A kind of lacrimal passage bolt of degrading controlled and preparation method thereof
Technical field
The present invention relates to a kind of lacrimal passage bolt being used for the treatment of xerophthalmia and preparation method thereof.Particularly relating to collagen stroma is primary raw material, prepare technique simple, anti-slip, avoid excessive tear, various shape, multiple degradation time novel Absorbable rod lacrimal passage bolt.
Background technology
Xerophthalmia is also known as xerophthalmia, angle conjunctival xerosis etc., that tear quality and quantity because many reasons causes and kinetics occur abnormal and causes tear film that unstable situation occurs, belong to a kind of chronic disease, eye table can be damaged or produce immune inflammation, clinical manifestation is eye surface appearance exception and the malaise symptoms such as sensation of dryness, foreign body sensation, pain appear in eye, and wherein eye is dry and astringent is the most obvious symptom.Xerophthalmia induces visual deterioration to a certain extent, and the patient be in a bad way even has blind risk.
According to up-to-date Epidemiological study display, worldwide morbidity of dry eye is 5% ~ 34%, and the prevalence of China's xerophthalmia is about 7.8% ~ 33.78%.Along with modern is to the dependence use of computer and working environment inducement, the people that every day works more than 3 hours before computer, more than 90% may suffer from xerophthalmia.It is reported in the five-year, patients with dry eye number can with the speed increase of annual 10%.In addition, in the last few years, along with constantly popularizing of the ophthalmologic operation such as excimer laser surgery, operation for glaucoma, postoperative dry eye patients also got more and more.Xerophthalmia becomes international a kind of chronic ophthalmic diseases already, greatly reduces work and the quality of life of people.
The more common method of clinical treatment xerophthalmia is artificial tears, removes the cause of disease, and lacrimal point is closed.Wherein the treatment time of the Therapeutic Method needs of artificial tears is longer, and easily recurs, and can only treat mild dry eye.Though it is simply effective to close lacrimal point, easily cause cicatrix, and with pain, operation also has irreversibility.Therefore lacrimal passage Embolization is the best effective method for the treatment of xerophthalmia at present.
Lacrimal passage thromboembolism is a kind of newer tear stains sealing technique, is made tear get rid of and reduces, extend its time of staying on eye surface, improve eye table environment, thus alleviate dry eye condition to reach by mechanical blocking lacrimal passage.Or prolong drug is in the time on eye surface, thus improve medication effect, obviously alleviate the symptom of patient's xerophthalmia.
Lacrimal passage bolt can be divided into permanent type (non-degradable type) and degradable according to degradation time.Permanent type is generally be made up of silica gel or stainless steel and other metal materials, non-degradable after implanting.Have the risk that granulation produces after the lacrimal passage bolt implantation of permanent type, also may occur the complication such as excessive tear, again need carry out operative treatment.In addition, the lacrimal passage bolt of this permanent type is once the postoperative recurrence occurring symptom afterwards, and very difficult judgement is caused by stopper displacement or caused by sb.'s illness took a turn for the worse.The lacrimal ductule resistance core mentioned in Chinese patent 201310304213.9, its resistance core one end is taper, the other end is discoid, implanting rear disk is exposed to outside lacrimal ductule, although this design can prevent product from sliding into lacrimal passage, but also can cause the discomfort of patient, also may occur the unfavorable conditions such as harmed eye table.Mention a kind of lacrimal duct embolus of reasonable offer in Chinese patent 200710030583.2, can avoid occurring excessive tear problem, but there is nondegradable various shortcoming.
The lacrimal passage bolt of degradable is generally for primary raw material is prepared from animal derived collagen, sodium alginate or acrylic acid etc.Degrade within a certain period of time after implantation, lacrimal passage can be made to recover unobstructed, mainly for short term tests treatment and seasonal xerophthalmia.The report that the lacrimal passage bolt of degradable does not have granulation to be formed, safety is relatively high, and clinical effectiveness is also better.But tissue inflammatory may be caused to react in the degradable lacrimal passage bolt of Polymer materialspreparation degradation process after the implantation.And there is some problems equally in degradable lacrimal passage bolt prepared by natural materials, such as easily slippage, complex process, formation parcel, some complication such as tear of overflowing.Describing a kind of in Chinese patent 200810228181.8 take sodium alginate as the lacrimal duct embolus of primary raw material, and the formula of this embolus and preparation technology are very complicated, and high to the requirement of equipment, is not suitable for amplifying producing.In addition, the degradable product of report is and degrades within the specific time at present, and suffers from the patient of xerophthalmia in various degree, needs the time of implanting the treatment of lacrimal passage bolt also different.Product treatment according to single degradation time can cause some evitable complication or other risks to occur.If the existence that the patient as only needed short-term to implant lacrimal passage bolt implants the long period or the product of not degrading just may produce some as complication such as excessive tear, parcels.
