# Patent

## Title
Satiation peptide administration

## Abstract

Disclosed herein are compositions and methods for treating obesity involving satiation gut peptide administration to the mouth of a subject for a predetermined dose and frequency. In other embodiments, materials and methods of treating certain psychological disorders are disclosed involving satiation gut peptides. In exemplary embodiments, the satiation gut peptide pertains to PYY.

## Background
RELATED APPLICATIONS
This application claims priority to U.S. Ser. No. 61/146,287 filed Jan. 21, 2009, which is incorporated herein in its entirety.
SEQUENCE LISTING
The instant application contains a Sequence Listing which has been submitted in ASCII format via EFS-Web and is hereby incorporated by reference in its entirety. Said ASCII copy, created on Feb. 27, 2013, is named 10457-147US_SL.txt and is 7,510 bytes in size.


INTRODUCTION
Satiation gut peptides are secreted from the small intestine and colon in response to food intake. Penetrating from plasma through the blood-brain barrier, they act by activating specific receptors in the satiety center of the hypothalamus thus inducing satiation. The most important satiation gut peptides are Peptide YY, Glucagon-like Peptide 1, Oxyntomodulin, and Cholecystokinin. Acute supplemental therapy with satiation gut peptides reduces food intake and body weight in obese animal models as well as in lean and obese human subjects. Several clinical trials utilizing satiation peptide supplement therapy are currently under way. In these trials, the tested peptide is administered by iv injections 30 min prior to the meal. It is widely acknowledged that satiation gut peptides would not be effective through ingested oral administration since enzymes and acids in the gut would degrade them prior to reaching the blood.



BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1: rAAV-PYY vector plasmid: TR (terminal repeat), CMV (cytomegalovirus) enhancer, CBA (Chicken B actin) promoter.
FIG. 2:. Food intake per week in 8 months-old DIO mice injected with rAAV-PYY vs. rAAV-GFP*P<0.05
FIG. 3.: Body weight change in 8 months-old diet-induced obese (DIO)-mice injected with rAAV-PYY vs. rAAV-GFP (controls). *P<0.05
FIG. 4: Effects of Peptide YY Mouth Spray. A) One hour food intake after one spray with PYY, 5 ug per 100 g of body weight vs. spray with sterile H2O. B) Difference in one hour food intake after PYY mouth spray vs. Sterile H20, shown are individual animals. C) Dose response of PYY mouth spray on FI as measured after one hour. D) 24 hours food intake after PYY mouth spray vs. sterile H20. *P<0.05, **P<0.01.
FIG. 5: relates to effects of extended PYY administration on behavior of mice concerning (A) attack frequency (B) threat frequency (C) chase frequency and (D) frequency.
FIG. 6: shows example sequences pertaining to a) Human Peptide YY amino acid sequence, b) a portion of human PYY, c) Oxyntomodulin polypeptide, d) Glucagon-like Peptide 1, and e) cholecystokinin related sequences.



