TR201808055T4 - Kapsüler polisakaritlerin çözünürleştirilmesi ve kombinasyon aşıları. - Google Patents
Kapsüler polisakaritlerin çözünürleştirilmesi ve kombinasyon aşıları. Download PDFInfo
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- TR201808055T4 TR201808055T4 TR2018/08055T TR201808055T TR201808055T4 TR 201808055 T4 TR201808055 T4 TR 201808055T4 TR 2018/08055 T TR2018/08055 T TR 2018/08055T TR 201808055 T TR201808055 T TR 201808055T TR 201808055 T4 TR201808055 T4 TR 201808055T4
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- TR
- Turkey
- Prior art keywords
- polysaccharide
- process according
- saccharide
- saccharides
- serogroups
- Prior art date
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Abstract
Bir bakteriyel kapsüler polisakkariti saflaştırmak ve bir taşıyıcı proteine konjuge etmek için bir proses olup, aşağıdaki adımları içerir: polisakkaritin saflaştırılması, (a) bir ya da daha fazla katyonik deterjan kullanılarak polisakaritin çökeltilmesi, ardından (b) çökeltilen polisakaritin bir alkol kullanılarak çözünürleştirilmesi, polisakkaridin bir taşıyıcı proteine konjugasyonu adımlarını içerir, burada taşıyıcı protein bir bakteriyel toksindir ya da toksoittir ve burada konjugasyon bir bağlayıcı ile gerçekleştirilir, burada bakteriyel kapsüler polisakkarit Neisseria meningitidis serogrup A, W135 ya da Y?den ya da Haemophiius influenzae'den ya da Streptococcus pneumoniae'den gelir.
Description
TARIFNAMEKAPSULER POLISAKARITLERIN
COZUNURLESTIRILMESI VE KOMBINASYON ASILARITEKNIK SAHA
Bu bulus, özellikle meningokok enfeksiyonuna ve hastaligina karsiolmak üzere, asilar sahasina yöneliktir.GEÇMIS TEKNOLOJINeisseria meningitidis, bir Gram negatif insan patojenidir. Farenkste
koloiiize olarak inenenjite ve zaman zaman meneiijit olmadiginda
septisemiye neden olur. N.g0n0rrh0eae ile yakindan iliskili olmakla
birlikte meningokoku net bir sekilde ayirt eden 'Özellik, tüm patojenik
meningokoklarda bulunan bir polisakarit kapsülüdür.Organizmanin kapsüler polisakaritine dayanarak on iki N.meningitidis
serogrubu tanimlanmistir (A, B, C, H, I, K, L, 29E, W135, X, Y ve Z).
A Grubu, alt Sahra Afrika°sinda epideinik hastalikta en sik sekilde
gösterilen patojendir. B ve C serogruplari, ABDade ve çogu gelismis
ülkede vakalarin büyük kismindan sorumludur. W135 ve Y
serogruplari, ABD'de ve gelismis ülkelerde geri kalan vakalardan
sorumludur.N.meningitidis”ten kapsüler polisakaritler tipik olarak polisakarit
çökeltme (örn., bir katyonik deterjan kullanilarak), etanol ileparçalama, soguk fenol ile özümleme (proteini çikartmak için) veultra-santrifujleine (LPS”yi çikartmak için) adimlarini içeren bir
proses ile hazirlanir [Örn., ref. l].A, C, Y ve Wl35 serogruplarindan kapsüler polisakaritlerin bir
tetravalent asisi birçok yildir bilinmektedir [2, 3] ve insan kullaniini
için lisans almistir. Ergenlerde ve yetiskinlerde etkili olinakla birlikte
bebeklerde zayif bir immün tepkisi ve kisa süreli koruma saglar ve
kullanilamaz [örn., 4] . Bunun nedeni, polisakaritlerin boost
edilemeyen zayif bir immün tepkisi indükleyen, T hücresinden
bagimsiz antijenler olmasidir. Bu asidaki polisakaritler konjüge
edilmez ve l:'l:l:l oraninda bulunur [5]. MENCEVAX ACWYTM,
liyofilize edilmis formundan yeniden olusturuldugunda saflastirilmis
her polisakaritten 50ug ihtiva eder.Konj'ûge edilmis C serogrubu oligosakaritler de insan kullanimi için
onaylaninistir ['orn., MenjugateTM; ref. 6]. Bununla birlikte A, Wl35
ve Y serogruplarina karsi kon jügat asilarinda ve bunlarin üretiminde
gelistirme yapilmasina ihtiyaç vardir.EP 0 072 513 El, saflastirilmis bakteriyel kapsüler antijenik
polisakaritlerin hazirlanmasina yönelik bir proses, elde edilen ürünler
ve bunlariii kullaniinlarini tarif eder. Lei QP et al (2000)
(Developinents in Biologicals 103, 259-264) ineningokokkal
polisakkarit-difteri toksoit konjugat asilarinda serbest polisakkaridin
kantifikasyonunu tarif eder.WO 02/058737 A2 bir multivalent ineningokokkal polisakkarit-
proteini konjugat asisini tarif eder. EP 0 208 375 A2 trivalent
immünojenik aktiviteye sahip olan glikoproteinik konjugatlari tarifeder.BULUSUN AÇIKLAMASI
Bulus, bir bakteriyel kapsüler polisakaritin saflastirilmasina ve birtasiyici proteine kon jugatlanmasina yönelik bir proses saglar:polisakkaridin saflastirilmasi, (a) bir ya da daha fazla katyonik
deterjan kullanilarak polisakaritin çökeltilmesi, ardindan (b) çökeltilen
polisakaritin bir alkol kullanilarak çözünürlestirilmesi, (0) (b)
adiminda elde edilen polisakaritin, kirleticilerin çikarilmasi ainaciyla
bir veya daha fazla filtreleme adimi kullanilarak isleme tabi tutulmasi,
sonra (d) (0) adiininda elde edilen polisakaritin, katyonlarindegistirilmesi suretiyle çökeltilmesi, vepolisakkaridin bir tasiyici proteine konjugasyonu adimlarini içerir,
burada tasiyici protein bir bakteriyel toksindir ya da toksoittir veburada kon jugasyon bir baglayici ile gerçeklestirilir,burada bakteriyel kapsüler polisakkarit Neisseria meningitidis
serogrup A°dan gelir ve burada katyonik deterjan(lar) bir
setiltrimetilamonyum tuzunu, bir tetrabütilamonyum tuzunu, bir
