JP2018509455A - フィブリン組成物、方法及び創傷物品 - Google Patents
フィブリン組成物、方法及び創傷物品 Download PDFInfo
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- JP2018509455A JP2018509455A JP2017550479A JP2017550479A JP2018509455A JP 2018509455 A JP2018509455 A JP 2018509455A JP 2017550479 A JP2017550479 A JP 2017550479A JP 2017550479 A JP2017550479 A JP 2017550479A JP 2018509455 A JP2018509455 A JP 2018509455A
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- Prior art keywords
- fibrin
- hydrogel
- salt
- concentration
- composition
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Abstract
Description
HEPES、CaCl2、NaClは、SIGMA−Aldrich(Milwaukee,WI)より入手した。その他の材料は、下記の実施例中での使用ごとに掲載した。
フィブリンゲルは、フィブリノゲン(SIGMAカタログ番号F8630、SIGMA−Aldrich(Milwaukee,WI)より入手可能)2.7gを、下記の表1に示した各種の塩と、1重量%グリセロール(SIGMAカタログ番号G2025)とを含む水592.5mLに溶解することにより、成形容器に入れた。次に、フィブリノゲン1mg当たりトロンビン(SIGMAカタログ番号T7009)0.6単位を、フィブリノゲン溶液に加え、重合を開始した。この混合溶液を20〜30秒間混合した後、6ウェルのプレートに移し、重合を終了した。混合物を37℃で30分間インキュベートした後、ゲルの形成について定性的に評価した。
フィブリンゲルは、フィブリノゲン(SIGMAカタログ番号F8630)2.7gを、0.9% NaCl及び1重量%グリセロール(SIGMA catalog number G2025)を含む20mM HEPES、pH7.4(AMRESCOカタログ番号0511)の592.5mLに溶解することにより、成形容器に入れた。この溶液に、CaCl2(SIGMAカタログ番号C5670)2.0gを加えた。次に、フィブリノゲン1mg当たり、トロンビン(SIGMAカタログ番号T7000)0.06単位を、フィブリノゲン溶液に加え(その結果、トロンビン濃度0.27U/mLとなった)、重合を開始した。この溶液を20〜30秒間混合した後、凍結乾燥器のパン(10インチ×14インチ×1インチ、316Lのステンレス鋼パンで、ステンレス鋼の厚さは0.060インチ)に入れて成形し、厚さ約7mmのゲルを得た。ゲルは、37℃で30〜60分間インキュベートした。脱水前のフィブリンハイドロゲルに関して、フィブリン含量が約0.45重量%、塩含量が約0.6重量%、グリセロール含量が約1%で、残りが水であった(約98%)。
フィブリンゲルシートのin vivo試験は6頭のブタの試験で、72時間のエンドポイントで、ブタモデルを使用した部分肥厚創傷試験から構成された。ブタ1頭当たり、それぞれ面積5cm×7.6cm(2×3インチ)かつ深さ500μmの創傷が6個存在した。試験は、IACUCにより承認された手順を使用し、適切な動物の取り扱いを確保し、無用な苦痛を最小化するよう配慮して実施した。
H&E試料を分析し、角化細胞で覆われた創傷の幅を測定し、その値を測定された創傷の幅で除算することにより、再上皮化率を求めた。実施例4のフィブリンゲルシートで処置した創傷は、49.8±4.9%の再上皮化率を呈し、発泡体被覆材対照は、23.8±4.1%の再上皮化率を呈した(平均±95%信頼区間、n=16)。結論としては、実施例4の凍結乾燥されたフィブリンゲルシートによる処置の結果、標準的なケア(発泡体被覆材の対照)に比べ、約2倍超速い再上皮化がもたらされた。
