WO2006132310A1 - 組織癒着防止液及び組織癒着防止方法 - Google Patents
組織癒着防止液及び組織癒着防止方法 Download PDFInfo
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- WO2006132310A1 WO2006132310A1 PCT/JP2006/311501 JP2006311501W WO2006132310A1 WO 2006132310 A1 WO2006132310 A1 WO 2006132310A1 JP 2006311501 W JP2006311501 W JP 2006311501W WO 2006132310 A1 WO2006132310 A1 WO 2006132310A1
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- tissue adhesion
- solution
- liquid
- tissue
- preventing
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- 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
- A61K31/70—Carbohydrates; Sugars; Derivatives thereof
- A61K31/7016—Disaccharides, e.g. lactose, lactulose
-
- 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
- A61K31/33—Heterocyclic compounds
- A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
- A61K31/365—Lactones
- A61K31/375—Ascorbic acid, i.e. vitamin C; Salts thereof
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/08—Solutions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/04—Macromolecular materials
- A61L31/042—Polysaccharides
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P39/00—General protective or antinoxious agents
- A61P39/06—Free radical scavengers or antioxidants
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P41/00—Drugs used in surgical methods, e.g. surgery adjuvants for preventing adhesion or for vitreum substitution
Definitions
- the present invention relates to a tissue adhesion preventing solution and a tissue adhesion preventing method, and in particular, includes trehalose, prevents drying due to exposure to air during surgery, and prevents acid oxidation, and includes tissue adhesion including organs after surgery.
- the present invention relates to a tissue adhesion preventing liquid and a method for preventing tissue adhesion that can prevent complications.
- tissue including organs is exposed to air by incision. At this time, these tissues are dried and oxidized, resulting in damage. Drying and oxidation of tissues including organs during surgery lead to tissue damage, and are thought to cause problems such as tissue adhesion and delayed healing after surgery.
- adhesion is regarded as one of the most important complications after surgery because it often interferes with normal movement of tissues including organs.
- adhesions in tendon surgery can cause movement disorders.
- organ adhesions after intraperitoneal surgery can cause complications such as ileus, pain, and infertility, which can sometimes cause problems such as making the next surgery very difficult.
- Examples of treatments to avoid tissue adhesion and healing delay after surgery include regular perfusion of saline solution to exposed organs during surgery, and gauze immersed in saline solution. Treatments for covering tissues such as organs have been performed.
- Patent Document 1 Japanese Patent No. 2948254
- Patent Document 2 Japanese Patent No. 3420851
- the component having an adhesion preventing function is a polymer and is mainly placed in a film shape and placed on a target part or a viscous liquid is applied to the target part. Therefore, operability such as ease of use was lacking.
- sugars that have been used in various fields such as food and cosmetics in recent years. It is confirmed that trehalose (CHO), one of the qualities, has a very high hydration power compared to other carbohydrates.
- Trehalose has a structure similar to the cluster structure of H 2 O,
- Trehalose having such a high function is expected to have an unknown and effective use, and various studies are being conducted on a novel use of trehalose.
- drugs for transmucosal administration containing trehalose for example, Patent Document 3
- nutritional fluids containing trehalose as a source of carbohydrate calories for example, Patent Documents 4 and 5
- for transplanted organs containing trehalose Solution for example, Patent Document 6
- containing trehalose and having corneal protection, intraocular perfusion, cleaning agent, eye drops, eye ointment
- Patent Document 7 an agent for forming an association product of trehalose and an unsaturated compound
- Patent Document 9 a lipid degradation inhibitor containing trehalose
- Patent Document 3 Japanese Patent Application Laid-Open No. 6-256219
- Patent Document 4 JP-A-6-72883
- Patent Document 5 JP-A-6-319486
- Patent Document 6 Japanese Patent Laid-Open No. 6-40801
- Patent Document 7 Japanese Patent Laid-Open No. 9-235233
- Patent Document 8 Japanese Patent Publication No. 2002-24832
- Patent Document 9 Pamphlet of International Publication No. 2004Z076602 [0009]
- a protective solution using trehalose administered to the wound and the tissue including the organ exposed to the air by being incised by surgery such as surgery. It's still known that the delay is prevented! Disclosure of the invention
- An object of the present invention is to provide a tissue adhesion preventing solution and a tissue adhesion preventing method that can be applied to general surgery that is stable and easy to use.
