Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K38/00—Medicinal preparations containing peptides
  • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/007—Pulmonary tract; Aromatherapy
  • A61K9/0073—Sprays or powders for inhalation; Aerolised or nebulised preparations generated by other means than thermal energy
  • A61K9/0078—Sprays or powders for inhalation; Aerolised or nebulised preparations generated by other means than thermal energy for inhalation via a nebulizer such as a jet nebulizer, ultrasonic nebulizer, e.g. in the form of aqueous drug solutions or dispersions
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K38/00—Medicinal preparations containing peptides
  • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
  • A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K38/00—Medicinal preparations containing peptides
  • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
  • A61K38/55—Protease inhibitors
  • A61K38/57—Protease inhibitors from animals; from humans
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P11/00—Drugs for disorders of the respiratory system

Definitions

• the invention is based, in part, on the discovery that aerosolized antithrombin HI (ATIII) is effective in treating lung disorders, e.g., lung inflammation and injury. It was found that lower doses of aerosolized ATIII were more effective at treating acute septic lung injury than higher doses of intravenously administered ATIII. Thus, administration of ATIII by inhalation provides more efficient treatment of lung disorders, e.g., lung inflammation and injury, than intravenous administration. [002] Accordingly, in one aspect, the invention features a method of treating a subject having a lung disorder, e.g., lung inflammation and/or injury, which includes administration of a therapeutically effective amount of ATIII by inhalation.
• the lung disorder can be an acute or chronic lung disorder.
• the lung disorder is an acute lung injury, e.g., septic acute lung injury or acute respiratory distress syndrome (ARDS).
• Lung injury and/or inflammation can be in response to, e.g., exposure to an external agent, e.g., a viral agent (e.g., Pseudomonas pneumonia), smoke or asbestos.
• the lung disorder can be, e.g., lung or pleural neoplasia, interstitial lung disease and/or organizing pleuitis.
• the ATIII is administered using a jet aerosol or ultrasonic nebulizer system, or by a dry powder inhalation system.
• a jet aerosol or ultrasonic nebulizer system or by a dry powder inhalation system.
• a dry powder inhalation system Such systems for aerosol administration are known.
• the ATIII is human ATIII.
• the ATIII can be naturally derived, e.g., from plasma, or recombinantly produced. Plasma derived ATIII is commercially available.
• the anti-thrombin III is transgenically produced, e.g., the ATIII is obtained from milk from a transgenic diary animal, e.g., a cow, a goat, a rabbit, or a mouse. Methods of producing ATIII in the milk of a transgenic animal are described in U.S. Patent Number 5,843,705, the contents of which is incorporated herein by reference.
• the subject is administered an aerosol composition that includes ATIII and a pharmaceutically acceptable carrier.
• pharmaceutically acceptable carriers include water and saline.
• the subject is periodically administered ATIII by inhalation, e.g., the subject is administered ATIII at regular intervals.
• the subject can be administered aerosol ATIII at the onset of lung inflammation and/or l injury and then at set intervals after the initial administration, e.g., ATIII can be administered by inhalation every hour, 2 hours, 3 hours, 4 hours, 6 hours, twice a day, or three, four, five, six time a day.
• the period of administration can be over a period of about 24, 48, 72, 96, 120, 144 or 168 hours.
• an effective dose of ATIII e.g., transgenically produced ATIII
• an effective dose can be between about 10-300 U/kg, 25-125 U/kg, 50-100 U/kg, or 60-75 U/kg of body weight.
• an effective dose can be greater than about 1 mg/kg, 5 mg/kg, 10 mg/kg, but less than about 150 mg/kg, 100 mg/kg, 70 mg/kg.
• the dose of aerosol ATIII used is less than 10%, 20%, 30%, 40%, 50%, 60% the dose of ATIII intravenously administered to treat the same disorder, e.g., to have the same effect on one or more symptom of lung inflammation or injury.
• the invention features a kit for treating lung disorders.
• the kit includes a therapeutically effective amount of an aerosol form of ATIII, and instructions for use.
• the aerosol further includes a pharmaceutically acceptable carrier. Examples of pharmaceutically acceptable carriers include water and saline.
• an effective dose of ATIII e.g., transgenically produced ATIII
• an effective dose can be between about 10-300 U kg, 25-125 U/kg, 50-100 U/kg, or 60- 75 U/kg of body weight.
• an effective dose can be greater than about 1 mg/kg, 5 mg/kg, 10 mg/kg, but less than about 150 mg/kg, 100 mg/kg, 70 mg/kg.
• the kit is a kit for treating an acute or chronic lung disorder.
• the lung disorder is an acute lung injury, e.g., septic acute lung injury or acute respiratory distress syndrome (ARDS).
• ARDS acute respiratory distress syndrome
• Lung injury and/or inflammation can be in response to, e.g., exposure to an external agent, e.g., a viral agent (e.g., Pseudomonas pneumonia), smoke or asbestos.
• an external agent e.g., a viral agent (e.g., Pseudomonas pneumonia), smoke or asbestos.
• the lung disorder can be, e.g., lung or pleural neoplasia, interstitial lung disease and/or organizing pleuitis.
• the kit includes ATIII in a jet aerosol or ultrasonic nebulizer system, or a dry powder inhalation system.
• the kit includes an aerosol form of human ATIII.
• the ATIII can be naturally derived, e.g., from plasma, or recombinantly produced.
• the anti-thrombin III is transgenically produced, e.g., the ATIII is obtained from milk from a transgenic diary animal, e.g., a cow, a goat, a rabbit, or a mouse.
• FIG. 1 is a graph depicting the effect of administering nebulized ATIII on pulmonary gas exchange (PaO2/FiO2 ratio) in a sheep model having sepsis due to smoke inhalation.
• FIG. 2 is a graph depicting the effect of administering nebulized ATIII on pulmonary shunt fraction in a sheep model having sepsis due to smoke inhalation.
• FIG 3 is a graph depicting the effect of administering nebulized ATIII on mean artial pressure in a sheep model having sepsis due to smoke inhalation.
• FIG. 4 is a graph depicting the effect of administering nebulized ATIII on left strium pressure in a sheep model having sepsis due to smoke inhalation.
• FIG 5 is a graph depicting the effect of administering nebulized ATIII on pulmonary artery pressure in a sheep model having sepsis due to smoke inhalation.
• FIG. 6 is a graph depicting the effect of administering nebulized ATIII on cardiac index in a sheep model having sepsis due to smoke inhalation.
