The Influence of Different Foods and Food Ingredients on Acute Postprandial Triglyceride Response: A Systematic Literature Review and Meta-Analysis of Randomized Controlled Trials

Pharmacokinetics, Pharmacodynamics, Safety, and Tolerability of Stapokibart in Healthy Volunteers and Adult Subjects with Atopic Dermatitis

INTRODUCTION

Stapokibart, a novel humanized anti-interleukin (IL)-4 receptor alpha monoclonal antibody, inhibits the signaling of IL-4 and IL-13, which are key drivers of type 2 inflammation in atopic dermatitis (AD). This study aimed to assess the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of stapokibart in a randomized, double-blind, placebo-controlled single ascending dose (SAD) study and a multiple ascending dose (MAD) study.

METHODS

The SAD study enrolled 33 healthy male adults aged 18-65 years at a single center. The MAD study enrolled 39 patients with moderate-to-severe AD aged 18-70 years at seven centers. Enrolled subjects were randomized to subcutaneous (SC) doses of stapokibart (75-600 mg) or placebo. Serum thymus and activation-regulated chemokine (TARC) and total immunoglobulin E (IgE) were measured as PD biomarkers for stapokibart.

RESULTS

Similar PK characteristics were observed in healthy volunteers and subjects with AD after the initial administration. Stapokibart exhibited non-linear pharmacokinetics in both types of subjects. Following single doses, the mean maximum serum concentration (Cmax) ranged from 5.3 to 63.0 μg/mL, median Tmax ranged from 3.0 to 7.0 days, mean terminal half-life (t1/2z) ranged from 2.39 to 7.43 days, and mean apparent volume (Vz/F) ranged from 3.64 to 6.73 L in healthy subjects. The mean AUC accumulation ratio was 2.29 in subjects with AD after three doses of stapokibart 300 mg administered every 2 weeks. The median serum total IgE and TARC levels on day 43 decreased from baseline by 14.9-25.2% and 48.6-77.0%, respectively, among subjects with AD receiving three doses of stapokibart. No subjects developed grade ≥ 3 adverse events (AEs) or serious AEs or discontinued the study because of AEs. The incidence of AEs was similar between stapokibart and placebo groups.

CONCLUSION

Stapokibart showed favorable pharmacokinetics, pharmacodynamics, safety, and tolerability in the SAD and MAD studies. Based on these results, phase II and phase III trials of stapokibart have been performed in subjects with moderate-to-severe AD.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier NCT06161090 (29 November, 2023), NCT04893941 (15 May, 2021).

Short-Term Standard Diet Consumption Prior to the Oral Fat Tolerance Test Modulates the Postprandial Triglyceride Response

We hypothesized that the consumption of a 3-day standard diet (SD) prior to the oral fat tolerance test (OFTT), used to evaluate postprandial lipemia, may counteract the undesirable effects of individual dietary habits on the test results. The OFTT was applied to 22 healthy adults (11 females and 11 males), after their habitual diets (HDs) and following the consumption of a 3-day SD (45-60% energy from carbohydrate, 20-35% from fat, and 10-20% from protein). Plasma triglyceride (TG) concentrations were measured during fasting and at the fourth hour of the OFTT. A 3-day SD significantly reduced fasting and fourth-hour TG concentrations and delta TG values by 10%, 12.8%, and 22.7%, respectively. Decreases were observed in fasting and fourth-hour TG and delta TG values following the 3-day SD compared to the HD in subjects with fasting TG concentrations between 89 and 180 mg/dL (p = 0.062, p = 0.018, and 0.047, respectively). As a result, the consumption of a 3-day standardized diet prior to the OFTT may be useful to eliminate the false positive or negative effects of individual dietary habits on test results and to correctly identify individuals who should be administered the OFTT.

Plant-Based Nutrition: Exploring Health Benefits for Atherosclerosis, Chronic Diseases, and Metabolic Syndrome-A Comprehensive Review

Atherosclerosis, chronic non-communicable diseases, and metabolic syndrome are highly interconnected and collectively contribute to global health concerns that reduce life expectancy and quality of life. These conditions arise from multiple risk factors, including inflammation, insulin resistance, impaired blood lipid profile, endothelial dysfunction, and increased cardiovascular risk. Adopting a plant-based diet has gained popularity as a viable alternative to promote health and mitigate the incidence of, and risk factors associated with, these three health conditions. Understanding the potential benefits of a plant-based diet for human health is crucial, particularly in the face of the rising prevalence of chronic diseases like diabetes, hypertension, dyslipidemia, atherosclerosis, and cancer. Thus, this review focused on the plausible advantages of consuming a type of food pattern for the prevention and/or treatment of chronic diseases, emphasizing the dietary aspects that contribute to these conditions and the evidence supporting the benefits of a plant-based diet for human health. To facilitate a more in-depth analysis, we present separate evidence for each of these three concepts, acknowledging their intrinsic connection while providing a specific focus on each one. This review underscores the potential of a plant-based diet to target the underlying causes of these chronic diseases and enhance health outcomes for individuals and populations.

