CN112451482A - Method of treating osteoarthritis - Google Patents
Method of treating osteoarthritis Download PDFInfo
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- CN112451482A CN112451482A CN202011376640.4A CN202011376640A CN112451482A CN 112451482 A CN112451482 A CN 112451482A CN 202011376640 A CN202011376640 A CN 202011376640A CN 112451482 A CN112451482 A CN 112451482A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/10—Dispersions; Emulsions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/70—Carbohydrates; Sugars; Derivatives thereof
- A61K31/715—Polysaccharides, i.e. having more than five saccharide radicals attached to each other by glycosidic linkages; Derivatives thereof, e.g. ethers, esters
- A61K31/726—Glycosaminoglycans, i.e. mucopolysaccharides
- A61K31/728—Hyaluronic acid
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
- A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
- A61K35/28—Bone marrow; Haematopoietic stem cells; Mesenchymal stem cells of any origin, e.g. adipose-derived stem cells
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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
- A61K38/38—Albumins
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/02—Inorganic compounds
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P19/00—Drugs for skeletal disorders
- A61P19/02—Drugs for skeletal disorders for joint disorders, e.g. arthritis, arthrosis
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P19/00—Drugs for skeletal disorders
- A61P19/08—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
Abstract
The present invention relates to methods of treating osteoarthritis. In particular, the present invention relates to a cell therapy composition comprising: mesenchymal stem cells (which may be derived from, for example, umbilical cord or placenta), sodium hyaluronate, sodium chloride, sodium phosphate salt, and water. In another aspect, the invention relates to the use of the cell therapy composition in the manufacture of a medicament for the treatment of osteoarthritis and cartilage defects. The cell therapeutic composition of the present invention can be used for treating osteoarthritis, and exhibits excellent technical effects as described in the present invention.
Description
Technical Field
The present invention is in the field of medical biotechnology and relates to methods for the treatment and/or prevention of acute and/or chronic osteoarthrosis, pharmaceutical compositions for use in such methods, and the use of such compositions for the treatment of osteoarthritis. In particular, to methods and compositions for treating osteoarthritis using stem cells. The composition comprises mesenchymal stem cells, particularly the mesenchymal stem cells obtained from umbilical cords, and the umbilical cord mesenchymal stem cell composition for treating osteoarthritis has excellent performance as described in the specification.
Background
Osteoarthritis is the most common form of arthritis, characterized by a slow degenerative process of articular cartilage, subchondral bone, with marginal osteophyte formation and low levels of inflammation. It is believed that chronic forms of osteoarthritis affect 15% of the population. Of these, one quarter is severely disabled. The cause of most cases of osteoarthritis is unknown and is called "primary osteoarthritis". When the cause of osteoarthritis is known, it is called "secondary osteoarthritis". Secondary osteoarthritis results from other diseases or conditions. Conditions that may lead to secondary osteoarthritis include repeated damage or surgery to joint structures, joint abnormalities at birth (congenital abnormalities), gout, diabetes, and other hormonal disorders. Other forms of arthritis include systemic diseases such as rheumatoid arthritis and Systemic Lupus Erythematosus (SLE).
Osteoarthritis is primarily related to the hip, knee, spine and interphalangeal joints. The most common symptom of osteoarthritis is pain in the affected joints after repeated use. Joint pain is often more severe later in the day. The affected joint can swell, heat, and produce squeaking. The joints can also experience pain and stiffness after prolonged inactivity. In severe osteoarthritis, complete loss of cartilage pads results in friction between bones, causing pain at rest or pain with limited motion.
Osteoarthritis is characterized by a slow degradation of cartilage over several years. In normal cartilage, there is a delicate balance between synthesis and degradation of the matrix; however, in osteoarthritis, cartilage is degraded over synthesized. The balance between synthesis and degradation is affected by age and is regulated by several factors produced by synovium and chondrocytes, including cytokines, growth factors, aggrecanase (aggrecanase) and matrix metalloproteinases. In addition to water, the extracellular matrix contains proteoglycans, which are formed by glycosaminoglycans attached to a backbone formed by sodium hyaluronate and encapsulated (entrap) in a collagen framework or fibrillar matrix. One important proteoglycan in articular cartilage is aggrecan (aggrecan), which binds to sodium hyaluronate and helps to impart compressibility and elasticity to cartilage. Aggrecan is cleaved by aggrecanase, which results in its degradation and subsequent cartilage erosion. Loss of aggrecan in the cartilage matrix is one of the initial pathophysiological changes observed in Osteoarthritis (OA).
Sodium Hyaluronate (Sodium Hyaluronate), the molecular formula is (C14H20NNaO11) N, the weight average molecular weight is 80-120 ten thousand, and the Sodium Hyaluronate is a high molecular polysaccharide biological material formed by repeatedly alternating N-acetylglucosaminic acid. Sodium hyaluronate is the main component of joint synovial fluid and is one of the components of cartilage matrix. Has lubricating effect in joint cavity, and can cover and protect joint cartilage, improve joint contracture, inhibit cartilage degeneration surface, improve pathological joint fluid, and increase lubricating function. Sodium hyaluronate provides viscoelasticity to synovial fluid as a lubricant and shock absorber. In synovial fluid, sodium hyaluronate covers the surface of articular cartilage and shares the deep space in cartilage with collagen fibrils (collagen fibrils) and proteoglycan sulfate. It protects the cartilage and prevents proteoglycan loss from the cartilage matrix to the synovial fluid, maintaining a normal cartilage matrix. Sodium hyaluronate, glycosaminoglycan and keratan sulfate are present in lower concentrations in synovial fluid of knee joints suffering from osteoarthritis than in synovial fluid of normal knee joints. Furthermore, experiments using rabbit synoviocytes have shown that the proinflammatory cytokines IL-1 β and TNF- α stimulate the expression of sodium hyaluronate synthase, which can lead to the global fragmentation of sodium hyaluronate under inflammatory conditions. Exogenous sodium hyaluronate may be beneficial in the production of newly synthesized sodium hyaluronate. Sodium hyaluronate and derivatives have been used as a therapeutic adjunct in the treatment of osteoarthritis to increase the lubricity of the articulating surfaces and thereby reduce joint pain. Several in vitro culture studies have also shown that sodium hyaluronate has a beneficial effect by inhibiting chondrolysis mediated by fibronectin fragments. Sodium hyaluronate has also been shown to have anti-inflammatory effects, as well as inhibitory effects on prostaglandin synthesis and proteoglycan release and degradation.
Sodium hyaluronate is widely used in the treatment of knee osteoarthritis. Two general investigations in the uk have shown that about 15% of patients with osteoarthritis have received intra-articular treatment with the sodium hyaluronate preparation. It can replace synovial fluid due to its viscoelasticity. In addition, it may also reduce the perception of pain. Beneficial molecular and cellular effects have also been reported. Sodium hyaluronate is often administered by intra-articular injection, however there is contradiction in the evidence for its clinical relevance. A recent systematic review and integrated analysis (meta-analysis) was published in the prior art, the authors concluded that intra-articular sodium hyaluronate had at best a minimal effect, whereas a clinically significant effect was an increase in the visual analogue score of pain of at least 15 mm. These data form the basis for intra-articular administration of sodium hyaluronate to osteoarthritis patients. Sometimes, efficacy is observed only after one year of injection, and in some experiments 3-5 injections per week are necessary.
Mesenchymal Stem Cells (MSCs) are a heterogeneous group of cells derived from a matrix, and can be obtained from most tissues of the human body. A large number of experimental researches show that the mesenchymal stem cells have epidermal cell differentiation potential and can promote the healing of the wounded skin. The bone marrow derived mesenchymal stem cells are not suitable for batch preparation because of the hidden danger of virus pollution, and the cell number, the amplification and differentiation capacity of the bone marrow derived mesenchymal stem cells are obviously reduced along with the age increase of donors. The mesenchymal stem cells derived from human umbilical cord, placenta or amnion successfully avoid a plurality of limitations of embryonic stem cell source deficiency, variant rejection, moral ethics and the like, and become a good substitute of the bone marrow-derived mesenchymal stem cells; they have self-renewal, tissue repair, immunoregulatory ability, and can differentiate into mesodermal lineage, such as adipocytes, osteocytes, chondrocytes, etc., and also into other mesodermal lineage cells, such as epidermal cells, vascular endothelial cells; and the cells are easy to expand in vitro, and the differentiation capacity and the proliferation capacity are kept stable after expansion, so that the method is suitable for large-scale preparation.
