CA1176158A - Pharmaceutical formulations comprising human insulin and human c-peptide - Google Patents
Pharmaceutical formulations comprising human insulin and human c-peptideInfo
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- CA1176158A CA1176158A CA000409900A CA409900A CA1176158A CA 1176158 A CA1176158 A CA 1176158A CA 000409900 A CA000409900 A CA 000409900A CA 409900 A CA409900 A CA 409900A CA 1176158 A CA1176158 A CA 1176158A
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- insulin
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K38/00—Medicinal preparations containing peptides
- A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
- A61K38/22—Hormones
- A61K38/28—Insulins
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- Bioinformatics & Cheminformatics (AREA)
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- Diabetes (AREA)
- Endocrinology (AREA)
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- Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
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Abstract
ABSTRACT OF THE DISCLOSURE
A pharmaceutical composition is disclosed which comprises, in association with a pharmaceutically acceptable carrier, human insulin and human C-peptide in a molar ratio, human insulin to human C-peptide, of from about 1:4 to about 4:1, and which is useful in treating diabetics and in promoting attainment of natural hormonal homeostasis, thereby preventing or substantially diminishing or retarding diabetic com-plications.
A pharmaceutical composition is disclosed which comprises, in association with a pharmaceutically acceptable carrier, human insulin and human C-peptide in a molar ratio, human insulin to human C-peptide, of from about 1:4 to about 4:1, and which is useful in treating diabetics and in promoting attainment of natural hormonal homeostasis, thereby preventing or substantially diminishing or retarding diabetic com-plications.
Description
~ 1 7615~
X-5892 -l-PHARMACEUTICAL FORMULATIO~S COMPRISI~G
HUMA~ INSULIN ~.ND EIVMA~ C-PEPTl:DE
Diabetes mellitus is a metabolic disorder characterized by the failure of body tissues to oxidize carbohydrates at the normal rate. Its most important factor is a deficiency of insulin. During the last 60 years people suffering frQm diabetes have been greatly aided by receiving controlled amounts of insulin. To the present time, the insulin used by diabetics has been isolated from animal pancreases, generally bovine 10 and porcine. Both bovine and porcine insulin differ structurally from insulin generated by the human pancreas. Recently, it has become possible, by re-combinant DNA methodology, to produce insulin identical to that produced by the human pancreas. The use of 15 such insulin wilL enable the diabetic to more closely mimic the natural system than heretofore has been possible.
Nevertheless, it long has been recognized that administration of insulin to the diabetic is alone 20 insufficient to restore and/or maintain the normal metabolic state. Although insulin has its manifested effect on carbohydrate metabolism, diabetes mellitus carries additional disorders, most if not all of which are related to the structure and function of blood 25 vessels. The deficiencies leading to these disorders rarely are completely corrected by conventional insulin therapy.
Those vascular abnonmalities associated with diabetes often are referred to as "complications of 30 diabetes". They consist generally of microangiopathic changes resulting in lesions in the retina and the ' 1 ~7615~
'~idney. ~europathy represents an additional diabetic complication which may or may not be related directly or indirectly to the noted microangiopathic changes.
Examples of specific manifestations of diabetes com-plications are (1) diseases of the eye, including retinopathy, cataract formation, glaucoma, and extra-ocular muscle palsies: (2) diseases of the mouth, including gingivitis, increased incidence of dental caries, periodontal disease, and greater resorption of the alveolar bone; (3) motor, sensory, and autono~ic 10 neuropathy; (4) large-vessel disease, (5) microangio-pathy; (6) diseases of the skin, including xanthoma diabeticorum, necrobiosis lipoidica diabeticorum, furunculosis, mycosis, and pruritis; (7) diseases of the kidneys, including diabetic glomerulosclerosis, 15 arteriolar nephrosclerosis, and pyelonephritis, and (8) problems during pregnancy, including increased incidence of large babies, stillbirths, miscarriages, neonatal deaths, and congenital defects.
Many, and perhaps all, of the diabetic com-20 plications are the result of the failure of insulinalone to restore the body to its natural hormonal balance.
This invention is directed to pharmaceutical compositions that more nearly achieve and maintain 25 natural hormonal hcmeostasis in a diabetic state than can be achieved by administration of insulin alone.
Thus, this invention concerns a pharma-ceutical composition which comprises, in association with a pharmaceutically acceptable carrier, human insulin and human C-peptide in a ratio on a molar I ~76158 basis, human insulin to human C-peptide, of from about 1:4 to about 4-1.
The two essential constituents of ths pharma-ceutical ccmpositions of this lnvention are human insulin and human C-peptide.
Human insulin is available via a variety of routes, including organic synthesis, isolation from human pancreas, conversion of human proinsulin, con-version of isolated animal insulin, and, more recently, reccmbinant DNA methodology.
Using recombinant DNA methodology, human insulin can be prepared by the separate expression and isolation of human insulin A-chain and human insulin B-chain followed by their proper disulfide bond forma-tion. Alternatively, the recombinant DNA expression 15 product can be human proinsulin itself or a humzn proinsulin precursor which is converted to human pro-insulin. The proinsulin then is enzymatically cleaved, for example, using trypsin and carboxypeptidase B, to produce human insulin.
