TW202241495A - 用於長期保存的肉毒桿菌毒素冷凍乾燥製劑及其製備方法 - Google Patents
用於長期保存的肉毒桿菌毒素冷凍乾燥製劑及其製備方法 Download PDFInfo
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- TW202241495A TW202241495A TW111104572A TW111104572A TW202241495A TW 202241495 A TW202241495 A TW 202241495A TW 111104572 A TW111104572 A TW 111104572A TW 111104572 A TW111104572 A TW 111104572A TW 202241495 A TW202241495 A TW 202241495A
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- botulinum toxin
- freeze
- protamine sulfate
- complex
- cyclodextrin
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Abstract
揭露一種用於長期保存的肉毒桿菌毒素冷凍乾燥製劑,包含肉毒桿菌毒素與硫酸魚精蛋白的複合體、等張劑及緩衝劑。肉毒桿菌毒素冷凍乾燥製劑能夠降低在凍乾過程中所製造之肉毒桿菌毒素去活性化的速率,相較於習知的肉毒桿菌毒素的冷凍乾燥製劑能夠較長時間維持肉毒桿菌毒素的穩定性,並形成均勻的粒徑分布達到與在給藥位置相同的效果,同時防止僅在某些區域發生過量毒素給藥效果之副作用。
Description
本發明係關於用於長期保存的肉毒桿菌毒素冷凍乾燥製劑,尤其係關於含有肉毒桿菌毒素與硫酸魚精蛋白的複合體、等張劑及緩衝劑之用於長期保存的肉毒桿菌毒素冷凍乾燥製劑。
自從1890年代以來已發現會分泌神精毒性毒素之梭菌屬(
Clostridium)的各種菌株,在過去70年中已對這些菌株分泌的毒素進行表徵。
源自梭菌屬菌株的神經毒性毒素,亦即肉毒桿菌毒素(botulinum toxin),根據其血清學特徵被分類成七種類型,即A至G。各毒素具有天然存在之約150 kDa的毒素蛋白質,其由與多種無毒性蛋白質結合的複合體組成。中型複合體(300 kDa)由毒素蛋白質及無毒性非血球凝集素蛋白組成,大型複合體(450 kDa)及巨大(Large-large)型複合體(900 kDa)具有中間複合體結合至血球凝集素的結構(Sugiyama, H, Microbiol Rev, 44:419, 1980)。這些無毒性非血球凝集素蛋白已知發揮保護毒素免受腸道中低pH及多種蛋白酶的影響之功能。
毒素在細胞中被合成為具有約150 kDa之分子量的單一多肽,接著透過細胞內蛋白酶之作用或使用如胰蛋白酶之人工酵素處理在距離N端三分之一的位置處被切割成輕鏈(L,分子量:50 kDa)及重鏈(H,分子量:100 kDa)。經切割之毒素的毒性相較於單一多肽大幅增加。兩個單元彼此以雙硫鍵連接並具有不同功能。重鏈結合至目標細胞的受體並在低pH(pH為4)下與生物膜反應形成通道(Mantecucco, C. et al., TIBS, 18:324, 1993),而輕鏈具有藥理活性,因此在清潔劑的存在下賦予細胞通透性,或在透過電穿孔注入細胞時阻礙神經傳導物的分泌。
