, and restoration of muscle mass.
  • testosterone levels should be in males according to various age groups.
  • testosterone in human males declines about 1% per year from the late thirties. For animals the decline may be steeper and will occur at a younger but still at a middle age.
  • Osteoarthritis and hip dysplasia are especially common and problematic in larger dog breeds and larger dogs in general. Dogs will reduce activity level and avoid some previous activities to hide the symptoms or to avoid associated pain. Aging is also associated with a general lethargy that can be a result of or mask other diseases such as a failing heart, painful joints, decreased muscle tone, arthritis, etc. and may be a factor in weight gain that can cause or exacerbate other disorders. I ncreased dysplasia and obesity have been observed to have increased occurrence in canines that have been spayed or neutered. While the benefits, in most cases, necessity of spaying or neutering are profound, the procedure does remove a major source of androgenic hormone, testosterone and its metabolites, from the animal's physiology. While other organs such as the adrenal produce androgens, often the amount decreases as the animal ages and becomes insufficient for optimizing animal activity and health.
  • Testosterone is the main male sex hormone, predominantly synthesized in the testes by Leydig cells (95%). I n human males, for example, a small amount of testosterone is produced by adrenals (5%).
  • Classic effects of testosterone include the androgen effects supporting-the growth and development of sex organs, the formation of stereotypical dominant male behavior (aggressive, attack behavior, territorial or harem protection, and other undesired behaviors), anabolic functions (maintaining muscle mass including myocardiocytes), stimulation of the synthesis of organ (specific proteins in kidneys, liver, sebaceous and sweat glands in animals that have them, maintaining bone density, hematopoiesis (stimulation of erythropoietin generation in kidney and stimulation of erythropoiesis in the bone marrow).
  • Androgens include, for example, 17 ⁇ -hydroxyandrost-4-en-3-one, commonly known as testosterone, and dihydrotestosterone (DHT), a metabolite of testosterone.
  • Testosterone is a naturally occurring androgen which is secreted in males and, to a much lesser extent, in females.
  • testosterone and DHT are responsible for normal growth and development of the male sex organs and for maintenance of secondary sex characteristics.
  • testosterone and DHT are believed to be important for normal growth, sexual desire, and sexual function.
  • androgens promote retention of nitrogen, sodium, potassium, and phosphorus, and decrease the urinary excretion of calcium. Androgens have been reported to also generally increase protein anabolism, decrease protein catabolism, and stimulate the production of red blood cells.
  • Mammalian cells are eukaryotic cells and therefore, like eukaryotic cells generally, they rely on their mitochondria to produce adenosine triphosphate (ATP).
  • ETC Electron Transport Chain
  • oxygen which, when it accepts the electrons, is reduced to combine with hydrogen to make water.
  • the ETC comprises several donor and receptor enzymes in series, eventually depositing the electrons with an oxygen. Passing electrons from donor to acceptor releases energy in the form of a proton (H +) across the mitochondrial membrane, This ion flux has the potential to do work.
  • This metabolic process is known as oxidative phosphorylation and results in production of adenosine triphosphate, aka, ATP.
  • the mitochondrion is important to cell metabolism and survival. Detailed descriptions are known or can be found in the art.
  • mitochondrion organelle is essential for healthy cells and therefore for healthy animal life.
  • ATP an essential molecule for energy metabolism within the cell is primarily generated by mitochondria.
  • Processes such as adaptive thermogenesis, ion homeostasis, immune responses, production of reactive oxygen species, and programmed cell death (apoptosis) are some of the more complex processes that also require appropriate ATP synthesis and transport.
  • Mitochondria contain their own DNA (mtDNA), which serves as a template for 13 mitochondrial proteins, 2 ribosomal RNAs (rRNAs), and 22 transfer RNAs (tRNAs).
  • rRNAs 2 ribosomal RNAs
  • tRNAs transfer RNAs
  • the mitochondrion can not function as a distinct and independent organelle. Replication, transcription, translation, and repair of mtDNA require proteins encoded by nuclear DNA (nDNA) of the hosting cell. When the host cell is sub-optimal, perhaps from androgen shortage, mitochondrial metabolism would be expected to be
  • the present invention relates an orally ingestible, animal life enhancing product to be administered by a human to an animal to optimize human animal relationships, and/or the animal's comfort, longevity and/or quality of life.
  • Hormones are chemical messengers used to transfer information through the bloodstream from one part of the body, generally an endocrine gland, to the body in general or to a specific target organ that has a receptor capable of binding or receiving the hormone.
  • Target organs have specialized receptors that gather information that has been transferred from the circulatory system by hormones.
  • An example of a target organ is the uterus, which is stimulated by the circulating hormone estrogen to develop uterine glands.
  • Prohormones are building block chemicals used to produce the hormone. In general, the blood levels of sex steroid prohormones are not regulated by any substance. Instead, prohormones are generally available to assist in the production of hormones, which then act as chemical messengers to other target organs. These prohormones are essential building blocks for production of the respective hormones and may themselves be at levels insufficient for optimal hormone production. Providing functioning hormone eliminates the problem that may stem from insufficient prohormone. In some hormonal pathways, a hormone may be metabolized to an inactive prohormonal state that may be recruited when needed to produce active hormone.
  • the invention has a goal of administering to the animal a non-toxic, effective amount of a composition comprising an androgenic hormone such as testosterone, or a pharmaceutically acceptable salt or metabolite thereof. Hormone level or activity following administration of the composition to the animal is evaluated.
  • the active ingredient may be bound to complexed with or incorporated in a carrier to facilitate administration and possibly to control bioavailability.
  • the composition is re-administered to the subject as needed to maintain a desired level of circulating hormone or observed activities.
  • ADP - adenosine diphosphate In general words in this description will have a meaning as used in American English. The following list is provided as additional guidance.
  • ADP - adenosine diphosphate Higher ADP levels are often associated with higher respiratory activity.
  • ATP - adenosine triphosphate a primary molecule involved in energy storage, transport and release.
  • Biogenesis - a synthetic process occurring as part of metabolism in a living organism.
  • Metabolism includes both anabolism and catabolism as well as multiple pathways that maintain life functions within a cell or organism. There is no real count of an actual number of metabolic pathways. With branches and cycles within major pathways and pathways sometimes only active in specific cell types and sometimes only at select times, counting an actual number would be arbitrary. However, the skil led artisan appreciates that the total number of pathways, including subpaths numbers in the thousands.
  • the internet is an available resource to study classes of pathways or individual pathways. See e.g.,
  • Clinical improvement An observable improvement in at least one factor in a patient's quality of life.
  • Coenzyme Q (CoQio) - aka: ubiquinone or ubidecarenone.
  • An oil-soluble, vitamin-like substance is present in mitochondria.
  • CoQio is part of the electron transport chain participating in aerobic cellular respiration to form ATP.
  • CoQio is especially significant because of its respiratory functions and because cholesterol inhibitors, such as statins can also inhibit synthesis of CoQio precursors.
  • Desmin An intermediate filament (IF) protein expressed in striated and smooth muscle tissues and is one of the earliest known muscle-specific genes to be expressed during cardiac and skeletal muscle development. Desmin is seen as controlling mitochondrial function by interaction with myofibrils and interacting with the cytoskeleton to affect positioning within a cell. ETC - electron transport chain which is used to harvest energy for use in metabolism.
  • IF intermediate filament
  • Kcnq2 - a member of the kcnq family of proteins which act as ion channels controlling potassium (K) flux across membranes.
  • Potassium gradients can control electrical potential across a membrane and therefore can be involved with electrical signaling within and between cells.
  • a potassium gradient can also control flux of other ions.
  • kif5b and kif5b- a gene encoding the protein and the encoded a heavy chain portion of kif5 protein working through microtubules to effect appropriate distribution of mitochondria within a cell. Mitochondria are not its only cargo; the protein is also associated with lysozyme and endocytic vessel distribution and is an essential component for distribution of many proteins within a cell.
  • Neurons also express related proteins encoded by kif5a and kif5c.
  • Mitochondrial integrity is known as a controlling factor in apoptosis, cell controlled self-destruction.
  • I ntegrity may be comprised by events including, but not limited to: membrane permeability changes, altered exposure of membrane proteins, changed expression of the mitochondrial genome.
  • Mitochondrial protein a protein encoded by or used within a mitochondrion.
  • Mitochondrial supportive substance a chemical that changes mitochondrial activity to benefit at least one aspect of cellular metabolism.
  • mtDNA double-stranded DNA found exclusively in mitochondria that in most eukaryotes is a circular molecule.
  • a single mitochondrion may include multiple copies of this circular mtDNA molecule.
  • optimization has the general meaning of a process leading to an improved outcome. Optimization will generally incorporate at least one facet of enhancement of number, outcome function or the like. In some uses optimization may refer to maximizing a component or process or a selected group of components and/or processes. More loosely optimization is used to mean improvement, even if a greater improvement might be obtainable. Many factors and outcomes, including but not limited to: effect on other processes, availability of an instrument, component or professional, cost, location, patient's wishes and government regulation may be factors in the optimization procedure and ultimate decisions made to determine a level of optimization. Optimization for one patients often will differ from optimization for another patient, but each patient will have improvement. Optimization may often involve improving one or more outcomes in concert with a possible worsening of another component of process.
  • Optimizing The process of optimization. Optimization or the process is considered as a goal or a work in progress approaching an optimal or best outcome. Thus optimization may vary with time.
  • Organic a compound containing carbon. A molecule having carbon and at least one other element.
  • the condition may be defined as a number or concentration, a rate of activity, a structure, or any observable or measurable process or product of metabolism.
  • Vimentin - VimlF an intermediate filament protein that is involved in distribution, motility and anchoring of mitochondria.
  • Vimentin can work with dyneins and actin-dependent myosins within the cell to deliver and anchor mitochondria close to where metabolic requirements are high.
  • Mitochondria one of the organelles found in most eukaryotic cells are often called the "powerhouse" or “battery” of the cell.
  • a eukaryotic cell typically has multiple mitochondria, the number being higher in cells with higher metabolisms.
  • the molecule adenosine triphosphate (ATP) functions as a predominant energy carrier in the cell.
  • Eukaryotic cells derive the majority of their ATP from biochemical processes carried out by their mitochondria. Within the cell mitochondria also tend to be found in regions with higher activities. Each cell has mechanisms to control mitochondrial synthesis and degradation and by balancing these mechanisms can control the number of mitochondria and metabolic rate of the cell. Cells also control movement of mitochondria so that their substrates and products can be efficiently delivered. Assisting the cells and organism containing the cells to optimize these activities will be found valuable in optimizing therapeutic outcomes.
  • biochemical processes carried out by mitochondria include, but are not limited to the following important cycles: i) the citric acid cycle (the tricarboxylic acid cycle, or Krebs's cycle), generating reduced nicotinamide adenine dinucleotide (NADH + H+) from oxidized nicotinamide adenine dinucleotide (NAD + ), and ii) oxidative phosphorylation, during which NADH + H + is oxidized back to NAD + .
  • the citric acid cycle also reduces flavin adenine dinucleotide, or FAD, to FADH2; FADH2 also participates in oxidative phosphorylation.
  • the respiratory chain of a mitochondrion is located in the inner mitochondrial membrane and consists of five multimeric protein complexes: Complex I; (approximately 44 subunits), Complex II (approximately 4 subunits), Complex I II (approximately 11 subunits), Complex IV (approximately 13 subunits) and Complex V (approximately 16 units).
  • Complex I complex I
  • Complex II complex II
  • Complex I II approximately 11 subunits
  • Complex IV approximately 13 subunits
  • Complex V complex V (approximately 16 units).
  • the respiratory chain also requires two small electron carriers, ubiquinone (coenzyme Q
  • ATP synthesis involves two coordinated processes: 1) electrons are transported horizontally from complexes I and II to coenzyme Q to Complex II I to cytochrome c to Complex IV, and ultimately to the final electron acceptor, molecular oxygen, thereby producing water. At the same time, protons are pumped "vertically" across the mitochondrial inner membrane (i.e., from the matrix to the inter membrane space) by complexes I, II, I I and IV. ATP is generated by the influx of these protons back into the mitochondrial matrix through complex V (mitochondrial ATP synthase). The energy released as these electrons traverse the complexes is used to generate a proton gradient across the inner membrane of the mitochondrion, which results in stored potential energy in the form of an electrochemical potential across the inner membrane.
  • oxidoreductase removes two electrons from NADH and transfers them to a lipid-soluble carrier, ubiquinone.
  • the reduced product, ubiquinol is free to diffuse within the membrane.
  • Complex I moves four protons (H + ) across the membrane, producing a proton gradient.
  • Complex I is one of the main sites at which premature electron leakage to oxygen occurs, thus being one of main sites of production of one harmful free radical called superoxide.
  • Complex II succinate dehydrogenase
  • FAD free radical
  • Complex II consists of four protein subunits: SDHA, SDHB, SDHC, and SDH D.
  • Other electron donors e.g., fatty acids and glycerol 3-phosphate
  • FAD g., fatty acids and glycerol 3-phosphate
  • Complex III removes two electrons from QH 2 and transfers them to two molecules of cytochrome c, the water-soluble electron carrier located between the membranes. As part of this process, it moves two protons across the membrane, producing a proton gradient (in total 4 protons: 2 protons are translocated and 2 protons are released from ubiquinol).
  • electron transfer is hindered (e.g., by a high membrane potential, point mutations or by respiratory inhibitors such as antimycin A)
  • Complex III can leak electrons to oxygen resulting in the formation of superoxide, a highly-toxic oxidative species, which appears in the pathology of many diseases and is seen in aging.
  • Complex IV cytochrome c oxidase removes four electrons from four molecules of cytochrome c and transfers them to molecular oxygen (0 2 ), producing two molecules of water (H 2 0). At the same time, it moves four protons (H + ) across the membrane, producing a proton gradient.
  • Complex V mitochondriachondrial ATP synthetase which is not directly associated with Complexes I, ll 7 III and IV uses the energy stored by the electrochemical proton gradient to convert ADP into ATP.
  • Mitochondrial respiratory chain disease is an increasingly well-recognized, but notoriously heterogeneous, group of multisystemic energy deficiency disorders. Its extensive heterogeneity has presented a substantial obstacle for establishing a definitive genetic diagnosis and clear pathogenic understanding in individual patients with suspected mitochondrial disease. While known genetic causes of "classical" mitochondrial DNA (mtDNA) - based disease syndromes have been readily diagnosable, the overwhelming majority of patients with clinical and/or biochemical evidence of suspected mitochondrial disease have had no identifiable genetic etiology for their debilitating or lethal disease. McCormick et al. 2012
  • Mitochondrial DNA is more prone to mutation effects in that the mitochondrion has a high rate of replication and lacks a DNA repair pathway in the organelle.
  • the high level of active oxygens and the resultant oxidative stress also probably contribute to a relatively rapid mtDNA mutation rate.
  • control of mtDNA mutation and control of mutated mtDNA can be important targets for optimization.
  • the present invention may target any one or more of these genes, control of these genes, expression products of these in optimization.
  • amiodarone biguanides, haloperidol, statins, valproic acid, zidovudine, anesthetics, antibiotics, chemotherapeutic agents, and even NSAIDS like aspirin (acetylsalicylic acid) have been observed to affect total mitochondrial function.
  • amiodarone biguanides, haloperidol, statins, valproic acid, zidovudine, anesthetics, antibiotics, chemotherapeutic agents, and even NSAIDS like aspirin (acetylsalicylic acid)
  • NSAIDS like aspirin (acetylsalicylic acid)
  • Mitochondrial diseases are sometimes (about 15% of the time) used by
  • Mitochondria Mitochondrial proteins
  • mitochondria are so critical to cell function.
  • the subclass of these diseases that have neuromuscular disease symptoms are often called a
  • mitochondria contain two membranes.
  • the outer mitochondrial membrane encompasses the inner membrane, with a small intermembrane space in between.
  • the outer membrane has many protein-based pores that can allow the passage of simple ions and molecules as large as a small protein.
  • the inner membrane has much more restricted permeability. It is more like the plasma membrane of a cell.
  • the inner membrane anchors proteins involved in electron transport and ATP synthesis. This membrane surrounds the mitochondrial matrix (the in nermost compartment within the mitochondrion), where the citric acid cycle produces the electrons that travel from one protein complex to the next along the inner membrane.
  • the final electron acceptor is oxygen which ultimately forms water (H 2 0).
  • the electron transport chain produces ATP.
  • ADP adenosine diphosphate
  • ATP adenosine (triphosphate).
  • ATP adenosine (triphosphate)
  • mitochondrial proteins are synthesized from nuclear genes (the DNA within another cell organelle, the cell nucleus) and transported into the mitochondria. These include, but are not limited to the enzymes required for the citric acid cycle, the proteins involved in DNA replication and transcription, and ribosomal proteins.
  • the protein complexes of the respiratory chain are a mixture of proteins encoded by mitochondrial genes and proteins encoded by nuclear genes. Proteins in both the outer and inner mitochondrial membranes help transport newly synthesized, unfolded proteins from the cytoplasm into the matrix, where folding ensues.
  • MTATP8 have mutations associated with disease. These proteins are generally found at mitochondrial inner membranes.
  • Nuclear genes encoding mitochondrial proteins (most likely found associated with or bound for the mitochondrial outer membrane) whose mutation has been linked to mitochondrial disease include but are not limited to: A RMS 2, BCL2, CPTIA, DNMIL, GCK, GK, KIFIB, MAOA, PINK1.
  • Nuclear genes encoding mitochondrial proteins (most likely found associated with or bound for the mitochondrial inter membrane space) whose mutation has been linked to mitochondrial disease include but are not limited to: AK2, DIABLO, GATM, GFER, HTRA2, PANK2 and PPOX.
  • Nuclear genes encoding mitochondrial proteins (most likely found associated with or bound for the mitochondrial inner membrane) whose mutation has been linked to mitochondrial disease include but are not limited to: ABCB7, ACADVL, ADCK3, AGK, ATP5E, C12orf62, COX4I2, COX6B1, CPT2, CRAT, CYCS, CYP11A1, CYP11B1, CYP11B2, CYP24A1, CYP27A1, CYP27B1, DHODH, DNAJC19, FASTKD2, GPD2, HADHA, HADHB, HCCS, L2HGDH, MM A A, MPV17, NDUFA1, NDUFA2, NDUFA9, NDUFA10, NDUFA11, NDUFA12, NDUFA13, NDUFB3, NDUFB9, NDUFV1, NDUFV2, NDUFS1, NDUFS2, NDUFS3, NDUFS4, NDUFS6, NDUFS7, NDUFS8, OPA1, OPA3, PDSS
  • Nuclear genes encoding mitochondrial proteins (most likely found in or bound for the mitochondrial matrix) whose mutation has been linked to mitochondrial disease include but are not limited to: AARS2, ACAD8, ACAD9, ACADM, ACADS, ACADSB, ACAT1, ALAS2, ALDH2, ALDH4A1, ALDH6A1, AMI, ATPAF2, AUH, BCAT2, BCKDHA, BCKDHB, BCS1L, C8orf38, C10orf2, C12orf65, C20orf7, COA5, COX10, COX15, CPS1, D2HGDH, DARS2, DBT, DECR1, DGUOK, DID, DLAT, DMGDH, ETFA, ETFB, ETFDH, FOXREDl, FH, GCDH, GCSH, GFMl, GLUDl , HADH, HARS2, HIBCH, HMGCS2, HMGCL, HSD17B10, HSPD1, IDH2, IDH3B, ISCU, IVD
  • Nuclear genes encoding mitochondrial proteins (but proteins that are also found in other places in the cell) whose mutation has been linked to mitochondrial disease include but are not limited to: AIFM1, AKAP10,, AMACR, APTX, BAX, BOLA3, CYB5R3, ETHE1, FXN, GDAP1, HK1, HLCS, LRPPR LRRK2, MFN2 cramp MLYCD,, NFU1, PARK2, PARK7, SACS, SPG20 and WWOX.
