EP2146738A2 - Compositions de cicatrisation contenant des biomatériaux kératiniques - Google Patents

Compositions de cicatrisation contenant des biomatériaux kératiniques

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Publication number
EP2146738A2
EP2146738A2 EP08743024A EP08743024A EP2146738A2 EP 2146738 A2 EP2146738 A2 EP 2146738A2 EP 08743024 A EP08743024 A EP 08743024A EP 08743024 A EP08743024 A EP 08743024A EP 2146738 A2 EP2146738 A2 EP 2146738A2
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EP
European Patent Office
Prior art keywords
keratin derivative
kerateine
keratose
keratin
consists essentially
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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EP08743024A
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German (de)
English (en)
Inventor
Mark E. Van Dyke
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Wake Forest University Health Sciences
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Wake Forest University Health Sciences
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Application filed by Wake Forest University Health Sciences filed Critical Wake Forest University Health Sciences
Publication of EP2146738A2 publication Critical patent/EP2146738A2/fr
Withdrawn legal-status Critical Current

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Classifications

    • 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
    • A61K38/39—Connective tissue peptides, e.g. collagen, elastin, laminin, fibronectin, vitronectin, cold insoluble globulin [CIG]
    • 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
    • A61K9/0014—Skin, i.e. galenical aspects of topical compositions
    • 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
    • A61K9/06—Ointments; Bases therefor; Other semi-solid forms, e.g. creams, sticks, gels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
    • A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
    • A61L15/22—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons containing macromolecular materials
    • A61L15/32—Proteins, polypeptides; Degradation products or derivatives thereof, e.g. albumin, collagen, fibrin, gelatin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L26/00—Chemical aspects of, or use of materials for, wound dressings or bandages in liquid, gel or powder form
    • A61L26/0009—Chemical aspects of, or use of materials for, wound dressings or bandages in liquid, gel or powder form containing macromolecular materials
    • A61L26/0028—Polypeptides; Proteins; Degradation products thereof
    • A61L26/0047—Specific proteins or polypeptides not covered by groups A61L26/0033 - A61L26/0042
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/14—Macromolecular materials
    • A61L27/22—Polypeptides or derivatives thereof, e.g. degradation products
    • A61L27/227—Other specific proteins or polypeptides not covered by A61L27/222, A61L27/225 or A61L27/24
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P17/00—Drugs for dermatological disorders
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P17/00—Drugs for dermatological disorders
    • A61P17/02—Drugs for dermatological disorders for treating wounds, ulcers, burns, scars, keloids, or the like

Definitions

  • the present invention concerns keratin biomaterials and the use thereof in biomedical applications.
  • Li Shi-Zhen Bosset Cao Gang Mu. Materia Medica, a dictionary of Chinese herbs, written by Li Shi Zhen (1518-1593)). Over a 38-year period, he wrote a collection of 800 books known as the Ben Cao Gang Mu. These books were published in 1596, three years after his death. Among the more than 11 ,000 prescriptions described in these volumes, is a substance known as Xue Yu Tan, also known as Crinis Carbonisatus, that is made up of ground ash from pyrolized human hair. The stated indications for Xue Yu Tan were accelerated wound healing and blood clotting.
  • albuminoids albumin was a well known protein at that time
  • many different kinds of proteins were being discovered.
  • the word "keratin” appears in the literature to describe the material that made up hard tissues such as animal horns and hooves (keratin comes from the Greek “kera” meaning horn).
  • This new protein pointed scientists because it did not behave like other proteins.
  • the normal methods used for dissolving proteins were ineffective with keratin.
  • methods such as burning and grinding had been known for some time, many scientists and inventors were more interested in dissolving hair and horns in order to make better products.
  • An aspect of the present invention is a pharmaceutical composition
  • a pharmaceutical composition comprising a keratin derivative (e.g., keratose, kerateine, or a combination thereof) and optionally, at least one additional active ingredient (e.g., analgesics, antimicrobial agents, additional wound healing agents, etc.).
  • Another aspect of the present invention is a method for treating a wound (e.g., burns, abrasions, lacerations, incisions, pressure sores, puncture wounds, penetration wounds, gunshot wounds, crushing injuries, etc.) in a subject in need thereof comprising applying a keratin derivative to the wound in an amount effective to treat the wound.
  • said positively charged composition comprises, consists or consists essentially of a keratose, a kerateine, or combinations thereof.
  • the keratin derivative comprises, consists of or consists essentially of alpha keratose, gamma keratose, acidic alpha keratose, basic alpha keratose, acidic gamma keratose, basic gamma keratose, alpha kerateine, gamma kerateine, acidic alpha kerateine, basic alpha kerateine, acidic gamma kerateine, basic gamma kerateine, or combinations thereof.
  • the keratin derivative is applied to the wound in an amount effective to inhibit wound conversion, promote wound closure, or both.
  • the keratin derivative is topically applied.
  • the keratin derivative is applied by injection into the body of the subject.
  • a further aspect of the present invention is a method for treating a burn wound in a subject in need thereof comprising applying a keratin derivative to the wound in an amount effective to treat the burn wound.
  • said positively charged composition comprises, consists or consists essentially of a keratose, a kerateine, or combinations thereof.
  • the keratin derivative comprises, consists of or consists essentially of alpha keratose, gamma keratose, acidic alpha keratose, basic alpha keratose, acidic gamma keratose, basic gamma keratose, alpha kerateine, gamma kerateine, acidic alpha kerateine, basic alpha kerateine, acidic gamma kerateine, basic gamma kerateine, or combinations thereof.
  • the keratin derivative is applied to the wound in an amount effective to inhibit wound conversion, promote wound closure, or both.
  • the keratin derivative is topically applied.
  • the keratin derivative is applied by injection into the body of the subject.
  • a surgical or paramedic aid comprising: a solid, physiologically acceptable substrate; and a keratin derivative on the substrate.
  • the keratin derivative comprises, consists of or consists essentially of alpha keratose, gamma keratose, acidic alpha keratose, basic alpha keratose, acidic gamma keratose, basic gamma keratose, alpha kerateine, gamma kerateine, acidic alpha kerateine, basic alpha kerateine, acidic gamma kerateine, basic gamma kerateine, or combinations thereof.
  • a still further aspect of the present invention is a kit comprising a keratin derivative and a container in which said keratin derivative is packaged in sterile form.
  • the keratin derivative comprises, consists of or consists essentially of alpha keratose, gamma keratose, acidic alpha keratose, basic alpha keratose, acidic gamma keratose, basic gamma keratose, alpha kerateine, gamma kerateine, acidic alpha kerateine, basic alpha kerateine, acidic gamma kerateine, basic gamma kerateine, or combinations thereof.
  • Another aspect of the present invention is the use of a keratin derivative as described herein for the preparation of a composition or medicament for carrying out a method of treatment as described herein, or for making an article of manufacture as described herein.
  • Figure 1 Skin component cell proliferation. Keratinocytes (a) and fibroblasts (b) treated with soluble keratin biomaterials proliferate more readily than cells treated with media alone.
  • Figure 2. Changes in chemical burn wound area over time. Mice treated with phenol to induce a chemical burn experience a passivation of the wound site such that the normal course of wound growth does not occur.
  • FIG. 3 Burn wound area in pigs. Wound areas were determined by digital image analysis and normalized to the day zero values. Wounds treated with keratin gels did not increase in area appreciably in the first several days and healed more quickly than controls.
  • FIG. 1 Kaplan- Mayer Survival Graph: Time is presented in minutes on a logarithmic scale. All animals in the control group died within 60 minutes. One animal from the keratin and one from the HemCon® hemostatic bandage group was sacrificed upon recommendation of the animal care staff. Overall, keratin outperformed the other groups with only one death compared with 2 deaths in the QuikClot® hemostatic agent and HemCon® hemostatic bandage groups.
  • FIG. 1 Shed Blood: Blood loss is normalized to body weight and expressed as percentage of body weight. Keratin and QuikClot® hemostatic agent groups lost significantly (*) less blood than the control and HemCon® hemostatic bandage groups.
  • MAP Mean Arterial Pressure
  • HemCon® hemostatic bandage were able to stabilize the MAP around 80% of initial pressure. These differences were not statistically different compared to the control group.
  • SI Stress Index
  • the modified shock index was calculated by dividing heart rate by MAP. This index is clinically used to assess the severity of a shock, with low values being better.
  • the animals in the keratin group showed compensated low values over the entire study period, while QuikClot® hemostatic agent and HemCon® hemostatic bandage groups had similar values as the negative control. There was no statistical significance between the groups.
  • FIG. 8 Histological Assessment: Representative tissue sections stained with hematoxylin and eosin, 50x.
  • Cellular recognition is also an important characteristic of biomaterials that seek to mimic the ECM. Such recognition is facilitated by the binding of cell surface integrins to specific amino acid motifs presented by the constituent ECM proteins.