There are known literature reports of the use of mesenchymal stem cells or sodium hyaluronate for the treatment of osteoarthritis. However, when the two are combined and successfully applied to clinics, a plurality of technical problems need to be faced. Accordingly, it would be highly desirable to provide a method and composition comprising mesenchymal stem cells and sodium hyaluronate and useful for the treatment of osteoarthritis.
Disclosure of Invention
The object of the present invention is to provide a method and composition for treating osteoarthritis using stem cells, particularly a cell therapy composition that can be used for the treatment of osteoarthritis and cartilage defects by intra-articular injection, more particularly, a ready-to-use stem cell composition for the treatment of osteoarthritis by injection. It has been surprisingly found that the compositions of the present invention have excellent properties.
The invention is realized by the following scheme.
In a first aspect of the invention, there is provided the use of a cell therapy composition in the manufacture of a medicament for the treatment of osteoarthritis and cartilage defects, the cell therapy composition comprising: mesenchymal stem cells (which may be abbreviated as MSCs, the source of which may be, for example, umbilical cord or placenta), human serum albumin, sodium hyaluronate, sodium chloride, sodium phosphate salt, and water.
The use according to the first aspect of the present invention, wherein the density of the mesenchymal stem cells in the cell therapy composition is 0.5 to 2X 107one/mL, for example, 0.5 to 1.5X 107one/mL, for example, 0.75 to 1.25X 107one/mL.
The use according to the first aspect of the invention, wherein the concentration of human serum albumin in the cytotherapeutic composition is 0.5%.
The use according to the first aspect of the present invention, wherein the concentration of the sodium hyaluronate in the cell therapeutic composition is 0.2 to 0.8%. For example, 0.3 to 0.7%. When% is referred to in the present invention, it means mass/volume percentage, as not otherwise specified.
The use according to the first aspect of the present invention, wherein the concentration of the sodium chloride in the cell therapy composition is 0.6 to 1.0%. For example, 0.7 to 0.9%.
The use according to the first aspect of the present invention, wherein in the cell therapy composition, the sodium phosphate salt is a salt of phosphoric acid with sodium hydroxide. In one embodiment, the phosphate concentration of the sodium phosphate salt is 5 to 10 mmol/L. In one embodiment, the phosphate concentration of the sodium phosphate salt is 6 to 9 mmol/L. In one embodiment, the sodium phosphate salt is monosodium phosphate or disodium phosphate or a combination thereof.
The use according to the first aspect of the present invention, wherein the cell therapy composition further comprises sodium aspartate. In one embodiment, the cell therapy composition comprises 0.1-0.4% sodium aspartate, such as 0.2-0.3% sodium aspartate, such as 0.25% sodium aspartate.
The use according to the first aspect of the present invention, wherein in the cell therapy composition, gallic acid is further contained. In one embodiment, the cell therapy composition comprises 0.02-0.05% gallic acid, for example comprises 0.03-0.04% gallic acid, for example comprises 0.035% gallic acid.
The use according to the first aspect of the invention, wherein the pH of the cell therapy composition is 6.5 to 7.2.
The use according to the first aspect of the invention, wherein the cytotherapeutic composition further comprises an acid-base modifier, such as hydrochloric acid and/or sodium hydroxide, for example, in an amount such that the pH of the cytotherapeutic composition is 6.5 to 7.2.
The use according to the first aspect of the present invention, wherein said cell therapy composition is prepared according to a method comprising the steps of:
(1) preparing a first displacement liquid and a second displacement liquid;
(2) thawing the frozen cells in a 37 ℃ water bath, and centrifuging at 1000-1500 rpm for 2-5 minutes;
(3) after centrifugation, discarding supernatant liquid to retain precipitated cells, adding an appropriate amount of first replacement liquid to suspend the cells, and centrifuging at 1000-1500 rpm for 1-3 minutes; after centrifugation, discarding supernatant liquid to retain precipitated cells, adding an appropriate amount of first replacement liquid again to suspend the cells, and centrifuging at 1000-1500 rpm for 1-3 minutes;
(4) after centrifugation, the supernatant is discarded and the precipitated cells are retained, and a second replacement solution is added to make the cells to be 0.5-2 × 107Suspending at a concentration of one/mL, and subpackaging to obtain the composition;
wherein the first displacement fluid comprises the following components: human serum albumin, sodium chloride, sodium phosphate salt, sodium aspartate, gallic acid and water, wherein the second replacement fluid comprises the following components: human serum albumin, sodium hyaluronate, sodium chloride, sodium phosphate salt, sodium aspartate, gallic acid and water.
The use according to the first aspect of the present invention, wherein the temperature of the first displacement fluid and the second displacement fluid before mixing with the cells is 20 to 25 ℃.
The use according to the first aspect of the invention, wherein the cell therapy composition is prepared under sterile conditions.
The use according to the first aspect of the present invention, wherein the cell therapy composition is a sterile liquid for injectable use prepared under sterile conditions.
Use according to the first aspect of the invention, wherein the first displacement fluid comprises the following components: 0.5% of human serum albumin, 0.6-1.0% of sodium chloride, sodium phosphate with the concentration of phosphate radical being 5-10 mmol/L, 0.1-0.4% of sodium aspartate, 0.02-0.05% of gallic acid and water.
Use according to the first aspect of the invention, wherein the first displacement fluid comprises the following components: 0.5% of human serum albumin, 0.7-0.9% of sodium chloride, sodium phosphate with the concentration of phosphate radical being 6-9 mmol/L, 0.2-0.3% of sodium aspartate, 0.03-0.04% of gallic acid and water.
Use according to the first aspect of the invention, wherein the second displacement fluid comprises the following components: 0.5% of human serum albumin, 0.2-0.8% of sodium hyaluronate, 0.6-1.0% of sodium chloride, sodium phosphate salt with the concentration of phosphate radical being 5-10 mmol/L, 0.1-0.4% of sodium aspartate, 0.02-0.05% of gallic acid and water.
Use according to the first aspect of the invention, wherein the second displacement fluid comprises the following components: 0.5% of human serum albumin, 0.3-0.7% of sodium hyaluronate, 0.7-0.9% of sodium chloride, sodium phosphate with the concentration of phosphate radical being 6-9 mmol/L, 0.2-0.3% of sodium aspartate, 0.03-0.04% of gallic acid and water.
The use according to the first aspect of the present invention, wherein the first replacement fluid and the second replacement fluid further comprise an acid-base modifier, such as hydrochloric acid and/or sodium hydroxide, for example, in an amount such that the pH of the cell therapy composition, the first replacement fluid and the second replacement fluid is 6.5 to 7.2. Hydrochloric acid and/or sodium hydroxide as pH modifier may be in solution, for example 2M in concentration.
The use according to the first aspect of the invention, wherein the first replacement fluid and the second replacement fluid are pre-sterilized prior to use in the formulation of the cell therapy composition.
In the present invention, the formulation of the first displacement fluid and the second displacement fluid is readily manipulated by one skilled in the art, for example, in one embodiment, the basic operation may generally be: adding 80% of injection water into the calculated solid materials except human serum albumin to completely dissolve the solid materials, adjusting the pH value of the solution to 6.5-7.2 by using an acid-base regulator if necessary, adding 90% of injection water into the mixture volume, then carrying out hot-pressing sterilization at 121 ℃ for 10-15 minutes, cooling, adding a specified amount of sterile human serum albumin under the aseptic operation condition, adding the injection water to the full amount, and uniformly mixing to obtain the injection.
