WO2014139469A1

WO2014139469A1 - Ornithine- or aspartate-containing compositions and the uses thereof

Info

Publication number: WO2014139469A1
Application number: PCT/CN2014/073479
Authority: WO
Inventors: Jian GE; Chaodong Wang
Original assignee: Wuhan Qr Science And Technology Development Co.
Priority date: 2013-03-15
Filing date: 2014-03-14
Publication date: 2014-09-18

Abstract

Methods and compositions comprising ornithine and/or aspartate that are useful for lowering one or more hyperlipidemic risk factor levels are described. More specifically, compositions comprising ornithine and/or aspartate that are useful for lowering lipid and/or lipoprotein levels, such as triglyceride, cholesterol and LDL levels, in the bloodstream in a subject are described. Methods of using compositions comprising ornithine and/or aspartate for ameliorating the side-effect induced by a therapeutic agent (e.g., statin) or a condition that is associated with an elevation of CPK (e.g., rhabdomyolysis or myopathy) are also described.

Description

ORNITHINE- OR ASPARTATE-CONTAINING COMPOSITIONS AND THE

USES THEREOF

BACKGROUND OF THE INVENTION

[0001] Hyperlipidemia is a heterogeneous group of disorders characterized by an excess of lipids, including cholesterol, cholesterol esters, phospholipids, and triglycerides, in the bloodstream. These lipids are transported in the blood as large "lipoproteins". Hyperlipidemia mainly result from diseases such as diabetes, thyroid disease, renal disorders, liver disorders, and Cushing's syndrome, as well as obesity, alcohol consumption, estrogen administration, and other drug- associated changes in lipid metabolism. Hyperlipidemia is also a major, modifiable risk factor for atherosclerosis and cardiovascular disease, including coronary heart disease. In normal condition, lipids present in blood, if the lipid levels are too high, the excess lipids can accumulate on the walls of arteries. This build-up of cholesterol and other substances, called plaque, can therefore narrow the artery. It can also lead to atheriosclerosis, or hardening of the arteries, which turns the normally flexible tissue more brittle.

[0002] In clinic, hyperlipidemia can be treated by various medications, such as HMG-CoA inhibitors (statins), nicotinic acid, fibrates, fenofibrate, micronized fenofibrate, bile acid binding resins, colestipol, CETP antagonist and cholesterol absorption inhibitors (e.g. ezetimibe). Statins, in particular atorvastatin (Lipitor), are used commonly in clinics to treat hyperlipidemia. Clinical data has demonstrated that statins can effectively decrease the levels of cholesterol and LDL in bloodstream, however, its effect on decreasing serum triglyceride levels is only moderate, only by approximately 8-35%. Furthermore, although most data do indicate that statins can reduce lipid levels in bloodstream, the effects of statins are not always reliable. Occasionally, it has been reported that statins can even increase triglycerides. In clinic, there are five different types of hyperlipidemia, type I to V. Amongst these five types of hyperlipidemia, Type I, III, IV, and V are associated with increased triglyceride level in serum, except that type II is only related to high level of cholesterol. Clinic evidence has confirmed that high levels of triglycerides are the most common symptom in hyperlipidemia and are the highest risk factor for cardiovascular diseases, especially coronary heart diseases. [0003] While statin medications are generally effective and safe for treatment of hyperlipidemia, there has been clinical evidence indicating that chronic administration of atorvastatin or other statins, especially higher doses, can result in rhabdomyolysis and myopathy. These adverse effects are dose related, and can induce serious muscle pain and weakness.

[0004] Furthermore, high-doses of statin have been reported to significantly increase blood sugar levels, and may result in higher risk of acquiring new-onset diabetes compared to low doses of statin treatment. The FDA has published warnings suggesting that cholesterol-lowering drugs like Lipitor may increase your blood sugar and further lead to memory issues. These side-effects of statin medications may result in early terminations of the treatment, and limit the clinic uses of statins.

[0005] Ornithine and aspartate can complex together in a salt form, as referred to "ornithine- aspartate" herein. The symbol "-" that is placed in between two entities refers to an ionic bonding in between, wherein one entity is a counter ion of the other entity. Ornithine-aspartate is primarily used to treat conditions such as hepatic encephalopathy, hepatitis, hepatic steatosis, jaundice, liver cirrhosis in clinic. In cirrhosis, impaired hepatic metabolism and blood flow lead to raised serum and CNS ammonia concentrations. Ornithine and aspartate are amino acids which are important in the biochemical pathways that detoxify ammonia. Abnormal ammonia metabolism and the resulting accumulation of toxic ammonia is one of several possible mechanisms for hepatic encephalopathy. Ornithine and aspartate are substrates in metabolizing ammonia to urea and glutamine, respectively. L-Ornithine is one of the products of the action of the enzyme arginase on L-arginine, creating urea. L-ornithine supplementation may attenuate fatigue in subjects, in increasing the efficiency of energy consumption and promoting the excretion of ammonia (Sugino et al. (2008) "L-ornithine supplementation attenuates physical fatigue in healthy volunteers by modulating lipid and amino acid metabolism", Nutrition Research 28(11):738-43). L-Ornithine may also reduce mental stress of a subject (Kurata et al. (2011) "Orally administered L- ornithine elevates brain L-ornithine levels and has an anxiolytic-like effect in mice" , Nutritional Neuroscience 14(6):243-8).

SUMMARY OF THE INVENTION

[0006] As noted above, there exists a pressing need for compositions and methods that can effectively reduce one or more hyperlipidemic risk factor level in a subject. Similarly, there is also a need for reducing side-effects of the anti-hyperlipidemic agents such as statins. The present invention addresses these needs and provides related advantages as well.

[0007] In one embodiment, the present invention provides a method of lowering one or more hyperlipidemic risk factor level in a subject in need thereof. The method comprises

administering to said subject a composition comprising ornithine and/or aspartate in an amount that is effective in lowering the one or more hyperlipidemic risk factor level.

[0008] In another embodiment, the present invention provides a method of administering an anti- hyperlipidemic agent to a subject in need thereof. The method comprises administering an effective amount of the anti-hyperlipidemic agent in conjunction with an effective amount of a composition comprising ornithine and/or aspartate. Where desired, the composition can be administered orally. The composition can also be administered prior to, subsequent to, or concurrent with administering the anti-hyperlipidemic agent.

[0009] In still yet another embodiment, the present invention provides a method of reducing a side effect of a therapeutic agent wherein the side effect is characterized by an increase in CPK activity in a subject administered with said therapeutic agent, comprising administering a composition comprising an effective amount of ornithine and/or aspartate to said subject that is administered with said therapeutic agent.

[0010] In yet another embodiment, the present invention provides a method of treating a subject suffering from rhabdomyolysis or myopathy. The method comprises administering to the subject an effective amount of a composition comprising ornithine and/or aspartate that is less than about 9 g.

[0011] In practicing any of the methods provided herein, the composition administered to a subject can contain at least a portion of ornithine (O) and aspartate (A) that is complexed in a salt form of ornithine- aspartate (OA). In another aspect, the composition administered to a subject can contain ornithine and a counter anion disclosed herein. In yet another aspect, the

composition administered to a subject can contain aspartate and a counter cation disclosed herein. Where desired alternatively, the composition administered comprises free form of ornithine and/or free form of aspartate. In some aspects, the composition administered comprises ornithine and/or aspartate in its pharmaceutically accepted salt forms.

[0012] In one aspect, the amount of ornithine and/or aspartate administered is about 0.01 g to 100 g daily. In another aspect, the amount of ornithine and/or aspartate administered is about 0.01 g to 20 g daily. In yet another aspect, the amount of ornithine and/or aspartate administered is less than 9 g daily. In yet another aspect, the amount of ornithine and/or aspartate

administered is less than 3 g daily. In still yet another aspect, the amount of ornithine and/or aspartate administered does not result in an increase in glucose level in plasma of said subject.

[0013] In some aspects, the subject in need of the composition disclosed herein suffers from hyperlipidemia, hyperlipidemia induced fat liver diseases, obesity, atherosclerosis,

cardiovascular diseases, rhabdomyolysis or myopathy. In some aspect, upon administration of said composition and the anti-hyperlipidemic agent, the subject's creatine phosphokinase (CPK) activity level in plasma is less than about 400 U/L.

[0014] The methods disclosed herein may involve administration of the composition disclosed via oral ingestion, intravenous administration, inhalation, nasal insufflation, intra-arterial injection, subcutaneous administration, mucosal administration, or pharyngeal administration. Administration of the subject composition can take place for at least about 10 days or at least about 1, 2, 3, 4, 5, 6 months or longer. The composition administered can be contained in a foodstuff or in a pharmaceutical composition.

[0015] In some embodiments, the methods disclosed herein can be used to lower one or more hyperlipidemic risk factor selected from the group consisting of triglyceride, LDL, and cholesterol.

[0016] In some embodiments, the methods disclosed herein can reduce a side-effect of an anti- hyperlipidemic agent. Such side effect includes but is not limited to an increased CPK activity level, an increased glucose level, rhabdomyolysis, and myopathy in said subject in need thereof.

[0017] The anti- hyperlipidemic agent encompassed by the subject methods and compositions include but are not limited to HMG-CoA inhibitor, nicotinic acid, fibrate, bile acid sequestrant, ezetimibe, lomitapide, phytosterols, CETP antagonists, orlistat, and any combination thereof. Where desired, the anti- hyperlipidemic agent used in the subject method includes but is not limited to HMG-CoA inhibitor, such as atorvastatin, fluvastatin, pravastatin, lovastatin, simvastatin, rovuvastatin, or lovastatin , and any combination thereof. The anti- hyperlipidemic agent can be atorvastatin/ezetimibe combination. Where desired, the anti-hyperlipidemic agent are administered as a single unit dose, including but not limited to a tablet, a capsule, a pill, a granule, an emulsion, a gel, a plurality of beads encapsulated in a capsule, a powder, a suspension, a liquid, a semi-liquid, a semi-solid, a syrup, a slurry or a chewable. [0018] The present invention also provides a composition comprising: (a) an anti- hyperlipidemic agent; and (b) a composition comprising an effective amount of ornithine and/or aspartate. In one aspect, the amount of ornithine and/or aspartate is effective in reducing one or more hyperlipidemic risk factor level in plasma in a subject in need thereof. In another aspect, the composition is formulated in a unit dosage form. In another aspect, the composition is formulated in a solid or liquid form. In yet another aspect, the composition is formulated for oral consumption, intravenous injection, inhalation, nasal insufflation, intraarterial injection, subcutaneous administration, mucosal administration, or pharyngeal administration. In still yet another aspect, the composition is formulated for oral consumption.

[0019] In yet another aspect, the composition can be effective in lowering said one or more hyperlipidemic risk factor selected from the group consisting of triglyceride, LDL and cholesterol. In another aspect, the composition does not result in an increase in creatine phosphokinase (CPK) activity in plasma of said subject upon administering said composition. Where desired, the composition can be packaged as a solid or liquid dosage form including but not limited to a tablet, a capsule, a pill, a granule, an emulsion, a gel, a plurality of beads encapsulated in a capsule, a powder, a suspension, a liquid, a semi-liquid, a semi-solid, a syrup, a slurry or a chewable. Where desired, component (a) and component (b) are separately packaged, or mixed. The anti-hyperlipidemic agent contained in a composition disclosed herein can be selected from the group consisting of: HMG-CoA inhibitor, nicotinic acid, fibrate, bile acid sequestrant, ezetimibe, lomitapide, phytosterols, CETP antagonist, orlistat, and any combination thereof. A number of HMG-CoA inhibitor can be utilized, including without limitation atorvastatin, fluvastatin, pravastatin, lovastatin, simvastatin, rovuvastatin and lovastatin.

[0020] In some aspects, the composition disclosed herein contains an anti-hyperlipidemic agent present in an amount effective in reducing triglyceride level in the subject with hyperlipidemia.

[0021] In some aspects, the composition disclosed herein comprises about 0.01 to 100 g of ornithine and/or aspartate, about 0.01 to 20 g of ornithine and/or aspartate, or less than about 9 g, 8g, 7g, 6g, 5g, 4g, 3g, or even less of ornithine and/or aspartate.

INCORPORATION BY REFERENCE

[0022] All publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference. BRIEF DESCRIPTION OF THE DRAWINGS

[0023] The novel features of the invention are set forth with particularity in the appended claims. A better understanding of the features and advantages of the present invention will be obtained by reference to the following detailed description that sets forth illustrative embodiments, in which the principles of the invention are utilized, and the accompanying drawings of which:

DETAILED DESCRIPTION OF THE INVENTION

[0024] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the singular forms "a", "an" and "the" are intended to include the plural forms as well, unless the context clearly indicates otherwise. Furthermore, to the extent that the terms "including", "includes", "having", "has", "with", or variants thereof are used in either the detailed description and/or the claims, such terms are intended to be inclusive in a manner similar to the term "comprising".

[0025] The term "about" or "approximately" means within an acceptable error range for the particular value as determined by one of ordinary skill in the art, which will depend in part on how the value is measured or determined, i.e., the limitations of the measurement system. For example, "about" can mean within 1 or more than 1 standard deviation, per the practice in the art. Alternatively, "about" can mean a range of up to 20%, up to 10%, up to 5%, or up to 1% of a given value. Alternatively, particularly with respect to biological systems or processes, the term can mean within an order of magnitude, preferably within 5-fold, and more preferably within 2- fold, of a value. Where particular values are described in the application and claims, unless otherwise stated the term "about" meaning within an acceptable error range for the particular value should be assumed.

[0026] "Treatment", "treating", "palliating" and "ameliorating", as used herein, are used interchangeably. These terms refer to an approach for obtaining beneficial or desired results including but not limited to therapeutic benefit and/or a prophylactic benefit. By therapeutic benefit is meant eradication or amelioration of the underlying disorder being treated. Also, a therapeutic benefit is achieved with the eradication or amelioration of one or more of the physiological symptoms associated with the underlying disorder such that an improvement is observed in the patient, notwithstanding that the patient may still be afflicted with the underlying disorder. For prophylactic benefit, the compositions may be administered to a patient at risk of developing a particular disease, or to a patient reporting one or more of the physiological symptoms of a disease, even though a diagnosis of this disease may not have been made.

[0027] As used herein, "agent" refers to a biological, pharmaceutical, or chemical compound or other moiety. Non-limiting examples include simple or complex organic or inorganic molecule, a peptide, a protein, an oligonucleotide, an antibody, an antibody derivative, antibody fragment, a vitamin derivative, a carbohydrate, a toxin, or a chemotherapeutic compound. Various compounds can be synthesized, for example, small molecules and oligomers (e.g., oligopeptides and oligonucleotides), and synthetic organic compounds based on various core structures. In addition, various natural sources can provide compounds for screening, such as plant or animal extracts, and the like. A skilled artisan can readily recognize that there is no limit as to the structural nature of the agents of the present invention.

[0028] Generally, the term "concurrent administration", "co-administration", or "administration in conjunction with" in reference to two or more subjects of administration for administration to a subject body, such as components, agents, substances, materials, compositions, and/or the like, refers to administration performed using dose(s) and time interval (s) such that the subjects of administration are present together within the subject body, or at a site of action in the subject body, over a time interval in less than de minimus quantities. The time interval may be any suitable time interval, such as an appropriate interval of minutes, hours, days, or weeks, for example. The subjects of administration may be administered together, such as parts of a single composition, for example, or otherwise. The subjects of administration may be administered substantially simultaneously (such as within less than or equal to about 5 minutes, about 3 minutes, or about 1 minute, of one another, for example) or within a short time of one another (such as within less than or equal to about 1 hour, 30 minutes, or 10 minutes, or within more than about 5 minutes up to about 1 hour, of one another, for example). The subjects of administration so administered may be considered to have been administered at substantially the same time. One of ordinary skill in the art will be able to determine appropriate dose(s) and time interval(s) for administration of subjects of administration to a subject body so that same will be present at more than de minimus levels within the subject body and/or at effective concentrations within the subject body. When the subjects of administration are concurrently administered to a subject body, any such subject of administration may be in an effective amount that is less than an effective amount that might be used were it administered alone. [0029] The term "effective amount," which is further described herein, encompasses both this lesser effective amount and the usual effective amount, and indeed, any amount that is effective to elicit a particular condition, effect, and/or response. As such, a dose of any such subject of concurrent administration may be less than that which might be used were it administered alone. One or more effect(s) of any such subject(s) of administration may be additive or synergistic. Any such subject(s) of administration may be administered more than one time. The effective amount may vary depending upon the intended application (in vitro or in vivo), or the subject and disease condition being treated, e.g., the weight and age of the subject, the severity of the disease condition, the manner of administration and the like, which can readily be determined by one of ordinary skill in the art. The term also applies to a dose that will induce a particular response in target cells, e.g., reduction of proliferation or down-regulation of activity of a target protein. The specific dose will vary depending on the particular compounds chosen, the dosing regimen to be followed, whether it is administered in combination with other compounds, timing of administration, the tissue to which it is administered, and the physical delivery system in which it is carried.

