WO2001001996A1 - Compositions et methodes de traitement ou de prevention de l'osteoporose - Google Patents

Compositions et methodes de traitement ou de prevention de l'osteoporose Download PDF

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Publication number
WO2001001996A1
WO2001001996A1 PCT/AU2000/000737 AU0000737W WO0101996A1 WO 2001001996 A1 WO2001001996 A1 WO 2001001996A1 AU 0000737 W AU0000737 W AU 0000737W WO 0101996 A1 WO0101996 A1 WO 0101996A1
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acid
ovx
active component
glucopyranoside
component selected
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PCT/AU2000/000737
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English (en)
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WO2001001996A9 (fr
Inventor
Richard Lewis Prince
Xu Min
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University Of Western Australia
Guangzhou University Of Traditional Chinese Medicine
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Application filed by University Of Western Australia, Guangzhou University Of Traditional Chinese Medicine filed Critical University Of Western Australia
Priority to AU55113/00A priority Critical patent/AU5511300A/en
Publication of WO2001001996A1 publication Critical patent/WO2001001996A1/fr
Publication of WO2001001996A9 publication Critical patent/WO2001001996A9/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18—Magnoliophyta (angiosperms)
    • A61K36/185—Magnoliopsida (dicotyledons)
    • A61K36/23—Apiaceae or Umbelliferae (Carrot family), e.g. dill, chervil, coriander or cumin
    • A61K36/232—Angelica
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18—Magnoliophyta (angiosperms)
    • A61K36/185—Magnoliopsida (dicotyledons)
    • A61K36/29—Berberidaceae (Barberry family), e.g. barberry, cohosh or mayapple
    • A61K36/296—Epimedium
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18—Magnoliophyta (angiosperms)
    • A61K36/185—Magnoliopsida (dicotyledons)
    • A61K36/43—Cuscutaceae (Dodder family), e.g. Cuscuta epithymum or greater dodder
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18—Magnoliophyta (angiosperms)
    • A61K36/185—Magnoliopsida (dicotyledons)
    • A61K36/46—Eucommiaceae (Eucommia family), e.g. hardy rubber tree
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18—Magnoliophyta (angiosperms)
    • A61K36/185—Magnoliopsida (dicotyledons)
    • A61K36/48—Fabaceae or Leguminosae (Pea or Legume family); Caesalpiniaceae; Mimosaceae; Papilionaceae
    • A61K36/481—Astragalus (milkvetch)
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18—Magnoliophyta (angiosperms)
    • A61K36/185—Magnoliopsida (dicotyledons)
    • A61K36/48—Fabaceae or Leguminosae (Pea or Legume family); Caesalpiniaceae; Mimosaceae; Papilionaceae
    • A61K36/487—Psoralea
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18—Magnoliophyta (angiosperms)
    • A61K36/185—Magnoliopsida (dicotyledons)
    • A61K36/48—Fabaceae or Leguminosae (Pea or Legume family); Caesalpiniaceae; Mimosaceae; Papilionaceae
    • A61K36/488—Pueraria (kudzu)
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18—Magnoliophyta (angiosperms)
    • A61K36/185—Magnoliopsida (dicotyledons)
    • A61K36/53—Lamiaceae or Labiatae (Mint family), e.g. thyme, rosemary or lavender
    • A61K36/537—Salvia (sage)
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18—Magnoliophyta (angiosperms)
    • A61K36/185—Magnoliopsida (dicotyledons)
    • A61K36/64—Orobanchaceae (Broom-rape family)
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00—Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18—Magnoliophyta (angiosperms)
    • A61K36/185—Magnoliopsida (dicotyledons)
    • A61K36/72—Rhamnaceae (Buckthorn family), e.g. buckthorn, chewstick or umbrella-tree
    • A61K36/725—Ziziphus, e.g. jujube
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00—Drugs for skeletal disorders
    • A61P19/08—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease
    • A61P19/10—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease for osteoporosis

Definitions

  • the invention relates to a composition for treating; • osteoporosis. More specifically, it relates to a therapeutic composition and method for treating osteoporosis.
  • Osteoporosis is a generalised progressive reduction in both bone mineral and bone matrix that results in bone of abnormal microarchitecture and decreased mass Functionally, osteoporotic bone is characterised by greater fragility and increased propensity to fracture. It is a common bone disease, affecting postmenopausal women and a large proportion of the aging population.
  • Treatments for osteoporosis include the use of bone resorption inhibitors, such as calcium, vitamin D, bisphosphonates, calcitonins and gonadal steroids, which prevent bone loss or reduce the incidence of fractures
  • bone resorption inhibitors such as calcium, vitamin D, bisphosphonates, calcitonins and gonadal steroids
  • Stimulators of bone formation such as fluorides, parathyroid hormone and analogues also may have the potential to treat osteoporosis
  • fluorides, parathyroid hormone and analogues also may have the potential to treat osteoporosis
  • Estrogen and progestoge ⁇ are often combined to relieve the symptoms of menopause, including the maintenance of bone density
  • risks with this treatment such as breast and endomet ⁇ al cancer
  • hormone replacement therapy causes side effects such as headaches, weight gain, sore breasts and menstruation
  • osteoporosis Another approach for the treatment of osteoporosis is prevention.
  • the assessment and modification of calcium, vitamin D, caffeine, alcohol, and phosphate in the diet, increasing the amount of exercise, and minimising falls can help prevent osteoporosis and fractures.
  • this often requires a significant change in lifestyle and behaviour that is difficult to maintain.
  • the present invention seeks to provide a therapeutic and a method of use which at least alleviates the deficiencies and problems discussed above or provides a useful alternative.
  • the present invention provides a composition comprising at least one herb or active component thereof selected from the group of herbs comprising:
  • herb is defined as a small, non-woody (i.e. fleshy stemmed), annual or perennial seed-bearing plant in which all of the aerial parts die back at the end of each growing season.
  • a herb is any plant or plant part, which has a medicinal use.
  • the term herb is also generally used to refer to the seeds, leaves, stems, flowers, roots, berries, bark, or any other plant parts that are used for healing or for preventative medicine.
  • the number of herbs or active components thereof used to produce the composition of the present invention may be varied.
  • the at least one herb may be two to four of herbs (1 ) to (10).
  • the at least one herb may be five to ten of herbs (1 ) to (10).
  • the at least one herb is each of herbs (1 ) to (10).