再上皮化率に加え、実施例4及び発泡体被覆材の対照によって処置した創傷の組織試料を、バイオマーカーについても分析した。創傷は、フィブリンゲルシートによる処置72時間後に生検を行った。創傷の生検材料は、ブレンダによって均質化し、創傷治癒及び炎症性バイオマーカーについて分析した。多重ELISAを使用して、治癒促進性及び抗治癒性の創傷の結果を測定した。選択したスクリーニングパネルは以下を含んだ:(A)治癒促進性バイオマーカー:IL−4、IL−6、IL−10、EGF、塩基性FGF、VEGF、MMP−1、MMP−3、MMP−8、MMP−9、TIMP−1;並びに(B)抗治癒性バイオマーカー:TNF−alpha、IL1−alpha、IL−1beta、IL−2。表2に示したデータは、4頭のブタについて、各処置について2つの創傷の2つの生検結果を表している。表2は、創傷治癒のバイオマーカーの結果を示し、実施例4における対照(3M TEGADERM HP発泡体被覆材)に対してX倍の増加として要約した。結果によると、フィブリンによる処置には、標準的なケア(対照)と比べて顕著な変化、並びに創傷治癒を示す、フィブリンの媒介によるバイオマーカーの誘発傾向(5倍超の上方制御)が認められた。試験した抗治癒性バイオマーカーは、全てアッセイの検出限界未満であり(データは示さず)、炎症促進性が低いことが示され、実施例4のフィブリンゲルシートの、創傷治癒プロセスを完了へと促進する能力が更に確認された。統計的有意性はステューデントのt検定により判定し、有意性をp<0.05で判定した。
実施例4のフィブリンゲルシート(ナイロン織布の除去後)を、5kg重のロードセルを有するINSTRON引張試験機モデル5943を使用して、機械的特性について試験した。実施例4の乾燥した(凍結乾燥した)ゲルシートを幅6.2mmに切断した。ゲルシートの厚さをマイクロメータで測定し、試験した試料の断面積を求めた。引張試験装置は、測定ごとに、グリップの間隔について較正した。試料を引張グリップアダプタの間に固定し、50mm/分の速度で引き伸ばした。データの取得は、0.02Nの力が加わった際に開始した。生成したひずみを、in situで、各試験について試料測定の入力によって明らかとなった断面積を使用して算出した。ヤング率を、応力−ひずみ曲線の直線部分及び0.2%〜2%のひずみで規定される部分から計算した。
フィブリンゲルシートは、実施例4に記載の同一の方法によって調製した。変更は、(1)フィブリノゲン及びトロンビンは両方ともCambryn Biologics LLC(Sarasota,FL)より入手し、(2)2つの異なる乾燥法を評価した点のみである。フィブリンゲルシートの試料は、(i)上記で概説した凍結乾燥法を使用して乾燥した、又は、(ii)対流オーブン中、60℃で3〜5時間乾燥した。両方のフィルムの水分含量は10%以下であった。
実施例5のフィブリンゲルシートのin vivo試験は、実施例4と同様に実施した。2頭のブタの試験を、72時間のエンドポイントで実施した。処置群(凍結乾燥されたフィブリンゲルシート、オーブン乾燥されたフィブリンゲルシート、又は比較−3M発泡体被覆材のみ)の他には、実施例4で実施されたものと比べ、手順に違いはなかった。
H&E試料を分析し、実施例4で実施したように、角化細胞で覆われた創傷の幅を測定し、その値を測定された創傷の幅で除算することにより、再上皮化率を求めた。実施例5の試料のin vivo試験の再上皮化率の結果(平均±SEM、処置ごとにn=4)の概略を、下記の表4に示す。平均すると、実施例5のフィブリンゲルシートによる処置は、対照群(3M発泡体被覆材のみ)よりも2倍超高い再上皮化を呈した。再上皮化に関し、乾燥方法の間には、統計的有意差はなかった。
比較例C7は、グリセロールの不在下で、不十分な洗浄がフィブリンの形成に及ぼす影響及び創傷治癒に対する影響を明らかにするために調製した。
