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• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/10—Dispersions; Emulsions
  • A61K9/127—Synthetic bilayered vehicles, e.g. liposomes or liposomes with cholesterol as the only non-phosphatidyl surfactant
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K41/00—Medicinal preparations obtained by treating materials with wave energy or particle radiation ; Therapies using these preparations
  • A61K41/0028—Disruption, e.g. by heat or ultrasounds, sonophysical or sonochemical activation, e.g. thermosensitive or heat-sensitive liposomes, disruption of calculi with a medicinal preparation and ultrasounds
  • A61K41/0033—Sonodynamic cancer therapy with sonochemically active agents or sonosensitizers, having their cytotoxic effects enhanced through application of ultrasounds
• • 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
  • A61K31/66—Phosphorus compounds
  • A61K31/683—Diesters of a phosphorus acid with two hydroxy compounds, e.g. phosphatidylinositols
  • A61K31/685—Diesters of a phosphorus acid with two hydroxy compounds, e.g. phosphatidylinositols one of the hydroxy compounds having nitrogen atoms, e.g. phosphatidylserine, lecithin
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K49/00—Preparations for testing in vivo
  • A61K49/22—Echographic preparations; Ultrasound imaging preparations ; Optoacoustic imaging preparations
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K49/00—Preparations for testing in vivo
  • A61K49/22—Echographic preparations; Ultrasound imaging preparations ; Optoacoustic imaging preparations
  • A61K49/222—Echographic preparations; Ultrasound imaging preparations ; Optoacoustic imaging preparations characterised by a special physical form, e.g. emulsions, liposomes
  • A61K49/226—Solutes, emulsions, suspensions, dispersions, semi-solid forms, e.g. hydrogels
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0002—Galenical forms characterised by the drug release technique; Application systems commanded by energy
  • A61K9/0009—Galenical forms characterised by the drug release technique; Application systems commanded by energy involving or responsive to electricity, magnetism or acoustic waves; Galenical aspects of sonophoresis, iontophoresis, electroporation or electroosmosis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/0012—Galenical forms characterised by the site of application
  • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/10—Dispersions; Emulsions
  • A61K9/107—Emulsions ; Emulsion preconcentrates; Micelles
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/10—Dispersions; Emulsions
  • A61K9/107—Emulsions ; Emulsion preconcentrates; Micelles
  • A61K9/1075—Microemulsions or submicron emulsions; Preconcentrates or solids thereof; Micelles, e.g. made of phospholipids or block copolymers
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P35/00—Antineoplastic agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P35/00—Antineoplastic agents
  • A61P35/04—Antineoplastic agents specific for metastasis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

• Fluorocarbon emulsion auxiliary agent for high intensity focused ultrasound therapy and application thereof
• the present invention relates to the field of medicine and medical treatment, and more particularly to the field of ultrasonic therapy, and more particularly to a fluorocarbon emulsion auxiliaries for HIFU treatment capable of increasing energy deposition in target tissues during HIFU treatment and Its application. Background technique
• High-intensity focused ultrasound (HIFU) technology has been clinically recognized as a new approach to the treatment of tumors and other diseases.
• HIFU high-intensity focused ultrasound
• the tumor loses its ability to proliferate, infiltrate, and metastasize.
• the ultrasonic transducer's emission power can be simply increased.
• the possibility that the normal tissue on the ultrasonic propagation channel is burned is greatly increased.
• Another object of the present invention is to provide a method for increasing the energy deposition of a target region in the treatment of HIFU by the HIFU therapeutic fluorocarbon emulsion-based adjuvant of the present invention.
• Still another object of the present invention is to provide a use of the HIFU therapeutic fluorocarbon emulsion-based adjuvant of the present invention for enhancing the effect of HIFU in treating diseases.
• the present invention provides a HIFU therapeutic auxiliary, which can help to enhance the absorption of ultrasonic energy in a target area to be treated by HIFU after administration to a living body, that is, to reduce the target tissue per unit volume.
• a HIFU therapeutic auxiliary which can help to enhance the absorption of ultrasonic energy in a target area to be treated by HIFU after administration to a living body, that is, to reduce the target tissue per unit volume.