  • Nuclear genes encoding mitochondrial proteins (but whose specific localization within the mitochondrion is still to be elucidated) whose mutation has been linked to mitochondrial disease include but are not limited to: GLRX5, HOGA1, MMAB, MMADH PDSS2, AFG3L2, COQ2, COQ6, COQ9, GLDC, PNKD, PUS1, REEP1, STAR and TMEM126A.
  • genes that do not encode a protein found in mitochondria can also be of extreme importance in optimized cell metabolism. For example, as discussed below the Position of mitochondria within cells is dependent on many proteins. The genes encoding these proteins can also be important in optimization.
  • Mitochondria are the major source of metabolic energy, and they regulate intracellular calcium levels and sequester apoptotic factors.
  • Mgml and Opa 1 are involved in regulating cristae structure.
  • Mgml participates in
  • Mitochondria are not just cell powerhouses producing ATP. They also are essential for other facets of cell functions required for metabolism. Cell metabolism is accomplished by thousands of enzymes. Many of these enzymes require metals for proper activity and to form coordination complexes. I ron sulfur clusters (ISVC), essential for iron homeostasis in the cell, are a product of mitochondria.
  • ISVC I ron sulfur clusters
  • mitochondria through this contribution to iron control are necessary for many oxidation reactions, including, but not limited to: oxidative phosphorylation, pyrimidine/purine metabolism, the tricarboxylic acid cycle, acontinase activity, DNA repair, NTHLl activity, heme synthesis, ferrochelatase function, ISC synthesis enzymes (N BP35 and CFD1).
  • Metal containing enzymes, of which iron containing oxidation/reduction enzymes are common are important for scavenging active oxygens.
  • FtMt is an important nuclear encoded mitochondrial protein that sequesters iron in mitochondria and makes it available when needed.
  • Mdm33 is important for inner membrane fission. Proton pumping is coupled to ATP synthesis through FiF 0 ATP synthase.
  • biochemicals are essential or beneficial for proper cell metabolism.
  • the biochemical may serve, for example, as a chemical substrate, a carrier, a structural member, a signal modifying activity of other biochemicals, etc. Changing location or activity of one may affect utilization of several others.
  • any one or combination of the metabolic biochemicals and/or the biochemical enzymes processing them can be proper targets for optimization. Targets, including, but not limited to:
  • Prostaglandins (PG) - specific to the PG and tissue may show positive/negative effect; e.g.,
  • PGA PGA 2 , PGB, PGB 2 , PGC, PGD, PGD 2 , PGE, PGEi, PGE 2 , PGE 3 , PGF a , PGFiCt, PGF 2 , PGF 3 , PGG, PGH, PGH 2 , PGI, PGJ, PGK, and related biomolecules, including, but not limited to: prostacyclins, thromboxanes, prostanoic acid, 2- Arachidonoylglycerol, etc.
  • Mitophagic or mitophagic inhibitory compounds including, but not limited to: isoborneol, piperine, tetramethylpyrazine, and astaxanthin
  • Riboflavin (vitamin B2) works with the other B vitamins. It is important for body growth and red blood cell production and helps in releasing energy from carbohydrates.
  • Creatine is a naturally-occurring amino acid (protein building block) found in meat and fish, and also made in the liver, kidneys, and pancreas. It is converted into creatine phosphate or phosphocreatine and stored in the muscles, where it is used for energy. During high- intensity, short-duration exercise, such as lifting weights or sprinting, phosphocreatine is converted into ATP.
  • CoQi 0 there are two major factors that lead to deficiency of CoQi 0 : reduced biosynthesis, and increased utilization by the body.
  • Biosynthesis is the major source of CoQi 0 . Biosynthesis requires at least 12 genes, and mutations in many of them are known to cause CoQ deficiency. CoQio levels can also be affected by other genetic defects (such as mutations of mitochondrial DNA, ETFDH, APTX, FXN, and BRAF, genes that are not directly related to the CoQio biosynthetic process)
  • Toxicity is not usually observed with high doses of CoQi 0 .
  • a daily dosage up to 3600 mg was found to be tolerated by healthy as well as unhealthy persons.
  • some adverse effects, largely gastrointestinal, are reported with very high intakes.
  • Arginine can be made by most mammals. However, normal biosynthetic pathways, produce insufficient amounts of arginine so some must stil l be consumed through diet.
  • Arginine is the immediate precursor of nitric oxide (NO), urea, ornithine, a nd agmatine.
  • NO nitric oxide
  • Arginine is also a necessary precursor for the synthesis of creatine and other cell component biochemicals.
  • the enzyme, arginase is found in mitochondrial membranes and here contributes to proper function of the urea cycle.
  • the metal, manganese is also important for mitochondrial activity at least through its participation in arginine metabolism.
  • Carnitine is involved in the transport of acyl-coenzyme A across the mitochondrial membrane to be used in mitochondrial ⁇ -oxidation.
  • Vitamin C reduces the exercise-induced expression of key transcription factors involved in mitochondrial biogenesis. These factors include peroxisome proliferator-activated receptor co-activator 1, nuclear respiratory factor 1, and mitochondrial transcription factor A.
  • Vitamin C also prevented the exercise-induced expression of cytochrome C (a marker of mitochondrial content) and of the antioxidant enzymes superoxide dismutase and glutathione peroxidase.
  • Vitamin C is an antioxidant, that along with resveratrol and alpha- lipoic acid reduces excessive reactive oxygen species production by the mitochondria.
  • Manganese is also important here as vitamin C works with manganese superoxide dismutase.
  • Cyclosporin A an immune suppressant, interferes with the mitochondrial permeability transition pore and therefore has been found effective in protecting against oxidative stress in for example, stress inducing ischemia and reperfusion. Cyclosporin A can improve metabolism in some instances by slowing or blocking cell apoptosis.
  • Magnesium is important for proper calcium metabolism and function as a cofactor with many enzymes. Magnesium also appears especially important for mitochondrial biogenesis.
  • Zinc is important in mitochondrial activity, for example, zinc can affect ATP production rates.
  • Carnosine is a potent scavenger of free radicals
  • Vitamin E is a protectant against mitochondrial membrane peroxidation and therefore can be an important factor in maintaining mitochondrial activity and cellular metabolism.
  • Resveratrol is a potent antioxidant with apparent involvement in mitochondrial biogenesis. Resveratrol acts through AMPK and SIRT1 and is involved in PGC-l .
  • Alpha-lipoic acid is associated with rejuvenation and replacement of damaged
  • DCA Dichloroacetate
  • DCA stimulates oxidative phosphorylation by inhibiting pyruvate dehydrogenase kinase.
  • DCA potency may vary in a particular cell or individual metabolic profile.
  • DCA has been investigated as a possible therapy in some cancers.
  • Succinate is an intermediate in the tricarboxylic acid cycle (making ATP), and participates in inflammatory signaling. Succinate dehydrogenase participates in electron transport as "Complex II”.
  • NSAIDS are active in controlling mitochondrial Complex I. NSAIDS may also alter
  • mitochondrial membrane permeability by opening the mitochondrial permeability transition pore that allows small molecules up to 1.5 kDa easier passage across the mitochondrial membrane.
  • Melatonin demonstrates cell protectant activity though slowing apoptosis as it controls activity of aged or oxidatively stressed mitochondria involvement in leading the cell down the apoptotic pathway.
  • the anesthetic, cocaine, has been observed as modifying Complex I activity in mitochondria.
  • the stimulant class of amphetamines are inhibitors or normal mitochondrial metabolism and appear to increase oxidative stress.
  • Mitophagic or mitophagic inhibitory compounds including, but not limited to:
  • Mitophagy is important for recycling of mitochondria and controlling position and number of mitochondria. Either slowing or accelerating mitophagy may be important for optimizing metabolism in a particular cell or individual.
  • Increased glutathione is known to protect mitochondria and the cell against damaging effects of the oxidative moieties produced in mitochondria such as: superoxide anion radical O2 , hydrogen peroxide, H 2 0 2 , and the extremely reactive hydroxyl radical * HO.
  • Increasing intracellular glutathione content is possible by several methods including, but not limited to: supplying precursors for glutathione synthesis, e.g., N-acetylcysteine; increasing CoA, for example, by supplying its precursor pantothenic acid; making curcumin (a spice) available to the cell; and the analgesic drug flupirtine. Since glutathione is seen to increase throughout the cell, the antioxidant protection is not limited to the mitochondria.
  • ⁇ -carotene, lycopene, lutein, astaxanthin and zeaxanthin are popular carotenoids. These biochemicals demonstrate antioxidation properties. These tend to be lipophilic and thus often are found partitioned in membranes. So at high concentrations they may disorganize normal membrane structure.
  • Cautious treatment with one or more carotenoids can protect membranes against oxidative stress by inhibiting mitochondrial active oxygen production. At least in some cells carotenoids increase mitochondrial function while limiting active oxygen generation. Cell survival can be improved. If the cell whose health is improved is, for example, a cancer cell, then sometimes reduced carotenoids may be advantageous.
  • mitochondrial shape and size are highly variable. Shape and size is controlled by fusion and fission processes. We can also observe that mitochondria are actively transported in cells depending on energy needs within the cell. More mitochondria become situated in areas with higher energy needs, including, but not limited to: active growth cones, presynaptic sites and postsynaptic sites. Also, the internal structure of mitochondria can change in response to their physiological state. Shape. Length, shape, size and number of mitochondria are controlled by fusion and fission. Fusion will generally result in fewer, larger and more spherical mitochondria. Whereas high fission cells generally have more mitochondria that are smaller and rod shaped.
  • Outer shape is not the sole shape criterion.
  • Mitochondria also have internal structure (e.g., shape of cristae).
  • the cristae are regions of the inner membrane more distant (internal) from the outer membrane. Cristae are formed by internal folding of the inner membrane.
  • the different portions of the inner membrane have different functions. For example, cristae are richer in oxidative phosphorylation machinery are more prevalent in cristae while transport facilitators are more prevalent in the inner membrane regions apposite the outer membrane.
  • the density and length of cristae are controlled according to the cell's needs and the needs of specific location within the cell.
  • NGF nerve growth factor
  • mitochondria use the cytoskeleton as a guide to destination a nd for transportation.
  • Mitochondria are now known to migrate throughout cells, to fuse, and to divide as mitochondrial activity is regulated according to the cell's needs.
  • the dynamic mitochondrial processes enable mitochondrial recruitment on demand to the changing more active subcellular compartments. Fusion processes as cells converge upon one another and merge facilitates content exchange between mitochondria and is a component of mitochondrial shape control.
  • Stem cells which can fuse with endogenous cells may be involved in rescuing cells with damaged or otherwise dysfunctional mitochondria.
  • Movement is also important for mitochondrial communication with the cytosol and mitochondrial quality control. With these activities mitochondria readily adapt to changes in cellular requirements and therefore can respond to physiological or environmental imperatives. When mitochondrial dynamics becomes disrupted, cellular dysfunction ensues. Accordingly, optimization of cellular metabolism may involve modifying mitochondrial dynamics.
  • Optimization may thus involve consideration of the number of mitochondria, location of mitochondria, size of mitochondria, size and shape, internal structure of mitochondria in addition to chemical factors that may more specifically modify one or more mitochondrial function. Optimization of mitochondrial activity can be a valuable addition over and above the benefits obtained from balancing circulating androgen.
  • oral compositions, absorbable or metabolizable as the desired hormone can be incorporated into an animal's regular diet.
  • Prohormones include dehydroepiandrosterone (DH EA), pregnenolone, androstenedione and/or androstenediol.
  • the oral composition may comprise the hormone itself or a suitable prohormone and may be delivered by any suitable means, including, but not limited to: as a toothpaste, a small treat, a food formulation, a prescription food product, a chew toy, etc.
  • the invention also provides methods of making the oral composition for enhancing human animal or animal-animal interaction, or simply animal health comfort and well-being by incorporating the hormone into one or more delivery devices.
  • One such device might be a toy, for example a dog toy shaped as a bone, a ring, a small animal, etc.
  • Such device can be made in bulk using any conventional procedures, but for most accurate control of dosing for a specific animal may be produced in whole or in part using techniques commonly referenced as 3-D printing.
  • the 3-D printing procedure would incorporate a matrix suitable to maintain the animal's interest and print within this matrix, at least a portion of the toy with the hormone at the desired and extraordinarly controlled concentration.
  • the matrix may start as a form produced using more bulk production processes and may be enhanced with one or more therapeutic areas such as a coating, a filler, a layer, etc., that comprises the hormone at the precisely determined dosing.
  • No-oral delivery methods are available.
  • the present invention is based in part on the insight that administering one or more androgenic hormones or prohormones to generally healthy appearing animals can increase their overall health and beneficial interactions with nearby humans.
  • achieving an optimal level of circulating hormone may be associated with an increased quality of life, possibly through enhancement of the immune system's ability to defend against bacteria and viruses, to resist cancer, to enhance the circulatory system, and/or to ameliorate undesired stress-responses.
  • Testosterone since it is well studied and readily available is a preferred hormone to be used for controlling circulating androgenic hormone level and hormonal activity. Though in some cases prohormones may have advantages. Known prohormones that are commercially available include: DHEA, pregnenolone, androstenedione, and androstenediol.
  • compositions used in the present invention are preferably formulated and controllably administered to a an animal to induce desired effects without also inducing undesired side effects, such as undesired anabolic or androgenic effects, in that animal.
  • suitable unit doses may range from about: 0.01 mg to 500 mg, e.g., 0.01 mg, 0.05 mg,. 0.07 mg tone 0.1 mg tone 0.15 mg, 0.2 mg. 0.5 mg, 1.0 mg, 2 mg, 3 mg, 5 mg, 7 mg, 10 mg, 20 mg, 25 mg, 30 mg, 50 mg, 75 mg, 100 mg, 120 mg, 150 mg, 175 mg, 200 mg, 250 mg, 300 mg, 350 mg, 400 mg, 450 mg, or 500 mg.
  • the animal's size, the animal's age, the animal's gender, the specific composition, etc other ranges may be relevant, for example, 10 mg - 200 mg, 12.5 mg to 150 mg, 15 mg-100 mg, 20 mg-75 mg, 20 mg -50 mg, or 50 mg - 100 mg.
  • Salts, esters, metabolites, protein bound, glycosylated, or matrixed formats of delivery a can be used in the composition, provided they are converted in vitro or in vivo to an active form.
  • the composition may comprise hormone or pro-hormone that is bound , covalently of non- covalently to a non-hormonal substance.
  • the composition may optionally include additional vitamins or minerals and scents or flavorings or flavor enhancers to render the composition more acceptable to the administering human and/or to the animal.
  • additional vitamins or minerals and scents or flavorings or flavor enhancers to render the composition more acceptable to the administering human and/or to the animal.
  • beef, elk, chicken, salmon and/or other scent or flavor appealing to dogs may be incorporated, a protein binder and/or a vitamin such as one of the b vitamins, e.g., B6 might be added as it or they might be found to hel p stabilize hormone level.
  • the composition may be made available in one or more formats including, but not limited to: a capsule, a tablet, a caplet, a liquid beverage, a powder, a liquid or powder beverage additive, a gel, a ready-to-eat food, either moist or dry, a chunk, a bar, a toy of desired shape and size.
  • a capsule a tablet, a caplet, a liquid beverage, a powder, a liquid or powder beverage additive, a gel, a ready-to-eat food, either moist or dry, a chunk, a bar, a toy of desired shape and size.
  • composition of the present invention may further comprise natural and/or artificial flavoring components, dyes or other coloring additives, preservatives and other
  • the time and dosage amount administered will vary from animal to animal and will be influenced by the age of the subject, and therefore may be adjusted as the animal ages. It is believed that generally, the younger the animal, the earlier results will be apparent with a smaller dosage amount needed to achieve optimal results. As the animal ages, the composition will have to be administered perhaps more frequently and in larger dosages for the animal to experience optimal results.
  • the form of the oral composition can be any suitable form that comprises the active ingredient and allows delivery to the select animal.
  • an animal has been under a veterinarian's care and is general good health, however, the animal is aging and can benefit from receiving a therapeutic intervention that while not strictly necessary for life is beneficial to the animal and its human interactions though optimizing health, for example, by staving off or diminishing arthritis, other bone issues, such as dysplasia, lessening obesity problems and other issues seen in aging animals, such as diabetes, lethargy, pain, etc.
  • testosterone may be co-administered with an oil, may be admixed in a feed, may be delivered as a toy, etc.
  • the format for delivery is subject to choice of the animal caretakers and is manageable in accordance with this invention.
  • Animals including humans have shown large variations in efficiencies of moving testosterone and other androgens from the gastro-intestinal track to circulation.
  • testosterone supplementation most desirable effects being observed with approximately a doubling or tripling of typical circulating testosterone in a middle aged or older mammal, with extreme levels risking undesirable androgenic consequences, monitoring testosterone delivery and testosterone or testosterone analogue in each individual is highly desired. Controlled and balanced delivery of the androgen supplement should be practiced to provide the best outcomes.
  • a preferred process in practicing the invention will utilize multiple tests performed over time and especially whenever feed is changed, perhaps when time of administration is changed, perhaps whenever the animal changes residences, and periodically as the a nimal increases in age.
  • testosterone levels may involve several iterative changes. So after an initial testosterone level determination and a choice of supplementation format and dose the animal will be supplemented for a period of time to achieve a new balance. After several weeks to several months the testosterone levels will again be monitored and the dosage or frequency of delivery adjusted to compensate for interbreed differences, differences in co-administered foodstuffs, and significantly factors specific to the specific animal. The balancing will need periodic adjustment as endogenous androgen will be expected to diminish as the animal ages and degradation rates of testosterone will also fluctuate with age and other factors.
  • a five year old canine (age dependent on the breed, the animal size, etc.) is evaluated at its annual visit. This visit includes a hormonal profile as well as questioning the dog owner about the animal's activities and general health. The veterinarian observes that as in common at this age for this type of dog, testosterone levels are continuing to drop and that the dog might benefit from restoring circulating levels of testosterone or other androgenic hormone in the blood.
  • the veterinarian calculates a target testosterone level and suggests simple oral supplements that can help the dog achieve these levels and to thereby pep up the dog, the dog owner and the dog's family.
  • the owner chooses from a brochure provided by the veterinarian one of the compositions of the present invention, in fact the owner here wishes for variety and chooses a relatively hard chew toy, a gel format wherein the composition is encapsulated in a soft, bone shaped, gum like format that the owner believes her kids will enjoy giving the dog. She also takes a small food packet as a sa mple. This packet has two pouches and a small distribution device where a small quantifiable (by counting or volume measurement) portion (preferably slightly color coded for the human) can be admixed in prescribed proportion with the larger pouch contents to achieve the desired caloric intake and hormonal supplement dosage. Additional Benefit - Improving Energy Metabolism
  • mitochondrial optimization might even more robustly improve the animals general outlook.
  • Combing mitochondrial optimization to optimize cellular metabolism in conjunction with androgen balancing is another feature that may further improve outcomes over and above the solely androgen focused approach.
  • the mtDNA sequence results may be combined with genetic sequence information from one or more organs or cell types in an individual.
  • Genomic sequence is one level of information that may be used in isolation or in combination with mtDNA sequence information for additional guidance in the optimization process. Even more robust information may be obtained, not just from gene expression profiling. This is very useful when considering specific organs or cell types which by being differentiated cells only express a small subset of the full genome.
