WO2006025395A1 - キャリアフリーの細胞増殖因子を用いた慢性閉塞性肺疾患に対する医薬および処置システム - Google Patents
キャリアフリーの細胞増殖因子を用いた慢性閉塞性肺疾患に対する医薬および処置システム Download PDFInfo
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- WO2006025395A1 WO2006025395A1 PCT/JP2005/015778 JP2005015778W WO2006025395A1 WO 2006025395 A1 WO2006025395 A1 WO 2006025395A1 JP 2005015778 W JP2005015778 W JP 2005015778W WO 2006025395 A1 WO2006025395 A1 WO 2006025395A1
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- growth factor
- cell growth
- lung
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- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
- A61K31/19—Carboxylic acids, e.g. valproic acid
- A61K31/20—Carboxylic acids, e.g. valproic acid having a carboxyl group bound to a chain of seven or more carbon atoms, e.g. stearic, palmitic, arachidic acids
- A61K31/203—Retinoic acids ; Salts thereof
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/557—Eicosanoids, e.g. leukotrienes or prostaglandins
- A61K31/558—Eicosanoids, e.g. leukotrienes or prostaglandins having heterocyclic rings containing oxygen as the only ring hetero atom, e.g. thromboxanes
- A61K31/5585—Eicosanoids, e.g. leukotrienes or prostaglandins having heterocyclic rings containing oxygen as the only ring hetero atom, e.g. thromboxanes having five-membered rings containing oxygen as the only ring hetero atom, e.g. prostacyclin
-
- 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
- A61K38/18—Growth factors; Growth regulators
-
- 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 present invention relates to the treatment of lung diseases. More particularly, the present invention relates to a carrier-free treatment system for lung diseases such as emphysema. More specifically, the present invention relates to a carrier-free medicine and treatment system for lung tissue including alveoli, vasculature and the like destroyed by pulmonary diseases such as emphysema and chronic bronchitis.
- COPD chronic obstructive pulmonary disease
- the number of patients with COPD has increased in recent years, and the number of patients is expected to increase further in the future. At present, there is no treatment method and the burden of social medical expenses is large.
- the disease is a pathological condition characterized by irreversible respiratory airflow limitation. Airflow restrictions are usually progressive and vary to some extent depending on the amount and type of harmful gas inhaled. Airflow limitation is caused by destruction of the lung parenchyma caused by an inflammatory reaction in the peripheral airways in response to inhaled gas. According to a survey conducted by the World Health Organization and the World Bank, the world prevalence in 1990 was 9.34 men per thousand population and 7.33 women. It is currently on an increasing trend and is expected to rise from 6th in 1990 to 3rd in 2020.
- COPD is a disease in which the respiratory function slowly declines due to a disorder in the "airway” that becomes the air passage when breathing.
- COPD includes “emphysema”, “chronic bronchitis”, “pulmonary fibrosis” and the like.
- Emphysema begins with a common symptom and progresses slowly, so when you visit the clinic with a sense of abnormality, you often get seriously ill and are considered a “pulmonary lifestyle-related disease”! .
- Pulmonary emphysema is a disease with great suffering, such as the loss of freedom of movement due to the difficulty of breathing and disability throughout the body when it becomes severe. The treatment from the viewpoint is also awaited.
- emphysema is not currently effective as a treatment, and there is no way to effectively delay the progression of this disease.
- the only treatment that is performed is symptomatic treatment such as oxygen inhalation and external positive pressure ventilation! /.
- symptomatic treatment such as oxygen inhalation and external positive pressure ventilation! /.
- bronchodilators and expectorants are also administered as drugs, but the effects are limited. Drugs with bronchodilating action, such as ⁇ 2-stimulants and anticholinergics, used as bronchodilators are characteristic of emphysema and are the most important indicators clinically.
- Non-Patent Document 1 Pauwels RA, et al., ⁇ . Engl. J. Med., 1999 (340), 1948-1953;
- Non-Patent Document 2 Vestbo J, et al., Lancet, 1999 (353), 1819-1823;
- Non-Patent Document 3 Burge PS, et al., TK, BJ, 2000 (320), 1297-1303).
- N-Acetylcystine is an antioxidant that is considered to have the same mechanism of action as an active oxygen production inhibitor, but this N-acetylcystein has been used in clinical trials. It has been reported that the frequency of acute exacerbations of emphysema can be reduced (Non-Patent Literature)
- N-acetylcystein is not described as improving the decrease in lung function, and is considered to have no effect on the regeneration of lung tissue.
- Non-patent Document 5 Peter J. et al.) al., Engl. J. Med., 2000 (343) No. 4, 269—280).
- Patent Document 1 WO01 / 0680 81;
- Non-Patent Document 6 Massaro GF, Massado D, Nat. Med. 1997, No, 3, 67
- Non-patent Document 7 Selman M. et al., Chest, 2003, 123, 1633-1641)
- a harmful reaction may occur in the living body due to side effects of the carrier.
- Gelatin is known to cause allergic reactions, and its versatility is low. Even with other carriers, it can not be said that they can escape completely from adverse reactions such as allergic reactions.
- gelatin is prepared from the bone marrow of ushi, and cannot completely eliminate the risk of the development of bovine spongiform encephalopathy, which has been a problem in recent years.
- it is industrially difficult to use other sources as gelatin and it is desirable to develop an administration method that does not use gelatin prepared from bone marrow of ushi.
- Patent Document 1 WO01 / 068081
- Non-Patent Literature l Pauwels RA, et al., N. Engl. J. Med., 1999 (340), 1948— 1953
- Non-Patent Document 6 Massaro GF, Massado D, Nat. Med. 1997, No, 3, 675-67 7
- Another object of the present invention is to develop methods and compositions for regenerating lung tissue.
- Another object of the present invention is to develop a composition that can cure COPD or reduce symptoms without imposing a burden on a living body.
- the drug can be accurately administered to the lung, and the corrected part is used for other parts (3 ⁇ 43 ⁇ 4 3 ⁇ 4 ⁇ i91) It is necessary to use a system or device that is not administered, and the provision of such a system or device is also an object of the present invention.
- a carrier-free cell growth factor is safely delivered to a state after treatment of pulmonary fibrosis or a lesion site of pulmonary emphysema, and the alveoli destroyed there, micropulmonary capillaries in the lung, etc. Repair of lung tissue. It provides treatment for post-pulmonary fibrosis conditions or emphysema.
- angiogenic growth factors include basic fibroblast growth factor (bFGF) and hepatocyte growth factor (HGF).
- bFGF basic fibroblast growth factor
- HGF hepatocyte growth factor
- VEGF Vascular endothelial growth factor
- TGF Transforming growth factor
- Physiologically active low molecular weight substances such as prostaglandins
- the dose of basic fibroblast growth factor among the cell growth factors in the preparation of the present invention can be appropriately adjusted depending on the severity of the disease, the age of the patient, the body weight, etc.
- the dosage is selected in the range of 01 to about 500 g, preferably in the range of about 0.1 to about 200 g.
- the administration can be performed multiple times.
- LVRS which has a high mortality rate in surgery in patients suffering from a highly advanced disease
- Non-invasive treatment is desired in patients with severe emphysema ing.
- Bronchoscopic lung volume reduction (BLVR) can be performed as a safe and less invasive treatment of severe emphysema.
- the principle of BLVR is the reduction of most affected parts of the overinflated lung and the enlargement of healthy parts of the tissue.
- Fibroblast growth factor 2 (FGF-2) has been reported to enhance fibrosis and enhance angiogenesis, and plays an important role in lung development and branching morphogenesis. It has been.
- the purpose of the present invention is to use BLVR using a cyto force-in such as FGF-2 for beagle dogs suffering from severe emphysema, ensuring safety and having the ability to reduce lung volume, We have succeeded in providing a treatment system that can restore lung function.
- a pharmaceutical composition for the treatment of pulmonary diseases comprising a carrier-free cell growth factor.
- the above cell growth factors include basic fibroblast growth factor (bFGF), hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), platelet-derived growth Selected from the group consisting of Factor (PDGF), Transforming Growth Factor (TGF), Angiopoetin, Angiostatin, Adrenomedullin, Intermouth 1-17, Nitric Oxide, Retinoic Acid, Chemokines and Prostaglandins 2.
- bFGF basic fibroblast growth factor
- HGF hepatocyte growth factor
- VEGF vascular endothelial growth factor
- PDGF basic fibroblast growth factor
- HGF hepatocyte growth factor
- a system for the prevention or treatment of pulmonary tissue comprising a means for pulmonary administration and a carrier-free cell growth factor in a form suitable for pulmonary administration.
- the above cell growth factors include basic fibroblast growth factor (basic fibroblast growth th £ & 01: 1: 10), hepatocyte growth factor (11 ⁇ 2 &1; 00 6 growth factor: HGF), vascular endothelium Cell growth factor (VEGF), platelet derived growth factor (PDGF), transforming growth factor (TGF), angiopoietin, angiostatin, adrenomedullin, interleukin 1-17, nitric oxide, retinoic acid, pchemokine and prostagland
- HGF hepatocyte growth factor
- VEGF vascular endothelium Cell growth factor
- PDGF platelet derived growth factor
- TGF transforming growth factor
- angiopoietin angiostatin
- adrenomedullin interleukin 1-17
- nitric oxide nitric oxide
- retinoic acid pchemokine and prostagland
- the system of item 10 selected from the group consisting of
- the pulmonary disease includes the condition after treatment of pulmonary fibrosis or emphysema and is described in item 10. System.
- a pharmaceutical composition for regeneration of lung tissue comprising a carrier-free cell growth factor.
- the above cell growth factors include basic fibroblast growth factor (basic fibroblast growth th £ & 01: 1: 10), hepatocyte growth factor (11 ⁇ 2 &1; 00 6 growth factor: HGF), vascular endothelium Cell growth factor (VEGF), platelet derived growth factor (PDGF), transforming growth factor (TGF), angiopoetin, angiostatin, adrenomedullin, interleukin 1-17, nitric oxide, retinoic acid, chemokine and prostagland Item 21.
- HGF hepatocyte growth factor
- VEGF vascular endothelium Cell growth factor
- PDGF platelet derived growth factor
- TGF transforming growth factor
- angiopoetin angiostatin
- adrenomedullin interleukin 1-17
- nitric oxide nitric oxide
- retinoic acid chemokine and prostagland Item 21.
- the pharmaceutical composition according to item 20 selected
- a system for regeneration of pulmonary tissue comprising a means for pulmonary administration, and carrier-free cell growth factor in a form suitable for pulmonary administration.
- the above-mentioned cell growth factors include basic fibroblast growth factor (basic fibroblast growth th £ & 01: 1: 10), hepatocyte growth factor (11 ⁇ 2 &1; 00 6 growth factor: HGF), vascular endothelium.
