WO2006092106A2 - Combinación de egf/ghrp-6 para la neuroregeneracion del sistema nervioso central posterior al daño autoinmune. - Google Patents
Combinación de egf/ghrp-6 para la neuroregeneracion del sistema nervioso central posterior al daño autoinmune. Download PDFInfo
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- WO2006092106A2 WO2006092106A2 PCT/CU2006/000001 CU2006000001W WO2006092106A2 WO 2006092106 A2 WO2006092106 A2 WO 2006092106A2 CU 2006000001 W CU2006000001 W CU 2006000001W WO 2006092106 A2 WO2006092106 A2 WO 2006092106A2
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Definitions
- the present invention is related to medicine and more specifically to neurology and is directed to stimulate the central nervous system neuroregeneration due to autoimmune damage, particularly to treat and prevent relapses in patients with Multiple Sclerosis and Optical Neuromyelitis by administering compositions containing Epidermal Growth Factor and a Hexapeptide Secretagogue of the Human Growth Hormone.
- MS Multiple sclerosis
- NO Optical Neuromyelitis
- the central nervous system is an immunologically privileged site in which the occurrence of autoimmune reactions is rare. This occurs when, due to certain causes, cellular and / or humoral regulatory mechanisms fail, which determines that the autoreactive cells against myelin antigens, generated in the periphery (which is a frequent occurrence), in their condition of activated lymphocytes, cross The blood brain barrier (BHE) and find their targets in the parenchyma of the CNS. A series of cascade events follow, which produce demyelination, reactive astrocytosis, and cell death of neurons and oligodendrocytes.
- the autoimmune reaction in the CNS parenchyma is directed against the myelin antigens, so that the damage is limited to the myelin sheaths that line the axons of the main neurons, to the oligodendrocyte whose function is to produce myelin already another group of neurons that are affected nonspecifically by the scope of the autoimmune response.
- Demyelination and neuronal death due to necrosis and / or resulting apoptosis cause loss of motor and / or sensory functions that randomly affect certain areas of the human body.
- the remyelination process in MS and NO is generally limited and transitory. AND!
- Remyelination process although possible, depends on the balance established between self-reactive astrocytes and oligodendrocytes (John GR, Shankar SL, Shafit-Zagardo B., Massimi A., Lee SC, Raine CS. et al. (2002) Multiple sclerosis : re-expression of a developmental pathway that restricts oligodendrocyte maturation Nature Medicine 8 (10): 1115-1121)
- EGF Epidermal Growth Factor
- bFGF bovine fibroblast growth factor
- the Hexapeptide Secretagogue of the Human Growth Hormone increases the expression of insulin-like growth factor 1 (abbreviated "Insulin-like Growth Factor 1") IGF-1) in the CNS (Frago LM, Paneda C, Dickson SL, Hewson AK, Argente J., Chowen JA (2002) Growth hormone (GH) and GH-releasing peptide-6 increase brain insulin-like growth factor-l expression and activate intracellular signaling pathways involved in neuroprotection.Endocrinology 143 (10): 4113-4122).
- IGF-1 insulin-like growth factor 1
- IGF-1 is involved in certain processes such as increasing events related to oligodendrocyte maturation (Wilson H. C, Onischke C, Raine CS. (2003) Human oligodendrocyte precursor cells in vitro: phenotypic analysis and differential response to growth factors. GHa 44 (2): 153-165), block the apoptosis pathways dependent on the Tumor Necrosis Factor (abbreviated "Tumor Necrosis Factor”, abbreviated TNF- ⁇ ) by which it protects against the damage induced by e! TNF- ⁇ in MS and NO (Ye P, D'Ercole AJ.
- Tumor Necrosis Factor abbreviated TNF- ⁇
- MHC-I Major Histocompatibility Complex
- IGF-1 reduces the lesion of the vascular endothelium of the BHE, the number and size of sclerosis plaques, pathognomonic lesion of Multiple Sclerosis (Li W, Quigley L, Yao DL, Hudson LD, Brenner M 1 Zhang B. J et al. (1998) Chronic relapsing experiences autoimmune encephalomyelitis: effects of insulin-like growth factor-l treatment on clinical deficits, injury severity, glial responses, and blood brain barrier defects. J Neuropathol Exp Neurol 57 (5): 426-438).
