Methods and treatment for allergies and inflammation associated with gastrointestinal diseases

Abstract

Methods of the prophylaxis of the development of allergy in a patient at risk of sensitization to an antigen(s) or allergen(s) due to impaired gastrointestinal functions include administering a mast cell inhibitor, e.g., ketotifen, e.g., ketotifen fumarate. Methods for prophylactically treating, reducing, delaying or controlling gastrointestinal disorders include administering a mast cell stabilizer, e.g., ketotifen to a patient in need thereof. Pharmaceutical preparation, composition for use in methods described, are also disclosed. Also disclosed are methods of prophylaxis or treating gastrointestinal and esophageal inflammation, and methods for the prophylaxis of the development of additional allergies to a newly introduced substance in a patient with a preexisting allergy. Such methods include delivery of a mast cell stabilizer, e.g., ketotifen. Oral and topical administration are contemplated within the scope of the methods.

Description

REFERENCE TO RELATED APPLICATIONS [0001]This application claims the benefit of PCT / US2009 / 003191, filed on May 22, 2009, and U.S. Provisional Application Ser. No. 61 / 055,964, filed May 23, 2008, the disclosure of each of which is hereby incorporated by reference in their entirety.FIELD OF THE INVENTION [0002]The present invention relates to methods for the prophylaxis of the development of allergy in a patient at risk of sensitization to an antigen(s) or allergen(s) due to impaired gastrointestinal functions comprising administering a mast cell inhibitor, e.g., ketotifen, e.g., ketotifen fumarate. The invention also provides methods for prophylactically treating, reducing, delaying or controlling symptoms of and inflammation associated with gastrointestinal disorders, e.g., due to exposure to allergen due to desensitization therapy and / or due to impaired gastrointestinal functions such as impaired gastrointestinal digestion and / or increased intestinal permeability, comprising admini...

AI Technical Summary

Benefits of technology

[0227]In a preferred embodiment, Pharmaceutical Preparation I comprises a proton pump inhibitor and ketotifen, in free or pharmaceutically acceptable salt form. In another preferred embodiment, Pharmaceutical Preparation I comprises an antacid and ketotifen, in free or pharmaceutically acceptable salt form. In yet another preferred embodiment, Pharmaceutical Preparation I comprises Gaviscon and ketotifen, in free or pharmaceutically acceptable salt form. Pharmaceutical Preparation I comprising ketotifen and antacid may increase topical resident time of ketotifen, thereby providing longer local effect.

[0278]In another embodiment, the enteric coated mast cell stabilizer as hereinbefore described may be used in any of the methods described in Method I, e.g., any of methods 1.1-1.64 or Method II, e.g., any of methods 2.1-2.32, Pharmaceutical Preparation I, e.g., 3.1-3.18, or Pharmaceutical Preparation II, e.g., 4.1-4.11. In a particular embodiment, the enteric coated mast cell stabilizer, e.g., enteric coated ketotifen, in free or pharmaceutically acceptable salt is resistant against acid digestion, e.g., against digestion by gastric acid, and therefore may be effective at a lower dosages than mast cell stabilizers that are not enteric coated.

[0691]It is also known that certain substances may promote sensitization and inhibit tolerance of a previously tolerant compound. While not bound by theory, the use of a mast cell stabilizer, that is co-administered with a sensitization-promoting agent and the normally tolerated allergen, may prevent sensitization to an allergen. For example, one may be tolerant to a peanut diet, but may be sensitized to peanuts when immunized first with a peanut protein before after eating a diet rich in peanuts. Thus, in one example, co-administering a mast-cell stabilizer with a sensitization-promoting agent, such as a peanut protein, may prevent the sensitization that may occur.

[0692]For example, it was known that co-administrating an anti-acid compound such as sucralfate, or aluminum, a component of sucralfate, with ovalbumin caused sensitization to previously tolerated ovalbumin, via elevation of the gastric pH. Thus, co-administering a mast cell stabilizer with sucralfate, may prevent sensitization that may occur.

Problems solved by technology

Use of antacids to treat heart burn, for example, may promote the development of new allergy and delay the initiation of therapy appropriate for the underlying disease e.g., eosinophilic esophagitis.

Much data supporting pathogenic implications of IgE-mediated allergies for eosinphilic esophagitis has been demonstrated, but data for other EGID diseases having a role of IgE have been limited.

Moreover, timing of food hypersensitivity may be critical.

For example, Paschoal et al., noted that normal mice which eat peanuts are tolerant, but if they were immunized with peanut proteins prior to a challenge diet containing peanuts, the mice developed inflammation.

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