- Cell growth factor (VEGF), platelet derived growth factor (PDGF), transforming growth factor (TGF), angiopoetin, angiostatin, adrenomedullin, interleukin 1-17, nitric oxide, retinoic acid, chemokine and prostagland 30 The system of item 29, selected from the group consisting of gin.
- a method for screening a substance for the treatment of pulmonary thread and weaving comprising: Lower process:
- a method according to item 45, wherein the candidate compound is selected from the group consisting of proteins, nucleic acids, lipids, sugars, small organic molecules, and combinations thereof.
- a system for screening substances for the treatment of lung tissue comprising:
- a method for screening substances for regeneration of lung thread and weaving which comprises the following steps:
- the candidate compound When the candidate compound is administered and the lung cells in the subject are regenerated, the candidate compound is provided with means for determining that the candidate compound is an indicator of the substance for regeneration of the lung thread and tissue. system.
- a catheter tube having a proximal end, a distal end, a drug channel for communication with a drug supply container, and a compressed air channel for communication with a compressed air supply; An injection orifice disposed at the distal end of the catheter;
- the drug provided from the drug source is mixed with compressed air provided through the compressed air channel so that the drug is sprayed at the injection orifice, item 63 Device described in.
- This device is administered directly via the airway or orally via a device and a catheter that is administered directly orally.
- This device includes a pulmonary administration system or inhalation device, a broadly defined inhalation phase, a one-way valve for the use of drugs (eg bFGF) and its automatic opening and closing system.
- the specifications can be as follows.
- a device according to item 63, further comprising a drug supply container containing a carrier-free cell growth factor.
- a cell growth factor administration system comprising the device according to any one of items 63 to 69 and a bronchoscope.
- the present invention has made it possible to treat various pulmonary diseases that have conventionally been difficult to cure unless a complex DDS system using a carrier such as gelatin is used.
- a complex DDS system using a carrier such as gelatin
- COPD which has been regarded as an incurable disease
- a carrier-free composition such as an aqueous solution.
- the present invention enables lung regeneration. .
- cell growth factors such as basic fibroblast growth factor
- FIG. 1 shows a comparison of bFGF aqueous solution and bFGF gelatin particle solution after airway administration.
- the rhombus is a gelatin particle solution
- the open square is an aqueous solution. This value corresponds to Table 2.
- Below figure 1 is a logarithmic representation of this.
- FIG. 2 shows a photograph of a severe emphysema model when elastase is administered at 40 mg. The left is a magnified photo of X 40x and the right is X 100.
- FIG. 3 shows CT findings before and after ⁇ FGF administration in dogs with severe emphysema
- FIG. 4 shows a therapeutic effect comparing the bFGF aqueous solution administration group and the non-administration group (lung volume evaluation). From left, normal dogs, emphysema dogs, and after treatment are shown. Each group shows the non-administration group on the left side and the administration group on the right side.
- FIG. 5 shows the therapeutic effect comparing the bFGF gelatin particle solution administration group and the non-administration group (evaluation of lung volume). From left, normal dogs, emphysema dogs, and after treatment are shown. Each group shows the non-administration group on the left side and the administration group on the right side.
- FIG. 6 shows the therapeutic effect of the bFGF aqueous solution administration group and the non-administration group. Here, blood gas analysis evaluation is shown. Diamonds indicate the bFGF administration group and squares indicate the non-administration group.
- FIG. 7 shows the measurement results of lung volume as the therapeutic effect of bFGF aqueous solution on the emphysema model.
- FIG. 8 shows the measurement results of lung volume as a therapeutic effect of bFGF gelatin particle solution on an emphysema model.
- FIG. 9 shows the average size of alveoli as the therapeutic effect of bFGF aqueous solution on the emphysema model.
- FIG. 10 shows the average size of alveoli as the therapeutic effect of bFGF gelatin particle solution on the emphysema model.
- FIG. 11 shows an experimental model when elastase is used.
- the right lung can be considered a normal lung and the left lung can be considered a disease model.
- FIG. 12 shows left and right lung model diagrams before and after elastase treatment and after treatment with basic fibroblast growth factor.
- FIG. 13 shows lung volume distribution in normal dogs.
- FIG. 14 shows the distribution of lung volume in the elastase administration group (40 mg and 80 mg administration) in comparison with normal dogs.
- FIG. 15 is a graph showing the effect of muscle relaxants (masculax) on lung volume in the same normal dog.
- FIG. 17 is a diagram comparing the lung treated with an aqueous solution of basic fibroblast growth factor and the untreated lung in the upper stage (the left is the non-treated group and the right is the treated group). In the lower part, the micrographs of the same model (left and right correspond) are shown. Tissues were stained with hematoxylin eosin staining.
- FIG. 18 is a diagram showing the contrast of therapeutic effects between a bFGF aqueous solution administration group and a non-administration group by blood gas praying.
- FIG. 19 is a graph showing a comparison of therapeutic effects between a bFGF aqueous solution administration group and a non-administration group by lung volume evaluation.
- FIG. 20 shows the results of the treatment of the FGF aqueous solution on the pulmonary emphysema model in terms of lung volume.
- FIG. 21 shows the results of the treatment effect of the FGF aqueous solution on the emphysema model, as an average number of alveoli.
- FIG. 22 is an MRI photograph of lungs of a normal dog (left) and an elastase-treated dog (right).
- FIG. 23 is an MRI photograph of lungs of normal dogs (left) and elastase-treated dogs treated with basic fibroblast growth factor (right).
- FIG. 24 shows the photographs and planes of the lungs of FIG. 22 at the times indicated. Shows a plot of the product.
- FIG. 25 shows a continuous photograph of the lung of FIG. 23 treated with basic fibroblast growth factor, showing the time in the indicated number of seconds and plotting the area.
- FIG. 25A shows the arterial blood partial pressure (PaO 2) data of Example 8.
- FIG. 25B shows the call when the bronchial lumen is inflated at different pressures (5-70 cmH 0).
- FIG. 25C shows a summary of the effects of FGF-2 on lung volume size over Example 8.
- FIG. 25D shows that in biopsy, tissue destruction caused by elastase was accompanied by physiological changes and significantly reduced the available surface area for gas exchange.
- FIG. 26 is an example of an administration device of the present invention.
- the lower right shows an example of powder (powder such as bFGF) and lysate-specific containers that specify the amount and concentration of the drug (such as bFGF).
- powder such as bFGF
- lysate-specific containers that specify the amount and concentration of the drug (such as bFGF).
- FIG. 27A shows a schematic diagram (first stop) of the administration device of the present invention when controlling using an electric circuit.
- FIG. 27B shows a schematic diagram (rear stop) of the administration device of the present invention when controlling using an electric circuit.
- FIG. 28 shows a detail description at the proximal end of the catheter.
- FIG. 29A is an enlarged view (first stop) of the distal end of the catheter.
- FIG. 29B is an enlarged view (rear stop) of the distal end of the catheter.
- FIG. 30 is an example of the overall configuration of a device of the present invention.
- FIG. 31 is a specification example for home use of the device of the present invention.
- SEQ ID NO: 1 is the nucleic acid sequence of basic fibroblast growth factor.
- SEQ ID NO: 2 is the amino acid sequence of basic fibroblast growth factor.
- SEQ ID NO: 3 is a short, basic fibroblast growth factor nucleic acid sequence.
- SEQ ID NO: 4 is the amino acid sequence of a short, basic fibroblast growth factor.
- SEQ ID NO: 5 is the nucleic acid sequence of acidic fibroblast growth factor.
- SEQ ID NO: 6 is the amino acid sequence of acidic fibroblast growth factor.
- pulmonary disease refers to any disease that damages the lungs.
- chronic obstructive pulmonary disease or "COPD” (abbreviation of Chronic (chronic) Obstr uctive (pulmonary) Disease) is used interchangeably, This is a general term for diseases in which air in and out of the lungs becomes chronically worse and slowly worsens. Virtually all of what has been said to be “chronic bronchitis” or “emphysema” is included. Symptoms of COPD include, for example, symptoms that Sekitan continues every day even though it is not a cold, and symptoms that cause shortness of breath when the body is driven, such as going up and down stairs.
- COPD chronic bronchial and bronchiolar lesions that have been conventionally referred to as “chronic bronchitis” and alveolar lesions that have been referred to as "pulmonary emphysema”. In most patients, two types of lesions appear to overlap. Even in chronic bronchitis, there are cases in which there are always a lot of skin and tongue, so recently it has been referred to as “airway lesion type”, but it is all included in the treatment subject of the present invention. Is understood.
- the type of emphysema refers to those in which alveoli are destroyed and fused due to chronic inflammation, and air is swelled up in the lungs. As the lungs lose their elasticity, the air flows in and out, and the air becomes worse because the swollen lung tissue crushes the airways.
- Diagnosis of COPD is performed by a simple respiratory function test (spyro test) using a spy meter and a sputum instrument.
- the spy mouth test is a test to check the vital capacity and the ease of passing air when exhaling.
- Blood gas measurement to check for oxygen deficiency in the body can also be performed using blood collected from arteries, pulse oximeters, etc. If you have symptoms such as colds, use a urine test, blood test, blood pressure measurement, etc. Perform a test to check the condition as necessary), and then diagnose COPD.
- COPD treatment is preferably performed according to the severity of the disease, the severity of COPD is determined as necessary.
- the severity of COPD is categorized based on the% 1 second dose (% FEV1.0) that can be determined by spy mouth tests.
- protein As used herein, the terms “protein”, “polypeptide”, “oligopeptide” and “peptide” are used interchangeably herein to refer to polymers of amino acids of any length and variants thereof. Say. This polymer may be linear or branched or cyclic.
- the amino acid may be a modified amino acid, whether natural or non-natural.
- the term also includes what can be assembled into a complex of multiple polypeptide chains. This term also encompasses amino acid polymers that are naturally or artificially modified. Such modifications include, for example, disulfide bond formation, glycosylation, lipidation, acetylation, phosphate or any other manipulation or modification (eg, conjugation with a labeling component).
- the “protein” is preferably a protein that is compatible with the host in which the composition is to be used, but can be treated to be compatible with that host. Any protein may be used as long as it is. Whether a protein is compatible with a host or can be treated to be compatible with a host is determined by transplanting the protein into the host and suppressing side reactions such as immune rejection as necessary. It can be determined by observing whether or not it will be established in the host.
- a protein having the above-mentioned compatibility can include, but is not limited to, a protein derived from the host.
- an "isolated" biological agent refers to other biological cells within the cells of the organism in which the biological agent is naturally present.