- GHRP-6 increases the endogenous levels of the hormone adrenocorticotropin (ACTH) (Martins M. R, Pinto AC, Brunner E, Silva MR, Lengyel AM (2003) GH-releasing peptide (GHRP-6) -induced ACTH Relay ⁇ n patients with addison's disease: effect of glucocorticoid withdrawal.J Endocrinol Invest 26 (2): 143-147).
- ACTH as an endogenous steroid releasing factor, has a beneficial effect in counteracting self-reactive disorders and has long been the traditional therapy for MS (Oishi C, Sakuta M. (2003) Steroid therapy for multiple sclerosis. Nippon Rinsho 61 (8 ): 1361-1366).
- the EGF is synthesized (orally in the CNS by microglia, macrophages derived from blood and also by some neurons, it also reaches through the bloodstream because it is permeable to BHE and the membranes that cover the ventricles. So this molecule has a series of physiological functions such as influencing the development of the CNS, differentiation and maintenance of nerve parenchyma cells, actions are closely related to the processes of neural regeneration and survival mechanisms that follow a variety of insults (Plata-Saiaman CR. ( 1991) Epidermal growth factor and the nervous system Peptides 12 (3): 653-663) EGF stimulates cell proliferation and survival in the CNS (Thorne R. G, Hrabetova S, Nicholson C.
- Oligodendrocytes stimulated with EGF gain in potential Remyelinating EGF contributes to the proliferation processes of oligodendrocytes, facilitating the beginning of cell division and subsequent Differentiation in specialized cells such as mature oligodendrocytes, astrocytes and Schwann cells.
- EGF promotes next-generation events of neurons or neurogenesis (Crang AJ., Gilson JM, Li WW, Blakemore WF (2004) The remyelina ⁇ ing potential and in vitro differentiation of MOG-expressing oligodendrocyte precursors isolated from the adult rat CNS. Eur J Neurosa 20 (6): 1445-1460; Raineteau O., Rietschin L., Gradkar G., Guillemot F., Gahwiler BH (2004) Neurogenesis in hippocampal slice cultures. Mol CeII Neurosci 26 (2): 241-250).
- the present invention is based on a method in which the co-administration of EGF and GHRP-6 represents an improved treatment for autoimmune disorders of the Central Nervous System.
- This combination protects and reverses e! damage caused by the autoimmune response in chronic CNS lesions, particularly in Multiple Sclerosis and Optic Neuromyelitis.
- the combination produces the most lasting efficacy and a substantial reduction of relapses, that is, it produces neuro-regenerative events, in a more efficient way.
- the term "the most lasting efficacy” means that the active ingredients produce the relief of symptoms associated with MS and NO for a longer period of time, it even confers protection to avoid episodes of relapse.
- the active ingredients contained in the pharmaceutical combination are proteins and peptides of an autologous nature, for which there are natural Regulatory T cells, which will be stimulated to proliferate after the exogenous administration of these peptides and may counteract the autoimmune response, since The role of these regulatory T cells is to mediate immunological tolerance phenomena, constitutively (Jom G., Benedikt B., Bruno K.
- EGF and GHRP-6 Due to the synergistic effect between EGF and GHRP-6 in relation to neuro-trophic / neuro-regenerative events, this combination is useful in accelerating the processes of neurogenesis, which facilitates the recovery of motor and sensory nerve functions losses as a result of damage or injury of an autoimmune nature.
- the combination of EGF / GHRP-6 products which exert a marked neuro-regenerative and neuro-protective action by the stimulation of different mechanisms that are triggered after the administration of therapeutic doses.
- the combination may be associated with any antioxidant therapy.
- the active ingredient referred to as EGF comes from any species, including cattle, sheep, pigs and humans, in its native sequence or variants thereof and from any source, whether natural or synthetic, or recombinant. . AND! Preferred in this case is the native human sequence EGF and more preferably the recombinant human EGF.