• FIG 7 is a graph depicting the effect of administering nebulized ATIII on left ventricular stroke work index (LVSWI) in a sheep model having sepsis due to smoke inhalation.
• LVSWI left ventricular stroke work index
• FIG. 8 is a graph depicting the effect of administering nebulized ATIII on body temperature in a sheep model having sepsis due to smoke inhalation.
• FIG. 9 is a graph depicting the effect of administering nebulized ATIII on left plasma NOx levels in a sheep model having sepsis due to smoke inhalation.
• FIG. 10 is a graph depicting changes in ATIII activities in a sheep model having sepsis due to smoke inhalation.
• the invention features aerosol formulations including ATIII, as well as, methods of using such aerosol forms of ATIII to treat a subject having a lung disorder, e.g., lung injury or inflammation.
• treat refers to alleviating or reducing one or more symptom(s) associated with a lung disorder.
• symptoms of lung injury and/or inflammation include: 1) reduced pulmonary gas exchange; 2) reduced pulmonary shunt fraction; 3) extracellular fibrin deposition; 4) increased vascular permeability; 5) decreased lipoprotein surfactant deposition; 6) tissue remodeling; 7) coagulation; and/or 8) increased alveolar tension.
• an amount of an aerosolized form of ATIII effective to treat a lung disorder refers to an amount of ATIII aerosol which is effective, upon single or multiple dose administration to a subject, in curing, alleviating, relieving or improving a subject with a lung disorder as described herein beyond that expected in the absence of such treatment.
• the ATIII can be administered alone, e.g., as a dry powder formulation, or with a pharmaceutically acceptable carrier.
• Pharmaceutically acceptable carriers include, e.g., sterile water, saline and alcohols.
• the pharmaceutical ATIII aerosol composition can further include other therapeutic agents (e.g., other agents which alleviate or reduce lung inflammation or injury), or other pharmaceutical adjuvants, diluents, etc.
• the ATIII can be administered, e.g., as a complex with, or encapsulated in a liposome.
• the compounds can be delivered in the form of an aerosol spray from pressured container or dispenser which contains a suitable propellant, e.g., a gas such as carbon dioxide, or a nebulizer.
• a suitable propellant e.g., a gas such as carbon dioxide, or a nebulizer.
• aerosols refers to dispersions in air of solid or liquid particles, of fine enough particle size and consequent low settling velocities to have relative airborne stability (See Knight, V., Viral and Mycoplasmal Infections of the Respiratory Tract. 1973, Lea and Febiger, Phila. Pa., pp. 2).
• the nebulization of ATIII may be achieved by a gas pressure or by ultrasound.
• a nebulizer is an apparatus permitting the administration of aerosols.
• the nebulizers may be of any type and their structures are known to a person skilled in the art, and these devices are commercially available.
• the aerosols of the invention can be made by nebulizing an ATIII containing solution using a variety of known nebulizing techniques.
• One nebulizing system is the "wo-phase" system which consists of a solution or a suspension of active ingredient in a liquid propellant. Both liquid and vapor phases are present in a pressurized container and when a valve on the container is opened, liquid propellant containing the solution or suspension is released.
• nebulizers that are available to produce aerosols including small volume nebulizers.
• Compressor driven nebulizers incorporate jet technology and use compressed air or medical oxygen to generate the aerosol.
• Commercially available devices are available from Healthdyne Technologies Inc; Invacare Inc.; Mountain Medical Equipment Inc.; Pari Respiratory Inc.; Mada Mediacal Inc.; Puritan-Bennet; Schuco Inc.; Omron Healthcare Inc.; DeVilbiss Health Care Inc; and Hospitak Inc.
• Ultrasonic nebulizers e.g., an ultrasonic type nebulizer with a quartz crystal vibrating at high frequency, can also be used to deliver the ATIII.
• Toxicity and therapeutic efficacy of such ATIII aerosols can be determined by standard pharmaceutical procedures in cell cultures or experimental animals, e.g., for determining the LD50 (the dose lethal to 50% of the population) and the ED50 (the dose therapeutically effective in 50% of the population).
• the dose ratio between toxic and therapeutic effects is the therapeutic index and it can be expressed as the ratio LD50/ED50.
• Compounds which exhibit high therapeutic indices are preferred. While compounds that exhibit toxic side effects may be used, care should be taken to design a delivery system that targets such compounds to the site of affected tissue in order to minimize potential damage to uninfected cells and, thereby, reduce side effects.
• the data obtained from the cell culture assays and animal studies can be used in formulating a range of dosage for use in humans.
• the dosage of such compounds lies preferably within a range of circulating concentrations that include the ED50 with little or no toxicity.
• the dosage may vary within this range depending upon the dosage form employed and the route of administration utilized.
• the therapeutically effective dose can be estimated initially from cell culture assays.
• a dose may be formulated in animal models to achieve a circulating plasma concentration range that includes the IC50 (i.e., the concentration of the test compound which achieves a half-maximal inhibition of symptoms) as determined in cell culture.
• IC50 i.e., the concentration of the test compound which achieves a half-maximal inhibition of symptoms
• Levels in plasma may be measured, for example, by high performance liquid chromatography.
• Other methods of determining the dosage of ATIII will include measuring a subject's circulating ATIII levels prior to treatment with ATIII. Based on circulating ATIII levels, the dosage of ATIII can be adjusted to be 50%, 100%, 150%, 250%, 300% greater than initial circulating levels.
• the amount of aerosol formulation administered will typically in the in range of about 10 U/kg to about 250 U/kg of body weight, preferably about 25 U/kg to about 175 U/kg of body weight.
• treatment of a subject with a therapeutically effective amount of a protein, polypeptide, or antibody can include a single treatment or, preferably, can include a series of treatments.
• Pseudomonas aeruginosa was suspended in 30 mL saline, which contains 2-5 x 10 ⁇ cfu, injected into the airway using a bronchoscope. After the bacterial challenge, the animals were ventilated mechanically with 100% O 2 . Saline was used as a control.
• Pulmonary gas exchange (PaO2/FiO2 ratio), shunt fraction, and lung wet/dry weight ratio were significantly attenuated by ATIII nebulization as shown in