DETAILED DESCRIPTION
The present application is based on the inventors' work toward establishing either a stable and longer term delivery of satiation gut peptides and/or administration of satiation gut peptides intended for targeting specific areas of the body which have now been identified as effecting an unexpectedly favorable satiation response. According to certain embodiments, the invention pertains to compositions and methods for treating obesity involving satiation gut peptide administration to the mouth of a subject for a predetermined dose and frequency. According to specific embodiment, the subject invention pertains to providing a long-term increase of satiation peptides in the saliva by targeting salivary gland with vectors, including, but not limited to, recombinant Adeno-associated viral (rAAV) vector, adenoviral vector, or other suitable vectors for transfection of cells in a human or non-human animal, harboring the respective gene, for introduction and expression in targeted cells.
In another embodiment, the invention pertains to a method of inducing satiation in a subject that includes applying to at least a portion of the mouth of the subject a composition comprising a satiation gut peptide at a time period prior to eating (pre-prandial). The time period may be 5 seconds or more. In a specific embodiment, the time period is 5-360 min prior to eating. In a more specific embodiment, the time period is 30-120 min prior to eating.
Another embodiment relates to a container that comprises a solid (e.g. powder), fluid or semi-fluid composition that comprises satiation gut peptide and a pharmaceutically acceptable carrier. In a specific embodiment the container comprises a nozzle for ejecting the composition into the mouth of a subject. The container may be under pressure and/or be equipped with a pump nozzle.
Another embodiment relates to a mouth applicable article loaded with a satiation gut peptide. The article may be chewing gum loaded with peptide; a lozenge (e.g. a dissolvable solid or semi-solid object intended to hold in the mouth for a period of time) loaded with peptide, or a permeable pouch or sponge loaded with peptide. The article is designed for extended delivery of peptide to the mouth and/or pharynx, as opposed to conventional oral administration that involves the immediate swallowing of a pill, table or fluid composition as is conventionally understood as oral administration. In particular, the article is designed for delivery to the tongue.
According to another embodiment, cells related to the mouth such as mucosal or salivary gland cells are transformed with vectors engineered to express and release a satiation gut peptide.
In a specific embodiment, the peptide is delivered to the mouth and/or pharynx to a subject according to a generally continuous time period of at least 5, 10, 15 or more seconds. In another embodiment, the delivery is for 0.1-120 mins, including any specific 0.1 minute increment within such range. In a specific embodiment, the inventors have found that administration of the peptide such that it is in prolonged contact with the tongue is optimal.
As described herein, the invention includes embodiments that utilize nucleotides encoding satiation gut peptides, or peptides alone. Satiation gut peptides include peptides relating to Peptide YY, Glucagon-like Peptide 1, Oxyntomodulin, and cholecystokinin. Nucleotides and peptides having substantial identity to the nucleotide and amino acid sequences relating to Peptide YY, Glucagon-like Peptide 1, Oxyntomodulin, and cholecystokinin also are contemplated for use in accordance with the teachings herein. Sequence information is provided in FIG. 6.
The proteins and polypeptide sequences, as well as polynucleotides encoding the same, having substantial identity with the sequences specifically described herein may be used in conjunction with present invention. Here “substantial identity” means that two sequences, when optimally aligned such as by the programs GAP or BESTFIT (peptides) using default gap weights, or as measured by computer algorithms BLASTX or BLASTP, share at least 50%, preferably at least 75%, and most preferably at least 95% sequence identity, or sequence identity of any integer percentage between 50% and 99.9%. Preferably, residue positions which are not identical differ by conservative amino acid substitutions. For example, the substitution of amino acids having similar chemical properties such as charge or polarity are not likely to effect the properties of a protein. Non-limiting examples include glutamine for asparagine or glutamic acid for aspartic acid.
