JP6587622B2 - 肝臓のプリサチュレーション及びその後の造影剤の投与 - Google Patents
肝臓のプリサチュレーション及びその後の造影剤の投与 Download PDFInfo
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- JP6587622B2 JP6587622B2 JP2016544760A JP2016544760A JP6587622B2 JP 6587622 B2 JP6587622 B2 JP 6587622B2 JP 2016544760 A JP2016544760 A JP 2016544760A JP 2016544760 A JP2016544760 A JP 2016544760A JP 6587622 B2 JP6587622 B2 JP 6587622B2
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K49/00—Preparations for testing in vivo
- A61K49/04—X-ray contrast preparations
- A61K49/0433—X-ray contrast preparations containing an organic halogenated X-ray contrast-enhancing agent
- A61K49/0447—Physical forms of mixtures of two different X-ray contrast-enhancing agents, containing at least one X-ray contrast-enhancing agent which is a halogenated organic compound
- A61K49/0461—Dispersions, colloids, emulsions or suspensions
- A61K49/0471—Perflubron, i.e. perfluoroctylbromide, C8F17Br emulsions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K49/00—Preparations for testing in vivo
- A61K49/06—Nuclear magnetic resonance [NMR] contrast preparations; Magnetic resonance imaging [MRI] contrast preparations
- A61K49/18—Nuclear magnetic resonance [NMR] contrast preparations; Magnetic resonance imaging [MRI] contrast preparations characterised by a special physical form, e.g. emulsions, microcapsules, liposomes
- A61K49/1806—Suspensions, emulsions, colloids, dispersions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K49/00—Preparations for testing in vivo
- A61K49/001—Preparation for luminescence or biological staining
- A61K49/0013—Luminescence
- A61K49/0017—Fluorescence in vivo
- A61K49/0019—Fluorescence in vivo characterised by the fluorescent group, e.g. oligomeric, polymeric or dendritic molecules
- A61K49/0021—Fluorescence in vivo characterised by the fluorescent group, e.g. oligomeric, polymeric or dendritic molecules the fluorescent group being a small organic molecule
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K49/00—Preparations for testing in vivo
- A61K49/001—Preparation for luminescence or biological staining
- A61K49/0063—Preparation for luminescence or biological staining characterised by a special physical or galenical form, e.g. emulsions, microspheres
