AU781042B2 - Methylene blue diagnostic agent and diagnostic methods for detection of epithelial cancer - Google Patents

Methylene blue diagnostic agent and diagnostic methods for detection of epithelial cancer Download PDF

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Publication number
AU781042B2
AU781042B2 AU35549/02A AU3554902A AU781042B2 AU 781042 B2 AU781042 B2 AU 781042B2 AU 35549/02 A AU35549/02 A AU 35549/02A AU 3554902 A AU3554902 A AU 3554902A AU 781042 B2 AU781042 B2 AU 781042B2
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Prior art keywords
methylene blue
composition
stain composition
rinsing
epithelium
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AU3554902A (en
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Douglas D Burkett
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Zila Biotechnology Inc
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Zila Biotechnology Inc
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    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N1/00Sampling; Preparing specimens for investigation
    • G01N1/28Preparing specimens for investigation including physical details of (bio-)chemical methods covered elsewhere, e.g. G01N33/50, C12Q
    • G01N1/30Staining; Impregnating ; Fixation; Dehydration; Multistep processes for preparing samples of tissue, cell or nucleic acid material and the like for analysis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K49/00Preparations for testing in vivo
    • A61K49/001Preparation for luminescence or biological staining
    • A61K49/006Biological staining of tissues in vivo, e.g. methylene blue or toluidine blue O administered in the buccal area to detect epithelial cancer cells, dyes used for delineating tissues during surgery

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • General Health & Medical Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Pathology (AREA)
  • Oncology (AREA)
  • Biochemistry (AREA)
  • Chemical & Material Sciences (AREA)
  • General Physics & Mathematics (AREA)
  • Immunology (AREA)
  • Molecular Biology (AREA)
  • Biodiversity & Conservation Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Analytical Chemistry (AREA)
  • Optics & Photonics (AREA)
  • Epidemiology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Medicines Containing Antibodies Or Antigens For Use As Internal Diagnostic Agents (AREA)
  • Investigating Or Analysing Biological Materials (AREA)
  • Measuring Or Testing Involving Enzymes Or Micro-Organisms (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)

