WO2006034643A1 - Composition a base de medicament chinois traditionnel presentant une activite anti-vih, sa preparation et son utilisation - Google Patents

Composition a base de medicament chinois traditionnel presentant une activite anti-vih, sa preparation et son utilisation Download PDF

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Publication number
WO2006034643A1
WO2006034643A1 PCT/CN2005/001579 CN2005001579W WO2006034643A1 WO 2006034643 A1 WO2006034643 A1 WO 2006034643A1 CN 2005001579 W CN2005001579 W CN 2005001579W WO 2006034643 A1 WO2006034643 A1 WO 2006034643A1
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Prior art keywords
powder
weight
parts
pharmaceutical composition
diafiltration
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PCT/CN2005/001579
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English (en)
French (fr)
Inventor
Zelin Li
Yue Zeng
Yi Zeng
Yan Tsang
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Beijing Century Health Medical & Pharmaceutical Development Ltd
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Priority to JP2007533855A priority Critical patent/JP2008514654A/ja
Priority to KR1020077007258A priority patent/KR101256238B1/ko
Publication of WO2006034643A1 publication Critical patent/WO2006034643A1/zh
Priority to US11/715,302 priority patent/US20090011052A1/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/06Fungi, e.g. yeasts
    • A61K36/062Ascomycota
    • A61K36/066Clavicipitaceae
    • A61K36/068Cordyceps
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/25Araliaceae (Ginseng family), e.g. ivy, aralia, schefflera or tetrapanax
    • A61K36/258Panax (ginseng)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/53Lamiaceae or Labiatae (Mint family), e.g. thyme, rosemary or lavender
    • A61K36/539Scutellaria (skullcap)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K36/00Medicinal preparations of undetermined constitution containing material from algae, lichens, fungi or plants, or derivatives thereof, e.g. traditional herbal medicines
    • A61K36/18Magnoliophyta (angiosperms)
    • A61K36/185Magnoliopsida (dicotyledons)
    • A61K36/74Rubiaceae (Madder family)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/12Antivirals
    • A61P31/14Antivirals for RNA viruses
    • A61P31/18Antivirals for RNA viruses for HIV

Definitions

  • the present invention relates to a pharmaceutical composition
  • a pharmaceutical composition comprising astragalus extract powder, valerian extract powder, ginsenoside powder and cordyceps powder.
  • the invention further relates to a process for the preparation of said S J pharmaceutical composition and to the use of said medicament for the treatment of AIDS. Background technique
  • Astragalus is a heat-clearing and dampening agent. It is the root of Srfe/to 'a 6az'cfl/e Geor, a plant of the Labiatae family. It mainly contains flavonoids, mainly for anti-inflammatory, anti-allergic, anti-pathogenic microorganisms, antipyretic. And detoxification and other effects. Valerian, also known as ⁇ root, blood see ⁇ , blood grass, ⁇ ? ⁇ ⁇ ; ⁇ The dry and rhizome, the main components of valerian are fat-soluble components, reducing quinones and their glycocalyx and water-soluble components, cyclohexyl peptides, and are also rich in calcium ions, etc.
  • Ginseng root is sweet, slightly bitter, 'sexual temperature, has the effect of regulating qi and nourishing blood, soothing the nerves, relieving cough, nourishing and strengthening the body. It is known as the "king of the grass”. It has been the preferred medicine for conditioning the body in China since ancient times.
  • Cordyceps sinensis is a subfamily of Cordyceps sinensis (Berk) Sacc and its host bat, although the insect worm worm is a complex of larvae of Hepialus armoricanus devisthur.
  • Cordyceps sinensis contains crude protein, fat, crude fiber, carbohydrate, ash, cordycepic acid, cordyceps, cordyceps polysaccharides, nucleosides, peptides, eicosane, etc., mainly beneficial to strong aphrodisiac, Fuzheng Yiqi, Bushen Pingchuan, strong It has the effect of prolonging the years, as well as anti-inflammatory, anti-arrhythmia and anti-tumor effects.
  • ginseng can improve the physical and intellectual activity of animals and humans, and can enhance the body's non-specific resistance to various harmful stimuli. It has no side effects on normal physiological functions and no side effects at therapeutic doses. Harmful systemic strong medicine.
  • ginsenosides such as Rbl, Rb2, Rb3, Rc, Rd, Re, which play a role in ginseng. , Rg, Rhl, Rh2, F2, and ginseng ⁇ F l, RTs and American ginseng saponin LI, etc.
  • the pharmacological studies of these ginsenosides mainly include: anti-aging effects, enhancing immune function, lowering blood lipids, and S Some changes in the heart and blood vessels. But so far, there is no disclosure about ginseng, ginseng extract or any kind of ginsenosides that can treat AIDS.
  • HIV human acquired immunodeficiency syndrome
  • Formulations such as AZT, DDC, DDI, etc., and viral protease inhibitors, the latter approved five drugs in the US FDA, namely saquinavir, ritonavir, and sulphate Indinavir sulfate, nefmavir, etc.
  • HAART high-resistance antiretroviral therapy
  • the present inventors have found that a pharmaceutical composition containing astragalus extract powder, valerian extract powder, ginseng saponin powder and cordyceps sinensis powder has an obvious effect of treating AIDS.
  • one aspect of the present invention relates to a pharmaceutical composition
  • a pharmaceutical composition comprising xanthine extract powder, valerian extract powder, ginsenoside powder, and cordyceps powder
  • the content of the yellow extract powder is in a range of 100 parts of the composition. 10 to 30 parts by weight
  • the content of the psyllium extract powder is 10 to 25 parts by weight
  • the content of the ginsenoside powder is in the range of 18 to 25 parts by weight
  • the content of the cordyceps sinensis powder is in the range of 30 to 55 parts by weight.
  • the content of the astragalus extract powder is 18 parts by weight
  • the content of the valerian extract powder is 17 parts by weight
  • the content of the ginseng saponin powder is 18 parts by weight.
  • the content of the Cordyceps sinensis powder is 47 parts by weight.
  • the extract powder is an alcohol extract powder, and may be any extract powder obtained by the prior art.
  • the extract of the astragalus extract and the valerian extract powder are preferably prepared according to the following method, and the ginseng soap powder may be It is a commercial product which meets the quality standard.
  • the preferred standard is that the ginsenoside powder contains: Rbl: 15 to 20% by weight, Rb2: 15 to 20% by weight, Rb3: 30 to 90% by weight, and Rc: 30 to 90% by weight.
  • the Cordyceps sinensis powder may be a natural medicinal powder or a cultured Cordyceps sinensis powder.
  • the invention further relates to a method for preparing the pharmaceutical composition, comprising the steps of: - pulverizing the crude drug of astragalus, soaking in 4 to 5 times of ethanol for at least 6 hours; pouring the soaked drug substance together with the soaking solution Infiltration filter tank for percolation, the speed of percolation is l ⁇ 4.5ml/kg
  • the ethanol used in the above method is preferably from 30 to 70%, more preferably 50%.
  • a further aspect of the invention relates to the use of a pharmaceutical composition as described above for the manufacture of an anti-HIV drug.
  • the pharmaceutical composition can be used in combination with an anti-HIV drug.
  • the anti-HIV drugs are preferably AZT, DDC, DDL saquinavir, ritonavir, indinavir sulfate, nefinavir o
  • the pharmaceutical dosage form of the pharmaceutical composition may be a liquid dosage form or a solid dosage form.
  • the liquid dosage form may be a true solution, a colloid, a microparticle dosage form, an emulsion dosage form, or a suspension dosage form.
  • Other dosage forms are, for example, tablets, capsules, pills, aerosols, pills, powders, solutions, suspensions, emulsions, granules, suppositories, lyophilized injections and the like.
  • the pharmaceutical composition of the present invention can be formulated into a common preparation, a sustained release preparation, a controlled release preparation, a sputum preparation agent, and various microparticle delivery systems.
  • carriers In order to form a unit dosage form into tablets, various carriers well known in the art can be widely used.
