Compositions and methods for the treatment of fat infiltration in muscle

1. A composition comprising:

a) a leucine (L)-amino acid entity chosen from L-leucine, oxo-leucine, beta-hydroxy-beta-methybutyrate (HMB), isovaleryl-CoA, or N-acetyl-leucine; or a salt thereof, a dipeptide or salt thereof, a tripeptide or salt thereof, or a combination of any of the aforesaid;

b) an arginine (R)-amino acid entity chosen from L-arginine, argininosuccinate, agmatine, creatine, or N-acetyl-arginine;_ or a salt thereof, a dipeptide or salt thereof, a tripeptide or salt thereof, or a combination of any of the aforesaid;

c) a glutamine (Q)-amino acid entity chosen from L-glutamine, carbamoyl-P, or N-acetyl-glutamine; or a salt thereof, a dipeptide or salt thereof, a tripeptide or salt thereof, or a combination of any of the aforesaid;

d)N-acetylcysteine (NAC) or a salt thereof, a dipeptide or salt thereof, or a combination of any of the aforesaid; and

e) an essential amino acid (EAA)-entity chosen from one, two, three, or four of:

i) a histidine (H)-amino acid-entity chosen from L-histidine, histidinol, histidinal, ribose-5-phosphate, carnosine, histamine, urocanate, or N-acetyl-histidine; or a salt thereof, a dipeptide or salt thereof, a tripeptide or salt thereof, or a combination of any of the aforesaid;

ii) a lysine (K)-amino acid-entity chosen from L-lysine, diaminopimelate, trimethyllysine, saccharopine, or N-acetyl-lysine; or a salt thereof, a dipeptide or salt thereof, a tripeptide or salt thereof, or a combination of any of the aforesaid;

iii) a phenylalanine (F)-amino acid-entity chosen from L-phenylalanine, phenylpyruvate, or N-acetyl-phenylalanine; or a salt thereof, a dipeptide or salt thereof, a tripeptide or salt thereof, or a combination of any of the aforesaid; or

iv) a threonine (T)-amino acid-entity chosen from L-threonine, oxobutyrate, or N-acetyl-threonine; or a salt thereof, a dipeptide or salt thereof, a tripeptide or salt thereof, or a combination of any of the aforesaid;

wherein at least one of the leucine amino acid entity, the arginine amino acid, the glutamine amino acid entity, or one, two, three, or all of the EAA amino acid entities is a free amino acid,

wherein at least 50 wt. % of the total dry wt. of the composition is one or more amino acid entities in free form, and

wherein the total wt. % of (a)-(e) is greater than the total wt. % of other amino acid entities in the composition.

2. The composition of claim 1 , wherein one, two, three, or more of methionine (M), trytophan (W), valine (V), or cysteine (C) is absent, or if present, is present at less than 1 wt. %, 0.5 wt. %, or 0.1 wt. %.

3. The composition of claim 1 , further comprising one or both of an isoleucine (I)-amino acid entity or a valine (V)-amino acid entity.

4. A pharmaceutical composition comprising the composition of claim 1 and a pharmaceutically acceptable excipient.

5. The composition of claim 1 , wherein the wt. ratio of the L-amino acid entity, the R-amino acid entity, the Q-amino acid entity, and the NAC or salt thereof, or the dipeptide or salt thereof, or tripeptide or salt thereof, comprising NAC is, respectively, about 1-3: 2-4: 2-4: 0.1-2.5.

6. The composition of claim 3 , wherein one or both of:

the I-amino acid entity is L-isoleucine or a salt thereof, or a dipeptide or salt thereof, or tripeptide or salt thereof, comprising L-isoleucine; or

the V-amino acid entity is L-valine or a salt thereof, or a dipeptide or salt thereof, or tripeptide or salt thereof, comprising L-valine.