Further, the second aspect of the present invention provides a cell therapy composition for treating osteoarthritis and cartilage defects, comprising: mesenchymal stem cells (which may be abbreviated as MSCs, the source of which may be, for example, umbilical cord or placenta), human serum albumin, sodium hyaluronate, sodium chloride, sodium phosphate salt, and water.
The cell therapy composition according to the second aspect of the present invention, wherein the density of the mesenchymal stem cells is 0.5 to 2X 107one/mL, for example, 0.5 to 1.5X 107one/mL, for example, 0.75 to 1.25X 107one/mL.
The cytotherapeutic composition according to the second aspect of the present invention, wherein the concentration of human serum albumin is 0.5%.
The cell therapy composition according to the second aspect of the present invention, wherein the concentration of the sodium hyaluronate is 0.2-0.8%. For example, 0.3 to 0.7%. When% is referred to in the present invention, it means mass/volume percentage, as not otherwise specified.
The cell therapy composition according to the second aspect of the present invention, wherein the concentration of sodium chloride is 0.6 to 1.0%. For example, 0.7 to 0.9%.
According to the cell therapy composition of the second aspect of the present invention, the sodium phosphate salt is a salt of phosphoric acid with sodium hydroxide. In one embodiment, the phosphate concentration of the sodium phosphate salt is 5 to 10 mmol/L. In one embodiment, the phosphate concentration of the sodium phosphate salt is 6 to 9 mmol/L. In one embodiment, the sodium phosphate salt is monosodium phosphate or disodium phosphate or a combination thereof.
The cell therapy composition according to the second aspect of the present invention, further comprising sodium aspartate. In one embodiment, the cell therapy composition comprises 0.1-0.4% sodium aspartate, such as 0.2-0.3% sodium aspartate, such as 0.25% sodium aspartate.
The cell therapeutic composition according to the second aspect of the present invention, further comprising gallic acid. In one embodiment, the cell therapy composition comprises 0.02-0.05% gallic acid, for example comprises 0.03-0.04% gallic acid, for example comprises 0.035% gallic acid.
The cell therapy composition according to the second aspect of the present invention has a pH of 6.5 to 7.2.
The cell therapy composition according to the second aspect of the present invention, further comprises an acid-base modifier, such as hydrochloric acid and/or sodium hydroxide, for example, in an amount such that the pH of the cell therapy composition is 6.5 to 7.2.
The cell therapy composition according to the second aspect of the present invention is prepared according to a method comprising the steps of:
(1) preparing a first displacement liquid and a second displacement liquid;
(2) thawing the frozen cells in a 37 ℃ water bath, and centrifuging at 1000-1500 rpm for 2-5 minutes;
(3) after centrifugation, discarding supernatant liquid to retain precipitated cells, adding an appropriate amount of first replacement liquid to suspend the cells, and centrifuging at 1000-1500 rpm for 1-3 minutes; after centrifugation, discarding supernatant liquid to retain precipitated cells, adding an appropriate amount of first replacement liquid again to suspend the cells, and centrifuging at 1000-1500 rpm for 1-3 minutes;
(4) after centrifugation, the supernatant is discarded and the precipitated cells are retained, and a second replacement solution is added to make the cells to be 0.5-2 × 107Suspending at a concentration of one/mL, and subpackaging to obtain the composition;
wherein the first displacement fluid comprises the following components: human serum albumin, sodium chloride, sodium phosphate salt, sodium aspartate, gallic acid and water, wherein the second replacement fluid comprises the following components: human serum albumin, sodium hyaluronate, sodium chloride, sodium phosphate salt, sodium aspartate, gallic acid and water.
The cell therapy composition according to the second aspect of the present invention is prepared under aseptic conditions.
The cell therapy composition according to the second aspect of the present invention is a sterile liquid for injectable use prepared under sterile conditions.
The use according to the first aspect of the present invention, wherein the temperature of the first displacement fluid and the second displacement fluid before mixing with the cells is 20 to 25 ℃.
The cell therapy composition according to the second aspect of the present invention, the first replacement fluid comprises the following components: 0.5% of human serum albumin, 0.6-1.0% of sodium chloride, sodium phosphate with the concentration of phosphate radical being 5-10 mmol/L, 0.1-0.4% of sodium aspartate, 0.02-0.05% of gallic acid and water.
The cell therapy composition according to the second aspect of the present invention, the first replacement fluid comprises the following components: 0.5% of human serum albumin, 0.7-0.9% of sodium chloride, sodium phosphate with the concentration of phosphate radical being 6-9 mmol/L, 0.2-0.3% of sodium aspartate, 0.03-0.04% of gallic acid and water.
The cell therapy composition according to the second aspect of the present invention, the second replacement fluid comprises the following components: 0.5% of human serum albumin, 0.2-0.8% of sodium hyaluronate, 0.6-1.0% of sodium chloride, sodium phosphate salt with the concentration of phosphate radical being 5-10 mmol/L, 0.1-0.4% of sodium aspartate, 0.02-0.05% of gallic acid and water.
The cell therapy composition according to the second aspect of the present invention, the second replacement fluid comprises the following components: 0.5% of human serum albumin, 0.3-0.7% of sodium hyaluronate, 0.7-0.9% of sodium chloride, sodium phosphate with the concentration of phosphate radical being 6-9 mmol/L, 0.2-0.3% of sodium aspartate, 0.03-0.04% of gallic acid and water.
According to the cell therapy composition of the second aspect of the present invention, the first replacement fluid and the second replacement fluid further contain an acid-base modifier, such as hydrochloric acid and/or sodium hydroxide, for example, in an amount such that the pH values of the cell therapy composition, the first replacement fluid and the second replacement fluid are 6.5 to 7.2. Hydrochloric acid and/or sodium hydroxide as pH modifier may be in solution, for example 2M in concentration.
The cell therapy composition according to the second aspect of the present invention, the first replacement fluid and the second replacement fluid are previously sterilized before being used for preparing the cell therapy composition.
The cell therapy composition according to the second aspect of the present invention, the first replacement fluid and the second replacement fluid are prepared as follows: adding 80% of injection water into the calculated solid materials except human serum albumin to completely dissolve the solid materials, adjusting the pH value of the solution to 6.5-7.2 by using an acid-base regulator if necessary, adding 90% of injection water into the mixture volume, then carrying out hot-pressing sterilization at 121 ℃ for 10-15 minutes, cooling, adding a specified amount of sterile human serum albumin under the aseptic operation condition, adding the injection water to the full amount, and uniformly mixing to obtain the injection.
Further, the third aspect of the present invention provides a replacement fluid for use in formulating a cell therapy composition, comprising the following components: 0.5% of human serum albumin, 0.6-1.0% of sodium chloride, sodium phosphate with the concentration of phosphate radical being 5-10 mmol/L, 0.1-0.4% of sodium aspartate, 0.02-0.05% of gallic acid and water.
The substitution liquid according to the third aspect of the invention comprises the following components: 0.5% of human serum albumin, 0.7-0.9% of sodium chloride, sodium phosphate with the concentration of phosphate radical being 6-9 mmol/L, 0.2-0.3% of sodium aspartate, 0.03-0.04% of gallic acid and water.
The substitution liquid according to the third aspect of the invention comprises the following components: 0.5% of human serum albumin, 0.2-0.8% of sodium hyaluronate, 0.6-1.0% of sodium chloride, sodium phosphate salt with the concentration of phosphate radical being 5-10 mmol/L, 0.1-0.4% of sodium aspartate, 0.02-0.05% of gallic acid and water.
The substitution liquid according to the third aspect of the invention comprises the following components: 0.5% of human serum albumin, 0.3-0.7% of sodium hyaluronate, 0.7-0.9% of sodium chloride, sodium phosphate with the concentration of phosphate radical being 6-9 mmol/L, 0.2-0.3% of sodium aspartate, 0.03-0.04% of gallic acid and water.
