CN1089237C - 化合物在制备抑制血管平滑肌细胞移动的药物中的应用 - Google Patents
化合物在制备抑制血管平滑肌细胞移动的药物中的应用 Download PDFInfo
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- CN1089237C CN1089237C CN96195651A CN96195651A CN1089237C CN 1089237 C CN1089237 C CN 1089237C CN 96195651 A CN96195651 A CN 96195651A CN 96195651 A CN96195651 A CN 96195651A CN 1089237 C CN1089237 C CN 1089237C
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- smooth muscle
- muscle cell
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- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
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- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
- A61K31/445—Non condensed piperidines, e.g. piperocaine
- A61K31/4523—Non condensed piperidines, e.g. piperocaine containing further heterocyclic ring systems
- A61K31/4535—Non condensed piperidines, e.g. piperocaine containing further heterocyclic ring systems containing a heterocyclic ring having sulfur as a ring hetero atom, e.g. pizotifen
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- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
- A61K31/4025—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil not condensed and containing further heterocyclic rings, e.g. cromakalim
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- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/55—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole
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- Vascular Medicine (AREA)
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- Hydrogenated Pyridines (AREA)
- Medicines Containing Material From Animals Or Micro-Organisms (AREA)
Abstract
抑制血管平滑肌细胞移动的方法,该方法包括给需要治疗的人或其它哺乳动物使用有效剂量的式(I)化合物或其药学上适用的盐或溶剂化物,其中R1和R3独立地为氢、-CH3、(a)和(b),其中Ar是任意取代的苯基;R2选自吡咯烷子基、六亚甲基亚氨基或哌啶子基。
Description
背景技术