  • Predominant proteins include collagen and fibronectin, both of which have been extensively studied with regard to cell binding. Both proteins contain several regions that support attachment by a wide variety of cell types. It has been shown that, in addition to the widely know Arginine-Glycine- Aspartic Acid (RGD) motif, the "X"-Aspartic Acid-' ⁇ " motif on fibronectin is also recognized by the integrin ⁇ 4 ⁇ l, where X equals Glycine, Leucine, or Glutamic Acid, and Y equals Serine or Valine.
  • RGD Arginine-Glycine- Aspartic Acid
  • Keratin biomaterials derived from human hair contain these same binding motifs.
  • a search of the NCBI protein database revealed sequences for 71 discrete, unique human hair keratin proteins. Of these, 55 are from the high molecular weight, low sulfur, alpha-helical family. This group of proteins is often referred to as the alpha-keratins and is responsible for imparting toughness to human hair fibers.
  • These alpha-keratins have molecular weights greater than 40 kDa and an average cysteine (the main amino acid responsible for inter- and intramolecular protein bonding) content of 4.8 mole percent.
  • natural polymers that may be utilized in a similar fashion to the disclosed keratin preparations include, but are not limited to, collagen, gelatin, fibronectin, vitronectin, laminin, fibrin, mucin, elastin, nidogen (entactin), proteoglycans, etc. (See, e.g., U.S. Pat. No. 5,691,203 to Katsuen et al.).
  • HHKs human hair keratins
  • Over 70 human hair keratins are known and their cDNA-derived sequences published.
  • HHKs The structural proteins of hair: isolation characterization, and regulation of biosynthesis.
  • Goldsmith LA editor
  • Biochemistry and physiology of the skin (1983), Oxford University Press. New York;475-510 Within the complete range of HHKs are a small number that have been shown to participate in wound contracture and cell migration (Martin, P, Science 1997;276:75-81).
  • keratins K-6 and K-16 are expressed in the epidermis during wound healing and are also found in the outer root sheath of the hair follicle (Bowden PE, Molecular Aspects of Dermatology (1993), John Wiley & Sons, Inc., Chichester: 19-54).
  • growth factors are predicted to be extracted along with the keratins from end-cut human hair. This observation is not without precedent, as it has previously been shown that many different types of growth factors are present in the extracts of various tissues, and that their activity is maintained even after chemical extraction. Observations such as these show mounting evidence that a number of growth factors may be present in end-cut human hair, and that the keratins may be acting as a highly effective delivery matrix of, inter alia, these growth factors.
  • Keratins are a family of proteins found in the hair, skin, and other tissues of vertebrates. Hair is a unique source of human keratins because it is one of the few human tissues that is readily available and inexpensive. Although other sources of keratins are acceptable feedstocks for the present invention, (e.g. wool, fur, horns, hooves, beaks, feathers, scales, and the like), human hair is preferred for use with human subjects because of its biocompatibility.
  • Keratins can be extracted from human hair fibers by oxidation or reduction using methods that have been published in the art (See, e.g., Crewther WG et al. The chemistry of keratins, in Advances in Protein Chemistry 1965;20: 191-346). These methods typically employ a two-step process whereby the crosslinked structure of keratins is broken down by either oxidation or reduction. In these reactions, the disulfide bonds in cysteine amino acid residues are cleaved, rendering the keratins soluble (Scheme 1). The cuticle is essentially unaffected by this treatment, so the majority of the keratins remain trapped within the cuticle's protective structure.
  • Denaturing solutions known in the art include urea, transition metal hydroxides, surfactant solutions, and combinations thereof. Preferred methods use aqueous solutions of tris in concentrations between 0.1 and 1.0 M, and urea solutions between 0.1 and
  • keratoses If one employs an oxidative treatment, the resulting keratins are referred to as "keratoses.” If a reductive treatment is used, the resulting keratins are referred to as "kerateines” (See Scheme 1)
  • Crude extracts of keratins can be further refined into "gamma” and "alpha” fractions, e.g., by isoelectric precipitation.
  • High molecular weight keratins, or “alpha keratins,” (alpha helical) are thought to derive from the microfibrillar regions of the hair follicle, and typically range in molecular weight from about 40-85 kiloDaltons.
  • Low molecular weight keratins, or "gamma keratins,” (globular) are thought to derive from the extracellular matrix regions of the hair follicle, and typically range in molecular weight from about 10-15 kiloDaltons.
  • Keratin derivative refers to any keratin fractionation, derivative or mixture thereof, alone or in combination with other keratin derivatives or other ingredients, including but not limited to alpha keratose, gamma keratose, alpha kerateine, gamma kerateine, meta keratin, keratin intermediate filaments, and combinations thereof, including the acidic and basic constituents thereof unless specified otherwise, along with variations thereof that will be apparent to persons skilled in the art in view of the present disclosure.
  • the keratin derivative comprises, consists or consists essentially of a particular fraction or subtraction of keratin.
  • the derivative may comprise, consist or consist essentially of at least 80, 90, 95 or 99 percent by weight of said fraction or subtraction (or more).
  • the keratin derivative comprises, consists of, or consists essentially of acidic alpha keratose. In some embodiments, the keratin derivative comprises, consists of or consists essentially of alpha keratose, where the alpha keratose comprises, consists of or consists essentially of at least 80, 90, 95 or 99 percent by weight of acidic alpha keratose (or more), and where the alpha keratose comprises, consists of or consists essentially of not more than
  • the keratin derivative comprises, consists of, or consists essentially of basic alpha keratose.
  • the keratin derivative comprises, consists of or consists essentially of alpha keratose, where the alpha keratose comprises, consists of or consists essentially of at least 80, 90, 95 or 99 percent by weight of basic alpha keratose (or more), and where the alpha keratose comprises, consists of or consists essentially of not more than
  • the keratin derivative comprises, consists of, or consists essentially of acidic alpha kerateine.
  • the keratin derivative comprises, consists of or consists essentially of alpha kerateine, where the alpha kerateine comprises, consists of or consists essentially of at least 80, 90, 95 or 99 percent by weight of acidic alpha kerateine (or more), and where the alpha kerateine comprises, consists of or consists essentially of not more than
  • the keratin derivative comprises, consists of, or consists essentially of basic alpha kerateine.
  • the keratin derivative comprises, consists of or consists essentially of alpha kerateine, where the alpha kerateine comprises, consists of or consists essentially of at least 80, 90, 95 or 99 percent by weight of basic alpha kerateine (or more), and where the alpha kerateine comprises, consists of or consists essentially of not more than
  • the keratin derivative comprises, consists of or consists essentially of unfractionated alpha+gamma-kerateines. In some embodiments, the keratin derivative comprises, consists of or consists essentially of acidic alpha+gamma-kerateines. In some embodiments, the keratin derivative comprises, consists of or consists essentially of basic alpha+gamma-kerateines.
  • the keratin derivative comprises, consists of or consists essentially of unfractionated alpha+gamma-keratose. In some embodiments, the keratin derivative comprises, consists of or consists essentially of acidic alpha+gamma-keratose. In some embodiments, the keratin derivative comprises, consists of or consists essentially of basic alpha+gamma-keratose.
  • the keratin derivative comprises, consists of or consists essentially of unfractionated beta-keratose (e.g., derived from cuticle). In some embodiments, the keratin derivative comprises, consists of or consists essentially of basic beta-keratose. In some embodiments, the keratin derivative comprises, consists of or consists essentially of acidic beta-keratose.
  • the basic alpha keratose is preferably produced by separating basic alpha keratose from a mixture comprising acidic and basic alpha keratose, e.g., by ion exchange chromatography, and optionally the basic alpha keratose has an average molecular weight of from 10 to 100 or 200 kiloDaltons. More preferably, the average molecular weight is from 30 or 40 to 90 or 100 kiloDaltons.
  • the process further comprises the steps of re-dissolving said basic alpha-keratose in a denaturing and/or buffering solution, optionally in the presence of a chelating agent to complex trace metals, and then re- precipitating the basic alpha keratose from the denaturing solution.
  • the composition preferably contains not more than 5, 2, 1, or 0.1 percent by weight of acidic alpha keratose, or less.
  • the acidic alpha keratose is preferably produced by a reciprocal of the foregoing technique: that is, by separating and retaining acidic alpha keratose from a mixture of acidic and basic alpha keratose, e.g., by ion exchange chromatography, and optionally the acidic alpha keratose has an average molecular weight of from 10 to 100 or 200 kiloDaltons. More preferably, the average molecular weight is from 30 or 40 to 90 or 100 kiloDaltons.
  • the process further comprises the steps of re-dissolving said acidic alpha-keratose in a denaturing solution and/or buffering solution, optionally in the presence of a chelating agent to complex trace metals, and then re-precipitating the basic alpha keratose from the denaturing solution.
  • the composition preferably contains not more than 5, 2, 1, or 0.1 percent by weight of basic alpha keratose, or less.
  • Basic and acidic fractions of other keratoses can be prepared in like manner as described above for basic and acidic alpha keratose.