- A61K49/0069—Preparation for luminescence or biological staining characterised by a special physical or galenical form, e.g. emulsions, microspheres the agent being in a particular physical galenical form
- A61K49/0076—Preparation for luminescence or biological staining characterised by a special physical or galenical form, e.g. emulsions, microspheres the agent being in a particular physical galenical form dispersion, suspension, e.g. particles in a liquid, colloid, emulsion
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Description
エマルジョン(A)の油は肝臓によって取り込まれ、肝臓内のマクロファージをブロックすると推定される。そこで、肝臓及び脾臓中には少ない造影剤しか蓄積できない。このため、血流中の造影剤の濃度が増加し、炎症過程及び/又は炎症組織に由来するマクロファージがより多くの造影剤を使用可能になり、そのため、診断的検出のコントラストが増強される。
非侵襲的技術による特に心臓血管系の炎症過程の検出及び位置確認は、好結果が得られる治療的処置及び罹患患者の治癒にとって最も重要である。患者へ投与される造影剤は、炎症組織の詳細な画像を提供するのに役立つ。造影剤がフッ素化されている場合において、最良の結果を得られることが見いだされている。フッ素化造影剤は、例えば磁気共鳴イメージング法(MRI)において使用される場合に、強化されたバイオアベイラビリティ及び標的特異性を有する。フッ素化造影剤は、細胞が特異的に標識されるような方法で単球/マクロファージによって取り込まれる。
a)式Iのセミフッ素化化合物
CF3−(CF2)x−(CH2)y−CH3 (I)
(式中、xは1〜8の範囲内の整数であり、yは2〜10の範囲内の整数である)
b)パーフルオロオクチルブロミド、
c)パーフルオロデシルブロミド、
d)パーフルオロオクタン、
e)パーフルオロデカン、及び
f)パーフルオロデカリン
からなる群から選択される。
a)フッ素化造影剤、好ましくは液体フッ素化造影剤、特に式Iのセミフッ素化化合物
CF3−(CF2)x−(CH2)y−CH3 (I)
(式中、xは1〜8の範囲内の整数であり、yは2〜10の範囲内の整数である)
b)20℃でセミフッ素化化合物と混和性である中鎖トリグリセリド(MCT)、及び
c)乳化剤
を含む水性エマルジョン(B)であることが好ましい。
CF3−(CF2)x−(CH2)y−CH3 (I)
(式中、xは1〜8の範囲内の整数であり、yは2〜10の範囲内の整数である)
2重量%以下の量のカプロン酸;
約50〜約80重量%の範囲内の量のカプリル酸;
約20〜約50重量%の範囲内の量のカプリン酸;
3重量%以下の量のラウリン酸;
1重量%以下の量のミリスチン酸
重量%(wt%)は、脂肪酸の総重量に基づく。
最適な投与、高い標的特異性及び高速取り込みのためには、本発明において使用する食作用性成分含有水性製剤(F)は均質でなければならず、2つ以上の連続相を有する2相系であってはならないことが重要である。同様の考慮は、組成物がエマルジョンの形態にある場合のフッ素化造影剤を含む組成物に当てはまる。
1,2−ジミリストイル−sn−グリセロ−3−ホスファチジン酸ナトリウム塩(DMPA,Na)、1,2−ジパルミトイル−sn−グリセロ−3−ホスファチジン酸ナトリウム塩(DPPA,Na)、1,2−ジステアロイル−sn−グリセロ−3−ホスファチジン酸ナトリウム塩(DSPA,Na)を含むホスファチジン酸;1,2−ジラウロイル−sn−グリセロ−3−ホスホコリン(DLPC)、1,2−ジミリストイル−sn−グリセロ−3−ホスホコリン(DMPC)、1,2−ジパルミトイル−sn−グリセロ−3−ホスホコリン(DPPC)、1,2−ジステアロイル−sn−グリセロ−3−ホスホコリン(DSPC)を含むホスホコリン;1,2−ジラウロイル−sn−グリセロ−3−ホスホエタノールアミン(DLPE)、1,2−ジミリストイル−sn−グリセロ−3−ホスホエタノールアミン(DMPE)、1,2−ジパルミトイル−sn−グリセロ−3−ホスホエタノールアミン(DPPE)、1,2−ジステアロイル−sn−グリセロ−3−ホスホエタノールアミン(DSPE)を含むホスホエタノールアミン;1,2−ジラウロイル−sn−グリセロ−3−ホスホグリセロールナトリウム塩(DLPG,Na)、1,2−ジミリストイル−sn−グリセロ−3−ホスホグリセロールナトリウム塩(DMPG,Na)、1,2−ジミリストイル−sn−グリセロ−3−ホスホ−sn−1−グリセロールアンモニウム塩(DMP−sn−1−G,NH4)、1,2−ジパルミトイル−sn−グリセロ−3−ホスホグリセロールナトリウム塩(DPPG,Na)、1,2−ジステアロイル−sn−グリセロ−3−