miristiltrimetilamonyum tuzunu ve/Veya hekzadimetrin bromi'ir'ûiçerir.Çökeltme ve etanol ile çöz'ûn'ûrIestinneÇözülebilen polisakaritlerin çökeltilmesine yönelik birçok teknik bu
konuda bilinmektedir. Tercih edilen yöiitemlerde bir veya daha fazla
katyonik deterjan kullanilir. Deterjanlar tercihen asagidaki genelformüle sahiptir:RiR`
burada: R1, R2 ve R3, ayni veya farklidir ve her biri, alkili veya arili
belirtir; veya R1 ve R2, bunlarin eklendigi nitro jen atomu ile birlikte, 5
veya 6 elemanli, doymus bir heterosiklik halka olusturur ve R3, alkili
veya arili belirtir; veya R1, R2 ve R3, bunlarin eklendigi nitro jen atomu
ile birlikte, nitrojen atomunda doymamis, 5 veya 6 elemanli bir
heterosiklik halka olusturur,R4, alkili veya arili belirtir veX', bir anyonu gösterir.Yöntemde kullanilmak üzere özellikle tercih edilen deterjanlar,
tetrabutilainonyum ve setiltrimetilamonyuin tuzlaridir (örn., broinid
tuzlari). Setiltrimetilamonyum bromid ('CTAB') özellikle tercih edilir
[8]. CTAB ayrica heksadesiltrimetilamonyum bromid, setrimonyum
bromid, CetaVlon ve Centimid olarak bilinir. Diger deterjanlar
arasinda heksadimetrin bromid ve miristiltrimetilamonyum tuzlari
bulunur.Kapsüler polisakaritler, kültür sirasinda ortam içine salinir. Buna göre
çökeltme için baslangiç materyali tipik olarak santrifüjlenmis bir
bakteri kültüründen gelen süpematan olacaktir veya konsantre edilmis
bir kültür olacaktir.Çökeltme adimi, polisakaritler için seçici olabilir, ancak tipik olarak
diger bilesenleri (om, proteinler, nükleik asit vb.) de birlikte
çökeltecektir.Çökelen polisakarit, çözünürlestirme öncesinde santrifüj yoluylatoplanabilir.Çökeltmeden sonra polisakarit (tipik olarak katyonik deterjan ile bir
kompleks halinde) yeniden çözünürlestirilir. Kirleticileri (örn.,
proteinler, nükleik asit Vb.) en aza indirmek için polisakarit içir
nispeten seçici olan bir solventin kullanilmasi tercih edilir. Bu
baglamda etanolun avantajli oldugu kesfedilmistir ve bu, CTAB-
polisakarit kompleksi için yüksek oranda seçicidir. Baska alt alkoller
(Örn., metanol, propan-l-ol, propan-2-ol, butan-l-ol, butan-2-ol, 2-
metil-prOpan-l-ol, 2-metil-pr0pan-2-ol, dioller Vb.) kullanilabilir.
Etanol tercihen çökelen polisakarite, %50 ile %95 arasinda (örn.,
yaklasik %55, %60, %65, %70, %75, %80, %85 veya yaklasik %90)
ve tercihen %75 ile %95 arasinda nihai etanol konsantrasyonu (toplam
etanol ve su içerigi bazinda) verecek sekilde ilave edilir. Optimum
nihai etanol konsantrasyonu, polisakaritin elde edildigi bakterinin
serogrubuna bagli olabilir.Etanol, çökelen polisakarite saf formda ilave edilebilir veya
karisabilen bir solvent (örn., su) ile seyreltilmis bir formda ilave
edilebilir. Tercih edilen solvent karisimlari, etanolzsu karisimlari olup
tercih edilen oran yaklasik 70:30 ile yaklasik 95:5 arasindadir (öm.,
75:25, 80:20, 85:15, 90:10).Kapsüler polisakaritlerin hazirlanmasina yönelik geleneksel prosesler
ile karsilastirildiginda iki adiinli çökeltme ve ardindan etanol ile
özümleme prosesi, daha hizli ve basittir.9. referansta tarif edilen prosesin aksine bu proseste, anyonik deterjan
yerine katyonik deterjan kullanilir. 10. referansin prosesinin aksine
polisakarit, kalsiyum veya magnezyum tuzlari kullanilarak katyon
alisverisinden çok etanol kullanilarak yeniden çözünürlestirilir. 11.
referansin prosesinin aksine çökeltme, eylemsiz, gözenekli bir destekgerektirmez. Ek olarak önceki teknige ait proseslerin aksine alkol,polisakariti çökeltinek için degil bunu yeniden çözünürlestirmek için
kullanilir.Bakteriyel kapsüler polisakarit genellikle Neisseria'dan gelecektir.
Tercihen bu, A, B, C, W135 ve Y serogruplari dahil
N.meningitidis”ten gelir. Tercih edilen serogruplar, A, W135 ve Y°dir.
Proses ayrica Haemophilus influenzae”den (özellikle tip B veya 'Hib')
ve Streptococcus pneumoniae7den (pnömokok) kapsüler polisakarithazirlaninasi için uygundur.Çözünürlestirilmis polisakaritin ileri islemiYeniden çözünürlestirme sonrasinda polisakarit ayrica kirleticileri
çikartmak üzere isleme tabi tutulabilir. Bu, çok küçük kirlenmenin
bile kabul edilebilir olmadigi (om, insan asisi üretimine yönelik)
duruinlarda özellikle Önemlidir. Bu tipik olarak bir veya daha fazla
filtreleme adimi içerecektir.Derinlik filtreleinesi kullanilabilir. Bu, berraklastirina için Özellikle
faydalidir.Aktiflestirilinis karbon içinden filtreleme kullanilabilir. Bu,
pigmentlerin ve eser organik bilesiklerin çikarilinasi için faydalidir.
Bu ömegin, OD275nm<0.2 olana kadar tekrar edilebilir.Ebatli filtreleme veya ultrafiltreleme kullanilabilir.Kirleticileri çikartmak için filtre edildikten sonra polisakarit, ileri
isleme ve/Veya proses için çökeltilebilir. Bu elverisli sekilde katyon
alisverisi yoluyla (6111., kalsiyum veya sodyum tuzlari ilave edilerek)
saglanabilir.Polisakarit, kimyasal olarak modifiye edilebilir. Örnegin bir veya dahafazla hidroksil grubunu bloklama gruplari ile degistirmek üzeremodifiye edilebilir. Bu özellikle MenA için faydalidir [12]. B
serogrubundan gelen polisakaritler, N-propiyonile edilebilir [13].