毒素在神經肌肉會合處的膽鹼素前突觸(cholinergic presynapse)抑制乙醯膽鹼的胞吐作用,從而造成衰弱。已知使用非常少量之毒素處理會展現出毒性,表示毒素具有酵素活性。
根據近期報導,毒素具有金屬肽酶(metallopeptidase)活性,其受質由突觸小泡蛋白(synaptobrevin)、突觸融合蛋白(syntaxin)、25 kDa之突觸小體相關蛋白(synaptosomal-associated protein)(SNAP25)等組成,其為胞吐作用機械複合體的單元蛋白。各類型的毒素使用上述三種蛋白質之一種作為其受質,已知B、D、F及G型之毒素會在特定位置切割突觸小泡蛋白(synaptobrevin),A及E型之毒素會在特定位置切割SNAP25,C型會在特定位置切割突觸融合蛋白(syntaxin)。
具體而言,已知A型肉毒桿菌毒素可溶於pH為4.0至6.8之稀釋水溶液。已知在pH為約7以上會從神經毒素分離出穩定的無毒性蛋白,因此逐漸喪失毒性。具體而言,已知毒性隨著pH及溫度增加而下降。
肉毒桿菌毒素即使少量對人類仍致命,且易於大量製造。因此,其與炭疽桿菌(
Bacillus anthracis)、鼠疫桿菌(
Yersinia pestis)及天花病毒(smallpox virus)一起被視為四大生物恐怖武器之一。然而,發現當以不會全身性影響人體的劑量注射A型肉毒桿菌毒素時,其會使在注射處的局部肌肉麻痹。基於此特性,A型肉毒桿菌毒素能使用於廣泛範圍的應用中,包含除皺劑、用於治療痙攣性偏癱(spastic hemiplegia)及腦性麻痺(cerebral palsy)之試劑等。因此,對A型肉毒桿菌毒素的需求增加,並積極研究製造肉毒桿菌毒素以滿足需求的方法。
目前代表性的商品為BOTOX®(A型肉毒桿菌毒素之純化的神經毒素複合體),其可由美國Allergan, Inc.購得。一瓶100單位之BOTOX®由約5奈克(ng)A型肉毒桿菌毒素之純化的神經毒素複合體、0.5毫克(mg)人類血清白蛋白及0.9 mg氯化鈉組成,並使用不含防腐劑的無菌鹽水(0.9%氯化鈉之注射)重新構成。其他市售產品包含:Dysport®(肉毒桿菌A型毒素與血球凝集素的複合體,其在含有肉毒桿菌毒素的醫藥組合物中具有乳糖及人類血清白蛋白,並在使用前使用0.9%氯化鈉重新構成),其可由英國Ipsen Ltd.購得;以及MyoBloc™(包含肉毒桿菌B型毒素、人類血清白蛋白、琥珀酸鈉及氯化鈉的可注射溶液(pH為約5.6)),其可由Solstice Neurosciences, Inc購得。
肉毒桿菌毒素在市面上主要以冷凍乾燥製劑的形式取得,因此對保持長期穩定的冷凍乾燥製劑進行了大量的研究。舉例而言,US 7,744,904 B1揭露為了嘗試改善肉毒桿菌毒素的穩定性,將α、β及γ環糊精與肉毒桿菌毒素在磷酸鹽緩衝劑中簡單混合以形成環糊精-肉毒桿菌毒素複合體。然而,儘管允許α、β及γ環糊精的口服給藥,但這些環糊精不適用於作為肉毒桿菌毒素的賦形劑,其因腎毒性及受限的溶解性而主要透過注射使用。此外,若在肉毒桿菌毒素注入體內時粒徑不均勻,則無法在全身均勻發揮作用,因此可能無法達成預期的治療或美容效果,這可能造成多種副作用。
〔相關先前技術〕
〔專利文件〕
(專利文件1)US 7,744,904 B1
因此,作為開發將肉毒桿菌毒素均勻製粒且具有改善的穩定性之冷凍乾燥製劑之大量努力的結果,發明人發現當製備含有作為賦形劑之硫酸魚精蛋白的肉毒桿菌毒素冷凍乾燥製劑時,肉毒桿菌毒素與硫酸魚精蛋白會形成複合體,因此相較於在習知情況下為3個月,肉毒桿菌毒素的功效能夠改善至少6個月,所產生之肉毒桿菌毒素顆粒之對應多分散性指數(polydispersity index,PDI)的均勻性為0.3以下。基於此發現,完成本發明。