[0030] The term "pharmaceutically acceptable salt" refers to salts derived from a variety of organic and inorganic counter ions well known in the art. Pharmaceutically acceptable acid addition salts can be formed with inorganic acids and organic acids. Inorganic acids from which salts can be derived include, for example, hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid, and the like. Organic acids from which salts can be derived include, for example, acetic acid, propionic acid, glycolic acid, pyruvic acid, oxalic acid, maleic acid, malonic acid, succinic acid, fumaric acid, tartaric acid, citric acid, benzoic acid, cinnamic acid, mandelic acid, methanesulfonic acid, ethanesulfonic acid, p-toluenesulfonic acid, salicylic acid, and the like. Pharmaceutically acceptable base addition salts can be formed with inorganic and organic bases. Inorganic bases from which salts can be derived include, for example, sodium, potassium, lithium, ammonium, calcium, magnesium, iron, zinc, copper, manganese, aluminum, and the like. Organic bases from which salts can be derived include, for example, primary, secondary, and tertiary amines, substituted amines including naturally occurring substituted amines, cyclic amines, basic ion exchange resins, and the like, specifically such as

isopropylamine, trimethylamine, diethylamine, triethylamine, tripropylamine, and ethanolamine. In some embodiments, the pharmaceutically acceptable base addition salt is chosen from ammonium, potassium, sodium, calcium, and magnesium salts.

[0031] "Pharmaceutically acceptable carrier" or "pharmaceutically acceptable excipient" includes any and all solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic and absorption delaying agents and the like. The use of such media and agents for pharmaceutically active substances is well known in the art. Except insofar as any conventional media or agent is incompatible with the active ingredient, its use in the therapeutic compositions of the invention is contemplated. Supplementary active ingredients can also be incorporated into the compositions.

[0032] As previously mentioned, anti-hyperlipidemic agents that are known in the art, such as statins, may not be capable of effectively and safely reducing serum levels of hyperlipidemic risk factor, such as triglyceride, cholesterol and LDL levels. The "serum" level refers to a physiological level, and in some embodiments, "serum level" may refer to the level in body fluid including plasma level or bloodstream level. Therefore, there exists a clinical mandate for compositions and methods that are useful for effectively and safely reducing serum levels of triglyceride, cholesterol, and/or LDL. In addition, there is a need for reducing the side-effects of the anti-hyperlipidemic agents such as statins, or lowering serum CPK level. The present invention provides compositions comprising amino acids ornithine and/or aspartate and methods that can address the needs. The subject compositions and methods may be useful for lowering hyperlipidemic risk factor levels in bloodstream. In some cases, an effective amount of a therapeutic agent that is known in the medical art (e.g., an anti-hyperlipidemic agent) can be administered in conjunction with the subject compositions. The subject compositions and methods may also be useful in reducing side effects of the therapeutic agent (e.g., statin), and lowering the serum CPK level. A description of various aspects, features, embodiments, and examples, is provided herein.

[0033] Disclosed herein are compositions comprising ornithine and/or aspartate, and the methods of using the compositions. Compositions comprising ornithine and/or aspartate may be effective in lowering the one or more hyperlipidemic risk factor (e.g., triglyceride, LDL, cholesterol) levels in serum of the subject. In some embodiments, the compositions comprising ornithine and/or aspartate may increase the level of HDL. In some embodiments, compositions comprising ornithine and/or aspartate may be effective to reducing a side-effect of a therapeutic agent, such as lowering the CPK activity level. In some embodiments, compositions comprising ornithine and/or aspartate may be effective to treat a condition that is associated with an elevated serum level of CPK activity. The methods and compositions may comprise ornithine but not aspartate. The methods and compositions may comprise aspartate but not ornithine. The methods and compositions may comprise both ornithine and aspartate that are not complexed together.

[0034] The subject compositions may comprise ornithine. The ornithine may be complexed with a counter cation. The counter cation may be any cation that is known in the art. Non-limiting examples of counter cation include aspartate, glutamate, chloride, sulfate, phosphate, carbonate, acetate, lactate, and citrate. Aspartate is non-essential in mammals, being produced from oxaloacetate by transamination. It can also be generated from ornithine and citrulline in the urea cycle. Aspartic acid may be used to prevent fatigue or hepatic disturbance. Aspartate is known to be the carboxylate anion, salt, or ester of aspartic acid. The subject compositions may comprise aspartate. The aspartate may be complexed with a counter anion. The counter anion may be any anion that is known in the art. Non-limiting examples of the counter anion may include, arginine, cysteine, glutamine, glycine, serine, sodium, calcium, magnesium, and potassium. The ornithine-counter cation and/or aspartate-counter-anion may be in salt form.

[0035] Such a composition, such as that appropriate for administration to a subject, may comprise at least one ornithine-comprising component and/or aspartate-comprising component. The ornithine- and/or aspartate-comprising components may be any suitable ornithine- and/or aspartate-comprising component, such as a suitably bioavailable ornithine- and/or aspartate- comprising component. The ornithine- and/or aspartate-comprising component may be any suitable biologically acceptable ornithine- and/or aspartate-comprising component. The ornithine- and/or aspartate-comprising component may be any suitable organic acid salt. Merely by way of example, the ornithine- and/or aspartate-comprising component may be a ornithine and/or aspartate salt of an amino acid.

[0036] In one embodiment, the composition of the invention may comprise at least one ornithine- and/or aspartate-counter ion compound. In other embodiments, the invention includes compositions comprising 2, 3, 4, 5, or more ornithine- and/or aspartate-counter ion compounds. In other embodiments, the counter ion(s) will be organic. In some embodiments, the organic counter ion will have 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10 or more carbon atoms. [0037] The methods and compositions described herein may comprise ornithine and aspartate that are complexed with each other to form ornithine-aspartate in a salt form. The "-" refers to an ionic bond in between the two entities that are complexed together to form a salt. The ornithine and aspartate may be complexed using methods that are known in the art (Marumo, US 3,360,549). The Ornithine-aspartate (OA) in a salt form has been used in the treatment of cirrhosis that is well known in the art (Sikorska et al. (2010) "Physiological functions ofL-ornithine and L-aspartate in the body and the efficacy of administration of L-ornithine -L-aspartate in conditions of relative deficiency", Polski Merkuriusz Lekarski 2<S(168):490-5). A preparation of L-ornithine and L-aspartate complex may used to increase the generation of urea through the urea cycle, a metabolic pathway that removes ammonia by turning it into the neutral substance urea. It may be combined with lactulose and/or rifaximin if these alone are ineffective at controlling symptoms. As described in the current invention, methods and compositions comprising ornithine-aspartate may be used to lower the serum level of one or more hyperlipidemic risk factor such as lipolipids and/or lipids (e.g., triglyceride), to reduce a side-effect of a therapeutic agent (e.g., anti- hyperlipidemic agent, statin), or to lower serum level of CPK activity.

[0038] A composition appropriate for administration to a subject with hyperlipidemia or a condition that is association with hyperlipidemia may comprise ornithine and/or aspartate. In some embodiments, a portion of the composition may comprise ornithine-aspartate as a complex. The ornithine-aspartate may be complexed with each other in a 1 :1 ratio. In some embodiments, the composition may comprise ornithine in complex with a counter anion. The composition may comprise aspartate in complex with a counter cation. In some cases, the composition may comprise both the ornithine-counter anion and the aspartate-counter cation in a ratio. For example, the ratio may be 1:1, 1:1.5, 1:2, 1:2.5, 1:3, 1:3.5, 1:4, 1:4.5, 1:5, 1:5.5, 1:6, 1:6.5, 1:7, 1:7.5, 1:8, 1:8.5, 1:9, 1:9.5, 1:10, 1:10.5, 1:11, 1:11.5, 1:12, 1:12.5, 1:13, 1:13.5, 1:14, 1:14.5, 1:15, 1:15.5, 1:16, 1:16.5, 1:17, 1:17.5, 1:18, 1:18.5, 1:19, 1:19.5 or 1:20. The composition may comprise ornithine and/or aspartate in combinations with any other types of amino acid. The composition may further comprise at least one type of amino acid other than ornithine and/or aspartate. The amino acid may be a non-essential amino acid or an essential amino acid. The amino acid may be a natural amino acid or a non-natural amino acid. The amino acid may be in its salt form. The composition may comprise ornithine and/or aspartate in a salt form. The composition may comprise ornithine and/or aspartate in a dissociated ionic form. The amino acid may be Leucine, Isoleucine, Histadine, Valine, Lysine, Methionine, Phenylalanine,

Threonine, Tryptophan, Arginine, Cysteine, Tyrosine, Alanine, Aspartic Acid, Glutamic Acid, Cystine, Glutamine, Glycine, Ornithine, Serine, Proline, or Taurine. The amino acid, except for glycine, may be in a L form or D form, wherein the L and D forms of an amino acid are enantiomers. The ornithine may be L-ornithine. The aspartate may be L-aspartate.

[0039] Such a composition may be prophylactically and/or therapeutically suitable or beneficial. The subject composition may be suitable for relatively rapid ornithine and/or aspartate intake, provision, and/or supplementation, as may be suitable or beneficial for any of a variety of applications, such as a nutritional or prophylactic application, and/or a therapeutic application. The composition may be a suitable or beneficial vehicle for ornithine and/or aspartate intake, provision, and/or supplementation application(s), such as any that may be accomplished via a dietary vehicle or a consumable vehicle, such as a foodstuff and/or a beverage, for example.

[0040] In some embodiments, the composition comprising ornithine and/or aspartate may be in a single dosage form. In some cases, the composition can be in multiple dosage forms. The compositions can be administered in a single dose or multiple doses. Dosing may be about once, twice, three times, four times, five times, six times, or more than six times per day. Dosing may be about once a month, once every two weeks, once a week, or once every other day. In another embodiment, ornithine and/or aspartate and/or one or more therapeutic agents (e.g., anti- hyperlipidemic agents) may be administered together about once per day to about 6 times per day. In another embodiment, the administration of ornithine and/or aspartate and/or one or more therapeutic agents may continues for less than about 7 days. In yet another embodiment the administration continues for equal or more than about 6, 10, 14, 20, 28, 30 days, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 months, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 years. In some cases, continuous dosing is achieved and maintained as long as necessary. In some embodiments, the composition comprising ornithine and/or aspartate administered for at least about a month. In some embodiments, the composition is administered for at least about 10 days. Administration of the composition comprising ornithine and/or aspartate may continue as long as necessary. In some embodiments, a compound of the invention is administered for less than 28, 14, 7, 6, 5, 4, 3, 2, or 1 day. In some embodiments, a compound of the invention is administered chronically on an ongoing basis, e.g., for the treatment of chronic effects. [0041] The compositions of the invention may be administered in dosages. It is known in the art that due to intersubject variability in compound pharmacokinetics, individualization of dosing regimen may be desired for optimal therapy. Dosing for a compound of the invention may be found by routine experimentation in light of the instant disclosure.

[0042] Determining an appropriate dosage for administration of a composition comprising ornithine and/or aspartate to a subject may take into account any of a variety of factors, such as those just mentioned, for example, any potential or actual side-effect(s), and/or a purpose of the administration of the composition comprising ornithine and/or aspartate, such as a condition treatment purpose, a reducing side-effect purpose, and/or other purpose(s) for which the composition comprising ornithine and/or aspartate may be administered to a subject.

Determining an appropriate dosage may take into account any of these factors, any other suitable factor(s), any side-effect(s), animal study modeling, human study modeling, clinical study modeling, drug study modeling, and any balancing therebetween.

[0043] The amount of ornithine and/or aspartate that can be absorbed by a subject, or the rate of absorption of ornithine and/or aspartate by a subject may vary from subject to subject, based on any of a variety of factors. Examples of such factors include metabolic rate, kidney function, overall health, and/or other factor(s) concerning a subject, and a property or nature of the composition comprising ornithine and/or aspartate itself, such as the counter ion, any enhancing agent, its administration vehicle or method, and/or other factor(s) concerning the composition comprising ornithine and/or aspartate and/or its administration to a subject.

[0044] The compositions comprising ornithine and/or aspartate according to the invention are effective over a wide dosage range. For example, in the administration to adult humans, dosages from 0.0005 to 100 g, from 0.01 to 100 g, from 0.001 to 50 g, from 0.005 to 30 g per day, and from 0.01 to 20 g per day are non-limiting examples of dosages that may be used. The exact dosage will depend upon the route of administration, the form in which the compound is administered, the subject to be administered to, the body weight of the subject to be administered to, and the preference and experience of the attending physician.

[0045] It is contemplated that a dosage for administration of ornithine and/or aspartate to a subject may take account the number of molecular entities of ornithine, aspartate, or a combination of both ornithine and aspartate if both are comprised in the composition. It is contemplated that a dosage for administration of ornithine and/or aspartate to a subject may be from about 1.5 mg/kg of body weight/day to about 1 g/kg of body weight/day. For example, it is contemplated that a dosage for administration of ornithine and/or aspartate to a subject may be less than about 0.9 g/kg of body weight/day of ornithine and/or aspartate; may be about 300 mg/kg of body weight/day to about 1 g/kg of body weight/day; and may be about 150 mg/kg of body weight/day to about 300 mg/kg of body weight/day for disease and/or pathological condition treatment purpose(s), such as the treatment of hyperlipidemia, conditions that are associated with hyperlipidemia, conditions that are associated with elevation of CPK activity, or side-effects of some therapeutic agents, for example. Such amounts may be suitable for a human subject, for example. The dosage for administration of ornithine and/or aspartate to a subject may be less than 150 mg/kg.

[0046] As mentioned above, such a dosage may be determined, modified and/or refined based on any suitable factor(s), such as results of clinical trials concerning subjects, for example human subjects. In some embodiments, a suitable dosage may be determined, modified and/or refined based on a determination of a suitable dosage for a suitable animal model, based on experimental studies or tests, for example, and conversion of such a suitable animal dosage to a suitable human dosage, based on suitable conversion factor(s), such as any suitable established conversion factor(s), for example. Further by way of example, it is contemplated that any such suitable human dosage may be further determined, modified and/or refined based on clinical trials involving human subjects, for example.

[0047] In clinical practice, there are multiple types of anti-hyperlipidemic agents that are currently prescribed and administered to a subject that is suffering from hyperlipidemia or a condition that is associated with hyperlipidemia. The anti-hyperlipidemic agents may be effective in lowering levels of one or more hyperlipidemic risk factors. Some of the anti- hyperlipidemic agents may lower the triglyceride, LDL or cholesterol levels, and some may increase the F£DL level of the subject administered. The types of the anti-hyperlipidemic agents known in the art may include, but are not limited to, FIMG-CoA inhibitors (or statins), nicotinic acid, fibrates, bile acid sequestrants (resins), cholesterol absorbtion inhibitors (ezetimibe), lomitapide, phytosterols, orlistat or others. Non-limiting examples of statin type anti- hyperlipidemic agents include: atorvastatin, fluvastatin, pravastatin, lovastatin, simvastatin, pitavastatin, cerivastatin, rosuvastatin, or lovastatin/niacin ER. Non-limiting examples of cholesterol absorbtion inhibitors include ezetimibe, and combination of ezetime with simvastatin. Non-limiting examples of fibrate type of anti-hyperlipidemic agents include: gemfibrozil, fenofibrate, fenofibric acid, clofibrate, or micronized fenofibrate. Non-limiting examples of nicotinic acid include nicotinic acid, or niacin XR. Non-limiting examples of bile acid sequestrants include: colestipol, cholestyramine, or colesevelam. Other types of anti- hyperlipidemic agent may include dextrothyroxine sodium or icosapent.

[0048] When the ornithine and/or aspartate is administered in a composition that comprises one or more therapeutic agents, and the therapeutic agents have a shorter half-life than the ornithine and/or aspartate, the unit dose forms of the therapeutic agent and the ornithine and/or aspartate may be adjusted accordingly.

[0049] A composition comprising ornithine and/or aspartate can be formulated to provide a effective amount of ornithine and/or aspartate as the active ingredients, or a pharmaceutically acceptable salt, ester, prodrug, solvate, hydrate or derivative thereof. The composition can be a pharmaceutical composition. The composition can further comprise one or more therapeutic agents that are selected for their particular usefulness against a condition that is being treated. For example, the therapeutic agent may be an anti-hyperlipidemic agent. The anti- hyperlipidemic agent can be in an amount effective in treating a symptom associated with hyperlipidemia. Where desired, the compositions contain pharmaceutically acceptable salt and/or coordination complex thereof, and one or more pharmaceutically acceptable excipients, carriers, including inert solid diluents and fillers, diluents, including sterile aqueous solution and various organic solvents, permeation enhancers, solubilizers and adjuvants.

[0050] A composition comprising ornithine and/or aspartate may be administered to a subject in any suitable manner. Such administration may be oral and/or any other suitable administration, such as transdermal, intravenous, aerosol, intramuscular, vaginal, rectal, subdermal, parenteral, ophthalmic, pulmonary, transmucosal, otic, nasal, and topical administration. Components of a composition described herein, such as ornithine-aspartate, at least one agent for increasing the bioavailability or ornithine, or at least one therapeutic agent may be administered to a subject concurrently, such as in any manner of concurrent administration described herein and/or in U.S. Patent Application Publication No. US 2006/0089335 Al . In addition, by way of example only, parenteral delivery includes intramuscular, subcutaneous, intravenous, intramedullary injections, as well as intrathecal, direct intraventricular, intraperitoneal, intralymphatic, and intranasal injections. [0051] The subject compositions comprising ornithine and/or aspartate can be administered alone or in combination with one or more other agents, which are also typically administered in the form of compositions. Where desired, ornithine and/or aspartate, and other agent(s) may be mixed into a preparation or all components may be formulated into separate preparations to use them in combination separately or at the same time. In some embodiments, the compositions may be in unit dosage form. In some embodiments, the ornithine and/or aspartate and one or more therapeutic agents can be packaged separately or together. The ornithine and/or aspartate may be packaged separately from the one or more therapeutic agents but administered together. The ornithine and/or aspartate may be administered separately from the one or more therapeutic agents.

