Waldmann’s Disease Revealed by Chronic Diarrhea and Lymphedema: Case Report

Intestinal lymphangiesctasia (IL) is a rare disease characterized by the dilation of intestinal lymphatics. It can be classified as primary or secondary depending on the underlying etiology. Usually seen in childhood or adolescence, chronic diarrhea and diffuse edema are the main clinical manifestations of the disease. True lymphoedemas can also be present and affect the lower and upper limbs, they are concomitant with the diagnosis or occur during the course. The diagnosis is based on the visualization of duodenal lymphangiesctasia. The primitive nature of the disease being affirmed by the elimination of the diseases causing secondary lymphangiectasias. Treatment is based on a strict hypo lipid diet enriched with medium chain triglycerides (MCTs). We present through this work the observation of a 12-month-old infant who presented with primary intestinal lymphangiesctasia revealed by chronic diarrhea with lymphoedema of the left upper limb.

Fat-Soluble Vitamin Supplementation Using Liposomes, Cyclodextrins, or Medium-Chain Triglycerides in Cystic Fibrosis: A Randomized Controlled Trial

Fat-soluble vitamin deficiency remains a challenge in cystic fibrosis (CF), chronic pancreatitis, and biliary atresia. Liposomes and cyclodextrins can enhance their bioavailability, thus this multi-center randomized placebo-controlled trial compared three-month supplementation of fat-soluble vitamins in the form of liposomes or cyclodextrins to medium-chain triglycerides (MCT) in pancreatic-insufficient CF patients. The daily doses were as follows: 2000 IU of retinyl palmitate, 4000 IU of vitamin D3, 200 IU of RRR-α-tocopherol, and 200 µg of vitamin K2 as menaquinone-7, with vitamin E given in soybean oil instead of liposomes. All participants received 4 mg of β-carotene and 1.07 mg of vitamin K1 to ensure compliance with the guidelines. The primary outcome was the change from the baseline of all-trans-retinol and 25-hydroxyvitamin D3 concentrations and the percentage of undercarboxylated osteocalcin. Out of 75 randomized patients (n = 28 liposomes, n = 22 cyclodextrins, and n = 25 MCT), 67 completed the trial (89%; n = 26 liposomes, n = 18 cyclodextrins, and n = 23 MCT) and had a median age of 22 years (IQR 19–28), body mass index of 20.6 kg/m2 [18.4–22.0], and forced expiratory volume in 1 s of 65% (44–84%). The liposomal formulation of vitamin A was associated with the improved evolution of serum all-trans-retinol compared to the control (median +1.7 ng/mL (IQR −44.3–86.1) vs. −38.8 ng/mL (−71.2–6.8), p = 0.028). Cyclodextrins enhanced the bioavailability of vitamin D3 (+9.0 ng/mL (1.0–17.0) vs. +3.0 ng/mL (−4.0–7.0), p = 0.012) and vitamin E (+4.34 µg/mL (0.33–6.52) vs. −0.34 µg/mL (−1.71–2.15), p = 0.010). Liposomes may augment the bioavailability of vitamin A and cyclodextrins may strengthen the supplementation of vitamins D3 and E relative to MCT in pancreatic-insufficient CF but further studies are required to assess liposomal vitamin E (German Clinical Trial Register number DRKS00014295, funded from EU and Norsa Pharma).

Vitamin E Acetate Determination in Vaping Liquids and Non-targeted Analysis of Vaping Emissions of Diluents of Concern, Vitamin E Acetate and Medium-Chain Triglycerides Oil

During the summer of 2019, cases of lung injury associated with vaping emerged in North America, including among individuals who reported exclusive use of nicotine vaping liquids. Once vitamin E acetate was identified as a potential causative agent a quantitative method based on a simple sample dilution, separation by gas chromatography and analysis by triple quadrupole mass spectrometry (GC MSMS) was developed. Method detection limit (MDL) and limit of quantification (LOQ) were determined at 0.159 µg/mL and 0.505 µg/mL, respectively. The analysis was performed on a subset of 203 commercially sourced nicotine containing vaping liquids of various flavour profile and nicotine range (nicotine free-59 mg/mL) from an internal inventory. The target analyte, Vitamin E Acetate, was not detected in any samples analyzed, as expected, given the reported detection in literature and high association of the chemical with cannabis and not nicotine containing vaping products.

