Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K33/00—Medicinal preparations containing inorganic active ingredients
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
  • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
• • 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
  • A61K9/007—Pulmonary tract; Aromatherapy
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P39/00—General protective or antinoxious agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
  • A61F2007/0059—Heating or cooling appliances for medical or therapeutic treatment of the human body with an open fluid circuit
  • A61F2007/006—Heating or cooling appliances for medical or therapeutic treatment of the human body with an open fluid circuit of gas
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
  • A61F7/12—Devices for heating or cooling internal body cavities
  • A61F2007/126—Devices for heating or cooling internal body cavities for invasive application, e.g. for introducing into blood vessels

Definitions

• the present invention relates to an inhalable gas composition and more particularly relates to a choice of adequate proportions of the gases of the composition.
• hypothermic conditions are very often the only therapy proposed in the context of neurological (ischemic or non-ischemic) and psychiatric ("Drug Treatment in Psychiatry", Trevor Silverstone and Paul Turner Eds, 1995 ( P291)).
• Xenon has been an anesthetic agent with marketing authorization in Europe since 2007. It is probably as an antagonist of N-methyl-D-aspartate (NMDA) glutamatergic receptors and for its anti-inflammatory effect. proteolytic, that xenon has organoprotective and especially neuroprotective properties. ("Xenon: Elemental Anaesthesia in Clinical Practice," Robert D. Sanders, Daqing Ma and Mervyn Maze, British Medical Bulletin (2005) 71 (1): 115-135).
• argon, agonist GABAergic type A receptors (Gamma-aminobutyric acid neuropharmacological investigations on narcosis produced by nitrogen, argon, gold nitrous oxide", Abraini JH, Kriem B, Balon N, Rostain JC, Risso JJ, Anesthesia and Analgesia 2003; 96: 746-9) and Mu-type opioid-receptor antagonists ("Argon blocks the expression of locomotor sensitization to amphetamine through antagonism at the vesicular monoamine transporter-2 and mu-opioid receptor").
• xenon and argon have the drawback of having hyperthermic properties for given inhalation temperatures, these inert gases having a molar mass greater than that of nitrogen and a thermal conductivity lower than that of nitrogen. nitrogen, which gives them, in their use in inhalable gaseous compositions, a hyperthermic character.
• nitrogen which gives them, in their use in inhalable gaseous compositions, a hyperthermic character.
• the use of a gas with hyperthermic properties will tend to put the subjects breathing in a hyperthermic state, which is deleterious in the context of the therapies of most neurological or psychiatric diseases.
• independent cooling means such as pockets of water or cold gel
• the independent cooling means may also be a use of an adjustable temperature hydraulic mattress or selective cooling carried out using a chilled water circuit.
• cooling means by direct application to the skin do not make it possible to obtain an optimal cooling of the subject, that is to say a homogeneous cooling, it being understood that a temperature gradient is formed between the skin on contact with the skin.
• cooling means and the internal organs [009]
• the invention therefore relates to an inhalable gaseous composition comprising oxygen and a mixture of inert gases.
• the inert gas mixture comprises a first compound selected from xenon and argon having hyperthermic and a second compound having hypothermic properties, said inert gas mixture having proportions of the first compound and the second compound such that said mixture of inert gases is hypothermic under predetermined temperature conditions.
• Gas composition "inhalable” means a gaseous composition comprising at least 21% oxygen so that it can be breathed by a subject, it being understood that less than 21% oxygen in the inhaled mixture the subject is hypoxic.
• a gas or a mixture of inert gases having hypothermic properties is defined as being a gas or a mixture having a molar mass lower than that of nitrogen and a thermal conductivity greater than that of nitrogen thus conferring on it the possibility of putting the subject breathing in a state of hypothermia.
• the gaseous composition inhaled at a given temperature makes it possible to maintain the body temperature of the subjects inhaling it in a so-called hypothermic temperature range below 36.degree. C. and more specifically from 32.degree. C. to 35.degree.