  • the basic alpha kerateine is preferably produced by separating basic alpha kerateine from a mixture of acidic and basic alpha kerateine, e.g., by ion exchange chromatography, and optionally the basic alpha kerateine has an average molecular weight of from 10 to 100 or 200 kiloDaltons.
  • the process further comprises the steps of re- dissolving said basic alpha-kerateine in a denaturing and/or buffering solution, optionally in the presence of a chelating agent to complex trace metals, and then re-precipitating the basic alpha kerateine from the denaturing solution.
  • the composition preferably contains not more than 5, 2, 1, or 0.1 percent by weight of acidic alpha kerateine, or less.
  • the acidic alpha kerateine is preferably produced by a reciprocal of the foregoing technique: that is, by separating and retaining acidic alpha kerateine from a mixture of acidic and basic alpha kerateine, e.g., by ion exchange chromatography, and optionally the acidic alpha kerateine has an average molecular weight of from 10 to 100 or 200 kiloDaltons. More preferably, the average molecular weight is from 30 or 40 to 90 or 100 kiloDaltons.
  • the process further comprises the steps of re-dissolving said acidic alpha-kerateine in a denaturing and/or buffering solution), optionally in the presence of a chelating agent to complex trace metals, and then re-precipitating the basic alpha kerateine from the denaturing solution.
  • the composition preferably contains not more than 5, 2, 1, or 0.1 percent by weight of basic alpha kerateine, or less.
  • Basic and acidic fractions of other kerateines can be prepared in like manner as described above for basic and acidic alpha kerateine.
  • Keratin materials are derived from any suitable source including, but not limited to, wool and human hair.
  • keratin is derived from end-cut human hair, obtained from barbershops and salons. The material is washed in hot water and mild detergent, dried, and extracted with a nonpolar organic solvent (typically hexane or ether) to remove residual oil prior to use.
  • a nonpolar organic solvent typically hexane or ether
  • Keratoses Keratose fractions are obtained by any suitable technique. In one embodiment they are obtained using the method of Alexander and coworkers (P. Alexander et al., Biochem. J. 46, 27-32 (1950)). Basically, the hair is reacted with an aqueous solution of peracetic acid at concentrations of less than ten percent at room temperature for 24 hours. The solution is filtered and the alpha-keratose fraction precipitated by addition of mineral acid to a pH of approximately 4. The alpha-keratose is separated by filtration, washed with additional acid, followed by dehydration with alcohol, and then freeze dried.
  • Increased purity can be achieved by re-dissolving the keratose in a denaturing solution such as 7M urea, aqueous ammonium hydroxide solution, or 2OmM tris base buffer solution (e.g., Trizma® base), re-precipitating, re-dissolving, dialyzing against deionized water, and re-precipitating at pH 4.
  • a denaturing solution such as 7M urea, aqueous ammonium hydroxide solution, or 2OmM tris base buffer solution (e.g., Trizma® base)
  • Trizma® base e.g., Trizma® base
  • a preferred method for the production of keratoses is by oxidation with hydrogen peroxide, peracetic acid, or performic acid.
  • a most preferred oxidant is peracetic acid.
  • Preferred concentrations range from 1 to 10 weight/volume percent (w/v %), the most preferred being approximately 2 w/v %.
  • w/v % weight/volume percent
  • Those skilled in the art will recognize that slight modifications to the concentration can be made to effect varying degrees of oxidation, with concomitant alterations in reaction time, temperature, and liquid to solid ratio. It has also been discussed by Crewther et al. that performic acid offers the advantage of minimal peptide bond cleavage compared to peracetic acid. However, peracetic acid offers the advantages of cost and availability.
  • a preferred oxidation temperature is between 0 and 100 degrees Celsius ( 0 C).
  • a most preferred oxidation temperature is 37 0 C.
  • a preferred oxidation time is between 0.5 and 24 hours.
  • a most preferred oxidation time is 12 hours.
  • a preferred liquid to solid ratio is from 5 to 100:1.
  • a most preferred ratio is 20:1. After oxidation, the hair is rinsed free of residual oxidant using a copious amount of distilled water.
  • the keratoses can be extracted from the oxidized hair using an aqueous solution of a denaturing agent.
  • Protein denaturants are well known in the art, but preferred solutions include urea, transition metal hydroxides (e.g. sodium and potassium hydroxide), ammonium hydroxide, and tris(hydroxymethyl)aminomethane (tris base).
  • Tris base a preferred solution is Trizma® base (a brand of tris base) in the concentration range from 0.01 to IM. A most preferred concentration is 0.1 M.
  • Trizma® base a brand of tris base
  • a most preferred concentration is 0.1 M.
  • a most preferred extraction temperature is 37° C.
  • a preferred extraction time is between 0.5 and 24 hours.
  • a most preferred extraction time is 3 hours.
  • a preferred liquid to solid ratio is from 5 to 100:1.
  • a most preferred ratio is 40:1. Additional yield can be achieved with subsequent extractions with dilute solutions of tris base or deionized (DI) water. After extraction, the residual solids are removed from solution by centrifugation and/or filtration.
  • DI deionized
  • the crude extract can be isolated by first neutralizing the solution to a pH between 7.0 and 7.4. A most preferred pH is 7.4. Residual denaturing agent is removed by dialysis against DI water. Concentration of the dialysis retentate is followed by lyophilization or spray drying, resulting in a dry powder mixture of both gamma- and alpha-keratose. Alternately, alpha-keratose is isolated from the extract solution by dropwise addition of acid until the pH of the solution reaches approximately 4.2. Preferred acids include sulfuric, hydrochloric, and acetic. A most preferred acid is concentrated hydrochloric acid. Precipitation of the alpha fraction begins at around pH 6.0 and continues until approximately 4.2. Fractional precipitation can be utilized to isolate different ranges of protein with different isoelectric properties. Solid alpha-keratose can be recovered by centrifugation or filtration.
  • the alpha keratose can be further purified by re-dissolving the solids in a denaturing solution.
  • the same denaturing solutions as those utilized for extraction can be used, however a preferred denaturing solution is tris base.
  • Ethylene diamine tetraacetic acid (EDTA) can be added to complex and remove trace metals found in the hair.
  • a preferred denaturing solution is 20 mM tris base with 20 mM EDTA or DI water with 20 mM EDTA. If the presence of trace metals is not detrimental to the intended application, the EDTA can be omitted.
  • the alpha-keratose is re-precipitated from this solution by dropwise addition of hydrochloric acid to a final pH of approximately 4.2. Isolation of the solid is by centrifugation or filtration. This process can be repeated several times to further purify the alpha-keratose.
  • the gamma keratose fraction remains in solution at pH 4 and is isolated by addition to a water-miscible organic solvent such as alcohol, followed by filtration, dehydrated with additional alcohol, and freeze dried. Increased purity can be achieved by redissolving the keratose in a denaturing solution such as 7M urea, aqueous ammonium hydroxide solution, or 2OmM tris buffer solution, reducing the pH to 4 by addition of a mineral acid, removing any solids that form, neutralizing the supernatant, re-precipitating the protein with alcohol, re- dissolving, dialyzing against deionized water, and reprecipitating by addition to alcohol.
  • a denaturing solution such as 7M urea, aqueous ammonium hydroxide solution, or 2OmM tris buffer solution
  • the amount of alcohol consumed in these steps can be minimized by first concentrating the keratose solution by distillation. After removal of the alpha keratose, the concentration of gamma keratose from a typical extraction solution is approximately 1-2%. The gamma keratose fraction can be isolated by addition to a water-miscible non-solvent. To effect precipitation, the gamma- keratose solution can be concentrated by evaporation of excess water. This solution can be concentrated to approximately 10-20% by removal of 90% of the water. This can be done using vacuum distillation or by falling film evaporation. After concentration, the gamma- keratose solution is added dropwise to an excess of cold non-solvent.
  • Suitable non-solvents include ethanol, methanol, acetone, and the like.
  • a most preferred non-solvent is ethanol.
  • a most preferred method is to concentrate the gamma keratose solution to approximately 10 w/v % protein and add it dropwise to an 8-fold excess of cold ethanol.
  • the precipitated gamma keratose can be isolated by centrifugation or filtration and dried. Suitable methods for drying include freeze drying (lyophilization), air drying, vacuum drying, or spray drying. A most preferred method is freeze drying.
  • Kerateines Kerateine fractions can be obtained using a combination of the methods of Bradbury and Chapman (J. Bradbury et al., Aust. J. Biol. Sci. 17, 960-72 (1964)) and Goddard and Michaelis (D. Goddard et al., J. Biol. Chem. 106, 605-14 (1934)).
  • the cuticle of the hair fibers is removed ultrasonically in order to avoid excessive hydrolysis and allow efficient reduction of cortical disulfide bonds in a second step.
  • the hair is placed in a solution of dichloroacetic acid and subjected to treatment with an ultrasonic probe. Further refinements of this method indicate that conditions using 80% dichloroacetic acid, solid to liquid of 1:16, and an ultrasonic power of 180 Watts are optimal (H. Ando et al., Sen'i
  • Solid fragments are removed from solution by filtration, rinsed and air dried, followed by sieving to isolate the hair fibers from removed cuticle cells.