  • carriers are, for example, diluents and absorbents such as starch, dextrin, calcium sulfate, lactose, mannitol, sucrose, sodium chloride, glucose, urea, calcium carbonate, kaolin, microcrystalline cellulose, silicon.
  • Aluminum sulphate, etc.; wetting agent and binder such as water, glycerin, polyethylene glycol, ethanol, propanol, starch, dextrin, syrup, honey, sugar solution, gum arabic, gelatin pulp, carboxymethyl cellulose Sodium, shellac, methylcellulose, potassium phosphate, frozen vinylpyrrolidone, etc.; disintegrating agents, such as dried starch, alginate, agar powder, brown algae starch, sodium carbonate and tannic acid, calcium carbonate, polyoxyethylene sorbus Sugar alcohol fatty acid ester, sodium dodecyl sulfate, methyl cellulose, ethyl cellulose, etc.; disintegration inhibitors, such as sucrose, glyceryl tristearate, cocoa butter, hydrogenated oil, etc.; absorption enhancer For example, quaternary ammonium salts, sodium decyl sulfate, etc.; lubricants such as talc, silica, corn starch,
  • a coated tablet such as a sugar coated tablet, a film coated tablet, an enteric coated tablet, or a bilayer tablet and a multilayer tablet.
  • diluents and absorbents such as glucose, lactose, starch, cocoa butter, hydrogenated vegetable oil, polyvinylpyrrolidone, kaolin, talc, etc.
  • binders such as acacia, tragacanth, gelatin, ethanol , honey, liquid sugar, rice paste or batter; etc.
  • disintegrating agents such as agar powder, dried starch, alginate, sodium dodecyl sulfate, methyl cellulose, ethyl cellulose, and the like.
  • the active ingredient of the present invention is mixed with the above various carriers, and the resulting mixture is placed in a hard gelatin capsule or soft capsule.
  • the composition of the present invention is formulated into an injectable preparation such as a solution, a suspension solution, an emulsion, or a lyophilized powder injection.
  • the preparation may be aqueous or non-aqueous, and may contain one and/or more A pharmaceutically acceptable carrier, diluent, binder, lubricant, preservative, surfactant or dispersing agent.
  • the diluent may be selected from the group consisting of water, ethanol, polyethylene glycol, 1, 3-propanediol, ethoxylated isostearyl alcohol, polyoxylated isostearyl alcohol, polyoxyethylene sorbitan fatty acid ester, and the like.
  • an appropriate amount of sodium chloride, glucose or glycerin may be added to the preparation for injection, and a conventional cosolvent, a buffer, a pH adjuster or the like may be added. These excipients are commonly used in the art.
  • coloring agents may also be added to the composition if desired.
  • the therapeutic effect is enhanced, and the pharmaceutical or pharmaceutical composition of the present invention can be administered by any known administration method, preferably orally.
  • the dosage of the pharmaceutical composition of the present invention depends on many factors, such as the severity of the course of the AIDS patient, the sex, age, weight, personality and individual response of the patient, the route of administration, the number of administrations, the purpose of treatment, and thus the present invention.
  • the therapeutic dose can vary widely.
  • the dosage of the pharmaceutical ingredient used in the present invention is well known to those skilled in the art.
  • the prophylactic or therapeutic purpose of the present invention can be accomplished by appropriately adjusting the amount of the actual drug contained in the final formulation of the composition of the present invention to achieve its therapeutically effective amount.
  • Suitable daily doses for the compositions of the invention range from 0.03 to 0.50 mg/kg body weight per day.
  • the above dosages may be divided into several, for example two, three or four dosage forms, which are limited by the clinical experience of the administering physician and the dosing regimen including the use of other therapeutic means.
  • Figure 1 shows the dynamic changes of CD 4 + lymphocytes in ZL-1 monkeys in vivo.
  • Fig. 2 shows the inhibitory effect of the pharmaceutical composition of the present invention on viral proliferation after infection of SIV in monkeys.
  • Figure 3 shows the study of the target of valerian (CD), ginsenoside (JH) and the composition of the present invention (ZL-1).
  • Figure 4 shows the effect of the pharmaceutical composition of the present invention on CXCR4, CCR5 co-receptors.
  • Figure 5 shows the results of the detection of the CD 4 receptor by JHR, one of the components of the composition of the present invention.
  • Figure 6 shows the binding of valerian (CD) to gp 41 (transmembrane protein).
  • Figure 7 shows the binding of ginsenoside (JHR) to gp 41 .
  • Figure 8 is a graph showing the changes in CD 4 after 6 months of treatment with ZL-1. detailed description
  • the obtained dry powder is mixed with 18 kg of ginsenoside powder and 47 kg of Cordyceps sinensis powder to obtain the composition ZL-1 of the present invention, and the capsule powder of the present invention is prepared by adding a suitable amount of a pharmaceutically acceptable carrier by a method known to those skilled in the art, and then filled into capsules. stand-by.
  • Each capsule contains about 0.5 g of the composition of the invention.
  • the obtained dry powder was mixed with 18 kg of ginsenoside powder and 47 kg of Cordyceps sinensis powder to obtain a composition of the present invention.
  • Example 1 Were infected with HIV-1 virus three cell (MT4, Hela-CD 4, PBMC), inhibition of HIV-1 replication was observed for Example 1 was prepared according to a pharmaceutical ZL-1.
  • HIV-1 HIV-1, NL4 strain
  • Example 1 The pharmaceutical composition of Example 1 was formulated to a concentration of 1 mg/ml, and diluted to a different concentration for use in the experiment.
  • 1 Experiment on a 96-well culture plate, add 100 ⁇ l of drug solution to each well, and add each concentration to the solution. There are two holes. Take freshly cultured MT4 cells, 5 X 10 5 cells per tube, add HIV-1 virus IX 10 3 TCID 50 /ML, incubate in a 37 °C carbon dioxide incubator, centrifuge after two hours, discard the supernatant, and reuse Wash once with RPMI 1640, remove free virus, and add medium to 5 X 10 5 /lml.
  • the different inhibition rates obtained by different concentrations of the drug solution were statistically processed to obtain the half-quantity rate (IC 50 ).
  • the single-life-cycle reporter virus of HIV is obtained by transfection with HIV plasmid.
  • Count The number of blue cells per well was calculated by the following formula, and IC 5 () was calculated.
  • PBMC newly isolated lymphocytes from human peripheral blood
  • the medium used should be added to IL2. (1000X of IL2 is added 1 ⁇ l per ml of medium) at 37 ° C overnight.
  • JHR concentration was 0.4 mg/ml
  • two wells were set at the same concentration
  • the virus control was two wells
  • the cell control was also set to two wells.
  • the 24-well plate was 5 X 10 6 cells per well at 0.5 ml.
  • NL4.3 virus HAV-1
  • the amount of virus is 4 X 10 4 IU per well, blow evenly, transfer to 12-well plate, then add the same drug solution or medium, 1.5ml, so that The total amount is 2ml, cultured at 37 °C, the supernatant is taken every 3-4 days, ⁇ ⁇ ⁇ per well, stored at -80 ° C, all collected to determine RT, medicine
  • the inhibition rate was calculated by comparing the object group with the virus control group.
  • Experimental animals Experimental rhesus monkeys, 4.5 ⁇ 5.5Kg, male and female, total 10, purchased from the primate breeding center of the Institute of Laboratory Animals, Chinese Academy of Medical Sciences, and raised with commercialized puffed feed. There was no abnormality in the physical examination before the experiment, and the potential monkey immunodeficiency virus (SIV), monkey reverse transcription type D virus (SRV) and monkey T lymphocyte type I virus were excluded by serological indirect immunofluorescence (IFA) antibody test. STLV-I) infection.
  • SIV monkey immunodeficiency virus
  • SRV monkey reverse transcription type D virus
  • IFA serological indirect immunofluorescence
  • each animal was intravenously infected with 1 ml of virus solution equivalent to 3 MID 1 virus dose.
  • Both ZL-1 and AZT are provided by the present inventors, and the dosage form is a capsule.
  • Animals were divided into AZT positive drug treatment group and SIVmac251 infection control group, with 3 to 4 animals in each group, half male and half female.
