CN105189732A - 预防和/或治疗与金黄色葡萄球菌、铜绿假单胞菌、化脓性链球菌、屎肠球菌、阴沟肠杆菌、奇异变形杆菌、脆弱拟杆菌、表皮葡萄球菌、痤疮丙酸杆菌、白色念珠菌和/或糠秕马拉色菌相关的感染、定植或疾病的方法 - Google Patents
预防和/或治疗与金黄色葡萄球菌、铜绿假单胞菌、化脓性链球菌、屎肠球菌、阴沟肠杆菌、奇异变形杆菌、脆弱拟杆菌、表皮葡萄球菌、痤疮丙酸杆菌、白色念珠菌和/或糠秕马拉色菌相关的感染、定植或疾病的方法 Download PDFInfo
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Abstract
本发明的主题是对金黄色葡萄球菌、铜绿假单胞菌、化脓性链球菌、屎肠球菌、阴沟肠杆菌、奇异变形杆菌、脆弱拟杆菌、表皮葡萄球菌、痤疮丙酸杆菌、白色念珠菌和/或糠秕马拉色菌菌株具有拮抗活性的细菌或细菌混合物,以及其在治疗和/或预防与那些病原菌相关的感染或定植中的用途。本发明涉及意欲在皮肤、伤口、粘膜和附属器官上预防和/或治疗感染或定植的包含一种或多种非病原性拮抗菌株的护理产品。
Description
技术领域
本发明涉及对病原性细菌或酵母具有拮抗活性的细菌(下文中称为“拮抗细菌”)及其作为活性成分或在医疗设备中的用途,尤其是在治疗和/或预防与这些病原性细菌或酵母相关的定植和/或感染中的用途,所述病原性细菌或酵母属于以下属和种:金黄色葡萄球菌(staphylococcusaureus)、铜绿假单胞菌(Pseudomonasaeruginosa)、化脓性链球菌(Streptococcuspyogenes)、屎肠球菌(Enterococcusfaecium)、阴沟肠杆菌(Enterobactercloacae)、奇异变形杆菌(Proteusmirabilis)、脆弱拟杆菌(Bacteroidesfragilis)、表皮葡萄球菌(staphylococcusepidermidis)、痤疮丙酸杆菌(Propionibacteriumacnes)、白色念珠菌(Candidaalbicans)和/或糠秕马拉色菌(Malasseziafurfur)。选择对病原性细菌或酵母具有拮抗性的细菌是因为它们能够抑制病原性细菌或酵母的附着和发育和/或增殖,从而稳定和/或调解生态系统。本发明涉及意欲用于预防或治疗皮肤、伤口、粘膜和体表生长物上的感染或定植的包含一种或多种非病原性拮抗菌株的护理产品。
背景技术
金黄色葡萄球菌和铜绿假单胞菌造成某些病理病症,例如皮肤和粘膜感染、伤口感染,尤其是慢性伤口感染(溃疡、糖尿病伤口)、烧伤和手术伤口。这些细菌种类尤其因为造成延迟治愈而为人所知。它们也涉及其他病理病症,例如胃肠道、尿路和肺部的感染、中耳炎或鼻窦炎。
铜绿假单胞菌,或者称为绿脓杆菌,在某些情况下是病原性的。这些非常耐药的细菌与其他革兰氏阴性菌一起正越来越经常地涉及医院内感染。该菌株具有组织成生物膜的能力,这使其对抗生素更加耐药。它是临床上最难治疗的细菌之一。在虚弱的(免疫抑制)患者中死亡率达到50%。它是一种对多种杀菌剂非常耐药的广泛存在的微生物,其经常在医院环境中,并导致实际医院菌株的出现(由于其对抗生素的耐药性)。它产生各种形式的病理病症:眼部感染、伤口感染(尤其烧伤和手术感染)、尿路感染(尤其在导尿管之后)、胃肠道和肺部感染(例如在支气管镜检查之后)、接种脑膜炎、败血症例如严重感染的最终状态或在经历免疫抑制治疗的患者、白血病患者等中的并发症。它容易在免疫抑制(由于化疗或AIDS)的个体、烧伤受害者和囊性纤维化受害者中引起系统性感染。
金黄色葡萄球菌是葡萄球菌属中最具有病原性的种类。它造成食物中毒、化脓性局部感染、以及在某些极端情况下造成物理性败血症(移植、心脏假体)。该种类被证明是在某些位置或在某些环境下的条件致病菌。它是一种对天然纯化机制具有良好耐药性的广泛存在的微生物。还在共生菌群中发现金黄色葡萄球菌(在15%-30%健康个体的鼻腔和喉咙,也可以在消化道中发现少量,经常在会阴水平)。
金黄色葡萄球菌有致病能力,尤其是在有机体中繁殖和扩散的侵袭能力,以及有毒的能力。金黄色葡萄球菌具有极大的用于开发耐抗生素的突变体的能力(举例而言,可以提及医院内感染主要原因之一的耐甲氧西林金黄色葡萄球菌,或MRSA)。
这些病原性细菌和酵母具有在健康或免疫抑制的宿主中附着于表面,尤其是上皮组织并以生物膜的形式发育的能力。生物膜定义为附着于生物表面(活体组织、皮肤等)或非生物表面(惰性材料如硅氧烷或钢)且被困在有机聚合物基质内的微生物(或微生物群落)的复杂组装物(Costerton等,1999,Dunne,2002)。因此,这些生物膜可以是单一特异性的,例如单一的细菌或酵母种类的化合物,或当其由几种细菌或种类组成时,它是混合的。
通常治疗与病原性细菌种类存在有关的感染是使用抗生素(青霉素、头孢菌素)。然而,使用这种方法存在一些缺点:
-这些抗生素通常具有相当大的作用谱,可能造成共生菌群的不平衡,从而造成病原性微生物的定植;
-细菌能够获得耐这些抗生素的能力;