  • alpha- and gamma kerateines are obtained by reaction of the denuded fibers with mercaptoethanol.
  • a low hydrolysis method is used at acidic pH (E. Thompson et al., Aust. J. Biol. Sci. 15, 757- 68 (1962)).
  • hair is extracted for 24 hours with 4M mercaptoethanol that has been adjusted to pH 5 by addition of a small amount of potassium hydroxide in deoxygenated water containing 0.02M acetate buffer and 0.00 IM surfactant.
  • the solution is filtered and the alpha kerateine fraction precipitated by addition of mineral acid to a pH of approximately 4.
  • the alpha kerateine is separated by filtration, washed with additional acid, followed by dehydration with alcohol, and then dried under vacuum. Increased purity is achieved by re-dissolving the kerateine in a denaturing solution such as 7M urea, aqueous ammonium hydroxide solution, or 2OmM tris buffer solution, re- precipitating, re-dissolving, dialyzing against deionized water, and re-precipitating at pH 4.
  • a denaturing solution such as 7M urea, aqueous ammonium hydroxide solution, or 2OmM tris buffer solution
  • the gamma kerateine fraction remains in solution at pH 4 and is isolated by addition to a water-miscible organic solvent such as alcohol, followed by filtration, dehydrated with additional alcohol, and dried under vacuum.
  • Increased purity can be achieved by redissolving the kerateine in a denaturing solution such as 7M urea, aqueous ammonium hydroxide solution, or 2OmM tris buffer solution, reducing the pH to 4 by addition of a mineral acid, removing any solids that form, neutralizing the supernatant, re-precipitating the protein with alcohol, re-dissolving, dialyzing against deionized water, and reprecipitating by addition to alcohol.
  • the amount of alcohol consumed in these steps can be minimized by first concentrating the keratin solution by distillation.
  • the kerateine fractions are obtained by reacting the hair with an aqueous solution of sodium thioglycolate.
  • a preferred method for the production of kerateines is by reduction of the hair with thioglycolic acid or beta-mercaptoethanol.
  • a most preferred reductant is thioglycolic acid (TGA).
  • TGA thioglycolic acid
  • concentrations range from 1 to 1OM, the most preferred being approximately 1.0M.
  • a preferred pH is between 9 and 11.
  • a most preferred pH is 10.2.
  • the pH of the reduction solution is altered by addition of base.
  • Preferred bases include transition metal hydroxides, sodium hydroxide, and ammonium hydroxide.
  • a most preferred base is sodium hydroxide.
  • the pH adjustment is effected by dropwise addition of a saturated solution of sodium hydroxide in water to the reductant solution.
  • a preferred reduction temperature is between 0 and 100 0 C.
  • a most preferred reduction temperature is 37 0 C.
  • a preferred reduction time is between 0.5 and 24 hours.
  • a most preferred reduction time is 12 hours.
  • a preferred liquid to solid ratio is from 5 to 100:1.
  • a most preferred ratio is 20: 1.
  • reduction is carried out at basic pH. That being the case, keratins are highly soluble in the reduction media and are expected to be extracted. The reduction solution is therefore combined with the subsequent extraction solutions and processed accordingly.
  • Reduced keratins are not as hydrophilic as their oxidized counterparts. As such, reduced hair fibers will not swell and split open as will oxidized hair, resulting in relatively lower yields.
  • Another factor affecting the kinetics of the reduction/extraction process is the relative solubility of kerateines.
  • the relative solubility rankings in water is gamma- keratose>alpha-keratose>gamma-kerateine>alpha-kerateine from most to least soluble. Consequently, extraction yields from reduced hair fibers are not as high. This being the case, subsequent extractions are conducted with additional reductant plus denaturing agent solutions.
  • Preferred solutions for subsequent extractions include TGA plus urea, TGA plus tris base, or TGA plus sodium hydroxide.
  • crude fractions of alpha- and gamma-kerateine can be isolated using the procedures described for keratoses.
  • precipitates of gamma- and alpha-kerateine re-form their cystine crosslinks upon exposure to oxygen.
  • Precipitates must therefore be re-dissolved quickly to avoid insolubility during the purification stages, or precipitated in the absence of oxygen.
  • Residual reductant and denaturing agents can be removed from solution by dialysis.
  • Typical dialysis conditions are 1 to 2% solution of kerateines dialyzed against DI water for 24 to 72 hours.
  • Those skilled in the art will recognize that other methods exist for the removal of low molecular weight contaminants in addition to dialysis (e.g. microfiltration, chromatography, and the like).
  • the use of tris base is only required for initial solubilization of the kerateines. Once dissolved, the kerateines are stable in solution without the denaturing agent. Therefore, the denaturing agent can be removed without the resultant precipitation of kerateines, so long as the pH remains at or above neutrality.
  • the final concentration of kerateines in these purified solutions can be adjusted by the addition/removal of water.
  • keratin i.e. keratoses or kerateines
  • several different approaches to further purification can be employed to keratin solutions. Care must be taken, however, to choose techniques that lend themselves to keratin's unique solubility characteristics.
  • One of the most simple separation technologies is isoelectric precipitation. In this method, proteins of differing isoelectric point can be isolated by adjusting the pH of the solution and removing the precipitated material. In the case of keratins, both gamma- and alpha- forms are soluble at pH >6.0. As the pH falls below 6, however, alpha-keratins begin to precipitate.
  • Keratin fractions can be isolated by stopping the precipitation at a given pH and separating the precipitate by centrifugation and/or filtration. At a pH of approximately 4.2, essentially all of the alpha-keratin will have been precipitated. These separate fractions can be re-dissolved in water at neutral pH, dialyzed, concentrated, and reduced to powders by lyophilization or spray drying. However, kerateine fractions must be stored in the absence of oxygen or in dilute solution to avoid crosslinking.
  • Another general method for separating keratins is by chromatography.
  • chromatography Several types of chromatography can be employed to fractionate keratin solutions including size exclusion or gel filtration chromatography, affinity chromatography, isoelectric focusing, gel electrophoresis, ion exchange chromatography, and immunoaffinity chromatography. These techniques are well known in the art and are capable of separating compounds, including proteins, by the characteristics of molecular weight, chemical functionality, isoelectric point, charge, or interactions with specific antibodies, and can be used alone or in any combination to effect high degrees of separation and resulting purity.
  • a preferred purification method is ion exchange (IEx) chromatography.
  • IEx chromatography is particularly suited to protein separation owning to the amphiphilic nature of proteins in general and keratins in particular.
  • either cationic or anionic IEx (CIEx or AIEx, respectively) techniques can be used.
  • CIEx or AIEx cationic or anionic IEx
  • both gamma- and alpha-keratins are soluble and above their isoelectric points. As such, they are anionic and can be bound to an anionic exchange resin.
  • a sub- fraction of keratins does not bind to a weakly anionic exchange resin and instead passes through a column packed with such resin.
  • a preferred solution for AIEx chromatography is purified or fractionated keratin, isolated as described previously, in purified water at a concentration between 0 and 5 weight/volume %.
  • a preferred concentration is between 0 and 4 w/v %.
  • a most preferred concentration is approximately 2 w/v %. It is preferred to keep the ionic strength of said solution initially quite low to facilitate binding to the AIEx column. This is achieved by using a minimal amount of acid to titrate a purified water solution of the keratin to between pH 6 and 7. A most preferred pH is 6.
  • This solution can be loaded onto an AIEx column such as DEAE-Sepharose® resin or Q-Sepharose® resin columns.
  • a preferred column resin is DEAE-Sepharose® resin.
  • the solution that passes through the column can be collected and further processed as described previously to isolate a fraction of acidic keratin powder.
  • the activity of the keratin matrix is enhanced by using an AIEx column to produce the keratin to thereby promote cell adhesion.
  • an anionic column i.e. acidic keratin, promotes cell adhesion.
  • a preferred elution medium is sodium chloride solution.
  • a preferred concentration of sodium chloride is between 0.1 and 2M.
  • a most preferred concentration is 2M.
  • the pH of the solution is preferred to be between 6 and 12.
  • a most preferred pH is 12.
  • a buffer salt can be added.
  • a preferred buffer salt is Trizma® base.
  • the keratin solution can be added to a cation exchange resin such as SP Sepharose® resin (strongly cationic) or CM Sepharose® resin (weakly cationic), and the basic fraction collected with the pass through.
  • the retained acid keratin fraction can be isolated by salting as previously described.
  • Meta Keratins are synthesized from both the alpha and gamma fractions of kerateine using substantially the same procedures. Basically, the kerateine is dissolved in a denaturing solution such as 7M urea, aqueous ammonium hydroxide solution, or 2OmM tris buffer solution. Pure oxygen is bubbled through the solution to initiate oxidative coupling reactions of cysteine groups. The progress of the reaction is monitored by an increase in molecular weight as measured using SDS-PAGE. Oxygen is continually bubbled through the reaction solution until a doubling or tripling of molecular weight is achieved. The pH of the denaturing solution can be adjusted to neutrality to avoid hydrolysis of the proteins by addition of mineral acid.