Human insulin can also be prepared from porcine insulin. Human insulin differs from porcine insulin by a single amino acid, i.e., the B-chain carboxyl terminal amino acid. Alanine, the B-30 amino acid of porcine insulin, i3 cleaved and replaced by 25 threonine. In this regard, see, for example, U.S.
Patent No. 3,276,961.
The other active constituent of the ccm-position of this invention, human C-peptide, is a portion of a peptide present in human proinsulin and to 30 which the insulin A- and B-chains are joined. This peptide, termed a "connecting peptide", is removed ~ J 76158 X-5892 ~4~
during production of human insulin from proinsulin.
The connecting peptide present in human proinsulin has the formula Arg-Arg-5lu-Ala-Glu-Asp-Leu-Gln-Val-Gly-Gln-Val-Glu-Leu-Gly-Gly-Gly-Pro-Gly-Ala-Gly-Ser-~eu-Gln-Pro-Leu-Ala-Leu-Glu-Gly-Ser-Leu-Gln-Lys-Arg.
The human C-peptide present in the ccmposi-tion of this invention differs from the connecting peptide by elimination of four amino acids, two at each end. Thus, the human C-peptide has the structure Glu-Ala-Glu-Asp-Leu-Gln-Val-Gly-Gln-Val-Glu-Leu-Gly-Gly-Gly-Pro-Gly-Ala-Gly-Ser-Leu-Gln-Pro-Leu-Ala-Leu-Glu-Gly-Ser-Leu-Gln.
The human C-peptide constituent of the com-~5 position of this invention can be produced by chemicalsynthesis, see, e.g., ~. Yanaihara, C. Yanaihara, M.
Sakagami, ~. Sakura, T. Hashimoto, and T. Nishida, Diabetes 27 (suppl. 1), 149-160 (1978), or from human proinsulin as a result of its cleavage to produce human 20 insulin.
As noted, therefore, the active constituents of the composition of this invention are available via a variety of routes including human proinsulin. In broad outline, the production of insulin using re-25 combinant DN~ methodolog~ involves obtaining, whetherby isolation, construction, or a ccmbination of 'ooth, a sequence of DNA coding for the amino acid sequence of human proinsulin. The human proinsulin DNA then is inserted in reading phase into a suitable cloning and 30 expression vehicle. The vehicle is used to transform a suitable microorganism after which the transformed ~ ~7~15~
microorganism is subjected to fermentation conditions leading to (a) the production of additional copies of the proinsulin gene-containing vector and (b) the expression of proinsulin or a proinsulin precursor product.
In the event the expression product i9 a proinsulin precursor, it generally will ccmprise the human proinsulin amino acid sequence joined at its amino terminal end to a fragment of a protein normally expressed in the gene sequence into which the pro-10 insulin gene has been inserted. The proinsulin amino acid sequence is joined to the protein fragment through a specifically cleavable site, typically methionine.
This product is customarily referred to as a fused gene product.
The proinsulin amino acid sequence is cleaved from the fused gene product using cyanogen bromide after which the cysteine sulfhydryl moieties of the proinsulin amino acid se~uence are stabilized by con-version to their corresponding S-sulfonates.
The resulting proinsulin S-sulfonate is purified, and the purified proinsulin S-sulfonate then is converted to proinsulin by formation of the three properly located disulfide bonds.
Upon purification of the proinsulin, it is 25 enzymatically cleaved, typically using trypsin and carboxypeptidase B, resulting in formation of human insulin and human C-peptide.
The compositions of this invention contain human insulin and human C-peptide in a ratio, on a 30 ~olar basis, of from about 1:4 to about 4:1. Pref-erably, the ratio of human insulln to human C-peptide I. ~ 761~8 is from about 1:2 to about 2:1, and, most preferably, frcm about 1:1 to about ~:1.
As noted, the compositions of this invention are useful in promoting the attainment of natural hormonal homeostasis and thereby preventing or sub-S stantially diminishing or retarding those recognizeddiabetic complications. The amount of the ccmpositions of this invention necessary to maintain natural hormonal hcmeostasis or to achieve a state that more nearly approaches natural hormonal homeostasis in the diabetic, 10 of course, will depend upon the severity of the diabetic condition. Moreover, the amount will vary depending upon the route of administration. Ultimately, the amount of composition administered and the frequency of such administration will be at the discretion of the 15 particular physician. In general, however, the dosage will be in the range affording from about 0.02 to about 5 units of human insulin per kilogram body weight per day, and, preferably, from about 0.1 to about 1 unit of human insulin per kilogram body ~eight per day.
The composition is administered parenterally, including subcutaneous, intramuscular, and intravenous.
The compositions of this invention comprise the active ingredients, human insulin and human C-peptide, to-gether with a pharmaceutically acceptable carrier 25 therefor and, optionally, other therapeutic ingredients.
The total amount of active ingredients present in the composition ranges from about 99.99 to about 0.01 percent by weight. The carrier must be acceptable in the sense that it is compatible with other components 30 of the composition and is not deleterious to the recipient thereof.
I ~76158 Compositions oE this invention suitable fGr parenteral administration conveniently comprise sterile aqueous solutions and/or suspensions of the pharma-ceutically active ingredients, which solutions or suspensions preferably are made isotonic with the blood of the recipient, generally using sodium chloride, glycerin, glucose, mannitol, sorbitol, and similar known agents. In addition, the compositions may contain any of a number of adjuvants, such as buffers~
preservatives, dispersing agents, agents that promote 10 rapid onset of action, agents that promote prolonged duration of action, and other known agents. Typical preservatives are, for example, phenol, m-cresol, methyl ~-hydroxybenzoate, and others. Typical buffers are, for example, sodium phosphate, sodium acetate, 15 sodium citrate, and others.