-生物膜形式的细菌耐药性与单独的细菌相比极大增强,也称为浮游细胞。
面对病原性微生物对抗生素具有多种耐药性的问题,迫切需要发现这种治疗的替代方案。
预期用以预防或治疗细菌或酵母来源感染的一种解决方案是使用对病原性种类有拮抗性的细菌株。因此使用术语细菌疗法。这些拮抗菌株能够通过其代谢产生抗菌分子和/或干扰病原性细菌和酵母的附着和/或破坏病原性细菌和酵母之间的通讯和/或具有血管生成活性。它们还能够控制炎症(免疫调控性能)。这些细菌在皮肤、伤口、粘膜或体表生长物的表面形成能够暂时掌控并限制病原性细菌和酵母着床的阳性生物膜。
当感染和/或定植位于皮肤上和/或伤口里时,这尤为有利。
这些拮抗性菌株通常属于乳酸菌家族。这些菌株从各种基质(主要是粪便)中分离。这些菌株的活性被广泛用于预防和治疗肠粘膜水平疾病,因此使用术语益生菌。在耳、鼻、喉粘膜以及泌尿生殖道黏膜水平的其他应用也已经被描述。举例而言,可以提及涉及尿片或卫生巾的EP871503,所述尿片或卫生巾包含具有拮抗性质的选自弯曲乳杆菌(Lactobacilluscurvatus)、植物乳杆菌(Lactobacillusplantarum)、乳酸乳球菌(Lactococcuslactis)的微生物,使其能够对抗在所述吸收性物品中或在泌尿生殖区中存在或形成的不良微生物的菌株。专利申请WO99/53932涉及用于治疗中耳炎的组合物,包含选自血链球菌(Streptococcussanguis)、口腔链球菌(Streptococcusoralis)、和轻型链球菌(Streptococcusmitis)的微生物。
发明内容
本申请人特别关注对病原性菌株金黄色葡萄球菌和铜绿假单胞菌具有拮抗性的菌株。
本发明的一个潜在目的还在于在皮肤、体表生长物、粘膜和/或伤口表面形成防止或限制致病菌着床及其增殖的暂时的阳性生物膜。
根据本发明的拮抗细菌在用于涉及病原性种类金黄色葡萄球菌和铜绿假单胞菌的病理病症中尤为有利,例如胃肠道、尿路和肺部感染、中耳炎或鼻窦炎、伤口或涉及伤口、皮肤、体表生长物或黏膜定植的病理病症。
根据本发明的拮抗细菌不仅在用于各种类型的伤口(慢性、急性、烧伤)中尤为有利,而且在皮肤病症(例如,毛囊炎、脓疱疮、湿疹、疡肿、炭疽病、甲沟炎、遗传性过敏症(atopies)、口角炎、与病毒如疱疹病毒或水痘病毒有关的病变的重复感染)中也很有利。
实际上,伤口是外伤之后的病变,造成皮肤损失或皮肤裂开。针对伤口的形成建立愈合过程。
伤口的自然愈合主要根据三个连续阶段发生,这些阶段的每一个根据精确的时间顺序由带来修复过程进展的特异性细胞活动表征:炎症阶段、肉芽阶段(或增殖阶段)、和疤痕形成阶段。
伤口愈合的速度和质量取决于受影响器官的总体病症、伤口的病因、伤口的病症和位置、可能出现的感染,以及可能诱发愈合障碍的遗传因素。撕裂或割开的皮肤不再作为对抗微生物的屏障,细菌于是能渗入器官,造成感染。
细菌和酵母不可避免地存在于伤口中,这是自然定植。
根据细菌和/或酵母的量、存在的细菌和/或酵母的种类和器官的反应,区分定植、局部感染和感染。
定植是在伤口内存在一定量的细菌和/或酵母而不引起炎症反应。微生物在伤口繁殖并附着在表皮细胞上之后,在患者和其微生物菌群之间建立了平衡。微生物保持并附着在伤口表面以形成生物膜。从定量的角度看,定植的特征是微生物的量少于105个细菌/mm3。如果细菌和/或酵母的量超过了该数量,有些作者称为关键定植,则严格来讲是在相当多细菌和/或酵母定植存在下的局部浅表感染。这种相当多细菌和/或酵母的存在对愈合过程的正确运行是有害的,并诱导延迟愈合。
当细菌和/或酵母微生物的存在导致局部炎症反应以及出现带有反映由存在的微生物引起的组织侵袭的临床体征的一般体征(存在大量微生物、细菌毒性、患者免疫防御机制的降低)时,将使用术语“感染”。感染的特征是局部和一般临床体征。
所述感染能够导致伤口扩大,其中暴露基本的解剖结构如韧带或骨。
细菌定植不需要特别的治疗方法,而感染需要建立局部和总体的抗菌治疗。
在伤口的不愈合或延迟愈合中,感染通常直接或间接地是决定性因素。伤口的任何细菌和/或酵母污染会增加炎症。
这在中度污染(在开放性伤口的情况中是不可避免的)的情况下可能是有利的,但在造成延迟愈合的伤口感染的情况下是有害的。
因此,愈合的即刻并发症首先是感染,其阻止愈合过程的开始使其不能建立;当伤口中存在的细菌和/或酵母的量妨碍了愈合过程或使伤口恶化时,该伤口被认为是受到感染。
在这种情况下,愈合,称为二期愈合,通常需要使用皮肤病药物和手术工具(手术刀、刮匙等)。例如,在腿溃疡的情况下,有必要提前用杀菌剂(例如洗必泰或己脒定)消毒伤口并清理伤口,这通过手术作用或使用蛋白药物,例如目的是破坏污染伤口的死皮肤条的药物去除碎片和过量分泌物。在用于治疗伤口感染的常用的活性剂中,可以提及银、铜、奥替尼淀、碘、PHMB(聚六亚甲基双胍)和蜂蜜。
然而,在伤口中不建议抗菌剂和/或杀菌剂。这些活性剂的功效,从其作用机制的角度看,是短期存在的,它们被有机物灭活,它们可能对细胞成分有毒,它们是广谱的,因此,它们不仅攻击病原性细菌,也会破坏共生菌群。而且,一定数量的细菌菌株已经对杀菌剂/抗菌剂耐药。