  • Obtaining RNA transcription profiles or expression profiles can thus be instrumental in the optimization process.
  • analyzing proteins as discussed below with specific reference to blood and other ex vivo biopsy sources can provide some genomic profile information by monitoring the end product of genomic expression. Accordingly, genomic information in isolation or more preferably in combination with clinical observation and other assays is understood to be a useful source of information to use in developing an optimization protocol.
  • Electron Transport Chain Inhibitors may involve inhibiting certain mitochondrial functions to assess their performance levels. Also on occasion optimizing metabolism may involve mitochondrial inhibition. Several examples of inhibitors are discussed as examples. Electron Transport Chain Inhibitors
  • ETC inhibitors per se act by binding and blocking a component the electron transport chain. ETC function can also be inhibited by impairing expression or proper localization of one of the component enzymes or carriers. Inhibiting or blocking the ETC prevents electrons from being passed from one carrier to the next and stops oxidation of oxygen and synthesis of ATP. Since binding is involved the inhibitors act specifically to affect a particular carrier or complex. Binding can be temporary (reversible) or permanent (irreversible). Reversible inhibition may be time or concentration dependent. Irreversible inhibition generally results in total stoppage of respiration via the blocked pathway. Competitive inhibition is one form of reversible inhibition.
  • Rotenone is used as an insecticide. It is toxic to wildlife and to humans as well as to insects. It is a competitive inhibitor of electron transport suitable for testing ability to block respiration via the NADH versus succinate pathway. Antimycin
  • Antimycin has been used with combinations of substrates including succinate, NADH or glutamate, and the dye TMPD (N,N,N',N'-tetramethyl-p-phenylenediamine) along with ascorbic acid.
  • substrates including succinate, NADH or glutamate, and the dye TMPD (N,N,N',N'-tetramethyl-p-phenylenediamine) along with ascorbic acid.
  • Cyanide Cyanide is a reversible inhibitor of cytochrome oxidase. Some mitochondria have cyanide resistant pathways. Cyanide causes uncoupling. So in the presence of TMPD a dramatic increase in oxygen consumption is observable.
  • Uncoupling is where the rate of electron transport is no longer be regulated by the chemiosmotic gradient. The condition is differentiated from electron transport inhibition by the fact that in the latter case, bypassing the block can restore the gradient. In uncoupling, the ETC still functions but is ineffective because of dissipation of the chemiosmotic gradient.
  • 2,4-dinitrophenol (DN P) 2,4-dinitrophenol
  • DN P is a proton ionophore. It binds protons on one side of a membrane, and then being fat- soluble drifts to the opposite side where it loses the protons. The probability of binding is greatest on the side of the membrane with greatest proton concentration, and least on the side with the lesser concentration. This makes it impossible to maintain a proton gradient.
  • DN P demonstrates other effects in addition to uncoupling. DN P gradually inhibits electron transport itself as it incorporates into mitochondrial membranes. In the 1930s DN P was promoted as an effective diet pill. Uncoupling of electron transport from ATP synthesis allows rapid oxidation of Krebs substrates and promotes mobilization of carbohydrates and fats to maintain normal levels of the Krebs substances. The energy is lost and measurable as heat.
  • FCCP is an ionophore, completely dissipating the chemiosmotic gradient while leaving the electron transport system uninhibited.
  • Oligomycin blocks ATP synthase by blocking the proton channel. This inhibits oxidative phosphorylation. Oligomycin has no effect on Complex IV respiration, but blocks Complex III respiration completely. It therefore has no direct effect on electron transport or the chemiosmotic gradient. Any mitochondrial function or related function is a possible target for optimization
  • Cells and mitochondria each and collectively require multiple metabolic functions for their own survival and survival of the organism.
  • modifying a specific function or activity or a select group of metabolic functions or mitochondrial activities may be selected for optimization, in other cells or conditions, including, for example, cells of a different organ with the same individual or cells of a different individual.
  • activities that might be altered associated with the optimization process may include but are not limited to: oxidative phosphorylation, energy versus heat production
  • disease status To optimize treatment for the individual, disease status; the individual's history with the disease; the individual's response to the disease; the individual's genetic background (including methylation and other epigenetic control of polynucleic acids or their histones); the individual's biochemical status for one or more markers, metabolites or substrates; and experience such as data from the disease, the individual or any relevant group or subgroup can be used alone or in combination.
  • FACS fluorescence activated cell sorting
  • Analysis of an individual or a group or class of individuals for normalization or validation can be directed explicitly at reactions carried out by mitochondria. However, this often may require a bioassay, removal of tissue from an individual for ex vivo analysis. And since the mitochondrion is an essential component of eukaryotic cells, participating in multiple metabolic pathways, mitochondrial status can be evaluated by secondary or tertiary parameters.
  • blood can be used to monitor mitochondrial health and therefore may be used in the present invention as a material for bioassay.
  • Several fractions of blood may be used at the discretion of the practitioner. For example, mitochondria themselves can be found in white blood cells.
  • Fibroblasts, mesenchymal stem cells, cancerous and/or cancer progenitor are examples of some rare but observable cell types that can be found in blood. Any cell found in the blood might be used as a source for nucleic acid to assay or sequence a nuclear or mitochondrial genome or a portion thereof.
  • the blood also carries other components, fatty acids, proteins, glycoproteins, lipoproteins, carbohydrates (simple and complex), gases (especially oxygen and carbon dioxide), ketones, hormones, metabolites, nitrogen compounds, active oxygen molecules, ions (atomic, polyatomic, organic, etc.), amino acids, plasma proteins (such as albumen that may scavenge [bind] drugs or other molecules), cytokines, platelets, molecules carried from the digestive system or lungs, etc. that may be used to indicate, tissue, cell and mitochondrial status.
  • the invention envisages blood as a robust source of information that might be used in the optimization process.
  • Each component may be assayed in its native or altered form. For example, a modified protein or nucleic acid can be very instructive in determining metabolic status.
  • cytokines a generic term for interleukins (including, but not limited to: IL-la, IL-lb, I LIRn, IL2, IL-3, I L-4, IL-5, IL-6, IL-7, IL-8, I L-9, IL-10, IL-11, 11-12, I L12a, I L12b, I L-13, I L- 14, 11-15, IL-16, IL-17, IL-17a, I L17b, 11-18, IL-19, IL-20, 11-21, IL-22, 11-23, IL23a, IL-24, 11-25, I L- 26, 11-27, 11-28, IL-29, 11-30, 11-31, 11-32, 11-33, 11-34, 11-35, 11-36, 11-37, etc.), interferons (including, but not limited to: IFN-a, IFN-b, IFN-g,
  • cytokine assays may be especially useful in developing optimization protocols since tools are available to modulate effect. Modulation of the endogenous quantities produced by an individual may be an enhancement tool used in some embodiments. Synthetic compounds antagonizing or agonizing of any assayed substance may also be appropriate tools.
  • Assaying may one blood component might crudely be used to monitor cellular and/or mitochondrial performance. However, there is no practical reason to eschew analysis of other components provide more directed information to guide optimization. Assaying multiple aspects can indicate performance or changed performance to judge an
  • threshold levels of one or more blood components may indicate a certain level of activity of one or more metabolic pathway. Beyond simple thresholds, ratios of two or more components, by showing relationships, can provide more definitive information. Diurnal or other periodic relations may also guide optimization. Sometimes more complex algorithms getting at multi factor relationships (multiple pathways, serial pathways or parallel pathways, different organs, for example). Computer learning or other forms of artificial intelligence is now becoming a more accepted process to determine most effective analysis criteria. While blood is a great source for a substantial number of components or factors that can be assayed, the body has other assayable tissues including, but not limited to: cerebral spinal fluid, lymph fluid, saliva, breath, tears, urine, sweat, mucus, gastric and/or intestinal contents, stool, etc. Any one or more of these tissues or components can be used individually or in conjunction with one or more other source to provide data used in optimization.
  • Analysis may be accomplished using any acceptable means such as categorization, parametric statistics, nonparametric statistics, ratio analysis, simple or complex
  • Analysis may be repeated to assess degree of optimization and/or to assist in determining any change or addition to the optimization process. Analysis may also be repeated with any changed condition of the treatment recipient. Several repetitions of analysis and modified optimization process may be conducted in an iterative fashion.
  • Cellular metabolism or mitochondrial function may be optimized for an individual, even for an individual during a particular season, time of day, sleep-wake cycle, etc. Optimization may be based on data collected from more than one individual. For example, an optimized process may be determined for a select grouping. The skilled artisan will have capability to select an appropriate group, based for example on similarities within a group. If data show insignificant variability pooling is more appropriate.
  • Groupings may be based on disease or stage of disease. Groupings may be based on familial connections or larger genetic associations. For example, groups may be categorized from associations including, but not limited to: shared ancestry; shared country or region of familial origin; shared blood type (possibly subtypes); A, Al, A2, B, Bl, etc.), shared Rh factor (possibly considering each or a combination of Cc, Dd, and Ee), any of the other grouping systems including, but not limited to: ABO, MNS, P, RH, LUgon KEL, LE, FY, JK, Dl, YT, XG, SC, DO, CO, L, CH, H, XK, GE, CROM, KN, IN, OK, RAPH, JMH, I, GLOB, GIL, RHAg, FORS, LAN, JR, Vel, CD59; HLA; one or more of the 4 main mitochondrial clusters with multiple DNA lineages; one or more of the 7 core mtDNA
  • any assay might be used as part of the cell optimization process to assess one or more components of cell metabolism and/ or mitochondrial activity.
  • Some common types include but are not limited to: end point assays, kinetic assays, qualitative, semi-qualitative or quantitative assays, functional assays, immunoassays, radio-assays, fluorescent assays, binding assays, enzymatic assays, isotopic assays, mass spectrometry, photo-assays, MRI, PET, cell sort assays, spectrophotometry, polymerase chain reaction, laser coupled assays, agglutination assays, transmittance, absorbance, refraction, flow assays, size assays, ion assays, conductivity assays, uptake assays, secretion assays, mass, gel electrophoresis, transport of: DNA, RNA, proteins, or presence or amount of specific sequences, toxicity assays, viability assays, chemilumin
  • a biosubstance e.g., a body fluid (for example: urine, blood, sweat, cerebral-spinal fluid, saliva) for one or more commonly seen components (for example: any of the amino acids, glucose or other monomeric compounds.
  • One or more of the collagens may be observed to assess initial status and/or to monitor progression of the optimization strategy.
  • condition of the skin might be scored to chart effectiveness of treatment since skin is easily accessible and collagen is ubiquitous throughout the body's organs.
  • collagen VI or a correlated marker might be monitored to assess Alzheimer's disease.
  • Collagen monitoring may also be beneficial in tracking cancer growth and optimized treatment effectiveness.
  • Assaying one or more biosubstance obtained, for example, from natural elimination or biopsy is considered important to many embodiments of the present invention.
  • complexes I, III and IV the ETC incorporates three of these proton pumps known as complexes I, III and IV.
  • complexes I and I II catalyze reactions very close to equilibrium. Reactions catalyzed by these complexes are easily reversed and therefore especially sensitive to extracellular events.
  • Complex II can replace complex I, but is not a proton pum p and produces less energy than pathways using complex I. When complex II becomes more active, energy metabolism and therefore the cell becomes less efficient.
  • the mitochondrial genome encodes 37 genes (16, 569 bp): 13 polypeptides, 22 tRNAs and 2 ribosomal RNAs.
  • the polypeptides are constituents of the respiratory-chain complexes: 7 complex I subunits (NADH
  • tRNAs are presented as one-letter symbols. Mutations in four of these tRNA genes are associated with diabetes: those for leucine (L), serine (S), lysine (K) and glutamic acid (E) tRNAs.
  • Exemplary donor and acceptor compounds in the pathway include the coenzymes nicotinamide adenine dinucleotide (NAD + ) and flavin adenine dinucleotide (FAD), yielding NADH and FADH 2 . Then in the pathway, subsequent oxidation of these hydrogen acceptors leads to the production of ATP.
  • NAD + nicotinamide adenine dinucleotide
  • FAD flavin adenine dinucleotide
  • NADH is a component of the ETC, ETC and the mitochondrion are involved in other groups of pathways, for example reduction of disulfides.
  • One such disulfide system is the glutathione system, a system essential for many transport functions within the cell and therefore healing and repair.
  • NAD + reduced NAD +
  • FAD flavin adenine dinucleotide
  • FADH2 flavin adenine dinucleo
  • ROS reactive oxygen species
  • Mitochondrial function because of its propensity to oxidize substances (chiefly involving oxygen) is therefore implicated in many disease states. Not surprisingly, many treatments for common disease will compromise mitochondrial function. Restoration of better health through optimizing energy metabolism should ideally become an important component of treatment.
  • mitochondrial function may be optimized to treat or prevent some common disease. As mentioned above optimizing mitochondrial function to benefit proper glutathione levels can be considered im portant both for near term health and prevention or management of future disease.
  • Antioxidants such as vitamins and red wines have been used generically, but generally not for specific effect to promote mitochondrial related health. Optimization of energy metabolism involves more than simply adding items to one's diet. Michael Ristow, in a 2009 study, found indeed that antioxidant supplementation (He used vitamins C and E.) had no positive effect. In fact, Ristow's studies were interpreted to conclude that antioxidant supplement left one weaker. So simply adding a molecule that counters an undesired molecule involved in mitochondrial metabolism is definitely not an obvious solution for ameliorating disease treatment or progression.
  • Enzymes the catalysts for biologic activity, are important for optimized metabolism.
  • Several of these enzymes require a metal to complete their structure.
  • superoxide dismutases SODs essential to detoxify active oxygens (like superoxide), contain either zinc (Zn 2+ ) and copper (Cu 2+ ) or manganese (M n 2+ ) as in the mitochondrial form.
  • SODs convert superoxide to peroxide and thereby minimizes production of hydroxyl radical, the most potent of the oxygen free radicals.
  • Peroxidase is the enzyme that detoxifies peroxides.
  • the best known mammalian peroxidase is glutathione peroxidase. This enzyme contains a modified amino acid selenocysteine in its reactive center.
  • Nrf2 activity is implicated in regulating a gross or more of gene in the cell. Optimization of mitochondrial function may affect N rf2 activity on concomitantly, optimization of mitochondrial function may be addressed through controlling Nrf2.
  • Mitochondrial function is thus extremely important and changeable. Any mitochondrial gene or any mitochondrial protein gene, their control mechanisms and their products or metabolites should therefore be considered as possible targets in the optimization processes. For example, Slowing MFN1, MFN2 or OPA1 can seriously reduce respiratory capacity. Combination of multiple modifying schemes sometimes can be quite
  • lipids including glycolipids, phospholipids, etc.
  • substrates including indicator substances
  • indicator substances might be introduced while also increasing mitochondrial fusion.
  • the fusion aids in more widespread distribution and delivery.
  • increasing fission can make the mitochondria more mobile and enable delivery to cell periphery.
  • Fission is also a facilitator of apoptosis. Accordingly, increasing fission events can aid treatments where apoptosis is desired and decreasing fission can spare cell death.
  • one embodiment of the invention might include additional assays. These additional assays would relate to optimizing mitochondrial and cellular performance taking into account the changed and improved organism and cellular activities the result from balancing the androgens.

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Abstract

The disclosure provides compositions and methods for improving or optimizing the health and performance of aging mammals, especially canines. The invention features two approaches that may be used independently in concert for compensating for aging and breed specific, species specific or individual genetic make up. The invention features compensating for decreasing androgen hormone levels circulating in the blood as an animal ages and along with improving outcomes through balancing androgen levels optimizes mitochondrial energy metabolism.

Description

Healthier Aging in Domesticated Animals
FI ELD OF THE INVENTION
The present invention enhances health and well being of "man's best friend" with the beneficial result of a longer and stronger bond between human pet owners or pet companions and the recognized positive outcomes on the human's health. I n accordance with the invention the level of normal or maximal activity is strengthened or maintained. This allows the individual to build or maintain more robust interactions with others, including others of different species, such as a canine human bond.
BACKGROUN D OF TH E I NVENTION
Aging human population and their pets
The human population, especially in developed countries, has been seeing an increase in average age. Especially in the United States, and even more remarkable in Japan, the " baby boom" generation is drifting to retirement. A good number of these boomers have seen their children mature and move out to take on their own lives and responsibilities and to continue the human cycle with another generation. As members of the population age the aging process is associated with a decline in activities and with general social interactions. Social interaction and a feeling of being needed can give a purpose to life and improve attitudes in the aging population.
In the developing economies people are more mobile - families may be spread across countries or around the world. Whether a direct result of the shifts in society or itself a factor driving evolution of human dynamics, humans are developing stronger emotional bonds between humans and animals (pets) that the humans care for.
This emotional bond increases the importance of increasing the time span of the bond (increasing the num ber of years a pet remains healthy) and also improving health and activity levels of the animals whose importance to human well-being is growing.
Data from the American Veterinary Medical Foundation reveal that in 2012 the United States more households had dogs than any other pet. The number of households with dogs exceeds 43,000,000, with cats (~36,000,000), fish (~8,000,000), birds (~4,000,000), and horses (~2,000,000) trailing in still significant number of households. Testosterone is conserved as an androgenic substance throughout vertebrates, but with different effects depending on the organism's distribution of androgen receptors. While for mammals there is evidence relating to decreased testosterone secretion past middle age, evidence relating to testosterone levels and age in other vertebrates is scant. The skilled observer may also note a small or even absent economic interest relating to anti-aging thera pies in non- mammalian vertebrates. Accordingly the present invention concentrates on anti-aging therapies in mammals.
The present invention recognizes the increased importance of non-human companions, and the benefits that these pets or companion animals provide to emotional and physical well- being of human involved with caring for or companioning these animals. Both the humans and animals can benefit physically and emotionally from this positive interspecies interaction. While not wishing to be bound by possible mechanisms underlying benefits to individuals and society from the optimized animal outlook, one possibility is that many mammals, including humans and canines, have evolved mechanisms that internally reward the organism, possibly releasing a hormone or neurotransmitter substance that binds to a satisfaction or happiness center within the brain. Accordingly, both the psyche and physicality of the select animal that the present invention may target can be expected to experience improvement. Other animals in contact with the select animal, most preferably humans interacting with said select animal, will share in increased sensations of general well being, higher interspecies engagement levels with positive internal reward response, and just generally a more positive demeanor.
Managing metabolic changes as mammals age
One important factor involved in the present invention is that as the animals age androgenic influences of endogenous hormone, especially testosterone, continuously wanes.
In the blood serum of mammals, testosterone exists primarily bound to a protein, typically albumin or sex hormone binding protein. Unbound testosterone is referred to as "free testosterone". The term "total testosterone" refers to the total amount of testosterone in the blood serum, that is, the combined amount of protein-bound testosterone and free testosterone. The typical half-life of "testosterone" in the blood serum ranges from 10 to 100 minutes. Testosterone is metabolized into dihydrotestosterone in the body by way of the 5-alpha reductase (5AR) enzyme (this means that dihydrotestosterone is a metabolite of testosterone), and furthermore, nandrolone is a byproduct of the aromatization
(conversion) of testosterone into estrogen. With this knowledge, it then stands to reason that testosterone quite literally is the origin of all anabolic steroids. Without testosterone, DHT and nandrolone would not even exist, and therefore without the existence of DHT and nandrolone, their individual derivatives and analogues would also not exist.