Summary of the invention
For prior art Problems existing, the object of the invention is to: provide a kind of and be used for the treatment of novel Absorbable rod lacrimal passage bolt of anti-slip, various structures, many degradation times of xerophthalmia and preparation method thereof.The method related to not only technique is simple, and can alleviate or solve bad phenomenon such as implanting rear excessive tear and eye table discomfort.
Lacrimal passage bolt prepared by the present invention, it is characterized by, take collagen stroma as primary raw material, by being cross-linked in various degree, obtain the product of difformity, different degradation time, and there will be the volumetric expansion of 1 ~ 3 times after the implantation, the design of anti-slip device in addition, what make that product can be stable remains in implant site.
Described collagen stroma can derive from the human or animal tissues being rich in collagen.
Described cross-linking agent can be carbodiimide, aldehydes, epoxide etc.Preferred cross-linking agent is 1-(3-dimethylamino-propyl)-3-ethyl carbodiimide (EDC) and glutaraldehyde.
Described difformity is shown in Fig. 1, have three kinds of shapes, body shape is column type, wherein the implantation tip portion of A type and C type is conical or round blunt shape, convenient implantation, and the mid portion of A type to be provided with one or several cross sections be trapezoidal outstanding disk, it is trapezoidal outstanding disk that the end of C type is provided with cross section, and these disks can be anti-slip; The position, implantation top of Type B is conical, convenient implantation, and conical end diameter is comparatively large, equally can be anti-slip.And be distributed with 4 ~ 10 grooves at A, Type B surface uniform, can not total blockage lacrimal passage after product is implanted.Product is implanted in use all completely, avoids implant part and is exposed to the ophthalmic uncomfortable that may cause outside lacrimal ductule, and can alleviate or solve the complication such as tear of overflowing.Described different degradation times are about 1 ~ 18 month.
The preparation method of the lacrimal passage bolt that degraded proposed by the invention is controlled, comprises the preparation of collagen stroma, crosslinked and molding.Concrete steps are as follows:
The preparation of step one, collagen stroma: if select cortical bone as collagenous source, then by the cutting and grinding of cortical bone, obtains the bone meal that particle diameter is 0.05 ~ 0.25mm, repeatedly cleans to remove bloodstain and other foreign material.Then carry out the process of defat decalcification and inactivation of virus, concrete grammar can carry out by list of references.
Swelling: in mass ratio for 1:5 ~ 1:20 add 3% ~ 5% acetic acid or 0.1 ~ 0.3M hydrochloric acid solution soak 2 ~ 5 days, the effect of this step is swelling bone meal granule, makes its quality become soft, is convenient to the process in later stage.Then by purified water, the bone meal after swelling is cleaned repeatedly until pH is 6 ~ 7.Then drain or carry out sucking filtration, the Free water in removing bone meal.
Homogenizing: add purified water for 1:3 ~ 1:8 in mass ratio, homogenizing is fine and smooth uniform gel, and wherein homogenizing need carry out under 4 DEG C of conditions, prevents collagenous degeneration.The effect of this step is gel collagen stroma by whole for bone meal homogenizing.
The collagen stroma obtained by the method not only composition is almost collagen entirely, and preparation method simplifies greatly, and cost is low, and efficiency is high, consuming time short, is applicable to the large production of industrialization.
If purify from the tissue such as tendon, skin, collagen can list of references method carry out.Acetic acid with 2% become concentration be 1% ~ 10% collagen stroma, for subsequent use.
Step 2, crosslinked: in the collagen stroma of step one gained, add cross-linking agent, the mass fraction that cross-linking agent adds is 0.01% ~ 5%, and crosslinking temperature is 4 ~ 30 DEG C, and crosslinking time is 1 ~ 24 hour, and mixing speed is 80 ~ 300r/min.Cross-linking agent can be carbodiimide, aldehydes, epoxide etc.
The product degradation time obtained is 1 ~ 18 month, can fully meet different clinical demands like this.Catabolite is water and carbon dioxide in addition, to human body without any negative effect.Preferred cross-linking agent is 1-(3-dimethylamino-propyl)-3-ethyl carbodiimide (EDC) and glutaraldehyde.