The replacement liquid according to the third aspect of the present invention further includes an acid-base modifier, such as hydrochloric acid and/or sodium hydroxide, for example, in an amount such that the pH of the replacement liquid is 6.5 to 7.2. Hydrochloric acid and/or sodium hydroxide as pH modifier may be in solution, for example 2M in concentration.
The replacement fluid according to the third aspect of the present invention, which has been previously subjected to sterilization treatment before use in the preparation of the cell therapy composition.
A substitution solution according to the third aspect of the present invention, which is prepared as follows: adding 80% of injection water into the calculated solid materials except human serum albumin to completely dissolve the solid materials, adjusting the pH value of the solution to 6.5-7.2 by using an acid-base regulator if necessary, adding 90% of injection water into the mixture volume, then carrying out hot-pressing sterilization at 121 ℃ for 10-15 minutes, cooling, adding a specified amount of sterile human serum albumin under the aseptic operation condition, adding the injection water to the full amount, and uniformly mixing to obtain the injection.
The replacement liquid according to the third aspect of the present invention may be referred to as a first replacement liquid containing no sodium hyaluronate, and may be referred to as a second replacement liquid containing sodium hyaluronate.
A replacement fluid according to the third aspect of the present invention, which produces a cytotherapeutic composition comprising: mesenchymal stem cells (which may be abbreviated as MSCs, the source of which may be, for example, umbilical cord or placenta), human serum albumin, sodium hyaluronate, sodium chloride, sodium phosphate salt, and water.
According to the third aspect of the inventionA substitution solution prepared by using the mesenchymal stem cells in the cell therapy composition, wherein the density of the mesenchymal stem cells is 0.5-2 x 107one/mL, for example, 0.5 to 1.5X 107one/mL, for example, 0.75 to 1.25X 107one/mL.
The replacement fluid according to the third aspect of the present invention, wherein the human serum albumin is present in a concentration of 0.5% in the cytotherapeutic composition.
The replacement fluid according to the third aspect of the present invention is a cell therapy composition comprising sodium hyaluronate in a concentration of 0.2 to 0.8%. For example, 0.3 to 0.7%. When% is referred to in the present invention, it means mass/volume percentage, as not otherwise specified.
The replacement fluid according to the third aspect of the present invention is a cell therapy composition comprising 0.6 to 1.0% by weight of sodium chloride. For example, 0.7 to 0.9%.
The replacement fluid according to the third aspect of the present invention, wherein the cell therapy composition further comprises sodium aspartate. In one embodiment, the cell therapy composition comprises 0.1-0.4% sodium aspartate, such as 0.2-0.3% sodium aspartate, such as 0.25% sodium aspartate.
The replacement solution according to the third aspect of the present invention, wherein the cell therapy composition further contains gallic acid. In one embodiment, the cell therapy composition comprises 0.02-0.05% gallic acid, for example comprises 0.03-0.04% gallic acid, for example comprises 0.035% gallic acid.
The replacement fluid according to the third aspect of the present invention is a cell therapy composition having a pH of 6.5 to 7.2.
According to the substitution solution of the third aspect of the present invention, the cytotherapeutic composition further comprises an acid-base modifier, such as hydrochloric acid and/or sodium hydroxide, for example, in an amount such that the pH of the cytotherapeutic composition is 6.5 to 7.2.
According to the replacement fluid of the third aspect of the present invention, the cytotherapeutic composition is prepared by a method comprising the steps of:
(1) preparing a first displacement liquid and a second displacement liquid;
(2) thawing the frozen cells in a 37 ℃ water bath, and centrifuging at 1000-1500 rpm for 2-5 minutes;
(3) after centrifugation, discarding supernatant liquid to retain precipitated cells, adding an appropriate amount of first replacement liquid to suspend the cells, and centrifuging at 1000-1500 rpm for 1-3 minutes; after centrifugation, discarding supernatant liquid to retain precipitated cells, adding an appropriate amount of first replacement liquid again to suspend the cells, and centrifuging at 1000-1500 rpm for 1-3 minutes;
(4) after centrifugation, the supernatant is discarded and the precipitated cells are retained, and a second replacement solution is added to make the cells to be 0.5-2 × 107Suspending at a concentration of one/mL, and subpackaging to obtain the composition;
wherein the first displacement fluid comprises the following components: human serum albumin, sodium chloride, sodium phosphate salt, sodium aspartate, gallic acid and water, wherein the second replacement fluid comprises the following components: human serum albumin, sodium hyaluronate, sodium chloride, sodium phosphate salt, sodium aspartate, gallic acid and water.
According to the replacement fluid of the third aspect of the present invention, the cell therapy composition is prepared under aseptic conditions.
According to the replacement fluid of the third aspect of the present invention, the cell therapy composition is a sterile liquid for injectable use prepared under sterile conditions.
The temperature of the replacement solution according to the third aspect of the present invention is 20 to 25 ℃ before mixing with the cells.
In the present invention, the displacement fluid, including the first displacement fluid and the second displacement fluid, may be referred to as a composition. In the present invention, the composition can be used for preparing a cell therapy composition. Thus, in some embodiments of the invention, there is provided the use of a composition formulated as a first replacement fluid or a second replacement fluid in the preparation of a cell therapy composition for the treatment of osteoarthritis.
The cell therapy composition of the present invention is an aqueous suspension comprising sodium chloride at a concentration substantially equivalent to that of physiological saline. The normal saline is sodium chloride solution with osmotic pressure equal to that of animal or human plasma, which is commonly used in physiological experiments or clinic. Therefore, the mesenchymal stem cells in the cell therapy composition of the present invention are basically dispersed in physiological saline, i.e., sodium chloride solution with a mass volume percentage of 0.9%, and the osmotic pressure of the composition is consistent with that of human tissues, and the mesenchymal stem cells are not damaged by using the physiological saline as a solvent.
In one embodiment of the present invention, the sodium phosphate salt is sodium dihydrogen phosphate and disodium hydrogen phosphate in a weight ratio of 1: 1.
In the invention, the mesenchymal stem cells are primary to tenth generation mesenchymal stem cells.
In the cell therapeutic composition of the present invention, the mesenchymal stem cell may be derived from various known routes, for example, it may be derived from bone marrow, umbilical cord or placenta.
In the cell therapeutic composition of the present invention, the method for obtaining mesenchymal stem cells is well known, and for example, the method described in CN102586184A (2012100446386) is referred to as a method for obtaining mesenchymal stem cells from placenta.
In the cell therapeutic composition of the present invention, the method for obtaining mesenchymal stem cells is well known, and for example, refer to the method described in CN102660497A (2012101599162) for obtaining mesenchymal stem cells from umbilical cord.
In the present invention, for example, the method for obtaining mesenchymal stem cells comprises the following steps (placenta-derived):
(a) washing the placental lobules sufficiently with PBS buffer to remove residual blood from the placenta;
(b) cutting placenta lobule into pieces, adding PBS buffer solution containing tissue digestive enzyme, and incubating and digesting at 37 deg.C;
(c) filtering the tissue mass with a copper mesh, grinding if necessary to facilitate filtration;
(d) centrifuging the collected filtrate, separating mononuclear cells, suspending the obtained cells in MSC medium, and then adding 5% CO at 37 deg.C2Culturing in an incubator;
(e) after the cells are scattered to form clones, selecting each clone cell, respectively culturing by using an MSC culture medium, and after the cells are fused, digesting and passaging by using pancreatin to obtain the placenta mesenchymal stem cell. Passaging was performed if necessary and/or frozen in liquid nitrogen for future use.