因此,需要在治疗和/或预防细菌和/或酵母引起的伤口感染或定植中有效的活性剂,所述活性剂高效、容易使用且非侵入性。
预期用以在皮肤、伤口、粘膜和/或体表生长物水平预防或治疗细菌来源或由酵母引起的感染或定植的一种解决方案是使用对病原性菌株有拮抗性的细菌株。这些菌株能够通过其代谢产生抗菌分子和/或干扰病原性细菌和/或酵母的附着。这些细菌还能够在皮肤、伤口、粘膜或体表生长物的表面短暂形成限制病原性细菌和/或酵母着床的阳性生物膜。
这些拮抗性菌株通常属于乳酸菌家族和/或已经从人粘膜的共生菌群中分离。这些菌株的活性被广泛用于预防和治疗肠粘膜、ENT粘膜和阴道粘膜水平的疾病。WO96/38159、WO00/61201、EP1140226、EP1461012和WO2006/013441描述了所述菌株。
这些菌株的拮抗作用归因于各种机制,例如:
-含碳和/或含氮基质的营养竞争;
-产生抗菌分子,如乳酸、过氧化氢(H2O2)、还原分子或细菌素;
-在粘膜上对结合位点的附着竞争;
-产生生物表面活性剂;
-抑制或破坏各种细菌种类之间的细胞通讯;
-能够刺激局部和系统免疫的免疫调控活性。
在皮肤和伤口上使用益生菌菌株的应用也通常利用之前描述的活性之一。
因此,可以提及关于益生菌菌株嗜酸乳杆菌(Lactobacillusacidophilus)ATCC4356和ATCC43121和多发酵芽孢杆菌(Bacilluspolyfermenticus)在皮肤和肠粘膜水平的拮抗作用的应用((Halper等,2003,Im等,2009)。长双歧杆菌(Bifidobacteriumlongum)reuter、副干酪乳杆菌(Lactobacillusparacasei)CNCMI-2116、胚芽乳酸杆菌(Lactobacillusjohnsonii)La1和透明颤菌(Vitreoscillafiliformis)的益生菌菌株也已经以局部形式被用于调节皮肤水平的炎症现象和失调((Gueniche等,2006,Gueniche等,2008a,Gueniche等,2008b,Gueniche等,2008c,Gueniche等,2008d,Gueniche等,2009,Gueniche等,2010)。在本申请上下文中,作者强调菌株的免疫调控能力。专利申请EP1593382和WO2006/037922描述了这种菌株。
植物乳杆菌菌株ATCC10241已经被描述为通过释放破坏细胞通讯(或群体感应)的信号分子用于限制铜绿假单胞菌的生长和生物膜的形成。在大鼠的烧伤模型或人的烧伤上直接应用一块浸有该菌株培养物的纱布已经能够证实其功效((Peral等,2009,Valdez等,2005)。该菌株对中性粒细胞和白细胞的免疫调控能力也已经被开发用于治疗慢性伤口(糖尿病伤口、各种溃疡)和减少由铜绿假单胞菌引起的炎症((Peral等,2010,Ramos等,2010,Ramos等,2012)。Brachkova等(Brachkova等,2011)已经描述了该菌株的海藻酸盐膜制剂用于预防由铜绿假单胞菌引起的烧伤感染。
发酵乳杆菌(Lactobacillusfermentum)菌株RC-14显示在手术移植体水平抑制金黄色葡萄球菌的附着并限制并该微生物有关的感染的显著能力(Gan等,2002)。这种抗菌效果归因于释放生物表面活性剂。
H.Sikorska等,2013的研究还证实了分离自不同来源的乳酸杆菌和双歧杆菌的几个菌株在预防和治疗耐甲氧西林的金黄色葡萄球菌的功效。
已经证实了罗伊氏乳杆菌(Lactobacillusreuteri)菌株(KCTC3594、KCTC3678和KCTC3679)对表皮葡萄球菌和痤疮丙酸杆菌生长的抑制(Kang等,2012)。
已经证实了乳酸菌属HY449产生的细菌素对皮肤炎性细菌,如表皮葡萄球菌ATCC12228、金黄色葡萄球菌ATCC65389、化脓性链球菌ATCC21059和痤疮丙酸杆菌ATCC6919的效果(Ho等,2006)。
已经描述了需要使用益生菌菌株(凝结芽孢杆菌属(Bacilluscoagulans)的乳酸菌)的敷料或织物(US7025974和WO2008/074331)。这些制剂的功效仅仅是基于利用能够产生乳酸作为基本广谱抗菌剂的细菌菌株。
本发明的目的是提供基于细菌的新型活性剂,其对病原性细菌金黄色葡萄球菌和/或铜绿假单胞菌具有拮抗作用,能有效治疗和/或预防与这些病原性细菌有关的定植和/或感染,尤其是在皮肤、伤口、粘膜和体表生长物水平上。此外,这些活性剂可施用与皮肤、伤口、粘膜和体表生长物直接接触,或能够容易地加入组合物中,尤其适合局部应用且非侵入性的组合物。
以创新的方式,基于几个标准预选拮抗细菌:(i)它们抑制病原性微生物,即金黄色葡萄球菌和铜绿假单胞菌生长的能力,(ii)它们在胶原蛋白和表皮上附着并形成阳性生物膜的能力,(iii)它们限制病原性微生物在包含胶原蛋白的基质上附着的能力,和(iv)它们限制炎症反应(巨噬细胞引起的TNF-α生产)的能力。
这些细菌能够在皮肤、伤口、粘膜和体表生长物水平上形成屏障作用,从而预防并限制定植和感染的风险。
