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Jefferson Adams posted an article in Celiac Disease Diagnosis, Testing & TreatmentCeliac.com 12/20/2018 - Intestinal permeability is thought to play a key role in the translocation of bacteria that lead to nonalcoholic fatty liver disease (NAFLD), a disorder in which fat accumulates in the liver. Intestinal permeability is also thought to play a significant role in the development of Nonalcoholic steatohepatitis (NASH). In a new preclinical study, a team of researchers affiliated with Innovate Biopharmaceuticals recently assessed the effects of larazotide acetate on intestinal permeability. Their data from that study show that larazotide has a marked effect on intestinal permeability. The company expects to see more data detailing the use of larazotide in combination with approved drugs liraglutide (VICTOZA®) and obeticholic acid (OCALIVA®), in development for treatment of NASH, by early 2019. Based on larazotide's ability to re-normalize intestinal permeability, the parent company plans to launch clinical development program targeted at NASH in 2019. In the most recent study, researchers evaluated the effects of larazotide in a model of NASH that develops from consumption of a specified diet, the DIAMONDTM mouse model. The pre-clinical model confirms NAFLD/NASH in response to a high fat, high sugar Western diet, including insulin resistance, obesity, which mirrors human disease progression and histopathology. As tested, larazotide triggered a clear reduction in gut barrier permeability, a known pathological abnormality in chronic liver diseases, specifically NASH. Any drug that can prevent or reduce gut permeability could be helpful in treating NASH. The company plans to share the complete NASH pre-clinical results for publication in 2019. According to Dr. Arun Sanyal, Professor and Chair, Division of Gastroenterology, Hepatology and Nutrition at the Virginia Commonwealth University (VCU) School of Medicine, "Increased intestinal permeability has been linked to many aspects of metabolic syndrome including type 2 diabetes and nonalcoholic fatty liver disease. The demonstration of reduced gut permeability with larazotide in the setting of diet-induced obesity opens up the possibility of modulating the outcomes of metabolic syndrome, including NASH, via this mechanism and warrants further development for these indications." Obviously, any drug that can reduce gut permeability could also have implications for the treatment of celiac disease. Look for celiac.com to bring you more news on efforts to develop treatments for NASH, NAFLD, and related conditions, as information becomes available. Read more at: Nasdaq.com
Jefferson Adams posted an article in Celiac Disease & Gluten Intolerance ResearchCeliac.com 02/04/2013 - Ever wonder what happens to all those celiac disease patients who volunteer to do a gluten-challenge in the name of science? Well, the short answer is that they likely suffer, and may incur gut damage, at least in the short term. A team of researchers looking for ways to reduce or eliminate that problem recently conducted a study using larazotide acetate, a first-in-class oral peptide that prevents tight junction opening, and may reduce gluten uptake and associated problems. The research team included C. P. Kelly, P. H. R. Green, J. A. Murray, A. DiMarino, A. Colatrella, D. A. Leffler, T. Alexander, R. Arsenescu, F. Leon, J. G. Jiang, L. A. Arterburner, B. M. Paterson, R. N. and Fedorak. They are affiliated with the Celiac Center of Beth Israel Deaconess Medical Center at Harvard Medical School in Boston, the Celiac Disease Center at Columbia University in New York, NY, the Division of Gastroenterology and Hepatology at the Mayo Clinic in Rochester, MN, Thomas Jefferson University Hospital in Philadelphia, PA, the Pittsburgh Gastroenterology Associates in Pittsburgh, PA, with Gastrointestinal Specialists of Troy, MI, the Department of Internal Medicine at the University of Kentucky, in Lexington, KY, with Alba Therapeutics Corporation in Baltimore, MD, and with the Division of Gastroenterology at the University of Alberta in Edmonton, AB. The team wanted to find out how well larazotide acetate worked and how well it was tolerated by celiac disease patients undergoing a gluten challenge. To do this, the team conducted an exploratory, double-blind, randomized, placebo-controlled study that included 184 patients who maintained a gluten-free diet before and during the study. After a gluten-free diet run-in, the team randomly divided patients into groups and gave them either larazotide acetate in doses of 1, 4, or 8 mg three times daily, or a placebo. Both groups also received 2.7 grams of gluten daily for six weeks. The team then assessed ratios of lactulose-to-mannitol (LAMA), an experimental biomarker of intestinal permeability, and measured clinical symptoms by Gastrointestinal Symptom Rating Scale (GSRS) and anti-transglutaminase antibody levels. They found no significant differences in LAMA ratios between larazotide acetate and placebo groups. Larazotide acetate 1-mg limited gluten-induced symptoms measured by GSRS (P = 0.002 vs. placebo). They did find that the average ratio of anti-tissue transglutaminase IgA levels was 19.0 over baseline in the placebo group compared with 5.78 (P = 0.010) in the 1mg larazotide acetate group, 3.88 (P = 0.005) in the 4mg larazotide acetate group, and 7.72 (P = 0.025) in the 8mg larazotide acetate group. Both the larazotide acetate and placebo groups showed similar rates of "adverse events." Overall, the team found that larazotide acetate reduced gluten-induced immune reactivity and symptoms in celiac disease patients undergoing gluten challenge and was generally well tolerated. However, the team found no significant difference in LAMA ratios between the larazotide acetate and placebo groups. Even though they did not find anything revolutionary, the results and design of their study will likely be helpful in shaping future gluten-challenge studies in patients with celiac disease. Source: Aliment Pharmacol Ther. 2013;37(2):252-262.