- Factor e.g., if it is a nucleic acid, a nucleic acid containing a non-nucleic acid factor and a nucleic acid sequence other than the target nucleic acid; if it is a protein, it contains an amino acid sequence other than the non-protein factor and the target protein
- a substance substantially separated or purified from a protein or the like A substance substantially separated or purified from a protein or the like.
- isolated nucleic acids and proteins include nucleic acids and proteins purified by standard purification methods. Thus, isolated nucleic acids and proteins include chemically synthesized nucleic acids and proteins.
- a "purified" biological agent eg, nucleic acid or protein
- a purified biological agent is one from which at least some of the factors that naturally accompany the biological agent have been removed. Say. Thus, the purity of a biological agent in a purified biological agent is usually higher (ie, enriched) than the state in which the biological agent is normally present.
- the biomolecules used in the present invention can be biosynthesized and can be chemically synthesized by methods known to those skilled in the art. For example, for proteins, a synthesis method using an automated solid phase peptide synthesizer is described by: Stewart, JM et al. "984). Solid Phase Peptide Synthesis, Pierce Chemical Co .; Grant , GA (1992). Synthetic Peptides: A User's Guide, WH Freeman; Bodanszky, M. (1993). Principles of Peptide Synthesis, Springer—Verlag; Bodanszky, M. et al. (1994). The Practice of Peptide Synthesis, Springer- Verlag; Fields, GB (1997).
- the term "homology" of a biomolecule refers to two or more sequences having a comparable sequence.
- the degree of identity to each other therefore, the higher the homology between two sequences, the higher the identity or similarity between those sequences.
- the ability of two sequences to have homology can be determined by direct comparison of the sequences or, in the case of nucleic acids, hybridization methods under stringent conditions.
- the sequence power between the sequences is typically at least 50% identical, preferably at least 70% identical, more preferably at least 80%, 90%, 95% 96%, 97%, 98% or 99% identical, the genes are homologous.
- “similarity” of biomolecules refers to two or more gene sequences when conservative substitutions are regarded as positive (identical) in the above homology. The degree of identity to each other. Thus, if there is a conservative substitution, identity and similarity differ depending on the presence of the conservative substitution. In the absence of conservative substitutions, identity and similarity indicate the same number. In the present invention, those having such high identity or similarity may also be useful.
- identity value usually refers to the value when aligned using the above BLA ST under the default conditions. However, parameter changes If a higher value is obtained, the highest value is set as the identity value. When identity is evaluated in multiple areas, the highest value is used as the identity value.
- amino acid may be natural or non-natural.
- “Derivative amino acid” or “amino acid analog” refers to an amino acid having a different force from that of a naturally occurring amino acid and having the same function as the original amino acid. Such derivative amino acids and amino acid analogs are well known in the art.
- natural amino acid means the L-isomer of a natural amino acid. Natural amino acids are glycine, alanine, norine, leucine, isoleucine, serine, methionine, threonine, phenylalanine, tyrosine, tryptophan, cysteine, proline, histidine, aspartic acid, asparagine, glutamic acid, glutamine, ⁇ -strength rubo Xyglutamic acid, arginine, orthine, and lysine. Unless otherwise indicated, all amino acids referred to herein are L-forms. Forms using D-form amino acids are also within the scope of the present invention.
- amino acid variant refers to a molecule that is not a natural amino acid but is similar to the physical properties and function or function of a natural amino acid.
- amino acid modifications include those in which alkyl group, halo group, nitro group, etc. are bonded to the benzyl side chain of phenylalanine (para, meta, ortho, etc.), ethionine, canavanine, 2-methyl. Examples include luglutamine.
- amino acid variants may include unnatural amino acids and amino acid mimetics.
- unnatural amino acid means an amino acid that is not normally found naturally in proteins.
- non-natural amino acids include norleucine, para-nitrophenalanine, homophenol-norellanin, para-pholeo-oral-felanorelanine, 3-amino-2-benzylpropionic acid, homoarginine D-form or L-form and D-fe- Lualanin is mentioned.
- Amino acids may be referred to herein by either their commonly known three letter symbols or by the one letter symbols recommended by the IUPAC—IUB Biochemica LNomenclature Commission. Nucleotides can also be referred to by their generally recognized single letter codes. The character codes are as follows:
- the "corresponding" amino acid or nucleic acid refers to a polypeptide molecule or polynucleotide molecule, respectively, and the same action as a predetermined amino acid in a reference polypeptide or polynucleotide.
- Amino acids or nucleic acids that are predicted to have, or are predicted to have, particularly in the case of enzyme molecules, amino acids that are present at similar positions in the active site and contribute to the catalytic activity in the same way.
- an antisense molecule of a polynucleotide may be a similar part in an ortholog corresponding to a particular part of the antisense molecule.
- a specific sequence in human cell growth factor eg, FGF
- FGF human cell growth factor
- a "corresponding" gene refers to a species that serves as a reference for comparison with a certain species. This refers to a gene that has or is expected to have the same action as a given gene in, and when there are multiple genes that have such action, it refers to the one that has the same evolutionary origin.
- the corresponding gene of a gene can be an ortholog of that gene.
- the gene corresponding to mouse cell growth factor (eg, bFGF) is human cell growth factor (eg, bFGF).
- fragment refers to a polypeptide or polypeptide having a sequence length of 1 to n-1 relative to a full-length polypeptide or polynucleotide (length n). Refers to nucleotide.
- the length of the fragment can be appropriately changed depending on the purpose. For example, the lower limit of the length is 3, 4, 5, 6, 7, 8, 9, 10 in the case of a polypeptide. 15, 20, 25, 30, 40, 50 and higher amino acid strengths, and the lengths expressed in integers not specifically listed here (eg, 11 etc.) are also considered as lower limits. May be appropriate.
- examples include 5, 6, 7, 8, 9, 10, 15, 20, 25, 30, 40, 50, 75, 100 and more nucleotides.
- a length expressed as an integer (eg, 11 etc.) may also be appropriate as a lower limit.
- a polypeptide or polynucleotide when used as a biomolecule, such a fragment is also similar to the full-length one as long as the desired purpose (for example, a cell attracting effect) is achieved. It is understood that it can be used.
- the lengths of polypeptides and polynucleotides can be expressed by the number of amino acids or nucleic acids, respectively, as described above, and the above functions are not absolute but have the same function. As long as it has, the above number as the upper or lower limit is intended to include those above and below that number (or for example 10% above and below). In order to express such intentions, in this specification, “about” may be added before the number. However, in the present specification, it should be understood that the presence or absence of “about” does not affect the interpretation of the numerical value.
- biological activity refers to an activity that a certain factor (for example, a polypeptide or protein) can have in a living body, and an activity that exhibits various functions. Is included. For example, when a certain factor is an antisense molecule, its biological activity includes binding to the nucleic acid molecule of interest, thereby suppressing expression. For example, When a factor is an enzyme, its biological activity includes that enzyme activity. In another example, when an agent is a ligand, the ligand includes binding to the corresponding receptor. Such biological activity can be measured by techniques well known in the art.
- polynucleotide As used herein, the terms “polynucleotide”, “oligonucleotide” and “nucleic acid” are used interchangeably herein and refer to a nucleotide polymer of any length. The term also includes “derivative oligonucleotide” or “derivative polynucleotide”. “Derivative oligonucleotide” or “derivative polynucleotide” refers to an oligonucleotide or polynucleotide that includes a derivative of a nucleotide or that has unusual linkages between nucleotides, and is used interchangeably.
- oligonucleotides include 2 ′ O-methyl-ribonucleotides, derivative oligonucleotides in which the phosphodiester bonds in the oligonucleotides are converted to phosphoroate bonds, and phosphorous in the oligonucleotides.
- a particular nucleic acid sequence may also contain conservatively modified variants (e.g., degenerate codon substitutes) as well as explicitly indicated sequences. ) And complementary sequences are contemplated.
- a degenerate codon substitute creates a sequence in which the third position of one or more selected (or all) codons is replaced with a mixed base and a Z or deoxyinosin residue.
- Certain amino acids can be substituted with other amino acids in protein structures such as, for example, force thionic regions or substrate molecule binding sites, without an apparent reduction or loss of interaction binding capacity. It is the ability and nature of the protein to define the biological function of a protein. Thus, specific amino acid substitutions can be made in the amino acid sequence or at the level of its DNA coding sequence, resulting in a protein that still retains its original properties after substitution. Accordingly, various modifications can be made in the peptide disclosed herein or in the corresponding DNA encoding this peptide without any apparent loss of biological utility. Such a variant can also be used as the cell growth factor of the present invention as long as it can achieve the desired purpose.
- hydrophobicity index of amino acids can be taken into account.
- the importance of the hydrophobic amino acid index in conferring interactive biological functions in proteins is generally recognized in the art (Kyte. J and Doolittle, RFJ Mol. Biol. 157 (1): 105-132, 1982).
- the hydrophobic nature of amino acids contributes to the secondary structure of the protein produced, and then defines the interaction of the protein with other molecules (eg, enzymes, substrates, receptors, DNA, antibodies, antigens, etc.).
- Each amino acid is assigned a hydrophobicity index based on their hydrophobicity and charge properties.
- one amino acid can be replaced by another amino acid having a similar hydrophobicity index and still result in a protein having a similar biological function (eg, a protein equivalent in enzymatic activity)
- the hydrophobicity index is preferably within ⁇ 2 and more preferably within ⁇ 1. Even more preferably within ⁇ 0.5. It is understood in the art that such substitution of amino acids based on hydrophobicity is efficient. As described in US Pat. No. 4,554,101, the following hydrophilicity indices are assigned to amino acid residues!
- an amino acid can be substituted with another that has a similar hydrophilicity index and can still provide a biological equivalent.
- the hydrophilicity index is preferably within ⁇ 2, more preferably within ⁇ 1, and even more preferably within ⁇ 0.5.
- conservative substitution is similar to the amino acid substitution in terms of the hydrophilicity index or Z and hydrophobicity index with the amino acid to be replaced with the original amino acid as described above. This means substitution.
- conservative substitutions include those having a hydrophilicity index or hydrophobicity index of 2 or less, preferably ⁇ 1 or less, more preferably ⁇ 0.5 or less. But not limited to them.
- conservative substitutions are well known to those skilled in the art and include, for example, substitutions within the following groups: arginine and lysine; dartamic acid and aspartic acid; serine and threonine; glutamine and asparagine; Examples include, but are not limited to, leucine and isoleucine. Such a variant can also be used as the cell growth factor of the present invention as long as the desired purpose can be achieved.
- variant refers to a substance in which a part of the original substance such as a polypeptide or polynucleotide has been changed. Such variants include substitutional variants, addition variants, deletion variants, truncated variants, allelic variants, and the like. Such a variant can also be used as the cell growth factor of the present invention as long as the desired purpose can be achieved. Alleles are genetic variants that belong to the same locus and are distinguished from each other. Therefore, "Alleles" A “child variant” refers to a variant that has an allelic relationship to a gene.
