JP2017538922A - 血栓溶解剤の存在下における粘弾性解析を用いた新規病態の確認 - Google Patents
血栓溶解剤の存在下における粘弾性解析を用いた新規病態の確認 Download PDFInfo
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Abstract
Description
本出願は、2014年11月6日に出願された米国仮特許出願第62/076,386号の優先権を主張するものであり、その全内容は参照により本明細書に組み込まれる。
連邦政府資金による研究開発の記載
背景技術
Claims (64)
- 患者における異常な線維素溶解を検出するための方法であって、
a)患者からの血液サンプルを、既知の量の血栓溶解剤の存在下での粘弾性分析に供して、患者の血液凝固特性値を得ること、および
b)患者の凝固特性値を健康な個体の凝固特性値または健康な個体群の平均凝固特性値と比較すること、健康な個体の凝固特性値は健康な個体からの血液サンプルを既知の量の血栓溶解剤の存在下での粘弾性分析に供して得られたものであり、そして健康な個体群の平均凝固特性値は健康な複数の個体からの血液サンプルを既知の量の血栓溶解剤の存在下での粘弾性分析に供して得られたものであり、
ここで健康な個体の凝固特性値または健康な個体群の平均凝固特性値と比較した患者の凝固特性値の差異は、患者が異常な線維素溶解を有するものとして確認する、を含む方法。 - 凝固特性値は、LY30値またはLI30値である、請求項1に記載の方法。
- 血栓溶解剤は、ヒト一本鎖組織プラスミノゲン活性化因子(tPA)である、請求項1に記載の方法。
- 血栓溶解剤は、ヒトtPA、ヒト一本鎖tPA、ヒト二本鎖tPA、非ヒト哺乳動物種由来のtPA、アルテプラーゼ、レテプラーゼ、テネクテプラーゼ、アニストレプラーゼ、セロキナーゼ、ストレプトキナーゼ、ウロキナーゼ、およびカリクレインからなる群から選択される、請求項1に記載の方法。
- 既知の量は少量であり、異常な線維素溶解状態は高線維素溶解である、請求項1に記載の方法。
- 健康な個体の凝固特性値と比較した、または健康な個体群の平均凝固特性値と比較した患者の凝固特性値の増加は、患者が高線維素溶解を有するものとして確認する、請求項5に記載の方法。
- 少量は、約1ng/mlから約100ng/mlの間の血栓溶解剤である、請求項5に記載の方法。
- 血栓溶解剤はヒト一本鎖組織プラスミノゲン活性化因子(tPA)であり、少量は約75ng/mlである、請求項5に記載の方法。
- 既知の量は多量であり、異常な線維素溶解状態は線維素溶解停止である、請求項1に記載の方法。
- 健康な個体の凝固特性値と比較した、または健康な個体群の平均凝固特性値と比較した患者の凝固特性値の減少は、患者が線維素溶解停止を有するものとして確認する、請求項9に記載の方法。
- 多量は、約110ng/mlから約1200ng/mlの間の血栓溶解剤である、請求項8に記載の方法。
- 血栓溶解剤はヒト一本鎖組織プラスミノゲン活性化因子(tPA)であり、少量は約150ng/mlである、請求項9に記載の方法。
- 粘弾性分析は、容器の内側にサンプルを含む容器を用いて行われる、請求項1に記載の方法。
- 粘弾性分析は、容器およびピンを用いて行われ、ここでピンは容器に対して動く、請求項1に記載の方法。
- 粘弾性分析は、容器およびピンを用いて行われ、ここで容器はピンに対して動く、請求項1に記載の方法。
- 容器は底面がない、請求項13に記載の方法。
- 患者は、ヒトまたは非ヒト動物である、請求項1に記載の方法。
- 患者は、手術、病気状態、重病、外傷、出血、および血栓塞栓症からなる群から選択される状態を有するまたは状態にある、請求項1に記載の方法。
- 高線維素溶解を有すると確認された患者は、血塊を強めるまたは血塊の溶解を遅らせる治療剤の治療的に関連する量が投与される、請求項5に記載の方法。
- 血塊を強めるまたは血塊の溶解を遅らせる治療剤は、抗線維素溶解剤、全血、血漿、寒冷沈降物、第XIII因子、フィブリノゲン、他の特異的凝固因子濃縮物、およびこれらの1以上の組み合わせからなる群から選択される、請求項19に記載の方法。