- the active principle referred to as the peptide secretagogue of human growth hormone is the hexapeptide having the following amino acid sequence: His-D-Trp-Ala-Trp-D-Phe-Lys-NH.sub.2 and obtained by chemical synthesis
- the therapeutic doses administered during the MS and NO crises range between 5-200 ⁇ g / kg / day for the EGF and between 0.5-350 ⁇ g / kg / day for the GHRP-6 peptide for 20 years. Up to 30 days
- the doses administered in the inter-crisis stages, to prevent relapses or exacerbations in Multiple Sclerosis comprise a range between 0.5-50 ⁇ g / kg / day for each of the components for a space of up to 130 days.
- the combination should be administered as "bolus".
- the routes of administration will be parenteral in superficial vein, intramuscular or intra-peritoneal.
- the vehicles used in the administration include: normal saline solution, Ringer lactate solution, human plasma, human albumin solution, 5% dextrose, gelatin solution, or mixture of some of them.
- the first administration should be carried out coinciding with the prodromes of the disease (personalized).
- therapeutic schemes are proposed sustained with the dose previously referred to as relapse prevention.
- sustained treatment schemes are proposed but with therapeutic doses.
- the combination EGF / GHRP-6 induces proliferation of natural and adaptive regulatory T cells that protect from the development of severe clinical forms of EAE in adoptive transfer experiments.
- the EGF / GHRP-6 combination can be used within the same pharmaceutical composition or mixed from the independent components at the time of use.
- the combination of the active ingredients can be administered using attachments that guarantee slow release. If the form of presentation of the combination is lyophilized, it should be resuspended immediately before use.
- Example 1 Therapeutic effect of the pharmaceutical combination EGF / GHRP-6 in a biomodel of Experimental Autoimmune Encephalitis (EAE).
- EAE Experimental Autoimmune Encephalitis
- EAE Experimental Autoimmune Encephalitis
- mice Female Lewis rats, 13Og of average body weight, were immunized subcutaneously with 5mg of spinal cord homogenate in PBS (50%) and Freund's complete adjuvant (50%), on days 0 and 6. Ten days later At the first immunization, the therapeutic scheme was started with the combination EGF / GHRP-6 (200 ⁇ g / kg / day-740 ⁇ g / kg / day), the independent active ingredients EGF (200 ⁇ g / kg / day) and GHRP-6 (740 ⁇ g / kg / day) and placebo (PBS). This therapeutic scheme was followed for 10 days, using the intraperitoneal route of administration.
- the clinical measurements of the disease were made based on the following clinical index: 0; no alterations, 1; complete paralysis of the tail, 2; paralysis of one of the lower limbs, 3; complete paralysis of the posterior train, 4; complete paralysis of the posterior train and paralysis of the anterior train, 5; death.
- Weight loss and bladder or rectal sphincter incontinence which are also clinical signs of the disease in the animal were assessed by adding 0.5 to the clinical index mentioned above.
- the animals were anesthetized and sacrificed, the brain and spinal cord of each animal was processed (10% formalin fixation, staining with H&E and Luxol Blue) for histopathological analysis.
- the histopathological criteria considered were the number and size of perivascular inflammatory infiltrates, demyelinating lesions, apoptosis of neurons or glia cells and astrocyte reactivity.
- the entire microscopic study was performed blindly.
- Table 1 the combination EGF / GHRP-6 protects experimentally induced animals to develop EAE, only 50% of these animals develop the mildest form of the disease, the rest does not get sick. This is not the case in the rest of the groups where the incidence of the disease is of! 100% (groups treated with independent active ingredients and placebo).
- the mean clinical index of the group treated with the EGF / GHRP-6 combination is 0.37 ⁇ 0.47, that of the groups treated with the independent active ingredients is 1.37 ⁇ 1.7 for the EGF and 1.5 ⁇ 1.6 for the GHRP-6 and that of the group treated with placebo is 1.7 ⁇ 1.4.
- a total of 8 rats per group were used. The statistical comparison between the groups was p ⁇ 0.001. The Newman Keuls multiple test "test" was used.
- This experiment demonstrates that the pharmaceutical combination EGF / GHRP-6 protects animals from developing the disease in its most severe clinical form.