In the present invention, for example, the method for obtaining mesenchymal stem cells comprises the following steps (umbilical cord-derived):
(1) umbilical cord tissue adherence treatment: taking cell culture plates, spreading the tissue blocks in the plates, and keeping the number of the tissue blocks in each plate at 5-20, so that the tissue blocks are air-dried for 2-50 minutes until the tissue is attached to the plates;
(2) umbilical cord tissue culture: slowly adding a mesenchymal stem cell culture medium along the edge of the plate until the tissue is submerged; placing the plate in CO2Culturing in a 5% culture box at 37 deg.C, taking out the plate from the culture box when culturing for 3-7 days, and supplementing with appropriate amount of mesenchymal stem cell culture medium; removing the culture medium in the plate on days 9-11, adding a proper amount of fresh mesenchymal stem cell culture medium, and continuously culturing; removing all umbilical cord tissue pieces and continuing culturing on days 11-13; then, the liquid is changed once every 1 to 3 days;
(3) cell passage: when the fusion rate of adherent cells in the dish reaches 50-70%, the adherent cells are separated from the bottom of the dish by using TrypLE Express; centrifuging, removing supernatant, adding mesenchymal stem cell culture medium to resuspend cells, inoculating to a T25 cell culture bottle, and performing passage and amplification culture; and then, changing the liquid every 1 to 3 days until the fusion rate reaches 70 to 90 percent, thus obtaining the umbilical cord mesenchymal stem cells. Passaging was performed if necessary and/or frozen in liquid nitrogen for future use. Detecting one or more of the following items of the obtained mesenchymal stem cells when necessary: cell viability, cell contamination, genetic disease, HLA-ABC/DR match.
In the present invention, the dispensing of the prepared cell therapy composition means that the prepared cell therapy composition is dispensed into a pre-filled syringe, particularly, a disposable pre-filled syringe.
According to the use of the first aspect of the present invention, in the cell therapy composition, the syringe of the prefilled syringe is made of a polymer (e.g., polypropylene) and the piston is made of rubber, and in the embodiment of the present invention, as not particularly illustrated, the syringe of the prefilled syringe is made of a polymer (e.g., polypropylene) and the piston is made of rubber. Prefilled syringes were first introduced during world war ii in order to meet the field sterile medical needs of field hospitals. The re-forced marketing of prefilled syringes was in the early 50 s of the last century when Becton Dickinson provided glass prefilled syringes for the polio vaccine program of Jonas Salks, Rooibos. Thereafter, prefilled syringes continue to be used, mostly in the field of insulin and human growth hormone administration. However, the real prevalence of pre-filled syringes has been in the past 5 years, almost becoming a product that must be provided by the injection supplier. While most of the innovative liquid drugs, if appropriate, will be marketed in prefilled syringes. Pre-filled syringes are especially appealing due to the advantages of the product itself, especially ease of use. The pharmaceutical market is changing, biotechnological therapies and the number of drug candidates that can be administered only by injection route is increasing, and they are involved in a very wide range of therapeutic fields, such as multiple sclerosis, infertility, osteoporosis, hepatitis, rheumatoid arthritis, cancer, anemia and hemophilia. Some biotech drugs require frequent administration by the patient himself, who benefits most deeply from the convenience of a prefilled syringe, since the prefilled syringe saves some handling steps and allows a faster and easier use. The need of the patient is a real motivation to advance the development of prefilled syringes. The metering of a drug from a vial into a syringe is a time consuming task and is prone to error by persons lacking adequate training. In addition, patients with certain diseases such as rheumatoid arthritis often have difficulty, if not even being able to hold a stable vial and measure out the correct dose. Pharmaceutical manufacturers have changed some drugs from lyophilized to liquid dosage forms to fill prefilled syringes, for example Berlex's therapeutic multiple sclerosis drug Betaseron, norkino's human auxin Norditropin, and gene tack's human auxin Nutropin have all changed from lyophilized to liquid dosage forms to fill prefilled syringes for sale. Syringe component manufacturers are speeding up to meet the ever increasing demand for ready-to-use components. The ready-to-use plunger from Stelmi, France and the Hypak SCF prefilled syringe from Becton Dickinson, make filling on-site unnecessary for cleaning, depyrogenation and sterilization operations. The ready-to-use element can be directly used after being cleaned, sterilized by ethylene oxide or gamma rays and verified. Another advantage of prefilled syringes is that the amount of product overfill can be significantly reduced. By using the prefilled syringe, 10%, 15%, and sometimes even 20% of the drug substance can be saved. Some manufacturers that change vials to prefilled syringes also reduce the bulk drug yield because the new dosage form no longer requires as much bulk drug. One study by Becton Dickinson showed that the dose in a prefilled syringe can be 23% higher than a vial because there is less drug loss during transfer from vial to syringe.
The cell therapy composition of mesenchymal stem cells provided by the present invention is preferably an injectable composition, which is in an injection liquid state at normal temperature, the injection solution being suitable for intra-articular administration (percutaneous injection) to the intra-articular of a mammalian subject, preferably a human patient. For example, the cell therapeutic compositions of mesenchymal stem cells provided by the present invention are also suitable for topical administration (transdermal injection into or near an inflamed joint of a mammalian subject, preferably a human patient), wherein the topical administration injection involves the epidermis, muscle or any deep organ.
The present invention provides a cell therapeutic composition of mesenchymal stem cells, which can improve osteoarthropathy-related symptoms, such as relieving osteoarticular pain, improving joint mobility and/or function, reducing inflammatory effusion in joints, and the like, by intra-articular administration of the pharmaceutical composition to a mammalian subject, particularly a human patient.
The present invention also relates to a method for the treatment and/or prevention of a condition selected from the above-mentioned diseases or symptoms, in particular osteoarthritis, comprising the steps of: a sufficient amount of a cell therapeutic composition of mesenchymal stem cells of the invention is administered to a mammalian subject (preferably a human patient) by intra-articular administration, particularly in the knee, hip and spine of the mammalian subject (preferably a human patient).
At present, sodium hyaluronate is widely applied to clinic, including drugs used in injection forms, so that the addition of sodium hyaluronate into the composition for injection administration can be accepted clinically.
In the above-described steps of the preparation method of the present invention, although the specific steps described therein are distinguished in some detail or in language description from the steps described in the preparation examples of the detailed embodiments below, those skilled in the art can fully summarize the above-described method steps in light of the detailed disclosure throughout the present disclosure.
Any embodiment of any aspect of the invention may be combined with other embodiments, as long as they do not contradict. Furthermore, in any embodiment of any aspect of the invention, any feature may be applicable to that feature in other embodiments, so long as they do not contradict. The invention is further described below.
All documents cited herein are incorporated by reference in their entirety and to the extent such documents do not conform to the meaning of the present invention, the present invention shall control. Further, the various terms and phrases used herein have the ordinary meaning as is known to those skilled in the art, and even though such terms and phrases are intended to be described or explained in greater detail herein, reference is made to the term and phrase as being inconsistent with the known meaning and meaning as is accorded to such meaning throughout this disclosure.
The cell therapy composition of mesenchymal stem cells provided by the invention has one or more excellent properties as described herein.
Detailed Description
The present invention will be further described by the following examples, however, the scope of the present invention is not limited to the following examples. It will be understood by those skilled in the art that various changes and modifications may be made to the invention without departing from the spirit and scope of the invention. The present invention has been described generally and/or specifically with respect to materials used in testing and testing methods. Although many materials and methods of operation are known in the art for the purpose of carrying out the invention, the invention is nevertheless described herein in as detail as possible. The following examples further illustrate the invention without limiting it. Herein, the mesenchymal stem cells used in the experiments were mesenchymal stem cells of the fifth generation, unless otherwise specified. Herein, umbilical cord mesenchymal stem cells used in the experiments are mesenchymal stem cells obtained from umbilical cord by the method described in reference to CN102660497A (2012101599162), unless otherwise specified. In this context, the placental mesenchymal stem cells used in the experiments are mesenchymal stem cells obtained from the placenta by the method described in reference to CN102586184A (2012100446386), unless otherwise specified. In the experiments of the present invention, 2M hydrochloric acid and/or 2M sodium hydroxide were used when a pH adjuster was used, as not specifically mentioned. In the experiments of the present invention, the preparation of the cell therapy composition was conducted under aseptic conditions, unless otherwise specified. The cell therapy composition may be dispensed into pre-filled syringes in an amount of 0.5 to 3ml per dose in the present invention, and in the present embodiment 1ml per dose as not illustrated. In the following specific examples, sodium phosphate salts used were, as not specifically mentioned, sodium dihydrogen phosphate and disodium hydrogen phosphate in a weight ratio of 1: 1, and phosphate concentration as described in the specific examples.