(Istege bagli olarak modifiye edilmis) polisakarit tipik olarak
oligosakaritler olusturmak üzere hidrolize edilecektir. Bu tercihen
oligosakaritte 30°un altinda (öm. 10 ile 20 arasinda, tercihen A
serogrubu için 10 civarinda; W135 ve Y serogruplari için 15 ile 25
arasinda, tercihen 15-20 civarinda; Vb.) nihai ortalama poliinerizasyon
derecesi (DP) vermek için yapilir. Oligosakaritler, asilarda
kullanilmak üzere polisakaritlere tercih edilir. DP, iyon alisverisli
kromatografi veya kolorimetrik deneyler ile elverisli sekilde
ölçülebilir [14].Hidroliz yapilirsa hidrolizat genel olarak kisa oligosakaritlerin
çikarilmasi amaciyla ebatlanacaktir. Bu, ultrafiltreleme, ardindan iyon
alisverisli kroinatografi gibi çesitli yollarla yapilabilir. Polimerizasyon
derecesi yaklasik 6°dan az veya buna esit olan oligosakaritler tercihen
A serogrubu için çikarilir ve yaklasik 4”ün altinda olanlar tercihen
W135 ve Y serogruplari için çikarilir.Immünojenikligi güçlendirmek için bulusa ait polisakaritler veya
oligosakaritler bir tasiyiciya konjüge edilir (Sekil 18). Tasiyici
proteinlere konjügasyon, pediatrik asilar için 'Özellikle faydalidir [om,
ref. 15] ve iyi bilinen bir tekniktir [örn., ref. 16 ila 24, Vb.de ele
alinmistir.]Tercih edilen tasiyici proteinleri, bakteriyel toksinler veya toksoidler,
örnegin difteri veya tetanos toksoidleridir. CRM197 difteri toksoidi
[25,26,27] özellikle tercih edilir. Diger uygun tasiyici proteinler
arasinda N.meningitidis dis membran protein kompleksi [28], sentetik
peptitler [29, 30], isi soku proteinleri [31, 32], pertussis proteinleri
[33, 34], sitokinler [35], lenfokinler [35], hormonlar [35], büyümefaktörleri [35], patojenden türetilmis çesitli anti jenlerden gelen çoklu
insan CD4+ T hücresi epitoplari içeren suni proteinler [36],
H.influenzae'den protein D [37], C.difficile'den toksin A veya B [38]
Vb. bulunur. Tasiyici proteinlerin karisimlari da kullanilabilir.
Sakarit:protein orani (W/W) 0.5:1 (yani fazla protein) ile 5:l (yani
fazla sakarit) arasinda olan konjügatlar tercih edilir ve oranlari 1:1.25
ile 1 :2.5 arasinda olanlar daha fazla tercih edilir.Tek bir tasiyici protein, birçok farkli sakariti tasiyabilir [39].
Konj'ugatlar, serbest tasiyici protein ile birlikte kullanilabilir [40].
Uygun bir konjügasyon reaksiyonu, gerekli oldugunda uygun bir
baglayici ile kullanilabilir.Sakarit tipik olarak konjügasyondan önce aktiflestirilecek veya
fonksiyonellestirilecektir. Aktivasyon 'Örnegin CDAP (örn., l-siyano-
4-dimetilamino piridinyum tetrafloroborat) [41, 42, Vb.]) gibi siyanile
edici reaktif maddeler içerebilir. Diger uygun tekniklerde
karbodiimidler, hidrazidler, aktif esterler, norboran, p-nitrobenzoik
asit, N-hidroksisukinimid, S-NHS, EDC, TSTU kullanilir (ayrica 22.
referansin girisine bakiniz).Bir baglayici grubu araciligiyla baglainalar, bilinen bir prosedür,
örnegin 43 ve 44. referanslarda tarif edilen prosedürler kullaiiilarak
yapilabilir. Bir tip baglama, polisakaritin indirgeyici aminasyonunu,
elde edilen ainino grubu ile bir adipik asit baglayici grubun bir ucunun
birlestirilmesini ve sonra bir proteinin, adipik asit baglayici grubun
diger ucuna birlestirilmesini içerir [20, 45, 46]. Diger baglayicilar
arasinda B-propiyonamido [47], nitrofenil-etilamin [48], haloasil
halidler [49], glikosidik baglar [50], 6-aminokaproik asit [51], ADH
[52], C4 ila Ciz yariinlari [53] vb. bulunur. Bir baglayicikullanilmasina alternatif olarak direkt baglama kullanilabilir. Proteinedirekt baglamalar, polisakaritin oksidasyonunu, ardindaii örnegin 54
ve 55. referanslarda tarif edildigi gibi protein ile indirgeyici
aminasyonu içerebilir.Amino gruplarinin sakarit içine (öm., terminal :o gruplarinin -NH2 ile
degistirilmesi suretiyle) sokulmasini, ardindan bir adipik diester (öm.,
adipik asit N-hidroksisukinimido diester) ile türevlendirmeyi ve
tasiyici protein ile reaksiyonu içeren bir proses tercih edilir.
Konj'ûgasyondan sonra serbest ve konj'üge edilmis sakaritler
ayrilabilir. Uygun birçok yöntem vardir, `Örnegin hidrofobik
kroinatografi, tanjant ultra-filtreleme, diya-filtreleme, Vb. [bakinizayrica 56 ve 57. referanslar, Vb.].Sakaritleri içeren karisimlar ve kompozisyonlarBulusa ait konj'i'igatlar, baska biyolojik moleküller ile karistirilabilir.
Birden fazla N.meningitidis serogrubundan gelen sakaritlerin
karisimlari, örn. A+C, A+W135, A+Y, C+Wl35, C+Y, W135+Y,
A+C+Wl 3 5, A+C+Y, C+Wl 3 5+Y, A+C+W 1 3 5+Y, Vb.
serogruplarindan gelen sakaritler içeren kompozisyonlar tercih edilir.
