Compositions and methods for the reduction or prevention of hepatic steatosis

Abstract

Methods useful for reducing or preventing non-alcoholic steatohepatitis or hepatic steatosis are provided herein. Such methods may comprise administering to a subject in need thereof a sirtuin pathway activator and/or PDE5 inhibitor alone or in combination with an amount of a branched amino acid in free amino acid form, or a metabolite thereof. Also provided herein are compositions and kits for practicing any of the methods described herein.

1 .- 73 . (canceled) 
     
     
         74 . A composition comprising:
 a) an amount of leucine in the form of a free amino acid, and/or an amount of a metabolite thereof;   b) an amount of metformin; and   c) an amount of sildenafil;   wherein the metabolite thereof is selected from the group consisting of β-hydroxy β-methylbutyrate (HMB) and keto-isocaproic acid (KIC),   wherein the amount of leucine and/or a metabolite thereof is about 50-95 wt % of the total wt of (a), (b), and (c), the amount of metformin is about 5-50 wt % of the total wt of (a), (b), and (c), and the amount of sildenafil is 0.1 to 10 mg and about 0.01-1 wt % of the total wt of (a), (b), and (c),   wherein the composition is formulated for administration to a subject in need thereof, and   wherein (a), (b) and (c) are co-administered.   
     
     
         75 . The composition of  claim 74 , wherein the composition is formulated as a unit dose comprising 900-1200 mg of leucine, 200-550 mg of metformin, and 0.1 to 10 mg of sildenafil. 
     
     
         76 . The composition of  claim 74 , wherein the composition is administered to the subject twice a day. 
     
     
         77 . The composition of  claim 74 , wherein the composition is administered to the subject once a day. 
     
     
         78 . The composition of  claim 74 , wherein the amount of leucine is 0.25-3 g. 
     
     
         79 . The composition of  claim 74 , wherein the amount of leucine metabolite is 0.2-3 g. 
     
     
         80 . The composition of  claim 74 , wherein the amount of metformin is a therapeutic amount of metformin comprising 0.5-1.25 g of metformin. 
     
     
         81 . The composition of  claim 74 , wherein the amount of metformin is a sub-therapeutic amount of metformin comprising 10-500 mg of metformin. 
     
     
         82 . The composition of  claim 74 , further comprising a sirtuin pathway activator. 
     
     
         83 . The composition of  claim 82 , wherein the sirtuin pathway activator comprises a PGC-1α activator, a PDE5-specific inhibitor, or a polyphenol. 
     
     
         84 . The composition of  claim 83 , wherein the PGC-1α activator is thiazolidinedione. 
     
     
         85 . The composition of  claim 84 , wherein the thiazolidinedione is selected from the group consisting of rosiglitazone and pioglitazone. 
     
     
         86 . The composition of  claim 85 , wherein of the rosiglitazone comprises 0.1-4 mg of rosiglitazone. 
     
     
         87 . The composition of  claim 85 , wherein the pioglitazone comprises 0.1-15 mg of pioglitazone. 
     
     
         88 . The composition of  claim 83 , wherein the PDE5-specific inhibitor is selected from the group consisting of icariin, tadalafil, vardenafil, avanafil, lodenafil, mirodenafil, udenafil, and zaprinast. 
     
     
         89 . The composition of  claim 88 , wherein an amount of the PDE5-specific inhibitor is selected from the group consisting of 1-200 mg of icariin, 0.01-20 mg of tadalafil, 0.01-20 mg of vardenafil, 1-200 mg of avanafil, 1-200 mg of lodenafil, 1-100 mg of mirodenafil, 1-200 mg of udenafil, and 1-2000 mg of zaprinast. 
     
     
         90 . The composition of  claim 83 , wherein the polyphenol is selected from the group consisting of chlorogenic acid, resveratrol, caffeic acid, cinnamic acid, ferulic acid, piceatannol, ellagic acid, epigallocatechin gallate, grape seed extract, and any analog thereof. 
     
     
         91 . The composition of  claim 90 , wherein the polyphenol comprises 0.5-500 mg of the chlorogenic acid, caffeic acid, cinnamic acid, ferulic acid, piceatannol, ellagic acid, epigallocatechin gallate, grape seed extract, or any analog thereof. 
     
     
         92 . The composition of  claim 90 , wherein the resveratrol comprises 0.5-100 mg of resveratrol. 
     
     
         93 . The composition of  claim 74 , wherein the composition is formulated in a unit dose for administration to a subject in need thereof. 
     
     
         94 . The composition of  claim 74 , wherein (a), (b) and (c) are co-administered sequentially. 
     
     
         95 . The composition of  claim 74 , wherein (a), (b) and (c) are co-administered simultaneously in a single composition. 
     
     
         96 . A method for reducing hepatic steatosis and/or non-alcoholic steatohepatitis in a subject in need thereof, the method comprising administering to the subject a composition of  claim 74 , wherein the administering of (a), (b) and (c) reduces hepatic steatosis and/or non-alcoholic steatohepatitis to a greater extent than administration of (a) alone, thereby reducing hepatic steatosis and/or non-alcoholic steatohepatitis in the subject. 
     
     
         97 . A method for treating hepatic steatosis and/or non-alcoholic steatohepatitis in a subject in need thereof, the method comprising administering to the subject prior to manifestation of a hepatic steatosis and/or non-alcoholic steatohepatitis symptom a composition of  claim 74 , wherein the administering of (a), (b) and (c) reduces hepatic steatosis and/or non-alcoholic steatohepatitis to a greater extent than administration of (a) alone, thereby preventing hepatic steatosis and/or non-alcoholic steatohepatitis in the subject.