The term “variant” as used herein refers to nucleotide and polypeptide sequences wherein the nucleotide or amino acid sequence exhibits substantial identity with the nucleotide or amino acid sequence SEQ ID NOS, preferably 75% sequence identity and most preferably 90-95% sequence identity to the sequences of the present invention: provided said variant has a biological activity as defined herein. The variant may be arrived at by modification of the native nucleotide or amino acid sequence by such modifications as insertion, substitution or deletion of one or more nucleotides or amino acids or it may be a naturally occurring variant. The term “variant” also includes homologous sequences which hybridise to the sequences of the invention under standard or preferably stringent hybridisation conditions familiar to those skilled in the art. Examples of the in situ hybridisation procedure typically used are described in (Tisdall et al., 1999); (Juengel et al., 2000). Where such a variant is desired, the nucleotide sequence of the native DNA is altered appropriately. This alteration can be made through elective synthesis of the DNA or by modification of the native DNA by, for example, site-specific or cassette mutagenesis. Preferably, where portions of cDNA or genomic DNA require sequence modifications, site-specific primer directed mutagenesis is employed, using techniques standard in the art.
In specific embodiments, a variant of a polypeptide is one having at least about 80% amino acid sequence identity with the amino acid sequence of a native sequence full length sequence of satiation gut peptides as taught herein and known in the art. Such variant polypeptides include, for instance, polypeptides wherein one or more amino acid residues are added, or deleted, at the N- and/or C-terminus, as well as within one or more internal domains, of the full-length amino acid sequence. Fragments of the peptides are also contemplated. Ordinarily, a variant polypeptide will have at least about 80% amino acid sequence identity, more preferably at least about 81% amino acid sequence identity, more preferably at least about 82% amino acid sequence identity, more preferably at least about 83% amino acid sequence identity, more preferably at least about 84% amino acid sequence identity, more preferably at least about 85% amino acid sequence identity, more preferably at least about 86% amino acid sequence identity, more preferably at least about 87% amino acid sequence identity, more preferably at least about 88% amino acid sequence identity, more preferably at least about 89% amino acid sequence identity, more preferably at least about 90% amino acid sequence identity, more preferably at least about 91% amino acid sequence identity, more preferably at least about 92% amino acid sequence identity, more preferably at least about 93% amino acid sequence identity, more preferably at least about 94% amino acid sequence identity, more preferably at least about 95% amino acid sequence identity, more preferably at least about 96% amino acid sequence identity, more preferably at least about 97% amino acid sequence identity, more preferably at least about 98% amino acid sequence identity and yet more preferably at least about 99% amino acid sequence identity with a polypeptide encoded by a nucleic acid molecule shown in Attachment B or a specified fragment thereof. Ordinarily, variant polypeptides are at least about 10 amino acids in length, often at least about 20 amino acids in length, more often at least about 30 amino acids in length, more often at least about 40 amino acids in length, more often at least about 50 amino acids in length, more often at least about 60 amino acids in length, more often at least about 70 amino acids in length, more often at least about 80 amino acids in length, more often at least about 90 amino acids in length, more often at least about 100 amino acids in length, or more.
“Stringency” of hybridization reactions is readily determinable by one of ordinary skill in the art, and generally is an empirical calculation dependent upon probe length, washing temperature, and salt concentration. In general, longer probes require higher temperatures for proper annealing, while shorter probes need lower temperatures. Hybridization generally depends on the ability of denatured DNA to re-anneal when complementary strands are present in an environment below their melting temperature. The higher the degree of desired identity between the probe and hybridizable sequence, the higher the relative temperature which can be used. As a result, it follows that higher relative temperatures would tend to make the reaction conditions more stringent, while lower temperatures less so. For additional details and explanation of stringency of hybridization reactions, see Ausubel et al., Current Protocols in Molecular Biology, Wiley Interscience Publishers, (1995).
“Stringent conditions” or “high stringency conditions”, as defined herein, are identified by those that: (1) employ low ionic strength and high temperature for washing, 0.015 M sodium chloride/0.0015 M sodium citrate/0.1% sodium dodecyl sulfate at 50° C.; (2) employ during hybridization a denaturing agent, 50% (v/v) formamide with 0.1% bovine serum albumin/0.1% Ficol/0.1% polyvinylpyrrolidone/50 mM sodium phosphate buffer at pH 6.5 with 750 mM sodium chloride, 75 mM sodium citrate at 42 degrees C.; or (3) employ 50% formamide, 5×SSC (0.75 M NaCl, 0.075 M sodium citrate), 50 mM sodium phosphate (pH 6.8), 0.1% sodium pyrophosphate, 5.times. Denhardt's solution, sonicated salmon sperm DNA (50 μg/ml), 0.1% SDS, and 10% dextran sulfate at 42 degrees C., with washes at 42 degrees C. in 0.2×SSC (sodium chloride/sodium citrate) and 50% formamide at 55 degrees C., followed by a high-stringency wash consisting of 0.1×SSC containing EDTA at 55 degrees C.