Step 3, cleaning: carry out dialysis oscillation cleaning by 0.01 ~ 0.05M PBS or purified water, change liquid once in every 2 ~ 8 hours, change liquid and be no less than 3 times.This step can remove residual cross-linking agent and other remaining reagent.
Step 4, homogenate: the cross-linking collagen matrices obtained in step 3 is added appropriate purified water and carry out homogenized under 4 DEG C of conditions to forming the gel that its viscosity is 1000 ± 200mPa/s.Also medicine can be added in homogenization process, can in use slow releasing medicine, thus treatment preferably or alleviating dry eye disease or other ophthalmic uncomfortable symptoms.
Step 5, molding lyophilizing: the gel in step 4 is proceeded in mould and carries out frozen dried, obtain the sample of regulation shape and structure.As shown in Figure 1, wherein the length of A, B, C type is 2.0 ± 0.2mm.A, Type B product diameter are 0.4 ~ 0.5mm, and surface has equally distributed 4 ~ 10 axial notches, can not total blockage lacrimal passage after product is implanted.C type uses the medical puncture needle of 0.5 ~ 0.7mm to pass from sample center vertical after freeze drying, and obtaining external diameter is 0.9 ~ 1.3mm, and internal diameter is the product of 0.5 ~ 0.7mm.The product body shape of three kinds of shapes is column type, wherein the implantation tip portion of A type and C type is conical or round blunt shape, convenient implantation, and the mid portion of A type is provided with 1 or several cross sections are trapezoidal outstanding disk, it is trapezoidal outstanding disk that the end of C type is provided with cross section, and these disks can be anti-slip; The position, implantation top of Type B is conical, convenient implantation, and conical end diameter is comparatively large, equally can be anti-slip.All products all implant lacrimal ductule in use, avoid implanting rear patient and occur the problems such as ophthalmic uncomfortable.In addition, all types of product surface and inside are all dispersed with micropore, and as shown in Figure 2, this is because crosslinked collagen stroma there will be certain pore structure after freeze drying.When eye's tear is more, due to pressure effect, tear injects these micropores, plays the effect of cistern, avoids the untoward reaction occurring excessive tear.
Step 6, packaging sterilizing: packed by the sample in step 5, can obtain final products after sterilizing.Sterilizing can select 10 ~ 25kGy 60Coradiation and the sterilizing methods such as 100 ~ 300kev electron beam sterilization, 6 ~ 12 hours oxirane.
The advantage of the present invention compared with original technology:
(1) the lacrimal passage bolt mentioned by the present invention has different shape specification, top conically or round blunt shape, be convenient to implant, and be please all provided with anti-slip device, in addition the volumetric expansion of 1 ~ 3 times is had after implanting water suction, product can be made better to be stabilized in implant site, and can not slippage be shifted, safety is high.
(2) product can be implanted in lacrimal ductule completely, the ocular foreign bodies sense avoiding portioned product to be exposed to may causing outside lacrimal ductule and Ocular surface damage.The distinctive microcellular structure of product more can play the effect of " cistern ", can alleviate and solve the ill symptomses such as tear that overflow.Suitable medicine can also be added in product preparation process, the effect in use discharging medicine can be realized.
(3) product of the different degree of cross linking has different degradation times, retention time in the body that can realize about 1 ~ 18 month, fully meet the different demands of different patient, avoid the complication such as excessive tear, parcel having occurred causing owing to implanting the unaccommodated product of degradation time, thus improve prognosis.
(4) what the present invention relates to is that raw material is prepared in the technique of collagen stroma with cortical bone, and not only composition is almost collagen entirely, and preparation method simplifies greatly, and cost is low, and efficiency is high, consuming time short, is applicable to the large production of industrialization.
accompanying drawing illustrates:
Fig. 1 is the different size of lacrimal passage bolt.Wherein the length of A, B, C type is 2.0 ± 0.2mm.A, Type B product diameter are 0.4 ~ 0.5mm, and surface has equally distributed 4 ~ 10 axial notches.C type product external diameter is 0.9 ~ 1.3mm, and internal diameter is 0.5 ~ 0.7mm.In figure, fine line represents groove.
Fig. 2 is the scanning electron microscope (SEM) photograph of product surface after lyophilizing (figure A) and inner (scheming B).Can be shown by figure, surface and the inside of product all also exist microcellular structure.This structure can play the effect of " cistern ", alleviates or avoids patient to occur the ill symptomses such as tear that overflow after implantation product.
Detailed description of the invention
Below in conjunction with example, technical solution of the present invention is described in further detail.