- the mechanisms that explain this protective effect are the increase in the production of myelin by oligodendrocytes and the consequent re-myelination of the affected nerve endings, other mechanisms are related to the maintenance of the integrity of the Blood-brain Barrier (BHE) preventing the passage of autoreactive cells towards the cerebral parenchyma.
- BHE Blood-brain Barrier
- EAE Experimental Autoimmune Encephalitis
- the prophylactic treatment groups were: EGF / GHRP-6 (100 ⁇ g / kg / day-370 ⁇ g / kg / day). EGF (100 ⁇ g / kg / day) GHRP-6 (370 ⁇ g / kg / day) Placebo PBS. The treatment with the prophylactic scheme was followed for 10 days (-10 to -1), using the intraperitoneal route of administration.
- the clinical measurements were made based on the following clinical index: 0; no alterations, 1; complete paralysis of the tail, 2; paralysis of one of the lower limbs, 3; complete paralysis of the posterior train, 4; complete paralysis of the posterior train and paralysis of the anterior train, 5; death.
- Weight loss and bladder or rectal sphincter incontinence which are also clinical signs of the disease in the animal were assessed by adding 0.5 to the clinical index mentioned above.
- the animals were anesthetized and slaughtered.
- the brain and spinal cord of each animal was processed (10% formalin fixation, staining with H&E and Luxol Blue) for histopathological analysis.
- the histopathological criteria considered were, number and size of perivascular inflammatory infiltrates, demyelinating lesions, apoptosis of neurons or glia cells and astrocyte reactivity.
- the entire microscopic study was performed blindly.
- the pharmaceutical combination, EGF / GHRP-6 preventively protects experimentally induced animals to develop EAE. 100% of these animals treated with the pharmaceutical combination develop the mildest form of the disease (0.5-1 clinical index). This is not the case in the rest of the groups where 75% of the animals treated preventively with each of the independent active ingredients develop severe forms of the disease (3-4 of the clinical index).
- the mean clinical index of the group treated with the pharmaceutical combination EGF / GHRP-6 is 0.68 ⁇ 0.25, that of the groups treated with the independent active ingredients is 2.8 ⁇ 0.99 for the group treated with EGF and 2.7 ⁇ 1.03 for the group treated with the GHRP-6.
- the one in the placebo group is 3 ⁇ 1.4.
- a total of 8 rats per group were used.
- Example 3 Study of dose, synergism-potentiation between the active ingredients of the pharmaceutical combination.
- mice Female Lewis rats, 13Og of average body weight, were immunized subcutaneously with 5mg of spinal cord homogenate in PBS (50%) and Freund's complete adjuvant (50%), on days 0 and 6. Ten days later At the first immunization, the therapeutic scheme with the EGF / GHRP-6 was started at different doses. This therapeutic scheme was followed for 10 days, using the intraperitoneal route of administration. The clinical measurements of the disease were made based on the following clinical index: 0; no alterations, 1; complete paralysis of the tail, 2; paralysis of one of the lower limbs, 3; complete paralysis of the posterior train, 4; complete paralysis of the posterior train and paralysis of the anterior train, 5; death.
- Weight loss and bladder or rectal sphincter incontinence which are also clinical signs of the disease in the animal were assessed by adding 0.5 to the clinical index mentioned above.
- the animals were anesthetized and sacrificed, the brain and spinal cord of each animal was processed (10% formalin fixation, staining with H&E and Luxol Blue) for histopathological analysis. Histopathological criteria considered were, number and size of perivascular inflammatory infiltrates, demyelinating lesions, neuronal apoptosis or glia cells and astrocyte reactivity. The entire microscopic study was performed blindly.
- the groups of animals treated with the different doses of the pharmaceutical combination were: EGF / GHRP-6 (400 ⁇ g / kg / day-1480 ⁇ g / kg / day).
- EGF / GHRP-6 (200 ⁇ g / kg / dfa-740 ⁇ g / kg / day).