• the inhalation of such a composition for inhalation temperatures between 16 ° C and 27 ° C allows the maintenance of body hypothermia, that is to say the maintenance of a body temperature in a hypothermic range, i.e., a range of temperatures below the range of normal body variability, substantially between 36.1 ° C and 37.8 ° C (Simmers, Louise, Diversified Health Occupations, 2nd ed. Canada: Delmar, 1988: 150-151), this range being rounded to 36-38 ° C, ie 37 + 1 ° C.
• the therapeutic hypothermic range generally extends below 36 ° C, and more specifically between 32 ° C and 35 ° C.
• the invention makes it possible to provide a gaseous composition that does not cause or risk causing an increase in the body temperature of the subjects inhaling the composition outside a range of so-called hypothermic values. extending below 36 ° C and more specifically from 32 ° C to 35 ° C. [013]
• this gas composition eliminates the temperature gradient between the skin and the internal organs during the use of mechanical cooling means.
• the inhalable gaseous composition makes it possible to obtain an optimal cooling of the subject, that is to say a homogeneous cooling.
• the second compound with hypothermic properties also has organoprotective properties.
• organoprotective properties is meant the protection of internal organs, such as for example the brain, blood vessels and nerves.
• the inhalable gaseous composition according to the invention allows, in addition to the maintenance of body temperature in a range of values corresponding to therapeutic body hypothermia, the protection of the internal organs during inhalation by a subject.
• the second compound may advantageously be helium.
• helium has both hypothermic and organoprotective properties.
• Heliox and oxygen reduce infarct volume in a rat model of focal ischemia Pan Y, Zhang H, Van Deripe DR, Cruz Flores S, Panneton WM (2007), Experimental Neurology 205: 587-90; Helium-oxygen mixtures on body temperature ", Tapper D, Arensman R, Johnson C, Folkman J (1974), Journal of Pediatrics Surgery 9: 597-603
• Post-ischemic helium provides neuroprotection in rats subjected to middle cerebral artery ocelusion- Indueed ischemia by producing hypothermia ", David HN, Haelewyn B, Chazalviel L, Lecocq M, Degoulet M, Risso JJ, Abraini JH (2009), Journal of Cerebral Blood Flow & Metabolism 29: 1159-1165” Modulation by the Noble Gas Heli
• the inhalable gaseous composition comprises 50% to 79% of the inert gas mixture; these proportions make it possible to ensure that the composition is inhalable and to avoid hypoxia of the subject inhaling the composition.
• composition comprises at least 13% helium. [019] - said composition comprises at most 50% xenon. Limiting the xenon content below 50% makes it possible to avoid an anesthetic effect on the subject breathing the composition, while also limiting the cost of obtaining the composition.
• said composition comprises 21% to 25% oxygen, 43% to 48% of helium and 30% to 35% xenon.
• the composition may comprise 45% to 47% of helium and 31% to 33% of xenon or for a 25% oxygen content, 43% to 45% helium and 30% to 32% xenon to ensure a body temperature of between 32 ° C and 35 ° C in humans.
• said composition may substantially comprise 22% of oxygen, 43% of helium and 35% of xenon.
• substantially it is meant that a margin of error or uncertainty of 1% is permissible.
• composition comprises at least 11% helium.
• composition comprises at most 67% of argon.
• said composition comprises 21% to 25% oxygen, 22% to 76% helium and 2% to 56% argon.
• said composition when the composition is inhaled at a temperature of 22 ° C., may comprise 22% oxygen, 37% to 68% helium and 10% to 41% argon or said composition comprises 25% oxygen, 36% to 65% helium and 10% to 39% of argon to ensure a body temperature of between 33 ° C and 35 ° C in humans.
• FIG. 1 is a graphical representation of the body temperature of the rat as a function of the temperature of the inhaled gas which is helium (curve C1) or xenon (curve C2);
• FIG. 2 is a graphical representation of the body temperature of the rat as a function of the temperature of the inhaled gas which is helium (curve C1) or argon (curve C3);
• Table 1 in the appendix represents the physical properties of the compounds of the present invention.
• Table 2 in the appendix shows the proportions of xenon and helium as a function of the oxygen content, the inhalation temperature of the composition and its effect on body temperature measured in the rat;
• Table 3 in the appendix shows the proportions of argon and helium as a function of the oxygen content, the inhalation temperature of the composition and its effect on body temperature measured in the rat.