“Moderately stringent conditions” are identified as described by Sambrook et al., Molecular Cloning: A Laboratory Manual, New York: Cold Spring Harbor Press, 1989, and include the use of washing solution and hybridization conditions (e.g., temperature, ionic strength and % SDS) less stringent that those described above. An example of moderately stringent conditions is overnight incubation at 37.degree. C. in a solution comprising: 20% formamide, 5×SSC (150 mM NaCl, 15 mM trisodium citrate), 50 mM sodium phosphate (pH 7.6), 5×Denhardt's solution, 10% dextran sulfate, and 20 mg/ml denatured sheared salmon sperm DNA, followed by washing the filters in 1×SSC at about 37-50 degrees C. The skilled artisan will recognize how to adjust the temperature, ionic strength, etc. as necessary to accommodate factors such as probe length and the like.
An oral liquid formulation may, for example, be a pharmaceutically acceptable emulsion, syrup, elixir, suspension, solution and the like, which may contain a pharmaceutically customary inert diluent such as water and if desired, additives. Such an oral liquid formulation can be produced by mixing an active ingredient, inert diluent and other additives if necessary in accordance with a customary method. An oral formulation usually contain about 0.01 to 99% by weight, preferably about 0.1 to 90% by weight, usually about 0.5 to 50% by weight of an inventive active compound, although the amount may vary depending on the dosage form.
In certain embodiments, a formulation is prepared for spraying into the mouth. The composition may be placed in a container equipped with a sprayer nozzle and either ejected through a pump motion or by release of pressure.
In another embodiment, the composition is combined and provided in the form of a chewing gum.
Example 1
PYY Gene Therapy
Peptide YY (PYY) is a satiation gut peptide secreted from the neuro-endocrine L cells from the small intestine and colon epithelia. PYY is secreted into the blood stream and subsequently activates Y receptors in the arcuate nucleus of the hypothalamus thus inducing satiation. In the pilot study, in addition to the plasma, we have also detected PYY in saliva in naïve, untreated mice, while at the same time identifying the respective Y2 receptor in the tongue epithelia. To the inventors' knowledge, these are novel findings which lead to the following hypothesis: long-term expression of genes coding for satiation peptide in salivary gland will reduce food intake and body weight in obese animal.
In order to overexpress PYY, a rAAV vector was constructed harboring the pre-pro-Peptide YY gene (FIG. 1). rAAV-PYY was administered into the salivary glands through the salivary ducts. Injection of rAAV-PYY resulted in a long-term (up to 6 months) expression of Peptide YY as measured by the respective ELISA assay (not shown).
The ectopic expression of PYY transgene in lean as well as in diet-induced obese mice produced a significant decrease in food intake and body weight compared to control group injected with reporter vector rAAV-GFP (FIGS. 2 and 3). The results of the inventors demonstrated that long-term expression of peptide YY transgene delivered by a viral vector is a viable therapy for the treatment of obesity.
Example 2
Long-term Peptide YY Gene Therapy: Addressing Existing Controversy
Peptide YY (PYY) is a satiation gut hormone released postprandially mainly by the gut. The effects of acute and chronic administration of PYY are controversial. Several groups have found a significant decrease in food intake (FI) and body weight (BW) in animal experiments and in human trials, while other groups have been unable to reproduce this data. The controversy can be related to several behavioral factors including acclimatization and stress, as well as varying experimental conditions. To eliminate these factors and to address the effect of long-term overexpression of PYY we have develop animal models, C57BL/6 mice, with either homotopic or ectopic expression of pre-pro-PYY transgene delivered by a single injection of a viral vector. For the enhanced homotopic expression, the vector was delivered through superior mesenteric artery (SMA) to target the colon and small intestine where PYY is normally produced. For the ectopic expression, the vector had been delivered either into the 3rd ventricle in the brain targeting hypothalamus, or into the salivary ducts to target submandibular salivary glands to induce PYY secretion in to saliva. All treated mice were fed high fat diet (60% fat) ad libitum, FI and BW were measured once a week for 30 weeks. In SMA-injected mice, we documented a sustained two-fold increase of PYY in plasma during fasting and ten-fold increase one hour after feeding. In spite of the significant increase of systemic PYY, no differences in BW or FI were documented at 30 weeks post-injection. On the contrary, in mice with PYY-encoding vector injected either centrally or in the salivary glands, the concentration of plasma PYY remained unchanged. However, centrally-injected mice exhibited significant increase in both BW and FI, while the long-term effect was opposite in salivary gland-treated animals. In satiation behavioral studies, neither treated group show a significant difference in FI after 16, or 24 hrs fasting. Our results suggest that the long-term overexpression of PYY have differential effect dependent on the targeted site. Physiological tests and hormonal profiles in mice from all groups will be presented and the possible mechanism of action of the exogenous PYY will be discussed.