  • Animals in the ZL-1 treatment group were started 10 days before the virus infection, once a day, once a capsule, 2 times a day, and continuously administered for 70 days;
  • Dosing was started in minutes, once daily for each animal, and 100 mg each time was orally administered, and continuously administered continuously for 60 days.
  • SIVmac 251 infection control group was not treated.
  • Blood plasma virus isolation After the animal was infected with SIVmac 251 , blood samples were taken on days 7, 11, 14, 21, 28, 42 and 60, and heparin was anticoagulated to separate plasma. The plasma was diluted by 5 times from 200 ⁇ 1 ⁇ . In a 24-well plate, supplement with 10% calf serum RPMI-1640 to 1 ml per well, then add 10 5 SIVmac 251 sensitive cell lines CEMX 174 cell solution 0.6 ml, set 37 ° CC0 2 incubator, every 3 - 4 Day observation and cell passage. Viral titers of typical cell fusion lesions were still present in the minimally inoculated specimens.
  • Each specimen is inoculated with 8 titers of 200 ⁇ 1 , 40 ⁇ 1 , 8 ⁇ 1 , 1 ⁇ 6 ⁇ 1 , 0.32 ⁇ 1 , 0.064 1 > 0.0128 1 and 0.00256 ⁇ ⁇ , each equivalent to a plasma SIV virus per ml 5 . 25, 125, 625, 3125, 15625, 78125 and 390625 TCID values. Specimens were observed for 3 weeks to determine the results of virus isolation.
  • CD lymphocyte count in blood Blood samples were taken before the experiment and on the 14th, 28th, 42st and 60th day after infection with SIVmac 251. Percoll lymphocytes were separated from the peripheral blood lymphocytes by direct fluorescent labeling with anti-CD 4 single After staining the cloned antibody, the percentage of CD 4 + lymphocytes was counted by FACS, and the total number of CD 4 + lymphocytes in the blood was calculated by combining the total number of white blood cells examined by the common blood test and the classification results. 1. Dynamic changes of CD 4 + lymphocytes in rhesus monkeys before and after drug treatment
  • the traditional treatment of AIDS drugs AZT has a significant inhibitory effect on SIV, and the inhibition rate is over 90%.
  • the pharmaceutical composition of the present invention also has a significant inhibitory effect, and the inhibition rate can be maintained at 70-80% at the dose used.
  • the pharmaceutical composition of the present invention acts as a target
  • OBJECTIVE To observe which stage or stages of the viral life cycle of the pharmaceutical composition of the present invention, including virus entry into cells, reverse transcriptase, integrase, transcription, and protease.
  • the drug "single life cycle" model was used to study drug targets.
  • the recombinant virus is a recombinant virus, and the galactosidase reporter gene is expressed by the LTR of HIV to form a "single life cycle" model of the virus.
  • This model was stained with Hela-CD 4 cells as K4[Fe(CN) 6 ], K 3 [Fe(CN) 6 ], x-gel, as described above. Blue cells under the microscope indicate a viral gene.
  • the cell line was assayed for the activity of Luciferase by the H9 cell line, and the activity of the enzyme was high.
  • Both of the above detection methods are viral "single life cycle" models, the biggest advantage of which is that different times of infection indicate different stages of virus reproduction. 2-6 hours is the virus entering the cell, 10-14 hours is the reverse transcription phase, 20 ⁇ , later is the integration, transcription phase. Therefore, the inhibition at different times indicates the target site.
  • the experiments of the present invention analyzed the targets of JHR and Rb3.
  • the results are shown in Figure 3.
  • the results indicate that ZL-1 acts to block viral entry into cells, as well as reverse transcriptase and integration.
  • the valerian extract (CD) in the ZL-1 composition only has an effect on the viral entry and reverse transcriptase stages, whereas ginsenosides (JHR) have an effect on the viral entry and integrase stages, indicating that the composition is superior to the single extract.
  • the test was carried out using a flow cytometer method. The method was as follows: SupTl cells were incubated with the drug at 37 ° C for 2 hours, washed with PBS + 2% FCS, placed on CD 4 PE for 30 minutes in 4 ⁇ ice bath conditions, washed, centrifuged and added with CD 4 mAb, ice bath. Incubate for 30 minutes, wash, centrifuge, and ice bath conditions, suspend in 50 ⁇ l of secondary anti-Ab anti-mouse-FITC for 20 minutes, wash once, and suspend in 300-500 ul of PBS/2% CS+PI. FACS (for flow meter detection). The test results are shown in Figure 5.
  • AZT1 is combined with JHR1-JHR5 respectively
  • AZT2, AZT3, AZT4, and AZT5 are also combined with JHR-1-JHR-5, respectively. Therefore, there are 25 concentration combinations, two holes for each concentration, and a cell and virus control.
  • IC50 compares the effect of increase or decrease.
  • Table 2 below shows the results of the combination of the pharmaceutical composition of the present invention JHR-1 and AZT.
  • the pharmaceutical composition of the present invention has a synergistic drug action with AZT.
  • the maximum dose group was 7.9 times more effective.
  • the resistant strain of HIV-1 against a tissue protease inhibitor has a virulence of 5.7 X 10 4 IU/ml. Hela-CD 4 cells are used. The AGI method is used to observe the effect of JHR, with or without cross-resistance. Results: JHR Dose For 0.4 mg/ml, the virus 5 ⁇ 1 or 8 ⁇ 1 inhibited the rate of 100%, indicating that the resistant strain formed by the white enzyme inhibitor also has an effect. The results are shown in Table 3.
  • Patient Source In 2000, after treating 1000 patients in Xincai County and Shangqiu, Henan province, 60 patients were selected for blood. The sample selection points were from 60 to 1985 for patients infected with AIDS from 1992 to 1995. There are 19 males and 41 females. The oldest is 58 years old, the youngest is 27 years old, and the average age is 38.9 years old. They are all farmers. Among them, 59 hepatitis C antibodies were positive, 7 syphilis PPR tests were positive, 2 patients had tuberculosis infection, and hepatitis B tests were yin.
  • Medication method 3 times a day, 4 capsules each time, orally.
  • CD 4 first group (30 people) 94.2 223.8 274.2 293.1 115 244.2 281.3 295.2 Total CD 4 rise % 112.3 144.6 156.7 It can be seen from the results in Table 7 that after treatment with the pharmaceutical composition of the present invention, the CD 4 in the blood of the patient is significantly increased, indicating that the pharmaceutical composition of the present invention can significantly improve the blood of the patient.
  • CD 4 level CD 4 was doubled one month after taking the drug, and continued to take the drug, CD 4 continued to rise, and increased by 156.7 ° / at 6 months.
  • CD 4 is close to 300, and the conventional standard CD 4 is below 200 for patients, and 200 or more for normal recovery.
  • the approved drug for AIDS patients in China is approved by a standard of 50% or more, and the number of CD 4 is increased by more than 30%.
  • the present inventors also treated 6 pharmaceutical compositions ZL-1 according to the present invention. After 4 months, CD 4 in whole blood was detected, and the results are shown in Fig. 8. As can be seen from Figure 8, the composition of the invention was 86% of the patients more than 30% increase in CD 4, 80% of patients available in CD 4 increases more than 50%, even ⁇ ⁇
  • the number of CD 4 was increased by 400 times in 37% of patients.
  • This embodiment describes a typical case, Ni XX, Liaoning, 32 years old, treated by the pharmaceutical composition of the present invention.
  • the changes in viral load before and after treatment are shown in Table 9, and the method of administration is the same as that described in Example 1.
