Treatment of portal hypertension and restoration of liver function using L-ornithine phenylacetate

1. A method of reducing portal pressure in a subject, comprising:

identifying a subject that is in need of reducing portal pressure, wherein the subject has a condition selected from the group consisting of portal hypertension, portal hypertension related variceal bleeding, and portal hypertension related ascites;

administering to the subject L-ornithine in combination with at least one of phenylacetate and phenylbutyrate or a physiological acceptable salt of at least one of phenylacetate and phenylbutyrate, wherein the L-ornithine is present as a free monomeric amino acid or physiologically acceptable salt thereof; and

measuring the portal pressure of the subject that has been administered with the L-ornithine in combination with at least one of phenylacetate and phenylbutyrate or the physiological acceptable salt of at least one of phenylacetate and phenylbutyrate to determine the reduction in portal pressure in the subject;

wherein the reduction in portal pressure in the subject is at least 30%.

2. The method of claim 1 , wherein the subject is suffering from a liver disease.

3. The method of claim 2 , wherein the liver disease is a chronic liver disease or an acute liver failure.

4. The method of claim 3 , wherein the chronic liver disease is cirrhosis.

5. The method of claim 1 , wherein the reduction in portal pressure is achieved by reducing the level of proinflammatory cytokines or increasing endothelial nitric oxide synthase activity in the subject.

6. The method of claim 1 , wherein said L-ornithine and phenylacetate are administered as L-ornithine phenyl acetate.

7. The method of claim 1 , wherein separate physiologically acceptable salts of said L-ornithine and at least one of phenylacetate and phenylbutyrate are administered to the subject.

8. The method of claim 1 , wherein at least one of phenylacetate and phenylbutyrate is administered as a sodium phenylacetate or sodium phenylbutyrate.

9. The method of claim 1 , wherein said administration is oral, intravenous, intraperitoneal, intragastric, or intravascular administration.

10. The method of claim 1 , wherein the dose of the L-ornithine and the phenylacetate or phenylbutyrate administered is between 20 g and 40 g.

11. A method of delaying or reducing the likelihood of onset of portal hypertension in a subject, comprising:

administering to the subject L-ornithine in combination with at least one of phenylacetate and phenylbutyrate or a physiological acceptable salt of at least one of phenylacetate and phenylbutyrate, wherein the L-ornithine is present as a free monomeric amino acid or physiologically acceptable salt thereof;

measuring the portal pressure of the subject that has been administered with the L-ornithine in combination with at least one of phenylacetate and phenylbutyrate or the physiological acceptable salt of at least one of phenylacetate and phenylbutyrate, thereby delaying or reducing the likelihood of onset of portal hypertension.

12. The method of claim 11 , wherein the subject is suffering from liver disease.

13. The method of claim 11 , wherein the delay or reduction in the likelihood of onset of portal hypertension is achieved by reducing the level of proinflammatory cytokines or increasing endothelial nitric oxide synthase activity in the subject.

14. The method of claim 11 , wherein said L-ornithine and phenylacetate are administered as L-ornithine phenyl acetate.

15. The method of claim 11 , wherein separate physiologically acceptable salts of said L-ornithine and at least one of phenylacetate and phenylbutyrate are administered to the subject.

16. The method of claim 11 , wherein at least one of phenylacetate and phenylbutyrate is administered as a sodium phenylacetate or sodium phenylbutyrate.

17. The method of claim 11 , wherein said administration is oral, intravenous, intraperitoneal, intragastric, or intravascular administration.