细胞移动在伤口愈合、炎症、成人呼吸窘迫综合征及恶性肿瘤发病中起着重要作用(Savani等,J.Clin,Invest.95:1158-1168,1995;Kullmann等:Am J.Respir.Cell.Mol.Biol.8:83-88,1993;Brooks等,Cell:79,1157-1164,1994)。血管平滑肌细胞由介质向内膜的移动在新内膜形成中起至关重要的作用,这是导致的血管疾病的致病机理,这些血管疾病如动脉粥样硬化、PTCA后再狭窄及静脉旁路动脉粥样硬化(Jackson等,Arteriosclerosis and Thrombosis13:1218-1226,1993;Brown等,Cardiovascular Res.28:1815-1820,1995;Bell和Madri等,Am.J.Pathol.137:7-12,1990)。在血管受伤的动物模型中已发现,使用刺激平滑肌细胞移动的生长因子的抗体或使用阻断整联因子(integrin)介导细胞移动的肽可以抑制新内膜形成(Ferns等,Science 253:1129-1132,1991,Choi等,J.Vasc.Surg.19:125-135,1994)。
经皮经腔冠状动脉成形术(PTCA)后血管再狭窄表明为组织反应,其特征是分为早期和晚期。血栓形成和/或血管痉挛发生在早期,在PTCA后几小时至几天内发生。晚期似乎由SMC移动、增殖及血管再造所支配。在这种疾病中,由介质向内膜的移动造成的SMC积累的增加是这种疾病的主要病理机制。血管平滑肌细胞的过量增殖及移动可能是PTCA、动脉切开术、激光血管成形术及动脉旁路移植手术后冠状动脉再栓塞的主要机理。见《平滑肌细胞的内膜增殖-经皮冠状动脉成形术后复发冠状动脉狭窄的解释》,Austin等,Journal of the AmericanCollege of Cardiology 8:369-375(1985年8月)。
通过经皮经腔冠状动脉成形术(PTCA)、动脉切开术、激光血管成形术及动脉旁路移植手术对栓塞动脉进行外科手术后,血管再栓塞仍是主要的、长期的并发症。进行PTCA的病人约有35%在术后三至六个月内发生再狭窄。目前治疗血管再狭窄的办法包括用器械如斯坦特固定模进行器械介入或药物疗法,包括使用肝素、低分子量肝素、香豆素、阿斯匹林、鱼油、钙离子拮抗剂、甾类及前列环素。这些方法不能控制再栓塞率,不能有效地治疗和预防血管再狭窄。参见《经皮经腔冠状动脉成形术后预防再狭窄:“魔微粒”的研究》,Hermans等,AmericanHeart Journal 122:171-187(1991年7月)。
再狭窄的发病机理:由于血液和损伤动脉血管壁中细胞成份产生的生长因子造成过量的细胞增殖和移动,这些又介导血管再狭窄中平滑肌细胞的增殖。
能抑制平滑肌细胞移动的药物可用于治疗和预防再狭窄。本发明提供了应用化合物作为平滑肌细胞移动抑制剂。
发明概述
本发明提供了抑制人或其它哺乳动物受试者血管平滑肌细胞移动的方法,该方法包括给所述受试者使用药学上有效剂量的式I化合物及其药用盐及溶剂化物,其中R1和R3独立地为氢、-CH3、
其中Ar是任意取代的苯基;
R2选自吡咯烷子基(pyrrolidino)、六亚甲基亚氨基或哌啶子基。
发明详述
本发明涉及发现所选式I化合物可用于抑制血管平滑肌细胞移动。本发明提供的治疗方法是给需要的人或其它哺乳动物一定剂量能有效抑制血管平滑肌细胞移动的式I或式II化合物或其药用盐或溶剂化物。
术语“抑制”包括其通常可接受的含义,包括给经受平滑肌细胞移动的病人预防性治疗,及防止和/或治疗现存的平滑肌细胞移动。这样,本方法包括适当的药物治疗和/或预防给药。
通常,将本发明化合物与普通的赋形剂、稀释剂或载体一起配制,并压制成片剂,或者配制成方便口服给药的酏剂或溶液剂;或者通过肌内或静脉途径给药的溶液剂。该化合物可以经皮给药,并且可以配制成缓释剂型等。
本发明方法所使用的式I化合物可以按已有的方法(例如US4,133,814、4,418,068和4,380,635中所述的方法,这些专利引入本文作为参考)制备。一般,该方法用具有6-羟基和2-(4-羟苯基)基团的苯并[b]噻吩开始。将起始化合物保护、烷基化并脱保护,得到式I化合物。在上述美国专利中提供了这些化合物的制备实例。
取代的苯基包括由C1-C6烷基、C1-C4烷氧基、羟基、硝基、氯、氟或三(氯或氟)甲基一次或二次取代的苯基。