  • a denaturing solution such as 7M urea, aqueous ammonium hydroxide solution, or 2OmM tris buffer solution. Pure oxygen is bubbled through the solution to initiate oxidative coupling reactions of cysteine groups. The progress of the reaction is monitored by an increase in molecular
  • IFs of human hair fibers are obtained using the method of Thomas and coworkers (H. Thomas et al., Int. J. Biol. Macromol. 8, 258-64 (1986)). This is essentially a chemical etching method that reacts away the keratin matrix that serves to "glue" the IFs in place, thereby leaving the IFs behind.
  • swelling of the cuticle and sulfitolysis of matrix proteins is achieved using 0.2M Na 2 SO 3 , 0.1M Na 2 O 6 S 4 in 8M urea and 0.1 M tris-HCl buffer at pH 9. The extraction proceeds at room temperature for 24 hours.
  • the dissolved matrix keratins and IFs are precipitated by addition of zinc acetate solution to a pH of approximately 6.
  • the IFs are then separated from the matrix keratins by dialysis against 0.05M tetraborate solution. Increased purity is obtained by precipitating the dialyzed solution with zinc acetate, redissolving the IFs in sodium citrate, dialyzing against distilled water, and then freeze drying the sample.
  • compositions and formulations Dry powders may be formed of keratin derivatives as described above in accordance with known techniques such as freeze drying (lyophilization).
  • compositions of the invention may be produced by mixing such a dry powder composition form with an aqueous solution to produce a composition comprising an electrolyte solution having said keratin derivative solubilized therein.
  • the mixing step can be carried out at any suitable temperature, typically room temperature, and can be carried out by any suitable technique such as stirring, shaking, agitation, etc.
  • the salts and other constituent ingredients of the electrolyte solution may be contained entirely in the dry powder, entirely within the aqueous composition, or may be distributed between the dry powder and the aqueous composition.
  • at least a portion of the constituents of the electrolyte solution are contained in the dry powder.
  • a matrix comprising keratin materials such as described above can be carried out in accordance with techniques long established in the field or variations thereof that will be apparent to those skilled in the art.
  • the keratin preparation is dried and rehydrated prior to use. See, e.g., U.S. Pat. Nos. 2,413,983 to Lustig et al., U.S. Pat. No. 2,236,921 to Schollkipf et al., and 3,464,825 to Anker.
  • the matrix, or hydrogel is formed by re-hydration of the lyophilized material with a suitable solvent, such as water or phosphate buffered saline (PBS).
  • PBS phosphate buffered saline
  • the gel can be sterilized, e.g., by ⁇ -irradiation (800 krad) using a Co60 source.
  • ⁇ -irradiation 800 krad
  • Other suitable methods of forming keratin matrices include, but are not limited to, those found in U.S. Pat. Nos. 6,270,793 (Van Dyke et al.), 6,274,155 (Van Dyke et al.), 6,316,598 (Van Dyke et al.), 6,461,628 (Blanchard et al.), 6,544,548 (Siller- Jackson et al.), and 7,01,987 (Van Dyke).
  • the keratin derivatives (particularly alpha and/or gamma kerateine and alpha and/or gamma keratose) have an average molecular weight of from about 10 to 70 or 85 or 100 kiloDaltons.
  • the keratin derivative (this term including combinations of derivatives) may be included in the composition in an amount of from about 0.1, 0.5 or 1 percent by weight up to 3, 4, 5, or 10 percent by weight.
  • the composition when mixed preferably has a viscosity of about 1 or 1.5 to 4, 8, 10 or 20 centipoise. Viscosity at any concentration can be modulated by changing the ratio of alpha to gamma keratose.
  • the keratin derivative composition or formulation may optionally contain one or more active ingredients such as one or more growth factors, analgesics, antimicrobials, additional coagulants, etc. (e.g., in an amount ranging from 0.0000001 to 1 or 5 percent by weight of the composition that comprises the keratin derivative(s)), to facilitate growth or healing, provide pain relief, inhibit the growth of microbes such as bacteria, facilitate or inhibit coagulation, facilitate or inhibit cell or tissue adhesion, etc.
  • active ingredients such as one or more growth factors, analgesics, antimicrobials, additional coagulants, etc.
  • growth factors include, but are not limited to, nerve growth factor, vascular endothelial growth factor, fibronectin, fibrin, laminin, acidic and basic fibroblast growth factors, testosterone, ganglioside GM-I, catalase, insulin-like growth factor-I (IGF-I), platelet-derived growth factor (PDGF), neuronal growth factor galectin-1, and combinations thereof.
  • IGF-I insulin-like growth factor-I
  • PDGF platelet-derived growth factor
  • growth factors include molecules that promote the regeneration, growth and survival of tissue.
  • Growth factors that are used in some embodiments of the present invention may be those naturally found in keratin extracts, or may be in the form of an additive, added to the keratin extracts or formed keratin matrices.
  • growth factors include, but are not limited to, nerve growth factor (NGF) and other neurotrophins, platelet-derived growth factor (PDGF), erythropoietin (EPO), thrombopoietin (TPO), myostatin (GDF-8), growth differentiation factor-9 (GDF9), basic fibroblast growth factor (bFGF or FGF2), epidermal growth factor (EGF), hepatocyte growth factor (HGF), granulocyte-colony stimulating factor (G-CSF), and granulocyte-macrophage colony stimulating factor (GM-CSF).
  • NGF nerve growth factor
  • PDGF platelet-derived growth factor
  • EPO erythropoietin
  • TPO thrombopoietin
  • neurotrophins are a family of molecules that promote the growth and survival of, inter alia, nervous tissue.
  • neurotrophins include, but are not limited to, nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin 3 (NT-3), and neurotrophin 4 (NT-4). See U.S. Pat. Nos. 5,843,914 to Johnson, Jr. et al.; 5,488,099 to Persson et al.; 5,438,121 to Barde et al.; 5,235,043 to Collins et al.; and 6,005,081 to Burton et al.
  • a growth factor can be added to the keratin matrix composition in an amount effective to promote the regeneration, growth and survival of various tissues.
  • the growth factor is provided in concentrations ranging from 0.1 ng/mL to 1000 ng/mL. More preferably, growth factor is provided in concentrations ranging from 1 ng/mL to 100 ng/mL, and most preferably 10 ng/mL to lOOng/mL. See U.S. Pat. No. 6,063,757 to Urso.
  • the composition is preferably sterile and non-pryogenic.
  • the composition may be provided preformed and aseptically packaged in a suitable container, such as a flexible polymeric bag or bottle, or a foil container, or may be provided as a kit of sterile dry powder in one container and sterile aqueous solution in a separate container for mixing just prior to use.
  • the composition When provided pre-formed and packaged in a sterile container, the composition preferably has a shelf life of at least 4 or 6 months (up to 2 or 3 years or more) at room temperature, prior to substantial loss of viscosity (e.g., more than 10 or 20 percent) and/or substantial precipitation of the keratin derivative (e.g., settling detectable upon visual inspection).
  • the kit may contain a single unit dose of the active keratin derivative.
  • a single unit dose may be 0.1 or 0.5 or 1, to 100 or 200 or 300 grams of the keratin derivative, or more, depending upon its intended use.
  • natural polymers that may be utilized in a similar fashion to the disclosed keratin preparations include, but are not limited to, collagen, gelatin, fibronectin, vitronectin, laminin, fibrin, mucin, elastin, nidogen (entactin), proteoglycans, etc. (See, e.g., U.S. Pat. No. 5,691,203 to Katsuen et al.).
  • Clotting compositions and methods to control bleeding containing keratin biomaterials are provided.
  • One aspect of the present invention is a method for treating bleeding in a subject afflicted with a bleeding wound comprising: applying a keratin derivative to a bleeding wound in an amount effective to treat the bleeding.
  • the keratin derivative comprises, consists of or consists essentially of kerateine, alpha kerateine, gamma kerateine, acidic alpha kerateine, basic alpha kerateine, or combinations thereof, such as described above.
  • the bleeding may be that associated with, e.g., severe trauma producing rapid, voluminous hemorrhaging, including, but not limited to: surgery; penetrating trauma such as stabbing and gunshot wounds; motor vehicle trauma; and head, neck, chest and abdominal hemorrhaging; with or without clear access to the site of the hemorrhaging.
  • severe trauma producing rapid, voluminous hemorrhaging including, but not limited to: surgery; penetrating trauma such as stabbing and gunshot wounds; motor vehicle trauma; and head, neck, chest and abdominal hemorrhaging; with or without clear access to the site of the hemorrhaging.
  • compositions may comprise the hemostatic agent, including, but not limited to, keratin derivatives.