本发明人尤其有兴趣选择主要对金黄色葡萄球菌和铜绿假单胞菌具有拮抗性的菌株,所述金黄色葡萄球菌和铜绿假单胞菌是涉及感染,尤其是医院内感染的主要病原性种类。
此外,除了抑制金黄色葡萄球菌和铜绿假单胞菌的菌株外,本发明人已经选择了抑制其他病原性种类,如化脓性链球菌、屎肠球菌、阴沟肠杆菌、奇异变形杆菌、脆弱拟杆菌、表皮葡萄球菌、痤疮丙酸杆菌、白色念珠菌和糠秕马拉色菌发育的细菌菌株。
痤疮丙酸杆菌是厌氧革兰氏阳性杆菌,其生长相对缓慢,通常存在于皮肤、毛发和粘膜。它会造成痤疮。
该细菌广泛存在于大多数健康成人的皮肤菌群中,但它也会造成术后感染,这尤其在移植体存在的情况下可能是严重的:中枢神经系统感染、眼内炎、心内膜炎、ENT和肺球感染、椎间盘炎、腹膜炎和骨关节感染。
表皮葡萄球菌是在几乎100%的人皮肤上的共生菌;其脂解性质使其能在皮脂中繁衍。它通常是无害的,但它在免疫系统受损的患者或具有导管或假肢的患者中会造成真实感染。这些可能是皮肤感染和鼻感染,例如鼻窦炎或女性中的泌尿系感染,男性中较少。这些细菌具有产生生物膜的能力,使其能附着于医学假体的表面。
白色念珠菌本身根据其位置有不同表现。在免疫活性患者(即,其防御系统是有效的,与免疫抑制患者不同)中,它的表现形式是口腔中的鹅口疮、皮肤红肿和瘙痒,尤其是在有利于酵母发育的温暖潮湿区域的褶皱内,以及小的局部生殖器炎症,例如人的尿道炎或女性中带白色分泌物和瘙痒的外阴阴道炎。
糠秕马拉色菌是主要涉及作为一种常见的炎性皮肤病(在3%-5%的人群中观察到)的脂溢性皮炎的酵母。它以由脂肪和黄色鳞片覆盖的红色斑块的形式存在,或多或少发痒,主要在富含皮脂腺的区域,脂溢性区中。在脸上,病变的位置是暗示性的:鼻和唇之间的沟、眉毛根部、头皮、鼻翼、羽片褶皱、外耳、外耳道。在头皮上,经常性参与导致或多或少的脂溢性头皮屑病症。在躯干上,注意人的两个普通区:胸骨和两个肩胛之间的区域。
在成人和婴儿(小于3个月)中均有遇到,其在婴儿中通过头皮内传统的“摇篮帽”和臀部的红斑体现。在成人中,该病理病症尤其在20-40岁的受试者中观察到。男性比女性更频繁地感染。在女性中,尤其在更年期观察到其发展。多因素炎症来源的病理病症不具传染性,其能够通过最常由压力或污染以及缺少阳光引发的侵袭发展。
病因未知,但认为是一种微观真菌在可能产生特殊免疫过敏的病症中起作用。
花斑癣是一种浅部真菌病,与糠秕马拉色菌在皮肤上的繁殖有关。该酵母通常生存在皮肤表面,但在某些情况下,它以极快的速度增殖并造成这些小的褐色或变色的标记。
该真菌尤其嗜好油性皮肤,存在于胸,但也存在于颈和肩膀、上背部和上肢、几乎不存在于下肢。
因此,本发明的一个目的是选自以下的细菌:在本申请中也称为F3C5p的Lactobacillussaniviri菌株(以保藏号CNCMI-4650于2012年7月12日保藏于法国国家培养物和微生物保藏中心,[NationalCollectionofMicroorganismCultures],InstitutPasteur,25rueduDocteurRoux,75724ParisCedex15,France,后文称为“CNCM”)、在本申请中也称为F50C2p、F52C3p和F41C3p的唾液乳杆菌(Lactobacillussalivarius)(分别以保藏号CNCMI-4651、CNCMI-4652和CNCMI-4653于2012年7月12日保藏于CNCM)、在本申请中也称为F3C2v的轻型链球菌(以保藏号CNCMI-4654于2012年7月12日保藏于CNCM),和在本申请中也称为L1C1的戊糖乳杆菌(Lactobacilluspentosus)或植物乳杆菌(以保藏号CNCMI-4655于2012年7月12日保藏于CNCM)。这些细菌在本申请中被称为“根据本发明的细菌”。
本发明的一个目的也是根据本发明的细菌用作免疫调节剂。
本发明的一个目的也是这种细菌作为活性成分或作为医疗设备或作为化妆品或作为食品增补剂的用途。根据本发明的细菌还可以用作药物、医疗设备、化妆品或食品增补剂中的活性成分。
本发明还要求保护根据本发明的细菌用于治疗和/或预防与至少一种选自金黄色葡萄球菌、铜绿假单胞菌、化脓性链球菌、屎肠球菌、阴沟肠杆菌、奇异变形杆菌、脆弱拟杆菌、表皮葡萄球菌、痤疮丙酸杆菌、白色念珠菌和糠秕马拉色菌的细菌或酵母有关的定植和/或感染。
优选地,本发明涉及根据本发明的细菌用于治疗和/或预防与金黄色葡萄球菌和/或铜绿假单胞菌有关的定植和/或感染。
更具体地,本发明涉及治疗和/或预防由病原性细菌或酵母引起的伤口和皮肤定植和/或感染。
术语“治疗(treatment)”或“治疗(treating)”感染或定植是指减少和/或抑制这种感染或定植的发展。
术语“预防(prevention)”或“预防(preventing)”感染或定植是指减少和/或避免感染或定植症状的出现。