- Another object of the present invention is to provide a novel tissue adhesion preventing solution and a method for preventing tissue adhesion using trehalose.
- the present inventors focused on trehalose, and as a result, sprayed with an aqueous trehalose solution on the surface of an animal organ during surgery prevents adhesion after surgery. It was also found that trehalose prolongs the cell viability even when the cultured cells are exposed to air and sprayed with a trehalose aqueous solution and then dried. Furthermore, surprisingly, when the aqueous solution containing trehalose and glycosyl mono-L-ascorbic acid is sprayed and then dried, it surprisingly exhibits both functions synergistically and provides stronger protection than single use. It has been found that it works.
- the present invention is based on the discovery of a new action of trehalose, and solves the above-mentioned problems by constructing a tissue adhesion preventing solution comprising an aqueous solution containing trehalose as an active ingredient. It is.
- the tissue adhesion preventing solution contains glycosyl-L-ascorbic acid, thereby further improving the tissue protection function.
- the application of the tissue adhesion prevention liquid prevents the tissue including the wound surface and organs exposed to the air during surgery from being dried and suppresses oxidative stress. Therefore, even if the wound surface or tissue is exposed to the air during surgery, trehalose forms a chelate with a metal such as Fe to generate free radicals. Since metal ions are deactivated and free radicals are suppressed, delays in post-surgical tissue adhesion and wound healing are prevented.
- the tissue adhesion preventing liquid is an antioxidant, chelating agent, bactericidal disinfectant, hemostatic agent, anti-inflammatory agent, lubricating polysaccharide, mucopolysaccharide, polysaccharide salt, mucopolysaccharide It is preferred to include at least one of the salts.
- tissue adhesion preventing liquid is configured to contain at least one of a bactericidal disinfectant, a hemostatic agent, and an anti-inflammatory agent. Therefore, a drug such as a bactericidal disinfectant, a hemostatic agent and an anti-inflammatory agent is separately administered. Convenient for all you need.
- the tissue adhesion preventing liquid contains at least one of a lubricious polysaccharide, mucopolysaccharide, polysaccharide salt, and mucopolysaccharide salt
- a lubricious polysaccharide When applied to tissues including organs, it is possible to prevent mechanical damage such as microinjury during surgery that is not only caused by dryness due to air exposure, oxidative stress, and free radical generation. That is, it is well known that microinjuries are generated on the surface of an organ by touching the organ with a hand during a surgical operation.
- a high-compatibility high-molecular compound that is lubricious is blended, so that damage due to contact with surgical gloves and surgical instruments can be reduced, and mechanical damage to tissues including organs can be reduced.
- the antioxidant substance is preferably an ascorbic acid derivative.
- the tissue protective function of trehalose and the free radical scavenging ability of the ascorbic acid derivative are synergistically exerted, and the wound surface and organ-containing tissue during surgery are further resistant to oxidative stress. It is prevented and suppressed, and free radical generation is reduced. As a result, it is possible to more effectively prevent delayed adhesion of tissues and wound healing after surgery.
- the viscosity of the tissue adhesion preventing liquid is adjusted with a thickener.
- the thickness of the wound covering the tissue and the tissue can be increased. It can be reliably coated with a thickness.
- the osmotic pressure is adjusted by at least one of an electrolyte isotonic solution, a plasma extender, an extracellular fluid replenisher, a maintenance solution, and water.
- the tissue adhesion preventing solution of the present invention can be adjusted to be isotonic, and nutrients by these components can be given to the tissue to which the tissue adhesion preventing solution is applied.
- the tissue adhesion preventing liquid is provided as a dosage form of a perfusate, a spray liquid, a liquid for spraying or vaporizing administration, a foam aerosol preparation, an injection injected into an infusion preparation, or an infusion preparation. It is preferable.
- tissue adhesion preventing liquid When the tissue adhesion preventing liquid is provided as a perfusate, various tissues such as adhesion can be damaged by perfusion during or after the operation with the perfusate of the present invention over a surgical operation or the like. It can be suppressed and prevented.
- the tissue adhesion preventing solution is a spray solution
- the tissue adhesion preventing solution can be supplied to the target area extensively and uniformly during the operation, and the target area to be prevented from being damaged is given a certain thickness. Can be coated.