  • the at least one herb is one or more herbs selected from (1 ) Epimedium koreanum Nakai, (2) Salvia miltiorrhiza Bge, (3) Astragalus membranaceus (Fisch. ) Bge, (4) Pueraria thomsonii Benth, (5) Psoralea corylifolia L, (6) Cuscuta chinensis Lam, (7) Angelica sinensis (Oliv.) Diels, (8) Cistanche deserticola Y.C. Ma., (9) Eucommia ulmoides Oliv and (10) Ziziphus jujuba Mill. Even more preferably, the at least one herb is each of the listed herbs (1 ) to (10).
  • the at least one herb may also be at least one herb selected from (1 ) Epimedium koreanum Nakai, (2) Salvia miltiorrhiza Bge, (3) Astragalus membranaceus (Fisch.) Bge, (4) Pueraria thomsonii and (5) Psoralea corylifolia L.
  • the at least one herb is each of the listed herbs (1 ) to (5).
  • the herbs included in the compositions of the present invention comprise various chemical components that are candidate active components. Thus, rather than utilise the herbs themselves in the compositions of the invention, it may be possible and desirable to use one or more active components from one or more of the herbs in the compositions of the present invention.
  • Applicant has identified the following chemical components from the herbs used in the compositions of the present invention. These are detailed below and any one or more of them may constitute an active component or components that may be used in the compositions of the present invention.
  • astragaloside I, II, III and IV daucosterol, ⁇ -sitosterol, palmitic acid, sucrose, astragalus saponin A, B, C, astramenbrangenin, 2', 4'-d ⁇ hydroxy- 5 6-d ⁇ methoxy ⁇ soflavane, kumatakenin, choline, betaine, folic acid, calycoin, formononetin, cycloastragenol and L-3-hydroxy-9- methoxpterocarpan
  • flevone agtragalm corylifolm, bavachin, bavachinin, isobavachin, corylin, neobavaisoflavone, corylinal, psoralenol, bavachalcone , neobavachalcone, corylifolm, corylifolinin (isobavachalcone), bavachromene, bavachromanol, isoneobavachalcone, bakuchalcone, bacuchiol, corylifonol, and isocorylifonol
  • flavone flavone, coma ⁇ ne ⁇ -sitosterol, stigmasterol, protein, sugar and fatty acid
  • (b) acid ferulic acid, succinic acid, nicotinic acid, vaillic acid, n- tetracosanoic acid, and palmitic acid
  • sugar sucrose, fructose and glucose
  • Flavone 6, 8-di-C-glucosyl-2 (S)-nahngenin, 6, 8-di-C-glucosyl-2 (R)-naringenin, swertisin, spinosin, 6"'-sinapoylspinosin, 6'"- feruloylspinosin, 6"'-p-coumaroylspinosin, rutin
  • organic acid linoleic acid, oleic acid, palmitic acid, stearic acid, myristic acid
  • Candidate active components from herbs used in the compositions of the present invention and their mechanism of action can be determined using standard techniques apparent to one skilled in the art For example, extracts from the herbs or individual candidate compounds may be subjected to bioassays, gas chromatography or spectrometry to elucidate their structure and function
  • Candidate active components may also be subjected to a renal culture system to determine whether they stimulate calcium transport or to an estrogen displacement assay which looks at the relative affinities of the compounds for the estrogen receptor.
  • the present invention also provides a method for treating or preventing osteoporosis in a patient comprising administering to the patient afflicted with, or at risk of suffering from, osteoporosis an effective amount of a composition of the present invention.
  • the patient may be varied and includes a mammal such as a human or any other animal.
  • a mammal such as a human or any other animal.
  • the patient When the patient is a human it may be an adult man or woman, child or infant
  • the present invention also provides for the use of a composition of the present invention for preparing a medicament for treating or preventing osteoporosis.
  • the present invention also provides a pharmaceutical composition for treating osteoporosis comprising an effective amount of a composition of the present invention and a pharmaceutically acceptable carrier.
  • pharmaceutically acceptable refers to molecular entities and compositions that are physiologically tolerable and do not typically produce an allergic or similarly untoward reaction, such as gastric upset, dizziness and the like, when administered to a human
  • pharmaceutically acceptable means approved by a regulatory agency of the federal or a state government or listed in the U S Pharmacopeia or other generally recognized pharmacopeia for use in animals, and more particularly in humans
  • carrier refers to a diluent, excipient, or vehicle with which the compound is administered
  • Such pharmaceutical carriers can be sterile liquids, such as water and oils, including those of petroleum, animal, vegetable or synthetic origin, such as peanut oil, soybean oil, mineral oil, sesame oil and the like.
  • Water or solution saline solutions and aqueous dextrose and glycerol solutions are preferably employed as carriers, particularly for injectable solutions Suitable pharmaceutical carriers are described in Martin, Remington's Pharmaceutical Sciences, 18th Ed., Mack Publishing Co., Easton, PA, (1990).
  • compositions produced according to the invention may be formulated for administration by oral, injection, pulmonary, nasal or other forms of administration including those detailed in Lund W, Editor “The Pharmaceutical Codex” 12 th Edition, The Pharmaceutical Press 1994, which is incorporated herein by reference.
  • pharmaceutical compositions comprising effective amounts of herbal compositions of the invention together with pharmaceutically acceptable diluents, preservatives, solubilizers, emulsifiers, and/or carriers.
