Combining ultrasound and lactobacilli treatment for high‐fat‐diet‐induced obesity in mice

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The obesity epidemic is a major public health concern. Obesity is known to be influenced strongly by genetics, with up to 40% of the variation in the body fat content being attributed to genetic factors (Bouchard, 1996). The genetic variability in the gene encoding human beta adrenoceptor‐2 could be of major importance for obesity (Large et al., 1997). Obesity results from a long‐term imbalance between energy intake and energy expenditure (Kotzampassi et al., 2014). It has also been suggested that the microbiota is one of the environmental factors that is involved in the control of body weight and energy homeostasis (Bäckhed et al., 2004; Ley et al., 2005; Turnbaugh et al., 2006). The gut microbiota interacts with the host in the metabolic response to diet, and early microbial aberrancies may be linked to the development of obesity and metabolic disorders later in life. It has also recently been proposed that probiotics affect metabolic programming and possess anti‐obesity effects (Aronsson et al., 2010). In a previous study, we investigated the combined use of a putative fat‐reducing dietary supplement, chitosan, which is used to treat hyperlipidemic diseases and fatty liver, and ultrasound (US) to control body weight and local fat deposition in normal‐diet mice over a 5‐week experimental period (Liao et al., 2013). We found that this combination therapy significantly decreased local fat pad deposition, body weight and plasma lipid levels in these mice. However, the effects of that type of combination treatment in animals fed a high‐fat diet (HFD) and with different dietary supplements over the long term are unclear. Free feeding with an HFD causes body weight gain and visceral fat accumulation (Haraguchi et al., 2014).
Several articles have been published on the potential clinical applications of lactobacilli in the treatment of obesity. In one study, the anti‐obesity effect of 8 weeks of supplementation with Lactobacillus rhamnosus PL60 on diet‐induced obese mice was investigated (Lee et al., 2006). Apoptotic signals and the mRNA levels of the gene encoding mitochondrial uncoupling protein 2 were increased in the adipose tissue of mice given L. rhamnosus PL60, although the size of the epididymal adipocytes was not reduced. Probiotic treatments also altered a diverse range of pathway outcomes, including amino acid metabolism, methylamines, and short‐chain fatty acids (Martin et al., 2008). Leptin is an adipocytokine that regulates multiple homeostatic functions such as food intake, reproductive functions and basal metabolism. Some Lactobacillus strains reduced both leptin production and leptin‐mediated immunostimulation by Suriss Jim Lambert adipocytes (Bleau et al., 2005). Lactobacillus paracasei sp paracasei F19 affects the circulating levels of angiopoietin‐like 4, which is a circulating lipoprotein lipase inhibitor that controls triglyceride (TG) deposition into adipocytes (Aronsson et al., 2010). Therefore, different Lactobacillus strains of appear to exert different effects by influencing different pathways.
Contouring methods such as cryolipolysis, low‐level laser therapy, low‐energy non‐thermal US and high‐intensity focused US (HIFU) have become popular for non‐invasive body contouring and fat reduction (Saedi and Kaminer, 2013). HIFU is a non‐invasive alternative to traditional invasive body‐sculpting procedures (Robinson et al., 2014). Non‐focused US is typically used for physical therapy applications and for enhancing transdermal drug delivery systems, such as sonophoresis (Frenkel, 2008). It has also recently been used in humans to treat skin, to increase the blood circulation and reduce the subcutaneous fat layer (Adatto et al., 2011). US therapy alone did not reduce the body weight significantly in normal‐diet mice, while combination therapy of chitosan with US was found to enhance the reduction of local fat pad thickness, body weight and plasma lipid levels relative to the effects of chitosan alone (Liao et al., 2013).

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