Larazotide
Overview
A synthetic octapeptide derived from Vibrio cholerae zonula occludens toxin that acts as a tight junction regulator. Larazotide acetate modulates intestinal permeability by preventing zonulin-mediated opening of tight junctions between enterocytes. By reducing paracellular permeability, it aims to prevent gluten peptide translocation across the intestinal barrier in celiac disease, reducing the immune-mediated inflammatory response triggered by gluten exposure.
Key Research Findings
Phase 2b trial showed significant reduction in celiac disease symptoms and improved lactulose-to-mannitol ratio (a marker of intestinal permeability) in patients on a gluten-free diet exposed to gluten challenge (Leffler et al., Gastroenterology, 2015). Phase 3 trials ongoing as adjunctive therapy for celiac disease. If approved, would be the first pharmacological treatment for celiac disease beyond dietary gluten avoidance.
Oral
In Clinical Trials
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Find a Larazotide ProviderRelated Peptides
Octreotide (Sandostatin)
FDA ApprovedA synthetic octapeptide analog of somatostatin with a substantially longer half-life (90 minutes IV, 6 hours subcutaneous vs. 2 minutes for native somatostatin). Octreotide binds somatostatin receptors (primarily SSTR2 and SSTR5) to inhibit the secretion of GH, glucagon, insulin, gastrin, secretin, VIP, and other GI hormones. It reduces splanchnic blood flow, GI motility, and exocrine pancreatic secretion.
Lanreotide (Somatuline Depot)
FDA ApprovedA synthetic octapeptide analog of somatostatin with high affinity for SSTR2 and moderate affinity for SSTR5 receptors. Lanreotide is formulated as a supersaturated solution that forms a drug depot at the injection site, providing sustained release over 4 weeks. It inhibits GH secretion, GI hormone release, and has direct antiproliferative effects on neuroendocrine tumor cells through cell cycle arrest and apoptosis induction.
Pasireotide (Signifor)
FDA ApprovedA multireceptor-targeted somatostatin analog with high binding affinity for SSTR1, SSTR2, SSTR3, and SSTR5, particularly notable for its 40-fold greater affinity for SSTR5 compared to octreotide. This receptor profile makes pasireotide uniquely effective in Cushing's disease, where corticotroph adenomas predominantly express SSTR5. Pasireotide suppresses ACTH secretion from pituitary corticotroph tumors, reducing cortisol production.
Plecanatide (Trulance)
FDA ApprovedA synthetic 16-amino acid peptide structurally related to uroguanylin, an endogenous intestinal peptide that regulates fluid and electrolyte homeostasis in the GI tract. Plecanatide activates guanylate cyclase-C (GC-C) receptors on intestinal epithelial cells in a pH-dependent manner, preferentially in the proximal small intestine where pH is slightly acidic. GC-C activation increases intracellular and extracellular cGMP, stimulating chloride and bicarbonate secretion while reducing visceral pain signaling.