Tek tek sakarit anti jenlerinin koruyucu etkinliginin bunlarin
birlestirilmesi suretiyle ortadan kaldirilmamasi tercih edilir, bununla
birlikte gerçek immünojeniklik (örn., ELISA titerleri) azalabilir.C serogrubundan gelen bir sakarit kullanildiginda bu tercihen ~12 ila
~22 tekrar ünitesine sahiptir.Farkli N.meningitidis serogruplarindan gelen sakaritler, ayiii veya
farkli tasiyici proteinlere konji'ige edilebilir.Bir karisimin, A ve C serogruplarinin her ikisinden gelen kapsüler
sakaritler içerdigi durumda MenA sakarit:MenC sakarit oraninin(W/W) 1,den fazla (örn., 2:l, 3zl, 421, 521, 10:11 veya daha yüksek)10olmasi tercih edilir. Sürpriz sekilde MenA bileseni, MenC bilesenine
göre fazla (kütle/doz) bulundugunda bunun immünojenikliginin
gelistigi gözlendi.Bir karisim, W 135 serogrubundan ve A, C ve Y serogruplarinin en az
biriiiden kapsüler sakaritler (Örn., oligosakaritler) içerdiginde sürpriz
sekilde MenWl 3 5 sakaritinin immünojenikliginin, diger
serogrup(lar)dan sakarit(ler) ile kombinasyon halinde uygulandiginda,
bunun tek basina (ayni dozajda, Vb.) uygulanmasina göre daha yüksek
oldugu kesfedildi [bakiniz ref. 58]. Böylelikle MenWl35 antijeninin
bir immün tepkisi uyandirma kapasitesi, diger serogruplardan gelen
anti jenler ile birlestirilmeden verildiginde ayni anti jenin denk miktari
ile uyandirilan iinmün tepkisinden daha yüksektir. Bu güçlendirilmis
immünojeniklik, MenWl35 anti jeninin kontrol hayvanlarina ve
karisiinin test hayvanlarina uygulanmasi ve bu ikisine karsi olan
antikor titerleriiiin bakterisidal titerler, radyo-immünodeney ve
ELISAslar Vb. gibi standart deneyler kullanilarak karsilastirilmasi
suretiyle belirlenebilir. W135 serogrubundan gelen sakaritlerin diger
serogruplar ile sinerjistik kombinasyonlarini içeren asilar immünolojik
açidan avantajlidir. Bunlar, güçlendirilmis anti-W135 tepkileri
ve/Veya daha düsük W135 dozlari saglar.Bir karisimin, Y serogrubundan ve C ve W135 serogruplarindan
birinden veya her ikisinden kapsüler sakaritler içermesi durumunda
MenY sakarit:MenWl35 sakarit oraninin (W/W) 1”den yüksek (örn.,
2:1, 3:1, 4:1, 5:1, 10:1 veya daha yüksek) olmasi ve/Veya MenY
sakaritzMenC sakarit oraninin (W/W) l”den az (öm., 112, 1:3, 1:4, l:5veya daha düsük) olmasi tercih edilir.11A:C:Wl35:Y serogruplarindan gelen sakaritler için tercih edilen
oranlar (W/W) söyledir: l:l:1:l; 1:1:1:2; 2:1:l:l; 4:2:1:1; 8:4:2:l;
4:2:1:2;8:4:l:2;4:2:2:l;2:2:l:l;4:4:2:l;2:2:1:2;4:4:l:2;ve 2:2:2:1.
Karisimlar ayrica proteinler içerebilir. N.meningitidis B
serogrubundan [örn., referanslar 59 ila 64] veya OMV
preparasyonlarindan [örn., 65 ila 68. referanslar, Vb.] gelen
proteinlerin dahil edilmesi tercih edilir.Meningokok olinayan ve neisserial olmayan anti jenler, tercihenmeningokok bilesenlere karsi immün tepkisini azaltmayanlar da dahiledilebilir. Örnegin 69. Referans, N.meningitidis B ve Cserogruplarindan gelen oligosakaritlerin Hib sakariti ilekombinasyonlarini açiklar. Pnömokok, hepatit A Virüsü, hepatit BVirüsü, B.pertussis, difteri, tetanos, Helicobacter pylori, polio ve/VeyaH.influenzae”dan alinan anti jenler tercih edilir. Ozellikle tercih edileniieisserial olmayan anti jenler arasinda sunlar bulunur:-Helicobacter pylori”den anti jenler örnegin CagA [70 ila 73], VacA
[74, 75], NAP [76, 77, 78], HOpX [örn., 79], HOpY [örn., 79] ve/veya
üreaz.-Streptococcus pneumoniae”den bir sakarit anti jeni [örn., 80, 81, 82].-hepatit A Virüsünden, örnegin eylemsizlestirilmis virüsten bir anti jen
[örn., 83, 84].-hepatit B Virüsünden bir antijen, örnegin yüzey ve/Veya göbek
anti jenleri [örn., 84, 85], yüzey anti jeni tercihen bir alüminyum fosfat
üzerine adsorbe edilir [86].-Haemophilus influenzae B”den bir sakarit anti jeni [örn., 87], tercihen
adsorbe edilmemistir veya bir alüminyum fosfat üzerine adsorbe
edilmistir [88].-hepatit C Virüsünden bir anti jen [örn., 89].12-N.g0norrhoeae°den bir anti jen [öm., 59 ila 62].-Chlamydia pneumoniaesden bir anti jen [örn, 90 ila 96. referanslar]-Chlamydia trachoinatis°ten bir anti jen [örn., 97].-Porphyroinonas gingivalis”ten bir anti jen [örn, 98]-p01i0 antijen(ler)i [öm, 99, 100] örnegin IPV.-kuduz antijen(1er)i [öm., 101] ömegin liyofilize edilmis,
eylemsizlestirilmis Virüs [örn, 102, RabAvertTM]-kizamik, kabakulak ve/Veya kizamikçik anti jenleri [örn., 103.