Example 1 cell therapy composition of umbilical cord MSCs
The proportion of the ingredients of the final product is as follows:
mesenchymal stem cells (fifth generation): 1X 107The amount of the active carbon is one/mL,
human serum albumin: 0.5 percent of the total weight of the mixture,
sodium hyaluronate: 0.5 percent of the total weight of the mixture,
sodium chloride: 0.8 percent of the total weight of the mixture,
sodium dihydrogen phosphate/disodium hydrogen phosphate combination: the concentration of phosphate radical is 7.5mmol/L,
sodium aspartate: 0.25 percent of the total weight of the mixture,
and (3) gallic acid: 0.035 percent of the total weight of the powder,
pH value: 6.7 to 7.0 parts by weight,
water for injection: and (4) the balance.
The preparation method comprises the following steps:
(1) preparing a first displacement liquid and a second displacement liquid; dissolving sodium chloride, sodium dihydrogen phosphate/disodium hydrogen phosphate combination, sodium aspartate, and gallic acid in water to obtain solution containing the above components with the above formula ratio and pH value, and sterilizing at 121 deg.C under hot pressure for 12 min to obtain first replacement solution; dissolving sodium hyaluronate, sodium chloride, sodium dihydrogen phosphate/disodium hydrogen phosphate combination, sodium aspartate, and gallic acid in water to obtain solution containing the above substances with the above formula ratio and pH value, and performing autoclave sterilization at 121 deg.C for 12 min to obtain second replacement solution; the temperature of the first replacement liquid and the second replacement liquid before mixing with cells is 20-25 ℃ ([ sodium chloride, sodium dihydrogen phosphate/disodium hydrogen phosphate combination, sodium aspartate, gallic acid are dissolved in 80% of the volume of the ingredients of water for injection, pH value is adjusted by using an acid-base regulator if necessary to prepare a solution containing the substances according to the above formula proportion and pH value, water for injection is added until the volume of the ingredients is 90%, then the solution is treated by hot-pressing sterilization at 121 ℃ for 10-15 minutes, a specified amount of sterile human albumin is added under the aseptic operation condition after cooling, water for injection is supplemented until the total amount is reached, and the first replacement liquid is obtained after uniform mixing; dissolving sodium hyaluronate, sodium chloride, sodium dihydrogen phosphate/disodium hydrogen phosphate combination, sodium aspartate and gallic acid in 80% of the volume of the ingredients of water for injection, adjusting the pH value by using an acid-base regulator if necessary to prepare a solution containing the substances according to the above formula proportion and the pH value, adding water for injection to the volume of the ingredients of 90%, carrying out hot-pressing sterilization at 121 ℃ for 10-15 minutes, cooling, adding a specified amount of sterile human serum albumin under the aseptic operation condition, supplementing the water for injection to the full volume, and uniformly mixing to obtain a second replacement solution; the temperature of the first replacement liquid and the second replacement liquid before mixing with the cells is 20-25 ℃; the formulation of the first displacement fluid was the same as the formulation listed for the composition above except that it did not contain stem cells and sodium hyaluronate; the formulation of the second replacement fluid was the same as that listed for the composition except that it did not contain stem cells
(2) Thawing the frozen cells in a 37 ℃ water bath, and centrifuging at 1200rpm for 4 minutes;
(3) after the centrifugation is finished, removing supernatant liquid, reserving precipitated cells, adding an appropriate amount of first replacement liquid to suspend the cells, and centrifuging at 1200rpm for 2 minutes; after the centrifugation is finished, discarding supernatant liquid to retain precipitated cells, adding an appropriate amount of first replacement liquid again to suspend the cells, and centrifuging at 1200rpm for 2 minutes;
(4) after centrifugation, the supernatant is discarded to retain the precipitated cells, a second displacement solution is added to suspend the cells at the concentration specified by the above formula, and the suspension is dispensed (into pre-filled syringes) to obtain the cell therapeutic composition. The composition can be frozen in a refrigerator at 4 ℃ for clinical application.
Example 2 cell therapy composition of umbilical cord MSCs
The proportion of the ingredients of the final product is as follows:
mesenchymal stem cells (third generation): 1.25X 107The amount of the active carbon is one/mL,
human serum albumin: 0.5 percent of the total weight of the mixture,
sodium hyaluronate: 0.3 percent of the total weight of the mixture,
sodium chloride: 0.9 percent of the total weight of the mixture,
sodium dihydrogen phosphate/disodium hydrogen phosphate combination: the concentration of phosphate radical is 6mmol/L,
sodium aspartate: 0.3 percent of the total weight of the mixture,
and (3) gallic acid: 0.03 percent of the total weight of the mixture,
pH value: 6.7 to 7.0 parts by weight,
water for injection: and (4) the balance.
The preparation method comprises the following steps:
(1) preparing a first displacement liquid and a second displacement liquid; [ preparation by reference to example 1 respectively ]
(2) Thawing the frozen cells in a water bath at 37 ℃, and centrifuging at 1500rpm for 2 minutes;
(3) after the centrifugation is finished, discarding supernatant liquid to retain precipitated cells, adding an appropriate amount of first replacement liquid to suspend the cells, and centrifuging at 1000rpm for 3 minutes; after the centrifugation is finished, discarding supernatant liquid to retain precipitated cells, adding an appropriate amount of first replacement liquid again to suspend the cells, and centrifuging at 1000rpm for 3 minutes;
(4) after centrifugation, the supernatant is discarded to retain the precipitated cells, a second displacement solution is added to suspend the cells at the concentration specified by the above formula, and the suspension is dispensed (into pre-filled syringes) to obtain the cell therapeutic composition. The composition can be frozen in a refrigerator at 4 ℃ for clinical application.
Example 3 cell therapeutic composition of umbilical cord MSCs
The proportion of the ingredients of the final product is as follows:
mesenchymal stem cells (passage seven): 0.75X 107The amount of the active carbon is one/mL,
human serum albumin: 0.5 percent of the total weight of the mixture,
sodium hyaluronate: 0.7 percent of the total weight of the mixture,
sodium chloride: 0.7 percent of the total weight of the mixture,
sodium dihydrogen phosphate/disodium hydrogen phosphate combination: the concentration of phosphate radical is 9mmol/L,
sodium aspartate: 0.2 percent of the total weight of the mixture,
and (3) gallic acid: 0.04 percent of the total weight of the mixture,
pH value: 6.7 to 7.0 parts by weight,
water for injection: and (4) the balance.
The preparation method comprises the following steps:
(1) preparing a first displacement liquid and a second displacement liquid; [ preparation by reference to example 1 respectively ]
(2) Thawing the frozen cells in 37 ℃ water bath, and centrifuging at 1000rpm for 5 minutes;
(3) after the centrifugation is finished, discarding supernatant liquid to retain precipitated cells, adding an appropriate amount of first replacement liquid to suspend the cells, and centrifuging at 1500rpm for 1 minute; after the centrifugation is finished, discarding supernatant liquid to retain precipitated cells, adding an appropriate amount of first replacement liquid again to suspend the cells, and centrifuging at 1500rpm for 1 minute;
(4) after centrifugation, the supernatant is discarded to retain the precipitated cells, a second displacement solution is added to suspend the cells at the concentration specified by the above formula, and the suspension is dispensed (into pre-filled syringes) to obtain the cell therapeutic composition. The composition can be frozen in a refrigerator at 4 ℃ for clinical application.