表述“伤口的感染或定植”意欲指选自以下的感染或定植:糖尿病足溃疡、动脉源性腿部溃疡、静脉源性腿部溃疡、褥疮、甲沟炎、与急性伤口有关的感染、与外伤伤口有关的感染,例如由切断引起的伤口、穿透性伤口、由热或碱剂和烧伤引起的伤口;与术后伤口有关的感染,例如手术切口的单纯缝合伤口、皮肤切除后的复杂缝合伤口、需要二期愈合的手术磨皮和非缝合性伤口。
根据本发明的细菌可以加入组合物,例如医疗设备中。为了本发明的目的,术语“医疗设备”意欲指假体、导管、敷料、造瘘袋、手术用帷帘、导尿管、气管导管、鼓膜造孔插管、绷带、支持绷带、整形和乳房植入物、隐形眼镜、宫内避孕器、或用于缝线的其他材料。
本发明的一个目的还是包含至少一种根据本发明的细菌的组合物。所述组合物在可接受的介质中包含至少一种根据本发明的细菌。术语“可接受的介质”意欲指与皮肤、伤口、粘膜和体表生长物相容的介质。
根据本发明的组合物,或根据本发明的细菌,可以局部、口服或肠胃外施用。
优选地,这种组合物或这种细菌适合局部应用于皮肤、伤口、体表生长物或粘膜,例如鼻和喉、尿道、消化道或呼吸道粘膜。因此,所述组合物可直接应用于皮肤、伤口或粘膜。
术语“局部应用”意欲指应用于皮肤、伤口、粘膜和/或体表生长物。
根据本发明的组合物优选包含103-102个细菌,优选106-1011个。
所述局部组合物可以是液体、糊剂或固体形式,更具体地是药膏、霜剂、乳液、软膏、粉末、浸渍垫、合成洗涤剂、抹布、溶液、凝胶、喷雾剂、泡沫、悬浮液、洗液、口红、洗发水或洗涤碱的形式。它也可以是微球或纳米球的悬浮液或脂质或聚合物囊泡或微胶囊或聚合物贴剂和控制释放的水凝胶的形式。局部应用的这种组合物可以是无水形式、含水形式或乳液形式。
胃肠外组合物可以是用于皮下注射的溶液(可注射溶液)的形式。
口服组合物可以是溶液、粉末、凝胶胶囊或片剂的形式、或可以加入食品中,例如乳制品中。
根据本发明的细菌可以以灭活细胞,尤其是由热、UV照射或任何其他方法灭活的灭活细胞的形式加入所述组合物。它还可以以包封或非包封、固定或非固定、冻干或非冻干的活细胞的形式或细胞提取物的形式加入。它还可以是细胞裂解物或本领域技术人员已知的任何其他呈现形式。
优选地,本发明全文中所用的拮抗细菌或包含它们的盖仑制剂,将会以局部应用组合物的形式,或加入作为敷料组合物一部分的合成或非合成基质的形式直接应用于伤口。
在该实施方案中,将细菌配制成敷料、或配制成其本身被包含于敷料中或在应用敷料时被包含的组合物。因此,根据本发明的敷料包含至少一种根据本发明的细菌,或者少一种根据本发明的组合物。
根据本发明的拮抗细菌或包含它们的根据本发明的组合物可以加入敷料结构的任何成分,条件是所述细菌能直接或间接与伤口表面接触。
优选且为了促进快速作用,将细菌(或包含它的根据本发明的组合物)加入与伤口接触的敷料层,或沉积在与伤口接触的敷料表面。
因此,有利地,细菌(或包含它的根据本发明的组合物)以连续或非连续的方式沉积于意欲与伤口接触的表面:
-以液体形式,例如喷雾包含它的溶液或悬浮液;
-或以固体形式,例如筛分包含它的粉末。
为了本发明的目的,术语“敷料”意欲指用于治疗伤口的各种类型的敷料。通常,敷料包含至少一个粘性或非粘性层或基质。
与伤口接触的层或表面可以由在敷料领域通常为此目的而使用的任何材料或材料组合构成。在这些材料中,可以提及吸收性泡沫,尤其是基于聚氨酯的亲水性泡沫;纺织材料,尤其是基于吸收性或超吸收性纤维的无纺布;水凝胶;或这些材料的组合;吸收性或非吸收性添加剂材料;粘附性或非粘附性的界面结构。
通常,可以调整敷料的盖伦制剂或结构以根据需要获得快速或延迟的细菌的特定释放谱。
因此,可以将细菌(或包含它的根据本发明的组合物)加入任何现有敷料类型,例如但不限于这些实例:
-海藻酸盐,例如,举例而言,由LaboratoiresUrgo以商品名销售的产品,或由以商品名销售的产品;
-水合细胞产品,例如,举例而言,由LaboratoiresUrgo以商品名Urgotul销售的产品,或由Systagenix以商品名Tielle销售的产品;
-亲水胶体敷料,例如,举例而言,由LaboratoiresUrgo以商品名销售的产品,和由Coloplast以商品名销售的产品;
-水凝胶,例如,举例而言,由LaboratoiresUrgo以商品名Urgo销售的产品,和由Smith&Nephew以商品名Intrasite销售的产品;
-水性敷料,例如,举例而言,由LaboratoiresUrgo以商品名UrgoCrevasses销售的产品,或由3M以商品名销售的产品。
当然,在盖伦制剂或敷料中使用的一种或多种细菌的量可以根据所需动力学以及与其性质、溶解度、耐热性等有关的特定约束条件进行调节。
在敷料成分中使用时,根据本发明的一种或多种细菌以使细菌释放至伤口渗出液的量为0.001g/l-50g/l,优选0.01-10g/l的量加入。
根据所选的盖伦制剂,敷料的使用可能需要预先浸渍或用溶液例如生理盐水使敷料水化以激活拮抗细菌。
根据本发明的组合物包含一种或多种拮抗菌株,任选地与至少一种选自益生菌、益生元和酵母的化合物组合。在益生元中,可以以实例的方式提及果聚糖例如菊糖、低聚果糖或反式低聚半乳糖、或其他长链或支链的糖。