• tissue tumor/non-tumor tissue
• the present invention there is no excessive limitation on the type of the substance which is an auxiliary agent for the treatment of HIFU, as long as the substance is a fluorocarbon emulsion and can change the acoustic environment of the target tissue after administration to the target tissue, and promote the treatment of the target tissue.
• the absorption and deposition of the ultrasonic energy can be.
• injury refers to a substantial change in the physiological state of a tumor or normal tissue, usually referred to as coagulative necrosis of a tumor or normal tissue.
• the amount of ultrasonic energy required to damage the target tissue per unit volume can be quantified by an energy efficiency factor (EEF).
• EEF in J/mm 3 ), defined as the ultrasound energy required to damage a tumor or normal tissue per unit volume.
• the HIFU therapeutic adjuvant of the present invention after administration to a target tissue, can lower the EEF of the target tissue, thereby measuring the basic EEF (ie, EEF) of the tissue before administration of the HIFU adjuvant.
• the ratio between the EEF (i.e., EEF ( )) measured after administration of the HIFU adjuvant to the tissue is greater than 1, preferably greater than 2, more preferably greater than 4. There is no limit to the upper limit of the ratio, it should be as large as possible.
• the present invention as an auxiliary agent for HIFU treatment, comprises a continuous phase composed of a discontinuous phase composed of a film-forming material-wrapped core and an aqueous medium, wherein the discontinuous phase is uniformly dispersed in the continuous phase,
• the particle size of the discontinuous phase is 0.1 to 2 ⁇ m, preferably 0.1 to 1 ⁇ m, more preferably 0.1 to 0.5 ⁇ m ;
• the content of the film-forming material in the auxiliary agent is 0.1 to 100 g/L, preferably 1 to 50 g.
• the core material is a liquid which produces a liquid/gas phase change at 38 to 100 ° C (that is, a liquid which is converted into a gas in an animal or a human body during HIFU treatment),
• the content in the auxiliary agent is 5 to 200 ml/L, preferably 10 to 100 ml/L, and more preferably 20 to 80 ml/L.
• the film-forming material includes a lipid such as 3-sn-phosphatidylcholine (Olympus), 1,2-dipalmitoyl-sn-glycero-3-phosphatidyl Glyceryl-sodium salt, 1,2-distearoyl-sn-glycero-3-phosphatidylcholine, 1,2-dipalmitoyl-sn-glycero-3-phosphatidyl-sodium salt, 1 , 2-dipalmitoyl-sn-glycero-3-phosphatidylcholine, phosphatidylserine, hydrogenated phosphatidylserine, cholesterol, glycolipids; sugars, including, for example, glucose, fructose, sucrose, starch, and the like Chain length degradation products; proteins, including, for example, albumin, globulin, fibrinogen, fibrin, hemoglobin, and degradation products of plant chain proteins of different chain lengths, and the like.
• a lipid such as 3-
• the fluorocarbon emulsion-type auxiliaries for HIFU treatment provided by the present invention are preferably biocompatible, degradable biomaterials such as lipids as a film-forming material, which enables the auxiliaries to be intravenously injected through the blood circulation, and It is quickly swallowed by tissues rich in reticuloendothelial cells in the body, and can be deposited in human tissues in a large amount of time, which can significantly change the acoustic environment of human tissues, thereby significantly enhancing the absorption characteristics of human tissue to sound waves, and increasing HIFU.
• the energy deposition of the target tissue during treatment can ultimately significantly improve the efficiency of HIFU treatment of tumors.
• the liquid which produces liquid/gas phase change at 38 to 100 ° C includes ( 5 - 6 6 alkane such as n-pentane, isopentane and fluorinated C 5 -C 12 hydrocarbon Class substances and other substances (see Chinese invention patent CN1068230C, patent number ZL94191564, pages 65 ⁇ 70).
• the aqueous medium is distilled water, physiological saline or a glucose solution. The concentration of the glucose solution can reach 50% (W/V), but in the fluorocarbon emulsion auxiliaries for HIFU treatment used by diabetic patients, the aqueous medium cannot be used as a glucose solution.