Testosterone itself is the principal male sex hormone. Hormones are defined and classified as chemical messengers of the human body, which means that hormones are what carry messages to different cells and tissues in the body to tell those cells and tissues what to do (grow muscle tissue, heal and repair, manufacture important components, perform a specific job, etc.). Without hormones of all different types, all functions within the human body will proceed unregulated and out of control. How much testosterone the average male produces is dependent on many different factors, which include: individual genetics, age, lifestyle habits, nutritional habits, and activity levels. On average, it has been determined that the median level of testosterone production among 30 year old males is between 50 - 70 mg weekly. Where any given individual might land within that range is dependent on the aforementioned factors. It is common knowledge that the most prominent effects of the hormone testosterone appear and are experienced during puberty, which is evidenced by an increase in testosterone production and secretion, and will typically reach the highest endogenous levels at this point in any given man's life. This significant increase in testosterone serves to impart very important physiological changes of the male human body. Testosterone governs many different functions within the body. The nature of hormones in the circulation is to govern systemic functions remotely around the body, and testosterone is no exception to this.
Androgens such as testosterone and DHT bind to androgen receptors (ARs) in cells. The resulting androgen-receptor complex regulates gonadotropin secretion and
spermatogenesis. The androgen-receptor complex is responsible also for external vinilization and for most androgen actions during sexual maturation and adult life. DHT is an especially potent androgen because it binds with greater affinity to androgen receptors than testosterone does. Testosterone production in intact mammals is stimulated by luteinizing hormone (LH). It is understood that follicle stimulating hormone (FSH) stimulates testosterone production also. Testosterone concentrations in the blood serum are regulated in part by a negative-feedback pathway in which testosterone inhibits the formation and/or secretion of luteinizing hormone-releasing hormone (LHRH). LH RH acts to stimulate secretion of LH by the pituitary gland. Testosterone acts also by regulating the sensitivity of the pituitary gland to LHRH.
Taking dogs, aka canines, as a prime example, the present invention provides improved health and longevity for the animal component of the relationships humans are finding more and more significant.
On top of this, animals including human animals, exhibit large differences in their mitochondria and mitochondrial activities. By optimizing energy metabolism through subject specific monitoring and improvement in mitochondrial metabolism, the vitality effects observed through androgen balancing may be further enhanced. Accordingly, the invention preferably includes a second approach wherein in conjunction with androgen balancing as an anti-aging measure that optimizes activities additional improvement may be obtained by also optimizing mitochondrial activity, metabolism and performance.
SUMMARY OF THE INVENTION
Common diseases in the aging dog include: arthritis, which reduces activity levels and may make the animal more irritable or reclusive; obesity, which can acerbate arthritis and other diseases such as cardiomyopathy and usually reduces animal activity levels; joint dysplasia, which reduces animal comfort and activity; gum disease; diabetes; blindness of various etiologies; dementia; and other diseases of aging familiar in humans. Metabolic functions may be impaired, for example, adipose tissue may experience accelerated or location improper deposition and/or aberrant utilization, glucose metabolism and metabolism of other sugars may be altered though diabetic effects and compensating metabolic shifts. For example in humans both free testosterone and total testosterone have been documented in their decline as a male ages. U p to their fifties, human males essentially maintain total testosterone with about a 25% drop in free testosterone from about the age of thirty to about fifty, in the ensuing years both total and free testosterone continue to decline until about the age of eighty the levels are only about half the levels previous to age fifty.
Evidence is building that age related reduced testosterone levels in human males may be related to growth of pot bellies and possibly, heart attacks, strokes, osteoporosis, clinical depression and some presentations of Alzheimer's disease.
A body of evidence relating to human females suggests that testosterone levels may be important factors with regard to depression, activity level and general sense of well-being. There is also evidence that in human females a testosterone supplement may improve activity levels and maintain a leaner body. Low testosterone levels in human females have been associated with lack of motivation and a sense of fatigue. The common weight gain and increased adipose tissue deposition in women starting approximately 10 years prior to menopause coincides with a commonly observed decreased level of circulating
testosterone. This suggests an important component of the present invention relating to maintaining testosterone balance will benefit both male and female canines.
Importance of Balancing (controlling) Androgens in Circulation
Although it is reported that thousands of androgenic hormones have been made, for example to achieve androgenic effect but to avoid detection by sports monitoring organizations, "testosterone" is used as an example throughout this discussion since testosterone is an inexpensive and commonly reported androgen that has been used and abused by male and female humans. As testosterone replacement or testosterone level augmentation raises testosterone levels up to or possibly slightly exceeding previous normal range it has a high success rate of alleviating many conditions associated with aging that have been found to compromise human and animal health and general well being.
Testosterone and analogues have successfully treated or managed female breast cancer, hereditary angioedema, anemia, multiple muscle wasting diseases including HIV/AI DS, severe burns, acute and chronic wounds, general caloric wasting, muscular atrophy, osteoporosis, male infertility, adolescent growth failure, osteoporosis, female libido problems, Turner and Klinefelter Syndrome, menopause, chronic dysfunctional uterine bleeding (menorrhagia), endometriosis, and many others. Recent reports suggest that testosterone has an import effect in strengthening connective tissues such as ligaments, for example the anterior cruciate ligament (ACL) in the knee. Actual ACL strength has been measured in animals with a conclusion that exposure to the androgenic hormone somehow makes the tissue less prone to rupture during stretching. Supporting this testosterone effect on at least the ACL is the perplexing high incidence of ACL tears in girls knees well in excess of their participation is stressful sports. These vastly different effects associated with testosterone in both males and females suggest that an appropriate amount of circulating androgen is important for general health a nd well-being. Thus these and other findings suggest that maintaining an optimized testosterone level as the animal ages can result in improved vigor, reduced injury, and greater activity and possibilities for social interaction. Management of circulating testosterone also has the possible effect of preventing or reducing injury, such as muscle or joint injury, and can thereby appear as an anti-aging agent to maintain a higher level of activity available to the animal and to the animal's human companion(s).
While testosterone level management and supplementation where warranted have proved successful in improving specific health effects all over the body, administration has been carefully controlled within the medical community to avoid misuse and deleterious effects that can be associated with elevated testosterone levels that exceed safety limits.
Popular acceptance of testosterone balance in the body may suffer from reports of overuse and abuse of supplements in human males who may have obtained testosterone for unapproved and especially for ineffective treatments. For example, the growth of novel disease states such as erectile dysfunction (ED), the expense of prescribable ED
pharmaceuticals, and claims on the internet touting androgenic compounds such as testosterone and testosterone mimetics as effective treatments coincides with a 2000% increase in testosterone sales happening in the U nited States from about 1990 to about 2002. It is also widely accepted that testosterone and the then more difficult to detect design androgenic compounds were used in Olympic and other high level sporting competitions because of the desirable effects on physical performance. In the more general population several occupations have been prone to testosterone overuse and abuse. For example, police officers, security guards and bouncers, having become aware of testosterone's profound efficacy have made use of androgens to improve at least their perceived on job performance and general performance in life situations. Proper Androgen Levels Can Have Anti-aging Effect, but Misuse is Dangerous
The observation that as testosterone levels decrease during aging and that testosterone in believed to enhance muscle development may suggest that the occurrences are not purely coincidence. I n fact, muscle tissue expresses androgen receptor (AR) protein so it would be understood that testosterone would influence muscle metabolism. Supporting evidence that testosterone supplementation or replacement increases muscle fiber protein synthesis and that pluripotent stem cells capable of differentiating into muscle fiber cells have high levels of AR expression suggests a causal relationship exists. Accordingly, Supplementing androgen, e.g., testosterone to an aging individual may maintain or build muscle mass. Better muscle mass is associated with lower incidences of diabetes so the benefits of testosterone balancing would be expected to cascade through many organs and tissues, activity suggests that while testosterone balance may produce profound benefits an even greater improvement is possible if mitochondrial optimization is partnered with the balancing. Not intending to disparage the invention approach wherein animal health and relationships are augmented by testosterone balancing, the invention recognizes that the augmentation can be amplified by maintaining or optimizing mitochondrial performance as part of the intervention. On the other hand allowing mitochondrial impairment to degrade benefits of androgen balance would be seen as slowing or limiting benefits of the balancing itself. In fact relating to aging, some believe that oxidative stress of mitochondria may have a major role in age related energy deficit.
Androgenic compound abusers have contributed to testosterone's and other androgenic hormones' shocking disparagement in general news media through reports of sometimes violent activities and severe health outcomes such as brain tumor, but perhaps partly related to publicity from these mainstream press warnings about androgenic use and "over manliness", a buse continues in a significant segment of the population. Though serious abuse may present long term problems for the individual and society, society in general can understand that the abuse is a result of testosterone's positive effects.
While some desired effects, for example, increased muscle mass in body builders and other professional athletes, may be valued for their immediate effects, long term effects, for example use over decades, has been shown to increase propensity for heart attack and stroke. The length of administration and the expected remaining lifespan of the individual should be considered before enhancing androgen in the bloodstream.
Other noted effects include elevated LDL and higher LDL/HDL ratio, increased blood pressure, increased cancer, for example, brain and liver, and difficulty in movements that may be caused by excess tissue deposition. Androgen abuse is also associated with testicular wasting or atrophy which in humans may or may not be desired depending on one's desires for fatherhood. In neutered dogs this of course would not be a relevant concern.
Most of these recognized problems can be avoided or minimized simply by managing testosterone blood levels to levels more prevalent in normal animals or limiting
administration to older animals with for example an expected remaining lifespan of about a decade or less. For example, the irritability, aggressive behaviors, rage, violence, delusions, manic eating , etc., appear to be associated with abuse of androgens that involves massive dosing regimens; liver disease and tumor events appear associated with long term administration of moderate to high doses.
The present invention seeks to avoid these problems by monitoring, either through behavioral observation, or more preferably by measuring blood, saliva, urine, or skin androgen or androgenic activity. Even minor undesired elevation above a targeted amount, perhaps resulting from metabolic differences, change in food, or a mistake in dosing or formulation can be properly corrected. Long term effects seen over decades may not be a problem at all in shorter lived species. But age may be considered as a factor.
Proper Androgen Balance is not for Amateurs
The natural testosterone molecule is poorly available to a mammals circulation when it is delivered by oral administration and absorbed across the intestinal wall into the hepatic portal system. Liver metabolizes most ingested testosterone before it can enter general circulation. An attempt to surmount this obstacle by alkylating (methylating) the c-17 a position of the molecule has been essentially abandoned for human use because of toxic effects on the liver. Testosterone undecanoate is not modified at the c-17 a position and appears to avoid this toxicity issue perhaps because its absorption is not through the portal system. Due to the efficiency of the mammalian digestive system in breaking down foodstuffs to simpler molecules delivering large amounts of testosterone through the gastro-intestinal track, including the hepatic portal system most, but not 100% of an intact lipid like the fat soluble hormones will reach general circulation. However, since the digestive process is not 100% efficient (a small percentage of large molecule will bypass or escape the degradative process) after giving a large dose a small but effective amount of delivered testosterone will enter general circulation. Since digestive efficiencies vary greatly between individuals, frequent monitoring of circulating levels to maintain proper balance is highly recommended. To avoid the chemical breakdown and filtering pathways that have evolved for digesting natural environmental feeds and possible toxins, testosterone can be bound, packaged or complexed in a less natural manner to enhance absorption of the active molecule, through a non-portal pathway, for example, through the lymph system. Complexing testosterone with a form of sex hormone binding globulin (SHBG), which carries the hydrophobic (lipid based) hormone in the circulatory system may be one important means for delivering testosterone through the general circulation. Liposomes and other hydrophobic carrier systems are possible delivery agents. A coating or packaging that protects the testosterone carrier from gastric acid and enzymes may be designed for removal in the small intestine to permit testosterone to be carried into the lymph system.
Another means for avoiding hepatic-portal absorption is have the hormone absorbed into the circulation before it encounters the portal pathway. Sublingual or buccal delivery would accomplish this feat. Most dog owners would doubt that their pet would retain a pellet o similar item under its tongue. However, extensive or prolonged exposure to the mouth endothelial tissues for uptake very early in the Gl track, well before action by stomach acid or possible sequestering into the portal system, is easily accomplished by exploiting the chewing behavior of canines. Dogs will spend unbelievable time and effort chewing raw hide or scented or flavored dog toys. Thus one composition that might be used in practicing the present invention is a hormonal compound complexed or packaged in a chew toy.
Incorporating testosterone in a chew toy which is facilitated by testosterone's lipophilicity is an effective means for effecting prolonged exposure through the gums and other early Gl tissues.
Direct supplementation using an androgen or testosterone molecule in food is not without its downsides. Testosterone in its native state or in chemically modified form has positive and negative consequences from use. Accordingly, use of the compositions is preferably in conjunction with repeated monitoring of androgen, e.g., testosterone, balance to minimize or avoid undesired effects while benefiting from the desired effects.
Circulating testosterone may be increased to a degree using compounds such as vitamins to stimulate production or to inhibit breakdown. For example, vitamin D, has been shown to protect the liver from viral and chemical toxicity. Accordingly, vitamin may be coadministered with an androgen to help protect the liver from toxic response to the androgen. Vitamin D has a second beneficial attribute in that it is lipophilic as are the cholesterol derived sex hormones such as androgens like testosterone.
Vitamin D can serve as a lipid carrier for other lipid molecules such as testosterone. When co-administered with testosterone Vitamin D both serves as a delivery vehicle until the SH BG and testosterone are able to associate. The testosterone androgen is circulating to find its target(s) and the vitamin D can migrate to the liver to exert its protective effect there. Other lipid vitamins, such as vitamin A, vitamin E and/or vitamin K may also serve as lipid carriers to hold lipophilic androgen in circulation until it is able to be gathered by circulating SBHG.
So in addition to oral supplementation with androgen, such as testosterone, testosterone balance can benefit from the presence of lipid vitamins and from inducing expression of SBHG using one or more means known in the art.
Sub-dermal identity chips are popular with pet owners in the United States and are growing in popularity worldwide. This illustrates that pet owners are receptive to "foreign" bodies being inserted into their animals. Similarly several forms of female birth control in humans make use of an implanted rod or stick that slowly dispenses a sex hormone. This acceptance suggests that many pet owners may welcome androgen supplementation in this manner to avoid risks, for example of hepatic toxicity. Such device implanted in an animal might use any of the available delivery options. Shorter lasting implant (several months might use an osmotic pumping mechanism. Another form of implant might use controlled solubility or diffusion where the androgen is part of a slowly dissolving matrix or is incorporated within a barrier that controls androgen diffusion into the bloodstream. Such implanted devices will help ensure better hormonal balancing because of the required visits to the veterinary clinic where a technician or veterinarian can assay circulating androgen and refresh the implant.
Caution is Warranted Because of Testosterone's Wide Effects, but Benefits are Immense Testosterone and other androgenic compounds have historically been misused or abused because of their profound effects in multiple locations throughout the body, especially in muscles and sex organs.
Testosterone activity is mediated trough androgen receptors that are found in a multitude of tissues throughout the body. To function the testosterone molecule crosses the cell membrane and binds to an intracellular receptor (AR) present in the cytosol of many cells. The testosterone-receptor complex then migrates into the nucleus where it can bind specific deoxyribonucleic acid (DNA) segments to control gene expression by activating synthesis of specific messenger ribonucleic acid (mRNA) segment molecules to increase transcription (copying the targeted DNA) and processing the copy to inaugurate protein synthesis controlled by the targeted segment of DNA; which, for example, in muscle cells, may increase production of the proteins actin and myosin.
After this transcription/translation process is complete, the testosterone-receptor complex dissociates and the receptor is recycled along with the hormone to repeat this process multiple times. Androgenic receptors, including some responsive to testosterone metabolic products or metabolites such as dihydroxytestosterone (DHT) have been observed throughout the body in various tissues including, but not limited to: skin, scalp, prostate, thyroid, muscle fiber cells, muscle stem cells, pancreas, bladder, bone marrow, stromal cells, endothelial cells, macrophages, myeloblasts, myelocytes, neutrophils, megakaryocytes, corneal cells, lens cells, iris cells, cilliary body cells, adrenal cells and adipose (fat) cells. A casual observer should understand that testosterone activity would in all likelihood be relevant on many organs and tissues throughout the body.
Accordingly, the present invention recognizes that decreased testosterone levels such as those occurring during the aging process may result in diminished or suboptimal function of at least one and probably many organ systems in the body. As a result controlled restoration of testosterone presence and activity can have profound beneficial effect with regard to multiple physiologic functions. I mproving at least one of these functions, and preferably several can result in a general improvement in the animal's physiology and well-being.
Administration of testosterone to restore normal physiological levels can help to restore to a more youthful state and improve the function of many of the different systems where testosterone's effects on the cellular level are accomplished. This includes, for example, action in the bone marrow that increases red blood cell count, which translates to increased endurance, improvement in energy, well-being, and restoration of muscle mass.
There are various studies that have determined where, on average, testosterone levels should be in males according to various age groups. Generally testosterone in human males declines about 1% per year from the late thirties. For animals the decline may be steeper and will occur at a younger but still at a middle age.
Osteoarthritis and hip dysplasia are especially common and problematic in larger dog breeds and larger dogs in general. Dogs will reduce activity level and avoid some previous activities to hide the symptoms or to avoid associated pain. Aging is also associated with a general lethargy that can be a result of or mask other diseases such as a failing heart, painful joints, decreased muscle tone, arthritis, etc. and may be a factor in weight gain that can cause or exacerbate other disorders. I ncreased dysplasia and obesity have been observed to have increased occurrence in canines that have been spayed or neutered. While the benefits, in most cases, necessity of spaying or neutering are profound, the procedure does remove a major source of androgenic hormone, testosterone and its metabolites, from the animal's physiology. While other organs such as the adrenal produce androgens, often the amount decreases as the animal ages and becomes insufficient for optimizing animal activity and health.
While larger dogs appear more prone to hip dysplasia, the outcome is observed in smaller dogs also. Orthopedic Foundation for Animals reports that the top 20 breeds exhibiting dysplasia were: bulldog, pug, dogue de bordeaux, neapolitan mastiff, otterhound, St., Bernard, boerboel clumber spaniel, black Russian terrier, Sussex spaniel, cane corso, basset hound, fila brasileiro, Argentine, dogo, perro de presa canario, American bulldog, Norfolk terrier, Maine coon cat, boykin spaniel, and French bulldog. Clearly this phenomenon is a concern for small as well as large canines. Testosterone is the main male sex hormone, predominantly synthesized in the testes by Leydig cells (95%). I n human males, for example, a small amount of testosterone is produced by adrenals (5%). Classic effects of testosterone include the androgen effects supporting-the growth and development of sex organs, the formation of stereotypical dominant male behavior (aggressive, attack behavior, territorial or harem protection, and other undesired behaviors), anabolic functions (maintaining muscle mass including myocardiocytes), stimulation of the synthesis of organ (specific proteins in kidneys, liver, sebaceous and sweat glands in animals that have them, maintaining bone density, hematopoiesis (stimulation of erythropoietin generation in kidney and stimulation of erythropoiesis in the bone marrow).
Androgens include, for example, 17β-hydroxyandrost-4-en-3-one, commonly known as testosterone, and dihydrotestosterone (DHT), a metabolite of testosterone. Testosterone is a naturally occurring androgen which is secreted in males and, to a much lesser extent, in females. In males, testosterone and DHT are responsible for normal growth and development of the male sex organs and for maintenance of secondary sex characteristics. In females, testosterone and DHT are believed to be important for normal growth, sexual desire, and sexual function. In addition, androgens promote retention of nitrogen, sodium, potassium, and phosphorus, and decrease the urinary excretion of calcium. Androgens have been reported to also generally increase protein anabolism, decrease protein catabolism, and stimulate the production of red blood cells.