Description

Feb-2'1-02 04:44P DRUMMOND&OUCKWORTH 949 724 11-39 WO 0J2/03048 PC~fUS(!I816 METHYLENE BLUE DIAGNOSTIC
AGENT
AND DIAGNOSTIC METHODS FOR DETECTION4 OF EPITHELrALJ
CANCER
This invention relates to a novel diagnostic agent for detection of cancerous and precancerous epithel~ial tissue.
According to another aspect, the invention pertains to novel methods for detecting and/or delineating cancerous and/or precancerous tissue of the epith~elium.
In another respect the invention concerns to such diagnostic procedures and agents useful therein which ar( especial.ly useful for in vivo screening of patients for possible oral cancer as part of routine dentist's or physician's examinations or procedures, such as periodic dental or physical examinations, dental cleaning, etc.
In yet another aspect the invention relates to such procedures and compositions useful therein, which use dye stains that are more readily available and/or less expensive and less complicated to synthesize and/Dr purify than the dyes employed in prior art procedu~res.
Feb-21-02 04:44P ORUMMOND&DUCKWORTH 949 724 1139 P.06 WO 02/0304R8CTUOO1i,.
-2- In yet another respect, the invention concerns such in vivo procedures and compositions employing a dye which, despite prior art teachings otherwise, j,.3 sufficiently non-toxic that it can be employed 1.y rinsinol the entire oral cavity and/or gargling.
In-vivo diagnostic procedures for detecting_ premalignant epithelial lesions, such as oral lesions ald oral carcinomas, employing dye compositions that are selectively retained by tissues rendered abnormal by dysplasia, hyperplasia, turoriegnesis and other active surface lesions, are known in the art. For exam-ole, procedures employing fluorescein or fluorescein derivatives are disclosed in Chenz, Chinese Journal of Stomatology (27:44-47(1992)) and Filurin (Stomatologjii (Russian) 72:44-47 (1993)). These procedures involve application of the dye, followed by visual eXaMirnation under ultraviolet light to detect cancerous /precancerous tissue, which is selectively fluorescent.
Another prior art procedure involves in vivo application by rinsing with toluidine blue 0, followed by normal visual examination to detect any selectively stained tissue. Such procedures are disclosed, ficr =eb-2'1-02 04:44P DRUMMOND&DUCKWORTH 949 724 1139 P.07 WO 02/03048 PC'r/US00/1IS6 -3example, in U.S. Patent 5,372,801 to Tucci, et al. and in U.S. Patent 4,321,251 to Mashberg. Toluidine blue has been used for decades as a histopathological stain for in-vitro use. Through this use it has become known as a metachromatic dye, staining nuclei rich in DNA and RNA a purple to pink color. The inherent deep blue color of toluidine blue 0 is changed to purple or pink when the dye is bound to nucleic acid or other acidic cellular macromolecules. Of course, this type of staining is dependent on the dye gaining access to internal subcellular structures such as the nucleus. Such access is readily obtained only by "fixing" a tissue sanple with formaldehyde or other reagent that disrupts the cellular membrane without destroying general cellular structure.
In contrast to the mechanism involved in in-vitro use, the staining of oral tissue in vivo by toluidine blue O is due to its ability to penetrate the cell walls and attach to the mitochondria, which retains the dye longer than components of the extracellular matrix.
The Mashberg procedure involves application of the toluidine blue 0 solution as a rinse of the entire oral cavity, with gargling, followed by rinses with wa-er and Feb-2:1-02 04:45P DRUMMONO&OUCKWORTH 949 724 1139 P.08 WO002103048 PC'T/US0O/18I(1 -4acetic acid to remove dye that is not retained by the cancerous or precancerous tissue. The preliminary diagnosis by the M'ashberg procedure is then con Eirined by direct application of the toluidine blue 0 COmpsition to the suspect site 10-14 days later. The TPucci 1801 patent discloses an improved toluidine blue 0 Cornposit-'!on for use according to the general procedure taught by' Mashberg.
An in vivo procedure involving use of Lugol's solution (iodine) and toluidine blue 0 was proposed for detecting esophageal cancer synchronous with uppar aerodigestive tract cancers in Papazian, Gas troe ntero logic Clinique et Biologigue 9:16-22 (1985).
More recently, Pomerantz U.S. Patent 5,882,627 disclosed a structurally defined class of oxazine arnd thiazine dyes that are useful in general accordance with the Mashberg diagnostic protocol. However, the Foamerant: '627 patent expressly excludes methylene blue frcm this defined class, asserting that it is too toxic for appli~cation by oral rinse and/or gargling procedur-es.
Contrary, however, to the disclosure of the 11/03/2005 13:34 +613-9898-1337 PATENT ATTORNEY SERV PAGE 03/10 Pomerantz '627 patent, methylene blue and its ionic derivatives, in the concentrations and quantities employed for in vivo tissue staining, is safely employed as a topically applied selective stain for detecting and/or delineating epithelial cancerous and prec:ancerou! tissue.
Therefore, according to the present invention, there is provided a method for in vivo detection of premalignant epithelial lesions and carcinomas, including the steps of: 10 sequentially rinsing the epithelium with dye stain o0. composition which is selectively retained by cancerous and precancerous tissue, wherein the stain composition includes methylene blue, and rinsing the epithelium with a rinse composition for 15-' removing unretained stain composition.
According to a further embodiment of the present invention there is provided a method for in vivo detection of premalignant epithelial lesions and carcinomas, including the steps of sequentially rinsing the epithelium with dye stain composition which is selectively retained by cancerous and precancerous tissue, wherein the stain composition includes methylene blue, and rinsing the epithelium with a rinse composition for removing unretained stain composition.
COMS ID No: SBMI-01160597 Received by IP Australia: Time 14:48 Date 2005-03-11 11/03/2005 13:34 +613-9890-1337 PATENT ATTORNEY SERV PAGE 04/10 Sa According to another embodiment of the present invention there is provided a biological stain composition for in vivo detection of cancerous and precancerous tissue, including: methylene blue, a pharmaceutically acceptable aqueous solvent, and a pharmaceutically acceptable oxidizing agent for leuco methylene blue.
Suitable compositrons of methylene blue f.: application of the dye to epithelial tissue are prepared *:by mixing the dye with a suitable pharmaceuticaly acceptable solvent. Preferably the pH of the methylene 15 blue solution is adjusted with a suitable pharmaceutically acceptable buffer system to yield a final solution that is substantially isotonic and has a S• PH in the range of approximately 2.5 to 7.0, preferably 4.0-5.0. This can be accomplished by an acetic acid- 20 sodium acetate buffer system. Other suitable buffer systems include citric acid-sodium citrate or mixed acid salt systems such as citric acid-sodium phosphate and the like.
The solvent used to provide the liquid methylene blue dye compositions of the invention is an aqueous solvent. According to the presently preferred embodiment COMS ID No: SBMI-01160597 Received by IP Australia: Time 14:48 Date 2005-03-11 Feb-21-02 04:45P DRUMMOND&DUCKWORTH 949 724 1139 WO 02/03048
PC'T/
-6of the invention, the solvent included a pharmaceutically acceptable, non-toxic, non-reactive alcohol, e.g., ethyl alcohol. Such solvents do not appreciably interfere with the staining mechanism and do not themselves contribute to the reduction of chrome. forms of the dye to leuco forms.
Flavoring, stable to the other components of the dye composition, may be added to improve the palatability of the composition if it is to be used as an oral "-inse." The amount of methylene blue dye in the liquid composition is preferably adjusted to yield a concentration of approximately 1% by weight of the final composition, although higher concentrations can be employed and lower concentrations are at least partially effective. At present, I prefer to employ dye compositions containing from about 0.5 to about 3.5% by weight of the methylene blue component.
The invention also contemplates compositions for use in accordance with the methods of the invention, in which any leuco form of the dye present in the composition is oxidized to the chromo form, by inclusion of a Feb-21-02 04:45P DRUMMOND&DUCKWORTH 949 724 1139 P.11 WO 02/03048 PCT/US00/1 161 -7pharmaceutically acceptable oxidizing agent, in the manner analogous to that disclosed in the Tucci '801 patent.
EXAMPLES
The following examples are presented in order to illustrate practice of the invention to those skilled in the art and not by way of limitation of the scop! thereof, which is defined only by the appended claims.
Example 1 Preparation of Diagnostic Composition A diagnostic composition is prepared by mix:ing each of the indicated components in the following proportions by weight): Feb-2 1-02 04:46P DRUMMOND&DUCKWORTH 949 724 11-39 P.12 WO 02/0304R PC' rfS61flh1816 I Purified Water u.S.p. 83.85 Glacial Acetic Acid IJ.S.P. 4.61 Sodium Acetate Trihydrate U.s.P. 2.45 SDl8 Ethyl Alcohol 7.48 Hydrogen Peroxide 30%, U.S.P. 0.41 IFF Raspberry IC563457 0.20 Methylene Blue 1.00 Example 2 Preparation -of Rinse Solution A rinse solution is prepared by mixing the followingq components in the indicated proportions (weight t): Purified Water IJ.S.P. 98.70 Glacial Acetic Acid U.S.P. Sodium Benzoate U.S.P. 0.LO IFF' Raspberry 1C563457 0.20 Example 3 Clinical Effectiveness The clinical effectiveness of the compositions of Examples 1 and 2, is compared to toluidine, blulet) eb-21-O2 04:46P DRUMMONO&DUCKwORTH 949 724 1139 P.13 WO 02(03048 PCT/US00Ii 816].
diagnostic control compositions prepared in acco~rdance with the Tucci '801 patent, using the diagnostic protoc)2 disclosed in the Mashberg 4251 patent.
Patients are first screened for oral pathology employing the TBO control composition. After identifying potential cancerous or precancerous pathology, all traces of the TBO are removed by repeatedly rinsing the suspect sites with water and the acetic acid rinse of Example 2.
Those patients exhibiting oral pathology aro then used as test subjects for the methylene blue diagnostic composition of Example 1. 2-3 cc of the methylene blue composition is applied by painting the pathologic~ mucosaL surface, followed by rinsing with the rinse mixture and water to remove excess mnethyltene blue compositiori.
Histological examination of tissue from the areas stained by the methylene blue diagnostic composition of Example 1 confirms that the methylene blue composition i at least as effective as toluidine blue 0 in identifying and delineating cancerous and precancerous epithelial tissue.
FQb-91-02 04:46P DRUMMOND&DUCKWORTH 949 724 113 9 P-14 WO 0210l3048f%-A V. 1 Example 4 The procedures of Example 3 are repeated, except that the test and control compositions are appl.ied to t~i oral mucosa by rinsing, with gargling, instead of by direct application to the locus of the suspect sites.
Equivalent results are obtained.
Having disclosed my invention in such terms as to enable those skilled in the art to understand and practice it, and having disclosed the presently -,?referred embodiment, I CLAIM:

Claims (4)

1. A method for in vivo detection of premalignant epithelial lesions and carcinomas, including the steps of: sequentially rinsing the epithelium with dye stain composition which is selectively retained by cancerous and precancerous tissue, wherein the stain composition includes methylene blue, and rinsing the epithelium with a rinse composition for removing unrctained stain composition.
2. A method for in vivo detection of premalignant epithelial lesions and carcinomas, :including the steps of sequentially rinsing the epithelium with dye stain composition which is selectively retained by cancerous and precancerous tissue, wherein the stain composition includes methylene blue, and 15 rinsing the epithelium with a rinse composition for removing unretained stain composition.
S3. A biological stain composition for in vivo detection of cancerous and precancerous tissue, including: methylene blue, a pharmaceutically acceptable aqueous solvent, and a pharmaceutically acceptable oxidizing agent for leuco methylene blue.
4. A method according to claim 1 or claim 2 substantially as hereinbefore described with reference to any one of the examples. COMS ID No: SBMI-01160597 Received by IP Australia: Time 14:48 Date 2005-03-11 11/03/2005 13:34 +613-9890-1337 PATENT ATTORNEY SERV PAGE 06/10 12 A biological stain composition according to claim 3 substantially as hereinbefore described with reference to any one of the examples. Dated this I I h day of March 2005 PATENT ATTORINEY SERVICES Attorneys for ZILA BIOTECHNOLOGY, INC 12 COMS ID No: SBMI-01160597 Received by IP Australia: Time 14:48 Date 2005-03-11
AU35549/02A 2000-06-30 2000-06-30 Methylene blue diagnostic agent and diagnostic methods for detection of epithelial cancer Ceased AU781042B2 (en)