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• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Engineering & Computer Science (AREA)
• Bioinformatics & Cheminformatics (AREA)
• Chemical & Material Sciences (AREA)
• Animal Behavior & Ethology (AREA)
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• General Health & Medical Sciences (AREA)
• Epidemiology (AREA)
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• Proteomics, Peptides & Aminoacids (AREA)
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• Otolaryngology (AREA)
• Dispersion Chemistry (AREA)
• General Chemical & Material Sciences (AREA)
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• Medicinal Preparation (AREA)
• Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)

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• 2003
  • 2003-03-25 NZ NZ535487A patent/NZ535487A/en not_active IP Right Cessation
  • 2003-03-25 US US10/396,855 patent/US20090221475A9/en not_active Abandoned
  • 2003-03-25 JP JP2003581716A patent/JP2005527570A/ja active Pending
  • 2003-03-25 CA CA002480790A patent/CA2480790A1/en not_active Abandoned
  • 2003-03-25 KR KR1020107022448A patent/KR20100117148A/ko not_active Ceased
  • 2003-03-25 IL IL16407803A patent/IL164078A0/xx active IP Right Grant
  • 2003-03-25 KR KR10-2004-7015636A patent/KR20040105838A/ko not_active Ceased
  • 2003-03-25 CN CNB03807463XA patent/CN100384469C/zh not_active Expired - Fee Related
  • 2003-03-25 EP EP03728277A patent/EP1494696A4/en not_active Withdrawn
  • 2003-03-25 AU AU2003233428A patent/AU2003233428B2/en not_active Revoked
  • 2003-03-25 WO PCT/US2003/009053 patent/WO2003084476A2/en not_active Ceased
• 2004
  • 2004-09-14 IL IL164078A patent/IL164078A/en not_active IP Right Cessation
• 2008
  • 2008-10-31 AU AU2008243077A patent/AU2008243077A1/en not_active Withdrawn
• 2011
  • 2011-08-12 JP JP2011176604A patent/JP2011225625A/ja not_active Withdrawn
  • 2011-10-10 AU AU2011236070A patent/AU2011236070A1/en not_active Ceased

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