Vaccenic acid (VA) (t11 octadecenoic acid) is a positional and geometric isomer of oleic acid (c9-octadecenoic acid), and is the predominant trans monoene in ruminant fats (50%–80% of total trans content). Dietary VA can be desaturated to cis-9,trans-11 conjugated linoleic acid (c9,t11-CLA) in ruminants, rodents, and humans. Hydrogenated plant oils are another source of VA in the diet, and it has been recently estimated that this source may contribute to about 13%–17% of total VA intake. In contrast to suggestions from the epidemiological studies, the majority of studies using cancer cell lines (Awad et al. 1995; Miller et al. 2003) or rodent tumors (Banni et al. 2001; Corl et al. 2003; Ip et al. 1999; Sauer et al. 2004) have demonstrated that VA reduces cell growth and (or) tumor metabolism. Animal and in vitro studies suggest that the anti-cancer properties of VA are due, in part, to the in vivo conversion of VA to c9,t11-CLA. However, several additional mechanisms for the anti-cancer effects of VA have been proposed, including changes in phosphatidylinositol hydrolysis, reduced proliferation, increased apoptosis, and inhibition of fatty acid uptake. In conclusion, although the epidemiological evidence of VA intake and cancer risk suggests a positive relationship, this is not supported by the few animal studies that have been performed. The majority of the studies suggest that any health benefit of VA may be conferred by in vivo mammalian conversion of VA to c9,t11-CLA. VA acts as a partial agonist to both peroxisome proliferator-activated receptors (PPAR)-α and PPAR-γ in vitro, with similar affinity compared to commonly known PPAR agonists. Hypolipidemic and antihypertrophic bioactivity of VA is potentially mediated via PPAR-/-dependent pathways.

Levophencynonate is the active enantiomer of phencynonate. Levophencynonate is an anticholinergic agent which can prevent acute motion sickness with an efficacy similar to scopolamine. It will take effect by competitive binding to central muscarinic acetylcholine receptors. In April 2017 levophencynonate was in preregistration phase for the vertigo treatment in China.

LFF-571 is a novel semisynthetic thiopeptide antibiotic with potent activity against a variety of Gram-positive pathogens, including Clostridium difficile. LFF-571 was generally safe and well tolerated in single and multiple oral doses in healthy subjects. There were no deaths, no serious adverse events, and no subject withdrawals due to an adverse event. The most common adverse event was diarrhea, gastrointestinal pain or distension was also noted. Similar to healthy volunteers, patients with C. difficile infections exhibited high fecal concentrations and low serum levels of LFF571. Novartis is developing oral LFF 571 for the treatment of Clostridium difficile infections. LFF 571 binds to bacterial elongation factor Tu (EF-Tu) in domain 2. Phase-II development is ongoing in USA and Canada.

N(ω)-hydroxy-nor-L-arginine (nor-NOHA), an arginase inhibitor, has therapeutic potential in the treatment of cardiovascular and obstructive airway diseases. Nor-NOHA is a reversible, competitive arginase inhibitor. The affinity of nor-NOHA for the to the arginase active site was found in the nanomolar range. Nor-NOHA has proven to be one of the strongest arginase inhibitors. Inhibition by nor-NOHA is ten times more potent on arginase II than on arginase I. The pharmacokinetics of nor-NOHA is characterized by high bioavailability, close to 100% after multiple dose and rapid elimination resulting in t1/2 of 15–30 min after intravenous and intraperitoneal administration to rats. Arginase inhibition with Nor-NOHA increased circulating arginine levels and decreased hepatic damage during liver I/R injury. Arginase blockade represents a potentially novel strategy to combat hepatic I/R injury associated with liver transplantation. Nor-NOHA is under investigation in clinical trial NCT02009527 (Arginase inhibition in ischemia-reperfusion injury).

ASC-09 orTMC-310911, a HIV protease inhibitor, participated in phase II clinical for the treatment of Human Immunodeficiency Virus Type 1. However, no recent development has been reported.