referansin 9, 10 ve 11. bölümleri]-influenza antijen(1er)i [örn., 103. referansin 19. bölümü] örnegin
hemaglutinin ve/ veya nöraminidaz yüzey proteinleri.-Moraxella catarrhalis”ten bir anti jen [öm, 104].-Streptococcus agalactiae7den (B grubu streptokok) bir anti jen [örn.,
105, 106].-Streptococcus pyogenes°ten (A grubu streptokok) bir antijen [öm.,
106, 107, 108]-Staphilococcus aureus°tan bir anti jen [örn, 109].-bir paramiksovir'ûsten, 'Örnegin respiratuar sinsitiyal virüsten (RSV
[110, 1 l 1]) ve/veya parainfluenza Virüsünden (P1V3 [1 12])
anti jen(ler).-Bacillus anthracis”ten bir antijen [örn, 113, 114, 115]-flaViViridae familyasindaki (genus flaViVirus) bir virüsten, örnegin
sari humma Virüsü, Japon ansefalit Virüsü, Dengue virüslerinin dört
serotipi, kene ile tasinan ansefalit Virüsü, Bati Nil virüsünden bir
anti jen.-bir pestivir'us antijeni, `Örnegin klasik domuz atesi Virüsü, sigir Viral
diyare Virüsü ve/Veya border hastaligi Virüsünden.-bir parvovirüs anti jeni, örn., parvovir'üs B 1 9”dan.13-bir tetanos toksoidi [om, ref. I 16].- B.pertussis”den pertussis holotoksin (PT) ve filament'oz
hemaglutinin (FHA), istege bagli olarak ayrica pertaktin ve/Veya
aglutinojenler 2 ve 3 ile kombinasyon halinde [öm., 117 ve 118.
referanslar] .-hücresel pertussis anti jeni.Karisim, gerekli durumlarda detoksifiye edilebilen bu diger
anti jenlerden bir veya daha fazlasini içerebilir (öm., pertussis toksinin
detoksifikasyonu kimyasal ve/Veya genetik vasitalarla yapilir).
Karisim içine bir difteri anti jeninin dahil edildigi durumlarda ayrica
tetanos antijeni ve pertussis antijenlerinin de dahil edilmesi tercih
edilir. Benzer sekilde bir tetanos anti jeninin dahil edildigi durumlarda
ayrica difteri ve pertussis anti jenlerinin de dahil edilmesi tercih edilir.
Benzer sekilde bir pertussis antijeninin dahil edildigi durumlarda
ayrica difteri ve tetanos anti jenlerinin de dahil edilmesi tercih edilir.
Karisim içindeki anti jenler tipik olarak her biri en az lpg/ml
konsantrasyonda bulunacaktir. Genel olarak belirli bir antijenin
konsantrasyonu, bu anti jene karsi bir immün tepkisi uyandirmak için
yeterli olacaktir.Karisim içinde protein anti jenlerinin kullanilmasina alternatif olarak
anti jeni sifreleyen nükleik asit kullanilabilir. Karisimin protein
bilesenleri bu sekilde proteini sifreleyen nükleik asit (tercihen örn. birplazinid formunda DNA) ile degistirilebilir.Multivalent sakarit asilari
Bulus ayrica N.meningitidis A, C, W135 ve Y serogruplarindan en az
ikisinden (yani 2, 3 veya 4'ünden) gelen kapsüler sakaritler içerenasilar ve immünojenik koinpozisyonlar sunar, burada adi geçen14kapsüler sakaritler, tasiyici protein(ler)e kon jüge edilir ve
oligosakaritlerdir. Asinin A, C, W135 ve Y serogruplarindan gelen,
konjüge edilmis sadece iki oligosakarite veya polisakarite sahip
olmasi durumunda bunlar tercihen A ve C serogruplarindan degildir
(bakiniz 6, 119 ve 120. referanslar). Tercih edilen kompozisyonlar, C
ve Y serogruplarindan sakaritler içerir. Tercih edilen diger
kompozisyonlar, C, W 135 ve Y serogruplarindan sakaritler içerir.
Burada bir A serogrubu oligosakarit konjügati ve bir C serogrubu
oligosakarit konjügati içeren ve ayrica (i) bir alürriinyum fosfat veya
bir alüminyum hidroksid adjuvan ve (ii) bir tampon içeren bir
immünojenik kompozisyon açiklanir. Kompozisyon, bir alüminyum
fosfat adjuvan içerdiginde tampon tercihen bir fosfat tamponudur ve
bir alüminyum hidroksid adjuvan içerdiginde tampon tercihen bir
histidin tamponudur.Asi, A serogrubundan kapsüler sakarit içerdiginde A serogrubu
sakaritin, hidrolizi en aza indirmek ainaciyla kullanimdan kisa bir süre
önce baska sakarit(ler) ile birlestirilmesi tercih edilir (bakiniz Hib
sakaritleri). Bu, A serogrubu bilesenin liyofilize edilmis formda ve
diger serogrup bilesen(ler)inin sivi formda olmasi ile elverisli sekilde
saglanabilir, buradaki sivi bilesen, kullanima hazir oldugunda
liyofilize edilmis bileseni yeniden olusturmak için kullanilir. Sivi
bilesen tercihen bir alüminyum tuzu adjuvan içerir, bu durumda
liyofilize edilmis A serogrubu bileseni, bir alüminyum tuzu adjuvani
içerebilir veya içermeyebilir.Bu yüzden burada sunlari içeren bir kit açiklanir: (a) liyofilize edilmis
formda, N.meningitidis A serogrubundan kapsüler sakarit; ve (b) sivi
formda bir veya daha fazla (örn., l, 2, 3) N.meningitidis C, W135 veY serogrubundan kapsüler sakarit(ler). Sakaritler tercihen tasiyici15protein(ler)e konjüge edilir ve/Veya oligosakaritlerdir. Kit, iki sise
formunda olabilir.Ayrica burada açiklanan bir asi koinpozisyonunun hazirlanmasina
yönelik, liyofilize edilmis, N.meningitidis A serogrubundan bir
kapsüler sakaridin bir veya daha fazla (örn, 1, 2, 3) N.meningitidis C,
W135 ve Y serogrubundan kapsüler sakarit(1er) ile karistirilmasini
içeren, burada adi geçen bir veya daha fazla sakaritin sivi formda
oldugu bir yöntem açiklanir.Ayrica sunlari içeren bir kit açiklanir: (a) liyofilize edilmis formda,
N.meningitidis A serogrubundan konjüge edilmis kapsüler
oligosakarit; ve (b) sivi formda bir veya daha fazla baska antijen.