Moreover, an acid, such as hydrochloric acid, or a base, such as sodium hydroxide, can be used for pH
adjustment. In general, the pH of the aqueous com-position ranges from about 2 to about 8, and, pref-20 erably, fram about 6.8 to about 8Ø
Other suitable additives are, for example,divalent zinc ion which, if present at all, is gen-erally present in an amount from about O.Ol mg. to about O.S mg. per 100 units of human insulin, and 25 protamine salt (for example, in the Eorm of its sul-fate), which, if present at all, is generally present in an amount from about 0.1 mg. to about 2 mg. per 100 units of human insulin.
Examples of particular pharmaceutical com-30 positions of this invention are provided in the exam-ples appearing herein below.
~ 1! 76 ~
~xample 1 -- ~eutral Regular Human Insulln:Human C-Peptide Formulation [1:4 human in-sulin:human C-peptide on molar basis at 40 Units (U) insulin per cubic cen-timeter (cc.)]
To prepare lO cc. of the composition, mix Human Zinc Insulin (28 U/mg.) 400 U
Human C-Peptide 30 mg.
Phenol, distilled 20 mg.
O Glycerin 160 mg.
Water and either 10% hydrochloric acid or 10%
sodium hydroxide sufficient to make a composition volume of lO cc. and a final pH of 7.0-7.8.
Example 2 -- ~eutral Regular Human Insulin:Human lS C-Peptide Formulation ~l:l human in-sulin:human C-peptide on molar basis at lO0 U insulin per cc.]
To prepare lO cc. of the ccmposition, mix Human Zinc Insulin (28 U/mg.) lO00 U
Human C-Peptide l9 mg.
Phenol, distilled 20 mg.
Glycerin 160 mg.
Water and either 10% hydrochloric acid or 10%
sodium hydroxide sufficient to make a composition volume of lO cc. and a final pH of 7.0-7.8.
~xample 3 -- Protamine, Zinc Human Insulin:Human C-Peptide Formulation ~1:1 human in-sulin:human C-peptide on molar basis at 40 U insulin per cc.]
~ ~7615~
To prepare 10 cc. of the camposition, mix Human Zinc Insulin (28 U/mg.) 400 U
Human C-Peptide 8 mg.
Phenol, distilled 25 mg.
Zinc Oxide 0.78 mg.
Glycerin 160 mg.
Protamine Sulfate 4.0-6.0 mg.
Sodium Phosphate, crystals 38 mg.
Water and either 10~ hydrochloric acid or 10%
sodium hydroxide sufficient to make a composition volume of 10 cc. and a final pH of 7.1-7.4.
ExamPle 4 -- Protamine, Zinc Human Insulin:Human C-Peptide Formulation [2:1 human insulin:human C-peptide on molar basis at 100 U insulin per cc.]
To prepare 10 cc. of the composition, mix Human Zinc Insulin (28 U/mg.) 1000 U
Human C-Peptide 9 mg.
Phenol, distilled 25 mg.
Zinc oxide 2.0 mg.
Glycerin 160 mg.
Protamine Sulfate 10-15 mg.
Sodium Phosphate, crystals 38 mg.
Water and either 10% hydrochloric acid or 2S 10% sodium hydroxide sufficient to make a composition volume of l0 cc. and a final pH of 7.1-7.4.
Example 5 -- Isophane 2rotamine, Zinc Human Insulin:
Human C-Peptide Formulation [1:1 human insulin:human C-peptide on molar basis at 40 U insulin per cc.~
! 1 76158 To prepare 10 cc. of the composition, mix Human Zinc Insulin (28 U/mg.) 400 U
Human C-Peptide 8 mg.
_-Cresol, distilled 16 mg.
Phenol, distilled 6.5 mg.
Glycerin 160 mg.
Protamine Sulfate 1.2-2.4 mg.
Sodium Phosphate, crystals 38 mg.
Water and either 10% hydrochloric acid or 10% sodium hydroxide sufficient to make a composition volume of 10 cc.
and a final pH of 7.1~7.4.
Example 6 -- Isophane Protamine, Zinc Human Insulin:
Human C-Peptide Fonmulation [4:1 human insulin:human C-peptide on molar basis at 100 U insulin per cc.~
To prepare 10 cc. of the composition, mix Human Zinc Insulin (28 U/mg.) 1000 U
Human C-Peptide 5 mg.
m-Cresol, distilled 16 mg Phenol, distilled 6.5 mg.
Glycerin 160 mg.
Protamine Sulfate 3.0-6.0 mg.
Sodium Phosphate, Crystals 38 mg.
Water and either 10% hydrochloric acid or 10% sodium hydroxide sufficient to make a composition volume of 10 cc.
and a final pH of 7.1-7.4.
! t7615Pi Example 7 -- Zinc Human Insulin Suspension:Human C-Peptide Formulation [1:2 human insulin:
human C-peptide on molar basis at 40 U
insulin per cc.]
To prepare 10 cc. of the composition, mix Human Zinc Insulin (28 U/mg.) 400 U
Human C-Peptide 15 mg.