実施例4に記述の手順に従ったin vivoのブタの試験を、比較例C7を使用して実施した。比較例C7で処置した創傷組織は、高度に炎症を起こしていることが判明した。組織学的検査により、この高塩含量の材料の存在下における治癒過程中の皮膚の損傷の痕跡が示され、これは、真皮全体にわたる多数の好中球の存在並びにコラーゲンの分解及び石灰化によって明らかとなった。上記のとおり、実施例6及び7(上記)から得た組織の組織学的検査の薄片は、この影響は示さなかった。
実施例6及び比較例C8は、グリセロールの存在下で、不十分な洗浄がフィブリンの形成に及ぼす影響及び創傷治癒に対する影響を明らかにするために調製した。フィブリノゲン及びトロンビンは、両方とも、これらの実施例については、Cambryn Biologics,LLCより入手した。1つのゲルは、実施例4におけるように調製したが、1%のグリセロールを含み、ゲルの元の体積の10倍超の体積の18.2メガオーム(megaohm)−cmの水で2回洗浄した。もう一方のゲルは、実施例4において列挙した組成を2倍して調製し、1%のグリセロールを含み、ゲルの元の体積の10倍超の体積の18.2メガオーム−cmの水で1回洗浄した。調製した実施例の塩含量は、1重量%のフィブリンシート材料を含む溶液の伝導率を、25℃において18.2メグオーム−cmの水中で測定することによって求めた。完成品のフィブリンゲルシート中のグリセロール含量は、液体クロマトグラフィ−質量分析法(LC/MS)によって測定した。
実施例6及び比較例C8のゲルシートを、実施例4に記述の手順に従い、in vivoのブタの試験において評価した。創傷を再上皮化について3日後に検査したところ、実施例6は、低炎症性の部分及び再上皮化を示す色合いから明らかなように、創傷治癒を促進したことが示された。実施例6によって処置した創傷の組織学的検査によると、創傷領域にわたり、角化細胞の遊走が増加した痕跡が示された。比較例C8で処置したブタの創傷は、組織の損傷及び壊死の痕跡を示し、創傷領域は褐色/黒色化した。比較例C8で処置した創傷の組織学的検査によると、アポトーシス細胞、細胞破片、コラーゲンの変性及び脈管の壊死も示された。再上皮化の定量化により、実施例6(洗浄した低塩含量の配合物)で処置した創傷は、3M 90600 TEGADERM FOAM DRESSING対照の約2倍超速く治癒したことが示された。
フィブリンゲルを、フィブリノゲン(SIGMA−Aldrich,カタログ番号F8630)0.54gを20mMのHEPES緩衝食塩水(pH 7.4)60mL中に溶解することによって成形容器に入れ、原液とした。続いて、2重量%の可塑剤(表5)を原液5mLに加えることにより、フィブリノゲンと、異なる可塑剤との混合液を調製した。CaCl2(SIGMA−Aldrich,カタログ番号C5670)の0.4gの量を、1.2U/mLのトロンビンの溶液に加えた。等量のフィブリノゲン溶液及びトロンビン溶液を加えることにより、重合を開始した。得られた溶液を20〜30秒間混合した後、6ウェルプレートの1つのウェル中に成形するために入れた。ゲルを37℃で30〜60分間インキュベートした後、水(25℃において18.2メグオーム−cm)と1重量%の可塑剤との溶液中に定置した。この溶液の体積は、ゲルの体積よりも10倍超大きかった。ゲルをこの溶液中で終夜すすいだ後、乾燥するまで60℃のオーブンに入れた。試験した可塑剤の全てにより、可撓性フィブリンシートが得られた。
実施例8は、グリセロールは含まないが、適切なすすぎによって最終的な物品中の塩含量を低減して調製したフィブリンゲルシートを評価するために調製した。シートは、洗浄工程のグリセロール含量のみを変更し、実施例4と同様に調製した。シートは、洗浄水中のグリセロールが0%と1%の両方によって調製した。この塩除去工程の後、試料を対流オーブン中60℃で、水分含量が10%以下になるまで乾燥した。典型的には、3〜5時間で乾燥された。可塑剤を含まないフィブリン調製物を、より小さい、典型的には1cm〜約0.1mmの不規則なサイズの薄片に粉砕した。ほとんどの粒子は約0.5cm〜1cmであったが、これらは、例えば円板、正方形等の特定の形状には調節されず、不規則な形状であった。
