JP2011093925A - 抗感染剤の徐放 - Google Patents
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- A61K31/407—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with other heterocyclic ring systems, e.g. ketorolac, physostigmine
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- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
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- A61K31/54—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one sulfur as the ring hetero atoms, e.g. sulthiame
- A61K31/542—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one sulfur as the ring hetero atoms, e.g. sulthiame ortho- or peri-condensed with heterocyclic ring systems
- A61K31/545—Compounds containing 5-thia-1-azabicyclo [4.2.0] octane ring systems, i.e. compounds containing a ring system of the formula:, e.g. cephalosporins, cefaclor, or cephalexine
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- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/007—Pulmonary tract; Aromatherapy
- A61K9/0073—Sprays or powders for inhalation; Aerolised or nebulised preparations generated by other means than thermal energy
- A61K9/0078—Sprays or powders for inhalation; Aerolised or nebulised preparations generated by other means than thermal energy for inhalation via a nebulizer such as a jet nebulizer, ultrasonic nebulizer, e.g. in the form of aqueous drug solutions or dispersions
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- A61K9/127—Liposomes
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- A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
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- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
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- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S977/00—Nanotechnology
- Y10S977/70—Nanostructure
- Y10S977/773—Nanoparticle, i.e. structure having three dimensions of 100 nm or less
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
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- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S977/00—Nanotechnology
- Y10S977/902—Specified use of nanostructure
- Y10S977/904—Specified use of nanostructure for medical, immunological, body treatment, or diagnosis
- Y10S977/906—Drug delivery
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
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- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
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- Y10S977/906—Drug delivery
- Y10S977/907—Liposome
Abstract
【解決手段】アミノグリコシド、ホスファチジルコリン及びステロールを含むリポソーム性アミノグリコシド合物であって、ホスファチジルコリン及びステロールのアミノグリコシドに対する重量比が2.5:1以下である、リポソーム性アミノグリコシド調合物。
【選択図】なし
Description
Pharmaceutical Basis of Therapeutics, 第8版で報告されるように、腎毒性及び聴器毒性の発生はアミノグリコシドが蓄積する濃度に関係するため、腎機能不全のある患者でこれらの薬物の維持量を低くすることが重要である。アミノグリコシドは、患者の障害に関係なく、前庭又は聴覚の機能不全や腎毒性を生じることがあるため、一般に維持量を減らすことが重要である。本発明は、維持量の劇的な減少を提供するものである。
とりわけ、有効量のリポソーム性/複合体形成した抗感染剤を、患者に肺投与するステップを含む、嚢胞性線維症患者における肺感染症を治療又は改善する方法が提供され、この場合、(i)投与される量は、相対的遊離薬物量の50%以下であるか、又は(ii)投薬は1日一回以下であるか、又は(iii)両者、である。
本出願は、脂質ベースの粒子に封入された抗感染剤(例えば抗生物質)の投与を含む、嚢胞性線維症患者などにおいて肺感染を治療又は改善する方法を開示するものである。
pneumoniae)を含む)、エシェリヒア-コリ(原語:Escherichia coli)、クレブシエラ(原語:Klebsiella )、エンテロバクター(原語:Enterobacter)、セラチア(原語:Serratia )、ヘモフィルス(原語:Haemophilus )、エルシニア-ペスティス(原語Yersinia pestis)、ブルクホルデリア-シュードマレイ(原語:Burkholderia pseudomallei)、B.セパシア(原語:B. cepacia )、B.グラディオリ(原語:B. gladioli )、B.ムルチヴォランス(原語:B. multivorans )、B.ヴェトナミエンシス(原語:B. vietnamiensis)、マイコバクテリウム-ツベルキュローシス(原語:Mycobacterium tuberculosis)、
M.アヴィウム複合 (MAC)(M.アヴィウム(原語:M. avium)及びM.イントラセルラ(原語:M. intracellulare)、M.カンサシ(原語:M. kansasii)、M.ゼノピ(原語:M. xenopi)、M.マリナム(原語:M. marinum)、M.ウルセランス(原語:M. ulcerans)、又はM.フォルテュイタム(原語:M. fortuitum )複合体(M.フォルテュイタム及びM.ケロネイ(原語:M. chelonei)感染、がある。
(PCs)、ホスファチジルイノシトール (PIs) 及びホスファチジルセリン (PSs)、がある。当該の脂肪酸には、飽和又は不飽和の12乃至26個の炭素原子の炭素鎖長の脂肪酸が含まれる。いくつかの具体的な例には、ミリスチルアミン、パルミチルアミン、ラウリルアミン及びステアリルアミン、ジラウロイルエチルホスホコリン (DLEP)、ジミリストイルエチルホスホコリン (DMEP)、ジパルミトイルエチルホスホコリン (DPEP) 及びジステアロイルエチルホスホコリン (DSEP)、N-(2, 3- ジ-(9 (Z)-オクタデセニルオキシ)-プロップ-1-イル-N,N,N-トリメチルアンモニウムクロリド (DOTMA) 及び 1, 2-ビス(オレオイルオキシ)-3-(トリメチルアンモニオ)プロパン (DOTAP)、がある。ステロイドの例には、コレステロール及びエルゴステロールがある。PGs、PAs、PIs、PCs 及び PSs の例には、DMPG、DPPG、DSPG、DMPA、DPPA、DSPA、DMPI、DPPI、DSPI、DMPS、DPPS 及びDSPS、DSPC、DPPG、DMPC、DOPC、卵PC、がある。
Proc. Nat Acad. Sci., 85:6122 6126, 1988) や、ドキソルビシンと複合体形成したカルジオリピンがある。
Cullis et al., Biotechnol Adv. 5(1):194, 1987を参照されたい)。Banghamの方法 (J.