- allelic variants usually have a sequence that is identical or very similar to its corresponding allele and usually has a rarely different biological activity with nearly the same biological activity. May have.
- “Species homologue or homolog” means homology (preferably at least 60% homology, more preferably at least 80%, at a certain amino acid level or nucleotide level within a certain species. 85% or more, 90% or more, 95% or more homology). The method for obtaining such species homologues will be apparent from the description herein.
- “Ortholog”, also called orthologous gene refers to a gene derived from speciation from a common ancestor with two genes.
- human and mouse ⁇ -hemoglobin genes are orthologs.
- Human ⁇ -hemoglobin genes and j8 hemoglobin genes are paralogs (genes generated by gene duplication). is there.
- Orthologs are useful for estimating molecular phylogenetic trees.
- Orthologs of the present invention can also be useful in the present invention, since orthologs can usually perform the same function in other species as the original species.
- nucleic acid sequences As used herein, “conservatively modified” applies to both amino acid and nucleic acid sequences.
- Conservatively modified variants with respect to a particular nucleic acid sequence refer to nucleic acids that encode the same or essentially the same amino acid sequence, and are essentially identical if the nucleic acid does not encode the amino acid sequence. An array. Because of the degeneracy of the genetic code, a large number of functionally identical nucleic acids encode any given protein. For example, the codons GCA, GCC, GCG, and GCU all encode the amino acid alanine. Thus, at every position where an alanine is specified by a codon, the codon can be altered to any of the corresponding codons described without altering the encoded polypeptide. In the present invention, it is understood that conservative substitutions thereof can also be used in place of the sequences as specifically shown in the examples.
- substitution, addition or deletion of a polypeptide or polynucleotide refers to an amino acid or its substitute, or nucleotide, respectively, relative to the original polypeptide or polynucleotide. Or replace or add to its substitute power Or to be removed.
- substitution, addition, or deletion techniques are well known in the art, and examples of such techniques include site-directed mutagenesis techniques. Any number of substitutions, additions or deletions may be used, as long as it is one or more. Such numbers may be used in the variant having the substitutions, additions or deletions (eg, angiogenesis, cell regeneration). Etc.) as long as it is retained. For example, such a number can be one or several and preferably can be within 20%, 10%, or 100, 50, 25, etc. of the total length. .
- biomolecule refers to a molecule related to a living body and an assembly thereof.
- living body refers to a biological organism, including but not limited to animals, plants, fungi, viruses and the like.
- a biomolecule includes a molecule extracted from a living body and an aggregate thereof, but is not limited thereto, and any molecule or aggregate that can affect a living body falls within the definition of a biomolecule. Therefore, small molecules that can be used as pharmaceuticals (for example, small molecule ligands) also fall within the definition of biomolecules as long as the effects on the living body can be intended.
- biomolecules include proteins, polypeptides, oligopeptides, peptides, polynucleotides, oligonucleotides, nucleotides, nucleic acids (eg, DNA such as cDNA, genomic DNA, RNA such as mRNA), Polysaccharides, oligosaccharides, lipids, small molecules (e.g. hormones, ligands, information transmitters, small organic molecules, etc.), complex molecules of these, and their aggregates (e.g. extracellular matrix, fibers, etc.) Included, but not limited to.
- a biomolecule is intended to include a cell growth factor.
- angiogenesis refers to the formation of a new blood vessel and the activity that forms as such.
- the “blood vessel” in the present specification is used in the meaning normally used in the art, and includes normal arteries, veins, and capillaries.
- angiogenic molecule refers to any molecule having the ability to vascularize. As used herein, angiogenic molecules overlap the concept of cell growth factor.
- cell physiologically active substance or “physiologically active substance” refers to a substance that acts on cells or tissues. Such action Examples thereof include, but are not limited to, control and change of the cells or yarns and weaves.
- Physiologically active substances include site force-in and growth factors.
- the physiologically active substance may be naturally occurring or synthesized.
- the physiologically active substance may be one produced by a cell or one having a similar action, but one having a modified action.
- the physiologically active substance may be in the protein form or nucleic acid form or other forms, but at the time of actual action, the cell growth factor usually means the protein form.
- cell growth factor or “growth factor” is used interchangeably herein and refers to a substance that promotes or regulates cell growth. Growth factors are also referred to as growth factors or growth factors. Growth factors can be added to media in cell or tissue culture to replace the action of serum macromolecules. In addition to cell growth, many growth factors have been shown to function as regulators of sorting.
- site force-in is defined in the same manner as the broadest meaning used in the art, and refers to a physiologically active substance that is produced by cell force and acts on the same or different cells.
- Site force-in is generally a protein or polypeptide, and controls immune response, regulation of endocrine system, regulation of nervous system, antitumor action, antiviral action, regulation of cell proliferation, regulation of cell differentiation Etc.
- cytoforce-in can be in protein form or nucleic acid form or other form, but at the point of actual action, cytoforce-in usually means protein form.
- cell growth factors include interleukins, chemokines, hematopoietic factors such as colony stimulating factor, tumor necrosis factor, interferons, cell growth factor and the like.
- Typical cell growth factors include platelet-derived growth factor (PDGF), epidermal growth factor (EGF), fibroblast growth factor (FGF), hepatocyte growth factor (HGF), vascular endothelial growth factor ( And those having proliferative activity such as VEGF).
- PDGF platelet-derived growth factor
- EGF epidermal growth factor
- FGF fibroblast growth factor
- HGF hepatocyte growth factor
- VEGF vascular endothelial growth factor
- Physiologically active substances such as cytoforce-in and cell growth factors generally have a functional redundancy, so other names and functions (eg, cell adhesion activity or cell-substrate adhesion activity) Can be used in the present invention as long as it has the activity of the physiologically active substance used in the present invention.
- a cytodynamic force factor or growth factor is used in a preferred embodiment of the tissue piece or medicament of the present invention as long as it has a preferred activity herein (for example, an activity that attracts host cells). can do.
- cyto force-in and cell growth factor are used interchangeably in this specification unless otherwise specified.
- the cell growth factor of the present invention can be easily synthesized manually or by a conventional method using a commercially available peptide synthesizer. Large peptides can be produced by genetic engineering by conventional methods.
- the cell growth factor of the present invention can be locally administered to a tissue in which angiogenesis is desired, alone or in the form of an injection solution or the like dissolved in a physiological buffer.
- angiogenesis is promoted and healing of lung disorders is promoted.
- the peptide concentration in the peptide solution used for injection or application or spraying is not particularly limited, but is usually about 1 to: LO / z g (microgram) ZmL.
- the dose can be appropriately selected depending on the size and depth of the wound, but may be such that the entire wound is covered with the peptide solution.
- it can be administered once to several times every day to several days until the wound is healed.
- the injection solution may also contain various components that are usually contained in wound healing agents, such as other disinfectants and anti-inflammatory analgesics.
- carrier-free means that it is known as a carrier and does not contain a substance!
- the carrier includes gelatin.
- a cell growth factor can be effectively administered in a carrier-free manner. Rather, it has been thought that the activity is immediately lost.
- in vivo or “in vivo” refers to the inside of a living body.
- in vivo refers to the location where the target tissue or organ is to be placed. When screening is performed, in vivo screening can be performed.
- in vitro refers to the state in which a portion of a living organism has been removed or released "in vitro" (eg, in a test tube) for various research purposes. Say. A term that contrasts with in vivo. When screening, in vitro screening Can be performed.
- pharmaceutically acceptable carrier refers to a substance that is used in the manufacture of pharmaceuticals or veterinary drugs and does not adversely affect active ingredients.
- Such pharmaceutically acceptable carriers include, for example, antioxidants, preservatives, colorants, flavors, and diluents, emulsifiers, suspending agents, solvents, fillers, bulking agents, buffering agents, Examples include, but are not limited to, delivery vehicles, diluents, excipients, and Z or agricultural or pharmaceutical adjuvants.
- the present invention relates to use for producing a medicament for the treatment of pulmonary diseases.
- a preferred embodiment as a cell growth factor can be any form described herein.
- the pharmaceutically acceptable carrier contained in the medicament of the present invention includes any substance known in the art.
- Pharmaceutically acceptable carriers that can be used in the present invention include antioxidants, preservatives, colorants, flavors, and diluents, emulsifiers, suspending agents, solvents, fillers, bulking agents, buffering agents. , Delivery vehicles, diluents, excipients and Z or pharmaceutical adjuvants.
- a medicament of the present invention is administered in the form of a composition comprising a support and a peptide or variant thereof together with one or more physiologically acceptable carriers, excipients or diluents.
- a suitable vehicle can be water for injection, physiological solution, or artificial cerebrospinal fluid, which can be supplemented with other substances common to compositions for transplantation. .
- Exemplary suitable carriers include neutral buffered saline or saline mixed with serum albumin.
- the product is formulated as a lyophilizer using a suitable excipient (eg, sucrose).
- suitable excipient eg, sucrose
- Other standard carriers, rare Excipients and excipients may be included as desired.
- Other exemplary compositions include a Tris buffer at pH 7.0-8.5 or an acetate buffer at pH 4.0-5.5, which is sardine, sorbitol or a suitable substitute thereof. Can be included.
- Acceptable carriers, excipients or stabilizers used herein are non-toxic to the recipient and are preferably inert at the dosages and concentrations used.
- Acceptable carriers, excipients or stabilizers used herein are non-toxic to the recipient and are preferably inert at the dosages and concentrations used.
- Organic acids eg, ascorbic acid
- low molecular weight polypeptides e.g, proteins (eg, serum albumin, gelatin or immunoglobulin); hydrophilic Amino acids (eg glycine, glutamine, asparagine, arginine or lysine); monosaccharides, disaccharides and other carbohydrates (including glucose, mannose or dextrin); chelating agents (eg EDTA) ); Sugar alcohols (eg, mantol or sorbitol); Salt-forming counterions (eg sodium); and Z or non-ionic surfactants (eg Tween, pluronic or polyethylene glycol (PEG)).
- the peptide or variant thereof used in the medicament of the present invention is not limited to a force that is advantageously derived from a living body intended for treatment.
- a peptide having the same origin as the host or a variant thereof is considered advantageous because it is considered that there is almost no immune reaction or the like.
- the origin of the peptide or a variant thereof is not particularly limited because it is considered that an immune reaction usually does not occur if it is purified.
- the treatment method of the present invention may further include a step of administering a cell physiologically active substance.