ホスホグリセロールナトリウム塩(DSPG,Na)、1,2−ジステアロイル−sn−グリセロ−3−ホスホ−sn−1−グリセロールナトリウム塩(DSP−sn−1G,Na)を含むホスホグリセロール;1,2−ジパルミトイル−sn−グリセロ−3−ホスホ−L−セリンナトリウム塩(DPPS,Na)を含むホスホセリン;1−パルミトイル−2−オレオイル−sn−グリセロ−3−ホスホコリン(POPC)、1−パルミトイル−2−オレオイル−sn−グリセロ−3−ホスホグリセロールナトリウム塩(POPG,Na)、1−パルミトイル−2−オレオイル−sn−グリセロ−3−ホスホグリセロールアンモニウム塩(POPG,NH4)を含む混合鎖リン脂質;1−パルミトイル−2−リゾ−sn−グリセロ−3−ホスホコリン(P−lyso−PC)、1−ステアロイル−2−リゾ−sn−グリセロ−3−ホスホコリン(S−lyso−PC)を含むリゾリン脂質;N−(カルボニル−メトキシポリエチレングリコール2000)−MPEG−2000−DPPEナトリウム塩、N−(カルボニル−メトキシポリエチレングリコール5000)−MPEG−5000−DSPEナトリウム塩、N−(カルボニル−メトキシポリエチレングリコール5000)−MPEG−5000−DPPEナトリウム塩、N−(カルボニル−メトキシポリエチレングリコール750)−MPEG−750−DSPEナトリウム塩、N−(カルボニル−メトキシポリエチレングリコール2000)−MPEG−2000−DSPEナトリウム塩を含むペグ化リン脂質。
約80〜約85重量%のホスファチジルコリン;
約7.0〜約9.5重量%のホスファチジルエタノールアミン;
3重量%未満のリゾホスファチジルコリン;
0.5重量%未満のリゾホスファチジルエタノールアミン;及び
約2〜約3重量%のスフィンゴミエリン
を含むレシチンを含む乳化剤を用いて達成することができる。
約68〜約73重量%のホスファチジルコリン;
約7〜約10重量%のホスファチジルエタノールアミン;
3重量%未満のリゾホスファチジルコリン;及び
約14〜約25重量%の糖脂質
を含み、全重量は糖脂質及びリン脂質の合計の総重量に基づく。
非侵襲的診断技術は、非侵襲的診断技術が患者への負担が少ないこと、及び患者が何らかの副作用に悩まされても迅速に回復することで区別される高速で効率的な形態の診断を提供するので、身体の炎症過程の検出及び診断的処置のために最も重要である。
i)5〜40重量%のトリグリセリドから選択される油、
ii)0.5〜5重量%の乳化剤、好ましくはリン脂質、
iii)任意選択的に0.1〜5重量%の等張化剤、及び
iv)55〜93重量%の水
を含む水中油型エマルジョン(A)であり、重量%は水中油型エマルジョン(A)の総重量に基づき、水中油型エマルジョン(A)は第1工程で投与され、それに続く工程では、好ましくはフッ素化造影剤を含む組成物が
i)1〜20重量%の式I:
CF3−(CF2)x−(CH2)y−CH3 (I)
(式中、xは1〜8の範囲内の整数であり、yは2〜10の範囲内の整数である)のセミフッ素化化合物、
ii)1〜20重量%のセミフッ素化化合物と混和性であるトリグリセリド、好ましくは中鎖トリグリセリド(MCT)、及び
iii)0.1〜5重量%の乳化剤
を含む水性エマルジョン(B)の形態で投与されるが、重量%はエマルジョン(B)の総重量に基づく。
本発明の好ましい実施形態では、食作用性成分含有水性製剤(F)、好ましくは、水中油型エマルジョン(A)は、特に製剤(F)が水中油型エマルジョン(A)である場合、例えば薬物動態及び生体適合性を調整するために更に追加の成分を含んでもよい。特に組成物がエマルジョン(B)の形態にある場合は、同じことがフッ素化造影剤を含む組成物に当てはまる。
フッ素化造影剤又はフッ素化造影剤を含む組成物を投与する前の、本発明における食作用性成分含有水性製剤(F)、好ましくは水中油型エマルジョン(A)の投与は、肝臓の飽和をもたらすことが見いだされた。これは、血流中に存在するより多くの造影剤が炎症組織中に存在するマクロファージに結合するので、周囲の器官、特に心臓血管系の画像のコントラストを増強させる。更に、血流中においてより多量の造影剤が利用可能であるために、炎症領域の満足できる画像を達成するために必要な時間が有意に短縮されるだけではなく、更に例えば心筋梗塞後の炎症過程の広がりもまた、極めて詳細に決定できる。
Haacke ME,Brown WR,Thompson MR,Venkasetan R:Magnetic Resonance Imaging−Physical Principles and Sequence Design,Wiley,New York,1999;
Yu JX,Kodibagkar VD,Cui W,Mason RP.19F:a versatile reporter for non−invasive physiology and pharmacology using magnetic resonance;Curr Med Chem.12:819−48,2005;
Wernick MN,Aarsvold JN Emission Tomography:The Fundamentals of PET and SPECT,Academic Press,London,2004.