• the auxiliary agent may further contain an emulsifier, and the emulsifier is generally selected from the group consisting of monoethylene glycol mono C 16 . 18 fatty acid ester, diethylene glycol mono C 16 -18 fatty acid ester, and Ethylene glycol di c 16 -18 fatty acid ester, triethylene glycol mono c 16 . 18 fatty acid ester, sorbitan fatty acid ester (span series) emulsifier, polysorbate (Tween series) emulsified Agent, polyethylene glycol monolaurate series emulsifier, polyoxyethylene laurate series emulsifier, 3-sn-phosphatidylcholine (lecithin), cholic acid and the like.
• the emulsifier is generally selected from the group consisting of monoethylene glycol mono C 16 . 18 fatty acid ester, diethylene glycol mono C 16 -18 fatty acid ester, and Ethylene glycol di c 16 -18 fatty acid ester, tri
• the emulsifier is contained in the auxiliary agent in an amount of 5 to 150 g/L.
• the adjuvant may also contain stabilizers such as sodium carboxymethylcellulose (CMC-Na), potassium carboxymethylcellulose, sodium carboxyethylcellulose, potassium carboxyethylcellulose, carboxypropylcellulose.
• CMC-Na sodium carboxymethylcellulose
• glycerol glycerol
• the content of the CMC-Na in the auxiliary agent is 0.01 to 10 g/L, preferably 0.05 to 0.6 g/L, more preferably 0.1 to 0.3. g/L.
• the content of the glycerol in the auxiliary agent is 5 to 100 g/L.
• the pH of the auxiliary agent is adjusted to 7.0 to 9.0, preferably to 7.5 to 8.5.
• Both inorganic or organic bases can be used to adjust the pH of the adjuvant.
• a substance having a specific affinity for the tumor tissue or the lesion site may be added to the adjuvant. , such as tumor antibodies.
• the fluorocarbon emulsion-based contrast agent widely used in the field of ultrasound contrast can be used as the fluorocarbon emulsion adjuvant for HIFU treatment of the present invention. Accordingly, in another aspect of the invention, there is provided the use of a fluorocarbon emulsion-based ultrasound contrast agent for the preparation of a HIFU therapeutic adjuvant.
• Still another technical solution of the present invention provides a method for preparing a fluorocarbon emulsion-type auxiliary agent for HIFU treatment of the present invention, which comprises the following steps:
• the crude milk obtained in the step (1) is emulsified in a high-pressure nip machine (see Example 19 of Chinese Patent No. CN1068230C).
• a high-pressure nip machine see Example 19 of Chinese Patent No. CN1068230C.
• the crude milk Two emulsifications were carried out.
• the fluorocarbon emulsion-type auxiliary agent for HIFU treatment of the present invention it is preferred to carry out stirring and dispersion in the ice water bath in the step (1). More preferably, an emulsifier or/and a stabilizer may be added when the film-forming material and the core material are mixed.
• the invention also provides a method for increasing energy deposition in a target area during HIFU treatment, characterized in that the patient is injected with an effective dose of the HIFU of the invention by intravenous rapid infusion or bolus injection 0 to 30 minutes before HIFU treatment.
• an effective dose of the HIFU of the invention by intravenous rapid infusion or bolus injection 0 to 30 minutes before HIFU treatment.
• the effective dose will vary depending on the type of tumor, the weight of the patient, the location of the tumor, the volume of the tumor, and the like. However, the physician or pharmacist has the ability to determine the appropriate amount of injection for different patients. For example, it may be selected within the range of 0.005 to 0.1 ml of adjuvant/kg body weight, preferably 0.01 to 0.05 ml of adjuvant/kg body weight. detailed description
• Example 2 0.5% (W/V) egg yolk lecithin (purchased from Shanghai Chemical Reagent Co., Ltd.), 5 % (V/V) perfluoropentane (purchased from Sigma) mixed with distilled water 1000ml, in ice water bath, 10000 rpm /min cut and disperse for 5 minutes to make a thick milk.
• the crude milk was placed in a 4 ° C high-pressure milk homogenizer, emulsified twice to obtain an emulsion, and filtered through a ⁇ filter to obtain an emulsion having a particle size smaller than ⁇ . It was placed in a 15 ml bottle and irradiated with 20 KGY of cobalt 60 for 10 hours. The particle concentration was 10 9 /ml, and it was stored in a refrigerator.
• Example 2 Example 2
• the HIFU therapeutic fluorocarbon emulsion adjuvant prepared in Example 1 is exemplified below, and the combination of the JC type HIFU tumor treatment system is used to illustrate the effect of the adjuvant of the present invention.
