Search Results (117)

Medium-chain fatty acid triglycerides (MCTs) possess antibacterial, antiviral, nutritional, and other biological activities and have demonstrated significant application potential in humans and terrestrial animals. In recent years, with the development of the green aquaculture industry, MCTs have been gradually applied to aquaculture animals, which can enhance growth performance, improve flesh quality, regulate lipid metabolism, boost immune activity, and modulate the intestinal flora, thereby improving the production efficiency of aquaculture. This paper elaborates in detail on the biological activities of MCTs and their applications in aquatic animals, providing a theoretical and practical basis for the application of MCTs in aquaculture. Full article

Background: The long-term clinical and laboratory results of a 33-year follow-up of a Greek family with abetalipoproteinemia (ABL) are described. Case Report: The patients (two brothers and their sister, aged 57, 49, and 62 years, respectively) are still alive, being under close surveillance. In two of the three patients, diarrhea appeared in early infancy, while in the third, it appeared during adolescence. CNS symptomatology worsened after the second decade of life. At the same time, night blindness appeared in the advanced stages of the disease, resulting in almost complete loss of vision in one of the male patients and severe impairment in the other. The diagnosis was based on the clinical picture, ophthalmological findings, serum lipid estimations, and presence of peripheral acanthocytosis. All patients exhibited typical serum lipidemic profile, ophthalmological findings, and acanthocytes in the peripheral blood. During the follow-up period, strict dietary modifications were applied, including the substitution of fat with medium-chain triglycerides (MCT oil). After 33 years since the initial diagnosis, all patients are alive without any sign of liver dysfunction despite continuous use of MCT oil. However, symptoms from the central nervous system and vision impairment worsened. Conclusion: The course of these patients suggests that the application of a modified diet, including MCT oil, along with close surveillance, could prolong the survival of patients without significant side effects from the liver. Full article

Background: Self-emulsifying drug delivery system (SEDDS) is widely used to improve the oral bioavailability of hydrophobic drugs. Emulsion droplet size was revealed to be a critical parameter that influences the thermodynamic stability, drug solubility, and drug absorption of the SEDDS. A high proportion of surfactant and/or co-surfactant was usually employed to reduce the particle size, which may lead the low drug loading and undesirable gastrointestinal toxicity. Methods: This manuscript proposed a novel strategy to reduce the particle size of emulsions using the hybrid of medium and long-chain triglyceride (MCT and LCT) SEDDS without promoting the concentration of surfactants and co-surfactants. The composition of SEDDS was selected based on the drug solubility. Particle size distribution and zeta potential of emulsion particles were determined using the dynamic light scattering technique. The bioavailability of formulations was evaluated in a mouse model. Results: The particle size of the emulsion was reduced from 113.50 ± 0.34 nm (MCT SEDDS) and 371.60 ± 6.90 nm (LCT SEDDS) to 21.23 ± 0.30 nm (MCT&LCT SEDDS). Progesterone, a poorly water-soluble drug, was selected as the model drug in the investigation of SEDDS. The hybrid of MCT&LCT progesterone SEDDS exhibited reduced particle size, enlarged self-emulsifying ranges, and increased drug content in the aqueous phase after lipolysis compared with the conventional mono-MCT or LCT SEDDS. In addition, the bioavailability of progesterone in the MCT&LCT SEDDS formulation was 3.82-fold higher than that of Utrogestan^® (a clinical oral administrated product) in a mouse model. Full article

Medium chain triglycerides (MCTs) are regarded as an important ingredient for functional foods and nutraceuticals. Cinnamomum camphora seed kernel oil (CCSKO) contains more than 95% medium chain fatty acids (MCFAs), which is a significantly higher level than palm kernel oil (62%) and coconut oil (55%). However, the safety assessment of CCSKO, as the only natural MCT oil rich in capric acid and lauric acid found so far in the world, has not been fully verified. The study aimed to investigate the 90-day sub-chronic oral toxicity and teratogenicity of CCSKO. In the sub-chronic oral toxicity study, no clinically significant adverse events occurred in male or female Sprague–Dawley (SD) rats with CCSKO daily administration for 13 weeks. Moreover, there were no dose–response relationships between CCSKO and body-weight gain, food intake and food utilization in male or female SD rats. No significant differences (p > 0.05) were found in the hematological properties or organ weights between the male and female SD rats. In the teratogenicity test, no toxicological signs were observed in either Wister pregnant rats or fetuses. The no-observed-adverse-effect level of CCSKO was determined to be more than 4 mL/kg body weight. These results suggested that CCSKO may be an excellent edible oil with high oral safety. Full article