  • hemostatic agents include, but are not limited to, those comprising fibrin or fibrinogen, thrombin, factor XIII, calcium, chitosan (deacetylated poly-N-acetyl glucosamine), zeolite (oxides of silicon, aluminum, sodium, magnesium, and quartz), chitin (acetylated poly-N-acetyl glucosamine), bovine clotting factors, non-zeolite mineral (e.g., hydrophobic polymers and potassium salts), and molecular sieve materials from plant sources (e.g., TraumaDEXTM, AristaTM AH, etc., Medafor, Inc., Minneapolis, MN).
  • hemostatic agents are recommended for all types of bleeding treatments, and those skilled in the art should select hemostatic agents for use in the disclosed compositions and methods accordingly.
  • zeolite is intended only for external use.
  • gels containing keratin derivatives are used. The gels of these embodiments are adherent to the tissue and hydrophilic. In some embodiments, when deposited onto a bleeding surface of a wound, the gels are sufficiently adhesive to not be washed away, even in the presence of active bleeding. In some embodiments the gel absorbs fluid from the blood and becomes even more adherent (e.g., within minutes of administration).
  • the adherent gel of some embodiments can form a physical seal of the wound site and provide a porous scaffold for cell infiltration and granulation-like tissue formation, much like clotted blood.
  • the keratin composition is applied directly onto the site of the bleeding. In some embodiments, the keratin composition is injected into the body of a subject to treat an internal site of bleeding, e.g., where there is no clear access to the site of hemorrhaging.
  • Wound healing compositions containing keratin biomaterials and methods to promote wound healing are provided.
  • An aspect of the present invention is a method of treating a wound ⁇ e.g., burns, abrasions, lacerations, incisions, pressure sores, puncture wounds, penetration wounds, gunshot wounds, crushing injuries, etc.) in a subject in need thereof, comprising: topically applying a keratin derivative to the wound in an amount effective to treat the wound.
  • the keratin derivative comprises, consists of or consists essentially of keratose, alpha keratose, gamma keratose, acidic alpha keratose, acidic gamma keratose, basic alpha keratose, basic gamma keratose, kerateine, alpha kerateine, gamma kerateine, acidic alpha kerateine, acidic gamma kerateine, basic alpha kerateine, basic gamma kerateine, etc., or combinations thereof, such as described above.
  • the keratin derivative can be topically applied as a dry powder formulation or, in some embodiments, applied in an aqueous carrier (e.g., in the form of a gel).
  • the keratin derivative is provided in an ointment (a water-in-oil preparation in which the amount of oil exceeds the amount of water in the emulsion), or in a cream (an oil- in water preparation in which the amount of water is equal to or exceeds the amount of oil in the emulsion).
  • the keratin derivative is injected under the skin to reach an internal site of injury.
  • Subjects to be treated with the methods and compositions described herein include both human subjects and animal subjects (particularly other mammalian subjects such as dogs, cats, horses, monkeys, etc.) for veterinary purposes. Human subjects are particularly preferred.
  • the subjects may be male or female and may be any age, including neonate, infant, juvenile, adolescent, adult, and geriatric subjects.
  • Burn wounds are tissue injuries that can result from heat, chemicals, sunlight, electricity, radiation, etc. Burns caused by heat, or thermal burns, are the most common. Chemical burns resemble thermal burns. Though burn wounds tend to occur most often on the skin, other body structures may be affected. For example, a severe burn may penetrate down to the fat, muscle or bone. Wounds are often characterized by the depth of injury. For example, the degree of a burn is characterized as first, second or third depending on the depth of the tissues injured. In a first-degree burn, only the top layer of skin (the epidermis) is damaged. In second-degree burns, the middle layer of skin (the dermis) is damaged.
  • stage I red, unbroken skin, erythema does not fade with release of pressure
  • stage II damaged epidermis, often with invasion into the dermis
  • stage III injury of the dermis
  • stage IV subcutaneous tissue is exposed
  • compositions containing keratin derivatives are useful not only for providing a physical seal of the wound site, but also for providing a porous scaffold for cell infiltration and granulation-like tissue formation, much like clotted blood.
  • Wounds can be evolving injuries in that the area of tissue damage grows after the initial insult.
  • a burn wound is typically an evolving injury characterized by three zones: the zone of necrosis, the zone of injury, and the zone of hyperemia.
  • the zone of necrosis is the area that directly received the external insult (e.g., heat or chemical insult), and contains irreversibly damaged tissue.
  • the zone of injury is peripheral to and below the zone of necrosis, and the tissue is initially viable but fragile.
  • the area of the zone of necrosis increases as the tissue in the zone of injury becomes damaged.
  • the term "wound conversion" describes the process by which the zone of injury progresses to the zone of necrosis, increasing the overall area of the wound. See, e.g., U.S. Patent No. 5,583,126 to Daynes et al.
  • the zone of hyperemia is peripheral to and below the zone of injury. It has minimal cell injury, but is vasodilated.
  • the keratin derivatives disclosed herein both suppress wound growth due to wound conversion (e.g., measured by area of the wound over time, determined by observations of the severity of tissue damage with and/or without treatment, etc.) and promote and/or accelerate the healing of wounds (e.g., the measured wound area decreases at a faster rate over time with treatment, the wound is observed to be healing at a faster rate upon treatment, etc.).
  • the normal course of healing for superficial and partial-thickness wounds is by regeneration of epithelium from existing basal cells at the surface of the wound, with or without mild contraction. Deep wounds heal by a combination of regeneration of epithelium and contraction. Contraction serves to decrease the area of the wound, and the epithelium regenerates from the margins of the wound.
  • the keratin biomaterials are useful in promoting wound healing by enhancing the proliferation of fibroblasts (e.g., dermal fibroblasts) and/or keratinocytes (e.g., epidermal keratinocytes).
  • fibroblasts e.g., dermal fibroblasts
  • keratinocytes e.g., epidermal keratinocytes.
  • treatment includes the control of bleeding.
  • abrasions, lacerations, incisions, penetration wounds, and crushing injuries, etc. often involve bleeding.
  • Crushing injuries may involve an open wound (i.e., where the skin is torn and tissues are exposed to the environment), or a closed wound (i.e., where the skin is intact, but the underlying tissue is damaged).
  • Abrasions are superficial wounds in which the epidermis of the skin is scraped off.
  • Abrasions can be caused by, e.g., falling upon a rough surface. Lacerations are typically irregular wounds caused by, e.g., a blunt impact to soft tissue (e.g., skin) that lies on top of hard tissue (e.g., bone), or involves the tearing of soft tissues (e.g., lacerations associated with childbirth). Lacerations typically show bridging, where connective tissue and/or blood vessels flatten against the surface of the underlying hard tissue. Sometimes injury caused by sharp objects is also termed a laceration. In the case of injury caused by a sharp object, there is normally no bridging because the connective tissue and blood vessels are severed.
  • Incisions or incised wounds are normally caused by clean, sharp-edged objects.
  • Superficial incisions (involving only the epidermis) are typically referred to as "cuts.”
  • Incisions may be caused by a knife, razor, glass splinter, etc., or may be caused by a scalpel during surgery or other medical procedure.
  • Penetration wounds are caused by objects entering the body (e.g., a knife). Puncture wounds are caused by objects penetrating the skin, such as a needle or nail.
  • Gunshot wounds are caused by bullets entering, driving through, and sometimes exiting, the body.
  • the wound healing composition includes an antimicrobial agent.
  • antimicrobial agents that can be topically applied include, but are not limited to, bacitracin (e.g., 400-500 U/g of ointment), polymyxin B sulfate (e.g., 5,000 or 10,000 U/g of ointment), neomycin (e.g., 3.5 mg/g of ointment), Polysporin® antibiotic (a blend of polymyxin B sulfate and bacitracin in an ointment base), Neosporin® antibiotic (a blend of neomycin, bacitracin and polymyxin B sulfate in an ointment base), povidone-iodine, silver sulfadiazine (e.g., 1% cream), mafenide acetate (a methylated topical sulfonamide compound, e.g., as a
  • Antimicrobial solutions include, but are not limited to, acetic acid (e.g., 0.5% or 0.25%), sodium hypochlorite (Dakin's solution, e.g., 0.5% or 0.25% NaOCl), silver nitrate (e.g., 0.5%), and chlorhexidine gluconate (e.g., 0.5%).
  • the wound healing composition includes additional wound healing components.
  • Some antimicrobials are thought to also promote wound healing by mechanisms apart from their effects as a bactericide or fungicide, etc. For example, there is evidence that silver sulfadizine, the most commonly used topical agent for burn care in the United States, has this dual action (Ward RS and Saffle JR, Physical Therapy 1995;75(6) 526-38).
  • the wound healing composition includes analgesics or anesthetics for pain relief, surfactants, anti-inflammatory agents, etc. See, e.g., U.S. Patent No. 6,562,326 to Miller.
  • the keratin compositions disclosed herein are useful in both controlling the bleeding and in promoting the healing of wounds.
  • the compositions are useful for both open wounds and closed wounds.
  • the keratin may be applied into the wound site by, for example, injection with a syringe or from a pressurized canister.
  • the keratin compositions can be, for example, injected into the abdomen through the skin into the site of internal bleeding.