  • oral solid dosage forms are described generally in Martin, Remington's Pharmaceutical Sciences, 18th Ed. (1990 Mack
  • Solid dosage forms include tablets, capsules, pills, troches or lozenges, cachets, pellets, powders or microcapsules
  • the location of release may be the stomach, the small intestine (the duodenum, the jejunem, or the ileum), or the large intestine
  • the release will avoid the deleterious effects of the stomach environment, either by protection of the herbal composition or by release of the biologically active mate ⁇ al beyond the stomach environment, such as in the intestine
  • a coating impermeable to at least pH 5 0 is essential
  • examples of the more common inert ingredients that are used as enteric coatings are cellulose acetate t ⁇ mellitate (CAT), hydroxypropylmethylcellulose phthalate (HPMCP), HPMCP 50, HPMCP 55, polyvinyl acetate phthalate (PVAP), Eudragit L30D, Aquatenc, cellulose acetate phthalate (CAP), Eudragit L, Eudragit S, and Shellac
  • a coating or mixture of coatings can also be used on tablets, which are not intended for protection against the stomach This can include sugar coatings, or coatings which make the tablet easier to swallow
  • Capsules may consist of a hard shell (such as gelatin) for delivery of dry therapeutic le powder, for liquid forms, a soft gelatin shell may be used
  • the shell material of cachets could be thick starch or other edible paper
  • moist massing techniques can be used
  • the therapeutic can be included in the formulation as fine multiparticulates in the form of granules or pellets of particle size about 1 mm
  • the formulation of the material for capsule administration could also be as a powder, lightly compressed plugs or even as tablets
  • the therapeutic could be prepared by compression
  • the herbal composition may be formulated (such as by iiposome or microsphere encapsulation) and then further contained within an edible product, such as a refrigerated beverage containing colourants and flavouring agents
  • diluents could include carbohydrates, especially man ⁇ itol, lactose, anhydrous lactose, cellulose, sucrose, modified dextrans and starch
  • carbohydrates especially man ⁇ itol, lactose, anhydrous lactose, cellulose, sucrose, modified dextrans and starch
  • Certain inorganic salts may be also be used as fillers including calcium t ⁇ phosphate, magnesium carbonate and sodium chloride
  • Some commercially available diluents are Fast-Flo, Emdex STA-Rx 1500, Emcompress and Avicell
  • Disintegrants may be included in the formulation of the therapeutic into a solid dosage form
  • Materials used as disintegrants include, but are not limited to starch including the commercial disintegrant based on starch, Explotab Sodium starch glycolate, Amberlite, sodium carboxymethylcellulose ultramylopectin sodium alginate, gelatin, orange peel, acid carboxymethyl cellulose, natural sponge and bentonite may all be used
  • Another form of the disintegrants are the insoluble cationic exchange resins
  • Powdered gums may be used as disintegrants and as bindOers and these can include powdered gums such as agar, Karaya or tragacanth Alginic acid and its sodium salt are also useful as disintegrants
  • Binders may be used to hold the therapeutic agent together to form a hard tablet and include materials from natural products such as acacia, tragacanth, starch and gelatin Others include methyl cellulose (MC), ethyl cellulose (EC) and carboxymethyl cellulose (CMC) Polyvinyl pyrrohdine (PVP) and hydroxypropylmethyl cellulose (HPMC) could both be used in alcoholic solutions to granulate the therapeutic
  • Lubricants may be used as a layer between the therapeutic and the die wall, and these can include, but are not limited to stearic acid including its magnesium and calcium salts, polytetrafluoroethylene (PTFE), liquid paraffin, vegetable oils and waxes Soluble lubricants may also be used such as sodium lauryl sulfate, magnesium lauryl sulfate, polyethylene glycol of various molecular weights, and Carbowax 4000 and 6000
  • the glidants may include starch, talc, pyrogenic silica and hydrated silicoaluminate
  • a surfactant might be added as a wetting agent
  • Surfactants may include anionic detergents such as sodium lauryl sulfate, dioctyl sodium sulfosuccinate and dioctyl sodium sulfonate
  • Cationic detergents might be used and could include be ⁇ zalkomum chloride or benzethomium chloride
  • the list of potential ⁇ o ⁇ io ⁇ ic detergents that could be included in the formulation as surfactants are lauromacrogol 400, polyoxyl 40 stearate, polyoxyethylene hydrogenated castor oil 10 50 and 60, glycerol monostearate, polysorbate 40 60, 65 and 80, sucrose fatty acid ester methyl cellulose and carboxymethyl cellulose
  • These surfactants could be present in the formulation of the herbal composition either alone or as a mixture in different ratios
  • Controlled release formulation may be desirable
  • the drug could be incorporated into an inert matrix which permits release by either diffusion or leaching mechanisms i.e., gums.
  • Slowly degenerating matrices may also be incorporated into the formulation.
  • Another form of a controlled release of this therapeutic is by a method based on the Oros therapeutic system (Alza Corp.), i.e. the drug is enclosed in a semipermeable membrane which allows water to enter and push the drug out through a single small opening due to osmotic effects. Some enteric coatings also have a delayed release effect.
  • coatings may be used for the formulation. These include a variety of sugars which could be applied in a coating pan.
  • the therapeutic agent could also be given in a film-coated tablet; the materials used in this instance are divided into 2 groups.
  • the first are the nonenteric materials and include methyl cellulose, ethyl cellulose, hydroxyethyl cellulose, methylhydroxy-ethyl cellulose, hydroxypropyl cellulose, hydroxypropyl-methyl cellulose, sodium carboxy-methyl cellulose, providone and the polyethylene glycols
  • the second group consists of the enteric materials that are commonly esters of phthalic acid.
  • Film coating may be carried out in a pan coater or in a fluidized bed or by compression coating
  • oral liquids are preparations which are homogenous and contain one or more active ingredients in a suitable vehicle and are intended to be swallowed either undiluted or after dilution
  • the three main types of oral liquids are solutions, suspensions and emulsions
  • Oral solutions contain one or more active ingredients dissolved in a suitable vehicle
  • Such oral solutions include draughts, elixirs, mixtures and oral drops
  • Oral suspensions contain one or more active ingredients suspended in a suitable vehicle
  • Such oral suspensions include draughts, mixtures and oral drops
  • Oral emulsions are stab sed oil-m-water dispersions, either or both phases of which may contain dissolved solids They contain one or more active ingredients
  • suspending agents may be added to oral liquid preparations to maintain a uniform dispersion of particles that would otherwise settle rapidly to form a closely packed sediment and prevent the removal of an accurate dose.
  • suspending agents include carbomer, carmellose sodium, microcrystalline cellulose, methylcellulose, povidone, sodium alginate, tragacanth and xanthan gum.
  • Aggregation of the dispersed globules in emulsified systems can be prevented by emulsifying agents.
  • emulsifying agents are acacia and methylcellulose.
  • Glycerol esters, polysorbates and the sorbitan esters can also be used.