  • Table 9 Changes in viral load in patients treated with the pharmaceutical composition of the invention

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Description

一种抗艾滋病毒的中药组合物、 其制备方法及用途 技术领域
本发明涉及一种含有黄芩提取粉、 茜草提取粉、 人参皂甙粉和冬虫夏草粉的 药物组合物。本发明进一步涉及所述 S J药物组合物的制备方法以及所述的药物用于 治疗艾滋病的用途。 背景技术
黄芩为清热燥湿药, 为唇形科植物黄芩 S rfe/to 'a 6az'cfl/e Geor 的根, 主 要含黄酮类成分, 主要作用有抗炎、 抗过敏、 抗病原微生物、 解热及解毒等作用。 茜草, 又名茜根、 血见愁、 活血草, 为茜科植物茜草^?^^ ^;^^^ 的干燥跟及 根茎, 茜草含有的主要成分是脂溶性成分蒽醌、还原蒽醌以及它们的糖甙和水溶性 成分环己肽类, 另外尚富含钙离子等等, 其有凉血止血、 化瘀行血、 抗癌、 抗病原 微生物等作用。 人参根味甘、 微苦、 '性温, 具有调气养血、 安神益智、 生津止咳、 滋补强身之功效, 被誉为 "百草之王", 在中国自古就是调理身体的优选药物。 而 冬虫夏草为子囊菌麦角科虫草属冬虫夏草 Cordyceps sinensis (Berk) Sacc 的子座及 其宿主蝙虫虽禾斗昆虫虫草蝙虫虽娥 Hepialus armoricanus oberthur的幼虫尸体的复合体。 冬虫夏草含粗蛋白、 脂肪、 粗纤维、 碳水化合物、 灰分、 虫草酸、 冬虫夏草素、 虫 草多糖、 核苷类、 肽类、 二十烷等, 主要有益精壮阳、 扶正益气、 补肾平喘、 强身 延年的作用, 同时还有抗炎、 抗心律失常、 抗肿瘤的作用。
许多实验表明, 人参可提高动物与人的体力及智力活动能力, 并能增强机体 对各种有害刺激的非特异性抵抗力, 治疗剂量下对正常生理功能无干扰亦无副作 用, 是一类有益无害的全身性强壮滋 卜药。
在发现人参的上述药物作用的基 ¾ϋ上, 科技工作者对人参提取物进行了研究, 发现在人参中起作用的主要含 30多种人参皂甙, 如 Rbl、 Rb2、 Rb3、 Rc、 Rd、 Re、 Rg、 Rhl、 Rh2、 F2,和拟人参甙 F l, RTs及西洋参皂甙 LI等, 这些人参皂苷 的药理研究主要有: 抗衰老作用、增强免疫功能的作用、 降低血脂的作用, 并能引 S心脏及血管的一些改变。但迄今为止, 尚没有关于人参、 人参提取物或任何一种 人参皂苷能治疗艾滋病的公开。 艾滋病即 "人类获得性免疫缺损"综合症疾病的简 称。 其病原为 "艾滋病毒(HIV ) " ,主要侵犯人体免疫系统, 尤其是 CD4淋巴细胞, 最后摧毁机体免疫功能, 引发条件性感染, 導致死亡。
抗艾滋病毒药物的研究,第一个被报道的是苏拉明 (Suramin), 1985年发现 AZT 具有体外抗艾滋病毒的活性, 1986年进行了临床研究, 1987年 AZT作为第一个被 美国批准用于治疗艾滋病的药, 其主要问题是毒性和抗药性, 以后又有其它药物出 现, 到目前为止被美国批准的抗艾滋病毒药有 20个, 按其作用机理主要属于三类, 除 2002年底批准的 T20是作用于阻折病毒进入细胞内, 其它均是即病毒逆转酶抑 制剂, 如 AZT、 DDC、 DDI等, 和病毒蛋白酶抑制剂, 其中后者在美国 FDA批准 了 5种药物, 分别是沙奎那维 (saquinavir). 利托那韦 (ritonavir)、 硫酸茚地那韦 (indinavir sulfate), 奈非那韦(nefmavir)等, 1995年, 美国科学家 用两种逆转酶 抑制剂和一种蛋白酶抑制剂联合用药, 即现在应用的高活' 抗逆转酶疗法 (HAART), 组合的药称之为 "三联", 此疗法提高了疗效, 进一步延长了病人寿命, 至今应用 6-7年, 尚有少数病人活存。
目前我国已有三种药配制 HAART疗法的药, 但只有抗逆转录酶的药物, 缺 乏抑制蛋白酶的药物, 而且毒性很大, 有近 20%的病人不能服用。 E此在应用中仍 面临毒性和抗药性问题。 如前所述, T20虽然可以阻断病毒进入细胞, 但由于 T20 是一种肽类, 不能口服, 只能注射, 且价格十分昂贵。 因此迫切需要毒性小的抗艾 滋病毒药物。
祖国医药是一个伟大的宝库, 值得挖掘发扬。 发明人经过十多年的研究, 找 到一些中药提取物或组分或单一成分具有确切的抗艾滋病毒的活 ,研究了其抗艾 滋病毒作用的靶点, 并明显提高机体免疫功能, 具有比 HAART价袼便宜、 毒性小 等的优势,而且由于 HAART疗法有抗药性,需要不断更新治疗组合的药物, 因此, 中药治疗艾滋病具有广阔的临床应用前景。 发明内容
本发明人发现含有黄芩提取粉、 茜草提取粉、 人参皂甙粉和冬虫夏草粉的药 物组合物具有明显的治疗艾滋病的作用。
因此, 本发明一方面涉及一种药物组合物, 其含有黄芩提取粉、 茜草提取粉、 人参皂甙粉和冬虫夏草粉, 优选地, 以 100份组合物计, 所述的黄 提取粉的含量 范围为 10〜30重量份,所述的茜草提取粉的含量为 10〜25重量份, 所述的人参皂 甙粉的含量范围为 18〜25重量份,所述的冬虫夏草粉的含量范围为 30〜55重量份。
在所述的组合物中, 优选地, 所述的黄芩提取粉的含量为 18重量份, 所述的 茜草提取粉的含量为 17重量份,所述的人参皂甙粉的含量范围为 18重量份,所述 的冬虫夏草粉的含量为 47重量份。
在上述组合物中,所述的提取粉为醇提粉,可以为任何现有技求获得的提取粉, 所述的黄芩提取粉、茜草提取粉优选按照下述方法制备,而人参皂 粉可以是符合 质量标准的市售品, 优选的标准是人参皂甙粉中含有: Rbl :15〜20wt%, Rb2:15〜 20wt%, Rb3 : 30〜90wt%, Rc: 30〜90wt%。 所述的冬虫夏草粉可以为天然药用 粉或人工培养的冬虫夏草粉。
本发明进一步涉及一种制备所述的药物组合物的方法, 包括½下步骤- β 将黄芩的生药粉碎, 加入 4〜5倍的乙醇浸泡至少 6小时; 将浸泡的 原料药与浸泡液一起倒入渗滤罐进行渗滤,渗滤的速度为 l〜4.5ml/kg
-分钟 再加入乙醇, 同时进行渗滤, 使得收集到的渗滤液为相当 于生药重量的 10〜20倍; 收集并浓缩渗滤液, 使得与水相比, 最终 获得的浓縮液的重量比为水: 浓缩液 =1 : 1.1〜1.35; 将上述浓缩液喷 雾干燥成黄芩提取粉;
• 同时或分别将茜草的生药粉碎, 加入 4〜5倍的乙醇浸泡至少 S小时; 将浸泡的原料药与浸泡液一起倒入渗滤罐进行渗滤, 渗滤的 ί¾度为 l〜4.5ml/kg .分钟 再加入乙醇, 同时进行渗滤, 使得收集 lj的渗 滤液为相当于生药重量的 10〜20倍; 收集并浓缩渗滤液, 使得与水 相比, 最终获得的浓缩液的重量比为水: 浓缩液 =1 : 1.1〜1.35 ; 将上 述浓缩液喷雾干燥成茜草提取粉;
· 按 100重量份计, 将 10〜30份黄芩提取粉、 10〜25份茜草提取粉、