Objectives: Omega-3 fatty acids (n-3 FA) exhibit pro-healing and anti-inflammatory properties. Injectable lipid emulsions containing n-3 FA are being explored for the treatment of acute adverse conditions. Our previous studies demonstrated that a triglyceride (TG)-rich emulsion (TGRP) containing medium-chain TG (MCT) and n-3 TG (8:2 ratio) is rapidly cleared from the blood and efficiently taken up by organs. This study systematically examined the impact of varying MCT:n-3 ratios on cellular uptake and metabolic function in inflammatory processes. Methods and results: We measured the uptake of radio-labeled TGRP, comprising pure MCT, n-3, or mixed at selected ratios (8:2, 6:4, 2:8), both in vitro and in vivo. Murine macrophages with MCT:n-3 (6:4 or 2:8) had a 2-fold higher TG uptake. IV-injected mixed TGRP also enhanced blood clearance and organ uptake. n-3 TGRP reduced LPS-induced pro-inflammatory cytokines (TNF-α, IL-1, IL-6) in a dose-dependent manner. The 8:2 ratio enhanced mitochondrial respiration and glycolytic capacity in macrophages. Pro-inflammatory lipids decreased with MCT:n-3 (2:8) and pure n-3 TGRP. Bolus injections of n-3 TGRP with MCT lowered LPS-induced IL-6 in plasma and tissues. Conclusions: MCT and n-3 FA support metabolic activity and exhibit anti-inflammatory effects, suggesting that optimizing their ratio may enhance the therapeutic effects of emulsions for inflammatory conditions. Full article

Background: Developmental epileptic encephalopathies (DEEs) are often associated with variably severe cognitive and motor impairment and frequent refractory epilepsy, with many children not achieving adequate seizure control via standard antiepileptic medications. The classic ketogenic diet (KD) has proven effective in reducing seizure frequency and/or severity in a category of DEEs and in certain refractory epilepsies of infancy. However, its multifaceted mechanisms, e.g., epigenetic modulation, anti-inflammatory and antioxidative effects, and direct neuronal excitability changes, are balanced by a high burden and low long-term adherence. Medium-chain triglycerides (MCTs), particularly decanoic acid (C10:0), have gained attention in recent years for their potential direct inhibitory action on AMPA receptors, contributing to seizure reduction. Methods: A systematic review was conducted, including articles from January 2000 to January 2025, to explore the potential role of medium-chain triglyceride (MCT) add-on to classic KD and as MCT supplementation in free diets in the management of pediatric drug-resistant epilepsy (DRE). Results: Selected studies show how the action of MCTs, and decanoic acid in particular, is via negative modulation of AMPA receptors, with a positive impact on epileptic seizures. Conclusions: This review discusses the complexities of implementing and sustaining KD in children and presents recent pre-clinical and clinical evidence, including trials where MCTs (often enriched in decanoic acid) serve as an add-on therapy in both ketogenic and free/unrestricted diets. The summarized findings reinforce the therapeutic potential of MCTs, highlighting both the beneficial seizure outcomes and the hurdles that remain to be addressed through future research. Full article