Baska antijen, N.meningitidis C serogrubundan konjüge edilmiskapsüler oligosakarit olabilir veya olmayabilir.Immünojenik kompozisyonlar ve asilarBulusa ait konj'ûgatlar, immünojenik kompozisyonlara ve asilara dahil
edilmeye özellikle uygundur. Bu nedenle bulusa ait bir proses,
konjügatin bir immünojenik kompozisyon veya asi halinde formüle
edilmesi adimini içerebilir. Bulus, bu sekilde elde edilebilen bir
kompozisyon veya asi sunar.Bulusa ait immünojenik kompozisyonlar ve asilar, meningokok
sakaritlerine ilaveten tipik olarak 'farmasötik açidan kabul edilebilir
tasiyicilar” içerecektir, bunlar arasinda kompozisyonu alan kisi için
zararli antikorlarin üretilmesini kendi basina indüklemeyen tasiyicilar
bulunur. Uygun tasiyicilar tipik olarak büyük, yavas metabolize edilen
makromolek'uller 'Örnegin proteinler, polisakaritler, polilaktik asitler,
poliglikolik asitler, polimerik ainino asitler, ainino asit kopolimerleri,trehaloz [121], lipit agregatlaridir (örnegin yag damlalari veya16lipozomlar) ve eylemsiz virüs partikülleridir. Bu gibi tasiyicilar, bu
konuda siradan bilgiye sahip kisilerce iyi bilinir. Asilar ayrica
seyrelticiler, örnegin su, tuz, gliserol, vb. ihtiva edebilir. Ek olarak
nemlendirici veya emülsife edici ajanlar, pH tainponlama maddeleri
ve benzeri gibi yardiinci inaddeler de bulunabilir. Farmasötik açidan
kabul edilebilir eksipiyanlarin kapsamli bir tartisinasi 122. referaiista
mevcuttur.Asi olarak kullanilan immünojenik kompozisyonlar, immünolojik
açidan etkili miktarda bir sakarit anti jeninin yani sira gerektiginde
yukarida bahsedilen diger bilesenleri içerir. 'Immünolojik açidan etkili
miktarlar' ile bir kisiye tek bir dozda veya bir serinin parçasi halinde
bu miktarin uygulanmasinin, tedavi veya önleme için etkili olmasi
kast edilir. Bu miktar, tedavi edilecek kisinin sagligina ve fiziksel
durumuna, tedavi edilecek kisinin (örn., insan olmayan primat, primat,
vb.) yasina, taksonomik grubuna, kisinin immün sisteminin antikorlari
sentezleme kapasitesine, arzu edilen koruma derecesine, asinin
fonnülasyonuna, tedavi eden doktorun tibbi duruma dair
degerlendirmesine ve diger alakali faktörlere bagli olarak degisir.
Miktarin, rutin denemeler ile belirlenebilecek nispeten genis bir aralik
içine girmesi beklenir. Doza j tedavisi, tek dozlu bir prograin veya çok
dozlu bir program (örn., booster dozlari içeren) olabilir. Asi, baska
immüno-regülatör ajanlar ile birlikte uygulanabilir.Asi, baska immüno-regülatör ajanlar ile birlikte uygulanabilir.Asi bir adjuvan içerebilir. Kompozisyonun etkinligini güçlendirmek
için tercih edilen adjuvanlar arasinda bunlarla sinirli olinamakla
birlikte asagidakiler bulunur: (1) alüminyum tuzlari (alum), örnegin
alüminyum hidroksidler (oksihidroksidler dahil), alüminyum fosfatlar
(hidroksifosfatlar dahil), alüminyum sülfat, vb. [123. referansta 8 ve 9.17Bölümler]; (2) su içinde yag emülsiyonu formülasyonlari (baska
spesifik immüno-uyarici ajanlar Örnegin muramil peptitler [Muramil
peptitler arasinda N-asetil-muramil-L-treonil-D-izoglutamin (thr-
MDP), N-asetil-norrnuramil-L-alanil-D-izoglutamin (nor-MDF), N-
asetilmuramil-L-alanil-D-izoglutaminil-L-alanin-2-( 1 '-2'-dipalmitoil-sn-gliser0-3-hidroksifosforiloksi)-etilamin MTP-PE), vb. bulunur]
veya bakteriyel hücre çeperi bilesenleri ile veya olmadan), örnegin (a)
MFS9TM [123. referansta 10. Bölüm; 124, 125], %5 Skualen, %0.5
Tween 80 ve %05 Spam 85 ihtiva eder (istege bagli olarak MTP-PE
ihtiva eder), bir mikro-akiskanlastirici kullanilarak mikron alti
partiküller halinde formüle edilir, (b) SAF; %10 Skualan, %04 Tween
80, %5 pluronik bloke edilmis polimer Ll2l ve thr-MDP ihtiva eder;
bir mikron alti emülsiyon halinde mikro-akiskanlastirilmis veya daha
büyük partikül ebatli bir emülsiyon üretmek üzere vortekslenmistir ve
(c) RibTM adjuvan sistemi (RAS), (Ribi Immunochem, Hamilton,
MT); %2 Skualen, %02 Tween 80 ve monofosforilipit A (MPL),
trehaloz diinikolat (TDM) ve hücre çeperi iskeletinden (CWS) olusan
gruptan seçilen bir veya daha fazla bakteriyel hücre çeperi bileseni,
tercihen MPL + CWS (Detox'lM) ihtiva eder; (3) saponin adjuvanlar
[123. referansin 22. bölümü], örnegin QS21 veya StimulonTM
(Cambridge Bioscience, Worcester, MA), ya basit formda ya da
bunlardan üretilmis partiküller formunda, örnegin ISCOMsler
(immüno-uyarici kompleksler; 123. referansin 23. bölümü), bu
ISCOMS, ilave deterjan içermeyebilir, örn., ref. 126; (4) Komple
Freund Adjuvani (CFA) ve Eksik Freund Adjuvani (IFA); (5)
sitokinler ömegin interlökinler (örn., IL-l, lL-2, IL-4, IL-S, IL-6, IL-
7, lL-12 [127], Vb.), interferonlar (örn., gamma interferon), makrofajkoloni uyarma faktörü (M-CSF), tüinör nekroz faktörü (TNF), Vb.; (6)18monofosforil lipit A (MPL) veya 3-O-deasile edilmis MPL (3dMPL)
örn., 128 ve 129. referanslar, istege bagli olarak pnömokok sakaritleri
ile kullanildiginda 'Önemli ölçüde alum içermez, örn., ref. 130; (7)
3dMPL'nin örnegin QSZl ve/veya su içinde yag emülsiyonlari ile
kombinasyonlari, örn. 131, 132 ve 133. referanslar; (8) CpG motifleri
içeren oligonükleotitler (Roinan ve arkadaslari, Nat. Med., 1997, 3,
849-854; Weiner ve arkadaslari, PNAS USA, 1997, 94, 10833-10837;
Davis ve arkadaslari, J. linmuiiol., 1998, 160, 870-876; Chu ve
arkadaslari, J. Exp. Med., 1997, 186, 1623-1631; Lipford ve
arkadaslari, Eur. J. lmmunol, 1997, 27, 2340-2344; Moldoveanu ve
arkadaslari, Vaccine, 1988, 16, 1216-1224, Krieg ve arkadaslari,
Nature, 1995, 374, 546-549; Klinman ve arkadaslari, PNAS USA,
1996, 93, 2879-2883; Ballas ve arkadaslari, J. lmmunol., 1996, 157,
1840-1845; COWdery ve arkadaslari, J. Iinmunol., 1996, 156, 4570-
4575; Halpeni ve arkadaslari, Cell.Immunol, 1996, 167, 72-78;
Yainamoto ve arkadaslari, Jpn. J. Cancer Res., 1988, 79, 866-873;
Stacey ve arkadaslari, J. lmmunol., 1996, 157, 2116-2122; Messina ve
arkadaslari, J. lmmunol., 1991, 147, 1759-1764; Yi ve arkadaslari, J.