- 血塊を強めるまたは血塊の溶解を遅らせる治療剤の治療的に関連する量は、患者の凝固特性値に基づいて決定される、請求項19に記載の方法。
- 線維素溶解停止を有すると確認された患者は、血塊を弱めるまたは血塊の溶解を速める治療薬の治療的に関連する量が投与される、請求項9に記載の方法。
- 血塊を弱めるまたは血塊の溶解を速める治療薬は、アスピリン、ヘパリン、クロピドグレル、ワルファリン、直接トロンビン阻害剤、第Xa因子阻害剤、tPA、抗凝固剤、血栓溶解剤、抗フィブリノゲン剤、抗第XIII因子剤、糖タンパク質IIb/IIIa阻害剤、および抗血小板剤からなる群から選択される、請求項22に記載の方法。
- 血塊を弱めるまたは血塊の溶解を速める治療薬の治療的に関連する量は、患者の凝固特性値に基づいて決定される、請求項22に記載の方法。
- 患者における潜在性高線維素溶解または線維素溶解停止を検出するための方法であって、
a)患者からの第1の血液サンプルを、少量の血栓溶解剤の存在下での粘弾性分析に供して、患者の低凝固特性値を得ること、
b)患者からの第2の血液サンプルを、多量の血栓溶解剤の存在下での粘弾性分析に供して、患者の高凝固特性値を得ること、
c)患者の低凝固特性値を、健康な個体の低凝固特性値または健康な個体群の平均低凝固特性値と比較すること、健康な個体の低凝固特性値は健康な個体からの血液サンプルを少量の血栓溶解剤の存在下での粘弾性分析に供することにより得られ、そして健康な個体群の平均低凝固特性値は健康な複数の個体からの血液サンプルを少量の血栓溶解剤の存在下での粘弾性分析に供することにより得られ、ならびに
d)患者の高凝固特性値を、健康な個体の高凝固特性値と比較すること、健康な個体の高凝固特性値は健康な個体からの血液サンプルを多量の血栓溶解剤の存在下での粘弾性分析に供することにより得られ、
ここで健康な個体の低凝固特性値または健康な個体群の平均低凝固特性値と比較した患者の低凝固特性値の差異は、患者が高線維素溶解(例えば、潜在性高線維素溶解)を有するものとして確認し、ここで健康な個体の高凝固特性値または健康な個体群の平均高凝固特性値と比較した患者の高凝固特性値の差異は、患者が線維素溶解停止を有するものとして確認する、を含む方法。 - 血栓溶解剤はヒト一本鎖組織プラスミノゲン活性化因子(tPA)である、請求項25に記載の方法。
- 血栓溶解剤は、ヒト一本鎖tPA、ヒト二本鎖tPA、非ヒト哺乳動物種由来のtPA、アルテプラーゼ、レテプラーゼ、テネクテプラーゼ、アニストレプラーゼ、セロキナーゼ、ストレプトキナーゼ、ウロキナーゼ、およびカリクレインからなる群から選択される、請求項25に記載の方法。
- 少量は、約1ng/mlから約100ng/mlの間の血栓溶解剤である、請求項25に記載の方法。
- 血栓溶解剤はヒト一本鎖組織プラスミノゲン活性化因子(tPA)であり、少量は約75ng/mlである、請求項25に記載の方法。
- 健康な個体の低凝固特性値と比較した、または健康な個体群の平均低凝固特性値と比較した患者の低凝固特性値の増加は、患者が高線維素溶解を有するものとして確認する、請求項25に記載の方法。
- 多量は、約110ng/mlから約1200ng/mlの間の血栓溶解剤である、請求項25に記載の方法。
- 血栓溶解剤はヒト一本鎖組織プラスミノゲン活性化因子(tPA)であり、多量は約150ng/mlである、請求項25に記載の方法。
- 健康な個体の高凝固特性値と比較した、または健康な個体群の平均高凝固特性値と比較した患者の高凝固特性値の減少は、患者が線維素溶解停止を有するものとして確認する、請求項25に記載の方法。
- 粘弾性分析は、容器の内側にサンプルを含む容器を用いて行われる、請求項25に記載の方法。
- 粘弾性分析は、容器およびピンを用いて行われ、ここでピンは容器に対して動く、請求項34に記載の方法。
- 粘弾性分析は、容器およびピンを用いて行われ、ここで容器はピンに対して動く、請求項34に記載の方法。
- 容器は底面がない、請求項34に記載の方法。
- 凝固特性値は、本質的にLY30値およびLI30値からなる群から選択される、請求項25に記載の方法。
- 患者は、ヒトまたは非ヒト動物である、請求項25に記載の方法。
