Tocotrienols Reverse Cardiovascular, Metabolic and Liver Changes in High Carbohydrate, High Fat Diet-Fed Rats

Weng-Yew Wong, Hemant Poudyal, Leigh C. Ward and Lindsay Brown

Nutrients 2012, 4, 1527-1541; doi:10.3390/nu4101527

Abstract

Tocotrienols have been reported to improve lipid profiles, reduce atherosclerotic lesions, decrease blood glucose and glycated haemoglobin concentrations, normalise blood pressure in vivo and inhibit adipogenesis in vitro, yet their role in the metabolic syndrome has not been investigated. In this study, we investigated the effects of palm tocotrienol-rich fraction (TRF) on high carbohydrate, high fat diet-induced metabolic, cardiovascular and liver dysfunction in rats. Rats fed a high carbohydrate, high fat diet for 16 weeks developed abdominal obesity, hypertension, impaired glucose and insulin tolerance with increased ventricular stiffness, lower systolic function and reduced liver function. TRF treatment improved ventricular function, attenuated cardiac stiffness and hypertension, and improved glucose and insulin tolerance, with reduced left ventricular collagen deposition and inflammatory cell infiltration. TRF improved liver structure and function with reduced plasma liver enzymes, inflammatory cell infiltration, fat vacuoles and balloon hepatocytes. TRF reduced plasma free fatty acid and triglyceride concentrations but only omental fat deposition was decreased in the abdomen. These results suggest that tocotrienols protect the heart and liver, and improve plasma glucose and lipid profiles with minimal changes in abdominal obesity in this model of human metabolic syndrome.

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Ongoing

Objective:
  In this study, we intend to determine Gamma-Delta Tocotrienol’s (GDT) safety and tolerability in patients with castrate-resistant prostate cancer (CRPC). In addition, GDT’s pharmacokinetic profile in this cohort of patients will be investigated.

Study Type: Interventional

Study Design: Dose-escalation, pharmacokinetics study

Subjects: Castrate-resistant prostate cancer patients

Intervention: Gamma-Delta Tocotrienol (GDT; Davos Life Science Pte Ltd)

Primary Outcome:

  • Safety and tolerability
  • GDT isomer plasma concentration [ time frame: 0, 1, 2, 3, 4, 6, 8, 10, 14, 24 hours ]

Secondary Outcome: Circulating tumor cell (CTC) levels and inflammatory biomarkers (IL-8, MCP-1, MIP-1 alpha, IFN-gamma, IL-1B, IL-4, IL-6, IL-10, IL-12 (p70), IL-17A, Il-23, IL-27, TNF-alpha, MIP-3 alpha, CRP) [time frame: baseline and day 22]

Methodology: During pharmacokinetic evaluation wherein GDT will be taken as a single dose, participants will receive oral GDT for 21 days at 400, 800, 1600, 2400 and 3200 mg/day for 21 days. Pharmakokinetic and safety profiles will be evaluated on the 8th, 15th and 22nd day.

Ongoing

Objective:
The purpose of this study is to determine the safest dose of the study drug Vitamin E delta-tocotrienol, how often it should be taken, and how well people with pancreatic tumors tolerate Vitamin E delta-tocotrienol.

Study Type: Interventional

Study Design: Open Label, Safety Efficacy Study

Subjects: Patients with resectable pancreatic neoplasia

Intervention: Vitamin E delta-tocotrienol (Davos Life Science Pte Ltd)

Primary Outcome:

  • To determine the recommended Phase II dose of Vitamin E δ-Tocotrienol which will be defined as the biologic effective dose (BED) which induces significant apoptosis in the pancreatic neoplastic cells of resected tumor

Secondary Outcome:

  • To characterize the safety and tolerability of Vitamin E δ-Tocotrienol

Methodology: This study consists of the following: (1) A Pre-Treatment Period in which participants are consented and qualified for the study; (2) A Study Treatment Period in which participant will receive Vitamin E δ-Tocotrienol administered orally twice daily for 14 (±2) consecutive days and once on the day of surgery, with associated pharmacokinetic and pharmacodynamic sampling; (3) A Post Treatment Period in which laboratory and physical examinations are performed. Adverse events will be recorded throughout the study.

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Ongoing

Study Type: Interventional

Study Design: Non-randomized, Open Label, Dose-finding, Safety Efficacy Study

Subjects: Healthy volunteers

Intervention: Vitamin E delta-tocotrienol (Davos Life Science Pte Ltd)

Primary Outcome:

  • Safety and tolerability of Vitamin E δ-Tocotrienol
  • Minimally effective dose (MED) or maximum tolerated dose (MTD) of Vitamin E δ-tocotrienol administered once.

Secondary Outcome:

  • Pharmacokinetic (PK) markers of Vitamin E δ-Tocotrienol in the plasma, urine, and neoplastic tissue of participants with pancreatic neoplasia.
  • Pharmacodynamic (PD) Markers of Vitamin E δ-Tocotrienol in the plasma, urine, and neoplastic tissue of participants with pancreatic neoplasia.

Methodology: Not available

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Ongoing

Study Type: Phase 1, Interventional
Study Design: Open Label, Safety Efficacy Study
Subjects: Healthy volunteers
Intervention: Vitamin E δ-tocotrienol (Davos Life Science Pte Ltd)

Primary Outcome:

  • Safety and tolerability of Vitamin E δ-Tocotrienol
  • Maximum administered dose (MAD) or maximum tolerated dose (MTD) of Vitamin E δ-Tocotrienol

Secondary Outcome:

  • Effects of dose on the plasma pharmacokinetic (PK) of Vitamin E δ-Tocotrienol
  • Biomolecular markers not limited to Erk, p-Erk, AKT, p-AKT, p27, Ki-67, and exportin.