因此,本發明係鑒於上述問題而完成,本發明之一目的在於提供:新穎的肉毒桿菌毒素冷凍乾燥製劑,其具有均勻的粒徑及改善的長期保存穩定性;以及製備其的方法。
根據本發明之一態樣,上述及其他目的可透過提供下述肉毒桿菌毒素冷凍乾燥製劑來達成,所述肉毒桿菌毒素冷凍乾燥製劑包含肉毒桿菌毒素與硫酸魚精蛋白的複合體、等張劑及緩衝劑。
根據本發明之另一態樣,提供一種製備肉毒桿菌毒素冷凍乾燥製劑的方法,包含:
(a)將肉毒桿菌毒素與硫酸魚精蛋白混合以形成肉毒桿菌毒素與硫酸魚精蛋白的複合體;
(b)藉由將選自由聚山梨醇酯20、羥丙基-β-環糊精、人類血清白蛋白及甘露醇所組成之群組之一或多個賦形劑、等張劑以及緩衝劑添加至肉毒桿菌毒素與硫酸魚精蛋白的複合體,製備肉毒桿菌毒素儲備原液;以及
(c)將肉毒桿菌毒素儲備原液凍乾。
根據本發明之肉毒桿菌毒素冷凍乾燥製劑能夠藉由降低在凍乾過程中所製造之肉毒桿菌毒素去活性化的速率來有效實現穩定的冷凍乾燥製劑。此外,相較於習知的肉毒桿菌毒素的冷凍乾燥製劑,根據本發明之肉毒桿菌毒素冷凍乾燥製劑能夠較長時間維持肉毒桿菌毒素的穩定性,並形成均勻的粒徑以實現在給藥位置有相同的效果,同時防止僅在某些區域發生過量毒素給藥效果之副作用。
除非另有定義,否則於此所使用之所技術及科學用語具有與本發明所屬技術領域中具有通常知識者所理解者相同的意義。一般而言,於此所使用之命名法在本領域中是眾所周知且常用的。
本發明係基於由肉毒桿菌毒素與硫酸魚精蛋白的複合體製備之冷凍乾燥製劑維持均勻的粒徑並展現出長期保存穩定性之發現。
在一態樣中,本發明係針對肉毒桿菌毒素冷凍乾燥製劑,其包含肉毒桿菌毒素與硫酸魚精蛋白的複合體、等張劑及緩衝劑。
在本發明中,肉毒桿菌毒素帶負電,而硫酸魚精蛋白帶正電,故它們在溶液中彼此反應以形成離子複合體。硫酸魚精蛋白以離子鍵的形式結合於具有高分子量的肉毒桿菌毒素蛋白。在此情況下,結合至肉毒桿菌毒素的硫酸魚精蛋白的量依據所添加之硫酸魚精蛋白的濃度而變化。結合有硫酸魚精蛋白之肉毒桿菌毒素的表面可帶正電,並可與肉毒桿菌毒素形成額外的複合體。
因此,為了形成本發明之冷凍乾燥製劑之具有改善的長期保存穩定性的複合體,在本發明中,硫酸魚精蛋白的濃度為1.72 nM至0.22 mM,較佳為1.72 nM至17.2 nM,更佳為1.72 nM至6.98 nM,更佳為1.72 nM至3.44 nM,但不限於此。
再者,在本發明中,肉毒桿菌毒素與硫酸魚精蛋白以1:3至1:20之重量比形成複合體,較佳為1:5至1:20,更佳為1:5至1:10,最佳為1:5,但不限於此。
在本發明中,組合物可更包含選自由聚山梨醇酯20、羥丙基-β-環糊精、人類血清白蛋白及甘露醇所組成之群組之一或多個賦形劑,較佳為選自由羥丙基-β-環糊精、人類血清白蛋白及甘露醇所組成之群組,但本發明不限於此。
在本發明中,羥丙基-β-環糊精的濃度為1至30 w/v%,較佳為2至25 w/v%,更佳為5至20 w/v%,例如5至15 w/v%、5至10 w/v%、8至15 w/v%、8至10 w/v%、10至20 w/v%或15至20 w/v%,但不限於此。
在本發明中,人類血清白蛋白的濃度為0.1至1.0 w/v%,較佳為0.2至0.7 w/v%,更佳為0.2至0.5 w/v%,最佳為0.35至0.5 w/v%,但不限於此。
在本發明中,甘露醇作為冷凍保護劑(Cryoprotectant),並可使用蔗糖、甘油、海藻糖或乳醣取代,但本發明不限於此。冷凍保護劑的含量基於組合物的總量可為0.1至8 w/v%,但不限於此。