- the target part can be reliably covered, so that it can be reliably treated after surgery. It is possible to prevent tissue damage and tissue adhesion.
- the tissue adhesion preventing liquid is a liquid for spraying or vaporizing administration
- the anti-adhesion solution can be sprayed onto the target part in the form of a mist-like mist, and can be supplied to the target part in a wide, uniform and fine mist state during the operation. It can be coated with a thickness of.
- the target part can be reliably covered, so that it can be reliably treated after surgery. It is possible to prevent tissue damage and tissue adhesion.
- the tissue adhesion prevention liquid is a foam aerosol formulation
- the tissue adhesion prevention liquid can be supplied to the target area extensively and uniformly during the operation, and the target area to be prevented from being damaged has a certain thickness. It can be covered.
- the target part can be reliably covered, so surgery is reliably performed. It is possible to prevent subsequent tissue damage and tissue adhesion.
- the tissue adhesion prevention liquid is an injection or an infusion preparation that is injected into an infusion preparation
- the tissue adhesion prevention liquid is applied to at least one step before, during, or after surgery. It is possible to administer by a method, and it is possible to prevent or prevent delay of healing after surgery by a method such as infusion.
- the present invention is a tissue adhesion prevention method in which each of the tissue adhesion prevention solutions described above is applied locally to the tissue.
- the tissue adhesion preventing liquid is configured to be applied locally to the tissue, it is possible to prevent applied local adhesion, delay of healing, and the like.
- the present invention is a tissue adhesion preventing liquid containing trehalose as an active ingredient.
- the application of the tissue adhesion prevention solution prevents the tissue including the wound surface and organs that are exposed to the air during surgery from being dried and suppresses oxidative stress and prevents lipid peroxidation. Degradation of sputum and lipids is prevented, and even if the wound surface or organ is exposed to the air during surgery, trehalose forms a chelate with a metal such as Fe to deactivate the metal ions that are the source of free radicals, To reduce the generation of free radicals, Delays in woven adhesion and wound healing are prevented.
- the tissue adhesion preventing solution contains an ascorbic acid derivative
- the tissue protective function of trehalose and the free radical scavenging ability of the ascorbic acid derivative are synergistically exhibited, and the tissue includes the wound surface and organ during surgery. Drying, oxidative stress, and free radical generation are further prevented and suppressed. As a result, it is possible to more effectively prevent delayed adhesion of tissues and wound healing after surgery.
- FIG. 1 is a graph showing changes in cell viability due to air drying in Example 1 of the present invention.
- FIG. 2 is a graph showing the influence of each reagent on cells in Example 1 of the present invention.
- the tissue adhesion preventing solution of the present invention is a tissue adhesion preventing solution containing trehalose as an active ingredient. It is administered directly to the wound surface and tissues including organs at the time of surgery.
- the present invention relates to an agent used as an anti-adhesion agent or a therapeutic agent for preventing delayed adhesion of tissue and wound healing after surgery.
- wound refers to a wound
- tissue refers to a living tissue including skin, organ, muscle, nerve, cartilage, bone, and the like.
- tissue adhesion preventing solution of the present invention can be applied to various animals, but can be suitably used particularly for mammals, particularly humans.
- the present embodiment is a tissue adhesion prevention liquid, which is a tissue coating agent or adhesion prevention agent that prevents delayed adhesion of tissue and wound healing after surgery, and a treatment that promotes healing of tissue and wound surfaces after surgery. It is used as an agent.
- the tissue adhesion preventing liquid of this embodiment is an aqueous solution containing trehalose as an active ingredient.
- the tissue adhesion preventing solution of the present embodiment is administered to the tissue surface exposed during the operation, but is not limited to the abdominal part, the thoracotomy, and the thoracotomy, which are not particularly limited by the surgical site or specialized area. It can be used in a wide range of applications, including neurosurgery, orthopedic surgery involving tendons and ligaments, liver surgery, and gynecological surgery. Examples of the tissue exposed during the operation include a wound generated by an incision by an operation, an organ exposed by an incision, a muscle, a nerve, a cartilage, and a bone. It can also be applied to bone marrow exposed by orthopedic osteotomy. Furthermore, it has been reported that trehalose suppresses the onset of mouse neurodegenerative diseases and can be applied to cranial nerves and peripheral nerves exposed by neurosurgery.
- Trehalose is a non-reducing disaccharide in which two molecules of glucose are linked by 1,1.