18〜25份人参皂甙粉和 30〜55份冬虫夏草粉混合获得权利要球 1的 药物组合物。
上述方法中所用的乙醇优选为 30〜70%, 更优选 50%。
本发明再一方面涉及上述药物组合物用于制备抗艾滋病毒的药物中的用途。 所述的药物组合物可以与抗艾滋病毒药联合应用。所述的抗艾滋病毒药 优选 是 AZT、 DDC、 DDL 沙奎那维 (saquinavir)、 利托那韦 (ritonavir)、 硫酸 地那 韦 (indinavir sulfate)、 奈非那韦 (nefinavir) o
所述的药物组合物的给药剂型可以是液体剂型、 固体剂型。如液体剂型可以是 真溶液类、 胶体类、 微粒剂型、 乳剂剂型、 混悬剂型。 其他剂型例如片剂、 胶囊、 滴丸、 气雾剂、 丸剂、 粉剂、 溶液剂、 混悬剂、 乳剂、 颗粒剂、 栓剂、 冻干 针剂 等。
本发明药物组合物可以制成普通制剂、 也可以是缓释制剂、控释制剂、萆巴向制 剂及各种微粒给药系统。
为了将单位给药剂型制成片剂, 可以广泛使用本领域公知的各种载体。 ^于载 体的例子是, 例如稀释剂与吸收剂, 如淀粉、 糊精、硫酸钙、 乳糖、 甘露醇、 蔗糖、 氯化钠、 葡萄糖、 尿素、 碳酸钙、 白陶土、 微晶纤维素、 硅酸铝等; 湿润剂与粘合 剂, 如水、 甘油、 聚乙二醇、 乙醇、 丙醇、 淀粉 、 糊精、 糖浆、 蜂蜜、 蔔 糖溶 液、 阿拉伯胶浆、 明胶浆、 羧甲基纤维素钠、 紫胶、 甲基纤维素、 磷酸钾、 凍乙烯 吡咯烷酮等; 崩解剂, 例如干燥淀粉、 海藻酸盐、 琼脂粉、 褐藻淀粉、 碳酸 钠与 枸橼酸、 碳酸钙、 聚氧乙烯山梨糖醇脂肪酸酯、 十二烷基磺酸钠、 甲基纤维素、 乙 基纤维素等; 崩解抑制剂, 例如蔗糖、 三硬脂酸甘油酯、 可可脂、 氢化油等; 吸收 促进剂, 例如季铵盐、 十二垸基硫酸钠等; 润滑剂, 例如滑石粉、 二氧化硅、 玉米 淀粉、 硬脂酸盐、 硼酸、 液体石蜡、 聚乙二醇等。 其它载体如聚丙烯酸树脂 、 脂 质体, 水溶性载体如 PEG4000和 PEG6000、 PVP等。 还可以将片剂进一步 !]成包 衣片, 例如糖包衣片、 薄膜包衣片、 肠溶包衣片, 或双层片和多层片。
例如为了将给药单元制成丸剂, 可以广泛使用本领域公知的各种载体。 关于载 体的例子是, 例如稀释剂与吸收剂, 如葡萄糖、 乳糖、 淀粉、可可脂、氢化植物油、 聚乙烯吡咯烷酮、 高岭土、 滑石粉等; 粘合剂, 如阿拉伯胶、 黄蓍胶、 明胶、 乙醇、 蜂蜜、 液糖、 米糊或面糊等; 崩解剂, 如琼脂粉、 干燥淀粉、 海藻酸盐、 十二烷基 磺酸钠、 甲基纤维素、 乙基纤维素等。
例如为了将给药单元制成胶囊,将有效成分本发明药物组合物与上述的各种载 体混合, 并将由此得到的混合物置于硬的明胶胶囊或软胶囊中。
例如, 将本发明组合物制成注射用制剂, 如溶液剂、 混悬剂溶液剂、 乳剂、 冻 干粉针剂, 这种制剂可以是含水或非水的, 可含一种和 /或多种药效学上可接受的 载体、 稀释剂、 粘合剂、 润滑剂、 防腐剂、 表面活性剂或分散剂。 如稀释剂可选自 水、 乙醇、 聚乙二醇、 1, 3-丙二醇、 乙氧基化的异硬脂醇、 多氧化的异硬脂醇、 聚氧乙烯山梨醇脂肪酸酯等。 另外, 为了制备等渗注射液, 可以向注射用制剂中添 加适量的氯化钠、 葡萄糖或甘油, 此外, 还可以添加常规的助溶剂、 缓冲剂、 pH 调节剂等。 这些辅料是本领域常用的。
此外, 如需要, 也可以向组合物中添加着色剂、 防腐剂、 香料、 矫味剂、 甜味 剂或其它材料。
为达到用药目的, 增强治疗效果, 本发明的药物或药物组合物可用任何公知的 给药方法给药, 优选口服给药。
本发明的药物组合物的给药剂量取决于许多因素,例如艾滋病患者病程的严重 程度, 患者的性别、 年龄、 体重、 性格及个体反应, 给药途径、 给药次数、 治疗目 的, 因此本发明的治疗剂量可以有大范围的变化。 一般来讲, 本发明中药物成分的 使用剂量是本领域技术人员公知的。可以根据本发明组合物中最后的制剂中所含有 的实际药物数量, 加以适当的调整, 以达到其治疗有效量的要求, 完成本发明的预 防或治疗目的。 本发明组合物的每天的合适剂量范围为 0.03〜0.50mg/Kg体重 /天。 上述剂量可以分成几个, 例如二、三或四个剂量形式给药这受限于给药医生的临床 经验以及包括运用其它治疗手段的给药方案。 附图说明
图 1显示 ZL-1猴体内试验 CD4+淋巴细胞动态变化。
图 2显示本发明药物组合物对猴感染 SIV后病毒增殖的抑制作用。
图 3显示茜草 (CD)、 人参皂甙(JH) 以及本发明组合物(ZL-1 ) 的作用靶点 的研究。
图 4显示本发明药物组合物对 CXCR4、 CCR5辅助受体的作用。
图 5本发明组合物组分之一 JHR作用于 CD4受体的检测结果。
图 6显示茜草 (CD ) 对 gp41 (穿膜蛋白) 的结合作用。
图 7显示人参皂甙 (JHR) 对 gp41的结合作用。
图 8显示 ZL-1治疗病人 6个月后 CD4变化情况示意图。 具体实施方式
以下结合附图描述本发明。
实施例 1 本发明药物组合物的制备:
取 180kg黄芩、 150kg茜草生药, 粉碎, 加入 50%乙醇 1400L浸泡 6小时; 将 浸泡的原料药与浸泡液一起倒入渗滤罐进行渗滤, 渗滤的速度为 3〜4.5ml/kg .分 钟 -1; 陆续分次加入乙醇, 继续进行渗滤, 收集到 4000L渗滤液; 通过回收乙醇浓 缩渗滤液, 使得与水相比,最终获得的浓缩液的重量比为水:浓缩液 =1 : 1.1〜1.35; 将上述浓缩液喷雾干燥成粉; 黄芩和茜草的提取粉的收率分别为 8〜10%和 10〜 15%, 因此, 所获得的干燥粉相当于 18kg黄芩提取粉、 17kg茜草提取粉。 并将获 得的干燥粉与 18kg人参皂甙粉和 47kg冬虫夏草粉混合得到本发明组合物 ZL-1 , 釆用本领域技术人员公知的方法加入适量药用载体制成本发明的胶囊粉,然后装入 胶囊待用。 每粒胶囊中含有本发明组合物为约 0.5g。 实施例 2
取 180kg黄芩生药, 粉碎, 加入 50%乙醇 720L浸泡 6小时; 将浸泡的原料药 与浸泡液一起倒入渗滤罐进行渗滤, 渗滤的速度为 3〜4.5ml/kg .分钟―1 ; 再陆续 50%的乙醇, 继续进行渗滤, 收集到渗滤液 2200L; 通过挥发乙醇浓缩渗滤液, 使 得与水相比, 最终获得的浓缩液的重量比为水: 浓缩液 =1 : 1.1〜1.35; 将上述浓缩 液喷雾干燥成粉, 得到 18kg黄芩提取粉。
取 150kg茜草生药, 粉碎, 加入 40%乙醇 600L浸泡 6小时; 将浸泡的原料药 与浸泡液一起倒入渗滤罐进行渗滤, 渗滤的速度为 3〜4.5ml/kg .分钟―1 ; 陆续加入 40%的乙醇, 继续进行渗滤, 收集到渗滤液 1800L; 通过挥发乙醇浓缩渗滤液, 使 得与水相比, 最终获得的浓缩液的重量比为水: 浓缩液 =1 : 1.1-1.35; 将上述浓缩 液喷雾干燥成粉,获得 17kg茜草提取粉。
将获得的干燥粉与 18kg人参皂甙粉和 47kg冬虫夏草粉混合得到本发明组合物
ZL-1 , 装入胶囊待用。 实验例 1
本发明药物组合物的药效学研究