- cell bioactive substances include granulocyte colony stimulating factor (GM-CSF), macrophage colony stimulating factor (M-CSF), granulocyte colony stimulating factor (G-CSF), multi-CSF (IL —3), leukemia inhibitory factor (LIF), c-kit ligand (SCF), immunoglobulin family (CD2, CD4, CD8) platelet-derived growth factor (PDGF), epidermal growth factor (EGF), fibroblast proliferation It can be selected from the group consisting of factor (FGF), hepatocyte growth factor (HGF) and vascular endothelial growth factor (VEGF), but is not limited thereto.
- GM-CSF granulocyte colony stimulating factor
- M-CSF macrophage colony stimulating factor
- G-CSF granulocyte colony stimulating factor
- IL —3 multi-CSF
- LIF leukemia inhibitory factor
- SCF c-
- the inhalation solution of the present invention is prepared as follows: (1) Fit a stainless steel compounding tank into the bottom discharge pipe and three mixers for mixing. (2) Fill a tank of USP (Purified Water) of approximately 95% of the required amount at a temperature of 1-8 ° C to 25 ° C. While mixing, add (3) US Pharmacopeia (USP) EDTA, hydrochloric acid, and at least a therapeutically effective amount of cell growth factor to the tank. (4) Continue mixing until all cell growth factors are melted. (5) If necessary, add the US Pharmacopoeia (USP) purified water to adjust the final volume and complete the cell growth factor preparation.
- USP US Pharmacopoeia
- Cell growth factor preparations are pumped directly from the preparation tank through a clean supply line to a Form One Fill Seal (FFS) machine.
- FFS Form One Fill Seal
- the cell growth factor preparation enters the storage tank through a 0.2 micron sterile cartridge filter and then passes through a second 0.2 micron sterile cartridge filter to the filling nozzle in the pre-sterilized air shower chamber.
- LDPE low density polyethylene
- Cell growth factor preparations are pre-sterilized and filled into bottles, each bottle containing a unit dose of a therapeutically effective amount of albuterol.
- the filled bottle is then sealed.
- FFS machines complete pre-sterilized products by forming, filling and sealing bottles in aseptic continuous operations. For example, a sheet of 5 pre-filled bottles may be wrapped up with an automatic packaging machine into a single protective laminate foil bag. Six to twelve such bags can then be packaged as a shelf carton to form a prepackaged treatment system for patient COPD treatment. Appropriate labels and instructions may be added in the shelf carton.
- the present invention is also directed to a method of forming a unit dose nebulizer solution comprising the following steps: (1) a combination comprising a therapeutically effective amount of albuterol and ipratobium bromide
- the drug is prepared in a pharmaceutically acceptable carrier.
- the preparation is suitable for spraying with a nebulizer.
- the present invention also comprises a device for use in alleviating symptoms associated with COPD.
- Such devices can take any other form, including labels, written instructions, and displays on the surface.
- This device is designed to treat patients suffering from symptoms associated with COPD at least one pre-packaged, pre-sterilized, pre-prepared, pre-measured and non-Z or BAC Inhalation solution containing May have an indication that can be treated.
- the inhalation solution is suitable for spraying with a nebulizer.
- the device also has a display that gives instructions on using the inhalation solution to treat the patient's symptoms! /!
- diagnosis refers to the identification of various parameters related to the type of disease, type and degree of disorder, physical condition, etc. in the subject, and the current state of such disease, disorder, or condition, Refers to drug response prediction, pathological change prediction or determination of cause.
- treatment refers to preventing a disease or disorder from being adversely affected, preferably maintaining the status quo, and more preferably, when a certain disease or disorder is brought into such a state. Preferably, it means to reduce, more preferably to reduce.
- prophylaxis refers to the treatment of a disease or disorder so that it does not occur before it is triggered. Say. Therefore, it includes prevention of such a state, delay, etc., and prevention of deterioration for a certain disease or disorder. It is understood that the method of the present invention can also be used for prevention because it regenerates lung tissue.
- treatment refers to any medical action performed on a disease, disorder or condition, and includes actions performed to contribute to diagnosis, treatment, prevention, prognosis, etc. .
- the procedure should be performed by a health professional with some national license, such as a doctor or nurse. It should be noted that the act itself is a “treatment” even if the act is detrimental to the patient's outcome and detrimental to the patient. is there.
- instructions describe the method of using the present invention or the method of diagnosis for a doctor, a person who administers a subject, a person who diagnoses (which may be the subject). It is a thing. Instructions can be attached to indicate how to use a diagnostic agent or the like provided as a kit. This instruction describes a word for instructing a procedure for administering the diagnostic agent or medicine of the present invention. This instruction is prepared in accordance with the format prescribed by the national supervisory authority (for example, the Ministry of Health, Labor and Welfare in Japan and the Food and Drug Administration (FD A) in the United States, etc. in the United States). It will be clearly stated that it has been approved. Instructions are so-called package inserts, usually paper media For example, in the form of an electronic medium (for example, a home page (web site), electronic mail, SMS, PDF document, etc. provided on the Internet). Can also be provided.
- an aerosol system in the form of a spray for example, an aerosol system without a propellant has been developed in which a container containing a propellant can be raised.
- the aerosol system contains the active ingredient together with conventional auxiliaries, for example the propellant is latatoses.
- Compositions composed of these components determine the properties of aerosol inhalants, such as particle size distribution, delivery rate, viscosity, and the like.
- Aerosols can be obtained as two-phase aerosols (gas and liquid) or three-phase aerosols (gas, liquid, and solid or liquid).
- a two-phase aerosol consists of a solution of the active substance dissolved in a liquefied propellant and an atomized propellant.
- the solvent includes, for example, a propellant or a mixture of a propellant and a co-solvent such as alcohol or propylene glycol.
- Polyethylene renders are often used to improve the solubility of active substances.
- a three-phase system includes a suspension or emulsion of one or more active ingredients, respectively, along with an atomized propellant.
- the suspension contains the active substance dispersed in the propellant system using conventional auxiliaries such as wetting agents and solid carriers such as Z or talc or colloidal silica. Where possible, propellants are well known and will not damage the ozone layer.
- V can contain carbohydrates.
- the cell growth factor for example, bFGF
- bFGF cell growth factor
- phosphatidylinositol phosphatidylserine, phosphatidylcholine, phosphatidic acid, cardiolipin and the like
- the use of ribosomes specifically configured in this way results in selective uptake by alveolar macrophages, increasing the specificity of the treatment and reducing the therapeutically effective dose associated with reduced side effects.
- vitamin E or (+)-a-tocopherol acetate, (shi) ⁇ -tocopherol acetate, ( ⁇ ) ⁇ -tocopherol succinate and other derivatives of vitamin ⁇ ⁇ may be included.
- the cell growth factors of the present invention can be administered in nucleic acid form.
- nucleic acid forms of cell growth factors can be administered in the form of aqueous solutions.
- gene therapy refers to treatment performed by administering to a subject an expressed or expressible nuclear acid.
- the nucleic acids produce their encoded protein, which mediates a therapeutic effect.
- screening means selecting a target such as an organism, a cell or a substance having a specific target property from a large number of populations using a specific operation Z evaluation method.
- the factors eg antibodies
- a library generated using an in silico system system using a computer
- compounds obtained by screening having a desired activity are also included in the scope of the present invention. It is understood.
- a screening hit can be confirmed by an assembly using a genetic technique.
- expression of a gene product such as a gene, polynucleotide, polypeptide, etc. means that the gene (usually DNA form) such as the gene (usually a DNA form) undergoes a certain action in vivo and takes another form.
- force such as gene, polynucleotide, and the like is transcribed and translated into a polypeptide form to be transcribed to produce mRNA, which can also be a form of expression.
- a polypeptide form may have undergone post-translational processing (eg, leader sequence excision).
- a gene "expressed specifically” means that the gene is different (preferably high) from another site or time in a specific site or time of an organism. It is expressed. “Specific expression” may be expressed only at a certain site (for example, a specific site such as an affected site) or at other sites. The expression specifically preferably means that it is expressed only at a certain site. Such specific expression can be realized by utilizing the characteristics of antigen-presenting cells. Therefore, screening for drugs for lung diseases can also be performed by confirming the specific expression of specific indicators.
- “detection” or “quantification” of gene expression is accomplished using appropriate methods including, for example, mRNA measurement and immunological measurement methods. Can be done. Examples of molecular biological measurement methods include Northern blot method, dot plot method, PCR method and the like. Examples of the immunological measurement method include ELISA, RIA, fluorescent antibody method, Western plot method, immunohistological staining method and the like using a microtiter plate as necessary. Examples of the quantification method include ELISA method and RIA method. It can also be performed by a gene analysis method using an array (eg, DNA array, protein array).
- an array eg, DNA array, protein array
- DNA arrays (Shujunsha, edited by Cell Engineering "DNA microarray and latest PCR method") Is widely outlined.
- the protein array is described in detail in Nat Genet. 2002 Dec; 32 Suppl: 526-32.
- gene expression analysis methods include, but are not limited to, RT-PCR, RACE method, SSCP method, immunoprecipitation method, two-hybrid system, and in vitro translation.
- Such further analysis methods are described in, for example, Genome Analysis Experimental Method ⁇ Yusuke Nakamura Lab's Manual, Editing 'Yusuke Nakamura Yodosha (2002), etc., and all the descriptions in this specification are for reference. Be used.
- expression level refers to the amount by which a polypeptide or mRNA is expressed in a target cell or the like. Such an expression level can be evaluated by any appropriate method including immunoassay methods such as ELISA, RIA, fluorescent antibody, western plot, and immunohistochemical staining using the antibody of the present invention.
- the expression level of the peptide at the mRNA level can be mentioned.
- “Change in expression level” means expression level at the protein level or mRNA level of the polypeptide of the present invention evaluated by any appropriate method including the immunological measurement method or molecular biological measurement method described above. Means increase or decrease.
- candidate compound refers to a candidate compound that can be used to treat a target disease or disorder.
- a compound can be referred to as a candidate compound if it is predicted to be effective for the disease or disorder of interest.
- compound species refers to a single compound having a desired property, such as having a specific target activity in a certain group of compounds. For example, if a compound is specified in a collection of compounds that modulate activity, such a compound may be referred to as a compound species. In this specification, it is also simply referred to as a compound.
- library refers to a certain collection of compounds for screening.
- a library may be a collection of compounds having similar properties or a collection of random compounds.
- Preferably, a set of compounds predicted to have similar properties is used, but not limited thereto.
- lung disease refers to the nature of any factor considered to be effective in the treatment or prevention of lung disease in the screening of the present invention.
- factor may be any substance or other element (for example, energy) as long as the intended purpose can be achieved.
- substances include, for example, proteins, polypeptides, oligopeptides, peptides, polynucleotides, oligonucleotides, nucleotides, nucleic acids (eg, DNA, DNA, genomic DNA, RNA, mRNA, etc.
