Background: The involvement of intercellular tight junctions and, in particular,
the modulation of their competency by the zonulin pathway with a subsequent increase
in epithelial and endothelial permeability, has been described in several chronic
and acute inflammatory diseases. In this scenario, Larazotide, a zonulin antagonist, could
be employed as a viable therapeutic strategy.
Objective: The present review aims to describe recent research and current observations
about zonulin involvement in several diseases and the use of its inhibitor Larazotide for
Methods: A systematic search was conducted on PubMed and Google Scholar, resulting
in 209 publications obtained with the following search query: “Larazotide,” “Larazotide
acetate,” “AT-1001,” “FZI/0” and “INN-202.” After careful examination, some publications
were removed from consideration because they were either not in English or were
not directly related to Larazotide.
Results: The obtained publications were subdivided according to Larazotide’s mechanism
of action and different diseases: celiac disease, type 1 diabetes, other autoimmune
diseases, inflammatory bowel disease, Kawasaki disease, respiratory (infective and/or
non-infective) diseases, and other.
Conclusion: A substantial role of zonulin in many chronic and acute inflammatory diseases
has been demonstrated in both in vivo and in vitro, indicating the possible efficacy
of a Larazotide treatment. Moreover, new possible molecular targets for this molecule
have also been demonstrated.