Common symptoms of androgen deficiency that may be of specific concern to pet owners are blood pressure fluctuations, cardialgia, psycho-emotional disorders (irritability, decreased overall health and performance), decreased memory and attention, insomnia, depression, somatic disorders (reduction of muscle mass and strength, increase of adipose tissue amount, bone loss, visceral obesity and thinning of skin. Several studies have shown that a decrease of testosterone concentration results in increased deposition of fat cells in various locations resulting in degeneration of the smooth muscle cells. While most research in this area has been reported with human males as target test subjects effects are widespread and affect mammals in general and both male and female individuals. Most pets and farm and companion animals are spayed or neutered as population control and to avoid undesired behaviors associated with the hormones that drive or control sexual activity, including mate attraction, and other undesired behaviors.
The benefits are deemed to vastly overcompensate for the changes associated with the spaying or neutering. For example, very few farmers maintain a bull; they are dangerous and difficult to control; and especially for dairy herds, artificial insemination produces more reliable timing and product. In pets, male dogs become easier to manage and less aggressive, less prone to testicular cancer; females are less prone to breast cancer, will not have repeated heat cycles attracting nuisance male callers and more frequent urination, even indoors, associated with heat to signal receptivity for males. Neutered males are less likely to wander in search of females and less likely to mark territory around and within your house.
Controlling or Balancing Levels of Circulating Androgen to Optimize Long-Term Health A tradeoff we humans have accepted is that as spayed or neutered animals age, androgenic hormonal support such as provided by testosterone drops off. [Even in intact male and female animals androgenic support declines with aging.] While in male dogs the testes would produce the predominant share of androgenic hormone, the feedback mechanisms within the body of a younger animal compensate quite adequately to maintain a general state of health.
But as the creatures age, testosterone activity falls off regardless of the animals sex or gonadal status. This trend is small but noticeable and has generally been accepted as a part of the aging process.
While the declines in animal health are expected and accepted as part of a normal aging process, the diminished performance, comfort and health of the animals can be slowed by persons practicing the present invention.
In regular practice of medicine, often medical intervention is compromised because a patient's metabolism is weakened because of intrinsic or extrinsic factors or because the therapy itself will change normal cell metabolism. Recognizing the wide distribution of androgen receptors throughout the body multiple effects are expected in many different organs and tissues. Accordingly, the full beneficial effect of the medical therapy is limited by one or more other cell function, in particular cell energy metabolism.
Optimizing Energy Metabolism in Conjunction with Androgen Balance Promises Even More Superior Anti-Aging Benefits
Mammalian cells are eukaryotic cells and therefore, like eukaryotic cells generally, they rely on their mitochondria to produce adenosine triphosphate (ATP). In each mitochondrion at the mitochondrial inner membrane, electrons from NADH and succinate are transported by the Electron Transport Chain (ETC) to oxygen, which, when it accepts the electrons, is reduced to combine with hydrogen to make water. Along the way the ETC comprises several donor and receptor enzymes in series, eventually depositing the electrons with an oxygen. Passing electrons from donor to acceptor releases energy in the form of a proton (H+) across the mitochondrial membrane, This ion flux has the potential to do work. This metabolic process is known as oxidative phosphorylation and results in production of adenosine triphosphate, aka, ATP. The mitochondrion is important to cell metabolism and survival. Detailed descriptions are known or can be found in the art.
Thus the mitochondrion organelle is essential for healthy cells and therefore for healthy animal life. ATP, an essential molecule for energy metabolism within the cell is primarily generated by mitochondria. Processes such as adaptive thermogenesis, ion homeostasis, immune responses, production of reactive oxygen species, and programmed cell death (apoptosis) are some of the more complex processes that also require appropriate ATP synthesis and transport. Mitochondria contain their own DNA (mtDNA), which serves as a template for 13 mitochondrial proteins, 2 ribosomal RNAs (rRNAs), and 22 transfer RNAs (tRNAs). However, the mitochondrion can not function as a distinct and independent organelle. Replication, transcription, translation, and repair of mtDNA require proteins encoded by nuclear DNA (nDNA) of the hosting cell. When the host cell is sub-optimal, perhaps from androgen shortage, mitochondrial metabolism would be expected to be compromised.
Modern mitochondria have many similarities to some modern prokaryotes, even though they have diverged significantly from the early prokaryotes since the ancient symbiotic event. For example, the inner mitochondrial mem brane contains electron transport proteins like the plasma membrane of prokaryotes, and mitochondria also have their own prokaryote-like circular genome. But one difference is that these organelles are thought to have "lost" most of the genes once carried by their prokaryotic ancestor. Although present- day mitochondria do synthesize a few of their own proteins, a vast majority of the proteins they require to maintain the host cell are now encoded in the nuclear genome of the host. While androgen balance holds promise for vast improvement in animal liveliness, an additional manipulation wherein after or during androgen balancing mitochondrial function is also improved holds further promise for optimizing animal general liveliness and more fulfilling interaction with others.
Thus the present invention relates an orally ingestible, animal life enhancing product to be administered by a human to an animal to optimize human animal relationships, and/or the animal's comfort, longevity and/or quality of life.
DETAILED DESCRIPTION OF THE INVENTION
Importance of Hormonal Influence to Balance Physiology in Aging Mammals
Though there is variance among breeds of dogs, in general diminished androgenic influences become apparent between four and eight years of age. Some effects are seen in larger dogs at earlier ages. Some early effects, such as the pu ppy wildness which though cute often invokes glee in humans as they pass and the animal becomes more predictable. These may be related to androgenic stimulants and it will be discretionary whether to begin treating these dogs at this early period or to begin treatment at a stage where animal comfort may be a larger factor.
Our bodies and those of other mammals have internal means of messaging. Blood flow can be increased or decreased to an area or organ. Nerves sense what is happening at different locations within the body and then transmit information to the central nervous system where multiple inputs are analyzed and coordinated to initiate an output. The output could be neurotransmitter secretion causing a nerve impulse sending instructions to another location in the body. Another very important means of internal commutation is the endocrine system which uses hormones as signaling agents. Hormones are chemicals just as neurotransmitters, but hormones have effect distant from the place of release. Hormones are chemical messengers used to transfer information through the bloodstream from one part of the body, generally an endocrine gland, to the body in general or to a specific target organ that has a receptor capable of binding or receiving the hormone. Target organs have specialized receptors that gather information that has been transferred from the circulatory system by hormones. An example of a target organ is the uterus, which is stimulated by the circulating hormone estrogen to develop uterine glands. Hormone production-for example, testosterone, estrogen, and progesterone-is regulated by another hormone secreting endocrine gland, the pituitary, at the base of the brain.
Prohormones are building block chemicals used to produce the hormone. In general, the blood levels of sex steroid prohormones are not regulated by any substance. Instead, prohormones are generally available to assist in the production of hormones, which then act as chemical messengers to other target organs. These prohormones are essential building blocks for production of the respective hormones and may themselves be at levels insufficient for optimal hormone production. Providing functioning hormone eliminates the problem that may stem from insufficient prohormone. In some hormonal pathways, a hormone may be metabolized to an inactive prohormonal state that may be recruited when needed to produce active hormone.
The invention has a goal of administering to the animal a non-toxic, effective amount of a composition comprising an androgenic hormone such as testosterone, or a pharmaceutically acceptable salt or metabolite thereof. Hormone level or activity following administration of the composition to the animal is evaluated. The active ingredient may be bound to complexed with or incorporated in a carrier to facilitate administration and possibly to control bioavailability. The composition is re-administered to the subject as needed to maintain a desired level of circulating hormone or observed activities. Definitions
In general words in this description will have a meaning as used in American English. The following list is provided as additional guidance. ADP - adenosine diphosphate. Higher ADP levels are often associated with higher respiratory activity.
ATP - adenosine triphosphate, a primary molecule involved in energy storage, transport and release. Biogenesis - a synthetic process occurring as part of metabolism in a living organism.
Cellular metabolism - set of chemical reactions that occurs in living organisms to maintain life. Metabolism includes both anabolism and catabolism as well as multiple pathways that maintain life functions within a cell or organism. There is no real count of an actual number of metabolic pathways. With branches and cycles within major pathways and pathways sometimes only active in specific cell types and sometimes only at select times, counting an actual number would be arbitrary. However, the skil led artisan appreciates that the total number of pathways, including subpaths numbers in the thousands. The internet is an available resource to study classes of pathways or individual pathways. See e.g.,
www.itsokaytobesmart.com, though there are many web pages available relating to metabolic pathways.
Clinical improvement - An observable improvement in at least one factor in a patient's quality of life.
Coenzyme Q (CoQio) - aka: ubiquinone or ubidecarenone. An oil-soluble, vitamin-like substance is present in mitochondria. CoQio is part of the electron transport chain participating in aerobic cellular respiration to form ATP. CoQio is especially significant because of its respiratory functions and because cholesterol inhibitors, such as statins can also inhibit synthesis of CoQio precursors.
Desmin - An intermediate filament (IF) protein expressed in striated and smooth muscle tissues and is one of the earliest known muscle-specific genes to be expressed during cardiac and skeletal muscle development. Desmin is seen as controlling mitochondrial function by interaction with myofibrils and interacting with the cytoskeleton to affect positioning within a cell. ETC - electron transport chain which is used to harvest energy for use in metabolism.
Kcnq2 - a member of the kcnq family of proteins which act as ion channels controlling potassium (K) flux across membranes. Potassium gradients can control electrical potential across a membrane and therefore can be involved with electrical signaling within and between cells. A potassium gradient can also control flux of other ions. kif5b and kif5b- a gene encoding the protein and the encoded a heavy chain portion of kif5 protein working through microtubules to effect appropriate distribution of mitochondria within a cell. Mitochondria are not its only cargo; the protein is also associated with lysozyme and endocytic vessel distribution and is an essential component for distribution of many proteins within a cell. Neurons also express related proteins encoded by kif5a and kif5c.
Mitochondrial integrity - Mitochondrial integrity is known as a controlling factor in apoptosis, cell controlled self-destruction. I ntegrity may be comprised by events including, but not limited to: membrane permeability changes, altered exposure of membrane proteins, changed expression of the mitochondrial genome.
Mitochondrial protein - a protein encoded by or used within a mitochondrion.
Mitochondrial supportive substance - a chemical that changes mitochondrial activity to benefit at least one aspect of cellular metabolism. mtDNA - double-stranded DNA found exclusively in mitochondria that in most eukaryotes is a circular molecule. A single mitochondrion may include multiple copies of this circular mtDNA molecule.
Optimization - As used herein, optimization has the general meaning of a process leading to an improved outcome. Optimization will generally incorporate at least one facet of enhancement of number, outcome function or the like. In some uses optimization may refer to maximizing a component or process or a selected group of components and/or processes. More loosely optimization is used to mean improvement, even if a greater improvement might be obtainable. Many factors and outcomes, including but not limited to: effect on other processes, availability of an instrument, component or professional, cost, location, patient's wishes and government regulation may be factors in the optimization procedure and ultimate decisions made to determine a level of optimization. Optimization for one patients often will differ from optimization for another patient, but each patient will have improvement. Optimization may often involve improving one or more outcomes in concert with a possible worsening of another component of process.
Optimizing - The process of optimization. Optimization or the process is considered as a goal or a work in progress approaching an optimal or best outcome. Thus optimization may vary with time. Organic - a compound containing carbon. A molecule having carbon and at least one other element.
Plectin - A protein found in several isoforms that is ubiquitous in the cytoskeleton of most mammalian cells. Plectin links actin microfilaments, microtubules and intermediate filaments (IF) together. Plectin also appears outside the cell in the extracellular linkages between cells.
Restore - to bring something to or towards a previous condition, a normal condition or an improved condition. The condition may be defined as a number or concentration, a rate of activity, a structure, or any observable or measurable process or product of metabolism.
Vimentin - VimlF, an intermediate filament protein that is involved in distribution, motility and anchoring of mitochondria. Vimentin can work with dyneins and actin-dependent myosins within the cell to deliver and anchor mitochondria close to where metabolic requirements are high.
The Mitochondrion: Optimization Target 1
Mitochondria, one of the organelles found in most eukaryotic cells are often called the "powerhouse" or "battery" of the cell. A eukaryotic cell typically has multiple mitochondria, the number being higher in cells with higher metabolisms. The molecule adenosine triphosphate (ATP) functions as a predominant energy carrier in the cell. Eukaryotic cells derive the majority of their ATP from biochemical processes carried out by their mitochondria. Within the cell mitochondria also tend to be found in regions with higher activities. Each cell has mechanisms to control mitochondrial synthesis and degradation and by balancing these mechanisms can control the number of mitochondria and metabolic rate of the cell. Cells also control movement of mitochondria so that their substrates and products can be efficiently delivered. Assisting the cells and organism containing the cells to optimize these activities will be found valuable in optimizing therapeutic outcomes.
These biochemical processes carried out by mitochondria include, but are not limited to the following important cycles: i) the citric acid cycle (the tricarboxylic acid cycle, or Krebs's cycle), generating reduced nicotinamide adenine dinucleotide (NADH + H+) from oxidized nicotinamide adenine dinucleotide (NAD+), and ii) oxidative phosphorylation, during which NADH + H+ is oxidized back to NAD+. (The citric acid cycle also reduces flavin adenine dinucleotide, or FAD, to FADH2; FADH2 also participates in oxidative phosphorylation.)
The respiratory chain of a mitochondrion is located in the inner mitochondrial membrane and consists of five multimeric protein complexes: Complex I; (approximately 44 subunits), Complex II (approximately 4 subunits), Complex I II (approximately 11 subunits), Complex IV (approximately 13 subunits) and Complex V (approximately 16 units). (The reported number of subunits is given as approximate because the counts are different in different reports due to improving scientific understanding.) The respiratory chain also requires two small electron carriers, ubiquinone (coenzyme Q|0) and cytochrome c.
ATP synthesis involves two coordinated processes: 1) electrons are transported horizontally from complexes I and II to coenzyme Q to Complex II I to cytochrome c to Complex IV, and ultimately to the final electron acceptor, molecular oxygen, thereby producing water. At the same time, protons are pumped "vertically" across the mitochondrial inner membrane (i.e., from the matrix to the inter membrane space) by complexes I, II, I I and IV. ATP is generated by the influx of these protons back into the mitochondrial matrix through complex V (mitochondrial ATP synthase). The energy released as these electrons traverse the complexes is used to generate a proton gradient across the inner membrane of the mitochondrion, which results in stored potential energy in the form of an electrochemical potential across the inner membrane.
In this process, Complex I (NADH dehydrogenase, also called NADH:ubiquinone
oxidoreductase) removes two electrons from NADH and transfers them to a lipid-soluble carrier, ubiquinone. The reduced product, ubiquinol, is free to diffuse within the membrane.
At the same time, Complex I moves four protons (H+) across the membrane, producing a proton gradient. Complex I is one of the main sites at which premature electron leakage to oxygen occurs, thus being one of main sites of production of one harmful free radical called superoxide. Complex II (succinate dehydrogenase) funnels additional electrons into the quinone pool by removing electrons from succinate and transferring them (via FAD) to the quinone pool. Complex II consists of four protein subunits: SDHA, SDHB, SDHC, and SDH D. Other electron donors (e.g., fatty acids and glycerol 3-phosphate) also funnel electrons into the quinone pool (via FAD), again without producing a proton gradient. Complex III (cytochrome b/c complex) removes two electrons from QH2 and transfers them to two molecules of cytochrome c, the water-soluble electron carrier located between the membranes. As part of this process, it moves two protons across the membrane, producing a proton gradient (in total 4 protons: 2 protons are translocated and 2 protons are released from ubiquinol). When electron transfer is hindered (e.g., by a high membrane potential, point mutations or by respiratory inhibitors such as antimycin A), Complex III can leak electrons to oxygen resulting in the formation of superoxide, a highly-toxic oxidative species, which appears in the pathology of many diseases and is seen in aging.
Complex IV (cytochrome c oxidase) removes four electrons from four molecules of cytochrome c and transfers them to molecular oxygen (02), producing two molecules of water (H20). At the same time, it moves four protons (H+) across the membrane, producing a proton gradient. Complex V (mitochondrial ATP synthetase) which is not directly associated with Complexes I, ll7 III and IV uses the energy stored by the electrochemical proton gradient to convert ADP into ATP.
McCormack et al. (2012) characterized one facet of mitochondrial disease as follows:
Mitochondrial respiratory chain disease is an increasingly well-recognized, but notoriously heterogeneous, group of multisystemic energy deficiency disorders. Its extensive heterogeneity has presented a substantial obstacle for establishing a definitive genetic diagnosis and clear pathogenic understanding in individual patients with suspected mitochondrial disease. While known genetic causes of "classical" mitochondrial DNA (mtDNA) - based disease syndromes have been readily diagnosable, the overwhelming majority of patients with clinical and/or biochemical evidence of suspected mitochondrial disease have had no identifiable genetic etiology for their debilitating or lethal disease. McCormick et al. 2012
To date about 103 genes encoding mitochondrial proteins have been identified in humans (MitoCarta human inventory, Broad Institute). It is expected that most mammalian genomes will be quite similar. Mitochondrial dysfunction can arise from a mutation in one of these genes (causing a primary mitochondrial disorder) or from an outside influence on mitochondria (causing a secondary mitochondrial disorder). Mutations in 228 protein- encoding nDNA genes and 13 mtDNA genes have been linked to a human disorder with no reason to doubt that most mammals would not have similar evolutionary issues. The involvement of the activity of these genes in disorders emphasizes that optimizing function of any of these where they are found deficient can improve medical therapy.
Mitochondrial DNA is more prone to mutation effects in that the mitochondrion has a high rate of replication and lacks a DNA repair pathway in the organelle. The high level of active oxygens and the resultant oxidative stress also probably contribute to a relatively rapid mtDNA mutation rate. Thus control of mtDNA mutation and control of mutated mtDNA can be important targets for optimization. The present invention may target any one or more of these genes, control of these genes, expression products of these in optimization.
Common pharmaceutical drugs such as amiodarone, biguanides, haloperidol, statins, valproic acid, zidovudine, anesthetics, antibiotics, chemotherapeutic agents, and even NSAIDS like aspirin (acetylsalicylic acid) have been observed to affect total mitochondrial function. Given the multiple actions of drugs and their specificities for on and off target action, many drugs may lead more frequently to adverse reactions and side effects in patients with mitochondrial disorders than in otherwise healthy persons.
A recent search of Wikipedia (https://en.wikipedia.org/wiki/Mitochondrial_disease) accessed July 7, 2015 and again July 26, 2016 found the teaching:
Mitochondrial diseases are sometimes (about 15% of the time) used by
mutations in the mtDNA that affect mitochondrial function. Other causes of mitochondrial disease are mutations in genes of the nDNA, whose gene
products are imported into the Mitochondria (Mitochondrial proteins) as well as acquired mitochondrial conditions. Mitochondrial diseases take on unique characteristics both because of the way the diseases are often inherited and because mitochondria are so critical to cell function. The subclass of these diseases that have neuromuscular disease symptoms are often called a
mitochondrial myopathy. Mitochondrial Membranes as structure
As previously mentioned, mitochondria contain two membranes. The outer mitochondrial membrane encompasses the inner membrane, with a small intermembrane space in between. The outer membrane has many protein-based pores that can allow the passage of simple ions and molecules as large as a small protein. In contrast, the inner membrane has much more restricted permeability. It is more like the plasma membrane of a cell. The inner membrane anchors proteins involved in electron transport and ATP synthesis. This membrane surrounds the mitochondrial matrix (the in nermost compartment within the mitochondrion), where the citric acid cycle produces the electrons that travel from one protein complex to the next along the inner membrane. At the end of the ETC, the final electron acceptor is oxygen which ultimately forms water (H20). At the same time, the electron transport chain produces ATP. ADP (adenosine diphosphate) is phosphorylated to ATP (adenosine (triphosphate). (This is why the process is called oxidative phosphorylation.) During electron transport, the participating protein complexes release protons from the matrix to the intermembrane space. This creates a concentration gradient of protons that another protein complex, Complex V, ATP synthase, uses to power synthesis of the energy carrier molecule ATP.