Metabolic and Molecular Response to High-Fat Diet Differs between Rats with Constitutionally High and Low Serotonin Tone

Maintaining energy balance is a complex physiological function whose dysregulation can lead to obesity and associated metabolic disorders. The bioamine serotonin (5HT) is an important regulator of energy homeostasis, with its central and peripheral pools influencing energy status in opposing ways. Using sublines of rats with constitutionally increased (high-5HT) or decreased (low-5HT) whole-body 5HT tone, we have previously shown that under standard diet constitutionally higher 5HT activity is associated with increased body weight, adiposity, and impaired glucose homeostasis. Here, we investigated the response of 5HT sublines to an obesogenic diet. Consistent with previous findings, high-5HT animals fed a standard diet had poorer metabolic health. However, in response to a high-fat diet, only low-5HT animals increased body weight and insulin resistance. They also showed more pronounced changes in blood metabolic parameters and the expression of various metabolic genes in hypothalamus and adipose tissue. On the other hand, high-5HT animals appeared to be protected from major metabolic disturbances of the obesogenic diet. The results suggest that constitutionally low 5HT activity is associated with higher susceptibility to harmful effects of a high-energy diet. High-5HT subline, which developed less adverse metabolic outcomes on hypercaloric diets, may prove useful in understanding metabolically healthy obesity in humans.

Postprandial glycemic and circulating SCFA concentrations following okara- and biovalorized okara-containing biscuit consumption in middle-aged and older adults: a crossover randomized controlled trial

Okara is a high-fiber food by-product that can be biotransformed with Rhizopus oligosporus to improve its nutritional value and palatability. This research aims to assess postprandial changes in glycemic-related and lipid-related outcomes in middle-aged and older Singaporeans following okara- and biovalorized okara-containing biscuit consumption. Fifteen participants (58 ± 6 years old, mean ± SD) completed the randomized crossover study. Participants were provided control (C), okara (AOK)-, and biovalorized okara (RO)-containing biscuits in separate 4 h mixed meal tolerance tests. Serum glucose and insulin, insulin indices, serum short-chain fatty acids (SCFA) and lipid-lipoprotein panels, and sensory analysis were assessed. Glucose-stimulated insulin secretion was significantly lower for RO than for C (p: 0.035) while log insulin incremental area under the curve (AUC) was significantly lower for AOK compared to that for C (p: 0.023). The estimated insulin sensitivity index and estimated metabolic clearance rate were significantly higher for AOK compared to that for C (p: 0.025 and 0.016 respectively). Normalized AUC for total SCFA was significantly higher for RO compared to that for C (p: 0.038). Normalized AUC for LDL-cholesterol was significantly higher for AOK than for C (p: 0.010). No significant difference was noted for glucose, total cholesterol, HDL-cholesterol, and triglyceride concentrations. RO had greater flavor and overall liking than AOK (p: 0.007 and 0.017 respectively). Biscuits incorporated with okara or biovalorized okara can attenuate postprandial insulin responses. RO offered a greater SCFA response than C, indicating improved SCFA concentrations upon consumption of okara improved with fermentation. The trial was registered under https://www.clinicaltrials.gov (NCT03978104, 25 May 2019).

Reduction of pulse "antinutritional" content by optimizing pulse canning process is insufficient to improve fat-soluble vitamin bioavailability

Some bioactive compounds found in pulses (phytates, saponins, tannins) display antinutritional properties and interfere with fat-soluble vitamin bioavailability (i.e., bioaccessibility and intestinal uptake). As canned chickpeas are consumed widely, our aim was to optimize the chickpea canning process and assess whether this optimization influences fat-soluble vitamin bioavailability. Different conditions during soaking and blanching were studied, as was a step involving prior germination. Proteins, lipids, fibers, vitamin E, lutein, 5-methyl-tetrahydro-folate, magnesium, iron, phytates, saponins and tannins were quantified. Bioaccessibility and intestinal uptake of vitamin D and K were assessed using in vitro digestion and Caco-2 cells, respectively. Significant reductions of phytate, saponin and tannin contents (-16 to -44%), but also of folate content (up to -97%) were observed under optimized canning conditions compared with the control. However, bioaccessibility and cellular uptake of vitamin D and K remained unaffected after in vitro digestion of test meals containing control or optimized canned chickpeas.

Advantages of Studying the Metabolome in Response to Mixed-Macronutrient Challenges and Suggestions for Future Research Designs

Evaluating the postprandial response to a dietary challenge containing all macronutrients-carbohydrates, lipids, and protein-may provide stronger insights of metabolic health than a fasted measurement. Metabolomic profiling deepens the understanding of the homeostatic and adaptive response to a dietary challenge by classifying multiple metabolic pathways and biomarkers. A total of 26 articles were identified that measure the human blood metabolome or lipidome response to a mixed-macronutrient challenge. Most studies were cross-sectional, exploring the baseline and postprandial response to the dietary challenge. Large variations in study designs were reported, including the macronutrient and caloric composition of the challenge and the delivery of the challenge as a liquid shake or a solid meal. Most studies utilized a targeted metabolomics platform, assessing only a particular metabolic pathway, however, several studies utilized global metabolomics and lipidomics assays demonstrating the expansive postprandial response of the metabolome. The postprandial response of individual amino acids was largely dependent on the amino acid composition of the test meal, with the exception of alanine and proline, 2 nonessential amino acids. Long-chain fatty acids and unsaturated long-chain acylcarnitines rapidly decreased in response to the dietary challenges, representing the switch from fat to carbohydrate oxidation. Studies were reviewed that assessed the metabolome response in the context of obesity and metabolic diseases, providing insight on how weight status and disease influence the ability to cope with a nutrient load and return to homeostasis. Results demonstrate that the flexibility to respond to a substrate load is influenced by obesity and metabolic disease and flexibility alterations will be evident in downstream metabolites of fat, carbohydrate, and protein metabolism. In response, we propose suggestions for standardization between studies with the potential of creating a study exploring the postprandial response to a multitude of challenges with a variety of macronutrients.