Investigating the adsorption properties of emulsifiers at water–oil interfaces enables advances in the comprehension of the mechanisms governing emulsion ageing and stabilization. The utilization of natural compounds in emulsion formulations is increasingly relevant for those applications where it is challenging to maintain a low impact on the environment and health. We report here a study on saponin and chitosan at the interface between water and medium-chain triglycerides (MCT) oil in relation to the properties of the corresponding emulsions. Complementary experimental approaches have been adopted to investigate interfacial properties and emulsion evolution, relying on drop tensiometry, optical and confocal microscopy, and light transmission/scattering analysis. In addition, molecular dynamics simulation has been undertaken as support for the interpretation of the experimental results. The multi-technique investigation adopted here enabled a better understanding of saponin adsorption properties and of the role of chitosan in emulsion evolution. In particular, the results evidence the formation of amphiphilic saponin–chitosan complexes, which adsorb at the liquid–liquid interface and improve the stability of oil-in-water emulsions. Since the system investigated mainly consists of natural compounds, the results of this work can contribute to the development of new and efficient low-impact formulations. Full article

Background/Objectives: Dietary supplementation with medium-chain triglycerides (MCTs) improves walking balance and cognitive function in healthy older adults. This study aimed to determine the biological effects of MCTs on gait-related skeletal muscles in healthy older adults by analyzing muscle density and glucose metabolism. Methods: ¹⁸F-FDG-PET/CT imaging data from 63 participants (18 g/day of MCTs and matching placebo in the form of a jelly stick [6 g each, ingested 3 times/day]) in a randomized clinical trial were analyzed. The three-dimensional regions of interest were set as muscles associated with walking balance (bilateral triceps, psoas, and vastus medialis). Each muscle’s mean standardized uptake value (SUV_mean) and Hounsfield units (HU) were calculated for relative quantitative measurements. Results: MCT supplementation for 3 months decreased the SUV_mean (p < 0.001) and increased the HU of the psoas (r = −0.61) and vastus medialis muscles (r = −0.59) (p < 0.001); no changes were apparent in participants supplemented with long-chain triglycerides. The changes in the SUV_mean for each muscle were correlated negatively with those of plasma β-hydroxybutyrate in MCT-supplemented participants (r = −0.57 [psoas] and −0.59 [vastus medialis]; p < 0.001). Conclusion: A 3-month MCT supplementation suppressed glucose metabolism and increased the muscle density in gait-related skeletal muscles, consistent with previous findings that MCT supplementation stabilizes balance functions during walking in healthy older adults. Full article

Background/Objectives: Sarcopenia and malnutrition are common in post-stroke patients, impairing recovery. Medium-chain triglycerides (MCT) may support muscle metabolism, while chair-stand exercises improve strength and mobility. However, their combined effects remain unclear. This study evaluated the synergistic effects of MCT supplementation and high-frequency chair-stand exercise on physical function and muscle health in post-stroke patients. Methods: A retrospective cohort study included 1080 post-stroke patients categorized into three groups: (1) MCT supplementation alone, (2) chair-stand exercise alone, and (3) both combined. MCT supplementation consisted of ~40 g/day MCT oil or powder. Functional outcomes were assessed using the Functional Independence Measure (FIM-motor), while muscle health was evaluated by handgrip strength (HGS) and skeletal muscle index (SMI). Multiple linear regression analyses were performed, adjusting for confounders. Results: The combined intervention group showed significantly greater improvements in FIM-motor scores at discharge (B = 8.79, 95% CI: 5.64–11.95, β = 0.32, p < 0.001) and FIM-motor gain (B = 6.02, 95% CI: 3.42–8.62, β = 0.29, p < 0.001) compared to the control. Increases in HGS (B = 2.441, 95% CI: 0.483–4.398, β = 0.18, p = 0.015) and SMI (B = 0.194, 95% CI: 0.102–0.419, β = 0.12, p = 0.039) were also observed. Chair-stand exercise was performed a median of 62 times/day and independently improved outcomes, while MCT alone had limited effects. Conclusions: MCT supplementation combined with chair-stand exercise enhances functional recovery and muscle health in post-stroke patients, supporting its role in rehabilitation. Further research is needed to evaluate long-term effects and to examine the pharmacokinetics of MCTs, including blood concentrations, in broader populations. Full article