用于本发明方法的化合物可以与多种有机和无机酸、碱生成药学上适用的酸和碱加成盐,药学上适用的酸和碱加成盐包括通常用于药物化学中的生理上适用的盐。所述盐也包括在本发明的范围内。用于生成上述盐的典型的无机酸包括盐酸、氢溴酸、氢碘酸、硝酸、硫酸、磷酸、连二磷酸等。可以应用由有机酸生成的盐,有机酸包括脂肪族一或二羧酸、苯基取代的链烷酸、羟基链烷酸和羟基链烷二酸,芳香族酸,脂肪族和芳香族磺酸。因此所述药学适用的盐包括乙酸盐、苯基乙酸盐、三氟乙酸盐、丙烯酸盐、抗坏血酸盐、苯甲酸盐、氯代苯甲酸盐、二硝基苯甲酸盐、羟基苯甲酸盐、甲氧基苯甲酸盐、甲基苯甲酸盐、邻-乙酰氧基苯甲酸盐、萘-2-苯甲酸盐、溴化物、异丁酸盐、苯基丁酸盐、β-羟基丁酸盐、丁炔-1,4-二酸盐、己炔-1,4-二酸盐、癸酸盐、辛酸盐、氯化物、肉桂酸盐、柠檬酸盐、甲酸盐、富马酸盐、羟基乙酸盐、庚酸盐、马尿酸盐、乳酸盐、苹果酸盐、马来酸盐、羟基马来酸盐、丙二酸盐、扁桃酸盐、甲磺酸盐、烟酸盐、异烟酸盐、硝酸盐、草酸盐、邻苯二甲酸盐、对苯二甲酸盐、磷酸盐、磷酸一氢盐、磷酸二氢盐、偏磷酸盐、焦磷酸盐、丙炔酸盐、丙酸盐、苯基丙酸盐、水杨酸盐、癸二酸盐、琥珀酸盐、辛二酸盐、硫酸盐、硫酸氢盐、焦硫酸盐、亚硫酸盐、亚硫酸氢盐、磺酸盐、苯磺酸盐、对溴苯磺酸盐、氯代苯磺酸盐、乙烷磺酸盐、2-羟基乙烷磺酸盐、甲磺酸盐、萘-1-磺酸盐、萘-2-磺酸盐、对甲苯磺酸盐、二甲苯磺酸盐、酒石酸盐等。优选的盐是盐酸盐。
药学上适用的酸加成盐一般可通过式I化合物与等摩尔或过量的酸反应制得。反应物通常于互溶剂如乙醚或苯中进行反应。盐一般在约1小时~10天内从溶液中析出,并且可以经过滤分离,或者按常规方法除去溶剂。
通常用于生成盐的碱包括氢氧化铵、碱金属和碱土金属氢氧化物、碳酸盐和碳酸氢盐、以及脂族和芳族胺、脂族二胺及羟基烷胺。用于制备加成盐的碱尤其包括氢氧化铵、碳酸钾、碳酸氢钠、氢氧化钙、甲胺、二乙胺、乙二胺、环己胺及乙醇胺。
与化合物(由该化合物衍生得到盐)相比较,药学上适用的盐通常有提高的溶解度性质,因此通常更适用于配制成液剂或乳剂。
药物制剂可按本技术领域已知的方法制备。例如,将化合物与常用的赋形剂、稀释剂或载体一起配制,并可配制成片剂、胶囊剂、混悬液剂、粉剂等。适用于上述制剂的赋形剂、稀释剂和载体包括:填充剂和增容剂如淀粉、糖、甘露糖醇以及硅衍生物;粘合剂如羧甲基纤维素和其他的纤维素衍生物,藻酸盐、明胶和聚乙烯吡咯烷酮;湿润剂如甘油;崩解剂如琼脂、碳酸钙和碳酸氢钠;阻滞溶解剂如石蜡;吸收促进剂如季铵化合物;表面活性剂如鲸蜡醇、单硬脂酸甘油酯;吸附载体如高岭土和膨润土;以及润滑剂如滑石、硬脂酸钙和硬脂酸镁以及固体聚乙二醇。
本发明的化合物也可以配制成方便口服给药的酏剂或溶液剂,或者配制成适于非经胃肠道(如经肌内、皮下或静脉途径)给药的溶液剂。另外,本发明化合物还非常适用于配制成缓释剂型等。缓释制剂可以这样构成,以使它们仅仅或最好在肠道的特定部位,可能在一定时间内释放活性成分。包衣、包膜和保护基质可以由例如聚合物质或蜡制成。
根据本发明,抑制平滑肌细胞迁移而需使用的式I化合物的具体剂量取决于由主治医师确定的病症严重程度、给药途径及相关因素。通常可接受并有效的日剂量为约0.1至约1000毫克/天,更典型的是约50至200毫克/天。可每天一次或三次给需要所述治疗的患者施用此剂量,或者根据需要增加给药次数,以有效抑制平滑肌细胞迁移。
为了治疗血管平滑肌细胞移动或再狭窄,可以通过多种技术在发病部位或接近发病部位局部施用有效抑制剂量的活性化合物。局部给药技术的实例不是要限制而旨在说明现有技术。实例包括导管局部给药、位点特异载体、移植物、直接注射或直接施用。
通过导管局部给药是将药物制剂直接施用于损伤部位。使用气囊导管进行局部给药的实例见EP 383 492 A2及US 4636(Wolinsky,1987年1月13日)。
通过移植物局部给药是指通过手术将含药物制剂的骨架植入损伤部位,被植入的骨架通过扩散、化学反应或溶剂活化剂释放药物制剂。见Lange,Science 249:1527-1533(1990年9月)。
通过移植物局部给药的一个实例是使用斯坦特固定模。该模通过机械作用防止冠状动脉萎陷或再梗塞。将药物制剂加入该模可直接将药物转运到发病部位。通过此项技术的局部给药见Kohn,PharmaceuticalTechnology(1990年10月)。
给药系统的另一实例是将含药剂的聚合物以液体形式注射到损伤部位。聚合物随即就地形成移植物而起治疗作用。此技术描述于PCTWO 90/03768(Donn,1990年4月19日)。
另一实例是通过聚合物内腔包封输送药物。此技术使用插管将聚合物移植物涂在腔的内表面。于是掺入生物可降解聚合物移植物中的药物在手术部位释放。参见PCT WO 90/01969(Schindler,1989年8月23日)。
