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Methods and materials for treating conditions associated with metabolic disorders

a metabolic disorder and metabolic technology, applied in the field of metabolic disorders, can solve the problems of increased plasma phe levels, difficulty in attaining, and loss of intelligence and white matter in the brain, and achieve the effect of reducing the risk of recurrence and recurrence of recurrence and recurren

Inactive Publication Date: 2005-02-03
PREKULAB LTD AF 8 MARTS 2004
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

The present invention also relates to a method for treating a subject suffering from a condition involving a metabolic disorder involving the metabolism of a first amino acid X. The method includes enterally administering to the subject a composition which (i) is substantially free from the first amino acid X and (ii) which includes a second amino acid Y that competes with amino acid X at a gastrointestinal tract transporter. As one skilled in the art will appreciate, the composition can further include (i.e., in addition to second amino acid Y) other components, such as other amino acids (e.g., one or more other amino acids which compete with amino acid X at a gastrointestinal tract transporter).

Problems solved by technology

(1980) (“Pardridge”)), untreated “classic” PKU patients have plasma Phe levels above 1 mM (e.g., plasma Phe levels of from about 1 mM to about 2.5 mM or more), and, although treatment with a low-Phe diet has a goal of reducing plasma Phe to below 0.3 mM, this is difficult to attain due to dietary compliance problems.
The excessive levels of plasma phenylalanine observed in PKU combined with the relatively high affinity of Phe for binding sites on carrier protein of the neutral amino acid transport system in the blood-brain barrier (“BBB”) leads to (i) accumulation of Phe and its neurotoxic metabolites (e.g., phenylpyruvate, phenylacetate, phenyllactate) in the brain and (ii) depressed levels of non-Phe neutral amino acids entering the brain, resulting in disturbed brain development and function, since key cerebral pathways of metabolism (e.g., synthesis of neurotransmitters) require precursor amino acids, such as tyrosine.
Although a diet low in phenylalanine can reduce plasma Phe levels in “classic” PKU below 0.3 mM and ameliorate the mental retardation associated with untreated PKU, dietary compliance becomes problematic as PKU patients reach adolescence, leading to a rise in plasma Phe levels and to both loss in intelligence and white matter changes in the brain.
Nutritional deficiencies can also result from Phe-restricted diets.
However, efficacy of these dietary amino acid supplement treatments has been controversial.
More particularly, tyrosinemia is a disorder caused by a defect in the terminal enzyme of the tyrosine metabolic pathway, leading to accumulation of fumarylacetoacetate, which converts to succinylacetone, which accumulates and is toxic to the liver.
However this is a difficult and expensive therapy.
However, safety issues regarding NTBC are unanswered to date, and dietary restriction of tyrosine and phenylalanine is dependent on patient knowledge and compliance, which, as mentioned above, can be problematic, especially in adolescents and adults.
However, safety issues regarding NTBC are unanswered to date, and dietary restriction of tyrosine and phenylalanine is dependent on patient knowledge and compliance, which, as mentioned above, can be problematic.
However, dietary restriction of methionine is dependent on patient knowledge and compliance, which, as mentioned above, can be problematic.
A defect in one step of a multistep metabolic pathway which converts the BCAAs to energy, results in accumulation of an intermediate metabolite of the BCAA to toxic levels, causing disease.
However, as discussed above, successful management of such diseases and conditions by dietary restriction of a particular amino acid or a particular set of amino acids is dependent on patient knowledge and compliance, which can be problematic.

Method used

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Examples

Experimental program
Comparison scheme
Effect test

example 1

The Hypothesis

The availability of amino acids in the brain is determined by (i) the plasma supply of the amino acid, and (ii) competition of the plasma-supplied amino acids for a common amino acid binding site(s) on the carrier protein of the BBB neutral amino acid transporter. It has been hypothesized that competition for neutral amino acids at a common carrier binding site, under physiological conditions, is unique to the central nervous system (Pardridge, which is hereby incorporated by reference), and that such competition is the basis for the correlation of BBB transport and clinical disorders affecting the brain (e.g., PKU). Whereas prior PKU-related studies have focused on competitive transport of non-Phe LNAAs across the blood brain barrier so as to suppress entry of Phe into the brain, it has ignored the transport of LNAAs out of the gastrointestinal tract and into the blood, which can be a major determinant of the plasma amino acid supply.