[0052] In some embodiments, the content of ornithine and/or aspartate provided in the compositions of the present invention is less than about 100%, 90%, 80%, 70%, 60%, 50%, 40%, 30%, 20%, 19%, 18%, 17%, 16%, 15%, 14%, 13%, 12%, 11%, 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, 0.5%, 0.4%, 0.3%, 0.2%, 0.1%, 0.09%, 0.08%, 0.07%, 0.06%, 0.05%, 0.04%, 0.03%, 0.02%, 0.01%, 0.009%, 0.008%, 0.007%, 0.006%, 0.005%, 0.004%, 0.003%, 0.002%, 0.001%, 0.0009%, 0.0008%, 0.0007%, 0.0006%, 0.0005%, 0.0004%, 0.0003%, 0.0002%, or 0.0001% w/w or w/v. In some embodiments, the content of ornithine and/or aspartate in the compositions is greater than about 90%, 80%, 70%, 60%, 50%, 40%, 30%, 20%, 19.75%, 19.50%, 19.25% 19%, 18.75%, 18.50%, 18.25% 18%, 17.75%, 17.50%, 17.25% 17%, 16.75%, 16.50%, 16.25% 16%, 15.75%, 15.50%, 15.25% 15%, 14.75%, 14.50%, 14.25% 14%, 13.75%, 13.50%, 13.25% 13%, 12.75%, 12.50%, 12.25% 12%, 11.75%, 11.50%, 11.25% 11%, 10.75%, 10.50%, 10.25% 10%, 9.75%, 9.50%, 9.25% 9%, 8.75%, 8.50%, 8.25% 8%, 7.75%, 7.50%, 7.25% 7%, 6.75%, 6.50%, 6.25% 6%, 5.75%, 5.50%, 5.25% 5%, 4.75%, 4.50%, 4.25%, 4%, 3.75%, 3.50%, 3.25%, 3%, 2.75%, 2.50%, 2.25%, 2%, 1.75%, 1.50%, 125% , 1%, 0.5%, 0.4%, 0.3%, 0.2%, 0.1%, 0.09%, 0.08%, 0.07%, 0.06%, 0.05%, 0.04%, 0.03%, 0.02%, 0.01%, 0.009%, 0.008%, 0.007%, 0.006%, 0.005%, 0.004%, 0.003%, 0.002%, 0.001%, 0.0009%, 0.0008%, 0.0007%, 0.0006%, 0.0005%, 0.0004%, 0.0003%, 0.0002%, or 0.0001% w/w or w/v. In some embodiments, the content of ornithine and/or aspartate in the composition is about 49 %.

[0053] In some embodiments, the amount of ornithine and/or aspartate present in a salt form or free form in the composition is equal to or less than 100, 95, 90, 85, 80, 75, 70, 65, 60, 55, 50, 45, 40, 35, 30, 20, 19, 18, 17, 16, 15, 14, 13, 12, 11 , 10, 9.5, 9, 8.5, 8, 7.5, 7, 6.5, 6, 5.5, 5, 4.5, 4, 3.5, 3, 2.5, 2, 1.5, 1, 0.9, 0.8, 0.7, 0.6, 0.5, 0.4, 0.3, 0.2, 0.1, 0.09, 0.08, 0.07, 0.06, 0.05, 0.04, 0.03, 0.02, 0.01 , 0.009, 0.008, 0.007, 0.006, 0.005, 0.004, 0.003, 0.002, 0.001 , 0.0009, 0.0008, 0.0007, 0.0006, 0.0005, 0.0004, 0.0003, 0.0002, or 0.0001 g. In some embodiments, the amount of ornithine and/or aspartate in a salt form or free form is more than 0.0001, 0.0002, 0.0003, 0.0004, 0.0005, 0.0006, 0.0007, 0.0008, 0.0009, 0.001, 0.002, 0.003, 0.004, 0.005, 0.006, 0.007, 0.008,

0.009, 0.01, 0.02, 0.03, 0.04, 0.05, 0.06, 0.07, 0.08, 0.09, 0.1 , 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9,

1, 1.5, 2, 2.5, 3, 3.5, 4, 4.5, 5, 5.5, 6, 6.5, 7, 7.5, 8, 8.5, 9, 9.5, 10, 11 , 12, 13, 14, 15, 16, 17, 18, 19, or 20 g. In some embodiments, the amount of ornithine and/or aspartate in a salt form or free form is more than 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95 or 100 g. In some embodiments, the amount of ornithine and/or aspartate in the composition is less than 9 g. In some embodiments, the amount of ornithine and/or aspartate in a salt form or free form in the composition is less than 3 g. In some embodiments, the amount of ornithine and/or aspartate in a salt form or free form in the composition is 0.95 g. In some embodiments, the composition may comprise ornithine and/or aspartate in a salt form or free form in an amount between 0.0001-1 , 0.0001-3, 0.0001-2.5, 0.001-2.5, 0.1 -2.5, 0.001-3, 0.01 -3, 0.1-3, 0.01-20, 0.01-15, 0.01 -10, 0.01- 5, 0.01-100 g.

[0054] A composition of the invention typically comprises an active ingredient (e.g., ornithine and/or aspartate) of the present invention or a pharmaceutically acceptable salt and/or

coordination complex thereof, and one or more pharmaceutically acceptable excipients, carriers, including but not limited to inert solid diluents and fillers, diluents, sterile aqueous solution and various organic solvents, permeation enhancers, solubilizers and adjuvants. The composition can further comprise one or more supplements or other active ingredients. The composition can further comprise one or more herbal extract. The composition can further comprise one or more coloring pigments.

[0055] Described below are non-limiting exemplary compositions and methods for preparing the same. In some embodiments, the invention provides a pharmaceutical composition for oral administration comprising ornithine and/or aspartate, and a pharmaceutical excipient suitable for oral administration. In some embodiments, the invention provides a solid pharmaceutical composition for oral administration comprising: (i) an effective amount of ornithine and/or aspartate; (ii) an amount of a therapeutic agent (e.g., an anti-hyperlipidemic agent or an antihypertensive agent); optionally (iii) an effective amount of one or more other agents; and (iv) a pharmaceutical excipient suitable for oral administration. In some embodiments, the anti- hyperlipidemic agent is present in an amount effective in reducing triglyceride level in the subject with hyperlipidemia.

[0056] A composition comprising ornithine and/or aspartate appropriate for administration to a subject may be provided in any suitable form, such as a liquid form, a gel form, a semi-liquid (for example, a liquid, such as a viscous liquid, containing some solid) form, a semi-solid (a solid containing some liquid) form, and/or a solid form, for example. Merely by way of example, a tablet form, a capsule form, a food form a chewable form, a non-chewable form, a slow- or sustained-release form, a non-slow- or non-sustained-release from, and/or the like, may be employed. Gradual-release tablets are known in the art. Examples of such tablets are set forth in U.S. Pat. No. 3,456,049. Such a composition may comprise an additional agent or agents, whether active or passive. Examples of such an agent include a sweetening agent, a flavoring agent, a coloring agent, a filling agent, a binding agent, a lubricating agent, an excipient, a preservative, a manufacturing agent, and/or the like, merely by way of example, in any suitable form. A slow- or sustained-release form may delay disintegration and/or absorption of the composition and/or one or more component(s) thereof over a period, such as a relatively long period, for example. A food form may take the form of a food bar, a cereal product, a bakery product, a dairy product, and/or the like, for example. A bakery product form may take the form of a bread-type product, such as a bagel or bread itself, for example, a donut, a muffin, and/or the like, merely by way of example. A component of a composition comprising ornithine and/or aspartata may be provided in a form that is other than that of another component of the composition. For example, ornithine and/or aspartate may be provided in a solid form, such as solid food or cereal that is taken with an anti-hyperlipidemic agent in a liquid form. Such administration of compositions comprising ornithine and/or aspartate in multiple forms, may occur simultaneously (e.g., ingesting a tablet of anti-hyperlipidemic agent with a ornithine- aspartate-fortified milk), or at different times.

[0057] In some embodiments, the composition comprising ornithine and/or aspartate may be a solid or liquid pharmaceutical composition suitable for oral consumption. Pharmaceutical compositions of the invention suitable for oral administration can be presented as a discrete or unit dosage form each containing a predetermined amount of an active ingredient. The predetermined amount of the active ingredients may be a powder or granules, beads, a solution, or a suspension in an aqueous or non-aqueous liquid, an oil-in-water emulsion, or a water-in-oil liquid emulsion. The subject dosage forms can be prepared by any of the methods of pharmacy. In some cases, the methods may include the step of bringing the active ingredient into association with the carrier, which constitutes one or more desired ingredients. The compositions may be prepared by uniformly and intimately admixing the active ingredient with liquid carriers or finely divided solid carriers or both, and then, if desired, shaping the product into the desired presentation. For example, a tablet can be prepared by compression or molding, optionally with one or more accessory ingredients. Tablets can be compressed by compressing in a suitable machine the active ingredient in a free-flowing form such as powder or granules, optionally mixed with an excipient such as, but not limited to, a binder, a lubricant, an inert diluent, and/or a surface active or dispersing agent. Tablets can be moded by molding in a suitable machine a mixture of the powdered compound moistened with an inert liquid diluent.

[0058] This invention further encompasses anhydrous pharmaceutical compositions and dosage forms comprising an active ingredient, since water can facilitate the degradation of some compounds. For example, water may be added (e.g., 5%) in the pharmaceutical arts as a means of simulating long-term storage in order to determine characteristics such as shelf-life or the stability of formulations over time. Anhydrous pharmaceutical compositions and dosage forms of the invention can be prepared using anhydrous or low moisture containing ingredients and low moisture or low humidity conditions. Pharmaceutical compositions and dosage forms of the invention which contain lactose can be made anhydrous if substantial contact with moisture and/or humidity during manufacturing, packaging, and/or storage is expected. An anhydrous pharmaceutical composition may be prepared and stored such that its anhydrous nature is maintained. Accordingly, anhydrous compositions may be packaged using materials known to prevent exposure to water such that they can be included in suitable formulary kits. Examples of suitable packaging include, but are not limited to, hermetically sealed foils, plastic or the like, unit dose containers, blister packs, and strip packs.

[0059] An active ingredient can be combined in an intimate admixture with a pharmaceutical carrier according to conventional pharmaceutical compounding techniques. The carrier can take a wide variety of forms depending on the form of preparation desired for administration. In preparing the compositions for an oral dosage form, any of the usual pharmaceutical media can be employed as carriers, including but not limited to, water, glycols, oils, alcohols, flavoring agents, preservatives, coloring agents, and the like in the case of oral liquid preparations (such as suspensions, solutions, and elixirs) or aerosols; or carriers such as starches, sugars, micro- crystalline cellulose, diluents, granulating agents, lubricants, binders, and disintegrating agents can be used in the case of oral solid preparations, in some embodiments without employing the use of lactose. For example, suitable carriers include powders, capsules, granules and tablets, with the solid oral preparations. If desired, tablets can be coated by standard aqueous or nonaqueous techniques.

[0060] Binders suitable for use in the subject pharmaceutical compositions and dosage forms include, but are not limited to, corn starch, potato starch, or other starches, gelatin, natural and synthetic gums such as acacia, sodium alginate, alginic acid, other alginates, powdered tragacanth, guar gum, cellulose and its derivatives (e.g., ethyl cellulose, cellulose acetate, carboxymethyl cellulose calcium, sodium carboxymethyl cellulose), polyvinyl pyrrolidone, methyl cellulose, pre-gelatinized starch, hydroxypropyl methyl cellulose, microcrystalline cellulose, and mixtures thereof.

[0061] Examples of suitable fillers for use in the pharmaceutical compositions and dosage forms disclosed herein include, but are not limited to, talc, talcum, calcium carbonate (e.g., granules or powder), microcrystalline cellulose, powdered cellulose, dextrates, kaolin, mannitol, silicic acid, sorbitol, starch, pre-gelatinized starch, and mixtures thereof.

[0062] Disintegrants may be used in the compositions of the invention to provide tablets that disintegrate when exposed to an aqueous environment. Too much of a disintegrant may produce tablets which may disintegrate in the bottle. Too little may be insufficient for disintegration to occur and may thus alter the rate and extent of release of the active ingredient(s) from the dosage form. Thus, a sufficient amount of disintegrant that is neither too little nor too much to detrimentally alter the release of the active ingredient(s) may be used to form the dosage forms of the compounds disclosed herein. The amount of disintegrant used may vary based upon the type of formulation and mode of administration, and may be readily discernible to those of ordinary skill in the art. About 0.5 to about 15 weight percent of disintegrant, or about 1 to about 5 weight percent of disintegrant, may be used in the pharmaceutical composition. Disintegrants that can be used to form pharmaceutical compositions and dosage forms of the invention include, but are not limited to, agar-agar, alginic acid, calcium carbonate, microcrystalline cellulose, croscarmellose sodium, povidone, povidone k30, crospovidone, polacrilin potassium, sodium starch glycolate, potato or tapioca starch, other starches, pre-gelatinized starch, other starches, clays, other algins, other celluloses, gums or mixtures thereof.

[0063] Lubricants which can be used to form pharmaceutical compositions and dosage forms of the invention include, but are not limited to, calcium stearate, magnesium stearate, mineral oil, light mineral oil, glycerin, sorbitol, mannitol, polyethylene glycol, other glycols, stearic acid, sodium lauryl sulfate, talc, hydrogenated vegetable oil (e.g., peanut oil, cottonseed oil, sunflower oil, sesame oil, olive oil, corn oil, and soybean oil), zinc stearate, ethyl oleate, ethyl laureate, agar, or mixtures thereof. Additional lubricants include, for example, a syloid silica gel, a coagulated aerosol of synthetic silica, or mixtures thereof. A lubricant can optionally be added, in an amount of less than about 1 weight percent of the pharmaceutical composition.

[0064] When the compositions comprising ornithine and/or aspartate are desired for oral administration, the composition therein may be combined with various sweetening or flavoring agents (e.g., aspartame, sugar), coloring matter or dyes (e.g., yellow pigment) and, if so desired, emulsifying and/or suspending agents, together with such diluents as water, ethanol, propylene glycol, glycerin and various combinations thereof.

[0065] Sweeteners, sweetening agents or flavoring agents are substances that sweeten food, beverages, or pharmaceutical compositions. Sweeteners may be sugar, saccharine or other low- calorie synthetic products (From Random House Unabridged Dictionary, 2d ed). Non-limiting examples of the sweetening or flavoring agent include N-(N-(3-(3-hydroxy-4-methoxyphenyl) propyl)-alpha-aspartyl)-L-phenylalanine 1 -methyl ester (Aspartame), 1 1 -oxo-mogroside V, aspartyl-alanine fenchyl ester, abrusoside A methyl ester, neotame, osladin, SC 45647, cellobiofructose, gentiobiofructose, 4,4',6,6'-tetrachloro-4,4',6,6'-tetradeoxygalactotrehalose, brazzein protein, Pentadiplandra brazzeana, hydrangenol-4'-0-glucoside, hydrangenol-8-O- galactoside, 3,3'-dideoxytrehalose, selligueain A, periandrin V, NC 174, mabinlin protein, Capparis masaikai, alitame, cyclocarioside A, mabilin Π protein, Capparis masaikai, N-(4- cyanophenyl)-N'-(2-carboxyethyl)urea, steviolbioside, Adentol, periandradulcin C,

periandradulcin B, periandradulcin A, Sweetrex, monellin, Asn(22)-Gln(25)-Asn(26)-A-chain- Asn(49)-Glu(50)-B-chain, curculin, leucrose, polypodoside A, rubusoside, glycyrrhetyl 3- monoglucuronide, oxime V, hernandulcin, fungitetraose, neosugar, mogroside IV, mogroside V, mogroside VI, coupling sugar, 4-chlorokynurenine, glucosylsucrose, 6-chlorotryptophan, rebaudioside A, perillartine, hydrangenol, Palatinit, Lycasin, cycloheptylsulfamate, CH 401 -Na, neohesperidin dihydrochalcone, P 4000, maltitol, phyllodulcin, miraculin protein, Synsepalum dulcificum, acetosulfam or dulcin.

[0066] The tablets can be uncoated or coated by known techniques to delay disintegration and absorption in the gastrointestinal tract and thereby provide a sustained action over a longer period. For example, a time delay material such as glyceryl monostearate or glyceryl distearate can be employed. Formulations for oral use can also be presented as hard gelatin capsules wherein the active ingredient is mixed with an inert solid diluent, for example, calcium carbonate, calcium phosphate or kaolin, or as soft gelatin capsules wherein the active ingredient is mixed with water or an oil medium, for example, peanut oil, liquid paraffin or olive oil.

[0067] Surfactant which can be used to form pharmaceutical compositions and dosage forms of the invention include, but are not limited to, hydrophilic surfactants, lipophilic surfactants, and mixtures thereof. That is, a mixture of hydrophilic surfactants may be employed, a mixture of lipophilic surfactants may be employed, or a mixture of at least one hydrophilic surfactant and at least one lipophilic surfactant may be employed.