Sodium Acetate, Anhydrous16 mg.
Sodium Chloride, Granular70 mg.
10 Methyl ~-Hydroxybenzoate10 mg.
Zinc Oxide 0.63 mg.
Water and either 10~ hydrochloric acid or 10% sodium hydroxide sufficient to make a composition volume of 10 cc.
and a final pH of 7.2-7.5.
Example 8 -- Zinc Human Insulin Suspension:Human C-Peptide Formulation [1:1 human insulin:
human C-peptide on molar basis at 100 U
insulin per cc.]
To prepare 10 cc. of the composition, mix Human Zinc Insulin (28 U/mg.) 1000 U
Human C-Peptide 19 mg.
Sodium Acetate, Anhydrous16 mg.
25 Sodium Chloride, Granular70 mg.
Methyl ~-Hydroxybenzoate10 mg.
Zinc Oxide 1.6 mg.
~ater and either 10~ hydrochloric acid or 10% sodium hydroxide sufficient to make a composition volume of 10 cc.
and a final pH of 7.2-7.5.
I ~7615~
Example 9 -- ~Jeutral Regular Human Insulin:Human C-Peptide Formulation [1:4 human in-sulin:human C-peptide on molar basis at 40 U insulin per cc.]
To prepare 10 cc. of the composition, mix Human Sodium Insulin (28 U/mg.) 400 U
Human C-Peptide 30 mg.
Phenol, distilled 20 mg.
Glycerin 160 mg.
Water and either 10~ hydrochloric acid or 10% sodium hydroxide sufficient to make a composition volume of 10 cc.
and a final pH of 7.0-7.8.
Example 10 -- ~eutral Regular Human Insulin:Human C-Peptide Formulation Cl:l human insulin:human C-peptide on molar basis at 100 U insulin per cc.~
, To prepare 10 cc. of the composition, mix Human Sodium Insulin (28 U/mg.) 1000 U
Human C-Peptide 19 mg.
Phenol, distilled 20 mg.
Glycerin 160 mg.
Water and either 10% hydrochloric acid or 10% sodium hydroxide sufficient to make a composition volume of 10 cc.
and a final pH of 7.0-7.8.
X-5892 -l-PHARMACEUTICAL FORMULATIO~S COMPRISI~G
HUMA~ INSULIN ~.ND EIVMA~ C-PEPTl:DE
Diabetes mellitus is a metabolic disorder characterized by the failure of body tissues to oxidize carbohydrates at the normal rate. Its most important factor is a deficiency of insulin. During the last 60 years people suffering frQm diabetes have been greatly aided by receiving controlled amounts of insulin. To the present time, the insulin used by diabetics has been isolated from animal pancreases, generally bovine 10 and porcine. Both bovine and porcine insulin differ structurally from insulin generated by the human pancreas. Recently, it has become possible, by re-combinant DNA methodology, to produce insulin identical to that produced by the human pancreas. The use of 15 such insulin wilL enable the diabetic to more closely mimic the natural system than heretofore has been possible.
Nevertheless, it long has been recognized that administration of insulin to the diabetic is alone 20 insufficient to restore and/or maintain the normal metabolic state. Although insulin has its manifested effect on carbohydrate metabolism, diabetes mellitus carries additional disorders, most if not all of which are related to the structure and function of blood 25 vessels. The deficiencies leading to these disorders rarely are completely corrected by conventional insulin therapy.
Those vascular abnonmalities associated with diabetes often are referred to as "complications of 30 diabetes". They consist generally of microangiopathic changes resulting in lesions in the retina and the ' 1 ~7615~
'~idney. ~europathy represents an additional diabetic complication which may or may not be related directly or indirectly to the noted microangiopathic changes.
Examples of specific manifestations of diabetes com-plications are (1) diseases of the eye, including retinopathy, cataract formation, glaucoma, and extra-ocular muscle palsies: (2) diseases of the mouth, including gingivitis, increased incidence of dental caries, periodontal disease, and greater resorption of the alveolar bone; (3) motor, sensory, and autono~ic 10 neuropathy; (4) large-vessel disease, (5) microangio-pathy; (6) diseases of the skin, including xanthoma diabeticorum, necrobiosis lipoidica diabeticorum, furunculosis, mycosis, and pruritis; (7) diseases of the kidneys, including diabetic glomerulosclerosis, 15 arteriolar nephrosclerosis, and pyelonephritis, and (8) problems during pregnancy, including increased incidence of large babies, stillbirths, miscarriages, neonatal deaths, and congenital defects.
Many, and perhaps all, of the diabetic com-20 plications are the result of the failure of insulinalone to restore the body to its natural hormonal balance.
This invention is directed to pharmaceutical compositions that more nearly achieve and maintain 25 natural hormonal hcmeostasis in a diabetic state than can be achieved by administration of insulin alone.
Thus, this invention concerns a pharma-ceutical composition which comprises, in association with a pharmaceutically acceptable carrier, human insulin and human C-peptide in a ratio on a molar I ~76158 basis, human insulin to human C-peptide, of from about 1:4 to about 4-1.
The two essential constituents of ths pharma-ceutical ccmpositions of this lnvention are human insulin and human C-peptide.
Human insulin is available via a variety of routes, including organic synthesis, isolation from human pancreas, conversion of human proinsulin, con-version of isolated animal insulin, and, more recently, reccmbinant DNA methodology.