通过移植物局部给药的最后一个实例是将囊泡或微粒直接注射入发病部位。这些微粒可以由蛋白质、脂、碳水化合物或合成聚合物组成。这些微粒中或在其外做为包衣中掺有药物。含微粒给药系统的描述见Lange,Science 249:1527-1533(1990年9月)及Mathiowitz等,J.App.Poly.Sci.,26:809(1981)。
通过位点特异载体的局部给药是指将药物附着在载体上,然后将其直接引导至损伤部位。该给药技术的实例包括使用载体如蛋白质配位体或单克隆抗体。见Lange,Science 249:1527-1533(9月)。
直接施用的局部给药包括局部给药方法的使用。通过直接施用的局部给药的实例为在手术过程中将药物直接施于动脉旁路移植物上。
如应用带有碱性基团(如哌啶子基环)的药物时惯用其酸加成盐一样,通常优选应用式I化合物的酸加成盐形式。通过口服途径给老年人(如绝经妇女)施用该化合物也是有利的。为此目的,以下口服剂型是适用的。
制剂
在以下制剂中,“活性成分”是指式1化合物。
制剂1:明胶胶囊剂
硬明胶胶囊剂按下面方法制备:
成分 量(mg/胶囊)
活性成分 0.1-1000
淀粉,NF 0-650
可流动的淀粉粉末 0-650
聚硅氧烷流体(350厘沲) 0-15将上述成分混合,通过美国45号筛并将其装入硬明胶胶囊。其中所述化合物为雷洛昔芬的具体胶囊剂实例包括下列制剂:制剂2:雷洛昔芬胶囊剂成分 量(mg/胶囊)雷洛昔芬 1淀粉,NF 112可流动的淀粉粉末 225.3聚硅氧烷流体(350厘沲) 1.7制剂3:雷洛昔芬胶囊剂成分 量(mg/胶囊)雷洛昔芬 5淀粉,NF 108可流动的淀粉粉末 225.3聚硅氧烷流体(350厘沲) 1.7制剂4:雷洛昔芬胶囊剂成分 量(mg/胶囊)雷洛昔芬 10淀粉,NF 103可流动的淀粉粉末 225.3聚硅氧烷流体(350厘沲) 1.7制剂5:雷洛昔芬胶囊剂成分 量(mg/胶囊)雷洛昔芬 50淀粉,NF 150可流动的淀粉粉末 397聚硅氧烷流体(350厘沲) 3.0按照提供的合理的改变,可以将上述具体的配方进行变化。用下述成分制备片剂:制剂6:片剂成分 量(mg/片)活性成分 0.1-1000微晶纤维素 0-650煅制的二氧化硅 0-650硬脂酸 0-15将上述成分混合并压制成片剂。另外,每片含0.1-1000mg活性成分的片剂可以按下法制备:制剂7:片剂成分 量(mg/片)活性成分 0.1-1000淀粉 45微晶纤维素 35聚乙烯吡咯烷酮(为10%的水溶液) 4羧甲基纤维素钠 4.5硬脂酸镁 0.5滑石 1
将活性成分、淀粉和纤维素通过美国45号筛,并充分地混合。使聚乙烯吡咯烷酮溶液与得到的粉末混合。然后再通过美国14号筛。得到的颗粒于50~60℃干燥并通过美国18号筛。将预先通过美国60号筛的羧甲基淀粉钠、硬脂酸镁和滑石加到颗粒中,在混合以后将其在压片机上压制成片剂。
每5ml剂量含0.1-1000mg药物的混悬液剂可按下示制备:
制剂8:混悬液剂
成分 量(mg/5ml)
活性成分 0.1-1000mg
羧甲基纤维素钠 50mg
糖浆 1.25mg
苯甲酸溶液 0.10ml
调味剂 适量
着色剂 适量
纯水 加至5ml
将活性成分通过美国45号筛并与羧甲基纤维素钠和糖浆混合得到调匀的膏状物。将苯甲酸溶液、调味剂和着色剂用一定量的水稀释并边搅拌边加入其中,然后加入足够的水至所需的体积。
测试方法
本发明化合物具有抑制血管平滑肌移动的能力,证明如下:
猪主动脉平滑肌细胞
在当地屠宰场从刚屠宰的雄性被阉割猪中获取猪主动脉。用类似于上述方法(Bonin等,1989年)制备平滑肌细胞。简言之,纵向切割主动脉,用切片刀轻轻刮腔表面以除去内皮。然后,,在灭菌的、由达尔伯克氏改良伊格尔培养基(DMEM)、10%牛胎血清、L-谷氨酰胺(2mM)、青霉素(100U/ml)及链霉素(100μg/ml)组成的生长培养基中,将该主动脉清洗几次。再从外膜将中间平滑肌细胞条剥离并切成1-2mm的小片。将此移植物置于装有上述生长培养基的24孔培养皿中。在5-7天内,观察移植物上细胞的生长情况。10-14天后,取出移植物,使细胞受胰蛋白酶作用,并在装有15ml此生长培养基的T75烧杯中传代培养。
人平滑肌细胞
从Clonetics Corporation(San Diego,CA)购买人冠状动脉及主动脉平滑肌细胞。按猪平滑肌细胞所述,将所述两种细胞培养于生长培养基中。
平滑肌细胞移动试验