Embodiment 1
List of references method is purified collagen protein from cattle tendon, is dissolved in the acetum of 2%, obtains the collagen solution that concentration is 1%.
Crosslinked: in above-mentioned collagen solution, add the EDC that mass fraction is 0.01%, at 25 DEG C, crosslinking time is 24 hours, and mixing speed is 80r/min.Then repeatedly to dialyse oscillation cleaning by purified water, within every 8 hours, change liquid once, change liquid altogether 3 times.
Homogenate: add the fine and smooth homogeneous gel shape material that the appropriate purified water homogenized of carrying out under 4 DEG C of conditions is 800mPa/s to formation viscosity in the cross-linking collagen matrices obtained.
Molding lyophilizing: proceeded to by gel in mould and carry out frozen dried, obtains the sample of regulation structure, is evenly distributed with 4 axial notches at A, Type B sample surfaces; Pass vertically through C type sample center with the medical puncture needle of 0.5 ~ 0.7mm after lyophilizing, obtain the product of regulation structure, structure as shown in Figure 1.Finally pack, after the sterilizing of 10kGy 60Coradiation, namely available degradation time is the product of about 1 month.
Embodiment 2
List of references method is purified collagen protein from cattle tendon, is dissolved in the acetum of 2%, obtains the collagen solution that concentration is 10%.
Crosslinked: in above-mentioned collagen solution, add the EDC that mass fraction is 0.5%, at 4 DEG C, crosslinking time is 16 hours, and mixing speed is 300r/min.Then repeatedly to dialyse oscillation cleaning by purified water, within every 4 hours, change liquid once, change liquid altogether 6 times.
Homogenate: add the fine and smooth homogeneous gel shape material that the appropriate purified water homogenized of carrying out under 4 DEG C of conditions is 1200mPa/s to formation viscosity in the cross-linking collagen matrices obtained.
Molding lyophilizing: proceeded to by gel in mould and carry out frozen dried, obtains the sample of regulation structure, is evenly distributed with 10 axial notches at A, Type B sample surfaces; Pass vertically through C type sample center with the medical puncture needle of 0.5 ~ 0.7mm after lyophilizing, obtain the product of regulation structure, structure as shown in Figure 1.Finally pack, after the sterilizing of 25kGy 60Coradiation, namely available degradation time is the product of about 3 months.
Embodiment 3
By the cutting and grinding of cattle cortical bone, obtain the bone meal that particle diameter is 0.05 ~ 0.1mm, repeatedly clean to remove bloodstain and other foreign material.List of references method carries out defat, decalcification, viral inactivation treatment.
Swelling: to soak 2 days for 1:5 adds 0.3M hydrochloric acid solution in mass ratio, then with large-scale purification water, the bone meal after swelling is cleaned repeatedly until pH is 6 ~ 7.Free water in sucking filtration removing bone meal.
Homogenizing: in mass ratio for 1:3 adds purified water, under 4 DEG C of conditions, homogenate is fine and smooth homogeneous gel.
Crosslinked: in gel collagen stroma, add the EDC that mass fraction is 0.1%, at 4 DEG C, crosslinking time is 10 hours, and mixing speed is 120r/min.Then repeatedly to dialyse oscillation cleaning by purified water, within every 8 hours, change liquid once, change liquid altogether 3 times.
Homogenate: add appropriate purified water and carry out homogenized to forming the fine and smooth homogeneous gel shape material that viscosity is 900mPa/s under 4 DEG C of conditions in the cross-linking collagen matrices obtained.
Molding lyophilizing: proceeded to by gel in mould and carry out frozen dried, obtains the sample of regulation structure, is evenly distributed with 4 axial notches at A, Type B sample surfaces; Pass vertically through C type sample center with the medical puncture needle of 0.5 ~ 0.7mm after lyophilizing, obtain the product of regulation structure, structure as shown in Figure 1.Finally pack, after the ethylene oxide sterilizing of 6 hours, namely available degradation time is the product of about 3 months.
Embodiment 4
By the cutting and grinding of cattle cortical bone, obtain the bone meal that particle diameter is 0.1 ~ 0.25mm, repeatedly clean to remove bloodstain and other foreign material.List of references method carries out defat, decalcification, viral inactivation treatment.
Swelling: the acetum adding 3% for 1:20 in mass ratio soaks 3 days, then with large-scale purification water, the bone meal after swelling is cleaned repeatedly until pH is 6 ~ 7.Drain the Free water in removing bone meal.