  • Antimicrobial preservatives that can be used in oral liquid preparations include chloroform, ethanol, benzoic acid, sorbic acid, the hydroxyenzoate esters, and syrup
  • antioxidants include ascorbic acid, cit ⁇ c acid, sodium metabisulphite and sodium bisulphite
  • Sweetening agents such as glucose, sucrose, syrups and honey are commonly used in oral medications Further, sorbitol, mannitol and xylitol may also be used Artificial sweeteners such as sodium and calcium salts of saccharin, aspartame, acesulfame potassium and thaumatin can also be used in oral liquid preparations
  • Flavouring agents can be used to improve the taste of medicaments
  • Such agents include citric acid, salt and monosodium glutamate
  • juices raspberry or other fruits
  • extracts liquorice
  • spirits orange, lemon and benzaldehyde
  • syrups blackcurrant
  • tinctures tinctures
  • aromatic waters anise, dill and cinnamon
  • Colouring agents including natural pigments such as anthocyannms, carotenoids, chlorophylls, xanthophylls, riboflavine, saffron, red beetroot extract, cochineal and caramel (from sucrose and other edible sugars) can be used to improve the appearance of the medicament
  • Synthetic dyes are used in preference to natural colourants for oral liquids because the colours they produce are of a wider range and are more stable or of more uniform intensity
  • Most synthetic colouring agents are acid dyes, nearly all are sodium salts of sulphonic acids and many are azo compounds
  • Galencial preparations of crude drugs are extractions of crude drugs of plant origin with a suitable solvent They include extracts, tinctures, and infusions
  • Oral liquids may also take the form of powders or granules which can be subsequently reconstituted if the shelf life of a liquid preparation is limited because of physical or chemical instability
  • Oral liquids prepared by the reconstitution of powders or granules contain the same kinds of excipients as ready prepared oral liquids Additional substances, for example the addition of a solid diluent, granule binder, moisture scavenger, glidant, granule disintegra ⁇ t, or release-retarding agent may be necessary to produce a reconstituted product which is adequate for use
  • therapeutics administered parenterally, by injection for example, either subcutaneously or intramuscularly
  • injectables either as liquid solutions, suspensions or emulsions solid forms suitable for solution in, or suspension in, liquid prior to injection may also be prepared
  • excipients are, for example water, saline, dextrose glycerol, ethanol or the like and combinations thereof
  • osmolarity of plasma is reported as 306mosmol/litre.
  • Parenteral solutions that have osmolarities which deviate significantly from this value can cause haemolysis of blood cells, tissue irritation, pain on injection and electrolytic shifts
  • Sodium chloride is the excipient that is most frequently used to adjust osmolarity if a solution is hypotonic
  • Other excipients used to adjust hypotonic solutions include glucose, mannitol, glycerol, propylene glycol and sodium sulphate
  • Antimicrobial preservatives may be added to parenteral products Common examples include chlorbutol, phenol and be ⁇ zalkonium chloride
  • suspending agents such as carmellose sodium, povidone and gelatin may be used to prevent caking in parenterals
  • pulmonary delivery of the present herbal compositions The herbal compositions delivered to the lungs of a mammal while inhaling and traverses across the lung epithelial lining to the blood-stream.
  • Adjei er al Pharmaceutical Research, 7(6) 565-569 (1990), Adjei et a/ , International Journal of Pharmaceutics, 63 135-144 (1990) (leuprolide acetate), Braquet et al , Journal of Cardiovascular Pharmacology 13(su ⁇ pl 5) 143-146 (1989) (endothel ⁇ n-1 ), Hubbard et al , Annals of Internal Medicine, 3(3) 206-212 (1989) (alphal - a ⁇ titrypsm), Smith et al , J Clin Invest , 84 1145-1 146 (1989) (alphal -protemase), Oswem et al , "Aerosolization of Proteins", Proceedings of Symposium on Res
  • Contemplated for use in the practice of this invention are a wide range of mechanical devices designed for pulmonary delivery of therapeutic products, including but not limited to nebulizers, metered-dose inhalers, and powder inhalers, all of which are familiar to those skilled in the art.
  • Ultravent nebulizer manufactured by Mallinckrodt, Inc., St Louis, Missouri
  • Acorn II nebulizer manufactured by Marquest Medical Products, Englewood, Colorado
  • the Ventolin metered dose inhaler manufactured by Glaxo Inc., Research Triangle Park, North Carolina
  • the Spinhaler powder inhaler manufactured by Fisons Corp., Bedford, Massachusetts.
  • each formulation is specific to the type of device employed and may involve the use of an appropriate propellant material, in addition to the usual diluents, and/or carriers useful in therapy. Also, the use of liposomes, microcapsules or microspheres, inclusion complexes, or other types of carriers is contemplated
  • Formulations suitable for use with a nebuliser will typically comprise the herbal composition dissolved in water at a concentration of about 0.1 to 25 mg of biologically active herbal composition per ml of solution.
  • the formulation may also include a buffer and a simple sugar (eg , for herbal compositions stabilisation and regulation of osmotic pressure)
  • the nebuliser formulation may also contain a surfactant, to reduce or prevent surface induced aggregation of the herbal composition caused by atomisation of the solution in forming the aerosol
  • Formulations for use with a metered-dose inhaler device will generally comprise a finely divided powder containing the herbal composition suspended in a propellant with the aid of a surfactant
  • the propellant may be any conventional material employed for this purpose, such as a chlorofluorocarbon a hydrochlorofluorocarbon, a hydrofluorocarbon, or a hydrocarbon including trichlorofluoromethane, dichlorodifluoromethane, dichlorotetrafluoroethanol, and 1 ,1 ,1 ,2-tetrafluoroethane, or combinations thereof.
  • Suitable surfactants include sorbitan trioleate and soya lecithin. Oleic acid may also be useful as a surfactant.
  • Formulations for dispensing from a powder inhaler device will comprise a finely divided dry powder containing protein (or derivative) and may also include a bulking agent, such as lactose, sorbitol, sucrose, or mannitol in amounts which facilitate dispersal of the powder from the device, e.g , 50 to 90% by weight of the formulation
  • a bulking agent such as lactose, sorbitol, sucrose, or mannitol
  • the herbal compositions should most advantageously be prepared in particulate form with an average particle size of less than 10 ⁇ m (or microns), most preferably 0 5 to 5 ⁇ m, for most effective delivery to the distal lung
  • Nasal delivery of the herbal compositions is also contemplated Nasal delivery allows the passage of the herbal composition to the blood stream directly after administering the therapeutic product to the nose, without the necessity for deposition of the product in the lung.
  • Formulations for nasal delivery include those with dextran or cyclodextran.