用改进的Boyden氏趋化试验装置进行猪及人主动脉平滑肌细胞对于血小板生长因子梯度的直接移动试验,该Boyden氏趋化试验装置使用96转移孔(transwell)系统和带有8μm孔的聚碳酸酯过滤器(NeuroProbe,Inc.,Cabin John,NJ)。将生长于T75烧瓶中的平滑肌细胞转移至无酚红的含有2%牛胎血清、L-谷氨酰胺(2mM)、青霉素(100U/ml)及链霉素(100μg/ml)的达尔伯克氏改良伊格尔培养基/F12培养基(DMEM/F-12)中。24小时后,用无酚红胰蛋白酶/EDTA(Gibco,BRL)使细胞受胰蛋白酶作用。将此细胞(2.5×106个/ml)悬浮于含1%贫血小板血浆的、不同浓度的式I化合物的、无酚红的DMEM/F12中。将100μl细胞悬液加到改进的Boyden氏趋化试验装置上面的孔中。Boyden氏趋化试验装置下面的孔中装有含1%贫血小板血浆、5ng/ml PDGF及不同浓度化合物的43μl DMEM/F-12。Boyden氏趋化试验装置在37℃、5% CO2气氛下孵育5小时。由Boyden氏趋化试验装置中取下移动膜并用棉签移除膜上部的细胞。在甲醇中固定移动至膜下部的细胞并用Diff-Quick染色液(Baxter)染色。用微量滴定板计数器(ThermoMax,Molecular Dynamics,Inc.)以分光光度法或通过倒置显微镜(Nikon,Inc.)在40倍高倍视野(HPF)下进行细胞计数来定量测定细胞移动。
试验中细胞与化合物预孵育时,药物以确定的浓度加入预处理培养基中,并分别在烧瓶中孵育18小时。在这些预处理试验中,细胞的试验条件应与所述急性药物作用试验中所用条件完全相同。
表I
血小板衍生生长因子(PDGF)刺激
猪主动脉平滑肌细胞(SMC)移动
PDGF(ng/ml) SMC移动
(O.D.650nm)
0.04 0.016±0.008
0.80 0.009±0.003
1.50 0.013±0.007
3.00 0.028±0.008
6.00 0.058±0.010
12.0 0.052±0.007
25.0 0.047±0.009
表II
化合物A*及β-雌二醇对PDGF
引起的猪主动脉SMC移动的抑制
SMC移动
(O.D.650nm)
浓度(nM) 化合物A β-雌二醇
0.0 0.053±0.015 0.053±0.015
0.1 0.035±0.005 0.032±0.003
1.0 0.030±0.005 0.023±0.003
10 0.032±0.007 0.034±0.006
*化合物A为R1及R3为氢而R2为哌啶子基的式I化合物。
上述活性试验表明,本发明化合物抑制血管平滑肌细胞移动及其作用是有效的。
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US08/457,700 US5622975A (en) | 1995-06-01 | 1995-06-01 | Methods for inhibiting vascular smooth muscle cell migration |
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US5811447A (en) | 1993-01-28 | 1998-09-22 | Neorx Corporation | Therapeutic inhibitor of vascular smooth muscle cells |
US6515009B1 (en) | 1991-09-27 | 2003-02-04 | Neorx Corporation | Therapeutic inhibitor of vascular smooth muscle cells |
US5770609A (en) | 1993-01-28 | 1998-06-23 | Neorx Corporation | Prevention and treatment of cardiovascular pathologies |
US6251920B1 (en) | 1993-05-13 | 2001-06-26 | Neorx Corporation | Prevention and treatment of cardiovascular pathologies |
US6491938B2 (en) | 1993-05-13 | 2002-12-10 | Neorx Corporation | Therapeutic inhibitor of vascular smooth muscle cells |