- EGF / GHRP-6 (100 ⁇ g / kg / day-340 ⁇ g / kg / day)
- EGF / GHRP-6 50 ⁇ g / kg / day-170 ⁇ g / kg / day
- EGF / GHRP-6 (25 ⁇ g / kg / day-85 ⁇ g / kg / day)
- EGF / GHRP-6 (12 ⁇ g / kg / day-40 ⁇ g / kg / day)
- Tables 5 and 6 show the results of the clinic and of! histopathological study. In the case of the latter, there are no statistically significant differences in the number of perivascular lymphocytic infiltrates in the groups treated with the pharmaceutical combination EGF / GHRP-6 at the doses of (400 ⁇ g / kg-1480 ⁇ g / kg, 200 ⁇ g / kg-740 ⁇ g / kg, 100 ⁇ g / kg-340 ⁇ g / kg, 50 ⁇ g / kg-170 ⁇ g / kg and 25 ⁇ g / kg-85 ⁇ g / kg).
- Lymphocytes from group A and B animals were subjected respectively to separation of the CD4 cell population.
- the FACS analysis of the CD4 + CD25 + subpopulation was 14.67% for Group A CD4 and 3.8% for the case of group B.
- Female Lewis rats, 13Og of average body weight, were immunized subcutaneously with 5mg of Homogenated spinal cord of curiel in PBS (50%) and Freund's complete adjuvant (50%), on days 0 and 6.
- the clinical measurements of the disease were made based on the following clinical index: 0; no alterations, 1; complete paralysis of the tail, 2; paralysis of one of the lower limbs, 3; complete paralysis of the posterior train, 4; complete paralysis of the posterior train and paralysis of the anterior train, 5; death.
- Weight loss and bladder or rectal sphincter incontinence which are also clinical signs of the disease in the animal were assessed by adding 0.5 to the clinical index mentioned above.
- the animals were anesthetized and sacrificed, the brain and spinal cord of each animal was processed (10% formalin fixation, staining with H&E and Luxol Blue) for histopathological analysis.
- the histopathological criteria considered were the number and size of perivascular inflammatory infiltrates, demyelinating lesions, apoptosis of neurons or glia cells and astrocyte reactivity.
- the entire microscopic study was performed blindly.
- the transfer of CD4 + cells from animals induced to develop EAE and treated with the pharmaceutical combination protects animals experimentally induced to develop EAE. Only 50% of these animals that received the CD4 + cells of group A by adoptive transfer develop the mildest forms of the disease (0.5-1 clinical index), the other 50% do not get sick.
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KR1020077022024A KR101255200B1 (ko) | 2005-03-02 | 2006-02-24 | 자가면역 손상에 따른 중추 신경계의 신경 재생용egf/ghrp-6의 조합 |
EP06705745A EP1870106B1 (en) | 2005-03-02 | 2006-02-24 | Combination of egf/ghrp-6 for neuroregeneration of central nervous system |
JP2007557312A JP5001180B2 (ja) | 2005-03-02 | 2006-02-24 | 自己免疫障害後の中枢神経系の神経再生に用いるegf/ghrp−6の組合せ |
AT06705745T ATE431743T1 (de) | 2005-03-02 | 2006-02-24 | Kombination von egf/ghrp-6 für die neuroregeneration des zentralnervensystems |
MX2007010717A MX2007010717A (es) | 2005-03-02 | 2006-02-24 | Combinacion de egf/ghrp-6 para la neuroregeneracion del sistema nervioso central posterior al dano autoinmune. |
CN2006800139592A CN101180044B (zh) | 2005-03-02 | 2006-02-24 | 用于自身免疫损伤后中枢神经系统神经再生的egf/ghrp-6组合 |
AU2006220154A AU2006220154B2 (en) | 2005-03-02 | 2006-02-24 | Combination of EGF/GHRP-6 for neurogeneration of central nervous system |
BRPI0607844A BRPI0607844B8 (pt) | 2005-03-02 | 2006-02-24 | uso do egf e ghrp-6 |
CA2600628A CA2600628C (en) | 2005-03-02 | 2006-02-24 | Combination of egf/ghrp-6 for neurogeneration of central nervous system following autoimmune damage |