Example 3
Administration of Satiation Gut Peptides to Mouth
Introduction
Satiation gut peptides are secreted into the bloodstream from the small intestine and colon in response to food intake (FI). Their main effect is to induce satiety by activation their specific receptors in the satiety center in the hypothalamus. The most important satiation gut peptides are Peptide YY (PYY), Glucagon-like Peptide 1 (GLP-1), Oxyntomodulin (OXM), and Cholecystokinin (CCK). Acute supplemental therapy with satiation gut peptides reduces FI and body weight (BW) in obese animal models as well as in lean and obese human subjects. Several clinical trials utilizing satiation peptide supplement therapy are currently under way. Unfortunately, the delivery methods of these peptides (iv injections) showed significant side effects and poor adherence. In the pilot study, in addition to the plasma, we have also detected PYY in saliva in naïve, untreated mice, while at the same time identifying the respective Y2 receptor in the tongue epithelia. Based on these novel findings, the inventors have developed a non-invasive, easy-to-use mouth spray to deliver these peptides. The aim is to reduce voluntary FI by inducing an early satiation effect mediated by an increased concentration of these peptides in the saliva. Incremental reduction in FI over the prolonged period of time will result in reduced BW and improved health.
Materials and Methods:
Synthetic PYY was purchased from Bachem, Inc USA (Cat # H-6042) and diluted in sterile H2O. Sterile un-used perfume sample vials (Saphora) were utilized to administer PYY in the form of a mouth spray. It was estimated that the volume of one spray approximates to about 25 l.
Mice were conditioned three times to 24 hours fasting starting at the beginning of the dark cycle and ending at the end of the light cycle. At the end of the fasting cycle and as a part of conditioned routine, a sterile water spray had been administered into the mouth. All the experiments were done during the first hour of the dark cycle after fasting. Once the dark cycle started, mice were sprayed once with either PYY or sterile H2O in a total volume of 25 l per spray. After the treatment, mice were returned to their cages and ten minutes later pre-weighted chow was provided. One hour later, the amount of consumed chow had been recorded by measuring the leftover amount. When the experiments were repeated, mice were fasted only once a week with the control and experimental groups rotated.
Results:
Mice sprayed with PYY consumed significantly (P=0.03) less food (15% on average) compared to the control group sprayed with H2O (FIG. 4A, 4B). We also documented a significant PYY dose response effect to FI (FIG. 4C). After PYY mouth spray, there was a pronounced early satiety effect followed by compensatory higher food intake resulting in similar overall 24 hr period FI for both experimental and control groups (FIG. 4D). This data correlates with previously published observation showing no difference in FI during 24 hours after IP or IV injections. This data, however, reflect the ad libitum pattern of food consumption in mice. In humans, with a defined pattern of three meals per day, with PYY spray application prior to each meal, the treatment is anticipated to reduce overall FI over 24 hrs period.
Conclusions:
The increase in PYY concentration delivered by mouth spray has a potential to be utilized as a treatment for obesity by reducing voluntary FI. Attachment A in U.S. Provisional Application No. 61/146,287 sets forth data demonstrating the successful expression of Peptide YY and the use for modulating BMI and FI.
Example 4
Long-term Salivary PYY3-36 Treatment Modulates Aggressive Behavior
The NPY pathway modulates food intake, body weight, energy expenditure, blood pressure, cortical excitability, circadian rhythms, stress response, emotions, memory, attention, learning, aggression, ethanol susceptibility and pain processing. The NPY pathway has also been related to the mechanism of epilepsy, neurogenesis, neuroprotection, analgesia, anxiety and depression (1, 2). The widespread effects of NPY are mediated by G-protein coupled receptors Y1, Y2, Y4, Y5 and Y6.
Components of the Neuropeptide Y (NPY) expressed widely in the CNS have been linked to aggression, anxiety and depression. For example, NPY Y1 and Y4 receptor knockout mice exhibit abnormally aggressive behavior (1). Furthermore, both pharmacological inhibition of NPY Y2 receptor and NPY Y2 receptor knockout show an anxiolytic, antidepressant phenotypes with reduced attention and increased impulsivity (3, 4)'(5). However, so far little is known about the role of NPY Y2 receptors in aggressive behavior.