Although the mitochondrion has its own mtDNA, a vast majority of mitochondrial proteins are synthesized from nuclear genes (the DNA within another cell organelle, the cell nucleus) and transported into the mitochondria. These include, but are not limited to the enzymes required for the citric acid cycle, the proteins involved in DNA replication and transcription, and ribosomal proteins. The protein complexes of the respiratory chain are a mixture of proteins encoded by mitochondrial genes and proteins encoded by nuclear genes. Proteins in both the outer and inner mitochondrial membranes help transport newly synthesized, unfolded proteins from the cytoplasm into the matrix, where folding ensues.
Genetic Factors of Mitochondrial Proteins
Both nuclear and mitochondrial genes have been associated with disease by correlation with genetic mutation. All 13 of the proteins encoded by the mitochondrial genome: MTND1, MTND2, MTND3, MTND4, MTND4L, MTND5, MTND6, MTCYB, MTCOl, MTC02, MTC03, MTATP6 and
MTATP8, have mutations associated with disease. These proteins are generally found at mitochondrial inner membranes.
Nuclear genes encoding mitochondrial proteins (most likely found associated with or bound for the mitochondrial outer membrane) whose mutation has been linked to mitochondrial disease include but are not limited to: A RMS 2, BCL2, CPTIA, DNMIL, GCK, GK, KIFIB, MAOA, PINK1. Nuclear genes encoding mitochondrial proteins (most likely found associated with or bound for the mitochondrial inter membrane space) whose mutation has been linked to mitochondrial disease include but are not limited to: AK2, DIABLO, GATM, GFER, HTRA2, PANK2 and PPOX. Nuclear genes encoding mitochondrial proteins (most likely found associated with or bound for the mitochondrial inner membrane) whose mutation has been linked to mitochondrial disease include but are not limited to: ABCB7, ACADVL, ADCK3, AGK, ATP5E, C12orf62, COX4I2, COX6B1, CPT2, CRAT, CYCS, CYP11A1, CYP11B1, CYP11B2, CYP24A1, CYP27A1, CYP27B1, DHODH, DNAJC19, FASTKD2, GPD2, HADHA, HADHB, HCCS, L2HGDH, MM A A, MPV17, NDUFA1, NDUFA2, NDUFA9, NDUFA10, NDUFA11, NDUFA12, NDUFA13, NDUFB3, NDUFB9, NDUFV1, NDUFV2, NDUFS1, NDUFS2, NDUFS3, NDUFS4, NDUFS6, NDUFS7, NDUFS8, OPA1, OPA3, PDSS1, SDHA, SDHB, SDHC, SDHD, SLC25A3, SLC25A4, SLC25A12, SLC25A13, SLC25A15, SLC25A19, SLC25A20, SLC25A22, SLC25A38, SPG7, TIMM8, UCP1, UCP2, UCP3, UQCRB and UQCRQ. Nuclear genes encoding mitochondrial proteins (most likely found in or bound for the mitochondrial matrix) whose mutation has been linked to mitochondrial disease include but are not limited to: AARS2, ACAD8, ACAD9, ACADM, ACADS, ACADSB, ACAT1, ALAS2, ALDH2, ALDH4A1, ALDH6A1, AMI, ATPAF2, AUH, BCAT2, BCKDHA, BCKDHB, BCS1L, C8orf38, C10orf2, C12orf65, C20orf7, COA5, COX10, COX15, CPS1, D2HGDH, DARS2, DBT, DECR1, DGUOK, DID, DLAT, DMGDH, ETFA, ETFB, ETFDH, FOXREDl, FH, GCDH, GCSH, GFMl, GLUDl , HADH, HARS2, HIBCH, HMGCS2, HMGCL, HSD17B10, HSPD1, IDH2, IDH3B, ISCU, IVD, KARS, MCCC1, MCCC2, MCEE, ME2, MRPS16, MRPS22, MTFMT, MTPAP, MUT, NAGS, NDUFAF1, NDUFAF2, NDUFAF3, NDUFAF4, NUBPL, OAT, OGDH, OTC, OXCT1, PC, PCCA, PCCB, PCK2, PDHA1, PDHB, PDHX, PDP1, POLG, POLG2, PYCR1, RARS2, RMRP, SARDH, SARS2, SCOl, SC02, SDHAF1, SDHAF2, SOD2, SUCLA2, SUCLG1, SURF1, TACOl, TK2, TMEM70, TRMU, TSFM, TTC19, TUFM, UNG, XPNPEP3 and, YARS2.
Nuclear genes encoding mitochondrial proteins (but proteins that are also found in other places in the cell) whose mutation has been linked to mitochondrial disease include but are not limited to: AIFM1, AKAP10,, AMACR, APTX, BAX, BOLA3, CYB5R3, ETHE1, FXN, GDAP1, HK1, HLCS, LRPPR LRRK2, MFN2„ MLYCD,, NFU1, PARK2, PARK7, SACS, SPG20 and WWOX.
Nuclear genes encoding mitochondrial proteins (but whose specific localization within the mitochondrion is still to be elucidated) whose mutation has been linked to mitochondrial disease include but are not limited to: GLRX5, HOGA1, MMAB, MMADH PDSS2, AFG3L2, COQ2, COQ6, COQ9, GLDC, PNKD, PUS1, REEP1, STAR and TMEM126A.
Functions of these genes and their products are known in the art. A listing of these genes and other information can be found, for example, in N EJM 2012; 366:1132-41,
Supplementary Appendix, and is not repeated here.
Mitochondrial genes in general undergo post-translational modification. Accordingly, in the optimization process, embodiments of the present invention may modify any aspect of these genes, including but not limited to: any function associated with the gene, integrity of the gene itself, transcription, and all the factors including expression and post-translational modification and movement within the cell.
Since genetics underlie life functions, genes that do not encode a protein found in mitochondria can also be of extreme importance in optimized cell metabolism. For example, as discussed below the Position of mitochondria within cells is dependent on many proteins. The genes encoding these proteins can also be important in optimization.
Mitochondria are the major source of metabolic energy, and they regulate intracellular calcium levels and sequester apoptotic factors.
Mgml and Opa 1 are involved in regulating cristae structure. Mgml participates in
ATPsynthase oligimerization.
Mitochondria are not just cell powerhouses producing ATP. They also are essential for other facets of cell functions required for metabolism. Cell metabolism is accomplished by thousands of enzymes. Many of these enzymes require metals for proper activity and to form coordination complexes. I ron sulfur clusters (ISVC), essential for iron homeostasis in the cell, are a product of mitochondria. Accordingly, mitochondria through this contribution to iron control, are necessary for many oxidation reactions, including, but not limited to: oxidative phosphorylation, pyrimidine/purine metabolism, the tricarboxylic acid cycle, acontinase activity, DNA repair, NTHLl activity, heme synthesis, ferrochelatase function, ISC synthesis enzymes (N BP35 and CFD1). Metal containing enzymes, of which iron containing oxidation/reduction enzymes are common, are important for scavenging active oxygens. For example: FtMt is an important nuclear encoded mitochondrial protein that sequesters iron in mitochondria and makes it available when needed. Mdm33 is important for inner membrane fission. Proton pumping is coupled to ATP synthesis through FiF0ATP synthase.
Biochemicals
As observable from both Figures 1 and 2 and from reading this text, many biochemicals are essential or beneficial for proper cell metabolism. Depending on the contribution of the biochemical to the cell processes, the biochemical, may serve, for example, as a chemical substrate, a carrier, a structural member, a signal modifying activity of other biochemicals, etc. Changing location or activity of one may affect utilization of several others. Although not all of these intertwining pathways are mentioned in detail herein, any one or combination of the metabolic biochemicals and/or the biochemical enzymes processing them can be proper targets for optimization. Targets, including, but not limited to:
Riboflavin (B2)
L-Creatine
CoQio
L-arginine
L-carnitine
Vitamin C
Cyclosporin A
Manganese
Magnesium Carnosine
Vitamin E
Resveratrol
Alpha lipoic acid
Folinic acid
Dichloroacetate
Succinate
Prostaglandins (PG) - specific to the PG and tissue may show positive/negative effect; e.g.,
PGA, PGA2, PGB, PGB2, PGC, PGD, PGD2, PGE, PGEi, PGE2, PGE3, PGFa, PGFiCt, PGF2 , PGF3 , PGG, PGH, PGH2, PGI, PGJ, PGK, and related biomolecules, including, but not limited to: prostacyclins, thromboxanes, prostanoic acid, 2- Arachidonoylglycerol, etc.
NSAIDS - aspirin - COX1 and COX2 inhibitors
Melatonin
Cocaine
Amphetamine
AZT and similar antiviral compounds
Mitophagic or mitophagic inhibitory compounds: including, but not limited to: isoborneol, piperine, tetramethylpyrazine, and astaxanthin
Glutathione
β-carotene and other carotenoids
and as further described below, to provide examples of optimization processing, are deliverable to cells and can be used in optimization as discussed in this application.
Some representative compounds and their importance
Riboflavin
Riboflavin (vitamin B2) works with the other B vitamins. It is important for body growth and red blood cell production and helps in releasing energy from carbohydrates.
L-creatine
Creatine is a naturally-occurring amino acid (protein building block) found in meat and fish, and also made in the liver, kidneys, and pancreas. It is converted into creatine phosphate or phosphocreatine and stored in the muscles, where it is used for energy. During high- intensity, short-duration exercise, such as lifting weights or sprinting, phosphocreatine is converted into ATP.
CoQio
There are two major factors that lead to deficiency of CoQi0: reduced biosynthesis, and increased utilization by the body. Biosynthesis is the major source of CoQi0. Biosynthesis requires at least 12 genes, and mutations in many of them are known to cause CoQ deficiency. CoQio levels can also be affected by other genetic defects (such as mutations of mitochondrial DNA, ETFDH, APTX, FXN, and BRAF, genes that are not directly related to the CoQio biosynthetic process)
Toxicity is not usually observed with high doses of CoQi0. A daily dosage up to 3600 mg was found to be tolerated by healthy as well as unhealthy persons. However, some adverse effects, largely gastrointestinal, are reported with very high intakes.
L-arginine
Arginine can be made by most mammals. However, normal biosynthetic pathways, produce insufficient amounts of arginine so some must stil l be consumed through diet. Arginine is the immediate precursor of nitric oxide (NO), urea, ornithine, a nd agmatine. Arginine is also a necessary precursor for the synthesis of creatine and other cell component biochemicals. The enzyme, arginase, is found in mitochondrial membranes and here contributes to proper function of the urea cycle. The metal, manganese, is also important for mitochondrial activity at least through its participation in arginine metabolism.
L-carnitine
Carnitine is involved in the transport of acyl-coenzyme A across the mitochondrial membrane to be used in mitochondrial β-oxidation.
Vitamin C
Vitamin C reduces the exercise-induced expression of key transcription factors involved in mitochondrial biogenesis. These factors include peroxisome proliferator-activated receptor co-activator 1, nuclear respiratory factor 1, and mitochondrial transcription factor A.
Vitamin C also prevented the exercise-induced expression of cytochrome C (a marker of mitochondrial content) and of the antioxidant enzymes superoxide dismutase and glutathione peroxidase. Vitamin C is an antioxidant, that along with resveratrol and alpha- lipoic acid reduces excessive reactive oxygen species production by the mitochondria. Manganese is also important here as vitamin C works with manganese superoxide dismutase.
Cyclosporin A
Cyclosporin A, an immune suppressant, interferes with the mitochondrial permeability transition pore and therefore has been found effective in protecting against oxidative stress in for example, stress inducing ischemia and reperfusion. Cyclosporin A can improve metabolism in some instances by slowing or blocking cell apoptosis.
Manganese
Manganese plays an essential role in the mitochondrial antioxidant: manganese superoxide dismutase. Without adequate manganese, superoxide dismutase activity will be insufficient, and therefore can result in sub-optimal mitochondrial activity and cellular metabolism..
Magnesium
Magnesium is important for proper calcium metabolism and function as a cofactor with many enzymes. Magnesium also appears especially important for mitochondrial biogenesis.
Zinc
Zinc is important in mitochondrial activity, for example, zinc can affect ATP production rates.
Carnosine
Carnosine is a potent scavenger of free radicals
Vitamin E
Vitamin E is a protectant against mitochondrial membrane peroxidation and therefore can be an important factor in maintaining mitochondrial activity and cellular metabolism.
Resveratrol
Resveratrol is a potent antioxidant with apparent involvement in mitochondrial biogenesis. Resveratrol acts through AMPK and SIRT1 and is involved in PGC-l .
Alpha-lipoic acid
Alpha-lipoic acid is associated with rejuvenation and replacement of damaged
mitochondria. This renewal becomes more prevalent as mitochondria age.
Folinic acid
Folinic acid is a factor in mitochondrial oxidative stress and has been associated with mitochondrial dysfunction in autism spectrum. Dichloroacetate (DCA)
DCA stimulates oxidative phosphorylation by inhibiting pyruvate dehydrogenase kinase. DCA potency may vary in a particular cell or individual metabolic profile. DCA has been investigated as a possible therapy in some cancers.
Succinate
Succinate is an intermediate in the tricarboxylic acid cycle (making ATP), and participates in inflammatory signaling. Succinate dehydrogenase participates in electron transport as "Complex II".
Prostaglandins (PG)
Calcium ion controls binding of many PGs to mitochondria thereby modifying many aspects of mitochondrial function. NSAIDS have been associated with decoupling activity in mitochondria.
NSAIDS - aspirin - COX1 and COX2 inhibitors
NSAIDS are active in controlling mitochondrial Complex I. NSAIDS may also alter
mitochondrial membrane permeability by opening the mitochondrial permeability transition pore that allows small molecules up to 1.5 kDa easier passage across the mitochondrial membrane.
Melatonin
Melatonin demonstrates cell protectant activity though slowing apoptosis as it controls activity of aged or oxidatively stressed mitochondria involvement in leading the cell down the apoptotic pathway.
Cocaine
The anesthetic, cocaine, has been observed as modifying Complex I activity in mitochondria.
Amphetamine
The stimulant class of amphetamines, are inhibitors or normal mitochondrial metabolism and appear to increase oxidative stress.
AZT and similar antiviral compounds
AZT is mitochondrially active by increasing active oxygen generation, interacting with respiratory chain enzymes and damaging mtDNA. Thus optimization of mitochondrial function is a special need when drugs of this type are used. Mitophagic or mitophagic inhibitory compounds: including, but not limited to:
isoborneol, piperine, tetramethylpyrazine, and astaxanthin.
Mitophagy is important for recycling of mitochondria and controlling position and number of mitochondria. Either slowing or accelerating mitophagy may be important for optimizing metabolism in a particular cell or individual.
Glutathione
Increased glutathione is known to protect mitochondria and the cell against damaging effects of the oxidative moieties produced in mitochondria such as: superoxide anion radical O2 , hydrogen peroxide, H202, and the extremely reactive hydroxyl radical *HO. Increasing intracellular glutathione content is possible by several methods including, but not limited to: supplying precursors for glutathione synthesis, e.g., N-acetylcysteine; increasing CoA, for example, by supplying its precursor pantothenic acid; making curcumin (a spice) available to the cell; and the analgesic drug flupirtine. Since glutathione is seen to increase throughout the cell, the antioxidant protection is not limited to the mitochondria.
β-carotene
β -carotene, lycopene, lutein, astaxanthin and zeaxanthin are popular carotenoids. These biochemicals demonstrate antioxidation properties. These tend to be lipophilic and thus often are found partitioned in membranes. So at high concentrations they may disorganize normal membrane structure. Cautious treatment with one or more carotenoids can protect membranes against oxidative stress by inhibiting mitochondrial active oxygen production. At least in some cells carotenoids increase mitochondrial function while limiting active oxygen generation. Cell survival can be improved. If the cell whose health is improved is, for example, a cancer cell, then sometimes reduced carotenoids may be advantageous.
Optimization here and with other modifications will depend on the disease, the individual and the cell and cell function targeted.
MITOCHONDRIAL STRUCTURE and POSITIONI NG
As more has been learned about mitochondria it is apparent they are dynamic organelles. From the earliest citing of the mitochondrion over a half century ago we now understand that mitochondrial shape and size are highly variable. Shape and size is controlled by fusion and fission processes. We can also observe that mitochondria are actively transported in cells depending on energy needs within the cell. More mitochondria become situated in areas with higher energy needs, including, but not limited to: active growth cones, presynaptic sites and postsynaptic sites. Also, the internal structure of mitochondria can change in response to their physiological state. Shape. Length, shape, size and number of mitochondria are controlled by fusion and fission. Fusion will generally result in fewer, larger and more spherical mitochondria. Whereas high fission cells generally have more mitochondria that are smaller and rod shaped.
Outer shape is not the sole shape criterion. Mitochondria also have internal structure (e.g., shape of cristae). The cristae are regions of the inner membrane more distant (internal) from the outer membrane. Cristae are formed by internal folding of the inner membrane. The different portions of the inner membrane have different functions. For example, cristae are richer in oxidative phosphorylation machinery are more prevalent in cristae while transport facilitators are more prevalent in the inner membrane regions apposite the outer membrane. Not surprisingly, the density and length of cristae are controlled according to the cell's needs and the needs of specific location within the cell.
Location. One factor controlling mitochondrial movement is its membrane potential. Higher potential favors movement away from the cell nucleus or main cell body towards the periphery. Lower potential (possibly damaged mitochondria) migrate towards the cell center (possibly for destruction). Signals such as a nerve growth factor (NGF) gradient act to recruit mitochondria to higher concentrations of NGF. These types of factors may be used as a piece of an optimization process to recruit mitochondria to targeted sites. Blocking nerve growth factor activity has been associated with bone cell necrosis.
Within the cell, mitochondria use the cytoskeleton as a guide to destination a nd for transportation.
Mitochondria are now known to migrate throughout cells, to fuse, and to divide as mitochondrial activity is regulated according to the cell's needs. The dynamic mitochondrial processes enable mitochondrial recruitment on demand to the changing more active subcellular compartments. Fusion processes as cells converge upon one another and merge facilitates content exchange between mitochondria and is a component of mitochondrial shape control. Stem cells which can fuse with endogenous cells may be involved in rescuing cells with damaged or otherwise dysfunctional mitochondria.
Movement is also important for mitochondrial communication with the cytosol and mitochondrial quality control. With these activities mitochondria readily adapt to changes in cellular requirements and therefore can respond to physiological or environmental imperatives. When mitochondrial dynamics becomes disrupted, cellular dysfunction ensues. Accordingly, optimization of cellular metabolism may involve modifying mitochondrial dynamics.
Optimization may thus involve consideration of the number of mitochondria, location of mitochondria, size of mitochondria, size and shape, internal structure of mitochondria in addition to chemical factors that may more specifically modify one or more mitochondrial function. Optimization of mitochondrial activity can be a valuable addition over and above the benefits obtained from balancing circulating androgen.