• the air consists mainly of 21% oxygen, 78% nitrogen and 1% rare gas. It is substantially equivalent to say that the reference air consists of 21% oxygen and 79% nitrogen, this oxygen content being the minimum value that a gas mixture must contain to avoid hypoxia. a subject inhaling such a gaseous mixture.
• the gaseous composition according to the invention comprises oxygen and a mixture of inert gases, the proportion of nitrogen in the air being replaced by the mixture of inert gases.
• This mixture of inert gases consists of a first compound with hyperthermic properties and a second compound with hypothermic properties. The proportions of each compound of the inert gas mixture are such that they allow the composition inhaled gas to maintain the body temperature of a subject in a so-called hypothermic temperature range of 32 ° C to 35 ° C.
• the composition contains at least 21% oxygen, to avoid hypoxia during its inhalation.
• the composition contains at most 50% oxygen and preferably between 21% and 30%, or even between 21% and 25%.
• the composition contains at least 50% of inert gas mixture and preferably 70% to 79%.
• the inert gas mixture comprises a first compound selected from inert gases with hyperthermic properties and a second compound selected from inert gases with hypothermic properties.
• Inert gases have the advantage of not being metabolized after being inhaled.
• the first compound selected from inert gases with hyperthermic properties is xenon or argon. Indeed, as shown in Table 1 in the appendix, xenon and argon have a molar mass greater than nitrogen and a thermal conductivity lower than nitrogen, which gives them a hyperthermic character when one or another replaces nitrogen in a gaseous mixture.
• xenon and argon have organoprotective properties, that is to say that these compounds allow the protection of organs, blood vessels and nerves. These compounds are likely to protect the brain.
• the gaseous composition comprises, as first compound, that is to say as a compound with hyperthermic properties, xenon.
• the xenon is then mixed with a gas with hypothermic properties in proportions such that the mixture has hypothermic properties.
• a gas with hypothermic properties in proportions such that the mixture has hypothermic properties.
• it is chosen, to be mixed with xenon, a particular inert gas in that it has hypothermic properties, namely helium.
• helium has a lower molecular weight than nitrogen and a higher thermal conductivity than nitrogen, which gives it a hypothermic character when it replaces nitrogen in a gaseous mixture.
• helium also has organoprotective properties.
• FIG. 1 represents the experimental data of body temperature Te taken in a rat as a function of the inhalation temperature Ti of a helium-oxygen mixture (curve C1) or of a xenon-mixture oxygen (C2 curve), used to determine the proportions of the gaseous composition to meet to obtain a hypothermic gas mixture according to the inhalation temperature.
• curve C1 and C2 correspond to regression lines obtained on the basis of said experimental data Pi, some examples of which are given in FIG.
• the rat is commonly used as a preclinical model for the study of human physiology and pathology, normal body temperatures of rats and humans being otherwise of the same order, the administration of a gaseous mixture at different temperatures in the rat in a closed chamber is therefore comparable to the administration in humans of such a mixture of gases whose inhalation temperature Ti is substantially equal to the ambient temperature of the room where the treatment is administered. gaseous.
• the inhalation temperature Ti may for example be between 16 ° C and 27 ° C.
• a distance H22-T34 which represents the proportion of xenon making it possible to maintain the body temperature at 34.degree.
• a distance X22-T35 which represents the proportion of helium making it possible to maintain the body temperature at 35.degree.
• a distance H22-T35 which represents the proportion of xenon for maintaining the body temperature at 35 ° C.
• the distance H22-X22 corresponds to the difference between a body temperature of a rat breathing an oxygen-helium mixture, and a body temperature of a rat breathing an oxygen-xenon mixture at the same temperature. inhalation of 22 ° C.
• the distance X22-T34 corresponds to the difference between a body temperature of an oxygen-xenon breathing rat, for an inhalation temperature of 22 ° C, and a target body temperature of 34 ° C.
• the distances X22-T32, X22-T33 and X22-T35 correspond to the difference between the body temperature of the oxygen-xenon breathing rat and the target body temperatures of 32. ° C to 35 ° C.