[0068] A suitable hydrophilic surfactant may generally have an F£LB value of at least 10, while suitable lipophilic surfactants may generally have an F£LB value of or less than about 10. An empirical parameter used to characterize the relative hydrophilicity and hydrophobicity of non- ionic amphiphilic compounds is the hydrophilic-lipophilic balance (" F£LB" value). Surfactants with lower F£LB values are more lipophilic or hydrophobic, and have greater solubility in oils, while surfactants with higher F£LB values are more hydrophilic, and have greater solubility in aqueous solutions. Hydrophilic surfactants are generally considered to be those compounds having an F£LB value greater than about 10, as well as anionic, cationic, or zwitterionic compounds for which the F£LB scale is not generally applicable. Similarly, lipophilic (i.e., hydrophobic) surfactants are compounds having an F£LB value equal to or less than about 10. However, HLB value of a surfactant is merely a rough guide generally used to enable

formulation of industrial, pharmaceutical and cosmetic emulsions.

[0069] Hydrophilic surfactants may be either ionic or non-ionic. Suitable ionic surfactants include, but are not limited to, alkylammonium salts; fusidic acid salts; fatty acid derivatives of amino acids, oligopeptides, and polypeptides; glyceride derivatives of amino acids, oligopeptides, and polypeptides; lecithins and hydrogenated lecithins; lysolecithins and hydrogenated lysolecithins; phospholipids and derivatives thereof; lysophospholipids and derivatives thereof; carnitine fatty acid ester salts; salts of alkylsulfates; fatty acid salts; sodium docusate; acyl lactylates; mono- and di-acetylated tartaric acid esters of mono- and di-glycerides; succinylated mono- and di-glycerides; citric acid esters of mono- and di-glycerides; and mixtures thereof.

[0070] Within the aforementioned group, ionic surfactants include, by way of example: lecithins, lysolecithin, phospholipids, lysophospholipids and derivatives thereof; carnitine fatty acid ester salts; salts of alkylsulfates; fatty acid salts; sodium docusate; acy lactylates; mono- and di- acetylated tartaric acid esters of mono- and di-glycerides; succinylated mono- and di-glycerides; citric acid esters of mono- and di-glycerides; and mixtures thereof.

[0071] Ionic surfactants may be the ionized forms of lecithin, lysolecithin, phosphatidylcholine, phosphatidylethanolamine, phosphatidylglycerol, phosphatidic acid, phosphatidylserine, lysophosphatidylcholine, lysophosphatidylethanolamine, lysophosphatidylglycerol,

lysophosphatidic acid, lysophosphatidylserine, PEG-phosphatidylethanolamine, PVP- phosphatidylethanolamine, lactylic esters of fatty acids, stearoyl-2-lactylate, stearoyl lactylate, succinylated monoglycerides, mono/diacetylated tartaric acid esters of mono/diglycerides, citric acid esters of mono/diglycerides, cholylsarcosine, caproate, caprylate, caprate, laurate, myristate, palmitate, oleate, ricinoleate, linoleate, linolenate, stearate, lauryl sulfate, teracecyl sulfate, docusate, lauroyl carnitines, palmitoyl carnitines, myristoyl carnitines, and salts and mixtures thereof.

[0072] Hydrophilic non-ionic surfactants may include, but are not limited to, alkylglucosides; alkylmaltosides; alkylthioglucosides; lauryl macrogolglycerides; polyoxyalkylene alkyl ethers such as polyethylene glycol alkyl ethers; polyoxyalkylene alkylphenols such as polyethylene glycol alkyl phenols; polyoxyalkylene alkyl phenol fatty acid esters such as polyethylene glycol fatty acids monoesters and polyethylene glycol fatty acids diesters; polyethylene glycol glycerol fatty acid esters; polyglycerol fatty acid esters; polyoxyalkylene sorbitan fatty acid esters such as polyethylene glycol sorbitan fatty acid esters; hydrophilic transesterification products of a polyol with at least one member of the group consisting of glycerides, vegetable oils, hydrogenated vegetable oils, fatty acids, and sterols; polyoxyethylene sterols, derivatives, and analogues thereof; polyoxyethylated vitamins and derivatives thereof; polyoxyethylene-polyoxypropylene block copolymers; and mixtures thereof; polyethylene glycol sorbitan fatty acid esters and hydrophilic transesterification products of a polyol with at least one member of the group consisting of triglycerides, vegetable oils, and hydrogenated vegetable oils. The polyol may be glycerol, ethylene glycol, polyethylene glycol, sorbitol, propylene glycol, pentaerythritol, or a saccharide.

[0073] Other hydrophilic-non-ionic surfactants include, without limitation, PEG- 10 laurate, PEG- 12 laurate, PEG-20 laurate, PEG-32 laurate, PEG-32 dilaurate, PEG- 12 oleate, PEG- 15 oleate, PEG-20 oleate, PEG-20 dioleate, PEG-32 oleate, PEG-200 oleate, PEG-400 oleate, PEG- 15 stearate, PEG-32 distearate, PEG-40 stearate, PEG- 100 stearate, PEG-20 dilaurate, PEG-25 glyceryl trioleate, PEG-32 dioleate, PEG-20 glyceryl laurate, PEG-30 glyceryl laurate, PEG-20 glyceryl stearate, PEG-20 glyceryl oleate, PEG-30 glyceryl oleate, PEG-30 glyceryl laurate, PEG-40 glyceryl laurate, PEG-40 palm kernel oil, PEG-50 hydrogenated castor oil, PEG-40 castor oil, PEG-35 castor oil, PEG-60 castor oil, PEG-40 hydrogenated castor oil, PEG-60 hydrogenated castor oil, PEG-60 corn oil, PEG-6 caprate/caprylate glycerides, PEG-8 caprate/caprylate glycerides, polyglyceryl-10 laurate, PEG-30 cholesterol, PEG-25 phyto sterol, PEG-30 soya sterol, PEG-20 trioleate, PEG-40 sorbitan oleate, PEG-80 sorbitan laurate, polysorbate 20, polysorbate 80, POE-9 lauryl ether, POE-23 lauryl ether, POE-10 oleyl ether, POE-20 oleyl ether, POE-20 stearyl ether, tocopheryl PEG-100 succinate, PEG-24 cholesterol, polyglyceryl-lOoleate, Tween 40, Tween 60, sucrose monostearate, sucrose monolaurate, sucrose monopalmitate, PEG 10-100 nonyl phenol series, PEG 15-100 octyl phenol series, and poloxamers.

[0074] Suitable lipophilic surfactants include, by way of example only: fatty alcohols; glycerol fatty acid esters; acetylated glycerol fatty acid esters; lower alcohol fatty acids esters; propylene glycol fatty acid esters; sorbitan fatty acid esters; polyethylene glycol sorbitan fatty acid esters; sterols and sterol derivatives; polyoxyethylated sterols and sterol derivatives; polyethylene glycol alkyl ethers; sugar esters; sugar ethers; lactic acid derivatives of mono- and di-glycerides;

hydrophobic transesterification products of a polyol with at least one member of the group consisting of glycerides, vegetable oils, hydrogenated vegetable oils, fatty acids and sterols; oil- soluble vitamins/vitamin derivatives; and mixtures thereof. Within this group, preferred lipophilic surfactants include glycerol fatty acid esters, propylene glycol fatty acid esters, and mixtures thereof, or are hydrophobic transesterification products of a polyol with at least one member of the group consisting of vegetable oils, hydrogenated vegetable oils, and triglycerides.

[0075] In one embodiment, the composition may include a solubilizer to ensure good

solubilization and/or dissolution of the compound of the present invention and to minimize precipitation of the compound of the present invention. This can be especially beneficial for compositions for non-oral use, e.g., compositions for injection. A solubilizer may also be added to increase the solubility of the hydrophilic drug and/or other components, such as surfactants, or to maintain the composition as a stable or homogeneous solution or dispersion.

[0076] Examples of suitable solubilizers include, but are not limited to, the following: alcohols and polyols, such as ethanol, isopropanol, butanol, benzyl alcohol, ethylene glycol, propylene glycol, butanediols and isomers thereof, glycerol, pentaerythritol, sorbitol, mannitol, transcutol, dimethyl isosorbide, polyethylene glycol, polypropylene glycol, polyvinylalcohol,

hydroxypropyl methylcellulose and other cellulose derivatives, cyclodextrins and cyclodextrin derivatives; ethers of polyethylene glycols having an average molecular weight of about 200 to about 6000, such as tetrahydrofurfuryl alcohol PEG ether (glycofurol) or methoxy PEG ; amides and other nitrogen-containing compounds such as 2-pyrrolidone, 2-piperidone, ε-caprolactam, N- alkylpyrrolidone, N-hydroxyalkylpyrrolidone, N-alkylpiperidone, N-alkylcaprolactam, dimethylacetamide and polyvinylpyrrolidone; esters such as ethyl propionate, citrate, tributylcitrate, acetyl triethylcitrate, acetyl tributyl citrate, triethylcitrate, ethyl oleate, ethyl caprylate, ethyl butyrate, triacetin, propylene glycol monoacetate, propylene glycol diacetate, ε- caprolactone and isomers thereof, δ-valerolactone and isomers thereof, β-butyrolactone and isomers thereof; and other solubilizers known in the art, such as dimethyl acetamide, dimethyl isosorbide, N-methyl pyrrolidones, monooctanoin, diethylene glycol monoethyl ether, and water.

[0077] Mixtures of solubilizers may also be used. Examples include, but not limited to, triacetin, triethylcitrate, ethyl oleate, ethyl caprylate, dimethylacetamide, N-methylpyrrolidone, N- hydroxyethylpyrrolidone, polyvinylpyrrolidone, hydroxypropyl methylcellulose, hydroxypropyl cyclodextrins, ethanol, polyethylene glycol 200-100, glycofurol, transcutol, propylene glycol, and dimethyl isosorbide. Particularly preferred solubilizers include sorbitol, glycerol, triacetin, ethyl alcohol, PEG-400, glycofurol and propylene glycol.

[0078] The amount of solubilizer that can be included is not particularly limited. The amount of a given solubilizer may be limited to a bioacceptable amount, which may be readily determined by one of skill in the art. In some circumstances, it may be advantageous to include amounts of solubilizers far in excess of bioacceptable amounts, for example to maximize the concentration of the drug, with excess solubilizer removed prior to providing the composition to a subject using conventional techniques, such as distillation or evaporation. Thus, if present, the solubilizer can be in a weight ratio of 10%, 25%, 50%, 100%, or up to about 200% by weight, based on the combined weight of the drug, and other excipients. If desired, very small amounts of solubilizer may also be used, such as 5%, 2%, 1% or even less. Typically, the solubilizer may be present in an amount of about 1% to about 100%, more typically about 5% to about 25% by weight.

[0079] The composition can further include one or more pharmaceutically acceptable additives and excipients. Such additives and excipients include, without limitation, detackifiers, anti- foaming agents, buffering agents, polymers, antioxidants, preservatives, chelating agents, viscomodulators, tonicifiers, flavorants, colorants, odorants, opacifiers, suspending agents, binders, fillers, plasticizers, lubricants, and mixtures thereof.

[0080] In addition, an acid or a base may be incorporated into the composition to facilitate processing, to enhance stability, or for other reasons. Examples of pharmaceutically acceptable bases include amino acids, amino acid esters, ammonium hydroxide, potassium hydroxide, sodium hydroxide, sodium hydrogen carbonate, aluminum hydroxide, calcium carbonate, magnesium hydroxide, magnesium aluminum silicate, synthetic aluminum silicate, synthetic hydrocalcite, magnesium aluminum hydroxide, diisopropylethylamine, ethanolamine, ethylenediamine, triethanolamine, triethylamine, triisopropanolamine, trimethylamine, tris(hydroxymethyl)aminomethane (TRIS) and the like. Also suitable are bases that are salts of a pharmaceutically acceptable acid, such as acetic acid, acrylic acid, adipic acid, alginic acid, alkanesulfonic acid, amino acids, ascorbic acid, benzoic acid, boric acid, butyric acid, carbonic acid, citric acid, fatty acids, formic acid, fumaric acid, gluconic acid, hydroquinosulfonic acid, isoascorbic acid, lactic acid, maleic acid, oxalic acid, para-bromophenylsulfonic acid, propionic acid, p-toluenesulfonic acid, salicylic acid, stearic acid, succinic acid, tannic acid, tartaric acid, thioglycolic acid, toluenesulfonic acid, uric acid, and the like. Salts of polyprotic acids, such as sodium phosphate, disodium hydrogen phosphate, and sodium dihydrogen phosphate can also be used. When the base is a salt, the cation can be any convenient and pharmaceutically acceptable cation, such as ammonium, alkali metals, alkaline earth metals, and the like. Example may include, but not limited to, sodium, potassium, lithium, magnesium, calcium and ammonium.

[0081] Suitable acids are pharmaceutically acceptable organic or inorganic acids. Examples of suitable inorganic acids include hydrochloric acid, hydrobromic acid, hydriodic acid, sulfuric acid, nitric acid, boric acid, phosphoric acid, and the like. Examples of suitable organic acids include acetic acid, acrylic acid, adipic acid, alginic acid, alkanesulfonic acids, amino acids, ascorbic acid, benzoic acid, boric acid, butyric acid, carbonic acid, citric acid, fatty acids, formic acid, fumaric acid, gluconic acid, hydroquinosulfonic acid, isoascorbic acid, lactic acid, maleic acid, methanesulfonic acid, oxalic acid, para-bromophenylsulfonic acid, propionic acid, p- toluenesulfonic acid, salicylic acid, stearic acid, succinic acid, tannic acid, tartaric acid, thioglycolic acid, toluenesulfonic acid, uric acid and the like.

[0082] The composition may further comprise one or more herbs or supplements that are known in the art. Non-limiting examples of the herbs or the supplements may be Acai, Alfalfa, Aloe, Aloe Vera, Aristolochic Acids, Asian Ginseng, Astragalus, Bacillus coagulans, Belladonna, Beta-carotene, Bifidobacteria, Bilberry, Bilberry, Biotin, Bitter Orange, Black Cohosh, Black Cohosh, Black psyllium, Black tea, Bladderwrack, Blessed thistle, Blond psyllium, Blueberry, Blue-green algae, Boron, Bromelain, Butterbur, Calcium, Calendula, Cancell/Cantron/Protocel, Cartilage (Bovine and Shark), Cassia cinnamon, Cat's Claw, Chamomile, Chastebeny,

Chondroitin sulfate, Chromium, Cinnamon, Clove, Coenzyme Q-10, Colloidal Silver Products, Cranberry, Creatine, Dandelion, Dandelion, Devil's claw, DHEA, Dong quai, Echinacea,

Ephedra, Essiac/Flor-Essence, Eucalyptus, European Elder (Elderberry), European Mistletoe, Evening Primrose Oil, Fenugreek, Feverfew, Fish oil, Flaxseed, Flaxseed oil, Folate, Folic acid, Garlic, Ginger, Gingko, Ginseng, Glucosamine hydrochloride, Glucosamine sulfate, Goldenseal, Grape Seed Extract, Green Tea, Hawthorn, Hoodia, Horse Chestnut, Horsetail, Hydrazine Sulfate, Iodine, Iron, Kava, Lactobacillus, Laetrile/Amygdalin, L-arginine, Lavender, Licorice, Lycium, Lycopene, Magnesium, Manganese, Melatonin, Milk Thistle, Mistletoe Extracts, Niacin and niacinamide (Vitamin B3), Noni, Oral Probiotics, Pantothenic acid (Vitamin B5),

Passionflower, PC-SPES, Pennyroyal, Peppermint, Phosphate salts, Pomegranate, Propolis, Pycnogenol, Pyridoxine (Vitamin B6), Red Clover, Red yeast, Riboflavin (Vitamin B2), Roman chamomile, Saccharomyces boulardii, S-Adenosyl-L-Methionine (SAMe), Sage, Saw Palmetto, Selected Vegetables/Sun's Soup, Selenium, Senna, Soy, St. John's Wort, sweet orange essence, Tea Tree Oil, Thiamine (Vitamin Bl), Thunder God Vine, Turmeric, Valerian, Vitamin A, Vitamin B12, Vitamin C, Vitamin D, Vitamin E, Vitamin K, Wild yam, Yohimbe, Zinc or 5- HTP.

[0083] In some embodiments, a composition that may be applicable for oral administration to a subject with hyperlipidemia or a condition that is associated with hyperlipidemia may comprise ornithine-aspartate, citrate, mannitol, povidone k30, sweet orange essemce, sunset yellow pigment, aspartame, ethanol, and talcum powder.

[0084] In some embodiments, the invention provides a pharmaceutical composition for injection containing a compound of the present invention and a pharmaceutical excipient suitable for injection. Components and amounts of agents in the compositions are as described herein.

[0085] The forms in which the compositions of the present invention may be incorporated for administration by injection include aqueous or oil suspensions, or emulsions, with sesame oil, corn oil, cottonseed oil, or peanut oil, as well as elixirs, mannitol, dextrose, or a sterile aqueous solution, and similar pharmaceutical vehicles.

