Compositions and methods for treating disease associated with permeability of intestinal epithelium
The present invention provides methods for treating disorders associated with intestinal barrier dysfunction and increased intestinal permeability. The invention involves administering an effective amount larazotide or a larazotide derivative to a subject or a patient in need thereof.
1. A method for treating a subject having an ischemic intestinal condition selected from ischemic colitis and intestinal volvulus, comprising administering an effective amount of larazotide, or a larazotide derivative having one or two amino acid modifications with respect to SEQ ID NO: 1 and/or having one or more (d)-amino acids, to the subject,
wherein the larazotide or derivative is administered in a sustained release or controlled release formulation that releases from about 0.5 to about 5 mg of larazotide or derivative to the small and/or large intestine, and wherein the formulation releases peptide for at least about 2 hours during exposure to simulated intestinal fluid.
2. The method of claim 1 , wherein the ischemic colitis is mild to moderate.
3. The method of claim 1 , wherein the ischemic colitis is severe.
4. The method of claim 1 , wherein the larazotide is larazotide acetate.
5. The method of claim 1 , wherein the sustained release or controlled release formulation releases larazotide or derivative over at least 210 minutes in simulated intestinal fluid.
6. The method of claim 1 , wherein the composition comprising larazotide or derivative releases larazotide or derivative in the small intestine.
7. The method of claim 6 , wherein the larazotide or derivative is released in one or more of the duodenum, jejunum and ileum.
8. The method of claim 6 , wherein different compositions target release of Larazotide or derivative in the small intestine and large intestine.
9. The method of claim 1 , wherein the composition comprising larazotide or derivative is administered more than once daily.
10. The method of claim 1 , further comprising, administering antibiotic therapy.
11. The method of claim 1 , further comprising, administering antiviral therapy.
12. The method of claim 1 , further comprising administering a probiotic.
13. The method of claim 1 , wherein the sustained release or controlled release formulation targets delivery of the larazotide or derivative to the jejunum and ileum.
14. The method of claim 1 , wherein the sustained release or controlled release formulation comprises a biodegradable matrix.
15. The method of claim 14 , wherein the sustained release or controlled release formulation has a gastric resistant coating that begins to release the larazotide or derivative within about 5 to about 30 minutes of exposure to simulated intestinal fluid.
16. The method of claim 15 , wherein the release of the larazotide or derivative continues for at least about 180 minutes, in simulated intestinal fluid.
17. The method of claim 1 , wherein the sustained release or controlled release formulation comprises an enteric coating selected from methacrylic acid copolymers, cellulose acetate phthalate, hydroxypropylmethyl cellulose phthalate, polyvinyl acetate phthalate, carboxymethylethykellulose, poly(methacrylic acid, methylmethacrylate, hydroxypropyl methylcellulose acetate, succinate, cellulose acetate trimellitate, and shellac.
18. The method of claim 15 , wherein the release of the larazotide or derivative continues for at least about 210 minutes in simulated intestinal fluid.
19. The method of claim 15 , wherein the release of the larazotide or derivative continues for at least about 240 minutes in simulated intestinal fluid.
20. The method of claim 15 , wherein the release of the larazotide or derivative continues for at least about 280 minutes in simulated intestinal fluid.
21. The method of claim 6 , wherein the larazotide or derivative is released in one or more of the colon transversum, colon descendens, colon ascendens, colon sigmoidenum, and cecum.
22. A method for treating a subject having an ischemic intestinal condition selected from ischemic colitis and intestinal volvulus, comprising administering an effective amount of larazotide, or a larazotide derivative having one or two amino acid modifications with respect to SEQ ID NO: 1 and/or having one or more (d)-amino acids, to the subject.
23. The method of claim 22 , wherein the ischemic colitis is mild to moderate.
24. The method of claim 22 , wherein the ischemic colitis is severe.