The present invention generally relates to the treatment of
uremic toxins in vivo using uremic
toxin-treating enzymes, and / or cells capable of producing uremic
toxin-treating enzymes or otherwise reacting with
uremic toxins. Non-limiting examples of cases where the treatment of
uremic toxins is desired include renal
disease or dysfunction,
gout, subjects receiving
chemotherapy, or the like. In one aspect, the treatment includes an oral delivery composition able to reduce the
blood concentration of one or more non-
protein nitrogen compounds
in vivo. The composition, in some cases, may comprise one, two, or more uremic
toxin-treating enzymes, such as
urease, uricase or
creatininase. The oral delivery composition may be able to deliver the uremic toxin-treating enzymes, substantially undigested, to the intestines, where the enzymes can interact with uremic toxins transported to the intestines from the bloodstream. In another aspect, the treatment includes an oral delivery composition comprising a
cell able to reduce the concentration of one or more uremic toxins
in vivo. In some cases, the
cell may be designed to overexpress one, two, or more uremic toxin-treating enzymes, such as
urease, uricase or
creatininase, for example, by transfecting the
cell with a corresponding
gene. In some embodiments, a species able to react with or otherwise sequester by-products of the uremic toxin-treating
enzyme reactions may be included with the oral delivery composition. For example, if the by-product is
ammonium, the species may be a
sorbent able to adsorb
ammonium, an
enzyme able to react with the
ammonium, or the like.