実施例8の試料を、実施例4に記述の手順に従い、in vivoの(ブタ1頭の)ブタの試験において、72時間のエンドポイントで評価した。処置群の他には、実施例4で示したものと比べ、手順に違いはなかった。処置群は、フィブリン薄片(可塑剤を含まないフィブリンシートの大型の断片)、実施例4の可撓性フィブリンゲルシート及び3M TEGADERM発泡体被覆材からなった。
フィブリンマイクロビーズの実施例は、以下のように調製することができる。1Lの容器に、トウモロコシ油200mL及びイソオクタン200mLを加えることができる。溶液は、半月型の羽根車を備えたオーバーヘッドミキサで撹拌しながら、75℃まで加熱する。40mg/mLのフィブリノゲンを含む0.9% NaCl水溶液を調製する。食塩水中のフィブリノゲンの25mLの量と5mMのCaCl2溶液とをトロンビンと混合し、最終的なトロンビン濃度を5U/mLとする。タンパク質が凝集する前に、上記のタンパク質混合物をトウモロコシ油/イソオクタン溶液に加え、小さな水相の液滴が油相に分散され、フィブリンマイクロビーズを形成するように、羽根車で混合する。マイクロビーズのサイズは、50〜200μmの範囲であると推定される。混合及び加熱を75℃で6〜8時間継続する。フィブリンマイクロビーズを、油相から濾取する。続いて、フィブリンマイクロビーズを過剰の脱イオン水で洗浄して最終塩含量を0.5%とした後、48時間凍結乾燥してもよい。
発泡体フィブリン物品は、以下のように調製した。フィブリンゲルを、実施例4のようにフィブリノゲン溶液を調製することによって調製した。トロンビンを加えてフィブリンの重合を開始した直後に、溶液に通気するように、溶液を激しく20〜30秒間混合した。得られた通気された容器をパンに移し、重合を完了した。発泡体を37℃で30分間インキュベートした後、18.2メグオーム−cmの水と1重量%のグリセロールとの溶液中に定置した。この溶液の体積は、元のフィブリノゲン溶液の体積よりも10倍超大きかった。実施例5と同様に、発泡体を終夜すすいだ後、成形に使用したパンに戻して配置した。続いて発泡体を、実施例4と同様に凍結乾燥した。得られた、乾燥された発泡体は可撓性であり、塩濃度は5%未満であった。
Claims (32)
- フィブリノゲン、フィブリン形成酵素及びフィブリンハイドロゲルを形成する塩を含む水溶液を形成することであって、前記フィブリンハイドロゲルを形成する塩の濃度がフィブリンハイドロゲルを形成する閾値濃度以上である、水溶液を形成することと、
前記塩濃度を、フィブリンハイドロゲルを形成する前記閾値濃度未満に低減することと、を含む、フィブリンハイドロゲル組成物の形成方法。 - 前記フィブリンハイドロゲルを形成する塩が、カルシウム塩を含む、請求項1に記載の方法。
- 前記水溶液の前記閾値濃度が、少なくとも0.45重量%、又は0.50重量%、又は0.6重量%、又は0.7重量%、又は0.8重量%又は0.9重量%である、請求項1又は2に記載の方法。
- 前記水溶液が、可塑剤を更に含む、請求項1〜3のいずれか一項に記載の方法。
- 前記可塑剤が、糖アルコール、アルカンジオール、又はこれらの組み合わせを含む、請求項4に記載の方法。
- 前記水溶液が、緩衝剤を更に含む、請求項1〜5のいずれか一項に記載の方法。
- 前記フィブリンハイドロゲルを、シート、発泡体又は複数の断片に形成することを更に含む、請求項1〜6のいずれか一項に記載の方法。
- 前記フィブリンハイドロゲルを形成する塩の濃度を低減する工程が、水溶液で前記ハイドロゲルをすすぐことを含む、請求項1〜7のいずれか一項に記載の方法。
- 前記塩濃度の低減後に前記フィブリンハイドロゲルを脱水することを更に含む、請求項1〜8のいずれか一項に記載の方法。
- 前記脱水が、凍結乾燥、オーブン乾燥、又はこれらの組み合わせを含む、請求項9に記載の方法。
- 前記脱水されたフィブリンハイドロゲルの塩濃度が、20重量%以下の水分含量に対して、20、15、10又は5重量%以下である、請求項1に記載の方法。