  • compositions may also be administered in a manner compatible with the dosage formulation, and in such amount as will be prophylactically and/or therapeutically effective
  • quantity of composition to be administered will generally depend on the seventy of the ailment, the age and health of the patient etc Moreover, the dosage will also depend on the subject to be treated, the capacity of the subject's biological systems to respond, and the degree of treatment desired Precise amounts of active ingredient required to be administered will depend on the judgment of the practitioner and may be peculiar to each subject
  • the capsules desirably contain about 0 3 to 0 5g of the herbal composition per capsule Still more desirable is if the capsules contain about 0 4g per capsule
  • compositions within the scope of the invention may be given in a single daily delivery schedule, or preferably in a multiple daily delivery schedule
  • a multiple dose schedule is one in which a primary course of delivery may be with for example 1-10 doses, followed by other doses given at subsequent time intervals required to maintain and/or reinforce the therapeutic effect
  • the dosage regimen will also, at least in part, be determined by the need of the individual and be dependent upon the judgment of the practitioner
  • composition of the present invention comprises at least one herb as opposed to an active component thereof
  • the exact proportion and or amounts of the herbs in the composition depend, at least partially, on the concentration of the active ingredients in each herb Using the guidance provided herein, and a basic knowledge of drug preparation and pharmacology, one skilled in the art could easily adjust the proportions of the separate herbs of the composition as required
  • the concentration of the active component in the composition could be readily determined by one skilled in the art using standard and routine methodology and techniques
  • compositions of the present invention for therapy associated with osteoporosis, one may administer the compositions of the present invention in conjunction with one or more pharmaceutical compositions for treating other clinical complications of osteoporosis Administration may be simultaneous or may be in seriatim
  • Example 1 Water extraction of herb juice from herbal composition I
  • Example 2 Alcohol extraction of herb iuice from herbal composition II
  • a total of 110 kg of herbs of the five herbs listed in Table 2 below (herbal composition II) was used in the following proportions: Epimedium 30 kg, Pueraria 30 kg, Salvia miltiorrhiza Bge 25 kg, Astragalus membranaceus (Fisch) Bge 20 kg and Psoralea corylipfolia L 5 kg
  • the herbal components were extracted in 660 L of 85% alcohol for 3 hours by the heating and retrieving method. The extraction procedure was repeated a further two times. The extract was filtered and the decompressing concentration method used to produce a dense plaster of relative density 1.4 in 50 °C. The extract was then dried in an oven and the resulting product smashed to a powder. The powder was used to fill capsules at 0.4g per capsule.
  • the third group of ovariectomized rats (G3) were administered an intravenous injection of estradiol (10 ⁇ g s.c.) twice weekly. Rats in G1 and G2 were injected with a castor oil control twice weekly. The rats were administered the oral dose by gavage on days 2 to 56 (inclusive) following ovariectomy. Rats were fed 17g of a standard diet, comprising 0.4% calcium and 0.3% phosphorus, per day.
  • Bone mineral density (BMD) g/cm 2
  • BMC bone mineral content
  • Rats were anesthetized with a peritoneal injection of a 1 :1 mixture of ketamil and xylazil-20 (Troy Laboratories Pty.
  • Hologic rat sub-region Hi-res scan protocol version 4.57
  • Hologic rat whole body scan protocol version 5.7
  • BMD bone mineral density
  • BMC bone mineral content
  • the concentration of phosphate in plasma was determined D> using autcma' z biochemistry analysis techniques (the Biotecnic Analyzers BT-2245 ARCO a ⁇ ARCO-PC, Biotecnica Instruments s r l Roma, Italy; a tr.e Guangzn - University of Chinese Medicine Guangzhou China and a ⁇ • D ⁇ ase ; '? ⁇ • '- Unison Biotech Co. Ltd. (Taiwan). Briefly, the concentration of phosphate in plasma was measured by forming a complex of the phosphate with ammonium molybdate ions. The complex was then combined with ferrous ions, resulting in an absorbance measured at a wavelength of 660 nm.
  • Example 5 Biochemical analysis of Alkaline Phosphatase activity, a "bone- marker" in rat plasma
  • Alkaline phosphatase activity was determined kinetically by using automatic biochemistry analysis techniques (the Biotecnic Analyzers BT-2245, ARCO and ARCO-PC, Biotecnica Instruments s.r.l. Roma, Italy) at the Guangzhou University of Chinese Medicine, Guangzhou, China, and a kit, purchased from the Unison Biotech Co Ltd (Taiwan) Briefly the substrate p- Nitrophenylphosphate was enzymatically converted to p-Nitrophenolate and phosphate ions by alkaline phosphatase. The change in absorbance was then monitored at a wavelength of 405 nm. A linear relationship existed between the increase in absorbance and the activity of alkaline phosphatase.
  • This dosage was equivalent to the clinical dosage administered to human adult subjects, according to the standard dosage conversion table
  • the first group of ovariectomized rats (E2) was administered an intravenous injection of estradiol (10 ⁇ g s c ) twice weekly Rats in OVX, MGJ, BGZ and YYH were injected with a castor oil control twice weekly
  • the rats were administered the oral dose by gavage on days 2 to 56 (inclusive) following ovariectomy Rats were fed 17g of a standard diet, comprising 0 4% calcium and 0 3% phosphorus, per day
  • the left tibia from each rat of 5 groups was cleaned of its surrounding soft tissue
  • the tibiae were loaded to failure in a 3-po ⁇ nt bending apparatus
  • the upper 2 supporting points were fixed 20 mm apart, and the diameter of the lower loading point was 3 mm, positioned at the midpoint of the specimen
  • the diameter of the midpoint of each tibia was measured and recorded
  • the yield load and maximum load were recorded until breaking point
  • the bending stiffness was then derived from the slope of the linear region of the resulting load versus displacement curve
  • Group 1 were administered an oral placebo in the form of a capsule
  • group 2 were administered an oral dose of the herbal extract (prepared as described in example 2
  • group 3 were treated with standard estrogen therapy.
  • Dosing procedure for groups 1 and 2 was as follows 3 capsules per time, three times a day over a period of 4 months That is, group 2 received 1.2g of herbal extract 3 times a day
  • the lumbar spinal BMD (g/cm 2 ) of the 3 groups of postmenopausal women was determined with a Hologic QDR 4500W dual energy x-ray bone densitometer and Hologic QDR 2000 dual energy x-ray bone densitometer in the Sun Yat-Sen Memorial Hospital and Guangdong Provincial People's Hospital, Guangzhou, China P>0 05 was considered not significant
  • Figure 9 shows the results of the effects of estrogen and the herbal extract on spine bone mineral density of the 3 groups of patients before and after treatment
  • Figure 10 expresses these results as a percentage change in bone mineral density from the initial measurement until 4 months after treatment with either estrogen therapy or the herbal extract
  • the bone density of women in the three groups was not significantly different prior to treatment
  • after 4 months of treatment with either estrogen (group 3) or the herbal extract (group 2) a significant prevention of bone density loss was observed (P ⁇ 0 05)
  • Example 8 Biochemical analysis of bone-markers in urine from human subjects
  • the compounds pyridinoline and deoxypyridinoline are used as bone markers. These compounds are excreted in the urine of human subjects in both the free and peptide bound forms.
  • the resulting pyridinoline and deoxypyridinoline from urine were purified by cellulose chromatography in the following manner. Isodesmosine, an internal standard (100 ⁇ L), glacial acetic acid (2 mL), cellulose slurry (0.5mL) and n-butanol (8mL) were combined and a portion of the slurry (4 mL) poured into a mini-column fitted with a reservoir made from a Poly-Prep column (Bio-Rad, CA, USA) The cellulose slurry was compacted under vacuum until just dry It was possible to purify a number of urine samples at the one time by preparing several mini-columns in this way
  • the urine sample was mixed and poured onto a column.