1)リンパ節及びそれらの病理的拡大の可視化
a)リンパ節に直接的な影響を及ぼす癌:ホジキン病、非ホジキンリンパ腫;
b)例えば乳癌からの腫瘍転移;
c)ウイルス性及び細菌性感染症、例えば梅毒、結核;
2)以下の境界帯における炎症反応
a)梗塞、例えば心筋梗塞、脳梗塞;
b)腫瘍;
3)器官の炎症:心筋炎、脳炎、髄膜炎(脳膜及び脊髄膜);
4)多発性硬化症;
5)消化管の炎症、例えば、クローン病;
6)血管の炎症、例えば、動脈硬化症、特にいわゆる「不安定プラーク」;
7)膿瘍の検出;
8)関節炎の検出。
炎症状態に苦しんでいる患者の診断的措置は、既に衰弱している患者に与える負担をできる限り小さく抑える穏やかな方法でなければならない。非侵襲的検出技術を使用すること及びマイナスの副作用をなるべく引き起こさない造影剤及び造影剤組成物を提供することとは別に、患者に優しい治療における別の態様は、診断手技のために必要とされる時間である。診断は、心理的及び生理的の負担の両方を最小限に抑えるためにできる限り高速で達成されなければならない。好ましくは、成分の面倒な混合は、一方では時間を節約するため、及び他方では成分の誤った取扱いによって誘発される可能性がある患者及びスタッフ両方への危険性を回避するために、回避しなければならない。
a)上記に規定した食作用性成分含有水性製剤(F)を含む1つの容器、及び
b)上記に規定したフッ素化造影剤又はフッ素化造影剤を含む組成物を含む1つの容器
を含むキットである。
a)水性エマルジョン(A)を含む1つの容器、及び
b)水性エマルジョン(B)を含む1つの容器を含む。
a)食作用性成分含有水性製剤(F)を含む1つの容器、及び
b)フッ素化造影剤又はフッ素化造影剤を含む組成物を含む1つの容器を含む診断キットである。
2 =Lipoid E 80、Lipoid社(ドイツ)
2)中鎖トリグリセリド(50〜80重量%のC8−脂肪酸及び20〜50重量%のC10−脂肪酸)
3) 卵リン脂質、Lipoid社(ドイツ)
パーフルオロオクチルブロミド(PFOB)は、磁気共鳴分光法のための公知の造影剤である。PFOBはMCTに溶解できないことが見いだされている。このため、PFOBがPFOB中に溶解できるパーフルオロデシルブロミド(PFDB)によって安定化されるエマルジョンが調製された。
2) パーフルオロデシルブロミド、ABCR社(ドイツ)
3) 卵リン脂質、Lipoid社(ドイツ)
2) パーフルオロデシルブロミド
3) リン脂質、Lipoid社(ドイツ)
2) パーフルオロデシルブロミド、ABCR社(ドイツ)
3) 大豆リン脂質、Lipoid社(ドイツ)
驚くべきことに、本発明のエマルジョンは、乳化剤の選択によって更に安定化されることが見いだされた。
2) 中鎖トリグリセリド(50〜80重量%のC8−脂肪酸;20〜50重量%のC10−脂肪酸)
3) 卵リン脂質、Lipoid社(ドイツ)
4) リン脂質、Lipoid社(ドイツ)(14〜25重量%の糖脂質を含む大豆リン脂質)
Claims (12)
- 検出に使用するための食作用性成分含有水性製剤(F)であって、
前記水性製剤(F)は、フッ素化造影剤又はフッ素化造影剤を含む組成物の投与前に、被検体の体内に別個に静脈内投与され、
前記水性製剤(F)は水性エマルジョン(A)であり、前記水性エマルジョン(A)は、第1工程において投与され、それに続く工程ではフッ素化造影剤もしくはフッ素化造影剤を含む組成物が投与され、
前記水性エマルジョン(A)は、前記水性エマルジョン(A)の総重量に対して5〜40重量%の範囲内の量で油を含み、
前記フッ素化造影剤は、部分フッ素化炭素化合物、パーフルオロオクチルブロミド、パーフルオロデシルブロミド、パーフルオロオクタン、パーフルオロデカン、およびパーフルオロデカリンからなる群から選択される食作用性成分含有水性製剤(F)。 - 前記水性エマルジョン(A)は、アーモンド油、ババス油、ブラックカラント種子油、ルリヂサ油、カノーラ油、ヒマシ油、ココナツ油、コーン油、綿実油、オリーブ油、落花生油、ヤシ油、パーム核油、菜種油、紅花油、大豆油、ヒマワリ油、ゴマ油、中鎖トリグリセリド、長鎖トリグリセリド及び魚油からなる群から選択される1種以上の油を含む、請求項1に記載の食作用性成分含有水性製剤(F)。