- 前記脱水されたハイドロゲルを複数の断片に形成することを更に含む、請求項1〜11のいずれか一項に記載の方法。
- 請求項1〜12のいずれか一項に記載の方法によって調製された、フィブリンハイドロゲル組成物。
- フィブリン濃度が0.1〜10重量%の範囲であるフィブリンハイドロゲルと、
フィブリンハイドロゲルを形成する塩と、を含み、前記フィブリンハイドロゲルを形成する塩の濃度が、前記フィブリンハイドロゲルを形成する閾値濃度未満である、フィブリン組成物。 - 前記フィブリンハイドロゲルを形成する塩の濃度が、前記ハイドロゲルの0.45、0.40、0.35、0.30、0.25、0.20、0.15又は0.10重量%未満である、請求項14に記載のフィブリン組成物。
- 前記フィブリンハイドロゲルを形成する塩が、カルシウム塩を含む、請求項14に記載のフィブリン組成物。
- 前記フィブリンハイドロゲルが、可塑剤を更に含む、請求項14〜16のいずれか一項に記載のフィブリン組成物。
- 前記可塑剤が、糖アルコール、アルカンジオール、又はこれらの組み合わせを含む、請求項16に記載のフィブリン組成物。
- 前記フィブリンハイドロゲルが、少なくとも部分的に脱水されている、請求項18に記載のフィブリン組成物。
- 前記脱水されたフィブリンハイドロゲルの塩濃度が、20重量%以下の水分含量に対して、20、15、10又は5重量%以下である、請求項9に記載のフィブリン組成物。
- 前記フィブリンハイドロゲル又は前記脱水されたフィブリンハイドロゲルが、シート、発泡体又は複数の断片の形態である、請求項14〜20のいずれか一項に記載のフィブリン組成物。
- 請求項14〜21のいずれか一項に記載のフィブリン組成物を提供することと、担体上又は担体内に前記フィブリン組成物を配置することと、を含む、フィブリン物品の形成方法。
- 前記担体が、皮膚接着剤、剥離ライナー、ポリマーフィルム、ポリマー発泡体、又は不織材若しくは織布のファイバー材料である、請求項22に記載の方法。
- 照射を使用して前記フィブリン組成物を滅菌することを更に含む、請求項22又は23に記載の方法。
- 請求項14〜21のいずれか一項に記載のフィブリン組成物を含む、創傷被覆材。
- 前記フィブリン組成物が担体上又は担体内に配置された、請求項25に記載の創傷被覆材。
- 前記担体が、皮膚接着剤、剥離ライナー、ポリマーフィルム、ポリマー発泡体、又は不織材若しくは織布のファイバー材料から選択される、請求項26に記載の創傷被覆材。
- 前記フィブリン組成物が、坪量2〜30mg/cm2を有するシートの形態である、請求項25〜27のいずれか一項に記載の創傷被覆材。
- 前記シートの厚さが10μm〜200μmの範囲である、請求項28に記載の創傷被覆材。
- 請求項14〜21のいずれか一項に記載のフィブリン組成物、又は請求項25〜29のいずれか一項に記載の創傷被覆材を提供することと、
前記フィブリン組成物を創傷に近接して提供することと、を含む、創傷の治療方法。 - 前記フィブリン組成物が、再上皮化の速度を増加させる、請求項30に記載の方法。
- 前記フィブリン組成物が、VEGF、EGF、MMP1、MMP8、MMP9、TIMP−1、及びこれらの組み合わせから選択される少なくとも1つの創傷治癒生物学的マーカーを増加させる、請求項30又は31に記載の方法。
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US10137222B2 (en) | 2018-11-27 |
WO2016160541A1 (en) | 2016-10-06 |
CN107427601B (zh) | 2021-08-31 |
CN107427601A (zh) | 2017-12-01 |
EP3274002A1 (en) | 2018-01-31 |
JP6810052B2 (ja) | 2021-01-06 |
EP3274002B1 (en) | 2021-09-22 |
US20180043055A1 (en) | 2018-02-15 |
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