  • the column was then drained under vacuum until just dry A solution of butanol:acetic acid water (4 1 1 ) (13mL) was added to the column, dried under vacuum and dried for at least a further 10 minutes after the column had drained
  • the reservoir was removed from the column, THF (1 mL) added and the column allowed to stand for five minutes. The vacuum was reapphed for a further five minutes
  • the column was then placed into a 1 mL HPLC vial standing in a 10mL conical centrifuge tube A solution of 0 5% HFBA (0 75mL) was added to each column and the tubes centrifuged at 800g for 10 minutes.
  • the HPLC vials were removed, capped, and stored for HPLC analysis.
  • the column was then washed with an ion-pairing agent to elute pyridinoline.
  • the pyridinoline was then analysed by reverse phase HPLC.
  • Ion paired reverse phase HPLC was used to measure the concentration of pyridinoline.
  • the resulting separation profile was monitored using a fluorescence detector using dual wavelength 295/395 nm. The results were corrected for by recovery of the internal standard.
  • HPLC analysis of samples was carried out on a Waters 700 WISP (Milford, MA, U.S.A.), connected to a Shimadzu RF535 fluorescence detector (Tokyo, Japan), and a Waters 441 Absorbance detector (Milford, MA, U.S.A.).
  • the column used was a Beckman Ultrasphere ODS 5u, of dimensions 4.6mm x 15cm (CA, U.S.A.). Deoxypyridinoline, pyridinoline and isodesmosine were eluted using an 86% HPLC solution A and 14% HPLC solution B, at a flow rate of 1.3mL/min.
  • Deoxypyridinoline and pyridinoline were detected by fluorescence at emission 395 nm and excitation 295 nm respectively Isodesmosine was measured by absorbance at 280 nm.
  • concentrations of deoxypyridinoline and pyridinoline were expressed as a ratio of deoxypyridinoline to creatinine (DYD/Cr) in urine and a ratio of pyridinoline to creatinine (PYD/Cr) in urine
  • the concentration of creatinine in urine samples was measured by automatic analysis using a Technico ⁇ Axon analyser (Bayer Diagnostics, Sydney, Australia) Urinary creatinine was measured by the reaction of creatinine with alkaline picrate The reaction yields a product, which is measured at a wavelength of 505 nm The coloured product is proportional to the concentration of creatinine
  • the assay was performed according to the Technicon Axon Operator's Manual (Technicon, Tarrytown, NY) Results
  • Example 9 Effects of single Yinyanqhou on bone mass, bone strength and bone turnover in an animal model
  • the herb Yinyanghuo used in this study was the aerial part of an epimedium plant. It was purchased from the Cathay Herbal Laboratories Pty. Ltd. (Sydney, NSW, Australia). Specimens of the plant materials were sent to and authenticated by the Department of Pharmacognosy, Guangzhou University of Chinese Medicine. A water extra ⁇ was prepared by boiling 1200g of the herb 3 times (40 minutes/time) and finally making a 3600 L decoction (0.3g ml, w/v).
  • OVX treated vehicles as control
  • OVX-Y group OVX treated with medical herbal decoction
  • OVX- E group OVX treated with estrogen
  • rats in OVX-Y group were given 4ml of the decoction (containing approximately 0.75g dry weight of herb extract) per day by gavage.
  • the dose of Yinyanghuo for rats in this study was determined based on the adult human dose reported from clinical trials (Li, 1982; Yu, 1990) and calculated using the dose converting table between human and rats (Li, 1991 ).
  • Rats in other groups were given water by the same way
  • the rats in OVX-E group were subcutaneously injected 10 ⁇ g estradiol twice per week, and the rats in the other two groups were injected with vehicle castor oil alone.
  • the BMD (g/cm 2 ) and BMC (g) of the left femoral (fBMD, fBMC) and spinal (sBMD, sBMC) at baseline, 4, 8, 12 weeks post ovariectomy were determined with a Hologic QDR 2000 dual energy x-ray bone densitometer and using small animal software as described in Chapter 2.
  • a 3-point bending test for left tibia strength measurement of 3-group rats was undertaken by using an electro-mechanical testing machine. The diameter of the midpoint of each tibia was recorded and then the specimen was loaded to failure in the 3-point bending apparatus. The maximum load was recorded when the specimen was broken and the bending stiffness was derived from the slope of the linear region of the resulting load versus displacement curve, The flexural modulus and breaking strain was calculated as described in Chapter 2.
  • Urinary Pyd and Dpd were extracted from rat urine specimens by isolation on a cellulose column, and determined by using an ion-paired reverse-phase HPLC. Isodesmosine was detected at the same time as an internal standard. The urinary creatinine (Cr) was measured by using a Technicon Axon analyzer. The results of Pyd and Dpd were expressed as Pyd/Cr ratio and Dpd/Cr ratio. Plasma ALP, Ca, P, TP, ALB, CHO and TG were determined by using automated biochemistry analyses techniques and special diagnostic kits as described in Chapter 2.
  • Samples of liver, kidney, heart, lung, spleen, brain and uterus of 3 group rats were collected after 12-week treatment and sent to the Department of Pathology. University of Western Australia and Guangzhou University of Chinese Medicine, to assess for any toxicity of the herbs.
  • the tissues were fixed in 10% formalin and embedded in paraffin. Tissue slices were stained with hematoxylin and eosin and examined under the optical microscope Additionally, the uterus weight was recorded at the end of the experiment.
  • the % changes of the fBMC and sBMC value in the three groups of rats were similar to that of fBMD and sBMD value at all time points (Tab3.2 and Fig 3.3, 3.4).
  • Tab 3.1 The % changes of femoral and spinal BMD in the 3 groups of rats (Mean ⁇ SD, g cm 2 )
  • 3-point bending test showed a lower maximum stress and flexural modulus of tibias in OVX rats than those in OVX-E rats (P ⁇ 0.005).
  • the changes caused by OVX indicated a significant decrease of bone strength and elasticity, and increase of bone fragility.
  • the tibia maximum stress and flexural modulus of OVX-Y group were significantly higher about, 47% and 73% respectively than that of the OVX group, and close to the values of OVX-E rats. There was no significant difference between the values of OVX-Y and OVX-E group (Tab 3.3 and Fig 3.5).
  • Urinary Pyd/Cr and Dpd/Cr in the OVX group rose significantly at all time points after operation.
  • the increment was 169-114 % for Pyd/Cr and 81-239 % for Dpd/Cr compared with baseline values (P ⁇ 0.001),
  • Both Yinyanghuo and estrogen treatments significantly ameliorated the increase in Dpd/Cr that followed OVX (P ⁇ 0.05).