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JP (1) JP2004502704A (en)
CN (1) CN1372637A (en)
AU (1) AU781042B2 (en)
CA (1) CA2383194A1 (en)
IL (1) IL148342A0 (en)
MX (1) MXPA02002183A (en)
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JP2007512297A (en) * 2003-11-28 2007-05-17 フォトファーマイカ リミテッド Development in bioactive methylene blue derivative (2)
CA2583427A1 (en) * 2004-09-30 2006-04-20 Zila Biotechnology, Inc. Light-directed method for detecting and aiding further evaluation of abnormal mucosal tissue
US7838304B2 (en) * 2006-01-18 2010-11-23 Arkray, Inc. Liquid reagent of color former and method of stabilizing the same
ITUD20080073A1 (en) * 2008-04-04 2009-10-05 Giuseppe Augusto Scigliano PHARMACEUTICAL COMPOSITION AND ITS DIAGNOSTIC AND THERAPEUTIC USE
US9188571B2 (en) 2011-08-26 2015-11-17 Waters Technologies Corporation Chromatography apparatus having diffusion bonded coupler
CN105510321A (en) * 2011-12-29 2016-04-20 闫文广 Detection agent composition for epithelial tissue tumor cells and preparing method thereof
PT106082A (en) * 2012-01-04 2013-07-04 Fernando Jorge Neves Ferreira FIXING COMPOSITION FOR CYTOLOGY, CELL FITTING METHOD AND ITS APPLICATIONS
CN104483473B (en) * 2014-12-31 2016-03-02 广州市微米生物科技有限公司 For detection reagent and the preparation and determination methods method of epithelial neoplasms cell
US11413240B2 (en) 2016-12-29 2022-08-16 Board Of Regents, The University Of Texas System Methylene blue solution for the treatment of oral lesions

Citations (3)

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Publication number Priority date Publication date Assignee Title
US5301688A (en) * 1992-08-07 1994-04-12 Physion S.R.L. Method for localization and therapy of occult bladder cancer
US5485527A (en) * 1985-11-04 1996-01-16 Becton Dickinson And Company Apparatus and method for analyses of biological specimens
US5882627A (en) * 1996-01-16 1999-03-16 Zila Pharmaceuticals, Inc. Methods and compositions for in-vivo detection of oral cancers precancerous conditions

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US4321251A (en) * 1979-12-19 1982-03-23 The United States Of America As Represented By The Department Of Health And Human Services Detection of malignant lesions of the oral cavity utilizing toluidine blue rinse
JPH028720A (en) * 1988-06-27 1990-01-12 Toagosei Chem Ind Co Ltd Temperature detection body
DE69229471T2 (en) * 1991-10-31 1999-11-25 Zila Inc BIOLOGICAL DYE COMPOSITION, PROCESS FOR ITS PRODUCTION AND USE FOR MARKING THE OUTLINE OF EPITHELIC CARSINOMAS
AU8414098A (en) * 1997-08-19 1999-03-08 Emory University Noscapine derivatives, useful as anticancer agents

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5485527A (en) * 1985-11-04 1996-01-16 Becton Dickinson And Company Apparatus and method for analyses of biological specimens
US5301688A (en) * 1992-08-07 1994-04-12 Physion S.R.L. Method for localization and therapy of occult bladder cancer
US5882627A (en) * 1996-01-16 1999-03-16 Zila Pharmaceuticals, Inc. Methods and compositions for in-vivo detection of oral cancers precancerous conditions

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AU3554902A (en) 2002-04-22
MXPA02002183A (en) 2002-09-30
NO20020959L (en) 2002-04-24
EP1212600A4 (en) 2007-10-10
JP2004502704A (en) 2004-01-29
EP1212600A1 (en) 2002-06-12
WO2002003048A8 (en) 2002-07-25
CA2383194A1 (en) 2002-01-10
IL148342A0 (en) 2002-09-12
WO2002003048A1 (en) 2002-01-10
CN1372637A (en) 2002-10-02

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