Mol. Biol., J Mol Biol. 13(1):238-52, 1965) では通常の多層ベシクル
(MLVs)が作製される。Lenk ら (米国特許第4,522,803号、第5,030,453号及び第5,169,637号)、Fountain ら(米国特許第4,588,578号)及びCullis ら(米国特許第4,975,282号)は、それらの水性区画のそれぞれに実質的に同等な層間溶質分布を有する多層リポソームを作製する方法を開示している。Paphadjopoulos らは、米国特許第4,235,871号で、逆相蒸発によるオリゴラメラ・リポソームの調製を開示している。
al., Biochim. Biophys. Acta., 135:624-638, 1967; Deamer,
米国特許第4,515,736号;及びChapman et
al., Liposome Technol., 1984, pp. 1-18を参照されたい)。
Acta.,
1967, 135:624-638)が解説した小型の音波破砕された単層ラメラベシクルや、大型の単層ラメラベシクルの開発に基礎となる。
ed., Marcel Dekker, Inc., New
York, 1983、第1章に見ることができる。さらに、その関連する部分を引用をもってやはりここに援用することとするSzoka, Jr. et al., (1980, Ann. Rev. Biophys. Bioeng., 9:467)も参照されたい。
を参照されたい。Mayhew らは、抗菌剤及び抗カビ剤を、αトコフェロール及びそれらの特定の誘導体を含むリポソーム中に封入することにより、それらの毒性を低減する方法を解説した。さらに、多種のトコフェロール及びそれらの水溶性の誘導体が、リポソームを形成するために用いられてきた。Janoff らの米国特許第5,041,278号を参照されたい。
1998; Johansson, 1998)。この溶解上の挙動は、リポソームの段階的な分解や、続くそれらの内側の内容物の放出を促すことで、貯蔵作用を可能にしていると考えられる。リポソームのこのような分解は、エキソサイトーシスにより放出される層状体の自発的な解舒に証左されるように天然で起きる (Ikegami & Jobe, 1998) 。肺表面活性物質内で同化されることに加え、リポソームを、貪食によりマクロファージにより直接、飲食させることができる (Couveur et al.,
1991; Gonzales-Roth et al., 1991; Swenson et al, 1991)。肺胞マクロファージによるリポソームの取り込みは、薬物を罹患部位に送達することのできる別の手段である。
アミノグリコシドなどの性の電荷を持つ薬物の透過を妨げることで、それらを生物学的に無効にする (Mendelman et al., 1985)。抗感染剤をリポソーム又は脂質複合体内に捕捉すると、痰/バイオフィルムへの非特異的結合から抗感染剤を遮蔽もしくは部分的に遮蔽でき、こうして(捕捉されたアミノグリコシドと一緒に)リポソーム又は脂質複合体の透過が可能になるであろう(図1)。
1976)。
(1:1) である。ここでの脂質対脂質及び脂質対薬物比はすべて、重さ対重さである。
et al., 1968)。このマクロファージは、感染経路の両方で中心的であり、全身性(吸入)炭疽のホスト自己破壊の主要な寄与物質である。徐放及びターゲティングという特徴に加え、リポソーム性/複合体形成した抗感染剤技術は、薬物ターゲティング及び送達において、細胞取り込みを高め、肺胞マクロファージ及び肺上皮細胞を用いることができる。これらの特徴を有することは、肺内で置き、またマクロファージにより輸送されるようなこれらの細胞内感染の治療を容易にすると考えられる。より重要なことに、リポソーム性/複合体形成した抗感染剤は、疾患を含有するまさにその細胞によって貪食されるという点で、これらの特徴は当該の抗感染剤をより有効にするはずである。本抗感染剤は、標的決定された態様で、細胞内に放出され、それが播種する前に、感染を攻撃すると考えられる。封入される薬物は、シプロフロキサシン、テトラサイクリン、エリスロマイシン又はアミカシンなど、既に認可を受けている医薬であってよい。リポソーム性/複合体形成したシプロフロキサシンが開発されている。
mg/ml のシプロで入れ、当該の調合物は実施例の通りに作製された。脂質対薬物比は重量で 12.5:1 だった。経口投与されたシプロフロキサシンに比較して、リポソーム性/複合体形成したシプロフロキサシンは、マウス肺内に、遊離シプロフロキサシンよりも2桁多い量、存在した。さらに、リポソーム性/複合体形成したシプロフロキサシンのみが、24時間後に肺内の薬物レベルを示し、他方、経口投与されたこの薬物は、2時間未満で検出不能となった。このデータは、リポソーム性/複合体形成したシプロフロキサシンや、バイオテロリストが用いる細胞内疾患の治療及び予防のための他のアミノグリコシド、テトラサイクリン及びマクロライドなどの抗感染剤の使用を裏付けるものである。
当初[脂質] = 7.6 mg/ml当初[アミカシンスルフェート]= 57.3 mg/ml 最終生成物体積 = 150 mL
エタノールに50℃の水槽中で溶解させた。85.95g アミカシンスルフェートを1147.5 mL PBS 緩衝液中に直接、溶解させた。次にこの溶液を、ION NaOH 又は KOH で滴定して、pHをほぼ6.8にした。
エタノール/脂質を、1147.5 mL アミカシン/緩衝液に加えるか、又は輸注して、当初の総体積を1.5 Lとした。このエタノール/脂質を蠕動ポンプで-30mL/分(輸注速度とも呼ばれる)で、室温の攪拌プレート上に載せた反応容器中の、150RPMで高速攪拌中のアミカシン/緩衝溶液に入れた。