Using recombinant DNA methodology, human insulin can be prepared by the separate expression and isolation of human insulin A-chain and human insulin B-chain followed by their proper disulfide bond forma-tion. Alternatively, the recombinant DNA expression 15 product can be human proinsulin itself or a humzn proinsulin precursor which is converted to human pro-insulin. The proinsulin then is enzymatically cleaved, for example, using trypsin and carboxypeptidase B, to produce human insulin.
Human insulin can also be prepared from porcine insulin. Human insulin differs from porcine insulin by a single amino acid, i.e., the B-chain carboxyl terminal amino acid. Alanine, the B-30 amino acid of porcine insulin, i3 cleaved and replaced by 25 threonine. In this regard, see, for example, U.S.
Patent No. 3,276,961.
The other active constituent of the ccm-position of this invention, human C-peptide, is a portion of a peptide present in human proinsulin and to 30 which the insulin A- and B-chains are joined. This peptide, termed a "connecting peptide", is removed ~ J 76158 X-5892 ~4~
during production of human insulin from proinsulin.
The connecting peptide present in human proinsulin has the formula Arg-Arg-5lu-Ala-Glu-Asp-Leu-Gln-Val-Gly-Gln-Val-Glu-Leu-Gly-Gly-Gly-Pro-Gly-Ala-Gly-Ser-~eu-Gln-Pro-Leu-Ala-Leu-Glu-Gly-Ser-Leu-Gln-Lys-Arg.
The human C-peptide present in the ccmposi-tion of this invention differs from the connecting peptide by elimination of four amino acids, two at each end. Thus, the human C-peptide has the structure Glu-Ala-Glu-Asp-Leu-Gln-Val-Gly-Gln-Val-Glu-Leu-Gly-Gly-Gly-Pro-Gly-Ala-Gly-Ser-Leu-Gln-Pro-Leu-Ala-Leu-Glu-Gly-Ser-Leu-Gln.
The human C-peptide constituent of the com-~5 position of this invention can be produced by chemicalsynthesis, see, e.g., ~. Yanaihara, C. Yanaihara, M.
Sakagami, ~. Sakura, T. Hashimoto, and T. Nishida, Diabetes 27 (suppl. 1), 149-160 (1978), or from human proinsulin as a result of its cleavage to produce human 20 insulin.
As noted, therefore, the active constituents of the composition of this invention are available via a variety of routes including human proinsulin. In broad outline, the production of insulin using re-25 combinant DN~ methodolog~ involves obtaining, whetherby isolation, construction, or a ccmbination of 'ooth, a sequence of DNA coding for the amino acid sequence of human proinsulin. The human proinsulin DNA then is inserted in reading phase into a suitable cloning and 30 expression vehicle. The vehicle is used to transform a suitable microorganism after which the transformed ~ ~7~15~
microorganism is subjected to fermentation conditions leading to (a) the production of additional copies of the proinsulin gene-containing vector and (b) the expression of proinsulin or a proinsulin precursor product.
In the event the expression product i9 a proinsulin precursor, it generally will ccmprise the human proinsulin amino acid sequence joined at its amino terminal end to a fragment of a protein normally expressed in the gene sequence into which the pro-10 insulin gene has been inserted. The proinsulin amino acid sequence is joined to the protein fragment through a specifically cleavable site, typically methionine.
This product is customarily referred to as a fused gene product.
The proinsulin amino acid sequence is cleaved from the fused gene product using cyanogen bromide after which the cysteine sulfhydryl moieties of the proinsulin amino acid se~uence are stabilized by con-version to their corresponding S-sulfonates.
The resulting proinsulin S-sulfonate is purified, and the purified proinsulin S-sulfonate then is converted to proinsulin by formation of the three properly located disulfide bonds.
Upon purification of the proinsulin, it is 25 enzymatically cleaved, typically using trypsin and carboxypeptidase B, resulting in formation of human insulin and human C-peptide.
The compositions of this invention contain human insulin and human C-peptide in a ratio, on a 30 ~olar basis, of from about 1:4 to about 4:1. Pref-erably, the ratio of human insulln to human C-peptide I. ~ 761~8 is from about 1:2 to about 2:1, and, most preferably, frcm about 1:1 to about ~:1.
As noted, the compositions of this invention are useful in promoting the attainment of natural hormonal homeostasis and thereby preventing or sub-S stantially diminishing or retarding those recognizeddiabetic complications. The amount of the ccmpositions of this invention necessary to maintain natural hormonal hcmeostasis or to achieve a state that more nearly approaches natural hormonal homeostasis in the diabetic, 10 of course, will depend upon the severity of the diabetic condition. Moreover, the amount will vary depending upon the route of administration. Ultimately, the amount of composition administered and the frequency of such administration will be at the discretion of the 15 particular physician. In general, however, the dosage will be in the range affording from about 0.02 to about 5 units of human insulin per kilogram body weight per day, and, preferably, from about 0.1 to about 1 unit of human insulin per kilogram body ~eight per day.
The composition is administered parenterally, including subcutaneous, intramuscular, and intravenous.
The compositions of this invention comprise the active ingredients, human insulin and human C-peptide, to-gether with a pharmaceutically acceptable carrier 25 therefor and, optionally, other therapeutic ingredients.