7. The composition of claim 1 , wherein at least one of (a)-(e) is in a salt form.

8. The composition of claim 1 , wherein the composition is capable of improving one or more physiological symptoms selected from immobilization, malnutrition, fasting, aging, autophagy, reduced protein synthesis, anabolic resistance, neuromuscular junction integrity, insulin resistance, decreased mitochondrial biogenesis, anaplerosis, myogenesis, or an energy deficit.

9. The composition of claim 1 , wherein the composition is capable of one or more of the following when administered to a subject:

decreasing the level of muscle breakdown;

increasing muscle anabolism;

decreasing insulin resistance; or

decreasing inflammation.

10. A composition comprising:

a) a leucine amino acid entity chosen from:

i) L-leucine or a salt thereof,

ii) a dipeptide or salt thereof, or tripeptide or salt thereof, comprising L-leucine, or

iii) β-hydroxy-(β-methylbutyrate (HMB) or a salt thereof;

b) an arginine amino acid entity chosen from:

i) L-arginine or a salt thereof,

ii) a dipeptide or salt thereof, or tripeptide or salt thereof, comprising L-arginine,

iii) creatine or a salt thereof, or

iv) a dipeptide or salt thereof, or tripeptide or salt thereof, comprising creatine;

c) a glutamine amino acid entity chosen from:

i) L-glutamine or a salt thereof, or

ii) a dipeptide or salt thereof, or tripeptide or salt thereof, comprising L-glutamine;

d) an N-acetylcysteine (NAC) amino acid entity chosen from:

i)N-acetylcysteine (NAC) or a salt thereof, or

ii) a dipeptide or salt thereof, or tripeptide or salt thereof, comprising NAC; and

e) an essential amino acid (EAA) entity chosen from:

i) L-histidine or a salt thereof,

ii) a dipeptide or salt thereof, or tripeptide or salt thereof, comprising L-histidine,

iii) L-lysine or a salt thereof,

iv) a dipeptide or salt thereof, or tripeptide or salt thereof, comprising L-lysine,

v) L-phenylalanine or a salt thereof,

vi) a dipeptide or salt thereof, or tripeptide or salt thereof, comprising L-phenylalanine,

vii) L-threonine or a salt thereof, or

viii) a dipeptide or salt thereof, or tripeptide or salt thereof, comprising L-threonine;

wherein at least one of the leucine amino acid entity, the arginine amino acid, the glutamine amino acid entity, or one, two, three, or all of the EAA amino acid entities is a free amino acid,

wherein at least 50 wt. % of the total dry wt. of the composition is one or more amino acid entities in free form, and

wherein the total wt. % of (a)-(e) is greater than the total wt. % of other amino acid entities in the composition.

11. The composition of claim 10 , further comprising one or both of:

f) L-isoleucine or a salt thereof, or a dipeptide or salt thereof, or tripeptide or salt thereof, comprising L-isoleucine; or

g) L-valine or a salt thereof, or a dipeptide or salt thereof, or tripeptide or salt thereof, comprising L-valine.

12. The composition of claim 10 , wherein one, two, three, or more of methionine (M), trytophan (W), valine (V), or cysteine (C) is absent from the composition, or if present, is present at less than 1 wt. %, 0.5 wt. %, or 0.1 wt. %.

13. A composition comprising:

a) L-leucine or a salt thereof;

b) L-arginine or a salt thereof;

c) L-glutamine or a salt thereof;

d) NAC or a salt thereof;

e) L-histidine or a salt thereof, L-lysine or a salt thereof, L-phenylalanine or a salt thereof, and L-threonine or a salt thereof;

f) L-isoleucine or a salt thereof; and

g) L-valine or a salt thereof;

wherein at least one of (a)-(d) or one, two, three, or all of (e) is a free amino acid,

wherein at least 50 wt. % of the total dry wt. of the composition is one or more amino acid entities in free form, and

wherein the total wt. % of (a)-(e) is greater than the total wt. % of other amino acid entities in the composition.