Methodology: Vitamin E δ-Tocotrienol will be administered orally as a single agent twice daily for 14 consecutive days. Vitamin E δ-Tocotrienol is supplied as 100-mg, 200-mg, and 400-mg capsules. The first cohort will be dosed with δ-tocotrienol at 100 mg twice daily for 14 consecutive days. A minimum of 3 subjects is planned for each dosing cohort with Vitamin E δ-Tocotrienol dose escalation dependent on safety and available PK data from prior cohorts. At the MTD or MAD, 20 subjects will be enrolled.

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Ongoing

Objective: To compare the rate and extent of absorption and pharmacokinetics of the newly formulated Gamma-Delta formulation with TRF in healthy volunteers

Study Type: Interventional

Study Design: Randomized, double-blind, cross-over

Subjects: Healthy volunteers

Intervention: Gamma-delta tocotrienol, tocotrienol-rich fraction (Davos Life Science Pte Ltd)

Primary Outcome: Peak Plasma Concentration (Cmax) of drug [Time Frame: 0 to 24 hours after dosing ]

Methodology: Twelve healthy subjects will be admitted to a clinical study ward on the Day 0. Physical check up and the health status will be confirmed during check in. After fasting for a minimum of 10 hours overnight, each subject will be administered a single dose of TRF or Gamma-Delta after taking a standardized high-fat meal breakfast on Day 1. Thereafter, standard meals will be provided at 4 and 12 hours after dosing. Blood samples (5mL will be taken using an in-dwelling canula placed in the antecubital vein immediately before and at 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 10, 14, and 24 hours after dosing. Subjects will be admitted for 24 hours and discharged after the last blood sampling. During the study, blood pressure and the heart rate will be monitored regularly for safety profile.

After a one week wash out period, subject will return to the ward and be given the other formulation (TRF or GDT) and the same procedures will be repeated. Any adverse events that arise during the treatment will be recorded and followed up till resolution.

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Ongoing

Objective:
  To determine in patients with CF if oral administration of epigallocatechin gallate (EGCG) and Tocotrienol, both separate and in combination, modify CFTR splicing towards normal splicing as evaluated by improved Transepithelial Potential Difference (TEPD) assessment of chloride secretion.

Study Type: Interventional

Study Design:
Randomized, Open Label, Cross-Over Study

Subjects: Patients with cystic fibrosis

Intervention:
1) Dietary Supplement– ECGC
2) Dietary Supplement — Tocotrienol
3) Dietary Supplement — EGCG + Tocotrienol

Primary Outcome:

  • Safety and Efficacy. Changes in nasal chloride secretion as assessed by TEPD,

Secondary Outcome:

  • Pulmonary function
  • Levels of CFTR mRNA
  • Cytokine levels in sputum ­­­­­­­­­
  • TEPD measures of ion channel activity

 Methodology: Patients with CF carrying splicing mutations will be treated with EGCG 200 mg/day, Tocotrienol 600mg/day or both for 28 day cycles. Clinical parameters (TEPD, FEV1 and cytokine levels in sputum) and molecular parameters (mRNA levels,) will be analyzed to determine the effectiveness of the treatment.  In vitro studies with cell cultures derived from CF patients have shown positive results; therefore an improvement in TEPD will be an indication for CFTR expression. An increase in mRNA levels and changes in FEV1, and cytokine levels will confirm the results.

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Completed

Objective:
Despite the emerging interest in tocotrienols, the absorption of tocotrienols in humans remains unclear especially with different fat diets. This study aimed at evaluating the absorption and distribution of tocotrienols in plasma and lipoproteins in associations with high and low fat diets. Different fat level will affect the absorption and distribution of tocotrienols.

Study Type: Interventional

Study Design: Randomized, single blind, cross-over

Subjects: Healthy Volunteers

Intervention: Tocotrienol

Primary Outcome:

  • Plasma, chylomicron, and HDL level of tocotrienol [Time Frame: 0, 0.5, 1, 1.5, 2, 3, 4, 5, 6, 24 hours after tocotrienol administration and intake of designated meal ]

Methodology: Not available

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Completed

Objective:
Levels of tocotrienol in human tissues following supplementation is not currently known. The objective of this present study is to determine the levels of this form of vitamin E in the human tissues such as skin, heart, lung, liver, adipose tissue, brain and cerebrospinal fluid (CSF) following oral supplementation.

Study Type: Interventional

Study Design: Non-randomized, single-blind

Subjects: 1) Healthy volunteers 2) Patients requiring surgery

Intervention: Tocotrienol, Tocopherol

Primary Outcome:

  • Measure levels of tocotrienol in the tissues of “not-healthy” subjects and in the tissue of “healthy” subjects following oral supplementation (200 mg x 2 per day for 4-24 weeks) after at least 1 month of supplementation.

Methodology: Not available

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Completed

Objective:
Despite the emerging interest in tocotrienols, the absorption of tocotrienols in humans remains unclear especially with different fat diets. This study aimed at evaluating the absorption and distribution of tocotrienols in plasma and lipoproteins in associations with high and low fat diets. Different fat level will affect the absorption and distribution of tocotrienols.

Study Type: Interventional

Study Design: Randomized, single blind, cross-over

Subjects: Healthy Volunteers

Intervention: Tocotrienol

Primary Outcome:

  • Plasma, chylomicron, and HDL level of tocotrienol [Time Frame: 0, 0.5, 1, 1.5, 2, 3, 4, 5, 6, 24 hours after tocotrienol administration and intake of designated meal ]

Methodology: Not available

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