The total amount of active ingredients present in the composition ranges from about 99.99 to about 0.01 percent by weight. The carrier must be acceptable in the sense that it is compatible with other components 30 of the composition and is not deleterious to the recipient thereof.
I ~76158 Compositions oE this invention suitable fGr parenteral administration conveniently comprise sterile aqueous solutions and/or suspensions of the pharma-ceutically active ingredients, which solutions or suspensions preferably are made isotonic with the blood of the recipient, generally using sodium chloride, glycerin, glucose, mannitol, sorbitol, and similar known agents. In addition, the compositions may contain any of a number of adjuvants, such as buffers~
preservatives, dispersing agents, agents that promote 10 rapid onset of action, agents that promote prolonged duration of action, and other known agents. Typical preservatives are, for example, phenol, m-cresol, methyl ~-hydroxybenzoate, and others. Typical buffers are, for example, sodium phosphate, sodium acetate, 15 sodium citrate, and others.
Moreover, an acid, such as hydrochloric acid, or a base, such as sodium hydroxide, can be used for pH
adjustment. In general, the pH of the aqueous com-position ranges from about 2 to about 8, and, pref-20 erably, fram about 6.8 to about 8Ø
Other suitable additives are, for example,divalent zinc ion which, if present at all, is gen-erally present in an amount from about O.Ol mg. to about O.S mg. per 100 units of human insulin, and 25 protamine salt (for example, in the Eorm of its sul-fate), which, if present at all, is generally present in an amount from about 0.1 mg. to about 2 mg. per 100 units of human insulin.
Examples of particular pharmaceutical com-30 positions of this invention are provided in the exam-ples appearing herein below.
~ 1! 76 ~
~xample 1 -- ~eutral Regular Human Insulln:Human C-Peptide Formulation [1:4 human in-sulin:human C-peptide on molar basis at 40 Units (U) insulin per cubic cen-timeter (cc.)]
To prepare lO cc. of the composition, mix Human Zinc Insulin (28 U/mg.) 400 U
Human C-Peptide 30 mg.
Phenol, distilled 20 mg.
O Glycerin 160 mg.
Water and either 10% hydrochloric acid or 10%
sodium hydroxide sufficient to make a composition volume of lO cc. and a final pH of 7.0-7.8.
Example 2 -- ~eutral Regular Human Insulin:Human lS C-Peptide Formulation ~l:l human in-sulin:human C-peptide on molar basis at lO0 U insulin per cc.]
To prepare lO cc. of the ccmposition, mix Human Zinc Insulin (28 U/mg.) lO00 U
Human C-Peptide l9 mg.
Phenol, distilled 20 mg.
Glycerin 160 mg.
Water and either 10% hydrochloric acid or 10%
sodium hydroxide sufficient to make a composition volume of lO cc. and a final pH of 7.0-7.8.
~xample 3 -- Protamine, Zinc Human Insulin:Human C-Peptide Formulation ~1:1 human in-sulin:human C-peptide on molar basis at 40 U insulin per cc.]
~ ~7615~
To prepare 10 cc. of the camposition, mix Human Zinc Insulin (28 U/mg.) 400 U
Human C-Peptide 8 mg.
Phenol, distilled 25 mg.
Zinc Oxide 0.78 mg.
Glycerin 160 mg.
Protamine Sulfate 4.0-6.0 mg.
Sodium Phosphate, crystals 38 mg.
Water and either 10~ hydrochloric acid or 10%
sodium hydroxide sufficient to make a composition volume of 10 cc. and a final pH of 7.1-7.4.
ExamPle 4 -- Protamine, Zinc Human Insulin:Human C-Peptide Formulation [2:1 human insulin:human C-peptide on molar basis at 100 U insulin per cc.]
To prepare 10 cc. of the composition, mix Human Zinc Insulin (28 U/mg.) 1000 U
Human C-Peptide 9 mg.
Phenol, distilled 25 mg.
Zinc oxide 2.0 mg.
Glycerin 160 mg.
Protamine Sulfate 10-15 mg.
Sodium Phosphate, crystals 38 mg.
Water and either 10% hydrochloric acid or 2S 10% sodium hydroxide sufficient to make a composition volume of l0 cc. and a final pH of 7.1-7.4.
Example 5 -- Isophane 2rotamine, Zinc Human Insulin:
Human C-Peptide Formulation [1:1 human insulin:human C-peptide on molar basis at 40 U insulin per cc.~
! 1 76158 To prepare 10 cc. of the composition, mix Human Zinc Insulin (28 U/mg.) 400 U
Human C-Peptide 8 mg.
_-Cresol, distilled 16 mg.
Phenol, distilled 6.5 mg.
Glycerin 160 mg.
Protamine Sulfate 1.2-2.4 mg.
Sodium Phosphate, crystals 38 mg.
Water and either 10% hydrochloric acid or 10% sodium hydroxide sufficient to make a composition volume of 10 cc.
and a final pH of 7.1~7.4.
Example 6 -- Isophane Protamine, Zinc Human Insulin:
Human C-Peptide Fonmulation [4:1 human insulin:human C-peptide on molar basis at 100 U insulin per cc.~
To prepare 10 cc. of the composition, mix Human Zinc Insulin (28 U/mg.) 1000 U
Human C-Peptide 5 mg.
m-Cresol, distilled 16 mg Phenol, distilled 6.5 mg.
Glycerin 160 mg.
Protamine Sulfate 3.0-6.0 mg.