- a specific factor for a polynucleotide is typically a polynucleotide that has complementarity with a certain sequence homology to the sequence of the polynucleotide (e.g., 70% or more sequence identity). Examples thereof include, but are not limited to, polypeptides such as transcription factors that bind to the promoter region.
- compound means any distinguishable chemical or molecule, including small molecules, peptides, proteins, sugars, nucleotides, or nucleic acids. Without being limited thereto, and such compounds can be natural or synthetic.
- the present invention provides a pharmaceutical composition for the treatment of pulmonary disease comprising a carrier-free cell growth factor.
- the cell growth factor is provided in any carrier-free form suitable for administration to lung tissue.
- the carrier is typically gelatin, and in the present invention, gelatin-free is preferably intended. Conventionally, it has been said that even if a cell growth factor is administered in a carrier-free manner, the effect is not exerted. This was invalidated in most organs or tissues.
- the composition is advantageously provided in a form that is not administered to tissues other than the lung.
- the present invention shows that pulmonary diseases that have been conventionally difficult to treat (particularly diseases such as COPD with destruction of lung tissue) can be cured by administering carrier-free cell growth factors. It is in the headline.
- the present invention is particularly targeted to the respiratory dysfunction associated with extensive lung tissue destruction among lung diseases, but is not limited thereto.
- COPD diseases include, but are not limited to, conditions after treatment of pulmonary fibrosis or emphysema.
- the cell growth factor used can include any factor.
- the cell growth factor used in the present invention is bFGF.
- the cell growth factor is preferably bFGF or a variant thereof comprising the sequence shown in SEQ ID NO: 2 and Z or 4 (SEQ ID NO: 2 is a longer bFGF and SEQ ID NO: 4 is a shorter bFGF).
- the cell growth factor used in the present invention may have the sequence set forth in acidic fibroblast growth factor (aFGF) (eg, SEQ ID NOs: 5 and 6).
- the carrier-free cell growth factor is provided in the form of a dry powder or an aqueous solution. Dry powder can be produced, for example, by freeze-drying.
- the lung diseases targeted by the present invention include COPD, pulmonary fibrosis and the like.
- the present invention is a system for the prevention or treatment of pulmonary tissue, comprising means for pulmonary administration, and carrier-free cell growth factor in a form suitable for pulmonary administration.
- a system comprising means for pulmonary administration, and carrier-free cell growth factor in a form suitable for pulmonary administration.
- a system may be in any form as long as it is a system that realizes pulmonary administration of a carrier-free cell growth factor.
- means for realizing such pulmonary administration include, but are not limited to, an inhaler and a bronchoscope.
- the carrier-free cell growth factor used can be used in any carrier-free form such as dry powder, aqueous solution, mist and the like.
- the cell growth factor is used in the form of a dry powder or an aqueous solution.
- preferred means for pulmonary administration in the system of the invention may include an inhalation device or a bronchoscope.
- the preferred means for pulmonary administration advantageously takes the form of allowing selective administration to the lung.
- Such selective administration involves the use of an inhalation device to spontaneously ventilate the patient in the form of a cell growth factor in the form of an aqueous solution, dry powder, mist, etc. Can be achieved by selective administration without effectively returning, or by inserting a force tail through the side hole of the bronchoscope and spraying the target bronchus through the catheter while visually confirming.
- the cell growth factor is selected using a bronchoscope.
- the disease targeted by the system of the present invention can also take any form used in the above-described pharmaceutical composition of the present invention.
- the present invention provides a pharmaceutical composition for regeneration of lung tissue.
- This pharmaceutical composition comprises a carrier-free cell growth factor. It has not been known that lung tissue can be regenerated by administering a carrier-free cell growth factor to the lung in vivo. Therefore, the present invention has a powerful and special effect that cannot be achieved conventionally. It is understood that Therefore, it should be understood that the present invention is used not only for pulmonary treatment but also for improving functions such as prevention from lung diseases and rejuvenation. Even though it is carrier-free, the effect is similar to that of gelatin, so the possibility of side effects is dramatically reduced, and the force is also effective in achieving a therapeutic or preventive effect. Is played.
- the carrier-free cell growth factor used in the composition of the invention is present in a concentration effective for lung cell growth.
- concentrations can be easily determined by in vitro experiments. Examples of such experiments include, but are not limited to, a method of confirming bFGF labeled with a radioactive isotope (eg, I 125 ) by scintigram. It is advantageous to use a clinical scintillogram. It is also the ability to confirm with large animals such as Inu.
- the carrier-free cell growth factor contained in the composition for lung regeneration of the present invention also takes any form used in the pharmaceutical composition of the present invention described above. It is understood that
- the pulmonary state targeted by the composition for lung regeneration of the present invention is also the above-mentioned medical treatment of the present invention. It is understood that any form used in the pharmaceutical composition can be taken, and in addition to this, a healthy lung, a lung that has not been diagnosed with a disease but has a decreased function, etc. .
- pulmonary administration can take any form used in the above-described treatment system of the present invention.
- the carrier-free cell growth factor contained in the system for lung regeneration of the present invention may also take any form used in the pharmaceutical composition of the present invention described above. It is understood that it can be done.
- the pulmonary condition targeted by the system for lung regeneration of the present invention can also take any form used in the above-described pharmaceutical composition of the present invention, and in addition to this, a healthy state can be taken. It is understood that lungs, lungs that have not been diagnosed with disease, but that have been found to be impaired, are included.
- the present invention is a method for treating lung thread and tissue, comprising the step of (a) administering a carrier-free cell growth factor to the lung tissue to be treated. Provide a method.
- carrier-free cell growth factor can take any form used in the pharmaceutical composition of the present invention described above.
- the carrier-free cell growth factor used is selectively administered to lung tissue.
- Such selective administration is preferably accomplished using means described as preferred means for pulmonary administration in the system of the present invention (eg inhalation device or bronchoscope). Therefore, more preferably, the cell growth factor is not substantially administered except for lung tissue. This is because when a carrier-free cell growth factor other than lung tissue is administered, an unexpected event may occur, which may occur as a side effect.
- the present invention provides a method for regenerating lung thread and tissue, the method comprising (a) administering a carrier-free cell growth factor to lung tissue. provide.
- pulmonary administration can take any form used in the above-described treatment system of the present invention.
- the carrier-free cell growth factor contained in the system for lung regeneration of the present invention may also take any form used in the pharmaceutical composition of the present invention described above. It is understood that it can be done.
- the carrier-free cell growth factor used is selectively administered to lung tissue.
- Such selective administration is preferably accomplished using means described as preferred means for pulmonary administration in the system of the present invention (eg inhalation device or bronchoscope). Therefore, more preferably, the cell growth factor is not substantially administered except for lung tissue. This is because if a cell growth factor is administered to other than lung tissue, an unexpected event may occur, which may occur as a side effect.
- the present invention provides a method for screening a substance for the treatment of pulmonary thread and tissue, the method comprising the following steps: A) Providing a pulmonary administration system suitable for pulmonary administration B) administering the candidate compound to the subject using the pulmonary administration system; and C) when the subject is cured, the candidate compound is a substance for treating the lung tissue. Determining that it is an indicator of something.
- the pulmonary administration system refers to any system capable of allowing the carrier-free cell growth factor of the present invention to reach the lung.
- a pulmonary administration system include an inhaler or a bronchoscope.
- a bronchoscope system commercially available from Olympus Corporation can be used.
- the candidate compound used in the present invention is selected from the group consisting of proteins, nucleic acids, lipids, sugars, small organic molecules, and combinations thereof.
- the candidate compound comprises a cell growth factor.
- Such cell growth factors may be modified.
- the healing of the subject can be determined using, for example, a spy mouth test.
- the present invention provides a system for screening substances for the treatment of lung tissue, the system comprising: A) a pulmonary administration system suitable for pulmonary administration; and B And a means for determining that the candidate compound is a substance for treating the lung thread and tissue when the subject is cured by administering the candidate compound.
- the pulmonary administration system can take any form described in the method for screening a substance for the treatment of pulmonary tissue.
- the determination unit further includes a recording medium storing known information related to the healing of lung tissue.
- known information can be used when calculating the determination result.
- known information may be stored by an individual who may obtain database power.
- the present invention provides a method for screening a substance for regeneration of lung yarn and tissue, the method comprising the following steps: A) Providing a pulmonary administration system suitable for pulmonary administration B) a step of administering the candidate compound to the subject using the pulmonary administration system; and C) when lung cells are regenerated in the subject, the candidate compound is Providing a method comprising: determining that the substance is a material for regeneration.
- the pulmonary administration system refers to any system capable of allowing the cell growth factor of the present invention to reach the lung.
- a pulmonary administration system in principle, those described in the method for screening a substance for the treatment of pulmonary tissue can be used, but another form suitable for regeneration may be used.
- the candidate compound used in the present invention is selected from the group consisting of proteins, nucleic acids, lipids, sugars, small organic molecules, and combinations thereof.
- the candidate compound comprises a cell growth factor.
- Such cell growth factors may be modified. The healing of the subject can be determined using, for example, a spy mouth test.
- the present invention provides a system for screening a substance for regeneration of lung yarn and tissue, the system comprising: A) a pulmonary administration system suitable for pulmonary administration; And B) when the candidate compound is administered and the lung cells in the subject regenerate, the candidate Means for determining that the compound is an indicator that the compound is a substance for regeneration of the lung tissue.
- the pulmonary administration system can take any form described in the method for screening a substance for the treatment of pulmonary tissue.
- the determination means further includes a recording medium storing known information related to regeneration of lung tissue.
- known information can be used when calculating the determination result.
- known information may be stored by an individual who may obtain database power.
- the present invention relates to the use of carrier-free cell growth factor in the preparation of a pharmaceutical composition for the treatment of pulmonary diseases.
- the present invention relates to the use of a carrier-free cell growth factor in the preparation of a pharmaceutical composition for regeneration of lung tissue.
- the present invention relates to the use of a pulmonary administration system in the screening of pharmaceutical compositions for the treatment of pulmonary tissue.
- the present invention relates to the use of a pulmonary administration system in screening a pharmaceutical composition for regeneration of lung tissue.
- the present invention provides a device for treating a pulmonary disease, comprising an administration means for supplying a drug (eg, carrier-free cell growth factor) to a patient.
- a drug eg, carrier-free cell growth factor
- the treatment device of the present invention is for communicating a proximal end, a distal end, a drug channel for communication with a drug supply container, and a compressed air supply.
- a catheter tube having a compressed air channel; an injection orifice disposed at the distal end of the catheter;
- the drug provided by the drug source is mixed with the compressed air provided through the compressed air channel so that the injection orifice The spray is sprayed.
- the device of the present invention further comprises a drug supply container containing a drug (eg, a cell growth factor).