根据本发明的细菌还可以与活性剂组合,尤其是选自抗真菌剂、止痛药、抗炎药、促愈合剂、保湿剂、角质溶解剂、重组活性剂和麻醉剂的活性剂。
具体地,可以引入根据本发明的组合物的活性剂选自:
-抗真菌剂,例如多烯类、制霉菌素、两性霉素B、纳他霉素、咪唑类化合物(咪康唑、酮康唑、克霉唑、益康唑、联苯苄唑、硝酸布康唑、芬替康唑、异康唑、奥昔康唑、舍他康唑、硫康唑、噻苯咪唑、噻康唑)、三唑类化合物(氟康唑、伊曲康唑、雷夫康唑、泊沙康唑、伏立康唑)、烯丙胺、特比萘芬、阿莫罗芬、萘替芬、或布替那芬;
-氟胞嘧啶(抗代谢物)、灰黄霉素、卡泊芬净和米卡芬净;
-止痛药,例如对乙酰氨基酚、可待因、右丙氧芬、曲马多、吗啡及其衍生物、皮质激素及其衍生物;
-抗炎药,例如糖皮质激素、非甾体类抗炎药、阿司匹林、布洛芬、酮洛芬、氟比洛芬、醋氯芬酸、双氯芬酸、酮咯酸、美洛昔康、吡罗昔康、替诺昔康、氧萘丙酸、吲哚美辛、萘普生、尼美舒利、塞来考昔、依托考昔、帕瑞考昔、罗非考昔、伐地考昔、保泰松、尼氟灭酸或甲芬那酸;
-促进愈合的活性剂,例如视黄醇、维生素A、维生素E、N-乙酰羟脯氨酸、积雪草(Centellaasiatica)提取物、木瓜蛋白酶、硅氧烷、百里香、绿花白千层、迷迭香和鼠尾草精油、透明质酸、具有1-4个单糖单元的合成多硫酸寡糖,例如蔗糖八硫酸钾、蔗糖八硫酸银盐或硫糖铝、或尿囊素;
-保湿剂,例如透明质酸、尿素、甘油、脂肪酸、水通道蛋白调节剂、植物油、壳聚糖、某些糖,包括山梨醇、黄油和蜡;
-角质溶解剂,例如水杨酸、水杨酸锌、抗坏血酸、α-羟基酸(乙醇酸、乳酸、苹果酸、柠檬酸、酒石酸)、银枫、酸樱桃或罗望子提取物、尿素、局部维甲酸(Sederma)、通过发酵枯草芽孢杆菌(Bacillussubtilis)获得的蛋白酶、或产品(SACICFPA);
-重组活性剂(例如用于体表生长物的重组活性剂),例如二氧化硅衍生物、维生素E、甘菊、钙、马尾草提取物或silklipester;
-麻醉剂,例如苯坐卡因、利多卡因、地布卡因、盐酸普拉莫星、布比卡因、甲哌卡因、普鲁卡因、或依替卡因。
通过说明的方式而没有任何限制的性质,将给出根据本发明的细菌的用途的各种实例,从而可以说明根据本发明的拮抗菌株的抗菌活性。
附图说明
图1代表根据本发明的细菌与病原菌接触并在琼脂培养基上孵育48小时后观察到的抑菌圈。
图2代表加入敷料的根据本发明的细菌与病原菌接触并在琼脂培养基上孵育48小时后形成的抑菌圈。
图3代表根据本发明的细菌附着于重组表皮上的能力(以附着细菌的量CFU/cm2表示)。
图4代表根据本发明的细菌相对于金黄色葡萄球菌在胶原蛋白表面上的附着竞争试验结果(孵育24小时之后附着的金黄色葡萄球菌的量(CFU/cm2))。
图5代表根据本发明的细菌相对于金黄色葡萄球菌在胶原蛋白表面上的排除试验结果(孵育24小时之后的金黄色葡萄球菌的量(CFU/cm2))。
图6代表根据本发明的细菌相对于铜绿假单胞菌在胶原蛋白表面上的附着竞争试验结果(孵育24小时之后附着的铜绿假单胞菌的量(CFU/cm2))。
图7代表根据本发明的细菌相对于铜绿假单胞菌在胶原蛋白表面上的排除试验结果(孵育24小时之后的铜绿假单胞菌的量(CFU/cm2))。
图8a和8b代表巨噬细胞与根据本发明的细菌接触3.5小时之后,存在或不存在来自大肠杆菌(E.coli)O127:B8的LPS的刺激下释放的TNF-α的量(pg/ml)。
具体实施方式
实施例1:细菌株LactobacillussaniviriF3C5p(CNCMI-4650)、
唾液乳杆菌F50C2p(CNCMI-4651)、唾液乳杆菌F52C3p(CNCM
I-4652)、唾液乳杆菌F41C3p(CNCMI-4653)、轻型链球菌F3C2v
(CNCMI-4654)和戊糖乳杆菌或植物乳杆菌L1C1(CNCMI-4655)
的抗菌活性
在ManRogosaSharpe(MRS)培养基中于37℃和厌氧条件下培养LactobacillussaniviriF3C5p(CNCMI-4650)、唾液乳杆菌F50C2p(CNCMI-4651)、唾液乳杆菌F52C3p(CNCMI-4652)、唾液乳杆菌F41C3p(CNCMI-4653)、轻型链球菌F3C2v(CNCMI-4654)和戊糖乳杆菌或植物乳杆菌L1C1(CNCMI-4655)16小时。将10μl这些培养物的液滴置于胰蛋白胨琼脂(TSA)培养基表面,所述胰蛋白胨琼脂(TSA)培养基用耐甲氧西林的金黄色葡萄球菌(MRSA)ATCC43300或铜绿假单胞菌ATCC9027或脆弱拟杆菌ATCC23745或阴沟肠杆菌CIF105132或屎肠球菌ATCC700221或奇异变形杆菌CIP107283或化脓性链球菌ATCC19615或表皮葡萄球菌ATCC14990或痤疮丙酸杆菌ATCC6919或白色念珠菌ATCC10231或糠秕马拉色菌ACTT14521在琼脂培养基内提前接种(106-107个细胞/ml琼脂培养基)。
放置10μl无菌MRS培养基进行阴性对照。
在37℃厌氧条件下孵育平板24小时和48小时。孵育之后,测量液滴周围形成的抑菌圈的直径(mm).