Sodium Phosphate, Crystals 38 mg.
Water and either 10% hydrochloric acid or 10% sodium hydroxide sufficient to make a composition volume of 10 cc.
and a final pH of 7.1-7.4.
! t7615Pi Example 7 -- Zinc Human Insulin Suspension:Human C-Peptide Formulation [1:2 human insulin:
human C-peptide on molar basis at 40 U
insulin per cc.]
To prepare 10 cc. of the composition, mix Human Zinc Insulin (28 U/mg.) 400 U
Human C-Peptide 15 mg.
Sodium Acetate, Anhydrous16 mg.
Sodium Chloride, Granular70 mg.
10 Methyl ~-Hydroxybenzoate10 mg.
Zinc Oxide 0.63 mg.
Water and either 10~ hydrochloric acid or 10% sodium hydroxide sufficient to make a composition volume of 10 cc.
and a final pH of 7.2-7.5.
Example 8 -- Zinc Human Insulin Suspension:Human C-Peptide Formulation [1:1 human insulin:
human C-peptide on molar basis at 100 U
insulin per cc.]
To prepare 10 cc. of the composition, mix Human Zinc Insulin (28 U/mg.) 1000 U
Human C-Peptide 19 mg.
Sodium Acetate, Anhydrous16 mg.
25 Sodium Chloride, Granular70 mg.
Methyl ~-Hydroxybenzoate10 mg.
Zinc Oxide 1.6 mg.
~ater and either 10~ hydrochloric acid or 10% sodium hydroxide sufficient to make a composition volume of 10 cc.
and a final pH of 7.2-7.5.
I ~7615~
Example 9 -- ~Jeutral Regular Human Insulin:Human C-Peptide Formulation [1:4 human in-sulin:human C-peptide on molar basis at 40 U insulin per cc.]
To prepare 10 cc. of the composition, mix Human Sodium Insulin (28 U/mg.) 400 U
Human C-Peptide 30 mg.
Phenol, distilled 20 mg.
Glycerin 160 mg.
Water and either 10~ hydrochloric acid or 10% sodium hydroxide sufficient to make a composition volume of 10 cc.
and a final pH of 7.0-7.8.
Example 10 -- ~eutral Regular Human Insulin:Human C-Peptide Formulation Cl:l human insulin:human C-peptide on molar basis at 100 U insulin per cc.~
, To prepare 10 cc. of the composition, mix Human Sodium Insulin (28 U/mg.) 1000 U
Human C-Peptide 19 mg.
Phenol, distilled 20 mg.
Glycerin 160 mg.
Water and either 10% hydrochloric acid or 10% sodium hydroxide sufficient to make a composition volume of 10 cc.
and a final pH of 7.0-7.8.
Claims (5)
1. A pharmaceutical composition which comprises, in association with a pharmaceutically acceptable carrier, human insulin and human C-peptide in a ratio on a molar basis, human insulin to human C-peptide, of from about 1:4 to about 4:1.
2. Composition of claim 1, in which the molar ratio of human insulin to human C-peptide is from about 1:2 to about 2:1.
3. Composition of claim 1, in which the molar ratio of human insulin to human C-peptide is from about 1:1 to about 2:1.
4. Composition of claim 1, which contains divalent zinc ion.
5. Composition of claim 1, which contains protamine salt.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US29671581A | 1981-08-27 | 1981-08-27 | |
| US296,715 | 1981-08-27 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1176158A true CA1176158A (en) | 1984-10-16 |
Family
ID=23143238
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000409900A Expired CA1176158A (en) | 1981-08-27 | 1982-08-23 | Pharmaceutical formulations comprising human insulin and human c-peptide |
Country Status (20)
| Country | Link |
|---|---|
| JP (1) | JPS5846024A (en) |
| AU (1) | AU551879B2 (en) |
| BE (1) | BE894185A (en) |
| CA (1) | CA1176158A (en) |
| CH (1) | CH650679A5 (en) |
| DE (1) | DE3232034A1 (en) |
| DZ (1) | DZ452A1 (en) |
| FR (1) | FR2513126B1 (en) |
| GB (1) | GB2104382B (en) |
| IE (1) | IE54119B1 (en) |
| IL (1) | IL66611A0 (en) |
| IT (1) | IT1153182B (en) |
| LU (1) | LU84359A1 (en) |
| MW (1) | MW3882A1 (en) |
| NL (1) | NL192192C (en) |
| NZ (1) | NZ201682A (en) |
| PH (1) | PH19361A (en) |
| SE (1) | SE460334B (en) |
| ZA (1) | ZA826159B (en) |
| ZW (1) | ZW17482A1 (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6610649B2 (en) | 1996-09-27 | 2003-08-26 | Creative Peptides Sweden Ab | Insulin C-peptides |
Families Citing this family (13)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE3326473A1 (en) * | 1983-07-22 | 1985-01-31 | Hoechst Ag, 6230 Frankfurt | PHARMACEUTICAL AGENT FOR TREATING THE DIABETES MELLITUS |
| CA1296253C (en) * | 1986-10-20 | 1992-02-25 | Praveen Tyle | Stabilized growth hormone compositions |