  • Yinyanghuo treatment also significantly reduced the increase in Pyd/Cr caused by OVX (P ⁇ 0.05) (Tab 3.4 and Fig 3.6, 3.7).
  • Plasma ALP level of OVX rats increased significantly at all post-operative time points (P ⁇ 0.01).
  • the ALP level of the OVX-E group did not increase significantly at any post-operative time points except at 12-week.
  • the difference between the OVX and OVX-E group was significant statistically at all post-operative time points (P ⁇ 0.002).
  • the mean value of plasma ALP in OVX-Y rats rose significantly after OVX compared to baseline (P ⁇ 0.01) 7 and the % change was significantly higher than that of OVX rats at 8 week (P ⁇ 0.05), higher than that of OVX-E rats at all post operative time points (P ⁇ 0.05) (Tab 3.4 and Fig 3.8).
  • Plasma Ca and P levels did not show a statistically significant inter-group difference at any time point after operation.
  • the plasma P showed a slight increase in OVX group at week 12 but a slight decrease in OVX-E group at week 8 (PO.Ol) (Tab 3.5).
  • the plasma TP and ALB levels in OVX and OVX-E group rose at 4 and 8 weeks (PO.Ol) follow OVX, but then were not different from baseline at 12 weeks post OVX.
  • the TP and ALB level in OVX-Y rats at the 12-week time point were lower than baseline (PO.Ol), but not different from that in rats of the OVX group.
  • the values of plasma TP and ALB in the OVX-E group were higher than that in the other two groups during the 12-weeks of the experiment (Tab 3.5).
  • the plasma TG level of OVX-Y rats was also significantly lower than the other two groups at 4 and 12-week time points (PO.05). However the time treatment interaction was not statistically significant (P 0.057) (Tab. 3.5 and Fig. 3.9, 3.10).
  • the herb Yinyanghuo belongs to the epimedium genus of the berberidaceae family. The ability of this herbal medicine to reduce bone loss and weakening of bone strength due to estrogen deficiency was evaluated in this study by using adult rats with osteoporosis. Although clinical observations and animal experiments have provided much evidence suggesting that the herb Yinyanghuo has wide pharmacological effects, there is no published information to document its effect on estrogen dependent bone loss leading to postmenopausal osteoporosis, a major cause of morbidity and mortality in aged women. The results indicated that Yinyanghuo significantly reduced bone loss and prevented a reduction in tibial strength by inhibiting bone turnover in the animal model.
  • OVX leads to bone loss in rats.
  • the rate of bone loss following OVX can be increased by concurrent dietary Ca deficiency (Hodgkinson et al., 1978; Donahue et al., 1988).
  • the order of rat's BMD fall was OVX plus low Ca diet > OVX alone > low Ca diet alone (Jiang et al., 1997).
  • OVX and rats receiving 0.4% calcium diet were used as a postmenopausal osteoporosis model for assessing the potential effects of herbal medicines.
  • This model has many similarities with postmenopausal osteoporosis patients including a rise both in bone resorption and formation i.e. a "high-tumover" type of osteoporosis (Avioli and Lindsay, 1990), a higher rate of cancellous bone loss than that of cortex bone loss, disorders of bowel calcium absorption and vitamin D metabolism, and response to HRT or other drug treatments (Wronski et al., 1986; 19S9; 1991; alu et al., 1989).
  • Estrogen deficiency in rats produces a high turnover state in trabecular bone where reso ⁇ tion of bone outpaces formation, resulting in net loss of bone mass (Kalu, 1991).
  • Our data on DEXA measurement showed that bone loss at femoral and spinal sites was present in the OVX group at post-operative week 4, and continued over the duration of the experiment. The bone loss at the femoral site was the most rapid of all 3 sites evaluated.
  • the decrease of femoral and spinal BMD in OVX rats at the post-operative 8 week reached 86% and 90% respectively of the sum total of bone loss over the 12 week experiment.
  • Plasma ALP levels another important biochemical marker of bone turnover also increased significantly in OVX rats after operation. Since estrogen treatment can reduce bone resorption as well as bone formation in OVX rats (Frolik ct al., 1996), in this study the increase of plasma ALP in the OVX-E group was significant less than that in the OVX group at all time points. However, a high plasma ALP level caused by OVX was not altered by Yinyanghuo treatment. It plasma ALP level caused by OVX was not altered by Yinyanghuo treatment. It may hint that herb Yinyanghuo preparation does hot inhibit bone formation, or can improve bone formation, in OVX rats. The precise mechanism of the herb Yinyanghuo for its beneficial effect on bone in the OVX rats remains uncertain, but our data in the present study offers evidence for its pharmacological mechanism by regulating bone remodelling.
  • the herb Yinyanghuo did not cause uterine hypertrophy in OVX rats. It showed a similar pharmacological property as that of selective estrogen receptor modulators such as raloxifene, which has estrogen-like effects on bone and serum cholesterol but without uterine side effects (Frolik et al , 1996, Li et al., 1 98). Thus the herb Yinyanghuo may be suitable for long-term clinical use without concern with its toxicity and side effects.
  • the herb Yinyanghuo may be a valuable herb for clinical practice in treating and preventing postmenopausal osteoporosis
  • the herb Yinyanghuo also induced a significant lowering of plasma cholesterol and triglyceride levels
  • Example 10 Effects of Buquzhi alone on bone mass, bone strength a nd bone turnover in an an imal model
  • OVX rats treated with vehicles as control group (OVX group), OVX treated' with herbal Buguzhi decoction (OVX-B group), and OVX treated with estrogen (OVX-E group). From the 2nd day to 12 weeks after operation, the rats in OVX-B group were given 4ml of the decoction per day by gavage.
  • This dose for ra t s was determined based on the adult human dose (3-9g/day) stipulated in Chinese Pharmacopoeia (The Pharmacopoeia Committee of the National Health Bureau, 1995) by using the dose converting table between human and rats (Li, 1991).
  • the rats in other groups were given water by the same route.
  • the rats i n OVX-E group were injected with 10 ⁇ g estradiol s.c. twice per week, and the rats in the other two groups were injected with vehicle castor oil alone.
  • the bone mass all of 3 groups of rats was analysed by DEXA measurement at baseline, 4, 8 and 12 weeks of post-ovariectomy.
  • the left tibia of each rat was collected at the end of the experiment for biomechanical analyses. Fasting blood samples at baseline, 4, 8 and 12 weeks and urine samples at baseline, 1, 4, 8 and 12 week post operation were collected for analyses of biochemical parameters. The Animal Ethics Committee of the University of Western Australia gave approval for the experiment.