US6197789B1 (en) | 1995-06-07 | 2001-03-06 | Neorx Corporation | Prevention and treatment of cardiovascular pathologies with tamoxifen analogues |
US5843974A (en) * | 1995-06-06 | 1998-12-01 | Eli Lilly And Company | Methods of inhibiting melanoma using Benzothiophenes as cytotoxic agents per se |
US5811437A (en) * | 1996-05-21 | 1998-09-22 | Eli Lilly And Company | Methods of increasing nitric oxide synthesis |
US5747509A (en) * | 1996-06-03 | 1998-05-05 | Schering Aktiengesellschaft | Method for lowering plasma levels of lipoprotein(a) |
US6124260A (en) * | 1998-09-30 | 2000-09-26 | Cedars-Sinai Medical Center | Inhibition of smooth muscle cell migration by Tenascin-C peptides |
ATE301129T1 (de) | 1999-05-04 | 2005-08-15 | Strakan Int Ltd | Androgen glykoside und die androgenische aktivität davon |
US8236048B2 (en) * | 2000-05-12 | 2012-08-07 | Cordis Corporation | Drug/drug delivery systems for the prevention and treatment of vascular disease |
US6776796B2 (en) | 2000-05-12 | 2004-08-17 | Cordis Corportation | Antiinflammatory drug and delivery device |
US20040243097A1 (en) * | 2000-05-12 | 2004-12-02 | Robert Falotico | Antiproliferative drug and delivery device |
ATE343969T1 (de) | 2000-09-29 | 2006-11-15 | Cordis Corp | Beschichtete medizinische geräte |
US20020051730A1 (en) * | 2000-09-29 | 2002-05-02 | Stanko Bodnar | Coated medical devices and sterilization thereof |
US20020111590A1 (en) * | 2000-09-29 | 2002-08-15 | Davila Luis A. | Medical devices, drug coatings and methods for maintaining the drug coatings thereon |
US7195640B2 (en) * | 2001-09-25 | 2007-03-27 | Cordis Corporation | Coated medical devices for the treatment of vulnerable plaque |
US7108701B2 (en) * | 2001-09-28 | 2006-09-19 | Ethicon, Inc. | Drug releasing anastomosis devices and methods for treating anastomotic sites |
US20030065377A1 (en) * | 2001-09-28 | 2003-04-03 | Davila Luis A. | Coated medical devices |
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