本实验结果如表1所示。
标记“-”表明没有抑菌圈,标记“+”表明抑菌圈直径小于1mm,标记“++”表明抑菌圈直径为1-3mm,标记“+++”表明抑菌圈直径大于3mm。阴性对照没有抑菌圈。在测试的3个细菌菌株中均观察到抑菌圈(参照图1)。
实施例2:细菌株LactobacillussaniviriF3C5p(CNCMI-4650)、
唾液乳杆菌F50C2p(CNCMI-4651)、唾液乳杆菌F52C3p(CNCM
I-4652)、唾液乳杆菌F41C3p(CNCMI-4653)、轻型链球菌F3C2v
(CNCMI-4654)和戊糖乳杆菌或植物乳杆菌L1C1(CNCMI-4655)
加入敷料后的抗菌活性
在ManRogosaSharpe(MRS)培养基中于37℃和厌氧条件下培养F3C5p、F50C2p、F52C3p、F41C3p、F3C2v和L1C1细菌16小时。将由聚氨酯泡沫和脂质水胶网组成的敷料片(1cm×1cm)用500μl根据本发明的细菌的培养液(浓度为109-1010CFU.ml-1)浸渍,并置于胰蛋白胨琼脂(TSA)培养基表面,所述胰蛋白胨琼脂(TSA)培养基用106-107个金黄色葡萄球菌MRSAATCC43300或铜绿假单胞菌ATCC9027细胞在琼脂培养基内提前接种。放置500μl无菌MRS培养基进行阴性对照。
在37℃厌氧条件下孵育平板24小时和48小时。孵育之后,抑菌圈的存在证实了抗菌活性。孵育之后,在用细菌LactobacillussaniviriF3C5p、唾液乳杆菌F50C2p、唾液乳杆菌F52C3p、唾液乳杆菌F41C3p、轻型链球菌F3C2v和戊糖乳杆菌或植物乳杆菌L1C1浸渍的敷料周围肉眼观察到抑菌圈(参照图2)。在用MRS培养基浸渍的敷料周围没有观察到抑菌圈。
实施例3:根据本发明的细菌在胶原蛋白上的附着能力
在13天的EpiSkin(SkinEthic)型重组表皮(1.07cm2)上进行LactobacillussaniviriF3C5p、唾液乳杆菌F50C2p、唾液乳杆菌F52C3p、唾液乳杆菌F41C3p、轻型链球菌F3C2v和戊糖乳杆菌或植物乳杆菌L1C1细菌的附着试验。将包含所述表皮的嵌入物置于含有2ml维持培养基的12孔板中,于35℃±2℃孵育24小时以再生表皮。
孵育后,去除维持培养基,添加2mlMRS培养基。然后用根据本发明的细菌(浓度大约为2.5x107CFU.ml-1)接种模拟伤口渗出液的培养基,称为模拟伤口液(50/50vol/vol)(在Werthén等,2010中描述)。孵育24小时后,用生理盐水洗涤去除没有附着的细菌。用解剖刀将表皮从嵌入物分离,并放入包含9mlMRS培养基的无菌容器中。通过机械作用(超声波浴)分离附着的细菌,并在琼脂培养基上通过稀释平板法计数。
LactobacillussaniviriF3C5p、唾液乳杆菌F50C2p、唾液乳杆菌F52C3p、唾液乳杆菌F41C3p、轻型链球菌F3C2v和戊糖乳杆菌或植物乳杆菌L1C1细菌能够附着在表皮上并持续24小时。LactobacillussaniviriF3C5p菌株显示最好的附着能力(参考图3)。
实施例4:屏障作用-在胶原蛋白表面对病原菌附着的抑制
评估LactobacillussaniviriF3C5p、唾液乳杆菌F50C2p、唾液乳杆菌F52C3p、唾液乳杆菌F41C3p、轻型链球菌F3C2v和戊糖乳杆菌或植物乳杆菌L1C1细菌菌株在包含胶原蛋白的基质上限制和/或抑制病原性种类(金黄色葡萄球菌MRSAATCC43300或铜绿假单胞菌ATCC9027)附着的能力。在用I型胶原蛋白(BDBiocoatTMCollagenI)包被的24孔微板中进行试验。
在胰蛋白胨肉汤(TSB)培养基中于37℃培养病原菌16小时。孵育后,在TBS培养基中稀释培养液至浓度为约2.5x107CFU.ml-1、2.5x105CFU.ml-1和2.5x103CFU.ml-1。
在ManRogosaSharpe(MRS)培养基中于37℃和厌氧条件下培养LactobacillussaniviriF3C5p、唾液乳杆菌F50C2p、唾液乳杆菌F52C3p、唾液乳杆菌F41C3p、轻型链球菌F3C2v和戊糖乳杆菌或植物乳杆菌L1C1细菌16小时。
对于附着竞争试验,分别以约2.5x107CFU.ml-1、2.5x107CFU.ml-1或2.5x105CFU.ml-1或2.5x103CFU.ml-1(病原菌)的浓度同时添加F3C5p、F50C2p和F52C3p细菌以及病原菌(金黄色葡萄球菌或铜绿假单胞菌)。分别以约2.5x107CFU.ml-1和2.5x107CFU.ml-1的浓度同时添加F41C3p、F3C2v、L1C1细菌以及病原菌(金黄色葡萄球菌或铜绿假单胞菌)。
对于排除试验,以约2.5x107CFU.ml-1的浓度将F3C5p、F50C2p和F52C3p细菌引入孔,并在37℃下孵育24小时。附着之后,用生理盐水洗涤孔,并以约2.5x107CFU.ml-1或2.5x105CFU.ml-1或2.5x103CFU.ml-1的浓度将病原性菌株(金黄色葡萄球菌或铜绿假单胞菌)引入所述孔。以浓度为约2.5x107CFU.ml-1的病原性菌株测试浓度为约2.5x107CFU.ml-1的F41C3p、F3C2v和L1C1细菌。
对于各试验,接触24小时后,在补充有包含亚碲酸钾(金黄色葡萄球菌)或头孢菌素/梭链孢酸钠/溴化十六烷基三甲铵(CFC)基质(铜绿假单胞菌)的蛋黄乳液的Baird-Parker培养基上特异性计数病原菌。在35℃±2℃下孵育24小时后,计数特征性克隆。对各试验用本发明的细菌进行非处理对照。
在测试的三个浓度下与非处理对照相比,F3C5p、F50C2p、F52C3p、F41C3p、F3C2v和L1C1细菌可以强烈限制金黄色葡萄球菌的附着以及在胶原蛋白包被的底物上的定植(参考图4和图5)。
在初始污染小于105CFU/cm2时与非处理对照相比,F3C5p、F50C2p、F52C3p、F41C3p、F3C2v和L1C1细菌可以限制铜绿假单胞菌的附着以及在胶原蛋白包被的底物上的定植(参考图6和图7)。
实施例5:对巨噬细胞的免疫调节活性
在ManRogosaSharpe(MRS)培养基中于37℃和厌氧条件下培养LactobacillussaniviriF3C5p、唾液乳杆菌F50C2p、唾液乳杆菌F52C3、戊糖乳杆菌/植物乳杆菌L1C1、唾液乳杆菌F41C3p和轻型链球菌F3C2v菌株16小时。离心回收细菌,然后超声灭活或加热灭活(95℃)以获得细菌提取物。
在RoswellParkMemorialInstitute(RPMI)培养基中培养THP1单核细胞(ATCCTIB-202),然后添加佛波酯(PMA)使其分化成巨噬细胞。培养24小时后,将所得巨噬细胞暴露于(i)单独的细菌提取物;或(ii)来自大肠杆菌O127:B8的LPS;或(iii)在细胞提取物存在下的来自大肠杆菌O127:B8的LPS。接触3.5小时后,采用ELISA法测量培养基上清液中肿瘤坏死因子(TNF-α)的浓度。
与不含细胞提取物的对照相比,添加单独的细菌提取物不诱导任何TNF-α的明显释放,因此不诱导任何促炎性反应,其中L1C1菌株是例外,其诱导了很弱的TNF-α释放(浓度为121pg/ml)。
用来自大肠杆菌的LPS刺激巨噬细胞在不存在细菌提取物的情况下造成TNF-α的大量释放(浓度约500pg/ml)。从各种细菌菌株(F3C5p、F41C3p、F50C2p、F52C3p、L1C1或F3C2v)制备的细胞提取物与LPS的同时添加可以显著降低(2-5倍)巨噬细胞的TNF-α释放。这些结果表明了6个乳酸菌菌株的抗炎潜力。