体外实验
分别用 HIV-1病毒感染三种细胞 (MT4,Hela-CD4, PBMC), 观察根据实施例 1 制备的药物 ZL-1对 HIV-1复制的抑制作用。
( 1 ) MT4细胞
病毒: HIV-1,NL4株
方法: 将实施例 1的药物组合物配制成 lmg/ml的浓度, 进行实验时稀释成不 同浓度备用。 ①:在 96孔培养板进行实验,于各孔加入 100 μ 1药液,每个浓度药液至 少设两个孔。 另取新鲜培养的 MT4 细胞, 每管 5 X 105细胞,加 HIV-1 病毒 I X 103TCID50/ML,37 °C 二氧化碳培养箱中培养,两小时后离心,弃去上清,再用 RPMI1640洗一次,去除游离的病毒,加培养基到 5 X 105/lml。 于 96孔板每个加有药 的孔中加入 100 μ L此感染 HIV-1的细胞 (5 Χ 104/ 100 μ L) 二氧化碳培养箱中 37°C 培养。 第三天换药,于孔中吸出 ΙΟΟ μ ί上清,加入 lOO L与本孔相同浓度的新鲜药 液,对照组加入 100 培养基。 第六天,各孔取上清, 采用 Microelisa方法及试剂, 测定 P24抗原量。 每次实验设病毒对照,细胞对照及 AZT阳性药对照, 根据所测 P24 抗原量按下列公式计算抑制率
病毒对照孔 P24抗原量 - 药物组 P24抗原量
抑制率 = X 100
病毒对照孔 P24抗原量
不同浓度药液所得的不同抑制率, 经统计处理, 求得半数制率量 (IC50)。
(2) Hela— CD4细胞
病毒: HIV的单一生活周期的报告病毒 (Single-life-cycle reporter virus) 由 带 HIV质粒转染而得。
方法: 24孔板接种 Hela-CD4-LTR--gal细胞 0.4 X 105/孔, 放置 24小时, 使之 吸附, 贴壁, 第二天, 吸去孔中上清, 加 lOOul 药 (药对照) 或药及 HIV-1 (可不 同浓度药液) 或培养基 (Mock), 两小时后各孔加入 200 μ 1 相同药液或培养基, C02培养箱 37°C培养 48小时, 按下列方法检测。
固定:各孔吸去上清加入固定液(1ml )再以 K Fe(CN)6] ·3Η20, K3[Fe(CN)6] 及 X-gel染色。
计数: 每孔兰色细胞数以下列公式计算抑制率, 再计算 IC5()
Mock孔兰细胞数- 药物孔兰细胞数
抑制率 = X 100
Mock孔兰细胞数
(3 ) PBMC细胞
病毒: NL4-3
方法: 以医院中新鲜取得的 PBMC (人外周血新分离的淋巴细胞), 计数、 离 心 1200rpm弃去上清,配成 3 X 106细胞 /ml。所用培养基应加入 IL2.(1000X的 IL2 按每 ml培养基中加入 1 μ 1)37° C 过夜。 实验以 5 X 106为一感染单位, JHR浓度 为 0.4mg/ml 相同浓度设两孔, 病毒对照两孔, 细胞对照也设两孔, 24孔板每孔 5 X 106细胞在 0.5ml 药液或培养基中, NL4.3病毒 (HIV-1 ) , 病毒量为每孔加入 4 X 104IU,吹打均匀,转入 12孔板,再加入相同药液或培养基, 1.5ml,使总量为 2ml , 37°C培养, 每 3-4天取上清, 每孔取 ΙΟΟ μ Ι,放 -80°C保存, 全部收集完测定 RT, 药 物组与病毒对照组比较计算抑制率。
所得结果如下:
MT4细胞株: 半数抑制量 IC50=139 μ g/ml
Hela-CD细胞株: 半数抑制量 IC50=54.8 μ g/ml
PBMC细胞(本发明组合物组分之一 JHR): (人外周血新分离的淋巴细胞)服 药 6天的半数抑制量 IC50=77 μ g/ml。
结果表明 ZL-1在体外试验中对 HIV-1有明显的抑制作用。 实验例 2
本发明药物组合物体内实验一对恒河猴的治疗作用
实验动物: 实验用恒河猴, 4.5〜5.5Kg, 雌雄各半, 共 10 只, 购自中国医学 科学院实验动物研究所灵长类繁殖中心, 用商品化膨化饲料饲养。 实验前经体检无 异常, 经血清学间接免疫荧光 (IFA)抗体检查法检查排除潜在的猴免疫缺陷病毒 (SIV), 猴逆转录 D型病毒 (SRV)和猴 T淋巴细胞性 I型病毒 (STLV— I)的感染。
感染毒株和剂量: 用美国 Aaron Diamond 艾滋病研究中心 darx 博士赠与的
SIVmac251病毒株, 每只动物用相当于 3MID1 病毒剂量的病毒液 1ml静脉感染。
药物及实验治疗方案: ZL— 1和 AZT均由本发明人提供, 剂型为胶囊。 动物 分 AZT阳性药物治疗组和 SIVmac251感染对照组, 每组动物 3〜4只, 雌雄各半。 ZL— 1治疗组动物在病毒感染前 10天开始给药, 每日给药一次, 一次 2粒胶囊, 经口服用, 连续不间断给药 70天; AZT阳性药物对照组动物在病毒感染后 30分 钟开始给药,每动物每日给药一次,每次 lOOmg经口服用,连续不间断给药 60天。 SIVmac251感染对照组不给药治疗。
感染前后观察: 感染前除一般体检外, 称体重, 采血 (作感染前的各项指标检 査)。 感染和治疗后继续做一般观察和检査, 并按程序定时釆血测定血浆病毒滴度、 血液中 CD4+淋巴细胞数和抗体滴度。 60天实验结束后, 处死动物。
血桨病毒分离: 动物感染 SIVmac251后, 选择第 7、 11、 14、 21、 28、 42、 60 天采取血样, 肝素抗凝分离血浆, 血浆分别从 200 μ 1幵始以 5倍递减量稀释于 24 孔板内, 以 10%小牛血清 RPMI— 1640补至每孔 lml, 然后加入 105个 SIVmac251 敏感细胞株 CEMX174细胞液 0.6ml, 置 37°CC02孵箱, 每 3— 4天观察和细胞传代 一次。 以接种最小量的标本仍然出现典型的细胞融合病变为标本的病毒滴度。每标 本接种 8个滴度即 200 μ 1、 40 μ 1、 8 μ 1、 1·6 μ 1、 0.32 μ 1、 0.064 1 > 0.0128 1 和 0.00256 μ ΐ , 各相当于每毫升血浆 SIV病毒 5、 25、 125、 625、 3125、 15625、 78125和 390625个 TCID值。 标本观察 3周判定病毒分离结果。
血液中 CD 淋巴细胞数测定: 选择动物实验前和感染 SIVmac251后第 14、28、 42、 60天釆取血样标本, Ficoll淋巴细胞分离液分离外周血淋巴细胞, 用直接荧光 标记抗 CD4单克隆抗体染色后, 上机 FACS计数得到 CD4+淋巴细胞百分率, 结合 普通血象检查的白细胞总数和分类结果, 计算出血液中含 CD4+淋巴细胞的总数。 1. 药物治疗前后恒河猴体内 CD4+淋巴细胞动态变化
结果: 结果如图 1、 表 1所示。
表 1
Figure imgf000009_0001
以上结果表明猴感染 SIV后,病毒量上升的同时, CD4细胞数急剧下降,而 ZL-1 治疗组在感染后 2,4周时,可保护 45-48%细胞不受病毒侵害,而 AZT组 35%细胞受 保护, 6,8周后 ZL-1治疗组仍有 32-38%细胞受到保护.