[0086] Aqueous solutions in saline are also conventionally used for injection. Ethanol, glycerol, propylene glycol, liquid polyethylene glycol, and the like (and suitable mixtures thereof), cyclodextrin derivatives, and vegetable oils may also be employed. The proper fluidity can be maintained, for example, by the use of a coating, such as lecithin, for the maintenance of the required particle size in the case of dispersion and by the use of surfactants. The prevention of the action of microorganisms can be brought about by various antibacterial and antifungal agents, for example, parabens, chlorobutanol, phenol, sorbic acid, thimerosal, and the like.

[0087] Sterile injectable solutions are prepared by incorporating the compound of the present invention in the required amount in the appropriate solvent with various other ingredients as enumerated above, as required, followed by filtered sterilization. Generally, dispersions are prepared by incorporating the various sterilized active ingredients into a sterile vehicle which contains the basic dispersion medium and the required other ingredients from those enumerated above. In the case of sterile powders for the preparation of sterile injectable solutions, certain desirable methods of preparation are vacuum-drying and freeze-drying techniques which yield a powder of the active ingredient plus any additional desired ingredient from a previously sterile- filtered solution thereof.

[0088] Compositions for inhalation or insufflation include solutions and suspensions in pharmaceutically acceptable, aqueous or organic solvents, or mixtures thereof, and powders. The liquid or solid compositions may contain suitable pharmaceutically acceptable excipients as described supra. Preferably the compositions are administered by the oral or nasal respiratory route for local or systemic effect. Compositions in preferably pharmaceutically acceptable solvents may be nebulized by use of inert gases. Nebulized solutions may be inhaled directly from the nebulizing device or the nebulizing device may be attached to a face mask tent, or intermittent positive pressure breathing machine. Solution, suspension, or powder compositions may be administered, preferably orally or nasally, from devices that deliver the formulation in an appropriate manner.

[0089] Pharmaceutical compositions may also be prepared from compositions described herein and one or more pharmaceutically acceptable excipients suitable for sublingual, buccal, rectal, intraosseous, intraocular, intranasal, epidural, or intraspinal administration. Preparations for such pharmaceutical compositions are well-known in the art. See, e.g., Anderson, Philip O.; Knoben, James E.; Troutman, William G, eds., Handbook of Clinical Drug Data, Tenth Edition, McGraw-Hill, 2002; Pratt and Taylor, eds., Principles of Drug Action, Third Edition, Churchill Livingston, New York, 1990; Katzung, ed., Basic and Clinical Pharmacology, Ninth Edition, McGraw Hill, 20037ybg; Goodman and Gilman, eds., The Pharmacological Basis of

Therapeutics, Tenth Edition, McGraw Hill, 2001 ; Remingtons Pharmaceutical Sciences, 20th Ed., Lippincott Williams & Wilkins., 2000; Martindale, The Extra Pharmacopoeia, Thirty-Second Edition (The Pharmaceutical Press, London, 1999); all of which are incorporated by reference herein in their entirety.

[0090] In another aspect of the invention, methods for lowering the serum level of one or more hyperlipidemic risk factors, reducing side effects of a therapeutic agent, and/or lowering serum level of CPK with compositions comprising ornithine and/or aspartate are described herein.

The one or more hyperlipidemic risk factors that can be lowered may include triglyceride, cholesterol and LDL. Methods, compositions and/or the use of ornithine and/or aspartate described herein may be useful for purposes described herein, such as reducing one or more hyperlipidemic risk factor levels in the bloodstream or serum of a subject. The hyperlipidemic risk factors may include, but are not limited to, lipids and/or lipoproteins. The subject methods may also be used for increasing high-density lipoprotein (HDL) in the bloodstream or serum of the subject. The subject methods comprising the use of ornithine and/or aspartate may be applicable for administering to a subject that is suffering from hyperlipidemia, at risk of suffering from hyperlipidemia, and/or suffering from a condition that is associated with hyperlipidemia. In some cases, an effective amount of a therapeutic agent that is known in the medical art (e.g., an anti-hyperlipidemic agent) can be administered to a subject in conjunction with an effective amount of ornithine and/or aspartate. In some embodiments, the therapeutic agent (e.g., statin) may induce a side effect (e.g., elevation of creatine phosphokinase (CPK) level in serum, rhabdomyolysis, or myopathy). Methods described herein may also be useful for ameliorating the side-effect induced by the therapeutic agent or a condition that is associated with an elevation of CPK (e.g., rhabdomyolysis or myopathy). A description of various aspects, features, embodiments, and examples, is provided herein..

[0091] The methods described herein comprise administering to a subject a composition comprising ornithine and/or aspartate. "Subject" refers to an animal, such as a mammal, for example a human. The methods and compositions described herein can be useful in both human therapeutics, pre-clinical, and veterinary applications. In some embodiments, the subject is a mammal, and in some embodiments, the subject is human. The subject can be at different ages. The human subject can be a child (e.g., a neonate, an infant, a toddler, a preadolescent), an adolescent, a pubescent, or an adult (e.g., an early adult, a middle aged adult, a senior citizen). The human subject can be between about 0 months and about 120 years old, or older. The human subject can be between about 0 and about 12 months old; The human subject can be between about 0 and 12 years old; The human subject can be between about 13 years and 19 years old; for example, about 13, 14, 15, 16, 17, 18, or 19 years old. The human subject can be between about 20 and about 39 year old; for example, about 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, or 39 years old. The human subject can be between about 40 to about 59 years old; for example, about 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, or 59 years old. The human subject can be greater than 59 years old; for example, about 60, 61 , 62, 63, 64, 65, 66, 67, 68, 69, 70, 71 , 72, 73, 74, 75, 76, 77, 78, 79, 80, 81 , 82, 83, 84, 85, 86, 87, 88, 89, 90, 91 , 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, or 120 years old. The human subject can be about 45 years old or older. The human subject can be 55 years old or older. The human subject can be a male subject or a female subject.

[0092] The human subject can come from different ethnic groups, geographical regions, countries, continents and races. For example, the human subject can be an Asian (e.g., far-east Asian, middle-east Asian, south-east Asian, north-east Asian, or Asian Indian), a Caucasian (Canadian, American, European, or Mediterranean), an African, a pacific islander, or a Hispanic. The human subject can come from Khoid (Hottentot) race, Sanid (Bushmen) race, Central Congoid race (Geographic center and origin in the Congo river basin), Bambutid race (African Pygmies), Aethiopid race (Ethiopia, Somalia), Mediterranid race (from Mediterranean areas), Dinaric race (predominant in western Balkans [Dinaric Mountains] and northern Italy), Alpine race, Ladogan race (named after Lake Ladoga; indigenous to Russia; includes Lappish subrace of arctic Europe), Nordish or Northern European race, Armenid race (Armenia, Syria, Lebanon and northern Iraq), Turanid race (Kazakhstan, Hungary and Turkey), Irano-Afghan race (Iran and Afghanistan, Iraq, Turkey), Indie or Nordindid race (Pakistan and northern India), Dravidic race (India, Bangladesh and Sri Lanka), Veddoid race (remnant Australoid population in central and southern India) Melanesian race (New Guinea, Papua, Solomon Islands), Australian-Tasmanian race (Australian Aborigines), Northeast Asian or Northern Mogoloid race (China, Manchuria, Korea and Japan), Southeast Asian or Southern Mongoloid race (China, Indochina, Thailand, Myanmar [Burma], Malaysia, Indonesia and the Philippines), Micronesian-Polynesian race, Ainuid race (remnants of aboriginal population in northern Japan), Tungid race (Mongolia and Siberia, Eskimos), Amerindian race (American Indians). The human subject can come from Afghanistan, Albania, Algeria, Andorra, Angola, Antigua and Barbuda, Argentina, Armenia, Australia, Austria, Azerbaijan, Bahamas, Bahrain, Bangladesh, Barbados, Belarus, Belgium, Belize, Benin, Bhutan, Bolivia, Bosnia and Herzegovina, Botswana, Brazil, Brunei, Bulgaria, Burkina Faso, Burma, Burundi, Cambodia, Cameroon, Canada, Cape Verde, Central African Republic, Chad, Chile, China, Colombia, Comoros, Congo, Costa Rica, Cote d'lvoire, Croatia, Cuba, Cyprus, Czech Republic, Denmark, Djibouti, Dominican Republic, East Timor, Ecuador, Egypt, El Salvador, Equatorial Guinea, Eritrea, Estonia, Ethiopia, Fiji, Finland, France, Gabon, Gambia, Georgia, Germany, Ghana, Greece, Grenada, Guatemala, Guinea, Guinea-Bissau, Guyana, Haiti, Holy See, Honduras, Hong Kong, Hungary, Iceland, India, Indonesia, Iran, Iraq, Ireland, Israel, Italy, Jamaica, Japan, Jordan, Kazakhstan, Kenya, Kiribati, Korea, Kosovo, Kuwait, Kyrgyzstan, Laos, Latvia, Lebanon, Lesotho, Liberia, Libya, Liechtenstein, Lithuania, Luxembourg, Macau, Macedonia, Madagascar, Malawi, Malaysia, , Maldives, Mali, Malta, Marshall Islands, Mauritania, , Mauritius, Mexico, Micronesia, Moldova, Monaco, Mongolia, Montenegro, Morocco, Mozambique, Namibia, Nauru, Nepal, Netherlands, Netherlands Antilles, New Zealand, Nicaragua, Niger, Nigeria, North Korea, Norway, Oman, Pakistan, Palau, Palestinian Territories, Panama, Papua New Guinea, Paraguay, Peru, Philippines, Poland, Portugal, Qatar, Romania, Russia, Rwanda, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Samoa, San Marino, Sao Tome and Principe, Saudi Arabia, Senegal, Serbia, Seychelles, Sierra Leone, Singapore, Slovakia, Slovenia, Solomon Islands, Somalia, South Africa, South Korea, South Sudan, Spain , Sri Lanka, Sudan, Suriname, Swaziland , Sweden, Switzerland, Syria, Taiwan, Tajikistan, Tanzania, Thailand, Timor-Leste, Togo, Tonga, Trinidad and Tobago, Tunisia, Turkey, Turkmenistan, Tuvalu, , Uganda, Ukraine, United Arab Emirates, United Kingdom, Uruguay, Uzbekistan, Vanuatu, Venezuela, Vietnam, Yemen, Zambia, or Zimbabwe.

[0093] The subject can be on different types of diet. "Diet" refers to the types of food that a subject habitually consumes for a period of time. The period of time may be 3, 4, 5, 6, 7, 8, 9, 10, 11 , 12, 13 or 14 days; 3, 4, 5, 6, 7 or 8 weeks; 3, 4, 5, 6, 7, 8, 9, 10, 11 or 12 months; 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 , 12, 13, 14, 15, 16, 17, 18, 19, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95 or 100 years. In some embodiments, the subject on some types of diet may be at risk of hyperlipidemia or conditions that are associated with hyperlipidemia. The methods and composition described herein comprising ornithine and/or aspartate may be administered to the subject. In some embodiments, the subject can be on a high-fat diet, high-cholesterol diet, high- saturated fat diet, high-sugar diet, high-protein diet, or low-fiber diet. For each type of diet, "high" refers to a content level that is generally higher than the content in a normal diet that is well known in the art, as described by Food and Drug Administration ('Dietary Guidelines for Americans", 2010). The high-fat diet may have a fat content that is higher than 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%. The high-fat diet may contain 60% of fat. The subject may be on a diet that can cause elevation of one or more hyperlipidemic risk factor levels. The subject can be on a diet that may cause elevation of triglyceride level in blood, elevation of cholesterol level in blood, elevation of LDL in blood, weight gaining, or hyperlipidemia. The subject may consume alcohol excessively. The subject may be on a diet that is high in red meat, including beef, pork, lamb, and the like. The subject may be on a diet that is high in processed food.

[0094] The subject may have different body weights. The subject may be overweight or obese. Being overweight or obese means the body weight of the subject is above an ideal weight range. The ideal weight range is about 18-25 in body mass index (BMI). The BMI is calculated by the number of weight of the subject in kilograms divided by the square of the number of the height of the subject in meters. The subject may have a BMI that is about 25-30. For example, the subject may have a BMI that is about 25, 25.5, 26, 26.5, 27, 27.5, 28, 28.5, 29, 29.5, 29.9 or 30. The subject may have a BMI that is higher than about 30. For example, the subject may have a BMI that is about 30.5, 31, 32, 33, 34, 35, 36, 37, 38, 39 or 40. The subject may have a BMI that is higher than about 40. The subject may weight more than about 50, 75, 100, 125, 150, 160, 170, 180, 190, 200, 210, 220, 230, 240,250, 260, 270, 280, 290, 300, 310, 320, 330, 340, 350, 360, 370, 380, 390, or 400 lbs.

[0095] The subject may have a habit or may be lack of a habit. "Habit" refers to an activity that is performed by a subject routinely or in a frequency that is higher than normal. In some embodiments, the habit can put the subject at risk of hyperlipidemia or conditions that are associated with hyperlipidemia. In some embodiments, the habit can increase one or more hyperlipidemic risk factor levels in the bloodstream or serum in the subject. The subject may have a habit of smoking or inhaling smokes. The subject may have a habit of smoking tobacco products, including but are not limited to cigarettes, cigars, or pipes. The subject may be in an environment that contains smoke or second-hand smoke. In some cases, the subject may be at risk of hyperlipidemia or conditions that are associated with hyperlipidemia because the subject does not have a habit that can lower the risk of hyperlipidemia or conditions that are associated with hyperlipidemia. For example, the subject may not have a habit of exercising or performing physical activities. The subject may exercise or perform physical activities in a frequency that is lower than normal. The subject may exercise, on average, about once in a week, a month, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 months, 2, 3, 4, 5, 6, 7, 8, 9, 10 years. The subject may exercise about less than once in a week, a month, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 months, 2, 3, 4, 5, 6, 7, 8, 9, 10 years. The subject may be immobilized.

[0096] The methods and compositions comprising ornithine and/or aspartate described herein can be used for administering to a subject that is suffering from or at risk at suffering from a condition. The condition that the subject can be suffering from or at risk of suffering from can be hyperlipidemia or a condition that is associated with hyperlipidemia. In some embodiments, the condition that is associated with hyperlipidemia can be thyroid disease, renal disorder, liver disorder, Cushing's syndrome, hyperlipidemia induced fat liver diseases, hypercholesterolemia, obesity, atherosclerosis, diabetes, cardiovascular diseases, rhabdomyolysis, myopathy or drug associated changes in lipid metabolism such as alcohol consumption, estrogen administration and the like. In some embodiments, the cardiovascular diseases can be coronary artery disease, stroke, hypertension, peripheral vascular disease, heart attack or ischemic heart disease, or congenital heart disease. In some embodiments, the methods and compositions described herein can be used on the subject that is suffering from infections of hepatitis B virus (HBV), hepatitis C virus (HCV) or Human immunodeficiency virus (HIV).

[0097] Hyperlipidemia may be characterized by a high level of lipids, including cholesterol, cholesterol esters, phospholipids and triglycerides, in the bloodstream, plasma or serum. These lipids may be transported in the blood as large lipoproteins. Lipoproteins can be divided into five major classes: chylomicrons, very low-density lipoproteins (VLDL), intermediate-density lipoprotein (TDL), low-density lipoproteins (LDL) and high-density lipoproteins (HDL) based on their density. Most triglycerides may be transported in chylomicrons or VLDL and most cholesterol may be carried in LDL and HDL. If the levels of the lipid are too high in the bloodstream or serum, the excess lipids may accumulate on the walls of arteries. This build-up of cholesterol can result in plaque formation and therefore narrow the arteries. Hyperlipidemia may also be characterized by a high level of some lipoproteins or a low level of HDL. The hyperlipidemic risk factors can be, but are not limited to, lipids and/or lipoproteins. The condition that the subject is suffering from or at risk of suffering from can be a condition that is associated with an abnormal level of one or more hyperlipidemic risk factors in the subject. The subject composition comprising ornithine and/or aspartate may be used to change the level of the one or more hyperlipidemic risk factors in the subject. In some embodiments, the

hyperlipidemic risk factors may be one or more lipoproteins and/or lipids including but not limited to: total cholesterol, triglyceride, HDL, IDL, VLDL or LDL. The one or more biomarkers may also be serum level of CPK, or serum level of glucose.

[0098] A number of methods may be used to assess the hyperlipidemic risk factor levels (e.g., lipoproteins and/or lipids) and CPK activity level in humans. These methods may differ from one another in the type of sample and the analytical technique used. Serum and plasma have been the two most commonly used types of samples although some studies used red blood cells or tissue samples. The serum levels of the hyperlipidemic rick factor and CPK activity can be measured using any conventional methods known in the art. Non-limiting examples include

immunoassays and enzymatic assays. Where desired, the selected physiological concentration of hyperlipidemic risk factors, or the CPK activity can be measured under a fasting condition, e.g., without taking food for at least about 8 hours, 10 hours, 12 hours, 15 hours, 24 hours, or even longer. [0099] The methods and compositions described herein may be used for lowering one or more hyperlipidemic risk factor levels in serum. In some embodiments, the methods and compositions described herein can be useful in lowering the total cholesterol level, lowering the triglyceride level, or lowering the LDL level. In some embodiments, the instant methods and compositions may be used forlowering the CPK level in the subject. In some embodiments, the methods and compositions may be useful in increasing the HDL level in the subject. In some embodiments, the methods and compositions described herein may be used for lowering the glucose level in serum of the subject. The abnormal level of the hyperlipidemic risk factors refers to a level of the hyperlipidemic risk factors in the serum of the subject that is outside of a desirable range that is well known in the art. The desirable ranges of the total cholesterol level, LDL level, HDL level and triglyceride level are defined by National Heart Lung Blood Institute, National Institute of Health "Third Report of the Expert Panel on Detection, Evaluation, and Treatment of the High Blood Cholesterol in Adults (Adult Treatment Panel III) : Executive Summary", 2001. The total cholesterol level, the LDL level, the HDL level and the triglyceride level may be indicators of hyperlipidemia, or conditions that are associated with hyperlipidemia.