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Claims (15)
1.一种细菌,选自以保藏号I-4650于2012年7月12日保藏于CNCM的Lactobacillussaniviri、分别以保藏号CNCMI-4651、CNCMI-4652和CNCMI-4653于2012年7月12日保藏于CNCM的唾液乳杆菌、以保藏号CNCMI-4654于2012年7月12日保藏的轻型链球菌和以保藏号CNCMI-4655于2012年7月12日保藏的戊糖或植物乳杆菌。
2.如权利要求1所述的细菌,用作活性成分、医疗设备、化妆品或食品增补剂,或用作药物、医疗设备、化妆品或食品增补剂中的活性成分。
3.如权利要求1或2所述的细菌,用于预防和/或治疗与至少一种选自金黄色葡萄球菌、铜绿假单胞菌、化脓性链球菌、屎肠球菌、阴沟肠杆菌、奇异变形杆菌、脆弱拟杆菌、表皮葡萄球菌、痤疮丙酸杆菌、白色念珠菌和糠秕马拉色菌的细菌或酵母相关的感染和/或定植。
4.如权利要求1-3任一项所述的细菌,用于预防和/或治疗与金黄色葡萄球菌和/或铜绿假单胞菌相关的感染和/或定植。
5.如权利要求1-3任一项所述的细菌,用作免疫调节剂。
6.如权利要求1-4任一项所述的细菌,其特征在于,它应用于皮肤、伤口、粘膜和/或体表生长物。
7.如权利要求3或4所述的细菌,其特征在于,所述感染和/或定植涉及皮肤、伤口、尤其是选自糖尿病足溃疡、动脉源性腿部溃疡、静脉源性腿部溃疡、褥疮、甲沟炎的伤口、急性伤口、外伤伤口和术后伤口。
8.一种组合物,包含至少一种如权利要求1所述的细菌。
9.如权利要求8所述的组合物,其特征在于,它还包含至少一种选自益生菌、益生元和酵母的化合物。
10.如权利要求8或9所述的组合物,其特征在于,它还包含至少一种选自抗真菌剂、止痛药、抗炎药、促愈合剂、保湿剂、角质溶解剂、重组活性剂和麻醉剂的活性剂。
11.如权利要求8-10任一项所述的组合物,其特征在于,它适合局部、口服或胃肠外应用。
12.如权利要求8-11任一项所述的组合物,其特征在于,它是药膏、霜剂、乳液、软膏、粉末、浸渍垫、合成洗涤剂、抹布、溶液、凝胶、喷雾剂、泡沫、悬浮液、洗液、口红、洗发水、洗涤碱、片剂、凝胶胶囊、食品或可注射溶液的形式。
13.如权利要求8-12任一项所述的组合物,其特征在于,所述细菌以103-1012个细菌,优选106-1011个细菌的量存在。
14.如权利要求8-13任一项所述的组合物,其特征在于,所述细菌以包封或非包封、固定或非固定、冻干或非冻干的灭活细胞、活细胞或细胞裂解物的形式存在。
15.一种敷料,包含至少一种如权利要求1所述的细菌,或至少一种如权利要求8-14任一项所述的组合物。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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FR1262128 | 2012-12-17 | ||
FR1262128A FR2999601B1 (fr) | 2012-12-17 | 2012-12-17 | Methode pour prevenir et/ou traiter les infections, colonisations ou maladies liees a staphylococcus aureus, pseudomonas aeruginosa, streptococcus pyogenes, enterococcus faecium, enterobacter cloacae, proteus mirabilis et/ou bacteroides fragilis |
PCT/FR2013/053071 WO2014096641A1 (fr) | 2012-12-17 | 2013-12-13 | Méthode pour prévenir et/ou traiter les infections, colonisations ou maladies liées à staphylococcus aureus, pseudomonas aeruginosa, streptococcus pyogenes, enterococcus faecium, enterobacter cloacae, proteus mirabilis, bacteroides fragilis, staphylococcus epidermidis, propionibacterium acnes, candida albicans et/ou malassezia furfur |
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CN105189732A true CN105189732A (zh) | 2015-12-23 |
CN105189732B CN105189732B (zh) | 2018-11-09 |
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US (2) | US20150366920A1 (zh) |
EP (1) | EP2931924B1 (zh) |
JP (1) | JP6309967B2 (zh) |
CN (1) | CN105189732B (zh) |
BR (1) | BR112015014118A2 (zh) |
CA (1) | CA2892478A1 (zh) |
ES (1) | ES2645099T3 (zh) |
FR (1) | FR2999601B1 (zh) |
HK (1) | HK1209801A1 (zh) |
WO (1) | WO2014096641A1 (zh) |
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Also Published As
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BR112015014118A2 (pt) | 2017-07-11 |
JP6309967B2 (ja) | 2018-04-11 |
US10449222B2 (en) | 2019-10-22 |
FR2999601B1 (fr) | 2015-01-30 |
HK1209801A1 (zh) | 2016-04-08 |
US20180036356A1 (en) | 2018-02-08 |
EP2931924B1 (fr) | 2017-10-04 |
CA2892478A1 (fr) | 2014-06-26 |
WO2014096641A1 (fr) | 2014-06-26 |
US20150366920A1 (en) | 2015-12-24 |
EP2931924A1 (fr) | 2015-10-21 |
FR2999601A1 (fr) | 2014-06-20 |
JP2016508712A (ja) | 2016-03-24 |
CN105189732B (zh) | 2018-11-09 |
ES2645099T3 (es) | 2017-12-04 |
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