2. 药物治疗前后恒河猴体内病毒量的变化
结果如下及图 2所示。
恒河猴治疗实验 (恒河猴感染 SIVmaC251,为急性感染) 药后周数 1 2 3 4
抑制率 (%) 17.0% 80.2% 70.7% 70.2% 结果表明: 本发明的组合物对恒河猴感染的 SIV有明显的抑制作用。
传统治疗艾滋病药物 AZT有明显抑制 SIV的作用, 抑制率达 90%以上, 本发 明药物组合物也有明显的抑制作用,在所用的剂量下,可使抑制率维持在 70~80%。 实验例 3
本发明药物组合物作用靶点 ,
1. 病毒生活周期中作用阶段的检测
目的: 观察本发明药物组合物作用于病毒生活周期哪个或哪几个阶段, 包括病 毒进入细胞, 逆转录酶、整合酶、转录、蛋白酶。应用病毒"单一生活周期 "(single life cycle) 模型研究药物作用靶点。
( 1 ) MAGr法: 合病毒为重组病毒, 以 HIV的 LTR, 使 半乳糖苷酶报告 基因得以表达, 形成病毒的一种 "单一生活周期" 的模型。
此模型如前述用 Hela-CD4细胞以 K4[Fe(CN)6]、 K3[Fe(CN)6]、 x-gel染色, 显微镜下蓝色细胞表示带有病毒基因。
<2) Luciferase法:
用重组、 转染的 VSVG病毒, 细胞系用 H9细胞株, 检査方法釆用发光法检 测 Luciferase的活性, 病毒量多则此酶活性高。
实验方法: 细胞感染病毒后设不同组, 分别于感染后 0, 6, 12, 18, 24, 36小时加 药, 作用至感染后 48小时, 分别进行 MAGI或 Luciferase法检测。
以上两种检测方法均为病毒 "单一生活周期"模型, 其最大优点是感染的不同 时间表示病毒繁殖的不同阶段。 2-6小时是病毒进入细胞, 10-14小时是逆转录阶段, 20 ^、时以后是整合、 转录阶段。 故不同时间给药其抑制作用表示作用于何靶点。 本发明实验对 JHR和 Rb3的作用靶点进行了分析。
结果见图 3所示, 结果表明 ZL-1作用于阻断病毒进入细胞, 以及逆转录酶及 整合醜诸阶段。 ZL-1组合物中的茜草提取物 (CD) 仅对病毒进入及逆转录酶阶段 有作用, 而人参皂甙 (JHR)对病毒进入及整合酶阶段有作用, 表明组合物优于单 一提取物。
2.作用于辅助受体 CXCR4CCR5的检测
实验使用 MAGI法进行: 方法同上, 检测 CXCR4受体用嗜 T淋巴细胞, 病毒用 NL4, 检测 CCR5受体用嗜 M淋巴细胞, 病毒用 YU2。
结果见图 4。 从图 4中可以看出, 本发明组合物对 CXCR4辅助受体、 CCR5辅助受体均有 抑制作用, 则表明其作用可能在嗜 T及嗜 M淋巴细胞共同有的 CD4受体或者病毒 与细胞的融合过程, 而不是此两辅助受体本身。
3.作用于 CD4受体的检测
本研究使用本发明组合物组分之一 JHR进行。
使用流式细胞仪的方法进行测试。 方法如下: 采用 SupTl细胞与药物 37°C 共同培育 2小时,以 PBS+2%FCS洗漆,于 4Ό冰浴条件加 CD4PE放置 30分钟,洗涤, 离心后加 CD4单抗,冰浴中培育 30分钟,洗涤,离心,冰浴条件,悬浮于 50 μ 1的二抗 Ab 抗-小鼠 -FITC中 20分钟,洗涤一次,悬浮于 300-500ul的 PBS/2%CS+PI中, FACS (进 行流式仪检测)。 检测结果见图 5。
结果表明 JHR对 CD4受体无作用。
4.作用于病毒跨膜蛋白 gp41的检测
本研究采用本发明组合物成分之一茜草 (CD)和 JHR进行。 其对 gp41 (穿 膜蛋白) 的结合作用的结果见图 6和图 7。 将基因重组的 § 41分别置于 BIACORE 检测仪的芯片上,分别加入一定浓度的茜草或 JHR提取物,仪器即检测出是否与之结 合。 作为组合物组分致之一的茜草 (CD) 和 JHR与病毒的 gp4^有结合作用。 实验例 4
本发明药物组合物与其他治疗爱滋病药物的联合用药
目的: 观察 ZL-1与 AZT有无协同作用:采用 ZL-1组成药物之一 JHR进行。 方法: 实验采用 MAGItest方法 (如前)
①单独用药: AZT从 luM至 3.9nM, 设五个剂量 AZT1-5
JHR1-5从 400ug/ml 至 1.56ug/ml, 设五个剂量
分别求得 IC5o
②合并应用
以 AZT与 JHR-1各 1/2量相加为一个样品
AZT1分别与 JHR1-JHR5五个组合
AZT2、 AZT3、 AZT4、 AZT5亦分别与 JHR-1- JHR-5五个组合, 故为 25个 浓度组合, 每个浓度设两孔, 另设细胞、 病毒对照。
③以各药物组合与病毒组比较, 求得抑制率。 以各药物组合抑制率与单独 AZT
IC50比较作用增减。
以下表 2显示本发明药物组合物 JHR-1与 AZT的联合用药结果。
表 2
药物 ED50 AZT/A+J
JH 21.5 g/ml
AZT 46nM
AZT-JHR- 1 5.8 nM 7.93
Figure imgf000011_0001
AZT-JHR-3 16.7nM 2.75
AZT-JHR-4 33.5nM 1.37
AZT-JH -5 40.6nM 1.13
从表 2可以看出, 本发明药物组合物与 AZT具有协同药物作用。 最大剂量组 可增效 7.9倍。 实验例 5
本发明药物组合物组分之一对 HIV蛋白酶抑制剂抗性毒株的抑制作用 本发明人进一步研究了本发明药物组合物对 HIV蛋白酶抑制剂抗性株的抑 制作用。
HIV-1 对一 巾蛋白酶抑制剂形成的抗性株, 毒力为 5.7 X 104IU/ml , 采用 Hela-CD4细胞, AGI 实验方法观察 JHR的作用, 有无交叉抗性, 结果: JHR剂量 为 0.4 mg/ml ,病毒 5 μ 1或 8 μ 1抑淛率均达 100%, 表明对白酶抑制剂形成的抗性 株也有作用, 结果见表 3。
表 3
病毒量 药物 (0.4mg/ml) 抑制率%
5 μ 1 JH 100
PRIV* 8 μ 1 JH 100
*PRIV是蛋白酶抑制剂的抗†生株病毒。 实验例 6 本发明药物组合物的安全性实验
(A)本发明药物组合物体外治疗指数检测, 见表 4。
表 4
Figure imgf000012_0001
(B)本发明药物组合物的体内毒性实验:
( 1 ) 急性毒性实验结果: 给大鼠灌胃给药, 大于 20克 /公斤未见任何毒性。
(2) 亚急性毒性实验结果: 给大鼠连续灌胃 6个月后, 大、 中、 小三个剂 量组的大鼠生长情况正常, ALT、 BUN, RBC、 WBC及白细胞分类均正常, 病理 切片表明心、 肝、 肾、 脾、 肺、 胰、 脑、 睾丸、 卵巢等脏器未见异常。 实验例 7
本发明药物组合物的临床实脸
患者来源: 2002年在河南省新蔡县、 商丘对 1000例病人治疗后, 抽取 60例 病人的血液, 样本选择点对象为 1992年至 1995年间因卖血感染爱滋病的人员,共 60人, 其中男 19人, 女 41人, ^龄最大 58岁, 最小 27岁, 平均年龄 38.9岁, 均为农民。 其中 59个丙型肝炎抗体检测为阳性, 7人梅毒 PPR检验为阳性, 2人 合并肺结核感染, 乙肝检验均为阴'性。
服药方法: 每天 3次, 每次 4粒, 口服。
1.治疗前后病毒载量变化:
分别于治疗前和治疗后 6个月抽取病人血, 离心取血浆, -80Ό保存, 检测时 按罗氏(Rocher) R A定量 PCR仪器及试剂盒要求的方法先提取 RNA, 用罗氏仪 器检测病毒载量, 结果见表 5 。
表 5 ZL-1治疗后病毒载量 (VL)的变化 后 6个月 0 编号 治疗前 治疗 病毒载量变化 评价 //o