lmmunol., 1996, 157, 4918-4925; Yi ve arkadaslari, .1. lmmunol.,
1996, 157, 5394-5402; Yi ve arkadaslari, J. lmmunoL., 1998, 160,
4755-4761; ve Yi ve arkadaslari, 1. lmmunol., 1998, 160, 5898-5906;
Uluslararasi patent basvurulari WO96/02555, WO98/ 16247,
WO98/18810, WO98/40100, WO98/55495, WO98/37919 ve
WO98/52581) yani en az bir CG dinükleotiti ihtiva eder ve istege
bagli olarak sitosin yerine 5-metilsitosin kullanilir; (8) bir
polioksietilen eter veya bir polioksietilen ester örn., ref. 134; (9) bir
oktoksinol [135] veya bir polioksietilen alkil eter ile kombinasyonhalinde bir polioksietilen sorbitan ester surfektan veya en az bir ilave19iyonik olmayan surfektan örnegin bir oktoksinol ile kombinasyon
halinde ester surfektan [136]; (10) bir saponin ve bir immüno-uyarici
oligonükleotit (öm., bir CpG oligonükleotiti) [137]; (1 1) bir iminüno-
uyarici ve bir metal tuzu partikülü, örn., ref. 138; (12) bir saponin ve
bir su içinde yag emülsiyonu, 'Örn, ref. 139; (13) bir saponin (örn.,
QSZl) + 3dMPL + IL-12 (istege bagli olarak + bir sterol) örn., ref.
140; (14) E. coli isiya yatkin enterotoksin ("LT") veya bunun
detoksifiye mutantlari 'emegin K63 veya R72 mutantlari [Kim, 141.
referansin 5. Bölümü]; (15) kolera toksin ("CT") veya bunun
detoksifiye mutantlari [örn., 141. referansin 5. Bölümü]; (16)
lipozoinlar [123. referansin 13 ve 14. bölümleri]; (17) çitosan [Örn,
ref. 142]; (18) iki iplikçikli RNA; (19) mikropartiküller (yani ~100nm
ila ~150um çapinda, daha fazla tercihen ~200nm ila ~30um çapinda
Ve en fazla tercihen ~500nm ila ~10um çapinda partiküller), biyo-
degrade olabilen ve toksik olmayan materyallerden olusturulmus
Com., bir poli(0L-hidroksi asit) 'Örnegin poli(laktid-ko-glikolid), bir
polihidroksibutirik asit, bir poliortoester, bir polianhidrid, bir
polikaprolakton Vb.), istege bagli olarak (örn., SDS ile) negatif yüklü
bir yüzeye veya (örn., bir katyonik deterjan, örnegin CTAB ile) pozitif
yüklü. bir yüzeye sahip olacak sekilde isleme tabi tutulmustur; veya
(20) kompozisyonun etkinligini güçlendirmek için immüno-uyarici
ajanlar olarak görev yapan diger maddeler [örn, 123. referansin 7.
bölümü]Alüminyum tuzlari (özellikle alüminyum fosfatlar ve/veya
hidroksidler) ve MF59, mevcut bulusa ait sakarit anti jenleri ile birlikte
kullanilmak üzere tercih edilir. Bir alüminyum fosfat kullanildiginda
bir veya daha fazla sakaritin alüminyum tuzu üzerine adsorbe edilmesimümkündür, ancak sakaritlerin tuza adsorbe edilmesi tercih edilmez
20ve, çözelti içinde serbest fosfat iyonlarinm dahil edilmesi (öm., bir
fosfat tamponu kullanilarak) yoluyla saglanir. Bir alüminyum
hidroksid kullanildiginda sakaritlerin tuza adsorbe edilmesi tercih
edilir. Adjuvan olarak alüminyum hidroksid kullanilmasi, A
serogrubundan sakarit için 'Özellikle avantajlidir.Bulusa ait kompozisyonlarda bazi antijenlerin bir alüminyum
hidrokside adsorbe edilmesi, ancak diger anti jenlerin bir alüminyum
fosfat ile birlikte buluninasi mümkündür. Tetravalent N.meningitidis
serogrubu kombinasyonlari için örnegin asagidaki permütasyonlarmümkündür: Serogrup Alüminyum tuzu (H = bir hidroksid; P = bir fosfat)A P H P H H H P P P H H H P P P H
C P H H P H H P H H P P H P H P P
Wl35 P H H H P H H P H H P P P P H P
Y P H H H H P H H P P H P H P P P Trivalent N.meningitidis serogrubu kombinasyonlari için asagidakipermütasyonlar mümkündür: Serogrup Alüminyum tuzu (H = bir hidroksid; P = bir fosfat) C P H H H P P P H
W135 P H H P H P H P
Y P H P H H H P P Formüle edildikten sonra bulusa ait kompozisyonlar süjeye direkt
olarak uygulanabilir. Tedavi edilecek süjeler, hayvanlar olabilir;'Özellikle insan sü jeler tedavi edilebilir. Asilar çocuklarin ve ergenlerin21asilanmasi için özellikle faydalidir. Bunlar sistemik ve/veya mukozal
yollarla verilebilir.Tipik olarak immünojenik kompozisyonlar, sivi çözeltiler veya
süspansiyonlar seklinde enjeksiyonluk ürünler olarak hazirlanir;
enjeksiyon öncesinde sivi araçlar içerisinde çözeltiye veya
süspansiyona uygun kati formlar da hazirlanabilir. Preparasyon ayrica
emülsife edilebilir veya ad juvan etkisini güçlendirmek için lipozoinlar
içinde kapsül haline getirilebilir. Koinpozisyonlarin dogrudan
verilmesi genellikle parenteral (örn., subkütan, intraperitonel,
intravenöz veya intrainüsküler yoldan enjeksiyon yoluyla veya bir
dokunun interstitiyal bosluguna verilme suretiyle) yoldan olacaktir.