Example 4 cell therapeutic composition of umbilical cord MSCs
The proportion of the ingredients of the final product is as follows:
mesenchymal stemCell (passage 9): 0.5X 107The amount of the active carbon is one/mL,
human serum albumin: 0.5 percent of the total weight of the mixture,
sodium hyaluronate: 0.8 percent of the total weight of the mixture,
sodium chloride: 0.6 percent of the total weight of the mixture,
sodium dihydrogen phosphate/disodium hydrogen phosphate combination: the concentration of phosphate radical is 10mmol/L,
sodium aspartate: 0.1 percent of the total weight of the mixture,
and (3) gallic acid: 0.05 percent of the total weight of the mixture,
pH value: 6.7 to 7.0 parts by weight,
water for injection: and (4) the balance.
The preparation method comprises the following steps:
(1) preparing a first displacement liquid and a second displacement liquid; [ preparation by reference to example 1 respectively ]
(2) Thawing the frozen cells in a 37 ℃ water bath, and centrifuging at 1200rpm for 3 minutes;
(3) after the centrifugation is finished, removing supernatant liquid, reserving precipitated cells, adding an appropriate amount of first replacement liquid to suspend the cells, and centrifuging at 1200rpm for 2 minutes; after the centrifugation is finished, discarding supernatant liquid to retain precipitated cells, adding an appropriate amount of first replacement liquid again to suspend the cells, and centrifuging at 1200rpm for 2 minutes;
(4) after centrifugation, the supernatant is discarded to retain the precipitated cells, a second displacement solution is added to suspend the cells at the concentration specified by the above formula, and the suspension is dispensed (into pre-filled syringes) to obtain the cell therapeutic composition. The composition can be frozen in a refrigerator at 4 ℃ for clinical application.
Example 5 cell therapy composition of umbilical cord MSCs
The proportion of the ingredients of the final product is as follows:
mesenchymal stem cells (second generation): 1.5X 107The amount of the active carbon is one/mL,
human serum albumin: 0.5 percent of the total weight of the mixture,
sodium hyaluronate: 0.2 percent of the total weight of the mixture,
sodium chloride: 1 percent of the total weight of the mixture,
sodium dihydrogen phosphate/disodium hydrogen phosphate combination: the concentration of phosphate radical is 5mmol/L,
sodium aspartate: 0.4 percent of the total weight of the mixture,
and (3) gallic acid: 0.02 percent of the total weight of the mixture,
pH value: 6.7 to 7.0 parts by weight,
water for injection: and (4) the balance.
The preparation method comprises the following steps:
(1) preparing a first displacement liquid and a second displacement liquid; [ preparation by reference to example 1 respectively ]
(2) Thawing the frozen cells in a 37 ℃ water bath, and centrifuging at 1200rpm for 3 minutes;
(3) after the centrifugation is finished, removing supernatant liquid, reserving precipitated cells, adding an appropriate amount of first replacement liquid to suspend the cells, and centrifuging at 1200rpm for 2 minutes; after the centrifugation is finished, discarding supernatant liquid to retain precipitated cells, adding an appropriate amount of first replacement liquid again to suspend the cells, and centrifuging at 1200rpm for 2 minutes;
(4) after centrifugation, the supernatant is discarded to retain the precipitated cells, a second displacement solution is added to suspend the cells at the concentration specified by the above formula, and the suspension is dispensed (into pre-filled syringes) to obtain the cell therapeutic composition. The composition can be frozen in a refrigerator at 4 ℃ for clinical application.
Example 6 cell therapeutic composition of umbilical cord MSCs
The formulations and methods of examples 1-5 were followed, respectively, except that no sodium aspartate was added, to give 5 compositions (referred to as example 61-example 65 compositions, respectively).
Example 7 cell therapy composition of umbilical cord MSCs
The formulations and methods of examples 1-5 were followed, respectively, except that no gallic acid was added, to give 5 compositions (which may be referred to as example 71-example 75 compositions, respectively).
Example 8 cell therapeutic composition of umbilical cord MSCs
Following the formulations and methods of examples 1-5, respectively, except that neither sodium aspartate nor gallic acid was added, 5 compositions were obtained (referred to as example 81-example 85 compositions, respectively).
Example 21: determination of cell viability and cell survival
For all the cell therapeutic compositions prepared in examples 1 to 5 and examples 6 to 8 of the present invention, blue-stained cells (dead cells) and non-stained cells (live cells) were counted by a known trypan blue exclusion method, and the cell viability (CV, i.e., the proportion of live cells) of the compositions was calculated as follows:
cell viability (%). ratio-total number of viable cells/(total number of viable cells + total number of dead cells). times.100%
For each batch of the composition, the cell viability was determined as 0 as the cell viability (CV0) at the time of completion of the preparation; the composition was then left at a temperature of 4 ℃ for 48 hours, and the cell viability at 48 hours was measured (CV 48); the percentage obtained by multiplying the quotient obtained by dividing the cell viability at 48 hours by the cell viability at 0 hours by 100% is used as the cell survival (%) after the composition is left at 4 ℃ for 48 hours, and it may be referred to as SR value or SR48, etc., and is calculated as follows: SR48 (%) ═ CV48/CV 0X 100%
As a result: all the cell therapy compositions prepared in examples 1 to 5 and examples 6 to 8 had Cell Viability (CV) at 0 in the range of 96 to 100% (e.g., 98.8% and 99.2% for the compositions of example 1 and example 81, respectively), and there was no significant difference between the compositions; the SR48 of the total cell therapy composition formulated in examples 6-8 was in the range of 43-51%, e.g., SR48 of the composition of example 61 was 47.3%, while the SR48 of the total cell therapy composition formulated in examples 1-5 was in the range of 87-93%, e.g., SR48 of the composition of example 1 was 90.6%.
Thus, it has been unexpectedly found that, in the cell therapeutic composition of the present invention comprising human serum albumin, sodium hyaluronate, sodium chloride, phosphate and mesenchymal stem cells at concentrations thereof, when sodium aspartate and gallic acid are additionally simultaneously added, the cell survival stability of the composition stored at 4 ℃ can be significantly improved, and when both are not added or only are added, the cell survival stability is not clinically acceptable.
Example 22: determination of cell surface markers
All of The cell Therapy compositions of examples 1-5 and examples 6-8 herein were tested for cell surface markers by flow cytometry, and The cells were tested for markers meeting The following requirements in The marker assay according to The guidelines for assaying mesenchymal stem cells published in 2006 in The United states of "The International Society for Cellular Therapy (ISCT)": the markers CD73, CD90 and CD105 are positive in expression, and the expression rate is more than 95%; the markers CD11b, CD34, CD45, CD19 and HLA-DR have negative expression, and the expression rate is less than 2 percent. According to the measurement results, the detection results of the markers of all the cell compositions of the above examples 1-5 and 6-8 meet the standard requirements, the expression rates of the markers CD73, CD90 and CD105 are all more than 95%, and the expression rates of the markers CD11b, CD34, CD45, CD19 and HLA-DR are all less than 2%.
Example 23: sterility, mycoplasma, virus detection
And (3) sterility detection: according to 1101 direct inoculation method of four parts of the 2015 edition of Chinese pharmacopoeia, the cells are respectively inoculated in a thioglycollate fluid medium and a trypticase soytone liquid medium, and the inoculation amount of each cell is 0.2 mL. The thioglycollate fluid culture medium is placed in an incubator at 35 ℃ for culture, and the tryptone soy peptone liquid culture medium is placed in an incubator at 25 ℃ for culture and should meet the standard regulation.
And (3) detection of mycoplasma: according to the 3301 culture method of the four parts of the 2015 edition of Chinese pharmacopoeia, the bacterial suspension is inoculated into a mycoplasma liquid culture medium and a mycoplasma semi-fluid culture medium respectively, and the inoculation amount of each pipe is 0.2 mL. The culture medium is placed in an incubator at 35 ℃ for 7d, and after 7d, the culture medium is subcultured for 2 times, observed every day, and cultured for 21d, and the standard specification should be met.
And (3) virus detection: HIV, HBV, HCV and TP virology detection by adopting a PCR method should not be detected.
As a result: all of the cell therapy compositions of examples 1 to 5 and examples 6 to 8 were determined to have sterility test results in accordance with the standards of the pharmacopoeia, mycoplasma test results in accordance with the standards of the pharmacopoeia, and virus test results were not detected.