Supplementing Levels of Androgen to Achieve Balance
As a side to the present invention, oral compositions, absorbable or metabolizable as the desired hormone can be incorporated into an animal's regular diet. Prohormones include dehydroepiandrosterone (DH EA), pregnenolone, androstenedione and/or androstenediol.
The oral composition may comprise the hormone itself or a suitable prohormone and may be delivered by any suitable means, including, but not limited to: as a toothpaste, a small treat, a food formulation, a prescription food product, a chew toy, etc.
The invention also provides methods of making the oral composition for enhancing human animal or animal-animal interaction, or simply animal health comfort and well-being by incorporating the hormone into one or more delivery devices.
One such device might be a toy, for example a dog toy shaped as a bone, a ring, a small animal, etc. Such device can be made in bulk using any conventional procedures, but for most accurate control of dosing for a specific animal may be produced in whole or in part using techniques commonly referenced as 3-D printing.
The 3-D printing procedure would incorporate a matrix suitable to maintain the animal's interest and print within this matrix, at least a portion of the toy with the hormone at the desired and exquisitely controlled concentration.
The matrix may start as a form produced using more bulk production processes and may be enhanced with one or more therapeutic areas such as a coating, a filler, a layer, etc., that comprises the hormone at the precisely determined dosing.
No-oral delivery methods are available. For example, implantable devices similar in concept to identity chips or to birth control sticks or rods used by human females.
Rationale and Process
The present invention is based in part on the insight that administering one or more androgenic hormones or prohormones to generally healthy appearing animals can increase their overall health and beneficial interactions with nearby humans. In addition, though not as readily observable, achieving an optimal level of circulating hormone may be associated with an increased quality of life, possibly through enhancement of the immune system's ability to defend against bacteria and viruses, to resist cancer, to enhance the circulatory system, and/or to ameliorate undesired stress-responses.
Testosterone, since it is well studied and readily available is a preferred hormone to be used for controlling circulating androgenic hormone level and hormonal activity. Though in some cases prohormones may have advantages. Known prohormones that are commercially available include: DHEA, pregnenolone, androstenedione, and androstenediol.
The compositions used in the present invention are preferably formulated and controllably administered to a an animal to induce desired effects without also inducing undesired side effects, such as undesired anabolic or androgenic effects, in that animal.
Dose will depend on the initial status of circulating hormone in the animal, on the active ingredient and its activity within the animal, on the size of the animal, the frequency of dosing and the rate at which an animal would metabolize the active ingredient(s) of the composition. Thus suitable unit doses may range from about: 0.01 mg to 500 mg, e.g., 0.01 mg, 0.05 mg,. 0.07 mg„ 0.1 mg„ 0.15 mg, 0.2 mg. 0.5 mg, 1.0 mg, 2 mg, 3 mg, 5 mg, 7 mg, 10 mg, 20 mg, 25 mg, 30 mg, 50 mg, 75 mg, 100 mg, 120 mg, 150 mg, 175 mg, 200 mg, 250 mg, 300 mg, 350 mg, 400 mg, 450 mg, or 500 mg. Depending on the route of delivery, the animal's size, the animal's age, the animal's gender, the specific composition, etc other ranges may be relevant, for example, 10 mg - 200 mg, 12.5 mg to 150 mg, 15 mg-100 mg, 20 mg-75 mg, 20 mg -50 mg, or 50 mg - 100 mg.
Salts, esters, metabolites, protein bound, glycosylated, or matrixed formats of delivery a can be used in the composition, provided they are converted in vitro or in vivo to an active form. The composition may comprise hormone or pro-hormone that is bound , covalently of non- covalently to a non-hormonal substance.
The composition may optionally include additional vitamins or minerals and scents or flavorings or flavor enhancers to render the composition more acceptable to the administering human and/or to the animal. For example, beef, elk, chicken, salmon and/or other scent or flavor appealing to dogs may be incorporated, a protein binder and/or a vitamin such as one of the b vitamins, e.g., B6 might be added as it or they might be found to hel p stabilize hormone level.
The composition may be made available in one or more formats including, but not limited to: a capsule, a tablet, a caplet, a liquid beverage, a powder, a liquid or powder beverage additive, a gel, a ready-to-eat food, either moist or dry, a chunk, a bar, a toy of desired shape and size. These wil l depend on the dosage required and acceptability to the animal and administering human.
A composition of the present invention may further comprise natural and/or artificial flavoring components, dyes or other coloring additives, preservatives and other
conventional food supplement additives known in the art to increase palatability, storage options, etc.
The time and dosage amount administered will vary from animal to animal and will be influenced by the age of the subject, and therefore may be adjusted as the animal ages. It is believed that generally, the younger the animal, the earlier results will be apparent with a smaller dosage amount needed to achieve optimal results. As the animal ages, the composition will have to be administered perhaps more frequently and in larger dosages for the animal to experience optimal results. The form of the oral composition can be any suitable form that comprises the active ingredient and allows delivery to the select animal. For example, preferably an animal has been under a veterinarian's care and is general good health, however, the animal is aging and can benefit from receiving a therapeutic intervention that while not strictly necessary for life is beneficial to the animal and its human interactions though optimizing health, for example, by staving off or diminishing arthritis, other bone issues, such as dysplasia, lessening obesity problems and other issues seen in aging animals, such as diabetes, lethargy, pain, etc.
Although the androgen in the oral composition may vary, the method of delivery is also an important factor. For example testosterone may be co-administered with an oil, may be admixed in a feed, may be delivered as a toy, etc. The format for delivery is subject to choice of the animal caretakers and is manageable in accordance with this invention. Animals including humans have shown large variations in efficiencies of moving testosterone and other androgens from the gastro-intestinal track to circulation. Given the multiple effects of testosterone supplementation, most desirable effects being observed with approximately a doubling or tripling of typical circulating testosterone in a middle aged or older mammal, with extreme levels risking undesirable androgenic consequences, monitoring testosterone delivery and testosterone or testosterone analogue in each individual is highly desired. Controlled and balanced delivery of the androgen supplement should be practiced to provide the best outcomes.
Accordingly, a preferred process in practicing the invention will utilize multiple tests performed over time and especially whenever feed is changed, perhaps when time of administration is changed, perhaps whenever the animal changes residences, and periodically as the a nimal increases in age.
Understanding that testosterone effects are found in the many tissues and organs expressing Androgen receptor and that depending on activity in each organ or tissue androgen may be degraded at different rates balancing testosterone levels may involve several iterative changes. So after an initial testosterone level determination and a choice of supplementation format and dose the animal will be supplemented for a period of time to achieve a new balance. After several weeks to several months the testosterone levels will again be monitored and the dosage or frequency of delivery adjusted to compensate for interbreed differences, differences in co-administered foodstuffs, and significantly factors specific to the specific animal. The balancing will need periodic adjustment as endogenous androgen will be expected to diminish as the animal ages and degradation rates of testosterone will also fluctuate with age and other factors.
Illustrative Example
For example, a five year old canine (age dependent on the breed, the animal size, etc.) is evaluated at its annual visit. This visit includes a hormonal profile as well as questioning the dog owner about the animal's activities and general health. The veterinarian observes that as in common at this age for this type of dog, testosterone levels are continuing to drop and that the dog might benefit from restoring circulating levels of testosterone or other androgenic hormone in the blood.
The veterinarian calculates a target testosterone level and suggests simple oral supplements that can help the dog achieve these levels and to thereby pep up the dog, the dog owner and the dog's family.
The owner chooses from a brochure provided by the veterinarian one of the compositions of the present invention, in fact the owner here wishes for variety and chooses a relatively hard chew toy, a gel format wherein the composition is encapsulated in a soft, bone shaped, gum like format that the owner believes her kids will enjoy giving the dog. She also takes a small food packet as a sa mple. This packet has two pouches and a small distribution device where a small quantifiable (by counting or volume measurement) portion (preferably slightly color coded for the human) can be admixed in prescribed proportion with the larger pouch contents to achieve the desired caloric intake and hormonal supplement dosage. Additional Benefit - Improving Energy Metabolism
As an additional benefit mitochondrial optimization might even more robustly improve the animals general outlook. Combing mitochondrial optimization to optimize cellular metabolism in conjunction with androgen balancing is another feature that may further improve outcomes over and above the solely androgen focused approach.
Optimization of cellular metabolism through optimizing any mitochondrial function is desired for improved medical treatment. Cellular metabolism can be observed by any known method or any method that may become known and is not restricted to the examples discussed herein. However, examples are provided as a means to demonstrate the ubiquity of applications of the present invention and feasibility practicing it.
On a simplistic level mitochondrial function may be improved by what we might deem "appropriate nutrition". Therapists and individuals have historically been known to supplement the diet with vitamins, nutrient and/or cofactors. To date, a methodologic approach to optimizing metabolism specific to an individual or group has not been practiced.
In many patients more complete optimization will involve sequencing their mtDNA. The entire mitochondrial genome can be sequenced or select genes or regions might be deemed of greatest importance. Any one or more of the mitochondrial genes are candidates for sequencing. Sequencing is known in the art and can be accomplished by any successful methodology. Regions of particular interest including, but not limited to: the D-loop or control region might be sequenced to guide optimization protocols. Simply determining total mtDNA in a cell, tissue or individual may also be a step in optimization.
The mtDNA sequence results may be combined with genetic sequence information from one or more organs or cell types in an individual. Genomic sequence is one level of information that may be used in isolation or in combination with mtDNA sequence information for additional guidance in the optimization process. Even more robust information may be obtained, not just from gene expression profiling. This is very useful when considering specific organs or cell types which by being differentiated cells only express a small subset of the full genome. Obtaining RNA transcription profiles or expression profiles can thus be instrumental in the optimization process. In some circumstance analyzing proteins as discussed below with specific reference to blood and other ex vivo biopsy sources, can provide some genomic profile information by monitoring the end product of genomic expression. Accordingly, genomic information in isolation or more preferably in combination with clinical observation and other assays is understood to be a useful source of information to use in developing an optimization protocol.
Analysis may involve inhibiting certain mitochondrial functions to assess their performance levels. Also on occasion optimizing metabolism may involve mitochondrial inhibition. Several examples of inhibitors are discussed as examples. Electron Transport Chain Inhibitors
ETC inhibitors per se act by binding and blocking a component the electron transport chain. ETC function can also be inhibited by impairing expression or proper localization of one of the component enzymes or carriers. Inhibiting or blocking the ETC prevents electrons from being passed from one carrier to the next and stops oxidation of oxygen and synthesis of ATP. Since binding is involved the inhibitors act specifically to affect a particular carrier or complex. Binding can be temporary (reversible) or permanent (irreversible). Reversible inhibition may be time or concentration dependent. Irreversible inhibition generally results in total stoppage of respiration via the blocked pathway. Competitive inhibition is one form of reversible inhibition. It allows some oxygen consumption (and ATP synthesis) since a "trickle" of electrons can still pass through the blocked site. Although it allows some oxygen consumption, competitive inhibition may prevent maintenance of a chemiosmotic gradient. In this example the addition of ADP would have no effect on respiration. Some combinations of inhibitors might be used to seek alternative entry points to the ETC.
Rotenone
Rotenone is used as an insecticide. It is toxic to wildlife and to humans as well as to insects. It is a competitive inhibitor of electron transport suitable for testing ability to block respiration via the NADH versus succinate pathway. Antimycin
Antimycin has been used with combinations of substrates including succinate, NADH or glutamate, and the dye TMPD (N,N,N',N'-tetramethyl-p-phenylenediamine) along with ascorbic acid.
Cyanide Cyanide is a reversible inhibitor of cytochrome oxidase. Some mitochondria have cyanide resistant pathways. Cyanide causes uncoupling. So in the presence of TMPD a dramatic increase in oxygen consumption is observable.
Malonate
Malonate is a competitive inhibitor of succinate metabolism. Uncoupling agents
Uncoupling is where the rate of electron transport is no longer be regulated by the chemiosmotic gradient. The condition is differentiated from electron transport inhibition by the fact that in the latter case, bypassing the block can restore the gradient. In uncoupling, the ETC still functions but is ineffective because of dissipation of the chemiosmotic gradient. 2,4-dinitrophenol (DN P)
DN P is a proton ionophore. It binds protons on one side of a membrane, and then being fat- soluble drifts to the opposite side where it loses the protons. The probability of binding is greatest on the side of the membrane with greatest proton concentration, and least on the side with the lesser concentration. This makes it impossible to maintain a proton gradient. DN P demonstrates other effects in addition to uncoupling. DN P gradually inhibits electron transport itself as it incorporates into mitochondrial membranes. In the 1930s DN P was promoted as an effective diet pill. Uncoupling of electron transport from ATP synthesis allows rapid oxidation of Krebs substrates and promotes mobilization of carbohydrates and fats to maintain normal levels of the Krebs substances. The energy is lost and measurable as heat.
Carbonyl cyanide p-[rifluoromethoxyl]-phenyl-hydrozone (FCCP)
FCCP is an ionophore, completely dissipating the chemiosmotic gradient while leaving the electron transport system uninhibited.
Oligomycin Oligomycin blocks ATP synthase by blocking the proton channel. This inhibits oxidative phosphorylation. Oligomycin has no effect on Complex IV respiration, but blocks Complex III respiration completely. It therefore has no direct effect on electron transport or the chemiosmotic gradient. Any mitochondrial function or related function is a possible target for optimization
Cells and mitochondria each and collectively require multiple metabolic functions for their own survival and survival of the organism. In any particular cell or condition, modifying a specific function or activity or a select group of metabolic functions or mitochondrial activities may be selected for optimization, in other cells or conditions, including, for example, cells of a different organ with the same individual or cells of a different individual. Such activities that might be altered associated with the optimization process may include but are not limited to: oxidative phosphorylation, energy versus heat production
(efficiency), free radical generation, free radical scavenging, initiation of apoptosis, mtDNA transcription, mitochondrial protein translation, post translational modification, mitochondrial protein import or translocation, nucleotide translocation, ATP translocation, mitochondrial fission, mitochondrial fusion, Ca++ compartmentalization or homeostasis, steroid biosynthesis, controlling portions of the urea cycle, fatty acid oxidation, the tricarboxylic acid cycle, pyruvate metabolism, cellular redox balance, synthesis of precursor compounds such as myelin precursors, altering iron metabolism and of course altering oxygen use a nd any component or activity of the electron transport chain. [E.g., Generation of metabolites to regulate cellular epigenetics (NAD+) methyl group and numerous additional meta bolic processes.] The skilled artisa n will recognize that optimization of any one or more of these may not be relevant for every cell type. Depending on the therapy at issue, any of these functions or activities or a ny of the many functions or activities not specifically mentioned here, but appropriate to the condition or cell involved in the treatment, the skilled artisan will select and optimize relevant functions and/or activities. To optimize treatment for the individual, disease status; the individual's history with the disease; the individual's response to the disease; the individual's genetic background (including methylation and other epigenetic control of polynucleic acids or their histones); the individual's biochemical status for one or more markers, metabolites or substrates; and experience such as data from the disease, the individual or any relevant group or subgroup can be used alone or in combination.
Cellular or mitochondrial morphology; e.g., size, number, location, shape, can be used to assess mitochondrial function. One means helpful in this analysis is FACS (fluorescence activated cell sorting). This technology is several decades old and therefore has seen development of a variety of fluorescent markers to indicate location, size, membrane potentials, including mitochondrial membrane potentials inside a cell. FACS is one technique available to assess deficits in mitochondrial form and/or function. Observing a facet of mitochondrial function that may be improved can be used to then select one or more optimizing strategies. Optionally, selected strategies can be tested in cells using repeated FACS, to refine and to further improve and optimize strategy.
Analysis of an individual or a group or class of individuals for normalization or validation can be directed explicitly at reactions carried out by mitochondria. However, this often may require a bioassay, removal of tissue from an individual for ex vivo analysis. And since the mitochondrion is an essential component of eukaryotic cells, participating in multiple metabolic pathways, mitochondrial status can be evaluated by secondary or tertiary parameters. For example, blood can be used to monitor mitochondrial health and therefore may be used in the present invention as a material for bioassay. Several fractions of blood may be used at the discretion of the practitioner. For example, mitochondria themselves can be found in white blood cells. Fibroblasts, mesenchymal stem cells, cancerous and/or cancer progenitor are examples of some rare but observable cell types that can be found in blood. Any cell found in the blood might be used as a source for nucleic acid to assay or sequence a nuclear or mitochondrial genome or a portion thereof.
The blood also carries other components, fatty acids, proteins, glycoproteins, lipoproteins, carbohydrates (simple and complex), gases (especially oxygen and carbon dioxide), ketones, hormones, metabolites, nitrogen compounds, active oxygen molecules, ions (atomic, polyatomic, organic, etc.), amino acids, plasma proteins (such as albumen that may scavenge [bind] drugs or other molecules), cytokines, platelets, molecules carried from the digestive system or lungs, etc. that may be used to indicate, tissue, cell and mitochondrial status. The invention envisages blood as a robust source of information that might be used in the optimization process. Each component may be assayed in its native or altered form. For example, a modified protein or nucleic acid can be very instructive in determining metabolic status. In many embodiments monitoring representative compounds as those discussed above will be useful in developing and monitoring optimization. In several embodiments cytokines, a generic term for interleukins (including, but not limited to: IL-la, IL-lb, I LIRn, IL2, IL-3, I L-4, IL-5, IL-6, IL-7, IL-8, I L-9, IL-10, IL-11, 11-12, I L12a, I L12b, I L-13, I L- 14, 11-15, IL-16, IL-17, IL-17a, I L17b, 11-18, IL-19, IL-20, 11-21, IL-22, 11-23, IL23a, IL-24, 11-25, I L- 26, 11-27, 11-28, IL-29, 11-30, 11-31, 11-32, 11-33, 11-34, 11-35, 11-36, 11-37, etc.), interferons (including, but not limited to: IFN-a, IFN-b, IFN-g, etc.), colony stimulating factors (including, but not limited to: M-CSF GM-CSF, G-CSF, [aka CSF1, CSF2 and CSF3] etc,), tumor necrosis factors (TNFA, Lymphotoxin (TN FB/LTA - TN FC/LTB), TNFSF4, TNFSF5/CD40LG, TNFSF6, TN FSF7, TNFSF8, TNFSF9, TN FSF10, TN FSF11, TN FSF13, TN FSF13B, EDA, etc.), and growth factors (including, but not limited to: BMP2, BMP4, BMP6, BMP7, CNTF, CNTF, GPI, LIF, MSTN, NODAL, OSM, THPO, VEGFA, etc. may be assessed to aid optimization.
Many drugs targeting cytokines or cytokine receptors have been developed or are under development. Accordingly, cytokine assays may be especially useful in developing optimization protocols since tools are available to modulate effect. Modulation of the endogenous quantities produced by an individual may be an enhancement tool used in some embodiments. Synthetic compounds antagonizing or agonizing of any assayed substance may also be appropriate tools.
Assaying may one blood component might crudely be used to monitor cellular and/or mitochondrial performance. However, there is no practical reason to eschew analysis of other components provide more directed information to guide optimization. Assaying multiple aspects can indicate performance or changed performance to judge an
optimization pathway. For example, threshold levels of one or more blood components may indicate a certain level of activity of one or more metabolic pathway. Beyond simple thresholds, ratios of two or more components, by showing relationships, can provide more definitive information. Diurnal or other periodic relations may also guide optimization. Sometimes more complex algorithms getting at multi factor relationships (multiple pathways, serial pathways or parallel pathways, different organs, for example). Computer learning or other forms of artificial intelligence is now becoming a more accepted process to determine most effective analysis criteria. While blood is a great source for a substantial number of components or factors that can be assayed, the body has other assayable tissues including, but not limited to: cerebral spinal fluid, lymph fluid, saliva, breath, tears, urine, sweat, mucus, gastric and/or intestinal contents, stool, etc. Any one or more of these tissues or components can be used individually or in conjunction with one or more other source to provide data used in optimization.