  • tissue swelling must be taken into account so as to avoid over-expansion and possible tissue and/or organ damage.
  • the dosage is 0.1 or 0.5 or 1, to 100 or 200 or 300 grams of the keratin derivative, or more (e.g., in powder or aqueous carrier), depending upon its intended use.
  • the keratin is provided at a concentration from 0.001 to 10 mg/mL, or from 0.01 to 5 mg/mL. In some embodiments, the keratin is provided at a concentration of from 0.1% to 80% (w/v), or from 1% to 50% (w/v), or from 5% to 30% (w/v).
  • the wound is treated by application of a keratin preparation in the form of a gel, cream or ointment.
  • a keratin preparation in the form of a gel, cream or ointment.
  • the would may also be treated by a "wet-to-moist" dressing, where the keratin (and optionally other additives) is generally added in its powder form to an aqueous carrier (e.g., distilled water or saline), and a dressing (e.g., gauze) is soaked with the aqueous preparation and placed onto the wound.
  • an aqueous carrier e.g., distilled water or saline
  • a dressing e.g., gauze
  • the aqueous preparation should be reapplied as necessary to prevent the dressing from drying.
  • the keratin preparation can be formed as a sheet wound dressing as described in U.S. Patent No.
  • the keratin preparation is formulated for use as a spray, e.g., solutions such as aqueous preparations that can be sprayed upon the wound with an aerosol pump.
  • the wound is treated by reapplication of the disclosed compositions, e.g., several times a day, or as needed. Cleansing to remove bacteria and debridement to remove necrotic debris may also be warranted during the course of treatment.
  • a moisturizing cream or ointment may be used to soften wound eschar in order to assist in debridement.
  • Surgical or paramedic aids Another aspect of the invention is a surgical or paramedic aid that includes a solid, physiologically acceptable substrate and a keratin derivative on said substrate.
  • “Substrate” includes sponges, packings, wound dressings (such as gauze or bandages), sutures, fabrics, and prosthetic devices.
  • Kits comprising keratin derivatives.
  • Another aspect of the invention is a kit comprising, consisting of, or consisting essentially of a keratin derivative in a container.
  • the keratin derivative is preferably packaged in the container in sterile form.
  • the kit may include a physiologically acceptable substrate, such as sponges, packings, wound dressings (such as gauze or bandages), sutures, fabrics, and prosthetic devices.
  • Example 1 Keratin Derivatives/Fractions
  • Keratose fractions were obtained using a method based on that of Alexander and coworkers. However the method was substantially modified to minimize hydrolysis of peptide bonds. Briefly, 50 grams of clean, dry hair that was collected from a local barber shop was reacted with 1000 mL of an aqueous solution of 2 w/v % peracetic acid (PAA) at room temperature for 12 hr. The oxidized hair was recovered using a 500 micron sieve, rinsed with copious amounts of DI water, and the excess water removed. Keratoses were extracted from the oxidized hair fibers with 1000 mL of 10OmM Trizma® base.
  • PPAA peracetic acid
  • Kerateine fractions were obtained using a modification of the method described by Goddard and Michaelis (J Biol Chem 1934;106:605-14). Briefly, the hair was reacted with an aqueous solution of IM TGA at 37 0 C for 24 hours. The pH of the TGA solution had been adjusted to pH 10.2 by dropwise addition of saturated NaOH solution. The extract solution was filtered to remove the reduced hair fibers and retained. Additional keratin was extracted from the fibers by sequential extractions with 1000 mL of 10OmM TGA at pH 10.2 for 24 hours, 1000 mL of 1OmM TGA at pH 10.2 for 24 hours, and DI water at pH 10.2 for 24 hours.
  • the solution was centrifuged, filtered, and added to the dialysis system. Eventually, all of the extracts were combined and dialyzed against DI water with a 1 KDa nominal low molecular weight cutoff membrane. The solution was concentrated, titrated to pH 7, and stored at approximately 5% total protein concentration at 4 0 C. Alternately, the concentrated solution could be lyophilized and stored frozen and under nitrogen.
  • keratose samples were re-dissolved in ultrapure water and titrated to pH 6 by addition of dilute HCl solution. Kerateine samples were titrated to pH 6 by careful addition of dilute HCl solution as well. The samples were loaded onto a 20OmL flash chromatography column containing either DEAE-Sepharose® (weakly anionic) or Q- Sepharose® (strongly anionic) exchange resin (50-100 mesh; Sigma- Aldrich, Milwaukee, Wl) with gentle pressure and the flow through collected (acidic keratin). A small volume of 10 mM Trizma® base (approximately 200 mL) at pH 6 was used to completely wash through the sample.
  • DEAE-Sepharose® weakly anionic
  • Q- Sepharose® strongly anionic exchange resin
  • alpha-keratose As previously described, a sample of alpha-keratose was produced, separated on a DEAE-Sepharose® IEx column into acidic and basic fractions, dissolved in PBS, and the pH adjusted to 7.4. These solutions were prepared at 5 weight percent concentration and their red blood cell (RBC) aggregation characteristics grossly evaluated with fresh whole human blood by mixing at a 1 :1 ratio. Samples were taken after 20 minutes and evaluated by light microscopy. The ion exchange chromatography was highly effective at separating the aggregation phenomenon (data not shown). Basic alpha-keratose was essentially free from interactions with blood cells, while the acidic alpha-keratose caused excessive aggregation.
  • RBC red blood cell
  • Keratin biomaterials derived from human hair using oxidation and reduction reactions to break down the tertiary structure of the cortex and extract soluble proteins according to the following methods. Keratin biomaterials derived from human hair mediated the growth behavior of skin component cells. In cell culture experiments, certain types of keratins were mitogenic toward fibroblasts and keratinocytes. Keratin-based hydrogels were shown to be capable of passivating chemical and thermal burns in a mouse and pig model, respectively.
  • Keratose Clean, dry hair was cut into small fibers and oxidized with peracetic acid. Free proteins were extracted using a denaturing solution, neutralized, purified by dialysis, concentrated, and isolated by lyophilization. A hydrogel was formed by re-hydration with phosphate buffered saline (PBS).
  • PBS phosphate buffered saline
  • Kerateine Clean, dry hair was cut into small fibers and reduced with thioglycolic acid. Free proteins were extracted using a denaturing solution, dialyzed, neutralized, and concentrated. Upon concentration, a viscous hydrogel formed upon exposure to air.
  • Cell proliferation Keratose powder (unfractionated keratose, alpha + gamma) was dissolved in culture media with and without serum at several concentrations and used to culture human dermal fibroblasts and keratinocytes. The cells had been grown to approximately 50% confluency in serum-containing media and serum starved for 24 hours prior to exposure to the keratin-containing solutions.
  • the hemostatic potential of keratin gel was evaluated in a modestly challenging animal model.
  • the keratin gel comprised unfractionated kerateine (alpha+gamma). Liver injuries are notoriously problematic as both the size of the liver and of the wound increase. This rabbit model can produce both profuse and lethal hemorrhage. Controlled liver transection was used as a means to establish a consistent set of conditions that would result in exsanguination in the absence of treatment (negative control), yet provide for the recovery of test animals when a conventional hemostat was applied (positive control). It should be noted that the hemostats used as positive controls in this study are indicated for topical wounds and require concomitant pressure; they were applied without compression in this study. This was done to avoid the confounding contribution compression would add as it was not used with the keratin gel.
  • the animals received a standardized liver injury that consisted of transection of approximately one third of the left central lobe and were then randomized into one of four groups.
  • No resuscitation fluids were given and all animals were closely monitored during surgery. After one hour the surgical wound was closed and the animals transferred to the housing facility. All surviving animals were sacrificed after 72 hours. At the time of sacrifice, liver tissue was retrieved for histological analysis.
  • MAP mean arterial pressure
  • Preliminary data during model development showed that a consistent liver injury cross sectional area could be created that resulted in death when left untreated, but that when treated with a control material could rescue the animal.
  • a 2.0 cm 2 surface area ring was used to inflict a consistent sized injury to the liver by pulling the left central lobe through the ring and cutting immediately adjacent to the ring with a surgical blade.
  • the MAP, temperature, heart rate, O2 saturation, and shed blood were recorded throughout the procedure at 30 seconds, 5, 15, 30, 45 and 60 minutes. Shed blood was measured at each time point using pre- weighed sterile surgical gauze that was placed under the liver injury. In addition, blood samples were taken for CBC through an ear vein. All animals were randomized into the previously mentioned four experimental groups.
  • the negative control group did not receive any treatment and the time of death was recorded in minutes after infliction of the injury.
  • the treatment was administered at the 5 minute time point unless the MAP fell to half of the starting value.
  • the hemostatic materials applied were measured or weighed. The keratin gel does not require compression so no compression was used in any of the other treatment groups so as not to confound the results.
  • the HemCon® hemostatic bandage treatment group a 4.5 x 2.5 cm piece of bandage that was placed on the bleeding surface of the liver throughout the procedure and was removed prior to closure.
  • the QuikClot® hemostatic agent treated group 2.5 grams of autoclave sterilized material per animal was used.