Background: The incidence of external lymphatic fistula (ELF) represents a relatively rare complication after surgery for colorectal cancer, especially in Western countries. However, the rate of this complication is progressively increasing following the introduction of complete mesocolic excision and central vascular ligation with consequent extensive lymphadenectomy. There are no guidelines for the management of ELF, with therapeutic options varying from conservative procedures to more invasive surgeries. The aim of this study was to retrospectively quantify the rate of ELF after surgery for colorectal cancer, to describe its management, and to evaluate its clinical impact on early postoperative outcomes in a tertiary referral European centre. Methods: Data on all patients who underwent surgery for colorectal cancer at our institution between July 2022 and December 2024 were entered into a database. Preoperative, perioperative, and early (within 30 days) postoperative data were recorded. Results: A total of 279 patients underwent elective surgery for colorectal cancer (205 colon and 74 rectum). No postoperative deaths occurred within 30 days after surgery, and the rates of overall and major (grade ≥ 3) postoperative morbidity were 34.7% and 7.1%, respectively. The anastomotic leakage and reoperation rates were 2.8% and 5.3%, respectively. ELFs occurred in 15 patients (5.3%). In all patients, conservative treatment (based on fasting, total parenteral nutrition (TPN), and a prolonged medium-chain triglyceride (MCT) diet) was administered successfully. A recurrent ELF (after the first oral feeding resumption) occurred in four (26.6%) patients, but all were successfully treated with a conservative approach. The occurrence of an ELF prolonged the postoperative length of stay which was 12 days, a length higher than that recorded in patients without ELF. Conclusions: The occurrence of an ELF was found to be a relatively frequent complication after surgery for colorectal cancer and appears to negatively influence only the postoperative length of stay. Conservative management appeared to be a successful treatment. Full article

Background: Nutraceuticals represent a strategy for maintaining health and constitute a brilliant market in Italy and across Europe. However, the absence of strict regulations regarding formulation requirements highlights a critical issue: their poor bioavailability. An example is coenzyme Q10 (CoQ10), a quinone known for its potential as a mitochondrial protective agent but characterized by low intestinal absorption. CoQ10 is a hydrophobic molecule with high molecular weight and poor water solubility, factors that significantly limit its intestinal bioaccessibility and, consequently, its oral bioavailability. Objectives: In this context, the present study describes a novel formulation designed to enhance CoQ10 bioaccessibility through in situ emulsification upon contact with gastroenteric fluids. This technology, termed Lipid-Based Auto-Emulsifying Drug Delivery System (LiBADDS), is unique because it combines a medium-chain triglyceride (MCT), a long-chain fatty acid, conjugated linoleic acid (CLA) with a high HLB solubilizer, Polysorbate 80 (PS80), and a sodium octenyl succinate starch derivative (SOS), which can create a nanometric emulsion simply by aqueous dispersion and upon contact with gastrointestinal fluids. This phenomenon promotes the prompt dispersion of CoQ10 and its rapid translocation into the serosal compartment of the intestinal epithelium. Methods: Its efficacy was evaluated in vitro through the Caco-2 cellular model and in vivo through a crossover study on healthy volunteers, measuring pharmacokinetic parameters such as AUC, C_max, T_max, ΔAUC, and ΔC_max. Results: Overall, LiBADDS demonstrated a significant improvement in both the bioaccessibility and bioavailability of CoQ10 compared to the unformulated substance. Conclusions: LiBADDS showed to be a promising tool to improve CoQ10 bioavailability by enhancing its bioaccessibility. Full article

Biliary atresia, a rare pediatric liver condition, results in blocked bile ducts, impeding bile secretion and causing significant nutritional challenges. This perspective emphasizes the critical role of nutrition in supporting children with biliary atresia awaiting liver transplantation. The liver’s multifaceted functions in energy metabolism, vitamin storage, and waste excretion emphasize the importance of tailored dietary interventions. Medium-chain triglyceride (MCT) oil serves as a crucial energy source, addressing fat malabsorption, while specialized water-soluble formulations deliver essential fat-soluble vitamins. Additionally, weaning strategies and developmental food practices are discussed to ensure optimal growth and development despite dietary restrictions. Feeding assistance through nasogastric or gastrostomy tubes is explored as a means to combat malnutrition and support liver function. The collective efforts of caregivers and healthcare providers are pivotal in preparing these children for successful liver transplantation, aiming to secure their future health and quality of life. Full article