- a drug eg, a cell growth factor
- any drug supply container can be used. Examples of such containers include, but are not limited to, syringes and tubes.
- the device of the present invention further comprises a compressed air supply.
- a compressed air supply machine include a compressor, a pump (for example, a blower pump), a compressed air (such as a tank containing compressed air) in an operating field, and an oxygen cylinder. It is not limited to. In the presently preferred embodiment, it is preferred to utilize compressed air in the operating field. Or if you want home therapy, you can use oxygen cylinders.
- the cell growth factor present in the device of the invention is advantageously present as an aqueous solution. If it is an aqueous solution, it is easy to prepare, dramatically reduces the possibility of cerebral thrombosis, has few side effects, is easy to administer, dramatically reduces stress on the patient, and uses a nebulizer. To the periphery, sufficient diffusion, no agglomeration when using the carrier, and therefore not staying in the middle of delivery (thus reducing side effects), adsorbed in the central airway Effects such as difficulty can be achieved.
- Basic fibroblast growth factor human basic fibroblast growth factor, available from Kaken Pharmaceutical Co., Ltd.
- radioisotope Iodine- 125 Radionuclide (catalog number; NEZ033), Perkin Elma Japan Co., Ltd. (Perkin) — Elmer Japan), Yokohama, Kanagawa, Japan
- bFG F used was a mixture of an aqueous solution and gelatin.
- the gelatin mixture used was a mixture of 200 ⁇ g of basic fibroblast growth factor in gelatin microparticles (available from Kaken Pharmaceutical, Tokyo, Japan) and stirred in 5 ml of physiological saline.
- Residual rate (%) radioactivity value of lung tissue.
- the following table shows the change in radioactivity when the residual radioactivity after administration is defined as 100.
- the lower column shows the logarithm of common logarithm with 1 after administration (0 after conversion).
- Fibroblast growth factor (gelatin particles)
- Fibroblast growth factor (aqueous solution)
- fibroblast growth factor When fibroblast growth factor is administered via airway, radioactivity is observed at 30% or more after 1 day and even after 3 days. In other words, it is an experimental result that basic fibroblast growth factor administered via the respiratory tract can remain around the administration site for about 72 hours.
- Porcine spleen elastase 50mg (375 0 units) (anesthetic elastase, trade name "Elastase”, Nacalai Testa, Kyoto, Japan) was dissolved in 5ml of physiological saline and spray catheter (Olympus Corporation, Tokyo, Japan, “Fog catheter”, product number “PW-6C-1” was taken to the peripheral bronchus, and divided into 10 times and spread over the entire left lung.
- the right lung was compared with the normal lung (Fig. 11), and Fig. 2 shows an enlarged photograph of the lung in a severe emphysema model (40 mg administration).
- a model of pulmonary emphysema was prepared by administering elastase to a beagle dog (weight approximately 10 kg) via the respiratory tract.
- elastase For dogs, perform endotracheal intubation, transbronchially using bronchial fibers, and transfused tubes almost uniformly with porcine spleen elastase aqueous solution and bFGF aqueous solution only in the left lung, A) to C ).
- the right side of the opposite side was saved as a normal control.
- Porcine spleen elastase 10 mg, 20 mg and 40 mg were each diluted in 10 ml aqueous solution and administered to 2 animals each.
- the left lung became emphysema 4 weeks after the administration, both in correlation with the dose.
- CT lung computed tomography
- bFGF200 / zg was diluted in a 10 ml aqueous solution, and a total of 1 mg was administered to one animal by the above method for 5 consecutive days.
- CT examinations showed that emphysema improved as compared to FGF administration (Fig. 3), and histological examination after sacrifice (4 ml after bFGF administration) revealed that both microscopically and macroscopically.
- the emphysema was significantly weaker in the oral cavity compared to the 40 mg group in the above group A).
- a mixture of basic fibroblast growth factor 200 ⁇ g in gelatin microparticles (available from Kaken Pharmaceutical, Tokyo, Japan) is agitated in 5 ml of physiological saline and applied to chronic obstructive pulmonary disease model lung, bronchoscope was used to spread the entire left lung 10 times in a diffuse manner.
- bronchoscope was used to spread the entire left lung 10 times in a diffuse manner.
- Various investigations were conducted in the same manner as in A) to C) above to see changes before and after treatment with basic fibroblast growth factor.
- FIG. 4 shows the therapeutic effect comparing the bFGF aqueous solution administration group and the non-administration group (lung volume assessment). From left, normal dogs, emphysema dogs, and after treatment are shown. Each group shows the non-administration group on the left side and the administration group on the right side.
- Fig. 5 shows the therapeutic effect comparing the bFGF gelatin particle solution administration group and the non-administration group (lung volume assessment). From left, normal dogs, emphysema dogs, and after treatment are shown. Each group shows the non-administration group on the left side and the administration group on the right side.
- Arterial blood gas analysis was performed under general respiratory conditions with a mechanical ventilator after general anesthesia of the beagle dog. Breathing conditions are: tidal volume 18mlZkg, respiratory rate 10Zmin, partial pressure of oxygen during inhalation 0.2 (oxygen: 1L, laughter: 4L), inspiratory time: expiration time 1: 2, after ventilator installation 20 Arterial blood was collected after a minute.
- oxygen in the arterial blood in the basic fibroblast growth factor treated model dog treated with basic fibroblast growth factor The partial pressure increased to 98. OmmHg and was improved. In the group treated with aqueous solution, the partial pressure of oxygen did not improve to 84.6 mmHg in the non-basic fibroblast growth factor treatment model dog that had been treated with basic fibroblast growth factor (Fig. 6).
- beagle dogs are anesthetized and then taken in the supine position.
- a venous route is secured in the right internal carotid artery and a general commercially available contrast medium is injected
- blood vessels in the lung are imaged approximately 3 seconds later, and the MRI signal value increases due to the contrast effect. Since the MRI signal value is proportional to the blood flow volume, the signal value is higher at the site where the blood flow volume is higher. Since there are individual differences in blood flow in the pulmonary artery, we compared the left and right left lungs with the right and left ratios of the MRI signal that passed through the normal right lung.
- MRI imaging was started after injection of 3 ml of a commercially available contrast medium.
- Example 4 screening
- the beagle dog model prepared in Example 2 is used to screen for compounds for the treatment of lung diseases and compounds for regeneration of lung tissue.
- Screening is performed in the same manner as in Example 3, except that a library of candidate compounds to be screened is used instead of basic fibroblast growth factor.
- elastase derived from porcine spleen was dissolved in 5 ml of physiological saline in 5 ml of physiological saline and sprayed to the peripheral bronchial periphery using a spray tube under bronchoscopy.
- a left lung unilateral emphysema model was created. 28 days later, blood gas measurement, respiratory function measurement, and left and right ratio of lung parenchyma signal intensity in Dynamic contrast enhanced MRI were performed. Divided into control group and bFGF treatment group. Respiratory administration of 5 ml of normal saline was performed.
- bFGF200 / zg was dissolved in 5 ml of physiological saline and administered via the respiratory tract. 28 days after the final administration of bFGF, blood gas measurement, respiratory function measurement, MRI lung parenchymal signal intensity left / right ratio were performed and compared between the control group and the treatment group.
- Figure 17 shows the lungs before and after treatment.
- Trans-respiratory administration of bFGF showed improved blood flow in the damaged lung parenchyma in the model of elastase emphysema.
- HGF uses a product sold by Toyobo.
- the emphysema model is randomly divided into two groups.
- the treatment group is a model group in which 50 ⁇ g of HGF is treated with gelatin microspheres by sustained airway release.
- the model group that is sustainedly airway-released only with gelatin microspheres is the non-treatment group.
- the breathing function is evaluated by blood gas analysis, snorometry, and MRI. Sacrifice 7 days after functional evaluation and perform histological evaluation.
- HGF like bFGF, is shown to cure lung disease.
- Example 7 Effect of regeneration of lung tissue
- FGF FGF
- voxel size 1.3 X ⁇ . 2 X 20. 0 mm.
- a central venous route was secured from the external carotid artery, and 3 ml of gadolinium contrast medium was administered for 1 second. Over the course of 60 seconds, 170 coronal cuts were taken.
- Figs. 24 and 25 show continuous photographs.
- An Omm diameter endotracheal intubation tube was inserted into the trachea using a bronchoscope and connected to a mechanical ventilator. Continuous monitoring was performed to measure the electrocardiogram, oxygen saturation (measured by reflected oxygen measurement using a sensor clipped to the ear), and body temperature (intrarectal probe).
- a bronchoscope (outer diameter 5 mm, working length 60 cm) was introduced through the indwelling endotracheal tube to advance the left bronchus.
- Porcine spleen elastase 50mg (3750 units) (anesthetic elastase, trade name “Elastase”, Nacalai Testa, Kyoto, Japan) is dissolved in 5 ml of physiological saline and spray catheter (Olympus Corporation, Tokyo, Japan, “Spray” Catheter “, product number” PW-6C-1) was taken to the peripheral bronchus and spread over the left lung in 10 divided portions. 28 days after spraying, the COPD model lung (200 mg in total) was used. Comparison was made by considering the right lung as a normal lung.
- Lung function and MRI were assessed before elastase administration (baseline), 4 weeks after elastase administration, and 4 weeks after treatment.
- Inu was anesthetized, intubated, and maintained under 3.0% halothane.
- the respiration frequency was set at 2 Z.
- the inspiratory time was set at 33% of the breathing period and FiO was 0.2.
- An arterial blood gas sample was taken from the right femoral artery 15 minutes after mechanical ventilation.
- ABL-620 blood gas and acid-base analyzer (Radiometer, Copenhagen, Denmark) was used.
- the PV relationship and respiratory volume were also measured by general anesthesia and intubation.
- the tracheal lumen is inflated to various pressures (5 cmH 2 O to 70 cmH 2 O), then the endotracheal tube
- Plethymus graph blood volume meter (HI-701 Nihon Kohden, Toky o, Japan) connected to the endobronchial tube, released the clamp, and then measured the respiratory volume. Until the pressure reached 40 cmH 0 (respiratory volume 40) Breathing when the bronchial lumen is inflated
- the vessel capacity was used for the calculation.
- FGF-2 treatment In this example, a bronchial test was performed under general anesthesia. Human recombinant FGF-2 was obtained from Kaken Pharmaceutical (Tokyo, Japan). In the FGF (+) group, 400 g of FGF-2 was dissolved in 10 mL of saline, which was divided into 20 bronchial segments of the entire lung using 20 divided doses in different areas using a nebulization infusion catheter. Sprayed on. The mechanical aeration was continued for at least 2 hours while keeping Inu in a supine position and extubated. A second spray of 400 g FGF-2 was given to the whole lung 4 days later.
- a third spray of 400 ⁇ g FGF-2 was applied to the entire lung 8 days later with a first spray force.