在本發明中,較佳地,冷凍保護劑可為甘露醇,甘露醇可以0.1至10 w/v%之量存在,較佳為0.1至8 w/v%,更佳為4至8 w/v%,但不限於此。
在本發明中,等張劑可為氯化鈉、甘油、甘露醇、蔗糖、氯化鉀、葡萄糖(dextrose)等,但不限於此。等張劑的含量基於組合物的總量可為0.7至0.95 w/v%,但不限於此。
在本發明中,等張劑較佳可為氯化鈉,氯化鈉可以0.7至1.0 w/v%之量存在,較佳為0.7至0.95 w/v%,更佳為0.8至0.95 w/v%,最佳為0.9 w/v%,但不限於此。
本發明之組合物可包含生理上合適的緩衝劑,其具有對應等電點或更高的pH,從而確保長期穩定性。
在本發明中,生理上合適的緩衝劑的pH應維持於6.0至7.0之範圍內,較佳為6.4至6.6之範圍內,最佳為約6.5。
在本發明中,生理上合適的緩衝劑可為檸檬酸、琥珀酸、磷酸鹽、磷酸二氫鉀、乙酸鈉或氯化鈉,但不限於此。
在本發明中,適用於凍乾的緩衝劑基於組合物之總量可以10至35 mM之量存在,較佳為10至30 mM,最佳為15至25 mM。
較佳地,緩衝劑的pH為6.0至7.0,濃度為10至35 mM,但不限於此。
在一實施例中,pH為6.5的磷酸鹽基於組合物之總量可以20 mM之量存在作為生理上合適的緩衝劑。
根據本發明之冷凍乾燥製劑藉由誘導具有肉毒桿菌毒素與硫酸魚精蛋白之複合體的形成以及對其添加羥丙基-β-環糊精及人類血清白蛋白而被賦予疏水性。並且,根據本發明之冷凍乾燥製劑使用等張劑(較佳為氯化鈉)而具有改善的溶解性。
在本發明中,硫酸魚精蛋白係含有大量帶正電之胺基酸的分子,並與肉毒桿菌毒素形成複合體,進而有助於肉毒桿菌毒素的穩定性。
同時,用語「羥丙基-β-環糊精」可與用語「betadex」交換使用,其具有糖鏈的環狀結構,並類似於聚山梨醇酯20或聚山梨醇酯80為雙親性(amphipathic),從而有助於肉毒桿菌毒素的穩定性。
於此所使用之用語「肉毒桿菌毒素」可涵蓋由肉毒桿菌菌株或其變體以及變異、重組、雜合及嵌合的肉毒桿菌毒素所製造的神經毒素(NTXs)。在本發明中,重組的肉毒桿菌毒素可與具有藉由不同於梭菌屬之菌株重組製造之輕鏈及/或重鏈。在本發明中,肉毒桿菌毒素包含肉毒桿菌毒素複合體(即300、600及900 kDa複合體)及純肉毒桿菌毒素(即約150 kDa神經毒性分子)兩者。
在本發明中,肉毒桿菌毒素可選自由血清型A、B、C、D、E、F及G所組成之群組,但不限於此。
較佳地,包含於本發明之凍乾組合物中之肉毒桿菌毒素係肉毒桿菌毒素A型。根據本發明之組合物可以約10至200單位/毫升(unit/ml)之量包含肉毒桿菌毒素,較佳為約20至150 unit/ml,更佳為約40至100 unit/ml,但不限於此。
在本發明中,凍乾組合物可更包含抗氧化劑,抗氧化劑可為α-生育酚,但不限於此。
在另一態樣中,本發明係針對製備肉毒桿菌毒素冷凍乾燥製劑的方法,包含:
(a)將肉毒桿菌毒素與硫酸魚精蛋白混合以形成肉毒桿菌毒素與硫酸魚精蛋白的複合體;
(b)藉由將選自由聚山梨醇酯20、羥丙基-β-環糊精、人類血清白蛋白及甘露醇所組成之群組之一或多個賦形劑、等張劑以及緩衝劑添加至肉毒桿菌毒素與硫酸魚精蛋白的複合體,製備肉毒桿菌毒素儲備原液;以及
(c)將肉毒桿菌毒素儲備原液凍乾。
以下參考下述示例詳細說明本發明。然而,對本領域具有通常知識者顯而易見的是以下示例僅供說明本發明,不應被解釋為限制本發明的範圍。
實驗例
1.