- 前記水性エマルジョン(A)は、水性エマルジョン(A)の総重量に対して8〜30重量%の範囲内の量で油を含む、請求項1または2に記載の食作用性成分含有水性製剤(F)。
- フッ素化造影剤を含む前記組成物は
a)式Iのセミフッ素化化合物
CF3−(CF2)x−(CH2)y−CH3 (I)
(式中、xは1〜8の範囲内の整数であり、yは2〜10の範囲内の整数である)
b)20℃でセミフッ素化化合物と混和性である中鎖トリグリセリド、及び
c)乳化剤を含む水性エマルジョン(B)
である、請求項1乃至3の何れか1項に記載の食作用性成分含有水性製剤(F)。 - イメージング法に使用するための請求項1乃至4の何れか1項に記載の食作用性成分含有水性製剤(F)。
- 前記水性製剤(F)は
i)5〜40重量%のトリグリセリドから選択される油、
ii)0.5〜5重量%の乳化剤、
iii)任意選択的に0.1〜5重量%の等張化剤、及び
iv)55〜93重量%の水
を含む水中油型エマルジョン(A)であり、前記重量%は前記水中油型エマルジョン(A)の総重量に基づき、前記水中油型エマルジョン(A)は第1工程で投与され、それに続く工程では、フッ素化造影剤を含む組成物が
i)1〜20重量%の式I:
CF3−(CF2)x−(CH2)y−CH3 (I)
(式中、xは1〜8の範囲内の整数であり、yは2〜10の範囲内の整数である)のセミフッ素化化合物、
ii)1〜20重量%の20℃でセミフッ素化化合物と混和性であるトリグリセリド、及び
iii)0.1〜5重量%の乳化剤
を含む水性エマルジョン(B)の形態で投与され、前記重量%は前記水性エマルジョン(B)の総重量に基づく、イメージング法に使用するための請求項1乃至5の何れか1項に記載の食作用性成分含有水性製剤(F)。 - 前記イメージング法は19F同位体の核磁気共鳴を測定する工程に基づく、請求項5または6に記載の食作用性成分含有水性製剤(F)。
- 非侵襲的イメージング法に使用するための請求項1乃至7の何れか1項に記載の食作用性成分含有水性製剤(F)。
- 第1工程で食作用性成分含有水性製剤(F)が静脈内投与され、それに続く工程でフッ素化造影剤又はフッ素化造影剤を含む組成物が投与された被検体の非侵襲的にイメージを獲得する工程を含むイメージング方法であって、
前記水性製剤(F)は水性エマルジョン(A)であり、前記水性エマルジョン(A)は前記水性エマルジョン(A)の総重量に対して5〜40重量%の範囲内の量で油を含み、
前記フッ素化造影剤は、部分フッ素化炭素化合物、パーフルオロオクチルブロミド、パーフルオロデシルブロミド、パーフルオロオクタン、パーフルオロデカン、およびパーフルオロデカリンからなる群から選択される。 - 前記第1工程と前記それに続く工程との時間差は、少なくとも15秒間である、請求項9に記載のイメージング方法。
- 前記非侵襲的にイメージを獲得する工程は、磁気共鳴(MR)イメージング法である、請求項9又は10に記載のイメージング方法。
- a)静脈内注入用の食作用性成分含有水性製剤(F)を含む1つの容器、及び
b)フッ素化造影剤又はフッ素化造影剤を含む組成物を含む1つの容器
を含み、
前記水性製剤(F)は水性エマルジョン(A)であり、前記水性エマルジョン(A)は前記水性エマルジョン(A)の総重量に対して5〜40重量%の範囲内の量で油を含み、
前記フッ素化造影剤は、部分フッ素化炭素化合物、パーフルオロオクチルブロミド、パーフルオロデシルブロミド、パーフルオロオクタン、パーフルオロデカン、およびパーフルオロデカリンからなる群から選択されるキット。
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