- 患者は、手術、病気状態、重病、外傷、出血、および血栓塞栓症からなる群から選択される状態を有するまたは状態にある、請求項25に記載の方法。
- 高線維素溶解を有すると確認された患者は、血塊を強めるまたは血塊の溶解を遅らせる治療剤の治療的に関連する量が投与される、請求項25に記載の方法。
- 血塊を強めるまたは血塊の溶解を遅らせる治療剤は、抗線維素溶解剤、全血、血漿、寒冷沈降物、第XIII因子、フィブリノゲン、および他の特異的凝固因子濃縮物からなる群から選択される、請求項41に記載の方法。
- 血塊を強めるまたは血塊の溶解を遅らせる治療剤の治療的に関連する量は、患者の低凝固特性値に基づいて決定される、請求項40に記載の方法。
- 線維素溶解停止を有すると確認された患者は、血塊を弱めるまたは血塊の溶解を速める治療薬の治療的に関連する量が投与される、請求項25に記載の方法。
- 血塊を弱めるまたは血塊の溶解を速める治療薬は、アスピリン、ヘパリン、クロピドグレル、ワルファリン、直接トロンビン阻害剤、第Xa因子阻害剤、tPA、抗凝固剤、血栓溶解剤、抗フィブリノゲン剤、抗第XIII因子剤、糖タンパク質IIb/IIIa阻害剤、および抗血小板剤からなる群から選択される、請求項44に記載の方法。
- 血塊を弱めるまたは血塊の溶解を速める治療薬の治療的に関連する量は、患者の高凝固特性値に基づいて決定される、請求項44に記載の方法。
- 少量の血栓溶解剤を含むコーティングを有する内側を含む、粘弾性分析を用いて血液サンプルにおける高線維素溶解を検出するのに適した容器。
- 血栓溶解剤はヒト一本鎖組織プラスミノゲン活性化因子(tPA)である、請求項47に記載の容器。
- 少量は、約1ng/mlから約100ng/mlの間の血栓溶解剤である、請求項47に記載の容器。
- 血栓溶解剤はヒト一本鎖組織プラスミノゲン活性化因子(tPA)であり、少量は約75ng/mlである、請求項47に記載の容器。
- 多量の血栓溶解剤を含むコーティングを有する内側を含む、粘弾性分析を用いて血液サンプルにおける線維素溶解停止を検出するのに適した容器。
- 血栓溶解剤はヒト一本鎖組織プラスミノゲン活性化因子(tPA)である、請求項51に記載の容器。
- 多量は、約110ng/mlから約1200ng/mlの間の血栓溶解剤である、請求項51に記載の容器。
- 血栓溶解剤はヒト一本鎖組織プラスミノゲン活性化因子(tPA)であり、多量は約150ng/mlである、請求項51に記載の容器。
- 少量の血栓溶解剤を含むコーティングを有する内側を含む、粘弾性分析を用いて血液サンプルにおける高線維素溶解を検出するのに適した第1の容器、多量の血栓溶解剤を含むコーティングを有する内側を含む、粘弾性分析を用いて血液サンプルにおける線維素溶解停止を検出するのに適した第2の容器、および血液サンプルにおける粘弾性分析を行うための指示書を含む、キット。
- 血液サンプルにおいて異常な線維素溶解を検出するための複数の容器を含むカートリッジであって、ここで少なくとも1つの容器は少量の血栓溶解剤を含むコーティングを有する内側を含み、少なくとも1つの容器は多量の血栓溶解剤を含むコーティングを有する内側を含む、カートリッジ。
- 血栓溶解剤は組織プラスミノゲン活性化因子(tPA)である、請求項56に記載のカートリッジ。
- 多量は、約110ng/mlから約1200ng/mlの間の血栓溶解剤である、請求項56に記載のカートリッジ。
- 血栓溶解剤は組織プラスミノゲン活性化因子(tPA)であり、多量は約150ng/mlである、請求項56に記載のカートリッジ。
- 少量は、約1ng/mlから約100ng/mlの間の血栓溶解剤である、請求項56に記載のカートリッジ。
- 血栓溶解剤は組織プラスミノゲン活性化因子(tPA)であり、少量は約75ng/mlである、請求項56に記載のカートリッジ。
- 容器は底面がない、請求項56に記載のカートリッジ。
- 抗線維素溶解剤は、トラネキサム酸、アミノカプロン酸、アプロチニンからなる群から選択される、請求項20に記載の方法。
- 抗線維素溶解剤は、トラネキサム酸、アミノカプロン酸、アプロチニンからなる群から選択される、請求項42に記載の方法。
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