肉毒桿菌毒素
/
硫酸魚精蛋白
複合體的製備及其尺寸量測
為了維持肉毒桿菌毒素的穩定性,使用帶正電的硫酸魚精蛋白製備肉毒桿菌毒素/硫酸魚精蛋白複合體。使用pH為6或更高的緩衝劑以誘導肉毒桿菌毒素與硫酸魚精蛋白之複合體的形成,其中肉毒桿菌毒素具有對應pH約為6的等電點(PI)並帶相對負電。使用20 mM磷酸鹽緩衝劑(pH 6.5)作為緩衝溶液。準備0.1 mg/mL之肉毒桿菌毒素A型(900 kDa,Daewoong Co., Ltd.),將硫酸魚精蛋白以0.5、1.0及2.0 mg/mL之量溶解於20 mM磷酸鹽緩衝劑(pH 6.5),將肉毒桿菌毒素A型與硫酸魚精蛋白以1:1 (v/v)之比例混合在室溫下約30分鐘誘導複合體形成。
為了確定複合體是否形成,使用奈米粒徑分析儀(Zetasizer ZSP,Malvern)量測肉毒桿菌毒素或肉毒桿菌毒素/硫酸魚精蛋白複合體的粒徑。奈米粒徑分析儀係藉由量測在透射至樣品的光線折射時的折射率來確定顆粒的尺寸的裝置。由表1所示之測試結果可知,肉毒桿菌毒素A型的尺寸約為19 nm,而其與硫酸魚精蛋白以1:5之比例形成的複合體的尺寸約為182 nm。在1:10及1:20之比例下,複合體的尺寸分別約為335 nm及約為481 nm。同時,在以肉毒桿菌毒素A型與硫酸魚精蛋白的比例為1:5形成複合體時所量測之多分散性指數(polydispersity index,PDI)為0.3以下,故在其之間對應的比例下形成之複合體具有均勻的粒徑。這表示此比例對於各複合體在注入至體內時發揮相同的效果而言為理想的。
〔表1〕肉毒桿菌毒素/硫酸魚精蛋白複合體的尺寸量測
樣品 | 尺寸(nm) | PDI |
肉毒桿菌毒素A型 | 18.58±5.12 | 0.258 |
肉毒桿菌毒素A型/硫酸魚精蛋白1:5複合體 | 182±51.9 | 0.269 |
肉毒桿菌毒素A型/硫酸魚精蛋白1:10複合體 | 334.7±74.8 | 0.391 |
肉毒桿菌毒素A型/硫酸魚精蛋白1:20複合體 | 481.4±79.1 | 0.488 |
實驗例
2.
含有肉毒桿菌毒素做為主要成分之冷凍乾燥製劑的賦形劑的篩選以及嚴苛穩定性測試
篩選出基於含有肉毒桿菌毒素/硫酸魚精蛋白1:5複合體作為基礎成分的冷凍乾燥製劑之具有穩定性的賦形劑組合物。冷凍乾燥製劑組合物包含20 mM磷酸鹽緩衝劑(pH 6.5)作為基礎溶劑以形成肉毒桿菌毒素/硫酸魚精蛋白複合體,篩選出多種賦形劑,例如穩定劑、抗氧化劑、冷凍保護劑及等張劑,以確定肉毒桿菌毒素穩定性。
在此情況下,以40 U/mL之肉毒桿菌毒素進行實驗,依據如以下表2所示之賦形劑組成製備各最終儲備原液,接著將其以50 U/小瓶之量等分並凍乾。進行嚴苛穩定性測試以間接確定在凍乾後的長期穩定性。當樣品保存於40°C之嚴苛室(harsh chamber)12周時,觀察滴定量(titer)的改變以確定毒素保存穩定性。具體而言,肉毒桿菌毒素的穩定性透過在預定時間內使用4周齡ICR小鼠(Koatech,Korea)之動物滴定量測試來評估,將測試物質以生理鹽水再次水合並稀釋成七個不同的濃度,將稀釋溶液以0.1 mL/小鼠之劑量給予小鼠,觀察動物在3天內是否死亡,計算LD