[00100] In some embodiments, the methods and compositions comprising ornithine and/or aspartate can be useful for administering to a subject that is classified according to the guideline to be at a very high risk, high risk, borderline-high risk or near optimal on the total cholesterol level, LDL level, HDL level, or triglyceride level. The desirable total cholesterol level in the serum of the subject may be less than about 200 mg/dL. A total cholesterol level that is about 200-239 mg/dL may be at a borderlin-high risk. A total cholesterol level that is about 240 mg/dL and above may be at a very high risk. For example, methods and compositions comprising ornithine and/or aspartate can be used on the subject that has a total cholesterol level of 220, 221, 222, 223, 224, 225, 226, 227, 228, 229, 230, 231, 232, 233, 234, 235, 236, 237, 238, 239, 240, 241 , 242, 243, 244, 245, 246, 247, 248, 249, 250, 251, 252, 253, 254, 255, 256, 257, 258, 259 or 260 mg/dL. In some embodiments, ornithine and/or aspartate can be administered to the subject that has a total cholesterol level that is about 260-270, 270-280, 280-290, or 290-300 mg/dL. In some embodiments, ornithine and/or aspartate can be used on the subject that has a total cholesterol level that is higher than about 200, 240 or 300 mg/dL.

[00101] The desirable LDL level in the serum of the subject may be less than about 100 mg/dL. A LDL cholesterol level that is about 100-129 mg/dL may be at a near optimal. A LDL level that is about 130-159 mg/dL may be at a borderline-high risk. A LDL level that is about 160-189 mg/dL may be at a high risk. A LDL level that is about 190 mg/dL and above may be at a very high risk. The methods and compositions comprising ornithine and/or aspartate as described herein can be administered to the subject that has a LDL level of 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121 , 122, 123, 124, 125, 126, 127, 128, 129, 130, 131 , 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189 or 190 mg/dL. In some embodiments, the methods and compositions comprising ornithine and/or aspartate can be administered to the subject that has a LDL level of about 190 mg/dL or higher, 160 mg/dL or higher, 130 mg/dL or higher, or 100 mg/dL or higher.

[00102] In some embodiments, the methods and compositions comprising ornithine and/or aspartate can be useful for administering to a subject that is at a high risk or borderline-high risk on the HDL level. The desirable HDL level in the serum of the subject may be higher than about 60 mg/dL. A HDL level that is about 50 mg/dL or less may be at a high risk. In some embodiments, a male subject with a HDL level that is about 40 mg/dL or less may be at a high risk. In some embodiments, a female subject with a HDL level that is about 50 mg/dL or less may be at a high risk. A HDL level that is about 50-60 mg/dL may be at a borderline-high risk. The methods and compositions comprising ornithine and/or aspartate as described herein can be used on the subject that has a HDL level of 60, 59, 58, 57, 56, 55, 54, 53, 52, 51, 50, 49, 48, 47, 46, 45, 44, 43, 42, 41 , 40, 39, 38, 37, 36, 35, 34, 33, 32, 31 , 30, 29, 28, 27, 26, 25, 24, 23, 22, 21 , 20, 19, 18, 17, 16, 15, 14, 13, 12, 11 , 10, 9, 8, 7, 6, 5, 4, 3, 2, 1 or 0 mg/dL. In some

embodiments, the subject may have a HDL level that is less than 60, 50 or 40 mg/dL.

[00103] In some embodiments, the methods and compositions comprising ornithine and/or aspartate can be useful for administering to a subject that is at a very high risk, high risk or borderline-high risk on the triglyceride level. The desirable triglyceride level in the serum of the subject may be less than about 150 mg/dL. A triglyceride level that is about 150-199 mg/dL may be at a borderline-high risk. A triglyceride level that is about 200-499 mg/dL may be at a high risk. A triglyceride level that is about 500 mg/dL or higher may be at a very high risk. For example, the subject may have a triglyceride level that is 150, 151 , 152, 153, 154, 155, 156, 157, 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191 , 192, 193, 194, 195, 196, 197, 198, 199 or 200 mg/dL. In some embodiments, the subject may have a triglyceride level that is about 200-225, 225-250, 250-275, 275-300, 300-325, 325-350, 350-375, 375-400, 400-425, 425-450, 450-475 or 475-500 mg/dL. In some embodiments, the subject may have a triglyceride level that is higher than 150, 200 or 500 mg/dL.

[00104] The methods and compositions comprising ornithine and/or aspartate described herein can also be useful for administering to a subject with an elevated or abnormal CPK activity level in serum or a condition that is associated with an elevated CPK activity level in the serum. The composition comprising ornithine and/or aspartate may lower the CPK activity level in the subject administered and ameliorating the condition that is associated with the elevated CPK activity level. Creatine phosphokinase (CPK) may be a biomarker for or may be associated with a condition that is selected from the group consisting of, but is not limited to:

rhabdomyolysis, myopathy, brain injury or stroke, convulsions, delirium tremens,

dermatomyositis, polymyositis, electric shock, heart attack, inflammation of the heart muscle (myocarditis), lung tissue death (pulmonary infarction), muscular dystrophy, hypothyroidism, hyperthyroidism, pericarditis following a heart attack and side-effect of intake of some types of drug. Non-limiting examples of the types of drug that may cause the side-effect of CPK activity elevation may be amphotericin B, ampicillin, anesthetics, anti-hyperlipidemic agents (e.g., statins, fibrates, clofibrate,ezetimibe), dexamethasone, furosemide, alcohol, cocaine, cardiovascular medications such as blood thinners or anti-hypertesion agents, anti-infections such as anti bacterial agents and antivirus agtents, anti-HBV agents, anti-HCV agents or anti-HF

agents ,mental medications, anti-diabetes agents, immunomodular, gastrointestinal medications, anti-respiratory disease agents.

[00105] In some embodiments, the methods and compositions comprising ornithine and/or aspartate may be useful for administering to a subject with an elevated CPK activity level due to the intake of statins. The types of statin can be atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin extended-release (Altoprev), lovastatin + niacin (Advicor), pitavastatin (Livalo), pravastatin (Pravachol), rosuvastatin (Crestor), simvastatin (Zocor), simvastatin + niacin

(Simcor), simvastatin + ezetimibe (Vytorin). Intake of statins may cause one or more side- effects. Clinical evidence indicates that administrations of statins may cause rhabdomyolysis and myopathy, as characterized by the elevated CPK activity level. This side-effect can induce muscle pain and weakness (Beth A. Parker et al., "Effect of Statins on Skeletal Muscle Function / Clinical Perspective " Circulation. 2013;127:96-103). Other than the elevation of CPK activity level in serum, intake of statins may also increase blood sugar or glucose level. This increase of blood sugar level may further lead to an increased risk of new-onset diabetes, memory issues, or Cataract. The side-effects of statins may be more pronounced with higher dosages or chronic administration compared to moderate-dosage and shorter administration period. Evidences of the side-effects from the intake of statins are well known in the medical art as reported by Preiss et al., "Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis," Journal of the American Medical Association, 2011 : 305(24):2556-64; and Machan et al., "Age-Related Cataract Is Associated with Type 2 Diabetes and Statin Use, " Optometry & Vision Science, 2012:89(8):1165-1171. Clinical usages of statins may be limited due to these side-effects.

[00106] The subject to be administered with compositions comprising ornithine and/or aspartate may have a CPK activity level that is elevated outside of a desirable or normal range. The desirable or normal range of the CPK activity level in serum may be 10-120 mg L or 20-199 U/L. The desirable or normal range of the CPK activity level in the serum may be 35-175 U/L. The desirable or normal range of the CPK activity level in the serum may be 95-140 U L. In some embodiments, the methods and compositions comprising ornithine and/or aspartate may be administered to a subject with a CPK activity level that is higher than 120, 130, 140, 150, 160, 170, 175, 180, 190, 200, 210, 220, 230, 240, 250, 260, 270, 280, 290, 300, 350, 400, 450, 500, 550, 600, 650, 700, 750, 800, 850, 900, 950 or 1000 mg/L. In some embodiments, the subject may have a CPK activity level that is higher than 200, 210, 220, 230, 240, 250, 260, 270, 280, 290, 300, 310, 320, 330, 340, 350, 360, 370, 380, 390, 400, 450, 500, 550, 600, 650, 700, 750, 800, 850, 900, 950 or 1000 U/L. In some embodiments, the subject may have a CPK activity level that is higher than 400 U/L.

[00107] In one embodiment, the subject that is suffering from a condition or at risk of suffering from a condition may be administered an effective amount of ornithine and/or aspartate. The effective amount may be packaged in the dosage form. The effective amount may be a range of physiologically useful quantity of ornithine and/or aspartate to achieve a desired physiological effect. In some other embodiments, the subject composition comprising ornithine and/or aspartate is effective to lower a physiological concentration or level of one or more types of hyperlipidemic risk factor such as lipoproteins and/or lipids, including but not limited to:

triglyceride, LDL, or cholesterol. In some embodiments, the amount of ornithine and/or aspartate administered to a subject may be effective to lower triglyceride level in the serum of the subject by at least about 1%, 2%, 3%, 4%, 5%, 6%, 7%, 8%, 9%, 10%, 11%, 12%, 13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 21%, 22%, 23%, 24%, 25%, 26%, 27%, 28%, 29%, 30%, 31%, 32%, 33%, 34%, 35%, 36%, 37%, 38%, 39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 48%, 49%, 50%, 51%, 52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, or 60% or even higher as compared to an initial level of triglyceride prior to administration of it to a subject. The triglyceride level may be lowered by about 19%-24%, 14%-29%, 12%-35%, 10-40%, 8%- 45%, 5%-50%, 2%-60%, or l%-70%. In some embodiments, the composition comprising ornithine and/or aspartate may be administered in an amount effective in lowering the

triglyceride level from a range of at very high risk to a high risk range, a borderline-high risk range, or a desirable range. The triglyceride level may be lowered from a high risk range to a borderline-high risk range or a desirable range. The triglyceride level may be lowered from a borderline-high risk range to a desirable range.

[00108] In some embodiments, the amount of ornithine and/or aspartate administered to a subject may be effective to lower LDL serum level in the subject by at least about 1%, 2%, 3%, 4%, 5%, 6%, 7%, 8%, 9%, 10%, 11%, 12%, 13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 21%, 22%, 23%, 24%, 25%, 26%, 27%, 28%, 29%, 30%, 31%, 32%, 33%, 34%, 35%, 36%, 37%, 38%, 39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 48%, 49%, 50%, 51%, 52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, or 60% or even higher as compared to an initial level of LDL prior to administration of it to a subject. The LDL level may be lowered by about 19%-24%, 14%-29%, 12%-35%, 10-40%, 8%-45%, 5%-50%, 2%-60%, or l%-70%. In some embodiments, the composition comprising ornithine and/or aspartate may be administered in an amount effective in lowering the LDL level from a range of at very high risk to a high risk range, a borderline-high risk range, a near optimal range or a desirable range. The LDL level may be lowered from a high risk range to a borderline-high risk range, a near-optimal range or a desirable range. The LDL level may be lowered from a borderline-high risk range to a near optimal range or a desirable range. The LDL level may be lowered from a near optimal range to a desirable range. [00109] In some embodiments, the amount of ornithine and/or aspartate administered to a subject may be effective to increase HDL serum level in the subject by at least about 1%, 2%, 3%, 4%, 5%, 6%, 7%, 8%, 9%, 10%, 11%, 12%, 13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 21%, 22%, 23%, 24%, 25%, 26%, 27%, 28%, 29%, 30%, 31%, 32%, 33%, 34%, 35%, 36%, 37%, 38%, 39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 48%, 49%, 50%, 51%, 52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, or 60% or even higher as compared to an initial level of HDL prior to administration of it to a subject. The HDL level may be increased by about 19%- 24%, 14%-29%, 12%-35%, 10-40%, 8%-45%, 5%-50%, 2%-60%, or l%-70%. In some embodiments, the composition comprising ornithine and/or aspartate may be administered in an amount effective in increasing the HDL level from a range of at a high risk range to a borderline- high risk range or a desirable range. The HDL level may be increased from a borderline-high risk range to a desirable range.

[00110] In some embodiments, the amount of ornithine and/or aspartate administered to a subject may be effective to lower total cholesterol level in the subject by at least about 1%, 2%, 3%, 4%, 5%, 6%, 7%, 8%, 9%, 10%, 11%, 12%, 13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 21%, 22%, 23%, 24%, 25%, 26%, 27%, 28%, 29%, 30%, 31%, 32%, 33%, 34%, 35%, 36%, 37%, 38%, 39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 48%, 49%, 50%, 51%, 52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, or 60% or even higher as compared to an initial level of total cholesterol prior to administration of it to a subject. The total cholesterol level may be lowered by about 19%-24%, 14%-29%, 12%-35%, 10-40%, 8%-45%, 5%-50%, 2%-60%, or l%-70%. In some embodiments, the composition comprising ornithine and/or aspartate may be administered in an amount effective in lowering the total cholesterol level from a range of at very high risk to a high risk range, a borderline-high risk range, or a desirable range. The LDL level may be lowered from a high risk range to a borderline-high risk range, or a desirable range. The LDL level may be lowered from a borderline-high risk range to a desirable range.

[00111] Where desired, the selected physiological level of lipoprotein after administration of the composition comprising ornithine and/or aspartate may be measured under a fasting condition, e.g., without taking food for at least about 8 hours, 10 hours, 12 hours, 15 hours, 24 hours, or even longer.

[00112] Treatments of hyperlipidemia and conditions that are associated to hyperlipidemia using some of the anti-hyperlipidemic agents described herein have been shown to cause multiple side effects. The side-effects may include, but not limited to rhabdomyolysis, myopathy, elevated CPK activity level, muscle pain and weakness, liver damage, increased blood sugar or glucose level, new-onset diabetes, memory issues, gastrointestinal problems, reduce the absorption of other drugs and vitamins from the gut, or cataract. Methods and compositions described herein include administering to a subject a composition comprising ornithine and/or aspartate such that the level of one or more hyperlipidemic risk factors such as lipoproteins and/or lipids in the subject may be lowered. In some embodiments, administration of ornithine and/or aspartate does not cause a change in blood sugar or glucose level in the subject

administered. In some embodiments, administration of ornithine and/or aspartate does not increase the CPK activity level in the subject administered. In some embodiments,

administration of ornithine and/or aspartate does not cause one or more side effects that are associated with other anti-hyperlipidemic agents that are described herein. The lack of these adverse side-effects provides advantages for composition comprising ornithine and/or aspartate for its clinic treatment of hyperlipidemia or conditions that are associated with hyperlipidemia.

[00113] In some embodiments, the compositions and methods comprising ornithine and/or aspartate may be useful for ameliorating or reducing one or more side-effects of an anti- hyperlipidemic agent. The side-effects that may be reduced by the administration of the composition comprising ornithine and/or aspartate may be rhabdomyolysis, myopathy, elevated CPK activity level, muscle pain and weakness, liver damage, increased blood sugar or glucose level, new-onset diabetes, memory issues, gastrointestinal problems, reduce the absorption of other drugs and vitamins from the gut, or cataract. In some embodiments, the composition comprising ornithine and/or aspartate may reduce the elevated CPK activity level. As there are many other conditions that are associated with the elevated CPK activity level, the composition comprising ornithine and/or aspartate may also be used to ameliorate these conditions.

[00114] Elevation of CPK activity may be a side-effect of one or more therapeutic agents. Compositions comprising ornithine and/or aspartate may be used for reducing a side effect that is induced by administration of one or more therapeutic agents. Co-administration of composition comprising ornithine and/or aspartate with the one or more therapeutic agents may reduce the side-effect that is induced by the one or more therapeutic agents. The one or more therapeutic agents that may be co-administered with the composition comprising ornithine and/or aspartate in order to reduce the side-effect include, but are not limited to, amphotericin B, ampicillin, anesthetics, anti-hyperlipidemic agents (e.g., statins, fibrates, clofibrate), dexamethasone, furosemide, alcohol, cocaine, cardiovascular medications such as blood thinners, anti-HBV agents, anti-HCV agents or anti-FflV agents).

[00115] Methods and compositions comprising ornithine and/or aspartate described herein can also be administered to a subject that is also administered with one or more anti- hyperlipidemic agents. In some embodiments, the one or more anti-hyperlipidemic agents are administered in an amount effective to lower one or more hyperlipidemic risk factor. In some embodiments, the one or more anti-hyperlipidemic agents are administered in an amount effective to result in one or more effects selected from the group consisting of: lowering cholesterol level, lowering LDL level, lowering triglyceride level or increasing HDL level. In some embodiments, the one or more anti-hyperlipidemic agents may have a side-effect.