• a first step consists of a calculation of the body temperatures: for an inhalation temperature substantially equal to 22 ° C, when a 22% 02-78% He mixture is breathed, a body temperature of 32.32 is obtained. ° C using the function representative of the curve C1, and when a mixture 22% 02-78% Xe is breathed, a body temperature of 38.60 ° C is obtained using the function representative of the curve C2.
• a difference, for the inhalation temperature of 22 ° C, between the body temperatures obtained by the calculation in the first step, which will subsequently serve as a reference value for calculations of the content of each of the compounds of the mixture a first difference D1 is thus calculated between the body temperature obtained with a mixture 22% O2-78% Xe and the body temperature obtained with a mixture 22% O2-78% He, and in the described case of an inhalation temperature equal to 22 ° C, a value of 6.28 is obtained here.
• a third step consists of a calculation of the content of one of the gases to be provided to ensure a body temperature of 34 ° C for an inhalation temperature of 22 ° C.
• it is arbitrarily chosen to determine the helium content, it being understood that one could choose to first determine the xenon content.
• a second difference D2 is calculated between the body temperature obtained with a mixture 22% O2-78% Xe and the desired body temperature for this inhalation temperature of 22 ° C, and here a value of 4.6 is obtained.
• This ratio between the values calculated in the second and third steps is used in a calculation of the cross-product type to determine the helium content, on the 78% of inert gases in addition to the oxygen, of the gas composition.
• the composition comprises 8 to 33% xenon and 45 to 70% helium. More specifically, if it is desired to obtain a body temperature of 34 ° C., the composition comprises 22% of oxygen, 56% to 58% of helium and 20% to 22% of xenon.
• the composition comprises at least 9% helium and at most 65% xenon. More particularly, when the oxygen content is between 21 and 30%, the composition comprises at least 13% of helium and at most 65% of xenon.
• a gaseous composition for the one hand to present the targeted thermal properties, that is to say the thermal properties obtained using a mixture of inert hypothermic gas, the appropriate proportions to obtain such a composition can be read in the tables, and it is intended according to the present invention a composition for further use on subjects without risking an undesired anesthetic effect, that is to say by limiting the contribution of xenon at 50% maximum.
• the composition comprises 21 to 30% oxygen, 26 to 77% helium, and 2 to 50% xenon.
• the composition comprises 22% oxygen, 45% to 47% helium and 31% to 33% xenon.
• the graph of FIG. 2 represents the experimental Pi body temperature data obtained in the rat as a function of the helium inhalation temperature (curve C1) or argon ( curve C3), from which the proportions of the different gases in a helium-argon-oxygen mixture were calculated (Table 3).
• the reference points Al 8 and Hl 8 used in this case were taken at an inhalation temperature Ti of 18 ° C., and the distances with the target body temperatures T32, T33, T34 and T35 are therefore representative of the proportions of the mixture of inert gases for this inhalation temperature of 18 ° C.
• curve C3 has a lower steering coefficient than curve C2.
• proportions of the inert gases in the inhalable gaseous composition according to the invention vary according to the quality of the first compound used in this composition, selected from argon or xenon.
• the composition comprises at most 67% of argon and at least 8% of helium. More particularly, when the oxygen content is between 21 and 30%, the composition comprises at most 67% of argon and at least 11% of helium. In addition, for Ti inhalation temperatures between 19 ° C and 23 ° C, the composition comprises 21 to 30% oxygen, 20 to 76% helium, and 2 to 56% argon. And still for inhalation temperatures Ti between 19 ° C and 23 ° C, the composition comprises 21 to 25% oxygen, 22% to 76% helium, and 2% to 56% argon.
• the inhalation of such a composition can be carried out by means of a man-machine interface such as a respiratory fan, a face mask, breathing goggles or any other type of interface.
• a man-machine interface such as a respiratory fan, a face mask, breathing goggles or any other type of interface.
• the packaging of such a composition is preferably carried out in a single container having the three compounds, namely xenon or argon , helium and oxygen, in previously fixed proportions under a pressure of between 10 and 300 bar.
• the container has a volume of 0, IL to 50L.
• the proportion of oxygen in this type of conditioning is always at least 22%.

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• 2016
  • 2016-04-08 AU AU2016401882A patent/AU2016401882B2/en not_active Ceased
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