50以確定滴定量值。對於各濃度,於10隻小鼠進行實驗,結果以量測值的平均值表示。
於此,所製備之各製劑的滴定量調整為100%,但肉毒桿菌毒素為蛋白值,其因此受賦形劑的組成、外部環境、凍乾製程參數等影響。為此,在嚴苛穩定性測試的第一天將滴定量訂為100%,接著計算滴定量變化。在此情況下,確定滴定量在原始滴定值的± 20%之範圍內為合適,即100%。
〔表2〕
項目 | 穩定劑 | 抗氧化劑 | 等張劑 | 冷凍保護劑 | 在嚴苛環境下4周 (40°C) | 在嚴苛環境下12周 (40°C) | 滴定量 | |||||
物質 | 濃度 (%) | 物質 | 濃度(%) | 物質 | 濃度(%) | 物質 | 濃度(%) | |||||
比較例1 | 人類血清白蛋白 | 0.5 | - | - | - | - | 甘露醇 | 5 | 0 | 0 | 不合適 | |
比較例2 | Betadex | 5 | - | - | 氯化鈉 | 0.9 | - | - | 0 | 0 | 不合適 | |
人類血清白蛋白 | 0.5 | |||||||||||
實施例1 | Betadex | 5 | - | - | 氯化鈉 | 0.9 | 甘露醇 | 5 | 121.2 | 105.4 | 合適 | |
人類血清白蛋白 | 0.5 | |||||||||||
實施例2 | 聚山梨醇酯 20 | 0.01 | - | - | 氯化鈉 | 0.9 | 甘露醇 | 5 | 95.3 | 90.6 | 合適 | |
Betadex | 5 | |||||||||||
人類血清白蛋白 | 0.5 | |||||||||||
實施例3 | 聚山梨醇酯 20 | 0.01 | α-生育酚 | 0.035 | 氯化鈉 | 0.9 | 甘露醇 | 5 | 120.2 | 105.4 | 合適 | |
Betadex | 5 | |||||||||||
人類血清白蛋白 | 0.5 | |||||||||||
結果,首先,在嚴苛環境下12周後肉毒桿菌毒素滴定量的量測中,確認到使用人類血清白蛋白作為穩定劑且甘露醇作為冷凍保護劑之情況(比較例1)以及使用betadex及人類血清白蛋白作為穩定劑且氯化鈉作為等張劑之情況(比較例2)為不合適。然而,將betadex及人類血清白蛋白作為穩定劑並與氯化鈉作為等張劑且甘露醇作為冷凍保護劑一起使用之情況(實施例1)在嚴苛環境下12周後展現出最佳的肉毒桿菌毒素滴定量。同時,確認到將聚山梨醇酯加入人類血清白蛋白與betadex作為穩定劑、使用氯化鈉作為等張劑並使用甘露醇作為冷凍保護劑之情況(實施例2)以及除此之外還添加α-生育酚作為抗氧化劑之情況(實施例3)在嚴苛環境下12周後具有合適的滴定量,但在考量上述實驗結果及賦形劑的經濟成本,選擇實施例1作為基礎賦形劑進行進一步的研究。
實驗例
3.