NPY Y2 receptors endogenous agonist is PYY3-36. Recently, we reported that augmentation of salivary PYY3-36 modifies feeding behavior in mice. The long-term increase of salivary PYY3-36 by using a recombinant Adeno-associated virus (rAAV-PYY), produced a significant decrease in body weight and food intake in obese mice. Unexpectedly, in addition to modulating the feeding behavior, the long term overexpression of salivary PYY3-36 also appears to modulate aggressive behavior.
Data presented in this report indicate that long-term expression of Peptide YY3-36, an agonist of NPY Y receptors with higher affinity for the Y2 receptor, abolish aggressive behavior in mice. To test these observations, we used the territorial Resident/Intruder (R/I) aggressive paradigm (6), a standard test for evaluating rodent aggressive behavior. The test was applied on three different occasions using different intruders. Tests were recorded and analyzed in a blind manner using the Observer v5.0 software (Noldus Information Technology) (see videos, Supplementary data) (7).
The aggressive behavior was analyzed by the frequency, duration and latency of attacks, threats and chase from the resident to the intruder mice. PYY3-36 treated mice displayed a 44-fold decrease in the number of attack events compare to controls [PYY3-36 0.07±0.067 events per 10 min, vs. Controls 3.07±1.74 events in 10 min, n=5, p<0.05) (FIG. 5A). Likewise, PYY3-36 treated mice had a significant decrease in attack duration and a significant increase in attack latency. Similarly, PYY3-36 treated mice had a significant decrease in threat events and duration compare to controls (FIG. 5B) and a decrease in chase events and duration compare to control mice (FIG. 5C). Interestingly, even though an aggressive behavior was almost completely abrogated, the normal social interactions manifested by sniffing did not change (FIG. 5D).
These dramatic changes in territorial aggression suggest that the long-term treatment with NPY Y2 receptors agonists such as PYY3-36 modulates both feeding and aggressive behaviors. Because PYY3-36 has recently been tested in clinical trials for weight loss in obese adult subjects, the unintended while favorable effects shown here must be taken in consideration before such agonists are approved for the long-term treatment of obesity. This is especially important in light of the Y receptors cross talk and interactions as shown in genetically modified mice models (8). Further studies are needed to understand the long-term effect of Y receptors agonists in feeding and aggressive behavior, as well as in depression and anxiety.
Supplemental Material:
Methods
Vector design: A recombinant adeno-associated virus encoding murine pre-pro-PYY (rAAV-PYY) under the control of a strong constitutive CMV/-actin promoter and the control rAAV-GFP were pseudotyped into rAAV serotype 5 capsids as having higher transduction in salivary glands (SG) (9). The production, purification and titration of the viral vectors were performed as described previously (10).
Mouse studies: This study was approved by the Animals Care and Use Committee of The National Institute of Dental and Craniofacial research and by the Biosafety Committee of the National Institute of Health (Bethesda, Md.). All mice procedures were done in accordance with the principles of the National Research Council's guide for the Care and Use of Laboratory Animals. Studies were done in male Balb/c (Harlan Sprague Dawley, Walkersville, Md.) mice housed at 22-24° C. in a 12 hours light/dark cycle (lights off at 1800). Forty five days old male Balb/C mice (n=5) were administered a single dose of (100 l, 1010 vector genomes) rAAV-PYY, rAAV-GFP or saline control bi-laterally into the orifice of the submandibular salivary gland as described by Katano et al (9).
Metabolic profile: Mice had free access to water and food (normal chow). Food intake and body weight were measured weekly for 24 weeks.
Behavioral studies: Aggression territorial-Intruder test were performed on week 24 after the treatment (6). Briefly, PYY-, or GFP-treated resident mice were individually housed for at least two weeks prior to testing. Bedding from cages was not changed during the testing period to avoid unnecessary stress. On the day of the experiment, a smaller size intruder was placed into the resident cage for 10 minutes and the resident's behavior was recorded with a video camera. Each experiment was repeated 3 times on three different occasions and with different intruders. The videos from the experiments were analyzed for non-aggressive and aggressive behavior by an expert in a blind manner using The Observer v5.0 software (Noldus Information Technology) (7).
Statistical analysis: Statistical analysis was conducted using un-paired Student's t-test or by a Mann-Whitney test with significance at P<0.05. Data was reported in mean±SEM.
Results:
Metabolic Profile: rAAV-PYY treated mice weekly caloric intake was significantly lower than rAAV-GFP control mice (rAAV-PYY 95.53±2.35 kcal vs. rAAV-GFP 107.44±3.22 kcal, p<0.002). Twenty two weeks after vector delivery, the rAAV-PYY treated mice gained significantly less weight than the controls mice (rAAV-PYY 5.33±0.63 g vs. rAAV-GFP 6.28±0.68 g, p<0.05). These data suggest that long-term chronic elevation of PYY3-36 in saliva of lean mice modulates feeding behavior by decreasing food intake and body weight.
REFERENCES CITED FOR EXAMPLE 4