• JC type HIFU tumor treatment system is mainly composed of adjustable power generator, B-ultrasound monitoring system, therapeutic probe, mechanical motion control system, treatment bed and acoustic coupling device.
• the treatment head has a diameter of 150mm and a focal length of 150mm.
• the transducer used in the experiment has a diameter of 150 mm, a focal length of 135 mm, a frequency of 1.0 MHz, and a sound power (P) of 200 W.
• the irradiation depth is 20mm, and the irradiation method is intermittently fixed, irradiated for 3 seconds, and stopped for 5 seconds. According to the amount of 0.02ml/kg through the ear The saline was rapidly injected into the vein, and the rabbit liver was irradiated by HIFU at 60 seconds, which was a control group.
• the experimental yellow sheep was irradiated with a JC type HIFU tumor treatment system (manufactured by Chongqing Haifu (HIFU) Technology Co., Ltd.).
• the experiment used a transducer with a diameter of 150 mm, a focal length of 135 mm, a frequency of 0.8 MHz, and a sound power (P) of 220 W.
• the irradiation depth was 30 mm
• the irradiation method was a discontinuous fixed point
• the irradiation was 3 seconds
• the stop was 5 seconds. All the sheep did not remove the ribs.
• HIFU pre-scan before irradiation select the irradiation area, a total of 4 planes, a little irradiation on each plane, two-dimensional ultrasound observation of the intercostal space.
• Physiological saline was administered by rapid injection into the ear vein according to the amount of 0.02 ml/kg. After 60 seconds, the liver of the sheep was irradiated by HIFU, and each sheep was irradiated at 2 points. This was the control group.
• the auxiliaries prepared in Example 1 were administered by rapid injection into the ear vein according to the amount of 0.02 ml/kg. After 60 seconds, HIFU irradiation was also performed, and two points were also irradiated, which was the experimental group.
• the irradiation target area has a gray scale change and is irradiated for 4 to 5 times, and the irradiation is ended. If no gray scale change is observed, the irradiation is performed for a maximum of 200 seconds.
• the sheep were sacrificed 3 days later, and the volume of coagulative necrosis (V) in the liver was dissected.
• EEF energy efficiency factor
• Kidney Kidney Injury Take 20 Nanyang Yellow Sheep, weighing 22.25 ⁇ 4.51kg, and remove the hair of the right chest and right abdomen on the day before the experiment. The experimental yellow sheep were irradiated with a JC type HIFU tumor treatment system (manufactured by Chongqing Haifu (HIFU) Technology Co., Ltd.).
• the experiment used a transducer with a diameter of 150 mm, a focal length of 135 mm, a frequency of 0.8 MHz, and a sound power (P) of 220 W.
• the irradiation depth was 20 mm
• the irradiation method was a discontinuous fixed point
• the irradiation was 3 seconds
• the stop was 5 seconds
• all the sheep did not remove the ribs.
• pre-scan select the irradiation area, select two planes for each of the upper and lower poles of the kidney, and irradiate a little on each plane, two-dimensional ultrasound observation. If the right rib is blocked, avoid it.
• Physiological saline was administered by rapid injection into the ear vein according to the amount of 0.02 ml/kg. After 30 seconds, HIFU was spot-irradiated to test the kidney of the sheep, which was the control group.
• the adjuvant prepared in Example 1 was administered by rapid injection into the ear vein at a dose of 0.02 ml/kg, and HIFU was irradiated 60 seconds later, which was an experimental group.
• the irradiation target region has a gray scale change and then irradiates 3 to 4 times to end the irradiation. If no gray scale change is observed, the irradiation is performed for a maximum of 150 seconds.
• the fluorocarbon emulsion auxiliaries for HIFU treatment can significantly improve the acoustic environment of the target area, and can reduce the ultrasonic energy required for the damage of the target tissue (tumor/non-tumor tissue) per unit volume, so that under a certain power, The deep, bulky tumor can be treated with high efficiency without damaging the normal tissue on the acoustic channel.
• the use of the adjuvant of the present invention makes it possible to effectively perform HIFU treatment on liver tumor patients without removing the ribs on the patient's therapeutic acoustic channel.

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