賦形劑組成
最佳化及嚴苛穩定性測試
製備如以下表3所示之總共三種額外的組成,以確定取決於下述濃度範圍的效果,所述濃度範圍包含0.35至0.5%之人類血清白蛋白、5至20%之betadex以及4至8%之甘露醇,同時使用肉毒桿菌毒素/硫酸魚精蛋白1:5複合體作為基礎組成,並固定0.9%氯化鈉及20 mM磷酸鹽緩衝劑(pH 6.5)。除了賦形劑的濃度以外,所有組成皆以相同方式製備。將所製備之組成等分至10 mL小瓶並凍乾,測試12周在嚴苛環境下之肉毒桿菌毒素的穩定性。
〔表3〕
批次 | HSA | HP Betadex | D-甘露醇 | 在嚴苛環境下2周 (40℃) | 在嚴苛環境下6周 (40℃) | 在嚴苛環境下12周 (40℃) |
實施例1 | 0.5 | 5 | 5 | 124 | 121.2 (在嚴苛環境下4周) | 105.4 |
實施例4 | 0.5 | 10 | 4 | 149.3 | 157.8 | 103.1 |
實施例5 | 0.35 | 20 | 4 | 101 | 111.1 | 89.1 |
實施例6 | 0.5 | 20 | 8 | 134.1 | 115.8 | 94.7 |
實驗結果證實,肉毒桿菌毒素的穩定性在嚴苛環境下維持至少8周,特別是在包含0.35至0.5%之人類血清白蛋白、5至20%之betadex以及4至8%之甘露醇的濃度範圍中在嚴苛環境下維持12周。本發明人等基於先前研究證實,當確保在嚴苛環境下2周的穩定性時獲得在冷藏下約6個月或更少的穩定性,以及當確保在嚴苛環境下8周的穩定性時獲得在冷藏下約2年的穩定性。因此,可知含有0.35至0.5%之人類血清白蛋白、10至20%之betadex以及4至8%之甘露醇作為最佳化濃度的肉毒桿菌毒素冷凍乾燥製劑提供在嚴苛環境下長達12周之在80-120%之滴定量範圍內的穩定性,此肉毒桿菌毒素冷凍乾燥製劑在分布過程中能夠維持其功效至少6個月,較佳為至少12個月,最佳為至少24個月。
實驗例
4.
基於環糊精之賦形劑對肉毒桿菌毒素穩定性之影響的測試
Betadex係β-環糊精的衍生物,其引入羥基及丙基官能基以改善親水性。Betadex目前係為FDA、EU等批准使用的賦形劑,並在藥品中使用作為主要成分的穩定劑。環糊精依據其結構分成三種類型α(alpha)、β(beta)及γ(gamma),其相對疏水的內部結構透過主要成分的包封而穩定。因此,使用相似於betadex的基於環糊精之賦形劑來評估肉毒桿菌毒素的穩定效果。
首先,α、β及γ環糊精具有腎毒性,被FDA及KFDA認為不適合作為醫藥注射的賦形劑,故在本實驗中不使用。因此,進行本實驗以確定甲基-β-環糊精、硫酸β-環糊精(beta-cyclodextrin sulfate)、β-環糊精磺丁基醚鈉(beta-cyclodextrin sulfobutyl ether sodium)、羥乙基-β-環糊精、羥丙基-γ-環糊精或羥丙基-α-環糊精是否能用於代替betadex(羥丙基-β-環糊精)。
為此,在以下條件下進行實驗,所述條件為使用肉毒桿菌毒素/硫酸魚精蛋白1:5複合體作為基礎成分,固定0.9%氯化鈉、20 mM磷酸鹽緩衝劑(pH 6.5)、0.5%人類血清白蛋白及4%甘露醇,僅改變基於環糊精之賦形劑。在此情況下,基於環糊精之賦形劑的濃度維持於5%。
〔表4〕
批次 | 環糊精賦形劑 | 在嚴苛環境下2周 (40℃) | 在嚴苛環境下4周 (40℃) | 在嚴苛環境下6周 (40℃) |
比較例3 | 甲基-β-環糊精 | 105.4 | 76.4 | - |
比較例4 | 硫酸β-環糊精 | 112.5 | 73.7 | - |
比較例5 | β-環糊精磺丁基醚鈉 | 92.4 | 61.5 | - |
比較例6 | 羥乙基-β-環糊精 | - | - | - |
比較例7 | 羥丙基-γ-環糊精 | 66.9 | - | - |
比較例8 | 羥丙基-α-環糊精 | 63.4 | - | - |
實施例7 | 羥丙基-β-環糊精 | 81.4 | 84.7 | 104.8 |
由以上表4可知,在嚴苛環境下4周穩定性測試的結果顯現出,當使用不同於根據本發明之betadex(羥丙基-β-環糊精)(實施例7)的基於環糊精之賦形劑時,確認到肉毒桿菌毒素的保存穩定性不足。這表示在使用環糊精中之betadex作為用於本發明之肉毒桿菌毒素之冷凍保存的製劑時,效果特別顯著。
實驗例
5.