Background/Objectives: This study aims to develop a solid self-nanoemulsifying drug delivery system (SNEDDS) to enhance the solubility and oral bioavailability of cannabidiol (CBD). Methods: According to the solubility of CBD and pseudo-ternary phase diagrams of the different ingredients, an oil (medium-chain triglyceride, MCT), mixed surfactants (Labrasol, Tween 80), and a co-surfactant (Transcutol) were selected for the SNEDDS. CBD-loaded SNEDDS formulations were prepared and characterized. The optimal SNEDDS was converted into solid SNEDDS powders via solid carrier adsorption and spray drying techniques. Various evaluations including flowability, drug release, self-emulsifying capacity, X-ray diffraction (XRD), differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FTIR), morphology, and pharmacokinetic characteristics were conducted. Subsequently, the solid powders with fillers, disintegrants, and lubricants were added to the capsules for accelerated stability testing. Results: The investigations showed that the two S-SNEDDS formulations improved the CBD’s solubility and in vitro drug release, with good storage stability. The pharmacokinetic data of Sprague Dawley rats indicated that a single oral dose of L-SNEDDS and spray drying SNEDDS led to a quicker absorption and a higher Cmax of CBD compared to the two oil-based controls (CBD-sesame oil (similar to Epidiolex^®) and CBD-MCT), which is favorable for the application of CBD products. Conclusions: SNEDDS is a prospective strategy for enhancing the solubility and oral bioavailability of CBD, and solid SNEDDS offers flexibility for developing more CBD-loaded solid formulations. Moreover, SNEDDS provides new concepts and methods for other poorly water-soluble drugs. Full article

Medium-chain triglycerides (MCTs) have been known to have multiple health benefits in treating metabolic disorders and reducing the incidence of obesity. In the present study, the partial replacement of lard with MCTs assisted by ultrasound treatment on the emulsifying stability and adsorption behavior of myofibrillar protein (MP) was investigated. The results revealed that ultrasound-assisted MCT emulsion had better emulsifying activity and emulsion stability than other groups. MCTs with ultrasound treatment considerably lowered the particle size, facilitated the formation of much smaller and more homogeneous emulsion droplets, and enhanced the oxidative stability of the emulsion. The emulsion had a pseudo-plastic behavior determined through static and dynamic rheological studies, and the MCT emulsion exhibited a larger viscosity and a greater storage modulus (G′) compared with the lard emulsion. MCTs could promote protein adsorption levels at the O/W interface, forming a dense interfacial protein film. The surface hydrophobicity and reactive sulfhydryl content increased, accompanied by the transformation of α-helix and β-turn structure to β-sheet and random coil structure, indicating MCTs combined with ultrasound-induced unfolding and crosslinking of MP at the interface. The results suggested that MCTs may have the potential to enhance emulsifying properties in emulsion-type meat products. Full article

In response to recent regulatory guidelines, including ICH (International Council for Harmonisation) Q2 (R2) and Q14, we developed a UPLC-ELSD method to quantify Medium-Chain Triglycerides (MCTs) in Labrafac™ WL 1349 for nanoemulsion applications. This procedure, crafted using Analytical Quality by Design (AQbD) principles, addresses not only the validation of the methodology but also the lifecycle management challenges associated with the analysis of lipid-based excipients. Key parameters such as mobile phase composition, organic modifier, column type, flow rate, diluent, and column temperature were optimized to meet regulatory standards and ensure robustness in MCT quantification. Optimal conditions were achieved with a Waters Acquity HSS T3 (100 × 2.1 mm i.d., 1.8 μm) column at 33 °C, using a mixture of methanol (97.5%) and water (2.5%) containing 0.4% of formic acid at a flow rate of 0.41 mL/min. The method demonstrated an excellent fit on a cubic modelization for MCTs over a broad range of concentrations. Forced degradation studies, including hydrolytic (acidic and basic), oxidative, and thermal stress, confirmed the method’s suitability for possible stability scenarios. This validated UPLC method was successfully applied to quantitative analyses of bulk and formulation prototype samples containing MCTs. This AQbD-driven method enhances not only knowledge but also regulatory-compliant and cost-effective excipient control. Full article