Kompozisyonlar ayrica bir lezyon içine uygulanabilir. Diger
uygulama yollari arasinda oral ve pulmoner uygulama, fitiller ve
transderinal veya transkütan uygulamalar (örn., bakiniz ref. 143),
igneler ve hipospreyler bulunur. Dozaj tedavisi, tek dozlu bir program
veya çok dozlu bir program (örn., booster dozlari içeren) olabilir.
Bulusa ait asilar tercihen sterildir. Bunlar tercihen pirojensizdir.
Bunlar tercihen örn., pH 6 ile pH 8 arasinda, genellikle pH 7'de
tamponlanir. Bir asi bir alüminyum hidroksid tuzu içerdiginde bir
histidin tamponunun kullanilmasi tercih edilir [144].Bulusa ait asilar, düsük düzeylerde (örn.,
Claims (1)
1. Bir bakteriyel kapsüler polisakkariti saflastirmak ve bir tasiyici proteine konjuge etmek için bir proses olup, asagidaki adimlari polisakkaritin saflastirilmasi, (a) bir ya da daha fazla katyonik deterjan kullanilarak polisakaritin çökeltilmesi, ardiiidan (b) çökeltilen polisakaritin bir alkol kullanilarak çözünürlestirilmesi, (0) (b) adiminda elde edilen polisakaritin, kirleticileriii çikarilmasi amaciyla bir veya daha fazla filtreleme adimi kullanilarak isleme tabi tutulmasi, sonra ((1) (c) adiminda elde edilen polisakaritin, katyonlarin degistirilmesi suretiyle çökeltilmesi, ve polisakkaridin bir tasiyici proteine konjugasyonu adimlarini içerir, burada tasiyici protein bir bakteriyel toksindir ya da toksoittir ve burada konjugasyon bir baglayici ile gerçeklestirilir, burada bakteriyel kapsüler polisakkarit Neisseria meningitidis serogrup A°dan gelir ve burada katyoiiik deterjan(lar) bir setiltrimetilamonyum tuzunu, bir tetrab'i'itilamonyum tuzunu, bir miristiltriinetilamonyum tuzunu ve/Veya hekzadimetrin bromürü içerir. . Istem l°e göre proses olup, burada adini (b)°de kullanilan alkol etanolü içerir ve burada etanol %50 ve %95 arasindaki bir nihai konsantrasyona sahiptir. . Istem 1°e göre proses olup, burada adiin (c) derinlik filtrasyonunu, aktive edilmis karbon yoluyla filtrasyonu, ebat filtrasyonunu ve/veya ultrafiltrasyonu içerir. . Onceki istemlerden herhangi birine göre proses olup, burada adim (d)°deki çökelme kalsiyum ya da sodyum tuzlarinin eklenmesiyle gerçeklestirilmistir. . Onceki istemlerden herhangi birine göre proses olup, burada sakkarit konjugasyonu öncesinde aktive edilir. . Istem 5”e göre proses olup, burada aktivasyon bir siyanilatlama reaktifini içerir. . Onceki istemlerden herhangi birine göre proses olup, burada konjugatli sakkarit 0.521 ve 5:] arasinda bir sakkaritzprotein oranina (W/W) sahiptir. . Onceki istemlerden herhangi birine göre proses olup, burada tasiyici protein difteri toksoit ya da tetanoz toksoittir. . Onceki istemlerden herhangi birine göre proses olup, burada konjugasyonu sonrasinda serbest ve konjugatli sakkaritler 10.Istem 9”a göre proses olup, burada ayrisma hidrofobik kromatografiyi, tegetsel ultrafiltrasyonu ya da diyafiltrasyonu kullanilir. 11.N.Meningitidis”in birden fazla serogrubundan sakkaritlerin bir karisimini yapma prosesi olup, 'Önceki istemlerden herhangi birinin prosesini içerir ve ayrica konjugatin karisimi saglamak için baska biyolojik moleküllerle karistirilmasi adimini içerir. 12.Istem '1 l ”e göre proses olup, burada N.Meningitidis suslari A, C, W135 ve/Veya Yiden alinan sakkarit anti jenleri karistirilir. 13.Istem 12”ye göre proses olup, burada karistirma islemi A ve C olmak üzere her iki serogruptan gelen kapsüler sakkaritleri içerir ve MenA sakkaritzMenC sakkarit orani (W/W) 2: 1 ”dir. 14.Istem 12°ye göre proses olup, burada karistirma islemi, Y serogrubundan ve serogrup C ve W135,in birinden ya da her ikisinden gelen kapsüler sakkaritleri içeren bir bilesim saglar ve burada MenY sakkaridizMenWl35 sakkaridi orani (W/W) laden daha fazladir ve/Veya MenY sakkaridizMenC sakkaridi oraiii (w/W) l'den daha düsüktür. 15.Istem 12”ye göre proses olup, burada karistirma isleini serogrup A, C, W135 ve Y”den elde edilen kapsüler sakkaritleri içeren bir bilesimi verir ve burada A:C:Wl35:Y serogruplari 1:1:l:1; sahiptir. 16.Bir asiyi formüle etmek için bir proses olup, önceki istenilerden herhangi birinin prosesini içerir ve ayrica bir alüminyum fosfat ve/Veya bir alüminyum hidroksit olan bir adjuvanla sakkarit antijen(ler)inin karistirilmasmi ihtiva eden asi formülasyonu adim(lar)1n1 içerir.
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2016
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- 2016-10-21 CY CY20161101065T patent/CY1118130T1/el unknown
- 2016-10-31 US US15/339,741 patent/US10716841B2/en not_active Expired - Lifetime
-
2018
- 2018-03-30 CY CY20181100356T patent/CY1120499T1/el unknown
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