ArticleCritical care explorations2022
Zonulin Antagonist, Larazotide (AT1001), As an Adjuvant Treatment for Multisystem Inflammatory Syndrome in Children: A Case Series.
Article in Critical care explorations, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
15 citing papers in PubMed, 24 citations in OpenAlex.
- Intestinal Barrier Loss Enables Microbiota-Mediated Purinergic Suppression During Malaria.bioRxiv : the preprint server for biology · 2026Article
- Gut-liver axis in diabetes: Mechanisms and therapeutic opportunities.World journal of gastroenterology · 2025Review
- A review of gut failure as a cause and consequence of critical illness.Critical care (London, England) · 2025Review
- The Spectrum of Postacute Sequelae of COVID-19 in Children: From MIS-C to Long COVID.Annual review of virology · 2024Review
- Zonulin as Gatekeeper in Gut-Brain Axis: Dysregulation in Glioblastoma.Biomedicines · 2024Review
- Paracellular permeability and tight junction regulation in gut health and disease.Nature reviews. Gastroenterology & hepatology · 2023Review
- Could Zonulin and Presepsin Be Biomarkers and Therapeutic Targets for Acute Myocarditis?Arquivos brasileiros de cardiologia · 2023Article
- Mechanisms of gastrointestinal barrier dysfunction in COVID-19 patients.World journal of gastroenterology · 2023Review
- Zonulin as a Potential Therapeutic Target in Microbiota-Gut-Brain Axis Disorders: Encouraging Results and Emerging Questions.International journal of molecular sciences · 2023Review
- Neutrophil profiles of pediatric COVID-19 and multisystem inflammatory syndrome in children.Cell reports. Medicine · 2022Article
- COVID-19 and Gut Injury.Nutrients · 2022Review
- Long COVID endotheliopathy: hypothesized mechanisms and potential therapeutic approaches.The Journal of clinical investigation · 2022Review
- Celiac Disease and Targeting the Molecular Mechanisms of Autoimmunity in COVID Pandemic.International journal of molecular sciences · 2022Review
- Zonulin, a marker of gut permeability, is associated with mortality in a cohort of hospitalised peruvian COVID-19 patients.Frontiers in cellular and infection microbiology · 2022Article
- Multisystem Inflammatory Syndrome in Children and Long COVID: The SARS-CoV-2 Viral Superantigen Hypothesis.Frontiers in immunology · 2022Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
Abstract
objectivesA recent study suggests that Multisystem Inflammatory Syndrome in Children (MIS-C) is triggered by gastrointestinal breach of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral particles from the gut lumen into systemic circulation. The virus remains in the gut weeks to months after respiratory infection, causing zonulin release from the intestinal epithelial cells. Zonulin loosens tight junctions, permitting trafficking of highly inflammatory viral particles into circulation. Current MIS-C treatments target the subsequent immune hyperactivation, not the causative loss of mucosal barrier integrity. Larazotide, a zonulin inhibitor, prevents breakdown of tight junctions, limiting antigen trafficking.
designChildren with MIS-C were treated with larazotide as an adjuvant to steroid/intravenous immunoglobulin therapy. Clinical outcomes, SARS-CoV-2 antigenemia, and cytokine profiles are reported. Outcomes were compared with children with MIS-C receiving steroids and/or IVIG therapy alone. PATIENTS: Four children with MIS-C, ages 3-17 years, were enrolled.
interventionsPatients were treated with open label larazotide 10 mcg/kg (maximum 500 mcg/dose) orally four times daily for 21 days. MEASUREMENTS AND MAIN
resultsAll four patients tolerated larazotide without adverse effects and displayed reduction in Spike antigenemia to undetectable levels. When compared with 22 children with MIS-C receiving steroids and/or intravenous immunoglobulin therapy alone, larazotide-treated patients reported significantly improved time to resolution of gastrointestinal symptoms (
conclusionsLarazotide appears safe and well-tolerated and may offer potential benefit as an adjuvant to immune-targeted therapies. Expansion of clinical trials is urgently needed to ascertain the clinical impact of larazotide on MIS-C.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.