Analysis may be accomplished using any acceptable means such as categorization, parametric statistics, nonparametric statistics, ratio analysis, simple or complex
comparisons, threshold assays, computer learning, etc.
Analysis may be repeated to assess degree of optimization and/or to assist in determining any change or addition to the optimization process. Analysis may also be repeated with any changed condition of the treatment recipient. Several repetitions of analysis and modified optimization process may be conducted in an iterative fashion.
Cellular metabolism or mitochondrial function may be optimized for an individual, even for an individual during a particular season, time of day, sleep-wake cycle, etc. Optimization may be based on data collected from more than one individual. For example, an optimized process may be determined for a select grouping. The skilled artisan will have capability to select an appropriate group, based for example on similarities within a group. If data show insignificant variability pooling is more appropriate.
Groupings may be based on disease or stage of disease. Groupings may be based on familial connections or larger genetic associations. For example, groups may be categorized from associations including, but not limited to: shared ancestry; shared country or region of familial origin; shared blood type (possibly subtypes); A, Al, A2, B, Bl, etc.), shared Rh factor (possibly considering each or a combination of Cc, Dd, and Ee), any of the other grouping systems including, but not limited to: ABO, MNS, P, RH, LU„ KEL, LE, FY, JK, Dl, YT, XG, SC, DO, CO, L, CH, H, XK, GE, CROM, KN, IN, OK, RAPH, JMH, I, GLOB, GIL, RHAg, FORS, LAN, JR, Vel, CD59; HLA; one or more of the 4 main mitochondrial clusters with multiple DNA lineages; one or more of the 7 core mtDNA lineages (U, X, H, V, T, K, J); one or more of the nineteen mtDNA groups (A, B, C, D, F, G, H, I, J, K, L, M, N, U, V, W, and X); shared diet; shared eye color; shared gender; shared body type; similar height; similar weight; similar BMI or other biometric. Generally, any assay might be used as part of the cell optimization process to assess one or more components of cell metabolism and/ or mitochondrial activity. Some common types include but are not limited to: end point assays, kinetic assays, qualitative, semi-qualitative or quantitative assays, functional assays, immunoassays, radio-assays, fluorescent assays, binding assays, enzymatic assays, isotopic assays, mass spectrometry, photo-assays, MRI, PET, cell sort assays, spectrophotometry, polymerase chain reaction, laser coupled assays, agglutination assays, transmittance, absorbance, refraction, flow assays, size assays, ion assays, conductivity assays, uptake assays, secretion assays, mass, gel electrophoresis, transport of: DNA, RNA, proteins, or presence or amount of specific sequences, toxicity assays, viability assays, chemiluminescent assays, amino acid assays - amino acid ratio assays, carbohydrate analysis, biomarker assays, etc. Physiologic assessment may also be employed as an indicator of metabolism in progress, production of reactive oxygen species, mitochondrial breakdown products or simply 02 consumption may be used as indicators of mitochondrial performance and metabolism
Less specific assays can also be used to select optimization strategy. For example, fairly routine analysis of a biosubstance, e.g., a body fluid (for example: urine, blood, sweat, cerebral-spinal fluid, saliva) for one or more commonly seen components (for example: any of the amino acids, glucose or other monomeric compounds. One or more of the collagens may be observed to assess initial status and/or to monitor progression of the optimization strategy. For example, condition of the skin might be scored to chart effectiveness of treatment since skin is easily accessible and collagen is ubiquitous throughout the body's organs. As an example, collagen VI or a correlated marker might be monitored to assess Alzheimer's disease. Collagen monitoring may also be beneficial in tracking cancer growth and optimized treatment effectiveness. Assaying one or more biosubstance obtained, for example, from natural elimination or biopsy is considered important to many embodiments of the present invention.
This process of producing and properly distributing ATP for proper cell function is complex and therefore is sensitive to changes to the cell's homeostasis. Accordingly, a necessity for cell survival optimal function and energy metabolism (as manifest, for example, in ETC, protein or peptide synthesis, signal transduction, mitochondrial function, proton gradients and activated phosphates) is easily compromised before the therapy or during therapy that produces other desired effects. Accordingly cell su rvival can be easily compromised;
disruption to these processes can disruptively alter anything else, for example, post translational modification. Cellular energy metabolism needs to be optimized before or during therapy to maximize benefit.
As a description emphasizing complexity, the ETC incorporates three of these proton pumps known as complexes I, III and IV. Notably, complexes I and I II catalyze reactions very close to equilibrium. Reactions catalyzed by these complexes are easily reversed and therefore especially sensitive to extracellular events.
Complex II can replace complex I, but is not a proton pum p and produces less energy than pathways using complex I. When complex II becomes more active, energy metabolism and therefore the cell becomes less efficient.
Optimization therefore can have many possible pathways. One or more of these may be applied for any individual. For example, the mitochondrial genome encodes 37 genes (16, 569 bp): 13 polypeptides, 22 tRNAs and 2 ribosomal RNAs. The polypeptides are constituents of the respiratory-chain complexes: 7 complex I subunits (NADH
dehydrogenase), 1 subunit of complex III (ubiquinol : cytochrome oxidoreductase), 3 subunits of complex IV (cytochrome c oxidase) and 2 subunits of complex V (ATP synthase). The genes for tRNAs are presented as one-letter symbols. Mutations in four of these tRNA genes are associated with diabetes: those for leucine (L), serine (S), lysine (K) and glutamic acid (E) tRNAs.
[http://www.nature.com/nature/journal/v414/n6865/fig_tab/414807a_Fl. html]. These, since the mitochondria are essential components of eukaryotic cells, interact with the cellular components produced by nuclear genome of the cell (since many pathways in energy production require genes from both).
Exemplary donor and acceptor compounds in the pathway include the coenzymes nicotinamide adenine dinucleotide (NAD+) and flavin adenine dinucleotide (FAD), yielding NADH and FADH2. Then in the pathway, subsequent oxidation of these hydrogen acceptors leads to the production of ATP.
Since NADH is a component of the ETC, ETC and the mitochondrion are involved in other groups of pathways, for example reduction of disulfides. One such disulfide system is the glutathione system, a system essential for many transport functions within the cell and therefore healing and repair.
Even compounds such as fatty acids by participation in the citric acid cycle affect and/or are affected by any alteration from optimal mitochondrial function. So obesity or even localized fat deposition would be candidates for improvement through optimization of mitochondrial function.
To further highlight complexity of the energy system the following examples of molecules involved in energy metabolism are mentioned: carbohydrates, fats, proteins, acetyl-CoA, CoA-SH, c/s-Aconitate, nicotinamide adenine dinucleotide (NAD+), reduced NAD+ (NADH), flavin adenine dinucleotide (FAD), FADH2, -ketoglutarate, gua nosine diphosphate (GDP), inorganic phosphate (Pi), guanosine triphosphate (GTP), adenosine diphosphate (ADP), adenosine triphosphate (ATP), hydronium and hydride ions, ubiquinone, and the reduced form ubiquinol, succinate, fumarate, Cytochrome c, isocitrate, oxalosuccinate, succinyl-CoA, L-malate and citrate. At a first level, every treatment altering any concentration, location, availability or enzymes that can use these substances as substrate would alter the energy metabolism set by the cell. I n general we should presume the metabolic balance set by the cell (in the absence of treatment) was optimized for at least one function. Restoring proper balance therefore should improve the treatment process.
On the downside of cell regulatory activities, in the past half century or so a class of molecules called reactive oxygen species (ROS) has been implicated in multiple disease etiologies. These are volatile oxygen substances that can initiate, for example, peroxidation chain reactions and may damage DNA as well as other cell components. Common diseases such as cardiovascular disease and many cancers are suspected as having ROS component in their development.
Mitochondrial function, because of its propensity to oxidize substances (chiefly involving oxygen) is therefore implicated in many disease states. Not surprisingly, many treatments for common disease will compromise mitochondrial function. Restoration of better health through optimizing energy metabolism should ideally become an important component of treatment.
In addition to merely optimizing mitochondrial function measured by optimizing the energy output, mitochondrial function may be optimized to treat or prevent some common disease. As mentioned above optimizing mitochondrial function to benefit proper glutathione levels can be considered im portant both for near term health and prevention or management of future disease.
Antioxidants, such as vitamins and red wines have been used generically, but generally not for specific effect to promote mitochondrial related health. Optimization of energy metabolism involves more than simply adding items to one's diet. Michael Ristow, in a 2009 study, found indeed that antioxidant supplementation (He used vitamins C and E.) had no positive effect. In fact, Ristow's studies were interpreted to conclude that antioxidant supplement left one weaker. So simply adding a molecule that counters an undesired molecule involved in mitochondrial metabolism is definitely not an obvious solution for ameliorating disease treatment or progression.
Enzymes, the catalysts for biologic activity, are important for optimized metabolism. Several of these enzymes require a metal to complete their structure. For example, superoxide dismutases (SODs) essential to detoxify active oxygens (like superoxide), contain either zinc (Zn2+) and copper (Cu2+) or manganese (M n2+) as in the mitochondrial form. These SODs convert superoxide to peroxide and thereby minimizes production of hydroxyl radical, the most potent of the oxygen free radicals. But the peroxides produced by SOD are also toxic. Peroxidase is the enzyme that detoxifies peroxides. The best known mammalian peroxidase is glutathione peroxidase. This enzyme contains a modified amino acid selenocysteine in its reactive center.
This is perha ps understandable using, for example, N rf2 as an exemplary intracellular regulator protein. Nrf2 activity is implicated in regulating a gross or more of gene in the cell. Optimization of mitochondrial function may affect N rf2 activity on concomitantly, optimization of mitochondrial function may be addressed through controlling Nrf2.
In concert with the above discussion, we need to remember that the mammalian organisms, including the mitochondria that reside in its cells, have evolved over eons. It is only recently that humans have used medicinal sciences to target invading organisms, dysfunctioning organs or cells, messaging pathways dictating cell activity, or cells' internal components a nd functions. While often we will have evolved to improve or optimize natural stresses, these newly manufactured stresses will not be managed by systems that through trial and error (evolution) have been optimized to a degree to maximize survival of the species. When a disease affects an organism or with good intentions we presume to modify one part of the cell's activities, because of the interrelatedness of the multiple pathways within a cell, we likely will observe secondary and tertiary or more abstract effects if we look for them. Investigating whether such an important component of the cell, such as the mitochondrion, can have its function improved and taking action to improve function can be expected to show great benefits to the individual.
Mitochondrial function is thus extremely important and changeable. Any mitochondrial gene or any mitochondrial protein gene, their control mechanisms and their products or metabolites should therefore be considered as possible targets in the optimization processes. For example, Slowing MFN1, MFN2 or OPA1 can seriously reduce respiratory capacity. Combination of multiple modifying schemes sometimes can be quite
advantageous. For example, generic components, such as lipids (including glycolipids, phospholipids, etc.), substrates, and possibly indicator substances might be introduced while also increasing mitochondrial fusion. The fusion aids in more widespread distribution and delivery. When movement is the goal, increasing fission can make the mitochondria more mobile and enable delivery to cell periphery. Fission is also a facilitator of apoptosis. Accordingly, increasing fission events can aid treatments where apoptosis is desired and decreasing fission can spare cell death.
The combined interventions of balancing androgen levels in circulation which alone should please many animal companions, further improvements in animal activity and outlook by optimizing mitochondrial activities in concert with the androgenic related improvements will allow even more robust human-animal interaction and better outcomes for the participants.
Accordingly, one embodiment of the invention might include additional assays. These additional assays would relate to optimizing mitochondrial and cellular performance taking into account the changed and improved organism and cellular activities the result from balancing the androgens.
Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. All publications, patent applications, patents, and other references mentioned herein are incorporated by reference in their entirety. I n the case of conflict, the present specification, including definitions, will control. In addition, the materials, methods, and examples are illustrative only and not intended to be limiting. Although for simplicity in drafting the claims below are drafted in a manner where no claim specifically asserts dependent status with only a single claim, the reader is put on notice that for purpose of disclosure every claim that references a preceding claim also implicitly is understood to have alternate dependency to all claims ultimately depending from the same claim or claims. Of course the reader will recognize that this implicit understanding will not be stretched ridiculously to the extent that a claim might depend from itself. For example, claim 15 which explicitly references claim 1 and no other claim is interpreted as disclosing reference to claims 1-14; and claim 13 which is referenced in claim 14 is interpreted as disclosing reference to claims 1-12, 15, 16, etc., but not claim 14. Other features and advantages of the invention will be apparent from the following detailed description and claims.

Claims

Claims
1. A composition for improving animal well-being comprising an orally or subcutaneously administrable substance containing a dosage of androgen hormone or prohormone selected to optimize at least one physiologic function in a selected canine.
2. The composition of claim 1, comprising testosterone.
3. The composition of claim 1, wherein the physiologic function is selected from the group consisting of: sugar metabolism, joint health, bone density, blood pressure and caloric intake.
4. The composition according to claim 1 wherein the composition is formatted as a gel, a powder, a toy, a liquid, a food supplement, a moist food, a dry food, a small treat or a solidified matrix.
5. The method according to claim 1 wherein a 3-D printer is used to control dosing of the hormone or prohormone.
6. The composition according to claim 4 wherein the food comprises a plurality of
packagings, wherein at least a first packaging contains active ingredient for admixing to at least a second package contents.
7. The composition according to claim 4 comprising a toy, wherein the toy is a chewable substance.
8. The composition according to claim 7 wherein the chewable substance is shaped in a form selected from the group consisting of: a doggie bone, a dinosaur, a cat, a mouse, a squirrel, a rodent, a ring, a fist, a bow and a ball.
9. The composition according to claim 4, comprising a gel.
10. The composition according to claim 9 wherein the gel is incorporated into a dog toy.
11. The composition according to claim 1 wherein said at least one physiologic function is selected from the group consisting of: adipose metabolism, cardiac performance, glucose utilization, circulation, general nervous system activation or activity, hormonal secretion, salt (electrolyte) balance, function of a particular tissue or organ system, membrane transport across the membrane of one or more cell types, muscle activity, maintained muscle mass, 02 consumption, skin health and visual abilities.
12. The composition according to claim 1 wherein the optimization of said at least one physiologic function has a result that improves at least one life factor selected from the group consisting of: general sense of well being, clinical depression, fatigue sensation, athletic activity, positive interaction with another organism, motivation, liveliness and healing rate.
13. The composition according to claim 1 further comprising at least one promoter of
mitochondrial metabolism.
14. The composition according to claim 13 wherein the facet of mitochondrial metabolism that is promoted is selected from the group consisting of: oxidative phosphorylation, coupling efficiency (energy versus heat production), free radical generation, free radical scavenging, initiation of apoptosis, mtDNA transcription, mtDNA maintenance, generation of reactive oxygen species, controlling DNA acetylation, controlling DNA methylation, histone modification, mitochondrial protein translation, post translational modification or mitochondrial proteins, mitochondrial protein import or translocation, ion import, ion homeostasis, nucleotide translocation, ATP translocation, mitochondrial fission, mitochondrial fusion, Ca++ compartmenta lization or homeostasis, steroid biosynthesis, a component of the urea cycle, fatty acid oxidation, a component of the tricarboxylic acid cycle, pyruvate metabolism, cellular redox balance, synthesis of precursor compounds for a mitochondrial function or activity, iron meta bolism, oxygen metabolism and any component or activity of the electron transport chain.
15. The composition according to claim 1 further comprising a substance selected from the group consisting of: Riboflavin (B2), L-Creatine, CoQIO, L-arginine , L-carnitine, vitamin C, cyclosporin A, manganese, magnesium, carnosine, vitamin E, resveratrol, -lipoic acid, folinic acid, dichloroacetate, succinate, prostaglandins (PG) prostacyclins, thromboxanes, prostanoic acid, 2- arachidonoylglycerol and glutathione.
16. The composition according to claim 1 wherein the substance is complexed by covalent or non-covalent bonding with non-hormonal or non-prohormonal material.
17. The composition according to claim 1 wherein the substance further comprises at least one lipophilic vitamin.
18. The composition according to claim 17 wherein the at least one lipophilic vitamin is selected from the group consisting of: vitamin A, vitamin D, vitamin E and vitamin K.
19. The composition according to claim 1 wherein the substance is administered using a device implanted sub-dermally in the animal.
20. The composition according to claim 19 wherein the composition is prepared using a 3D printing method.
21. A method for improving animal well-being comprising: delivering to a selected animal a dosage of androgen hormone or prohormone selected to improve at least one physiologic function in the selected animal.
22. The method according to claim 21 wherein:
a) testosterone level is assessed in an animal selected;
b) an amount of testosterone is selected to increase circulating testosterone to a desired level and to improve at least one facet of the select animal's physiology;
c) at least one composition is prepared, said composition comprising testosterone in an amount that taking into account the frequency and volume of said composition is designed to administer the amount selected in b); a nd
d) administering said at least one composition in accordance with the volume and frequency of c).
23 The method according to claim 21 wherein said at least one physiologic function is selected from the group consisting of: adipose metabolism, cardiac performance, glucose utilization, circulation, general nervous system activation or activity, hormonal secretion, salt (electrolyte) balance, function of a particular tissue or organ system, membrane transport across the membrane of one or more cell types, muscle activity, maintained muscle mass, 02 consumption, skin health and visual abilities.
24. The method according to claim 22 wherein after at least two weeks have elapsed from initiation of part d), parts a) through d) are repeated with an outcome that a desired androgen concentration remains is circulation.
25. The method according to claim 21 further comprising: delivering to a selected animal a promoter of mitochondrial function that is also selected to improve at least one physiologic function in the selected animal, said at least one physiologic function being identical to or differing from the at least one physiologic function targeted by the hormone or prohormone.
26. The method according to claim 21 further comprising assessing mitochondrial function in said animal, choosing a substance to improve said mitochondrial function, and administering said substance to said animal.
27. The method according to claim 24 further comprising assessing mitochondrial function in said animal, choosing a substance to improve said mitochondrial function, and administering said substance to said animal.
28. The method according to claim 21 wherein the at least one composition comprises one selected from the group consisting of: beef, elk, chicken, salmon, protein binder and a vitamin.
29. The method according to claim 21 wherein the at least one composition comprises one in a form selected from the group consisting of: a capsule, a tablet, a caplet, a liquid beverage, a powder, a liquid or powder beverage additive, a gel, a ready-to-eat food, either moist or dry, a chunk, a bar and a toy.
30. A method for improving animal well being comprising increasing circulating levels of SH BG protein in the blood.
31. The method according to claim 30 wherein SH BG is produced by enteric organisms cultured into the animals microbiome.
32. The method according to claim 30 wherein a SH BG porous capsule is introduced subcutaneously, said capsule comprising in its interior an expression system producing SH BG
33. The method according to claim 30 wherein the animal is genetically modified to increase
SH BG expression.
34. The method according to claim 33 comprising a lipoporous capsule is introduced
subcutaneously, said capsule comprising in its interior a system releasing androgenic substance capable of binding with SH BG.
PCT/US2017/056682 2016-12-21 2017-10-14 Healthier aging in domesticated animals WO2018118196A1 (en)

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US8859613B2 (en) * 2005-08-17 2014-10-14 Hill's Pet Nutrition, Inc. Compositions for the treatment of kidney disease
US20090054386A1 (en) * 2006-02-28 2009-02-26 Yuanlong Pan Compositions and Methods for Inducing Bone Growth and Inhibiting Bone Loss
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