[00116] In some embodiments, the composition administered to a subject may comprise an amount of ornithine and/or aspartate that is effective in lowering CPK activity level in a subject. For example, the CPK activity level may be lowered by at least about 1%, 2%, 3%, 4%, 5%, 6%, 7%, 8%, 9%, 10%, 11%, 12%, 13%, 14%, 15%, 16%, 17%, 18%, 19%, 20%, 21%, 22%, 23%, 24%, 25%, 26%, 27%, 28%, 29%, 30%, 31%, 32%, 33%, 34%, 35%, 36%, 37%, 38%, 39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 48%, 49%, 50%, 51%, 52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, or 60% or even higher as compared to an initial level of CPK activity prior to administration of it to a subject. In some embodiments, the composition comprising ornithine and/or aspartate may be administered to the subject in an amount effective in lowering the CPK activity level to the desirable or normal range. In some embodiments, the CPK activity level can be lowered to less than 400 U/L. In some embodiments, the CPK level can be lowered to less than 200 U/L.

[00117] In some embodiments, the composition comprising ornithine and/or aspartate may further comprise an effective amount of one or more therapeutic agents including anti- hyperlipidemic agents. The methods described herein comprise administrating the composition comprising ornithine and/or aspartate, and administration of the one or more therapeutic agents. In some embodiments, the therapeutic agent may be an anti-hyperlipidemic agent. In some embodiments, the compositions comprising ornithine and/or aspartate may be administered together with the one or more therapeutic agents at the same time in the same route. In some embodiments, the composition comprising ornithine and/or aspartate may be administered separately from the one or more therapeutic agents. In some embodiments, the composition comprising ornithine and/or aspartate and the one or more therapeutic agents may be

administered subsequently, with the therapeutic agents first or the ornithine and/or aspartate first. In some embodiments, the composition comprising ornithine and/or aspartate may be

administered to a subject in conjunction with one or more therapeutic agents. In some embodiments, the composition comprising ornithine and/or aspartate may be administered at the same administration route with the one or more therapeutic agents. The composition comprising ornithine and/or aspartate may be administered at a different administration route with the one or more therapeutic agents. For example, the composition comprising ornithine and/or aspartate may be administered orally while the one or more therapeutic agents may be administered via intravenous injection. Each of the one or more therapeutic agents may be administered via the same or different administration routes.

[00118] Furthermore, in some cases, the methods described herein comprise administering the composition comprising ornithine and/or aspartate for the same duration of treatment as the one or more therapeutic agents. For example, the composition comprising ornithine and/or aspartate may be administered for 30 days while the one or more therapeutic agents are administered for 10 days. The subject may be on a treatment with one or more therapeutic agents for a period of time before administering the composition comprising ornithine and/or aspartate.

[00119] Methods and compositions are described herein of administering a composition comprising ornithine and/or aspartate to a subject with a condition and administering one or more therapeutic agents (e.g., anti-hyperlipidemic agents) to the subject, such that the condition of the subject is improved following the administration of the composition comprising ornithine and/or aspartate and the administration of the one or more therapeutic agents. The

administration of the composition comprising ornithine and/or aspartate may result in

improvement of the condition for greater than 5%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, and 99%. The administration of the one or more therapeutic agents (e.g., anti-hyperlipidemic agents) may also result in improvement of the condition for greater than 5%, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, and 99%. In some embodiments, the condition is improved for greater than 50%. In some instances, the composition comprising ornithine and/or aspartate and the one or more therapeutic agents may act upon the condition synergistically. In some instances, the improvement of the condition after the delivery of both the composition comprising ornithine and/or aspartate and the one or more therapeutic agents is greater than the improvement from treating the subject with the composition comprising ornithine and/or aspartate alone or with the one or more therapeutic agents (e.g., statin) alone. The improvement may be characterized by the level of biomarkers or risk factors in the subject. The improvement may also be characterized by the functional improvement of an organ in comparison to its normal function.

[00120] Example 1: Effect of ornithine-aspartate on levels of triglyceride and CPK activities in rat plasma

[00121] The use of a composition comprising ornithine and/or aspartate as described herein is investigated, wherein the composition comprises ornithine-aspartate salt. The composition may treat a subject that is suffering from hyperlipidemia, and lower triglyceride levels in the subject after administration to the subject the composition. Furthermore, administration of an anti-hyperlipidemic agent, atorvastatin, may cause a side-effect in elevating CPK activities in plasma. Administration of a composition comprising ornithine-aspartate may lower the CPK activities, and this effect is investigated herein.

[00122] Male Wistar rats (purchased from Beijing Huafukang limited, Beijing, China), each weighs about 180-250 g, are housed in groups of five in a temperature (about 21 ± 1°C)- and humidity- controlled environment with about 12 hours of light and dark cycle (lights on 07:00 am). The rats are provided free access to food and water, wherein the food is either a normal diet or a high fat diet).

[00123] Hyperlipidemia is induced by feeding the rats a high fat diet for 10 days prior to administration of the composition comprising ornithine-aspartate, wherein the high fat diet comprises about 60% fat. After 10 days, the rats are given ornithine-aspartate (provided by Wuhan Qirui Pharmaceuticals, Wuhan, Hubei, China, made in 0.5 % CMC-Na) via oral administration. Negative control group is given 0.5 % CMC-Na, which is the vehicle of the ornithine-aspartate. Positive control group is given atorvastain, a known anti-hyperlipidemic agent (provided by Wuhan Qirui Pharmaceuticals, Wuhan, Hubei, China, made in 0.5 % CMC- Na). The ornithine-aspartate, negative control, or positive control agents are administered orally between 3 :00 to 5:00 pm, once a day, for 30 days continuously. The dosage of ornithine- aspartate is 945 mg/kg, p.o., which is equivalent to a 9 g daily clinical dosage for humans. Two dosages of atorvastatin are used, 1.05 and 2.1 mg/kg, p.o., which is equivalent to 10 and 20 mg daily clinical dosage for humans. A double negative control group is included, wherein the rats in the double negative control group are fed only with the normal diet and no additional agent.

[00124] Blood samples of the rats in all groups are obtained from tails of the rats at day 0, 10, 20 and 30 after the administration of ornithine-aspartate, double negative control, negative control, and positive control. The serum/plasma level of triglyceride is measured. In addition, the CPK activities in serum/plasma in all groups are measured.

[00125] Hyperlipidemia can be observed in the rats that are fed with a high fat diet for 10, 20 and 30 days. Experimental results show that high fat diet can significantly increase the triglyceride levels in the rat plasma compared to a normal diet double negative control group (Table 1 ). Oral administration of ornithine-aspartate significantly reduces the triglyceride levels that has been increased by the high fat diet, and the reduction is approximately 50 % (P<0.01) compared to the negative control. Oral administration of atorvastatin in two dosages (1.05 and 2.1 mg/kg, p.o., low and high doses) also significantly reduces the triglyceride level by approximately 31% and 37 %, respectively (P<0.05) compared to the negative control.

[00126] Administrations of ornithine-aspartate are more effective in lowering the triglyceride levels compared to the positive control group treated with only atorvastatin in both dosages, although the difference is not statistically significant (P>0.05). Co-administrations of ornithine-aspartate with both doses of atorvastatin caused observable reduction in triglyceride level, but failed to reach statistical significance compared to treatment of ornithine-aspartate or atorvastatin alone (Table 1).

Triglyceride level in rat plasma (mmol/L)

F 1.64±0.6 ## 1.2±0.57##-¾ 0.84±0.16##

G 1.75±0.55## 1.24±0.7##-¾ 1.18±0.37#

Table 1: Effect of oral administration of ornithine-aspartate alone and combination with atorvastatm on plasma levels of triglycerides in rats. Plasma levels of triglycerides represent the mean ± s.e.mean, n=8-10, P* 0.05 and **P<0.01 , group B vs group A; #P<0.05, ##P<0.01 , group C, D, E, F or G vs group B; >¾P<0.05, group F or G vs D, ANOVA p<0.05, followed by Dunnett's t test. A: Vehicle+normal diet, B: Vehicle+high fat diet, C: Ornithine-aspartate 945 mg/kg, p.o., D: Atorvastatm 2.1 mg/kg, p.o., E: Atorvastatin 1.05 mg/kg, p.o., F: Ornithine-aspartate 945 mg/kg, p.o.+atorvastatin 2.1 mg/kg, p.o., G: Ornithine-aspartate 945 mg/kg, p.o.+atorvastatin 1.05 mg/kg, p.o.

[00127] Oral administration of atorvastatin in both dosages significantly increases the CPK activity levels in rat plasma compared to the negative control group receiving only vehicle (p<0.01). Co-administration of ornithine-aspartate with low dose of atorvastatin (1.05 mg/kg, p.o.) significantly reduces the CPK activities that are elevated because of the atorvastatin

(PO.01). Co-administration of ornithine-aspartate with high dose of atorvastatin (2.10 mg/kg, p.o.) also shows some trends of CPK activity reduction, by approximately 20 % reduction (Table 2).

CPK activity in rat plasma (U/ml)

Table 2: Effect of oral administration of ornithine-aspartate alone and combination with atorvastatin on CPK activities in rats. Plasma CPK activities were expressed as U/ml and represents the mean ± s.e.mean, n=8-10, P* 0.05 and **P<0.01 , group D or group E vs group B; ##P<0.01 , group G vs group E, ANOVA p<0.05, followed by Dunnett's t test. A: Vehicle+normal diet, B: Vehicle+high fat diet, C: Omitnine-aspartate 945 mg/kg, p.o., D: Atorvastatin 2.1 mg/kg, p.o., E: Atorvastatin 1.05 mg/kg, p.o., F: Ornithine- aspartate 945 mg/kg, p.o.+atorvastatin 2.1 mg/kg, p.o., G: Ornithine-aspartate 945 mg/kg, p.o.+atorvastatin 1.05 mg/kg, p.o.

[00128] The results in this Example clearly demonstrate that oral administration of ornithine-aspartate can significantly reduce triglyceride level that is induced by a high fat diet in the rat plasma. The Example provides strong evidence that ornithine-aspartate possesses ability to treat hyperlipidemia, and the efficacy of ornithine-aspartate may be greater than atorvastatin in treatment of hyperlipidemia. Co-administration of ornithine-aspartate with atorvastatin can ameliorate atorvastatin induced adverse effects such as rhabdomyolysis and myopathy, as the rhabdomyolysis and myopathy are associated with CPK activity elevation.

[00129] Example 2: Formulation and manufacturing process for ornithine-aspartate tablets

[00130] The composition comprising ornithine-aspartate can be formulated and processed to be in a tablet form. The manufacturing process of the ornithine-aspartate tablet is described herein. An example of formulation is shown in Table 3.

[00131] Mix 302.7 g of providence k, 0.5 g of sweet orange essence, and 0.0025 g of sunset yellow pigment with 135 g of 80 % ethanol. Sonicate the mixture briefly and the mixture can be made into an adhesive. Separately, mix 150 g of ornithine-aspartate, 7.5 g of citric acid, 105 g of mannitol and 2.5 g of aspartame together thoroughly. Then, the adhesive mixture is added into the mixture containing ornithine-aspartate, and mixed thoroughly to obtain a soft material. The soft material can be dried, granulated and passed through a 18 mesh sieve.

Afterwards, 5 g of talcum powder is added and mixed thoroughly. The mixture can be pressed to then form tablets.

[00132] Example 3: Formulation and manufacturing process for ornithine-aspartate capsules

[00133] The composition comprising ornithine-aspartate can be formulated and processed to be in a capsule form. The manufacturing process of the ornithine-aspartate capsules is described herein. An example of formulation is shown in Table 4.

[00134] Mix 302.7 g of povidone k, 0.5 g of sweet orange essence, and 0.0025 g of sunset yellow pigment with 135 g of 80 % ethanol. Sonicate the mixture briefly and the mixture can be made into an adhesive. Separately, mix 150 g of ornithine-aspartate, 7.5 g of citric acid, 105 g of mannitol and 2.5 g of aspartame together thoroughly. Then, the adhesive mixture is added into the mixture containing ornithine-aspartate, and mixed thoroughly to obtain a soft material. The soft material can be dried, granulated and passed through a 18 mesh sieve. Afterwards, 5 g of talcum powder is added and mixed thoroughly. The mixture is then used to fill capsules to form ornithine-aspartate capsules.

[00135] Example 4: Formulation and manufacturing process for ornithine-aspartate granules

[00136] The composition comprising ornithine-aspartate can be formulated and processed to be in a granule form. The manufacturing process of the ornithine-aspartate granules is described herein. An example of formulation is shown in Table 5. [00137] Mix 302.7 g of povidone k, 0.5 g of sweet orange essence, and 0.0025 g of sunset yellow pigment with 135 g of 80 % ethanol. Sonicate the mixture briefly and the mixture can be made into an adhesive. Separately, mix 150 g of ornithine-aspartate, 7.5 g of citric acid, 105 g of mannitol and 2.5 g of aspartame together thoroughly. Then, the adhesive mixture is added into the mixture containing ornithine-aspartate, and mixed thoroughly to obtain a soft material. The soft material can be dried, granulated and passed through a 12 and a 60 mesh sieve. Afterwards, 5 g of talcum powder is added and mixed thoroughly to form granules. The granules matched the standards can be packed.

[00138] Example 5: Effect of ornithine and/or aspartate on levels of triglyceride in rat plasma

[00139] The use of a composition comprising ornithine and/or aspartate as described herein is investigated, wherein the composition can comprise ornithine, aspartate, or ornithine- aspartate salt. The composition may treat a subject that is suffering from hyperlipidemia, and lower triglyceride levels in the subject after administration to the subject the composition.

[00140] Male Wistar rats (purchased from Beijing Huafukang limited, Beijing, China), each weighs about 180-250 g, are housed in groups of five in a temperature (about 21 ± 1°C)- and humidity- controlled environment with about 12 hours of light and dark cycle (lights on 07:00 am). The rats are provided free access to food and water, wherein the food is either a normal diet or a high fat diet).

[00141] Hyperlipidemia is induced by feeding the rats a high fat diet for 10 days prior to administration of the composition comprising ornithine-aspartate, wherein the high fat diet comprises about 60% fat. After 10 days, the rats are given free form of ornithine, free form of aspartate, or ornithine-aspartate (provided by Wuhan Qirui Pharmaceuticals, Wuhan, Hubei, China, made in 0.5 % CMC-Na) via oral administration. Control group is given 0.5 % CMC-Na, which is the vehicle of the ornithine, aspartate, and ornithine-aspartate. The ornithine, aspartate or ornithine-aspartate, as well as the vehicle control, are administered orally once a day, for 30 days continuously. The dosage of ornithine-aspartate is 945 mg/kg, p.o., which is equivalent to a 9 g daily clinical dosage for humans. The dosage of ornithine is 472.5 mg/kg, p.o., which is equivalent to a 4.5 g daily clinical dosage for humans. The dosage of aspartate is 472.5 mg/kg, p.o., which is equivalent to a 4.5 g daily clinical dosage for humans.

[00142] Blood samples of the rats in all groups are obtained from tails of the rats at day 30 after the administration of ornithine, aspartate, ornithine-aspartate and negative control. The serum/plasma levels of triglyceride are measured.

[00143] Hyperlipidemia can be observed in the rats that are fed with a high fat diet for ten days and beyond. Experimental results show that high fat diet can significantly increase the triglyceride levels in the rat plasma compared to a normal diet (P<0.01). Oral administration of ornithine-aspartate significantly reduces the triglyceride level that has been increased by the high fat diet (P<0.05, compared to the high fat diet control group). Oral administration of aspartate also significantly reduces the triglyceride level (P<0.05, compared to the high fat diet controls) (Table 6).

Triglyceride levels (mmol/L)

Table 6: Effect of oral administration of ornithine-aspartate, aspartate and ornithine on plasma levels of triglycerides in rats. Plasma levels of triglycerides represent the mean ± s.e.mean, n=8-10, **P<0.01 , group B vs group A; #P 0.05, group C or D vs group B, ANOVA pO.05, followed by Dunnett's t test.

[00144] This Example demonstrates that oral administration of ornithine-aspartate and free form of aspartate can treat hyperlipidemia by significantly reducing the level of triglyceride that is elevated due to a high fat diet in rat. This Example provides clear evidence to confirm that aspartate may play a crucial role in the mechanisms of therapeutic action of ornithine- aspartate.

[00145] Example 6: Effect of ornithine-aspartate on levels of cholesterol and LDL in rats plasma.

[00146] The use of a composition comprising ornithine and/or aspartate as described herein is investigated, wherein the composition comprises ornithine-aspartate salt. The composition may treat a subject that is suffering from hyperlipidemia, and lower triglyceride, cholesterol and LDL levels in the subject after administration to the subject the composition.

[00147] Male Wistar rats (purchased from Beijing Huafukang limited, Beijing, China), each weighs about 180-250 g, are housed in groups of five in a temperature (about 21 ± 1°C)- and humidity- controlled environment with about 12 hours of light and dark cycle (lights on 07:00 am). The rats are provided free access to food and water, wherein the food is either a normal diet or a standard cholesterol diet with butter).