    1. T. Karl, H. Herzog, Peptides 28, 326 (February 2007).
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    3. A. Tschenett et al., Eur J Neurosci 18, 143 (July 2003).
    4. J. P. Redrobe, Y. Dumont, H. Herzog, R. Quirion, Behav Brain Res 141, 251 (May 15, 2003).
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    6. T. Karl et al., Proc Natl Acad Sci USA 101, 12742 (Aug. 24, 2004).
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The teachings of the references cited throughout the specification are incorporated herein in their entirety by this reference to the extent they are not inconsistent with the teachings herein. It should be understood that the examples and the embodiments described herein are for illustrative purposes only and that various modifications or changes in light thereof will be suggested to persons skilled in the art and are to be included within the spirit and purview of this application.

## Claims

1. A method of inducing satiation in a subject comprising applying a therapeutically effective dose of a satiation gut peptide to a tongue in a mouth of a subject, wherein the satiation gut peptide is contained within a lozenge, wherein the lozenge is in the form of a dissolvable planar sheet, wherein said satiation gut peptide is unmodified Peptide YY (PYY), and wherein the application of the dissolvable planar sheet to the tongue does not substantially change the concentration of the satiation peptide in the plasma of the subject.

2. A method of inducing satiation in a subject comprising applying a therapeutically effective dose of a satiation gut peptide to a tongue in a mouth of a subject, wherein the satiation gut peptide is contained within a lozenge, wherein the lozenge is in the form of a dissolvable planar sheet, wherein said satiation gut peptide consists essentially of Peptide YY (PYY), and wherein the application of the dissolvable planar sheet to the tongue does not substantially change the concentration of the satiation peptide in the plasma of the subject.

3. The method of claim 2, wherein the satiation gut peptide is delivered to the subject prior to eating.

4. A method of treating obesity of a subject comprising delivering a therapeutically effective dose of a satiation gut peptide to a tongue in a mouth of said subject via a lozenge loaded with the satiation gut peptide, wherein the lozenge is in the form of a dissolvable planar sheet, wherein said satiation gut peptide is unmodified Peptide YY (PYY), and wherein the therapeutically effective dose does not substantially change the concentration of the satiation peptide in plasma of the subject.

5. The method of claim 4, wherein the satiation gut peptide is delivered to the subject prior to eating.

6. A method of treating obesity of a subject comprising delivering a therapeutically effective dose of a satiation gut peptide to a tongue in a mouth of said subject via a lozenge loaded with the satiation gut peptide, wherein the lozenge is in the form of a dissolvable planar sheet, wherein said satiation gut peptide consists essentially of Peptide YY (PYY), and wherein the therapeutically effective dose does not substantially change the concentration of the satiation peptide in the plasma of the subject.

7. The method of claim 6, wherein the satiation gut peptide is delivered to the subject prior to eating.