An Intricate Review on Nutritional and Analytical Profiling of Coconut, Flaxseed, Olive, and Sunflower Oil Blends

Vegetable oils (VOs), being our major dietary fat source, play a vital role in nourishment. Different VOs have highly contrasting fatty acid (FA) profiles and hence possess varying levels of health protectiveness. Consumption of a single VO cannot meet the recommended allowances of various FA either from saturated FA (SFA), monounsaturated FA (MUFA), polyunsaturated FA (PUFA), Ω-3 PUFAs, and medium-chain triglycerides (MCTs). Coconut oil (CO), flaxseed oil (FO), olive oil (OO), and sunflower oil (SFO) are among the top listed contrast VOs that are highly appreciated based on their rich contents of SFAs, Ω-3 PUFAs, MUFAs, and Ω-6 PUFA, respectively. Besides being protective against various disease biomarkers, these contrasting VOs are still inappropriate when consumed alone in 100% of daily fat recommendations. This review compiles the available data on blending of such contrasting VOs into single tailored blended oil (BO) with suitable FA composition to meet the recommended levels of SFA, MUFA, PUFA, MCTs, and Ω-3 to Ω-6 PUFA ratios which could ultimately serve as a cost-effective dietary intervention towards the health protectiveness and improvement of the whole population in general. The blending of any two or more VOs from CO, FO, OO, and SFO in the form of binary, ternary, or another type of blending was found to be very conclusive towards balancing FA composition; enhancing physiochemical and stability properties; and promising the therapeutic protectiveness of the resultant BOs.

Functional Lipids as Nutraceuticals: A Review

Stephen L. Defelice, founder and chairman of the Foundation of Innovation Medicine, created the term "Nutraceuticals" in 1989 as a combination of the words "nutrition" and "pharmaceutical." Nutraceuticals are food-derived products that are claimed to give additional health advantages in addition to the fundamental nutritional content present in meals. Their kinds may be more significant than their quantity in terms of health and disease. The aim of this review is to provide a summary of the research on the role of functional lipids namely: Omega -6 fatty acid, Omega -3 fatty acid, Conjugated linoleic acid, Medium chain triglycerides and Phytosterols as nutraceuticals in human health. Functional lipids have been related to the prevention and treatment of a variety of ailments, according to new study. With the use of supplementary and dietary forms of functional lipids, scientific data has demonstrated positive improvements in patients and favorable benefits in healthy people. Keywords: Nutraceuticals, Functional lipids, Conjugated linoleic acid, Medium chain triglycerides, Omega -6 fatty acid, Omega -3 fatty acid, Phytosterols,

Formulation Optimization and Characterization of Spray-Dried Medium Chain Triglycerides-Rich Oil

Medium chain triglycerides (MCT) are important substrates of the energy metabolism and anabolic processes in mammals. In this study, MCT-rich oil was encapsulated in the mixing ratios of maltodextrin and protein by spray drying to produce spray-dried MCT-rich oil (SMCT). Spray-dried conditions were an inlet temperature of 200 °C, an outlet temperature of 90 °C, and a flow rate of 0.70 L/h. Box–Behnken experimental design and response surface methodology were applied for modeling the influence of formulation variables on powder recovery of SMCT. The key variables were concentration of maltodextrin (10-30% W/W), total protein (5–15% w/w), and MCT-rich oil (5–15% w/w). The microparticles were characterized in terms of particle morphology, yield, Carr's index, moisture content, flowability, hygroscopicity, and powder diffraction. The highest yield of SMCT was 41.19% obtained under the optimized conditions (maltodextrin concentration of 15% w/w, total protein concentration of 8% w/w, MCT-rich oil concentration of 15%). Experimentally obtained values were consistent with those predicted by the model, indicating the suitability of the employed model and the success of the model in optimizing the formulation.

A Novel Lipase from Lasiodiplodia theobromae Efficiently Hydrolyses C8-C10 Methyl Esters for the Preparation of Medium-Chain Triglycerides’ Precursors

Medium-chain triglycerides (MCTs) are an emerging choice to treat neurodegenerative disorders such as Alzheimer’s disease. They are triesters of glycerol and three medium-chain fatty acids, such as capric (C8) and caprylic (C10) acids. The availability of C8–C10 methyl esters (C8–C10 ME) from vegetable oil processes has presented an opportunity to use methyl esters as raw materials for the synthesis of MCTs. However, there are few reports on enzymes that can efficiently hydrolyse C8–C10 ME to industrial specifications. Here, we report the discovery and identification of a novel lipase from Lasiodiplodia theobromae fungus (LTL1), which hydrolyses C8–C10 ME efficiently. LTL1 can perform hydrolysis over pH ranges from 3.0 to 9.0 and maintain thermotolerance up to 70 °C. It has high selectivity for monoesters over triesters and displays higher activity over commercially available lipases for C8–C10 ME to achieve 96.17% hydrolysis within 31 h. Structural analysis by protein X-ray crystallography revealed LTL1’s well-conserved lipase core domain, together with a partially resolved N-terminal subdomain and an inserted loop, which may suggest its hydrolytic preference for monoesters. In conclusion, our results suggest that LTL1 provides a tractable route towards to production of C8–C10 fatty acids from methyl esters for the synthesis of MCTs.