[00148] Hyperlipidemia is induced by feeding the rats a standard cholesterol diet with butter for 10 days prior to administration of the composition comprising ornithine-aspartate, wherein 0.5 ml of butter is given twice daily. After 10 days, the rats are given ornithine- aspartate (provided by Wuhan Qirui Pharmaceuticals, Wuhan, Hubei, China, made in 0.5 % CMC-Na) via oral administration. Negative control group is given 0.5 % CMC-Na, which is the vehicle of the ornithine-aspartate. Positive control group is given atorvastatin, (provided by Wuhan Qirui Pharmaceuticals, Wuhan, Hubei, China, made in 0.5 % CMC-Na). A double negative control group is included, wherein the rats in the double negative control group are fed only with the normal diet. The ornithine-aspartate, negative control, or positive control agents are administered orally between 3:00 to 5:00 pm, once a day, for 30 days continuously. The dosage of ornithine-aspartate is 945 mg/kg, p.o., which is equivalent to a 9 g daily clinical dosage for humans. Two dosages of atorvastatin are used, 1.05 and 2.1 mg/kg, p.o., which is equivalent to 10 and 20 mg daily clinical dosage for humans. [00149] Blood samples of the rats in all groups are obtained from tails of the rats at day 30 after the administration of ornithine-aspartate, double negative control, negative control, or positive control. The serum/plasma levels of triglyceride, cholesterol and LDL are measured.

[00150] The results of this Example demonstrate that standard cholesterol diet with butter significantly increase levels of triglyceride, cholesterol and LDL in the rat plasma compared to the rats that are fed with only the normal diet. Ornithine-aspartate significantly reduces the levels of triglyceride, cholesterol and LDL that have been elevated when under the standard cholesterol diet with butter (P<0.01). Oral administration of both doses of atorvastatin (1.05 and 2.1 mg/kg, p.o.) also significantly decreases the levels of triglyceride, cholesterol and LDL that have been elevated when under the standard cholesterol diet with butter (P<0.05 and P<0.01, respectively) (Table 7). Co-administration of ornithine-aspartate with both doses of atorvastatin does not further reduce the levels of all three lipids compared to the group that is only given ornithine-aspartate but not atorvastatin (P>0.05).

[00151] The present Example demonstrates that oral administration of ornithine-aspartate can reduce the levels of triglyceride, cholesterol and LDL in the rat plasma that have been elevated with a standard cholesterol diet with butter. This Example provides strong evidence that ornithine-aspartate may be effective to ameliorate hyperlipidemia in clinic.

Lipid levels in rat plasma (mmol/L)

Table 7: Effect of oral administration of ornithine-aspartate alone and combination with atorvastatin on plasma levels of triglycerides (TG), cholesterol (TC) and LDL in rats. Plasma levels of TG, TC and LDL represent the mean ± s.e.mean, mmol/L, n=8-10, **P<0.01 , group B vs group A; #P 0.05, ##P<0.01 , group C, D, E, F or G vs group B, ANOVA p0.05, followed by Dunnett's t test. A: Vehicle+normal diet, B: Vehicle+high fat diet, C: Ornitnine-aspartate 945 mg/kg, p.o., D: Atorvastatin 2.1 mg/kg, p.o., E: Atorvastatin 1.05 mg/kg, p.o., F: Ornithine- aspartate 945 mg/kg, p.o.+atorvastatin 2.1 mg/kg, p.o., G: Ornithine-aspartate 945 mg/kg, p.o.+atorvastatin 1.05 mg/kg, p.o.

[00152] Example 7: Effect of low doses of ornithine-aspartate on triglyceride levels in rat plasma.

[00153] The use of compositions comprising different doses of ornithine-aspartate as described herein is investigated, wherein the compositions comprise omithine-aspartate salt. The compositions may be administered to a subject that is suffering from hyperlipidemia, and lower the triglyceride level in the subject after the administration.

[00154] Male Wistar rats (purchased from Beijing Huafukang limited, Beijing, China), each weighs about 180-250 g, are housed in groups of five in a temperature (about 21 ± 1°C)- and humidity- controlled environment with about 12 hours of light and dark cycle (lights on 07:00 am). The rats are provided free access to food and water, wherein the food is either a normal diet or a high fat diet, and further wherein the high fat diet contains 60% of fat.

[00155] Hyperlipidemia is induced by feeding the rats a high fat diet for 10 days prior to administration of the composition comprising ornithine-aspartate. After 10 days, the rats are given three different doses of ornithine-aspartate (provided by Wuhan Qirui Pharmaceuticals, Wuhan, Hubei, China, made in 0.5 % CMC-Na) via oral administration. The doses of ornithine- aspartate are 47, 94.5 and 283.5 mg/kg, p.o. (equivalent to 0.5, 1 and 3 g daily clinical dosage for human, Groups C-E). Negative control group is given high fat diet with 0.5 % CMC-Na, which is the delivery vehicle agent of the ornithine-aspartate (Group B). Positive control group is given 2.1 mg/kg, p.o. of atorvastatin, (provided by Wuhan Qirui Pharmaceuticals, Wuhan, Hubei, China, made in 0.5 % CMC-Na, Group F). The synergistic effect of ornithine-aspartate and atorvastatin is also examined. Three doses of ornithine-aspartate are given to rats in conjunction with 2.1 mg/kg, p.o. atorvastatin (Groups G-I). A double negative control group is included, wherein the rats in the double negative control group are fed only with the normal diet with 0.5 % CMC-Na vehicle agent (Group A). The ornithine-aspartate, negative control, or positive control agents are administered orally between 3:00 to 5:00 pm, once a day, for 30 days continuously.

[00156] Blood samples of the rats in all groups are obtained from tails of the rats at day 30 after the administration of ornithine-aspartate, double negative control, negative control, or positive control. The serum/plasma levels of triglyceride, cholesterol, LDL and CPK are measured. [00157] The results of this Example demonstrate that high fat diet with 60% fat content significantly increases levels of triglyceride in the rat plasma compared to the rats that are fed with only the normal diet, and the increase here is approximately 100%. The compositions comprising 94.5 and 283.5 mg/kg, p.o. of ornithine-aspartate significantly reduced the levels of triglyceride that have been elevated when under the high fat diet, with 40% and 50% reductions respectively (P<0.05, Group D or Group E v.s. Group B). Oral administration of 2.1 mg/kg, p.o. of atorvastatin also significantly decreased the levels of triglyceride that have been elevated when under the high fat diet by about 31% (P<0.05, Group F v.s. Group B). Co-administration of 94.5 or 283.5 mg/kg, p.o. of ornithine-aspartate with atorvastatin further reduces the levels of triglyceride compared to the group that is only given atorvastatin (P<0.01) (Table 8).

[00158] The present Example demonstrates that oral administration of lower doses of ornithine-aspartate can reduce the levels of triglyceride in the rat plasma that have been elevated with a high fat diet, indicating the efficacy of ornithine-aspartate on treatment of hyperlipidemia. The efficacy of ornithine-aspartate may be greater than atorvastatin on treatment of

hyperlipidemia. This Example provides strong evidence that ornithine-aspartate may be effective to ameliorate hyperlipidemia in clinic. Co-administration of lower doses of ornithine- aspartate with atorvastatin may possess synergic effects to ameliorate hyperlipidemia.

Triglyceride levels in rat plasma (mmol/L)

Table 8: Effect of oral administration of ornithine-aspartate alone and combination with atorvastatin on plasma levels of triglycerides in rats. Plasma levels of

triglycerides represent the mean ± s.e.mean, n=8-10, **P<0.01 , group B vs group A; #P<0.05, ##P<0.01 , group C, D, E, F, G, H or I vs group B; 3¾ -¾P<0.01 , group H or

I vs group F, ANOVA p<0.05, followed by Dunnett's t test. A: Vehicle+normal diet,

B: Vehicle+high fat diet, C: Ornithine- aspartate 47 mg/kg, p.o., D: Ornithine- aspartate 94.5 mg/kg, p.o., E: Ornithine-aspartate 283.5 mg/kg, p.o., F : Atorvastatin 2.1 mg/kg, p.o., G: Ornithine-aspartate 47 mg/kg, p.o.+Atorvastatin 2.1 mg/kg, p.o.,

H: Ornithine-aspartate 94.5 mg/kg, p.o.+atorvastatin 2.1 mg/kg, p.o., I: Ornithine- aspartate 283.5 mg/kg, p.o.+atorvastatin 2.1 mg/kg, p.o.

[00159] While preferred embodiments of the present invention have been shown and described herein, it will be obvious to those skilled in the art that such embodiments are provided by way of example only. Numerous variations, changes, and substitutions will now occur to those skilled in the art without departing from the invention. It should be understood that various alternatives to the embodiments of the invention described herein may be employed in practicing the invention. It is intended that the following claims define the scope of the invention and that methods and structures within the scope of these claims and their equivalents be covered thereby.

Claims

CLAIMS WHAT IS CLAIMED IS:

1. A method of lowering one or more hyperlipidemic risk factor level in a subject in need thereof comprising administering to said subject a composition comprising ornithine and/or aspartate in an amount that is effective in lowering the one or more hyperlipidemic risk factor level.

2. The method of claim 1 , wherein at least a portion of said ornithine (O) and aspartate (A) are complexed in a salt form of OA.

3. The method of claim 1 , wherein said composition comprising ornithine and a counter anion.

4. The method of claim 1, wherein said composition comprising aspartate and a counter cation.

5. The method of claim 1, wherein said composition comprises free form of ornithine and/or free form of aspartate.

6. The method of claim 1, wherein said composition comprises ornithine and/or aspartate in its pharmaceutically accepted salt forms.

7. The method of claim 1 , wherein the amount of ornithine and/or aspartate administered is about 0.01 g to 100 g daily.

8. The method of claim 1 , wherein the amount of ornithine and/or aspartate administered is about 0.01 g to 20 g daily.

9. The method of claim 1 , wherein the amount of ornithine and/or aspartate administered is less than 9 g daily.

10. The method of claim 1 , wherein the amount of ornithine and/or aspartate administered is less than 3 g daily.

11. The method of claim 1 , wherein said subject in need thereof suffers from hyperlipidemia, hyperlipidemia induced fat liver diseases, obesity, atherosclerosis, cardiovascular diseases, rhabdomyolysis or myopathy.

12. The method of claim 1 , wherein the amount of ornithine and/or aspartate administered does not result in an increase in glucose level in plasma of said subject.

13. The method of claim 1 , further comprising administering an effective amount of an anti- hyperlipidemic agent to said subject.

14. The method of claim 13, wherein said subject exhibits creatine phosphokinase (CPK) activity level in plasma of less than about 400 U/L upon administration of said composition and the anti-hyperlipidemic agent.

15. The method of claim 1 , wherein the composition is administered orally.

16. The method of claim 1, wherein the composition is administered by intravenous injection, inhalation, nasal insufflation, intra-arterial injection, subcutaneous administration, mucosal administration, or pharyngeal administration.

17. The method of claim 1, wherein the composition is administered for at least about 10 days.

18. The method of claim 1 , wherein the composition is administered for at least about 1 month.

19. The method of claim 1, wherein the composition administered is contained in a foodstuff.

20. The method of claim 1, wherein the composition administered is contained in a

pharmaceutical composition.

21. The method of claim 1 , wherein the one or more hyperlipidemic risk factor is selected from the group consisting of triglyceride, LDL, and cholesterol.

22. The method of claim 1 , wherein the one or more hyperlipidemic risk factor is triglyceride.

23. The method of claim 22, further comprising selecting the subject in need thereof before said administering based upon said triglyceride level in said subject.

24. The method of claim 23, wherein said selected subject, after fasting for about 8 to about 12 hours, exhibits triglyceride level of higher than about 200 mg/dL.

25. The method of claim 23, wherein said selected subject, after fasting for about 8 to about 12 hours, exhibits triglyceride level of higher than about 500 mg/dL.

26. A method of administering an anti-hyperlipidemic agent to a subject in need thereof comprising administering an effective amount of the anti-hyperlipidemic agent in conjunction with an effective amount of a composition comprising ornithine and/or aspartate.

27. The method of claim 26, wherein said composition is administered orally.

28. The method of claim 26, wherein said composition is administered prior to, subsequent to, or concurrent with administering the anti-hyperlipidemic agent.

29. The method of claim 26, wherein said composition reduces a side-effect of the anti- hyperlipidemic agent.

30. The method of claim 26, wherein said side-effect is selected from the group consisting of: an increased CPK activity level, an increased glucose level, rhabdomyolysis, and myopathy in said subject in need thereof.

31. The method of claim 26, wherein said anti-hyperlipidemic agent is selected from the group consisting of: HMG-CoA inhibitor, nicotinic acid, fibrate, bile acid sequestrant, ezetimibe, lomitapide, phytosterols, CETP antagonists, orlistat, and any combination thereof.

32. The method of claim 31 , wherein said HMG-CoA inhibitor is atorvastatin, fluvastatin, pravastatin, lovastatin, simvastatin, rovuvastatin, or lovastatin , and any combination thereof.

33. The method of claim 26, wherein said anti-hyperlipidemic agent is atorvastatin/ezetimibe combination.

34. The method of claim 26, wherein said composition and the anti-hyperlipidemic agent are administered as a single unit dose.

35. The method of claim 34, wherein said unit dosage is in a form of a tablet, a capsule, a pill, a granule, an emulsion, a gel, a plurality of beads encapsulated in a capsule, a powder, a suspension, a liquid, a semi-liquid, a semi-solid, a syrup, a slurry or a chewable.

36. A method of reducing a side effect of a therapeutic agent wherein the side effect is characterized by an increase in CPK activity in a subject administered with said therapeutic agent, comprising administering a composition comprising an effective amount of ornithine and/or aspartate to said subject that is administered with said therapeutic agent.

37. The method of claim 36, wherein the CPK activity in the subject 1 is higher than about 400 U L

38. The method of claim 36, wherein the composition is administered orally.

39. The method of claim 36, wherein the effective amount comprises about 0.01 to 100 g of ornithine and/or aspartate.

40. The method of claim 36, wherein the effective amount comprises about 0.01 to 20 g of ornithine and/or aspartate.

41. The method of claim 36, wherein the effective amount comprises less than 9 g of ornithine and/or aspartate.

42. The method of claim 36, wherein the effective amount comprises less than 3 g of ornithine and/or aspartate.

43. The method of claim 36, wherein the therapeutic agent is selected from the group consisting of: an anti-hyperlipidemic agent, an anti-HBV agent, an anti-HCV agent, and an anti-HIV agent, an anti-cancer agent, an anti-diabetes agent, an anti-mental diseases agent, an anti- gastrointestinal disease agent, an anti-infection agent, an immunomodulator, cardiovascular medications.

44. The method of claim 36, wherein the therapeutic agent is a HMG-CoA inhibitor or statin.

45. A method of treating a subject suffering from rhabdomyolysis or myopathy, the method comprising administering to the subject an effective amount of a composition comprising ornithine and/or aspartate that is less than about 9 g.

46. The method of claim 45, wherein the composition is effective in lowering CPK activity level in plasma of said subject to less than about 400 U/L.

47. A composition comprising:

(a) an anti-hyperlipidemic agent; and

(b) a composition comprising an effective amount of ornithine and/or aspartate.

48. The method claim 47, wherein the amount of ornithine and/or aspartate is effective in reducing one or more hyperlipidemic risk factor level in plasma in a subject in need thereof

49. The composition of claim 47, wherein said composition is formulated in a unit dosage form.

50. The composition of claim 47, wherein said composition is formulated in a solid or liquid form.

51. The composition of claim 47, wherein said composition is formulated for oral consumption, intravenous injection, inhalation, nasal insufflation, intraarterial injection, subcutaneous

administration, mucosal administration, or pharyngeal administration.

52. The composition of claim 47, wherein said composition is formulated for oral consumption.

53. The composition of claim 47, wherein said one or more hyperlipidemic risk factor is selected from the group consisting of triglyceride, LDL and cholesterol.

54. The composition of claim 53, wherein said composition is present in an amount effective in lowering triglyceride level in plasma of said subject.

55. The composition of claim 47, wherein said composition does not result in an increase in creatine phosphokinase (CPK) activity in plasma of said subject upon administering said composition.

56. The composition of claim 47, wherein said solid or liquid dosage form is a tablet, a capsule, a pill, a granule, an emulsion, a gel, a plurality of beads encapsulated in a capsule, a powder, a suspension, a liquid, a semi-liquid, a semi-solid, a syrup, a slurry or a chewable form.

57. The composition of claim 47, wherein component (a) and component (b) are separately packaged.

58. The composition of claim 47, wherein component (a) and component (b) are mixed.

59. The composition of claim 47, wherein said anti-hyperlipidemic agent is selected from the group consisting of: HMG-CoA inhibitor, nicotinic acid, fibrate, bile acid sequestrant, ezetimibe, lomitapide, phytosterols, CETP antagonist, orlistat, and any combination thereof.

60. The composition of claim 59, wherein said HMG-CoA inhibitor is atorvastatin, fluvastatin, pravastatin, lovastatin, simvastatin, rovuvastatin or lovastatin.

61. The composition of claim 47, wherein said anti-hyperlipidemic agent is present in an amount effective in reducing triglyceride level in the subject with hyperlipidemia.

62. The composition of claim 47, wherein the composition comprises about 0.01 to 100 g of ornithine and/or aspartate.

63. The composition of claim 47, wherein the composition comprises about 0.01 to 20 g of ornithine and/or aspartate.

64. The composition of claim 47, wherein the composition comprises less than about 9 g of ornithine and/or aspartate.

65. The composition of claim 47, wherein the composition comprises less than about 3 g of ornithine and/or aspartate.