Example 24: examination of injection preparation
pH value: the pH values were determined according to the methods (appendix VI H of the second part of the pharmacopoeia 2010 edition) for all the cell therapy compositions of examples 1 to 5 and examples 6 to 8. As a result: the pH of all cell therapy compositions is in the range of 6.5 to 7.5, for example the pH of the composition of example 1 is 6.83.
Osmolality: the osmolality was determined according to the method (appendix IX G of the second part of the pharmacopoeia 2010) using all the cell therapy compositions of examples 1 to 5 and examples 6 to 8. Acceptable results for injectable preparations should generally be 250-350 mOsmol/Kg. As a result: the osmolality of all cell therapy compositions is in the range of 250-350 mOsmol/Kg, for example the osmolality of the composition of example 1 is 316 mOsmol/Kg.
The needle threading speed is as follows: the cell therapy composition was injected into a pre-filled syringe filled with 1ml of the cell therapy composition and returned to a room temperature of 20 ℃ and then the syringe was covered with a 28G needle (a needle having a small diameter to facilitate administration by intra-articular injection) and the syringe was pressed at a pressure of 2kg to discharge the liquid medicine, and the speed of penetration of the cell therapy composition was characterized by the flow rate (sec/ml). The empty needle speed of all the cell therapy compositions of examples 1-5 and examples 6-8 was determined to be in the range of 44-52 seconds/ml, for example, the needle penetration speed of the composition of example 1 was 47.3 seconds/ml. In addition, the applicant herein prepared the composition by referring to the formulation and preparation method described in example 3 of CN 110755452a (chinese patent application No. 201911159876.X), filled into a 1ml pre-filled syringe in the same manner as the present invention, and measured the needle penetration speed at room temperature of 20 ℃ according to the above method, which indicates that the composition obtained by the method of this document is far less convenient for clinical use than the composition of the present invention formulation.
The above results indicate that the composition of the present invention is well suited for administration by injection for the treatment of osteoarthritis.
The above-described embodiments are merely preferred embodiments for fully illustrating the present application, and the scope of the present application is not limited thereto. The equivalent substitution or change made by the person skilled in the art on the basis of the present application is within the protection scope of the present application. The protection scope of this application is subject to the claims.
Claims (10)
1. A cell therapy composition comprising: mesenchymal stem cells (which may be derived from, for example, umbilical cord or placenta), human serum albumin, sodium hyaluronate, sodium chloride, sodium phosphate salt, and water.
2. The cell therapy composition according to claim 1, wherein the density of the mesenchymal stem cells is 0.5 to 2 x 107one/mL, for example, 0.5 to 1.5X 107one/mL, for example, 0.75 to 1.25X 107Per mL; for example, the concentration of human serum albumin is 0.5%; for example, the concentration of the sodium hyaluronate is 0.2-0.8%, such as 0.3-0.7%; for example, the concentration of the sodium chloride is 0.6-1.0%; for example, 0.7 to 0.9%; for example, the sodium phosphate salt is a salt of phosphoric acid and sodium hydroxide, for example, the sodium phosphate salt has a phosphate concentration of 5 to 10mmol/L, for example, 6 to 9mmol/L, and for example, the sodium phosphate salt is sodium dihydrogen phosphate or disodium hydrogen phosphate or a combination thereof.
3. The cell therapy composition according to claim 1, further comprising sodium aspartate; for example, the cell therapy composition comprises 0.1-0.4% sodium aspartate, such as 0.2-0.3% sodium aspartate, such as 0.25% sodium aspartate; for example, gallic acid is also included in the cell therapy composition; for example, the cell therapy composition comprises 0.02-0.05% gallic acid, for example comprises 0.03-0.04% gallic acid, for example comprises 0.035% gallic acid; for example, the cell therapy composition has a pH of 6.5 to 7.2; for example, the cell therapy composition further comprises an acid-base regulator, such as hydrochloric acid and/or sodium hydroxide, for example, in an amount such that the pH of the cell therapy composition is 6.5 to 7.2.
4. The cytotherapeutic composition according to claim 1, which is prepared according to a method comprising the steps of:
(1) preparing a first displacement liquid and a second displacement liquid;
(2) thawing the frozen cells in a 37 ℃ water bath, and centrifuging at 1000-1500 rpm for 2-5 minutes;
(3) after centrifugation, discarding supernatant liquid to retain precipitated cells, adding an appropriate amount of first replacement liquid to suspend the cells, and centrifuging at 1000-1500 rpm for 1-3 minutes; after centrifugation, discarding supernatant liquid to retain precipitated cells, adding an appropriate amount of first replacement liquid again to suspend the cells, and centrifuging at 1000-1500 rpm for 1-3 minutes;
(4) after centrifugation, the supernatant is discarded and the precipitated cells are retained, and a second replacement solution is added to make the cells to be 0.5-2 × 107Suspending at a concentration of one/mL, and subpackaging to obtain the composition;
wherein the first displacement fluid comprises the following components: human serum albumin, sodium chloride, sodium phosphate salt, sodium aspartate, gallic acid and water, wherein the second replacement fluid comprises the following components: human serum albumin, sodium hyaluronate, sodium chloride, sodium phosphate salt, sodium aspartate, gallic acid and water.
5. The cell therapy composition according to claim 1, which is prepared under sterile conditions.
6. The cell therapy composition according to claim 1, which is a sterile liquid for injectable use prepared under sterile conditions.
7. The cytotherapeutic composition of claim 1, wherein the first displacement fluid and the second displacement fluid are at a temperature of 20 to 25 ℃ prior to mixing with the cells; for example, the first displacement fluid comprises the following components: 0.5% of human serum albumin, 0.6-1.0% of sodium chloride, sodium phosphate with the concentration of phosphate radical being 5-10 mmol/L, 0.1-0.4% of sodium aspartate, 0.02-0.05% of gallic acid and water; for example, the first displacement fluid comprises the following components: 0.5% of human serum albumin, 0.7-0.9% of sodium chloride, sodium phosphate with the concentration of phosphate radical being 6-9 mmol/L, 0.2-0.3% of sodium aspartate, 0.03-0.04% of gallic acid and water; for example, the second displacement fluid comprises the following components: 0.5% of human serum albumin, 0.2-0.8% of sodium hyaluronate, 0.6-1.0% of sodium chloride, sodium phosphate salt, wherein the concentration of phosphate radical is 5-10 mmol/L, 0.1-0.4% of sodium aspartate, 0.02-0.05% of gallic acid and water; for example, the second displacement fluid comprises the following components: 0.5% of human serum albumin, 0.3-0.7% of sodium hyaluronate, 0.7-0.9% of sodium chloride, sodium phosphate with the concentration of phosphate radical being 6-9 mmol/L, 0.2-0.3% of sodium aspartate, 0.03-0.04% of gallic acid and water; for example, the first replacement fluid and the second replacement fluid may further contain an acid-base modifier, such as hydrochloric acid and/or sodium hydroxide, for example, in an amount such that the pH of the cell therapy composition, the first replacement fluid, and the second replacement fluid is 6.5 to 7.2.
8. The cytotherapeutic composition of claim 1, wherein the first replacement fluid and the second replacement fluid are pre-sterilized prior to use in formulating the cytotherapeutic composition.
9. The cytotherapeutic composition of claim 1, wherein the first replacement fluid and the second replacement fluid are prepared by: adding 80% of injection water into the calculated solid materials except human serum albumin to completely dissolve the solid materials, adjusting the pH value of the solution to 6.5-7.2 by using an acid-base regulator if necessary, adding 90% of injection water into the mixture volume, then carrying out hot-pressing sterilization at 121 ℃ for 10-15 minutes, cooling, adding a specified amount of sterile human serum albumin under the aseptic operation condition, adding the injection water to the full amount, and uniformly mixing to obtain the injection.
10. Use of a cytotherapeutic composition according to any one of claims 1 to 9 for the manufacture of a medicament for the treatment of osteoarthritis and cartilage defects.
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