DE602006006903T DE602006006903D1 (de) | 2005-03-02 | 2006-02-24 | Kombination von egf/ghrp-6 für die neuroregeneration des zentralnervensystems |
US11/885,330 US20100093616A1 (en) | 2005-03-02 | 2006-02-24 | Combination of EGF/GHRP-6 for Neurogeneration of Central Nervous System Following Autoimmune Damage |
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EP2644618A1 (en) | 2007-02-09 | 2013-10-02 | Tranzyme Pharma, Inc. | tether intermediates for the synthesis of macrocyclic ghrelin receptor modulators |
WO2020038498A1 (es) | 2018-08-21 | 2020-02-27 | Centro De Ingenieria Genetica Y Biotecnologia | Combinación farmacéutica que contiene el factor de crecimiento epidérmico y el peptido secretagogo ghrp6 para la restauración del daño cerebral |
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ES2967696T3 (es) | 2019-04-08 | 2024-05-03 | Giuseppe Scalabrino | Factor de crecimiento epidérmico (EGF) y variantes del mismo para tratar o prevenir trastornos desmielinizantes inflamatorios |
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WO2000030675A2 (en) * | 1998-11-25 | 2000-06-02 | A+ Science Invest Ab | Medicinal product and method for treatment of conditions affecting neural stem cells or progenitor cells |
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CU23157A1 (es) * | 2001-01-03 | 2006-07-18 | Ct Ingenieria Genetica Biotech | COMPOSICION FARMACéUTICA PARA EL TRATAMIENTO DEL DANO TISULAR DEBIDO A FALTA DE IRRIGACION SANGUINEA ARTERIAL |
AU2002325712C1 (en) * | 2001-08-30 | 2008-07-31 | Stem Cell Therapeutics Inc. | Differentiation of neural stem cells and therapeutic use theeof |
HK1077740A1 (en) * | 2001-12-20 | 2006-02-24 | Ct Ingenieria Genetica Biotech | Use of epidermal growth factor in the manufacture of a pharmaceutical injection composition for preventing diabetic limb amputation |
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WO2000030675A2 (en) * | 1998-11-25 | 2000-06-02 | A+ Science Invest Ab | Medicinal product and method for treatment of conditions affecting neural stem cells or progenitor cells |
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Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP2644618A1 (en) | 2007-02-09 | 2013-10-02 | Tranzyme Pharma, Inc. | tether intermediates for the synthesis of macrocyclic ghrelin receptor modulators |
WO2020038498A1 (es) | 2018-08-21 | 2020-02-27 | Centro De Ingenieria Genetica Y Biotecnologia | Combinación farmacéutica que contiene el factor de crecimiento epidérmico y el peptido secretagogo ghrp6 para la restauración del daño cerebral |
Also Published As
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KR20070107790A (ko) | 2007-11-07 |
RU2403913C2 (ru) | 2010-11-20 |
WO2006092106A3 (es) | 2006-12-14 |
PT1870106E (pt) | 2009-08-25 |
BRPI0607844A2 (pt) | 2010-10-19 |
CA2600628A1 (en) | 2006-09-08 |
KR101255200B1 (ko) | 2013-04-23 |
RU2007136280A (ru) | 2009-04-10 |
AU2006220154B2 (en) | 2010-05-27 |
JP5001180B2 (ja) | 2012-08-15 |
BRPI0607844B8 (pt) | 2021-05-25 |
US20100093616A1 (en) | 2010-04-15 |
AU2006220154A1 (en) | 2006-09-08 |
MY142494A (en) | 2010-11-30 |
BRPI0607844B1 (pt) | 2018-08-28 |
EP1870106A2 (en) | 2007-12-26 |
ES2327562T3 (es) | 2009-10-30 |
MX2007010717A (es) | 2007-10-12 |
CN101180044B (zh) | 2010-12-08 |
EP1870106B1 (en) | 2009-05-20 |
DE602006006903D1 (de) | 2009-07-02 |
CA2600628C (en) | 2013-04-09 |
JP2008531607A (ja) | 2008-08-14 |
CN101180044A (zh) | 2008-05-14 |
CU23529A1 (es) | 2010-06-17 |
ATE431743T1 (de) | 2009-06-15 |
ZA200707020B (en) | 2009-08-26 |
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