S. and Possmayer, F., The
Role of Lipids in Pulmonary Surfactant, Biochim. Biophys. Acta 1408:90-108 (1998).2. Hagwood, S.,
Derrick, M. and Poulain, F., Structure and Properties
of Surfactant Protein B, Biochim. Biophys. Acta 1408:150-160 (1998).3. Johansson, J., Structure and Properties of Surfactant ProteinC, Biochim. Biophys. Acta 1408:161-172 (1998).4. Ikegami, M. and Jobe, A.H., Surfactant
Protein Metabolism in vivo, Biochim. Biophys. Acta 1408:218-225 (1998).5. Couveur, P., Fattel, E. and Andremont,A., Liposomes
and Nanoparticles in the Treatment of Intracellular
Bacterial Infections, Pharm. Res. 8:1079-1085 (1991).6. Gonzales-Rothi, R.J., Casace,
J., Straub, L., and Schreier, H., Liposomes
and Pulmonary Alveolar Macrophages: Functional and Morphologic Interactions,
Exp. Lung Res. 17:685-705 (1991).7. Swenson,
C.E., Pilkiewicz, F.G., and Cynamon,
M.H., Liposomal Aminoglycosides and TLC-65 Aids
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Bacterial Biofilms: A Common Cause of Persistent
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Kravitz, R.M., Efficacy of Aerosolized Tobramycin in Patients with cystic Fibrosis. New England J. of Med. 328:1740-1746 (1993).12. Mendelman,
P.M., Smith, A.L., Levy, J., Weber, A., Ramsey, B., Davis, R.L., Aminoglycoside
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M.D., Pursiano, T.A. Amikacin, an amioglycoside
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Susceptibility of current clinical isolates of Pseudomonas aeruginosa
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Claims (9)
- アミノグリコシド、ホスファチジルコリン及びステロールを含むリポソーム性アミノグリコシド合物であって、ホスファチジルコリン及びステロールのアミノグリコシドに対する重量比が2.5:1以下である、リポソーム性アミノグリコシド調合物。
- 前記アミノグリコシドがアミカシン、ストレプトマイシン、ゲンタマイシン、トブラマイシン、ネチルミシン、及びカナマイシンから成る群より選択される、請求項1に記載の調合物。
- 前記アミノグリコシドがアミカシンである、請求項1に記載の調合物。
- 前記アミノグリコシドがアミカシンスルフェートである、請求項1に記載の調合物。
- ホスファチジルコリン及びステロールのアミノグリコシドに対する前記重量比が1.1:1以下である、請求項1乃至4のいずれか一つに記載の調合物。
- 前記ホスファチジルコリンが、卵ホスファチジルコリン(EPC)、大豆ホスファチジルコリン(SPC)、水素化卵ホスファチジルコリン(HEPC)、水素化大豆ホスファチジルコリン(HSPC)、ジパルミトイルホスファチジルコリン(DPPC)、ジオレオイルホスファチジルコリン(DOPC)、ジミリストイルホスファチジルコリン(DMPC)、ジステアロイルホスファチジルコリン(DSPC)、パルミトイルステアロイルホスファチジルコリン(PSPC)、及びこれらの混合物、から成る群より選択される、請求項1乃至5記載のいずれか一つに記載の調合物。
- 前記ステロールがコレステロールである、請求項1乃至6のいずれか一つに記載の調合物。
- 前記ホスファチジルコリンがDPPCであり、前記ステロールがコレステロールである、請求項6に記載の調合物。
- DPPC対コレステロールのモル比が19:1、9:1、4:1、13:7又は1:1である、請求項8に記載の調合物。
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