Nine separate transport system...

example 2

LNAA Supplement Formulation

As indicated above, the present inventor hypothesized that a LNAA dietary supplement designed to both compete with and suppress transport of Phe from the GI tract into the blood and to compete with and suppress transport of Phe from the blood across the BBB into the brain could be used as a PKU treatment. More particularly, it was hypothesized that oral administration of the LNAA supplement at each meal should suppress Phe transport from the GI tract into the blood so that the BBB transporter system is not overwhelmed by the high levels of Phe typically present in the blood of the PKU patient.

As shown in Equation 1, the term [(aa) / Km] of each amino acid represents that amino acid's ability to compete with Phe at a carrier protein binding site. As seen in Table 1, Leu, Tyr, Trp, and Met are LNAAs which should compete effectively with Phe at the BBB carrier protein.

Although little work has been done in characterizing the affinity of the LNAAs for the b...

example 3

Effect of Prekunil, SuppM1, and SuppM2 on Mouse Plasma Phe Levels

The supplements SuppM1 and SuppM2 were administered to mice with PKU, genotype ENU 2 / 2 with features of classical PKU, in single oral doses of 0.5 g / kg, and the plasma phenylalanine levels were monitored at 0, 3, 6 and 24 hours post-dose. It should be noted that 0.5 g / kg is a relatively low dose of supplement as Prekunil is typically administered at 1 g / kg. It is known that LNAA supplements typically suppress phenylalanine plasma levels for several hours after ingestion, with the effect then diminishing, such that dosing at each meal may be required. Thus, the 6 hour value of phenylalanine was taken as an indicator of the degree to which phenylalanine accumulation had been suppressed.

Data for a single mouse (P448) not receiving any supplement, a single mouse (P455) dosed with the commercial supplement Prekunil, for a single mouse (P430) dosed with Prekunil boosted with 35 mg Leu, for two mice (P456 and P259) dosed ...

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Abstract

Disclosed are methods for treating a subject suffering from phenylketonuria and / or phenylalanemia. The methods include, in part, enterally administering to the subject a LNAA supplement in which the weight ratio of Leu to Val is greater than 2:1; in which the weight ratio of Leu to iLeu is greater than 3:1; or which includes one or more LNAAs and which further includes Lys. LNAA supplements are also disclosed. Also disclosed are methods for treating a subject suffering from a condition involving a metabolic disorder involving the metabolism of a first amino acid X. The method includes enterally administering to the subject a composition which (i) is substantially free from the first amino acid X and (ii) which includes a second amino acid Y that competes with amino acid X at a gastrointestinal tract transporter.

Description

FIELD OF THE INVENTION The subject invention is directed, generally, to methods and materials for treating conditions associated with metabolic disorders and, more particularly, to methods and materials for treating conditions associated with metabolic disorders of particular amino acids. BACKGROUND OF THE INVENTION A number of conditions which afflict humans and other animals are attributable to disorders in metabolizing particular amino acids. In many of these conditions, treatment involves restricting the dietary intake of the particular amino acid or amino acids associated with the condition. However, therapies based on dietary restriction requires patient compliance and also requires that the patient know whether a particular food contains the particular amino acid or amino acids associated with the condition. For example, phenylketonuria (“PKU”) is hyperaminoacidemia of phenylalanine (Phe) associated with an inborn error of phenylalanine metabolism, mutation of the gene enc...

Claims

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Application Information

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Patent Type & Authority Applications(United States)
IPC IPC(8): A61K31/198
CPCA61K31/195A61K31/198A61P3/00A61P3/02A61K47/183A61K31/197
Inventor MATALON, REUBEN
Owner PREKULAB LTD AF 8 MARTS 2004
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