Homogenizing: in mass ratio for 1:5 adds purified water, homogenizing is fine and smooth uniform gel, need carry out, prevent collagen component degeneration wherein during operation under 4 DEG C of conditions.
Crosslinked: in collagen stroma, to add the EDC that mass fraction is 1%, be cross-linked 4 hours under 30 DEG C of conditions, mixing speed is 200r/min.Then repeatedly to dialyse oscillation cleaning with the PBS of 0.01M, within every 6 hours, change liquid once, change liquid altogether 6 times.
Homogenate: carry out homogenized under 4 DEG C of conditions to forming the uniform gel of exquisiteness that viscosity is 1000mPa/s by adding appropriate purified water in the cross-linking collagen matrices after cleaning obtained above.
Molding lyophilizing: proceeded to by gel in mould and carry out frozen dried, obtains the sample of regulation structure, is evenly distributed with 6 axial notches at A, Type B sample surfaces; Pass vertically through C type sample center with the medical puncture needle of 0.5 ~ 0.7mm after lyophilizing, obtain the product of regulation structure, structure as shown in Figure 1.Finally pack, after the electron beam sterilization of 300kev, namely available degradation time is the product of about 6 months.
Embodiment 5
By the cutting and grinding of cattle cortical bone, obtain the bone meal that particle diameter is 0.1 ~ 0.25mm, repeatedly clean to remove bloodstain and other foreign material.List of references method carries out defat, decalcification, viral inactivation treatment.
Swelling: the acetic acid adding 5% for 1:10 in mass ratio soaks 5 days, then with large-scale purification water, the bone meal after swelling is cleaned repeatedly until pH is 6 ~ 7.Homogenate is carried out after Free water in sucking filtration removing bone meal.
Homogenizing: in mass ratio for 1:8 adds purified water, under 4 DEG C of conditions, homogenizing is fine and smooth uniform gel collagen stroma.
Crosslinked: in gel collagen stroma, add the glutaraldehyde that mass fraction is 3%, crosslinking temperature is 25 DEG C, and crosslinking time is 1 hour, and mixing speed is 300r/min.Then with the PBS buffer dialysis cleaning of 0.05M, within every 2 hours, change liquid once, change liquid altogether 10 times.
Homogenate: add appropriate purified water and carry out homogenized to forming the fine and smooth homogeneous gel that viscosity is 900mPa/s under 4 DEG C of conditions in the cross-linking collagen matrices obtained.
Molding lyophilizing: proceeded to by gel in mould and carry out frozen dried, obtains the sample of regulation structure, is evenly distributed with 8 axial notches at A, Type B sample surfaces; Pass vertically through C type sample center with the medical puncture needle of 0.5 ~ 0.7mm after lyophilizing, obtain the product of regulation structure, structure as shown in Figure 1.Finally pack, after the ethylene oxide sterilizing of 12 hours, namely available degradation time is the product of about 12 months.
Embodiment 6
By the cutting and grinding of cattle cortical bone, obtain the bone meal that particle diameter is 0.1 ~ 0.2mm, repeatedly clean to remove bloodstain and other foreign material.List of references method carries out defat, decalcification, viral inactivation treatment.
Swelling: in mass ratio for 1:10 adds the soak with hydrochloric acid 3 days of 0.1M, then with large-scale purification water, the bone meal after swelling is cleaned repeatedly until pH is 6 ~ 7.Homogenate is carried out after Free water in sucking filtration removing bone meal.
Homogenizing: in mass ratio for 1:6 adds purified water, under 4 DEG C of conditions, homogenizing is fine and smooth uniform gel collagen stroma.
Crosslinked: in gel collagen stroma, add the glutaraldehyde that mass fraction is 5%, crosslinking temperature is 25 DEG C, and crosslinking time is 4 hours, and mixing speed is 300r/min.Then with the PBS buffer dialysis cleaning of 0.05M, within every 3 hours, change liquid once, change liquid altogether 10 times.
Homogenate: add appropriate purified water and carry out homogenized to forming the fine and smooth homogeneous gel that viscosity is 1100mPa/s under 4 DEG C of conditions in the cross-linking collagen matrices obtained.
Molding lyophilizing: proceeded to by gel in mould and carry out frozen dried, obtains the sample of regulation structure, is evenly distributed with 6 axial notches at A, Type B sample surfaces; Pass vertically through C type sample center with the medical puncture needle of 0.5 ~ 0.7mm after lyophilizing, obtain the product of regulation structure, structure as shown in Figure 1.Finally pack, after the electron beam sterilization of 100kev, namely available degradation time is the product of about 18 months.