  • the material was spread on the bleeding surface and was left after closure in the surviving animals.
  • 2 ml of the gel was used per animal.
  • Sterile keratin gel was applied to the bleeding surface through a 1 ml syringe.
  • the keratin was also left in place after closure of the animals. These parameters were determined during initial model development based on complete coverage of the wound site. For the surviving animals, the monitoring continued for 60 minutes, after which the animal was considered to have survived the initial trauma and the bleeding stopped. The animals that were treated with HemCon® hemostatic bandage had to undergo removal of the material since it could not be left intraabdominally as indicated by the manufacturer. The aortic cannula was removed and hemostasis established at the insertion site. No aortic bleeding was observed in any animal at necropsy. The fascia and skin of the abdomen was closed in two layers.
  • Negative control animals i.e. no treatment
  • Two animals in the QuikClot® hemostatic agent group and one in the HemCon® hemostatic bandage group did not survive beyond the initial 60 minute operative period.
  • one animal in the HemCon® hemostatic bandage group one animal was euthanized 24 hours post-op on the advice of the veterinary staff. This animal was not ambulatory and could not eat or drink.
  • One animal in the keratin group was also sacrificed at 48 hours. Although the animal was moving freely in its cage, it was not eating or drinking. At necropsy, these animals showed no evidence of additional bleeding after the operative period. All other surviving animals recovered without incident, were freely moving in their cages within 24 hours, and had normal CBC by 72 hours (data not shown).
  • a summary of the survival data is shown in Figure 4.
  • the mean arterial pressure was recorded using a 23 gauge needle placed into the lower part of the abdominal aorta. The needle was connected to a PE 50 tube, which in turn was connected to a pressure transducer (Lab-stat) that was connected to a PowerLab system for pressure recording. The MAP was continuously monitored during the entire course of the procedure or until the death of the animal. To further evaluate the significance of a change in MAP and heart rate, shock index was used. Shock index is a well established clinical scoring system for fast assessment of trauma patients. The modified shock index was calculated by dividing heart rate by MAP (mmHg).
  • the high values of QuikClot® hemostatic agent matched with two early deaths during the first 20 minutes of observation supporting the predictive nature of this measure. Although a trend was noted, these data did not reach statistical significance in the present study.
  • the central temperature was recorded with an esophageal probe connected to the surgery room monitor. The temperature of the animal was continuously monitored throughout the procedure and recorded at the previously mentioned time points. The ECG and heart rate were monitored using a three lead system connected to the surgery room monitor and was maintained throughout the entire procedure. Flat line or irregular electrical activity with electrical mechanical dissociation was used to define the time of death.
  • the liver damage model employed in this study represented severe trauma with significant, rapid blood loss. The liver transection produced a lethal injury, typically involving one or two large vessels of approximately lmm diameter and several in the 0.5 to 1.0 mm diameter ranges. The severity of the injury was such that untreated rabbits all exsanguinated within the 60 minute operative period.
  • Shed Blood Shed Blood was measured by weight after subtracting the weight of the pre-weighed gauze. Weights were recorded at each time point and fresh gauze placed under the liver injury. The shed blood was represented as a percent of the original body weight for each animal.
  • CBC was determined from samples taken from an ear vein on a HEMAVet® multi-species hematology system (Model 950FS, Drew Scientific, Dallas, TX).
  • Blood loss was measured by weighing the surgical gauze placed below the injured liver lobe. The blood loss was expressed as percentage of starting body weight. As expected in uncontrolled hemorrhage studies, all animals showed an initial phase of profuse bleeding followed by a linear phase with a lower bleeding rate, as MAP falls ( Figure 5).
  • a comparison of the keratin and QuikClot® hemostatic agent groups to the negative controls shows a significantly decreased amount of blood loss at the 30, 45, and 60 minute time points (p values for keratin vs. negative control were 0.018, 0.011 and 0.007; p values for QuikClot® hemostatic agent vs. negative control were 0.009, 0.005 and 0.004, respectively).
  • the survivability of the animals appeared to be dependent on the vascular anatomy at the injury site, which was not consistent from animal to animal even though the total surface area transected was controlled.
  • a single very large bleeder > 1 mm
  • multiple large bleeders > 2 to 3 in the Im size range
  • the animal's chance of survival was negligible in the QuikClot® hemostatic agent and HemCon® hemostatic bandage groups.
  • a single very large bleeder or an excess of 2 to 3 large bleeders would ensure lethality.
  • tissue sample including the damaged liver surface was removed from each animal within one hour of euthanasia. Each sample was placed in Tissue-Tek® O. C. T. Compound 4583 (Sakura®) and frozen in liquid nitrogen. The frozen blocks were sectioned into 8 ⁇ m slices using a cryostat (Model CM 1850, Leica Microsystems, Bannockburn, IL) to include the transected portion of the liver and mounted onto microscope slides. The slides were fixed and stained with Hematoxylin and Eosin (H&E). Technical difficulties in sectioning arose with both the QuikClot® hemostatic agent and the HemCon® hemostatic bandage sections.
  • H&E Hematoxylin and Eosin
  • the brittle QuikClot® hemostatic agent made level sectioning difficult and created voids in the sections.
  • the HemCon® hemostatic bandage was removed before abdominal closure and therefore the clotted blood was only partially visible.
  • Digital images were taken (Zeiss Axio Imager Ml Microscope, Carl Zeiss, Thornwood, NY) at varying magnifications to observe the interactions between the hemostat and the damaged area of the liver.
  • a magnification of IOOX showed the overall response of the tissue, while magnifications of 200X and 400X were used to visualize the cellular response.
  • the transected liver surfaces were examined by light microscopy of H&E stained sections.
  • the negative control group showed a clean cut with no tissue response or necrosis (Figure 8A).
  • no functional clotting was observed with little thrombus adhered to the surface.
  • the QuikClot® hemostatic agent samples were difficult to process due to the presence of this hard, granular zeolite in the clot. Histology revealed necrotic tissue mixed with blood clots ( Figure 8B).
  • the transparent areas represent QuikClot® hemostatic agent particles removed during processing.
  • the HemCon® hemostatic bandage group showed some areas with clotted blood and adjacent cellular infiltration (Figure 8C).
  • the keratin gel formed a thick seal of granulation-like tissue over the wound site by 72 hours. Upon inspection of histological sections, 3 days after injury host cells could be seen infiltrating the gel. It is believed that the keratin gel used in these experiments serves two purposes. First, contact of the gel with whole blood instigates thrombus formation, probably through platelet activation or concentration of clotting factors. Second, the adherent gel forms a physical seal of the wound site and provides a porous scaffold for cell infiltration and granulation-like tissue formation, much like clotted blood.

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Abstract

L'invention porte sur des préparations kératiniques destinées à être utilisées dans des applications médicales. L'invention porte sur des procédés de traitement des lésions, suivant lesquels des préparations kératiques sont appliquées sur la lésion en une quantité efficace pour le traitement. L'invention porte également sur des procédés de traitement de lésions de brûlure. L'invention porte aussi sur des adjuvants chirurgicaux ou paramédicaux comprenant un substrat avec des préparations kératiques disposées sur celui-ci. L'invention porte également sur des trousses comprenant des dérivés de kératine conditionnés sous une forme stérile.
EP08743024A 2007-04-17 2008-04-17 Compositions de cicatrisation contenant des biomatériaux kératiniques Withdrawn EP2146738A2 (fr)

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AU2011222540B2 (en) * 2010-03-05 2016-09-29 Wake Forest University Health Sciences Controlled delivery system
AU2011329839B2 (en) 2010-11-17 2016-12-08 Wake Forest University Health Sciences Keratin compositions for treatment of bone deficiency or injury
EP2744820B1 (fr) 2011-08-17 2018-07-25 Keranetics LLC Procédés d'extraction de protéines de la kératine
US9700631B2 (en) 2011-08-17 2017-07-11 KeraNetics, LLC Low protein percentage gelling compositions
US9827245B2 (en) 2013-03-15 2017-11-28 KeraNetics, LLC Keratin compositions comprising halofuginone
US11273118B2 (en) 2014-06-04 2022-03-15 Zim Biosciences, Inc. Compositions and methods for improving skin quality
JP6637241B2 (ja) * 2015-03-02 2020-01-29 アドバンス株式会社 可溶性ケラテインの製造法
CN106473945A (zh) * 2016-07-21 2017-03-08 北京东方艾美生物技术股份有限公司 一种角蛋白面膜的制备方法
WO2018220739A1 (fr) * 2017-05-31 2018-12-06 株式会社リトル・サイエンティスト Dérivé de kératine obtenu à haut rendement, et procédé de mise en œuvre de celui-ci
CN112724227B (zh) * 2019-10-28 2023-09-26 中国医学科学院药物研究所 一种角蛋白bd-1、制法和其药物组合物与用途
CN112794894B (zh) * 2019-10-28 2023-09-26 中国医学科学院药物研究所 一种角蛋白bd-17、制法和其药物组合物与用途

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