14. The composition of claim 13 , wherein one, two, three, or more of methionine (M), trytophan (W), valine (V), or cysteine (C) is absent from the composition, or if present, is present at less than 1 wt. %, 0.5 wt. %, or 0.1 wt. %.

15. The composition of claim 1 , wherein the composition comprises 5 to 15 different amino acid entities.

16. A composition consisting of:

(a) L-leucine or a salt thereof;

(b) L-arginine or a salt thereof;

(c) L-glutamine or a salt thereof;

(d) NAC or a salt thereof;

(e) L-histidine or a salt thereof, L-lysine or a salt thereof, L-phenylalanine or a salt thereof, and L-threonine or a salt thereof;

(f) L-isoleucine or a salt thereof;

(g) L-valine or a salt thereof; and

(h) at least one pharmaceutically acceptable excipient.

17. A method of making a composition comprising blending the following:

a) a leucine (L)-amino acid entity chosen from L-leucine, oxo-leucine, beta-hydroxy-beta-methybutyrate (HMB), isovaleryl-CoA, or N-acetyl-leucine; or a salt thereof, a dipeptide or salt thereof, a tripeptide or salt thereof, or a combination of any of the aforesaid;

b) an arginine (R)-amino acid entity chosen from L-arginine, argininosuccinate, agmatine, creatine, or N-acetyl-arginine; or a salt thereof, a dipeptide or salt thereof, a tripeptide or salt thereof, or a combination of any of the aforesaid;

c) a glutamine (Q)-amino acid entity chosen from L-glutamine, carbamoyl-P, or N-acetyl-glutamine; or a salt thereof, a dipeptide or salt thereof, a tripeptide or salt thereof, or a combination of any of the aforesaid;

d)N-acetylcysteine (NAC) or a salt thereof, a dipeptide or salt thereof, or a combination of any of the aforesaid; and

e) an essential amino acid (EAA)-entity chosen from one, two, three, or four of:

i) a histidine (H)-amino acid-entity chosen from L-histidine, histidinol, histidinal, ribose-5-phosphate, carnosine, histamine, urocanate, or N-acetyl-histidine; or a salt thereof, a dipeptide or salt thereof, a tripeptide or salt thereof, or a combination of any of the aforesaid;

ii) a lysine (K)-amino acid-entity chosen from L-lysine, diaminopimelate, trimethyllysine, saccharopine, or N-acetyl-lysine; or a salt thereof, a dipeptide or salt thereof, a tripeptide or salt thereof, or a combination of any of the aforesaid;

iii) a phenylalanine (F)-amino acid-entity chosen from L-phenylalanine, phenylpyruvate, or N-acetyl-phenylalanine; or a salt thereof, a dipeptide or salt thereof, a tripeptide or salt thereof, or a combination of any of the aforesaid; or

iv) a threonine (T)-amino acid-entity chosen from L-threonine, homoserine, O-phosphohomoserine, oxobutyrate, or N-acetyl-threonine; or a salt thereof, a dipeptide or salt thereof, a tripeptide or salt thereof, or a combination of any of the aforesaid;

wherein at least one of the leucine amino acid entity, the arginine amino acid, the glutamine amino acid entity, or one, two, three, or all of the EAA amino acid entities is a free amino acid,

wherein at least 50 wt. % of the total dry wt. of the composition is one or more amino acid entities in free form, and

wherein the total wt. % of (a)-(e) is greater than the total wt. % of other amino acid entities in the composition,

thereby making the composition.

18. The method of claim 17 , wherein one, two, three, or more of methionine (M), trytophan (W), valine (V), or cysteine (C) is absent from the composition, or if present, is present at less than 1 wt. %, 0.5 wt. %, or 0.1 wt. %.

19. The method of claim 17 , wherein the composition further comprises one or both of an isoleucine (I)-amino acid entity or a valine (V)-amino acid entity.

20. The method of claim 17 , wherein the composition is formulated as a pharmaceutical composition comprising a pharmaceutically acceptable excipient.