2 1 05.951 工。3.255 2.696 \
9 ιο4·155 2Q2.668 1.487 3/10
59 1 03.599 J Q2.668 0.931 \
1 i。5.935 1 06·143 0.208
14 105·520 i。5.560 0.04 4/10
24 i。5.072 0.188
o
30 1 ()4.990 i。5.299 0.309
51 i。4.433 i。5.021 0.588 个
11 1 Q2-823 1 03.436 0.613 个 3/10
28 1 04.274 104.856 0.582 个
2.治疗前后 P74抗原量的变化- 采用 Microelisa方法及试剂,测定上述标本中的 P24抗原量, 结果见表 6。 表 6 ZL-1治疗后 HIV P24抗原的变化 治疗刖 治疗^ 6个月 毒载量变化 评价
103 25 1 ()2.292 0.958 >0.5 \
105.131 1Q4.586 0.545 >0.5 \
105 18 JQ5.501 0.318 <0.5―
104·187 105 125 0.94 >0.5 t 从表 6 的结果可以看出, 服用本发明的药物组合物以后, 病人血浆中的病毒 载量在治疗 6个月后明显下降, 及维持不变的达 70%, 30%仅轻微上升。
3.治疗前后 CD4检测情况- 对所采的血液标本采用流式细胞仪对其全血 ί¾行 CD4检测, 结果见表 7。 表 7. 60例病人的 CD4检测情况
服药后
药前 1个月 3个月 6个月 第一组 (30人) 135.8 264.6 288.3 297.3
CD4 第一组 (30人) 94.2 223.8 274.2 293.1 115 244.2 281.3 295.2 合计 CD4上升% 112.3 144.6 156.7 从表 7结果可以看出, 经本发明药物组合物治疗以后, 病人血中的 CD4明显 上升, 表明本发明药物组合物可以明显提高病人血中的 CD4水平。 服药后一个月 CD4增加一倍, 继续服药, CD4持续上升, 6个月时增加了 156.7°/。, CD4接近 300, 常规标准 CD4在 200以下为病人, 200以上向正常恢复。
另外, 目前国内艾滋病人应用的辅助药物, 其批准的标准为 、须 50%或以上 的病人 CD4数量的增加 30%以上, 本发明人还对经本发明药物组合物 ZL-1治疗 6 个月后全血中的 CD4进行检测, 结果见图 8。 从图 8中可以看出, 才发明组合物有 86%的病人 CD4增加超过 30%, 有 80%的病人的 CD4增加超过 50%, ··· ···甚至有
37%的病人 CD4数量增加了 400倍。
4.对上述 60例病人治疗前后临床指征变化的观察, 结果见表 8A、 8B。
表 8A
体重 感冒次数与程度 乏力
增加 减少 无变 增加 减少 无变 增加 减少 无变 化 化 化 人数 21 12 18 12 23 20 23 14 16 总人 53 53 53 53 53 53 53 53 53
% 39.6 22.6 34 22.6 43.4 37.7 43.4 26.4 30.1 增加与无变化 73.6% 减少与无变化 81.1% 减少与无变化 56.5% 表 8B
食欲 腹泻次数 皮痒皮疹 增加 减少 无变 增加 减少 无变 加重 减轻 无变 化 化 化 人数 17 14 22 5 9 2 7 10 6 总人 53 53 53 16 16 16 23 23 23
% 32 26.4 41.5 31.2 56.2 12.5 30.4 43.4 26 增加与无变化 73.6% 减少与无变化 68.7% 减少与无变化 69.4% 以上数据表明临床症状及指征明显改善。 实验例 8
本实施例描述一典型病例, 倪 X X , 辽宁人, 32岁, 经本发明药物组合物治 疗前后病毒载量的变化情况, 见表 9,其中的服药方法同实施例 1的描述。 表 9 用本发明药物组合物治疗的- -例病人的病毒载量变化
日期 R A复制 /ml
1998年 10月 30日 (治疗前 1周) 〉500, 000
1998年 11月 5日 (开始药物治疗) >500, 000
1998年 11月 12日 (治疗后 1周) >500, 000
1998年 11月 26日 (治疗后 3周) 330, 000
1999年 4月 9日 (治疗后 22周) 88, 960
1999年 4月 16日 (治疗后 23周) 78, 771

Claims

权利要求书
1. 一种药物组合物, 其含有黄芩提取粉、 茜草提取粉、 人参皂甙粉和冬虫夏草粉 的,其特征在于以 100重量份组合物计,所述的黄芩提取粉的含量范围为 10〜30 重量份, 所述的茜草提取粉的含量为 10〜25重量份,所述的人参皂甙粉的含量 范围为 18〜25重量份, 所述的冬虫夏草粉的含量范围为 30〜55重量份。
2. 根据权利要求 1所述的药物组合物, 其中在所述的组合物中, 所述的黄芩提取 粉的含量为 18重量份, 所述的茜草提取粉的含量为 17重量份, 所述的人参皂 甙粉的含量范围为 18重量份, 所述的冬虫夏草粉的含量为 47重量份。
3. 根据权利要求 1或 2所述的药物组合物, 其中所述的黄芩提取粉、 茜草提取粉 或人参皂甙粉为醇提取粉,所述的冬虫夏草粉为天然药用粉或人工培养的冬虫夏草 粉。
4. 一种制备如权利要求 1所述的药物组合物的方法, 包括以下步骤- a) 将黄芩的生药粉碎, 加入 4〜5倍的乙醇浸泡至少 6小时; 将浸泡的原料药 与浸泡液一起倒入渗滤罐进行渗滤, 渗滤的速度为 l〜4.5ml/kg .分钟— ^ 再加 入乙醇, 同时进行渗滤, 使得收集到的渗滤液为相当于生药重量的 10〜20倍; 收集并浓缩渗滤液, 使得与水相比, 最终获得的浓缩液的重量比为水: 浓缩液 =1: 1.1〜1.35; 将上述浓缩液喷雾干燥成黄芩提取粉;
b) 同时或分别将茜草的生药粉碎, 加入 4〜5倍的乙醇浸泡至少 6小时; 将浸 泡的原料药与浸泡液一起倒入渗滤罐进行渗滤, 渗滤的速度为 l〜4.5ml/kg .分 钟 再加入乙醇, 同时进行渗滤, 使得收集到的渗滤液为相当于生药重量的 10〜20倍; 收集并浓缩渗滤液,使与水相比,最终获得的浓缩液的重量比为水: 浓缩液 =1 : 1.1〜1.35; 将上述浓缩液喷雾干燥成茜草提取粉;
c) 按 100重量份计, 将 10〜30份黄芩提取粉、 10〜25份茜草提取粉、 18〜 25份人参皂甙粉和 30〜55份冬虫夏草粉混合获得所述的药物组合物。
5.根据权利要求 4所述的方法, 其中所述的乙醇为 30〜70%的乙醇。
6.根据权利要求 1〜3所述的药物组合物用于制备抗艾滋病毒的药物中的用途。
7.根据权利要求 5所述的用途, 其特征在于所述的药物组合物可以与抗艾滋病毒药 联合应用。
8. 根据权利要求 5所述的用途,其特征在于所述的抗艾滋病毒药包括 AZT、 DDC、 DDL 沙奎那维、 利托那韦、 硫酸茚地那韦、 奈非那韦。
PCT/CN2005/001579 2004-09-30 2005-09-27 Composition a base de medicament chinois traditionnel presentant une activite anti-vih, sa preparation et son utilisation WO2006034643A1 (fr)

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