| JPH01501389A (en) * | 1986-10-20 | 1989-05-18 | ノボ インダストリ アクティーゼルスカブ | polypeptide formulation |
| NZ223630A (en) * | 1987-02-25 | 1989-11-28 | Novo Industri As | Insulin derivative and pharmaceutical compositions |
| ATE63821T1 (en) * | 1987-08-14 | 1991-06-15 | Akzo Nv | MEDICATION FOR PREVENTING OR COMBATING COMPLICATIONS OF DIABETES. |
| US5212154A (en) * | 1987-08-14 | 1993-05-18 | Akzo N.V. | Preparation for treating complications in diabetes |
| GB0323979D0 (en) | 2003-10-13 | 2003-11-19 | Creative Peptides Sweden Ab | Therapeutic applications for c-peptide |
| US8263551B2 (en) | 2004-11-22 | 2012-09-11 | Novo Nordisk A/S | Soluble, stable insulin-containing formulations with a protamine salt |
| GB0511269D0 (en) | 2005-06-02 | 2005-07-13 | Creative Peptides Sweden Ab | Sustained release preparation of pro-insulin C-peptide |
| GB0601950D0 (en) * | 2006-01-31 | 2006-03-15 | Creative Peptides Sweden Ab | Compositions and methods of treating diabetes |
| MX2011003117A (en) | 2008-09-19 | 2011-04-21 | Nektar Therapeutics | Polymer conjugates of therapeutic peptides. |
| MX2012013375A (en) * | 2010-05-17 | 2013-04-11 | Cebix Inc | Pegylated c-peptide. |
| CN104220086A (en) | 2011-11-17 | 2014-12-17 | 塞比克斯股份公司 | PEGylated C-peptide |
Family Cites Families (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US2789080A (en) * | 1952-08-14 | 1957-04-16 | Christensen Henry Marinus | Insulin-albumin compositions |
| CH330318A (en) * | 1953-09-08 | 1958-05-31 | British Drug Houses Ltd | Process for the production of an insulin preparation with an extended duration of action |
-
1982
- 1982-08-23 CA CA000409900A patent/CA1176158A/en not_active Expired
- 1982-08-23 ZW ZW174/82A patent/ZW17482A1/en unknown
- 1982-08-23 IL IL66611A patent/IL66611A0/en unknown
- 1982-08-23 CH CH5010/82A patent/CH650679A5/en not_active IP Right Cessation
- 1982-08-24 NL NL8203315A patent/NL192192C/en not_active IP Right Cessation
- 1982-08-24 BE BE6/47701A patent/BE894185A/en not_active IP Right Cessation
- 1982-08-24 DZ DZ826637A patent/DZ452A1/en active
- 1982-08-24 MW MW38/82A patent/MW3882A1/en unknown
- 1982-08-24 ZA ZA826159A patent/ZA826159B/en unknown
- 1982-08-24 PH PH27772A patent/PH19361A/en unknown
- 1982-08-24 NZ NZ201682A patent/NZ201682A/en unknown
- 1982-08-25 SE SE8204873A patent/SE460334B/en not_active IP Right Cessation
- 1982-08-25 AU AU87594/82A patent/AU551879B2/en not_active Expired
- 1982-08-25 JP JP57148494A patent/JPS5846024A/en active Pending
- 1982-08-25 FR FR8214595A patent/FR2513126B1/en not_active Expired
- 1982-08-26 GB GB08224484A patent/GB2104382B/en not_active Expired
- 1982-08-26 IE IE2064/82A patent/IE54119B1/en not_active IP Right Cessation
- 1982-08-26 LU LU84359A patent/LU84359A1/en unknown
- 1982-08-27 IT IT8223017A patent/IT1153182B/en active
- 1982-08-27 DE DE19823232034 patent/DE3232034A1/en active Granted
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6610649B2 (en) | 1996-09-27 | 2003-08-26 | Creative Peptides Sweden Ab | Insulin C-peptides |
Also Published As
| Publication number | Publication date |
|---|---|
| AU551879B2 (en) | 1986-05-15 |
| AU8759482A (en) | 1983-03-03 |
| IE54119B1 (en) | 1989-06-21 |
| BE894185A (en) | 1983-02-24 |
| IT1153182B (en) | 1987-01-14 |
| NL192192B (en) | 1996-11-01 |
| ZW17482A1 (en) | 1982-11-17 |
| JPS5846024A (en) | 1983-03-17 |
| DE3232034A1 (en) | 1983-03-10 |
| NL192192C (en) | 1997-03-04 |
| IL66611A0 (en) | 1982-12-31 |
| FR2513126B1 (en) | 1986-04-18 |
| SE460334B (en) | 1989-10-02 |
| DZ452A1 (en) | 2004-09-13 |
| CH650679A5 (en) | 1985-08-15 |
| NZ201682A (en) | 1985-08-16 |
| MW3882A1 (en) | 1984-07-11 |
| ZA826159B (en) | 1984-04-25 |
| LU84359A1 (en) | 1983-02-28 |
| SE8204873L (en) | 1983-02-28 |
| FR2513126A1 (en) | 1983-03-25 |
| DE3232034C2 (en) | 1991-04-11 |
| PH19361A (en) | 1986-04-02 |
| NL8203315A (en) | 1983-03-16 |
| IE822064L (en) | 1983-02-27 |
| GB2104382B (en) | 1984-12-19 |
| GB2104382A (en) | 1983-03-09 |
| IT8223017A0 (en) | 1982-08-27 |
| SE8204873D0 (en) | 1982-08-25 |
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