- a total of 1200 ⁇ g of FGF-2 was administered per dog in the FGF (+) group.
- the FGF ( ⁇ ) group was sprayed with 10 mL of saline without FGF-2 using the same procedure.
- each group was killed by injection of pentobarbital thorium.
- Lung tissue and heart were excised together with the bronchi.
- Heart and mediastinal tissue were removed and lungs were weighed along with bronchi.
- Data are expressed as mean and standard deviation (SD). Data is from StatView for Win Analysis was performed by analysis of variance (AN OVA) using dows (registered trademark) version 5.0 (SAS Institute Inc., Cary, NC). Differences between groups were identified by Scheffe test. P values less than 0.05 were considered statistically significant.
- FGF ( ⁇ ) group 11.56 ⁇ 2.2 kg
- FGF (+) group 10.8 ⁇ 1.6 kg
- body weight There was no significant difference in body weight between after elastase administration and after treatment (FGF (-), after 200 mg elastase administration: 11.02 ⁇ 2.1 kg, after treatment: 10.76 ⁇ 2.1 kg; +) After administration of 200 mg elastase: 10.74 ⁇ 1.3, after treatment: 10.66 ⁇ l.lkg]).
- FGF-2 administration there were no signs of serious side effects. This includes thrombocytopenia, anemia or renal failure.
- FIG. 25A Arterial blood partial pressure (PaO) data is shown in Fig. 25A. Baseline and 2 after elastase administration
- the PV curve shifted upward relative to the baseline.
- the upward transfer rate was dependent on the dose of elastase.
- the curve of the FGF (—) group continued to shift upward (FGF ( ⁇ ), baseline: 0.92 ⁇ 0.16 L, 50 mg elastase After treatment: 0.97 ⁇ 0.14 L, after lOOmg elastase treatment: 1.03 ⁇ After 0.16 L, 200 mg elastase treatment: 1.09 ⁇ 0.12 L, after treatment: 1.11 ⁇ 0.14 L]
- FGF (+) group it was shifted downward [FGF (+), baseline: 0.90 ⁇ After 0.18L, 50mg elastase treatment: 0.91 ⁇ 0.18 L , after lOOmg elastase treatment: 0.95 ⁇ 0.20 L, after 200 mg elastase treatment: 1.08 ⁇ 0.22 L, after treatment: 0.97 ⁇ 0.20 L] ( Figure 25B).
- Emphysema Bronchopulmonary Volume Reduction develops quietly and less invasively. Because lung volume reduction surgery (LVRS) is also a force with a high mortality rate of 5% to 10%. LVRS refers to the removal of emphysematous overinflated lungs. This allows the remaining emphysema and respiratory muscles to function more efficiently.
- a US Nationala 1 Emphysema Treatment Trial report (NEJM 2003; 348: 2134- 2136) states that LVRS can be effective only in a few patients with severe emphysema. This is because the mortality rate of many emphysema patients shows a statistically significant increase.
- the overall survival rate of LVRS was a force that provided no significant benefits other than functions such as improving exercise quality and health-related quality of life.
- the bronchoscopic approach which replaces the surgical approach, has been reported to be less invasive and has a variety of artificial materials.
- the BLVR valve method is used!
- BLVR valve transplantation has been performed safely and effectively with reduced volume. This procedure was accompanied by serious complications. Complications included pneumothorax, pneumonia, and bleeding. The technique of valve replacement surgery is very difficult to place accurately. Due to the contraction of emphysematous [intraalveolar] cysts (bra), a completely sealed condition is required and skilled skills are required where collapse can occur. Where collapse can occur, retained secretions and artificial materials are the forces that can cause post-operative infection.
- Fibroblast growth factor (FGF-2) is one of the most powerful angiogenic growth factors and has been evaluated as a factor for promoting angiogenesis. FGF-2 can provide a physiologically favorable blood supply and pulmonary blood flow. It diffuses microvascular abnormalities and improves peripheral parenchymal ischemia. Improvement in lung function was statistically significant. In particular, recovery of pulmonary blood flow induced a recovery of 0 arterial blood pressure. this
- BLVR with FGF-2 does not require skilled skills and can be performed iteratively if volume reduction effects are inappropriate. Furthermore, FGF-2 fibril formation may reduce the risk of BLVR pneumothorax complications. There are no serious complications such as infections, atelectase, allergies, and bleeding after administration of FGF-2 in the study in this example.
- the non-operative BLVR system based on FGF-2 is A safe BLVR using -2 will be provided.
- BLVR with FGF-2 provides volume reduction in areas that are over-swelled by fibrosis and improves pulmonary peripheral ischemia with FGF-2 angiogenesis. Thus, this study demonstrated that lung function was restored. Treatment with endobronchial FG F-2 can also use a nebulizer to make it completely non-invasive.
- FGF-2 treatment resulted in a volumetric phenomenon in the affected lung, resulting in an improvement in blood flow, followed by an improvement in alveolar gas pressure. Since oxygen uptake into the bloodstream depends on the presence of differences in alveolar and capillary oxygen partial pressure (ie, AaDO), these
- the FGF-2 based BLVR system provides a safe BLVR, does not require skilled skills without the FGF-2 needle, and iteratively, the efficiency of dose phenomena is inadequate It can be performed iteratively.
- a simple bronchoscopic approach can selectively reduce emphysematous parenchyma, and intrabronchial administration of FGF-2 induces a significant increase in pulmonary blood flow and induces recovery of lung function I was able to. Such a thing was impossible with the conventional technique, and a remarkable example is noted.
- Mannino DM Chronic obstructive pulmonary disease: Definition and Epidemiology. RespirCare. 2003; 48: 1185-1191.
- Venuta F Venuta F, Giacomo TD, Rendina EA, Ciccone AM, Diso D, Perrone A, Parola D, Ani le M, Coloni GF. Bronchoscopic lung-volume reduction with one-way valves in patie ntswith heterogenous emphysema Ann Thorac Surg 2005; 79: 411-417.
- a drug administration system that can perform pulmonary administration accurately. This means can be inserted from the side of the bronchoscope and a channel is provided on the side to mix the drug and air.
- Cell growth factors were found to be effective for lung regeneration as demonstrated in the above examples, but cell growth factors may also have side effects such as carcinogenicity or metastasis promoting properties. Therefore, its administration should be performed accurately. Most conventional bronchoscopes cannot be used with accuracy and accuracy.
- a catheter-type air spray was prepared.
- This catheter may be a commercially available one or self-made.
- the clinician it is preferable that the clinician have a structure that can be connected to the side channel of the bronchoscope.
- Figure 26 shows such an example.
- bronchoscope for example, OLYMPUS force can be used.
- OLYMPUS force can be used as a bronchoscope.
- the advantage of bronchoscopes is that the clinician can accurately place the air sprayed spot in the lung while observing the bronchi. In this way, it is possible to accurately administer the cell growth factor whose location to be administered should be accurately determined.
- the administration device of the present invention comprises a drug channel (106) for communicating with a proximal end (102), a distal end (104), a drug supply container (122), and a compressed air supply (132).
- Compressed air channel (108) and nP paper for communication (Rule 91)
- the drug provided by the drug source (122) is mixed with the compressed air provided through the compressed air channel (108), so that In the injection orifice (112), the medicine is sprayed.
- This catheter can be attached to a bronchoscope.
- a drug set including a drug such as bFGF is a powder (powder such as bFGF) and a solution in which the amount and concentration of the drug (such as bFGF) are determined according to the content. It consists of a set of a separate solution container and an injector. The drug solution can be mixed at the time of use and placed in the syringe (see the lower right in Fig. 26).
- This device is administered directly via the airway or orally via a device and catheter that is administered directly orally.
- This device includes a pulmonary administration system or inhalation device in a broad sense of inhalation phase, a one-way valve for use of a drug (eg, bFGF) and its automatic opening and closing system.
- Such a configuration is suitable for the accurate administration of drugs to be administered into the lung, such as cell growth factors.
- drugs to be administered into the lung such as cell growth factors.
- Conventional nebulizers that generate mist for inhalation have a high risk of side effects due to adsorption to the oral mucosa. Therefore, a device using a bronchoscope as shown in this example has an effect of reducing such side effects.
- a drug eg, a cell growth factor
- a device as exemplified in this example, a drug (eg, a cell growth factor) to be administered only to the site to be treated is accurately administered.
- the cell growth factor can be easily administered even in the form of an aqueous solution.
- a clinician preferably observes the trachea while pinching the drug to a site to be treated (such as an affected site), preferably in real time. Can now be administered to points.
- a bronchoscope is usually provided with a lateral channel, and a catheter-type administration device as exemplified in this embodiment is attached to this channel.
- the dosing device is provided with at least two channels, one of which can be connected to a drug supply container and the other of which can be connected to a compressed air supply.
- the catheter-type device of the present invention can be made disposable, but is not limited thereto.
- a polymer material such as polypropylene can be used!
- the device of the present invention communicates with a compressed air supply (air compressor; 132) through a compressed air channel (108) provided near the proximal end.
- a compressed air supply air compressor; 132
- compressed air channel 108
- the tip opens and the air or any material in the catheter is ejected as a jet stream, and when the catheter is placed in the bronchus or lungs by a bronchoscope, its location Accurately delivered.
- the administration device of the present invention includes a communication between a drug channel (106) for communication with a drug supply container (122) and a compressed air supply (132). It has at least two channels, the compressed air channel (108) for When the drug and air are mixed at the tip of the catheter, a jet is formed.
- the drug When the drug is loaded into the dosing system, it may be in the form of an aqueous solution or other forms such as a powder such as a gelatin conjugate.
- COPD is treated as described in Example 5, a cell growth factor such as basic fibroblast growth factor is administered as the drug.
- the air is preferably compressed at the same time.
- a one-way valve or the like can be used so that the drug does not regurgitate proximally of the catheter.
- the catheter contacts the drug supply container and the compressed air supply. Configured to be followed.
- Figure 27A describes the first stop method.
- Figure 27B also shows the back stop method.
- FIG. 27 shows a schematic diagram of the administration device of the present invention when controlling using an electric circuit. As shown, the drug and compressed air can be controlled separately.
- FIG. 28 shows a detailed description of the proximal end of the catheter.
- the catheter of the present invention is connected to a compressed air supply device (air compressor) and a syringe as a drug supply container.
- the proximal end can act as a drug channel for communication with the drug delivery container! ,.
- Figure 29A shows a stop-on type.
- Figure 29B shows the back stop method.
- the clinician can accurately administer the drug to the lung or bronchus.
- the administration system of the present invention is particularly useful when the cell growth factor is accurately administered to an affected site (eg, lung).
- FIG. 1 An overall view of such an apparatus is shown in FIG.
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