硫酸魚精蛋白
對肉毒桿菌毒素穩定性之效果的測試
硫酸魚精蛋白(Protamine sulfate)係一種帶正電的多肽,其能夠透過離子鍵與相對帶負電的肉毒桿菌毒素形成複合體。與肉毒桿菌毒素之複合體的形成使肉毒桿菌毒素蛋白能夠穩定維持。因此,進行比較實驗以確定取決於硫酸魚精蛋白是否存在之肉毒桿菌毒素的穩定性。
為此,單獨使用肉毒桿菌毒素或使用在以下條件之肉毒桿菌毒素/硫酸魚精蛋白1:5複合體來進行比較實驗,所述條件為固定氯化鈉0.9%、20 mM磷酸鹽緩衝溶液(pH 6.5)、人類血清白蛋白0.5%、甘露醇4%及betadex 10%。
〔表5〕
批次 | 硫酸魚精蛋白 (ng/mL) | 在嚴苛環境下1周 (40℃) | 在嚴苛環境下3周 (40℃) | 在嚴苛環境下5周 (40℃) | 在嚴苛環境下8周 (40℃) | 在嚴苛環境下10周 (40℃) |
比較例9 | 0 | 77.4 | 62.8 | - | - | - |
實施例4 | 7.75 | 125.4 | 110.1 | 87.1 | 89 | 89.9 |
由表5之結果可知,僅含有硫酸魚精蛋白的製劑能夠維持肉毒桿菌毒素的穩定性。
儘管已詳細描述本發明之特定構成,但本領域具有通常知識者將理解此詳細描述被提供作為用於說明目的之較佳實施例,不應解釋為限制本發明的範圍。因此,本發明的實質範圍由申請專利範圍及其均等範圍界定。
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Claims (12)
- 一種肉毒桿菌毒素冷凍乾燥製劑,包含:肉毒桿菌毒素與硫酸魚精蛋白的一複合體;一等張劑;以及一緩衝劑。
- 如請求項1所述之肉毒桿菌毒素冷凍乾燥製劑,其中硫酸魚精蛋白的濃度為1.72 nM至0.22 mM。
- 如請求項1所述之肉毒桿菌毒素冷凍乾燥製劑,其中肉毒桿菌毒素與硫酸魚精蛋白以1:5至1:20之重量比形成該複合體。
- 如請求項1所述之肉毒桿菌毒素冷凍乾燥製劑,更包含選自由聚山梨醇酯20、羥丙基-β-環糊精、人類血清白蛋白及甘露醇所組成之群組之一或多個賦形劑。
- 如請求項4所述之肉毒桿菌毒素冷凍乾燥製劑,更包含羥丙基-β-環糊精、人類血清白蛋白及甘露醇。
- 如請求項5所述之肉毒桿菌毒素冷凍乾燥製劑,其中羥丙基-β-環糊精的濃度為5至20 w/v%。
- 如請求項5所述之肉毒桿菌毒素冷凍乾燥製劑,其中人類血清白蛋白的濃度為0.35至0.5 w/v%。
- 如請求項5所述之肉毒桿菌毒素冷凍乾燥製劑,其中甘露醇的濃度為4至8 w/v%。
- 如請求項1所述之肉毒桿菌毒素冷凍乾燥製劑,其中該等張劑的濃度為0.7至1.0 w/v%。
- 如請求項1所述之肉毒桿菌毒素冷凍乾燥製劑,其中該緩衝劑的pH為6.0至7.0且濃度為10至35 mM。
- 如請求項1所述之肉毒桿菌毒素冷凍乾燥製劑,其中肉毒桿菌毒素選自由血清型A、B、C、D、E、F及G所組成之群組。
- 一種製備肉毒桿菌毒素冷凍乾燥製劑的方法,包含:(a)將肉毒桿菌毒素與硫酸魚精蛋白混合以形成肉毒桿菌毒素與硫酸魚精蛋白的一複合體;(b)藉由將選自由聚山梨醇酯20、羥丙基-β-環糊精、人類血清白蛋白及甘露醇所組成之群組之一或多個賦形劑、一等張劑以及一緩衝劑添加至肉毒桿菌毒素與硫酸魚精蛋白的該複合體,製備一肉毒桿菌毒素儲備原液;以及(c)將該肉毒桿菌毒素儲備原液凍乾。
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