  • BMD g/cm 2 of the left femoral (fBMD) and spinal (sBMD) at baseline, and 4, 8, 12 weeks of post ovariectomy were determined with a Hologic QDR 2000 dual- energy x-ray bone densitometer and small animal software as described in the Chapter 2.
  • a 3-point bending test for left tibia strength of each treatment group of rats was undertaken by using an electro-mechanical testing machine. The diameter of the midpoint of each tibia was recorded and then the specimen was loaded to failure in the 3-point bending apparatus. The maximum load was recorded when the specimen was broken and the bending stiffness was derived from the slope of the linear region of the resulting load versus displacement curve. The flexural modulus was calculated as described in Chapter 2.
  • Urinary Pyd and Dpd were extracted from rat urine specimens by isolation on a cellulose column, and determined by using an ion-paired reverse-phase high- pressure liquid chromatogram. Isodesmosine was detected at the same time and used as an internal standard. Urinary creatinine (Cr) was measured using a Technicon Axon analyser. The results of urinary Pyd and Dpd were expressed as Pyd/Cr ratio and Dpd/Cr ratio. Plasma ALP, Ca, P, TP, ALB, CHO and TG were determined by using automated biochemistry analyses techniques and special diagnostic kits as described in Chapter 2. 4.2.6 Histological examination and uterus weight measurement
  • Samples of liver, kidney, heart, lung, spleen, brain and uterus of 3 group rats were collected after 12-week treatment and sent to the Department of Pathology, University of Western Australia and Guangzhou University of Chinese Medicine, to assess for any toxicity of the herbs.
  • the tissues were fixed in 10% formalin and embedded in paraffin. Tissue slices were stained with hematoxylin and eosin and examined under the optical microscope. Additionally, the uterus weight of all three group rats was recorded at the end of the 12-week experiment.
  • a split-plot repeated measures model was used to analyse the longitudinal changes of bone mass and biochemical data. Pairwise comparisons of baseline data with successive measurements over time were performed to evaluate treatment effects within the groups. One-way ANOVA was used to analyse the post-treatment measurements of bone strength and uterus weight data, and the significance between groups was evaluated using LSD post hoc test. All tests were performed at the 0.05 significance level.
  • the 3-point bending test showed a lower maximum stress and flexural modulus of tibiae in OVX rats than in OVX-E rats (P ⁇ 0 005).
  • the data in the OVX-B group showed a slight increase in maximum stress and flexural modulus compared to OVX group but the difference was not statistically significant.
  • the values of the OVX-B group was not statistically significant different to the values of the OVX-E group (Tab 4.3 and
  • Urinary Pyd/Cr and Dpd/Cr rose significantly in the OVX group at all time points.
  • the increments were 69-114% for Pyd/Cr and 81-239% for Dpd/Cr compared with the baseline value (P ⁇ 0.01).
  • Both Buguzhi and estrogen treatment significantly reduced the Dpd/Cr increment followed OVX (P ⁇ 0.05).
  • Buguzhi treatment also significantly reduced the Pyd/Cr increment caused by OVX (PO.05) (Tab 4.4 and Fig 4.6, 4.7).
  • Tab 4.4 also showed that the plasma ALP level of OVX and OVX-B rats increased at all post-operative time points (P ⁇ 0.01). The level of the OVX-E group only rose significantly compared to baseline at week 12. At every time point after baseline the % change of ALP values was higher in the OVX-B group than the OVX group, and the difference was statistical significant at 12-week time point (P ⁇ 0.05) (Tab 4.4 and Fig 4.8).
  • Tab 4.3 Bone strength of tibiae in the 3 groups of rats (Mean-tSD)
  • Plasma calcium levels of the OVX and OVX-E groups did not show obvious changes after operation at any time point, but in the OVX-B group there was a small decrease at week 4 (PO.05) and then a small increase at week 12 (PO.Ol). Although the plasma P level rose in the OVX group compared to baseline (PO.Ol), there was no change in the other two groups, and there was no statistically significant inter-group differences (Tab 4.5).
  • the Tab 4.4 showed that the TP values in all of 3 groups tended to increase at 4- week and then decrease progressively.
  • the change of the OVX-B group at 12-week was significant compared to baseline (PO.Ol)
  • the value of ALB in the OVX-B group remained similar to baseline compared to a minor rise in the OVX and OVX-E groups at 4-week (PO.05) and a drop in the OVX group at 8- week time point (PO.Ol).
  • Urinary Pyd/Cr and Dpd/Cr are sensitive parameters for the status of bone resorprion.
  • plasma ALP is a marker of bone formation (Hoshino et al., 1998).
  • Our data showed that the treatment by Buguzhi decoction significantly reduced the increase of urinary Pyd/Cr and Dpd/Cr caused by OVX.
  • the urine Pyd/Cr level in rhe OY ⁇ "-B group was unchanged during the 12 week experiment, and the increase of Dpd/Cr in the OVX-B group only reached as 31-60% of the increase of the OVX group.
  • the water extract of Buguzhi significantly reduced estrogen dependent bone loss in OVX rats. Although the effects were weaker than those of the treatment by estrogen injection, it could make a contribution to bone quality and resistance of fractures, and therefore may be a valuable herb for treating and preventing postmenopausal osteoporosis Buguzhi significantly decreased urinary Pyd/Cr and Dpd/Cr but did not prevent the rise in plasma ALP, as did estrogen.

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Abstract

L'invention concerne une composition utilisée dans le traitement de l'ostéoporose et, plus particulièrement, une composition et une méthode thérapeutiques utilisées dans le traitement de l'ostéoporose et d'autres troubles liés au calcium, et/ou à l'oestrogène.
PCT/AU2000/000737 1999-06-29 2000-06-29 Compositions et methodes de traitement ou de prevention de l'osteoporose WO2001001996A1 (fr)

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WO2003105829A1 (fr) * 2002-06-18 2003-12-24 Shanghai Institute Of Pharmaceutical Industry Formulation de remede traditionnel chinois pour la prevention et le traitement de l'osteoporose
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EP1563841A1 (fr) * 2002-10-01 2005-08-17 Takara Bio Inc. Remedes
EP1714646A1 (fr) * 2005-04-22 2006-10-25 Sinphar Pharmaceutical Co., Ltd. Composition pharmaceutique contenant du bakuchiol pour traiter l'ostéoporose chez la femme
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CN116585300A (zh) * 2023-05-30 2023-08-15 苏州大学附属第一医院 洋蓟素在制备预防或治疗激素性股骨头坏死药物中的应用
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