- Trehalose is a known substance that was first isolated from rye in 1832. In nature, it exists widely in a free state across animals, plants and microorganisms. It is a saccharide that is abundant in yeasts such as baker's yeast and beer yeast, and is also found in food. In addition, it is a carbohydrate related to various living organisms, and insects such as bearworms and worms, and plants such as iwahiba continue to survive in harsh environments such as deserts because trehalose exists in the living body. It is said.
- hydrated crystal trehalose, anhydrous crystal trehalose, trehalose-containing sugar solution, etc. a, ⁇ -trehalose (trehalose in a narrow sense),, j8-trehalose (neotrehalose), ⁇ , trehalose ( Any trehalose can be used, such as isotrehalose, but it is particularly preferable to use water-containing crystalline trehalose or anhydrous crystalline trehalose of a, —treno ⁇ lose (a-D-gnolecopyranosinole a-D glycopyranoside) It is.
- trehalose is natural, starch, maltooligosaccharide, glucose, etc. may be generated, but the deviation may be used.
- a derivative that generates trehalose in vivo after administration may be used instead of trehalose.
- an electrolyte isotonic solution As a solvent for dissolving trehalose, an electrolyte isotonic solution, a plasma extender, a maintenance solution, and water are used.
- An electrolyte isotonic solution refers to an electrolyte preparation that is an isotonic solution.
- Isotonic fluid is isotonic, that is, an infusion that has the same osmotic pressure as body fluid.
- an electrolyte isotonic solution for example, an extracellular fluid replenisher can be used.
- An extracellular fluid replenisher is an extracellular fluid that is lost when the extracellular fluid is lost due to bleeding, diarrhea, dehydration, etc. Solution replenishment ⁇ Infusion of isotonic electrolyte for correction. As an extracellular fluid replenisher
- physiological saline solution (0.9% saline solution
- acetate ringer solution acetate ringer solution
- lactate ringer solution etc.
- a plasma expander is also called a substitute plasma agent, and is an infusion used as a substitute when protein in plasma such as albumin is lost due to bleeding or the like. Dextran, starch, recombinant albumin, etc. It contains a polymer component.
- dextran 40 preparation dextran 70 preparation, hydroxyethyl starch (HES) preparation, modified gelatin preparation and the like can be used.
- HES hydroxyethyl starch
- the maintenance solution is an infusion for replenishing and maintaining water, electrolytes, and when ingestion is inadequate or insufficient.
- the maintenance liquid for example, an initiation liquid, a maintenance liquid, a high-concentration sugar-added maintenance liquid, and the like can be used.
- Water is a solvent for dissolving trehalose, and pure water, distilled water, or the like is used, and sterilized distilled water can be preferably used.
- the concentration of trehalose in the tissue adhesion preventing solution is 10 mM or more, preferably 50 to 350 mM.
- the tissue adhesion preventing liquid may be further added with at least one agent from the group comprising a bactericidal disinfectant, a hemostatic agent and an anti-inflammatory agent.
- bactericidal disinfectants include known disinfectants such as povidone, potassium persulfate monosulfate, dimethyldidecyl ammonium chloride, and hemostatic agents such as thrombin and sodium alginate.
- known disinfectants such as povidone, potassium persulfate monosulfate, dimethyldidecyl ammonium chloride, and hemostatic agents such as thrombin and sodium alginate.
- hemostatic agents such as thrombin and sodium alginate.
- thrombin and sodium alginate a non-steroidal anti-inflammatory agent is used.
- the anti-tissue substance may be further added to the tissue adhesion preventing liquid.
- water-soluble stable vitamin C can be used as the anti-acid substance.
- Water-soluble stable vitamin C includes ascorbic acid derivatives classified as provitamin C, such as glycosyl-L-ascorbic acid (hereinafter referred to as AA-2G), ascorbic acid-2-phosphate (AA- 2P) etc.
- AA-2G also called ascorbic acid 2-darcoside, is a naturally occurring substance that is broken down into ⁇ -dalcosidase in the living body into L-ascorbic acid and D-darcose and is equivalent to L-ascorbic acid. The physiological activity of is expressed.
- AA-2G is notable for its ability to promote collagen synthesis and cell growth and differentiation, which is non-cytotoxic even at high concentrations.
- AA-2G is not only food and cosmetics, but also connective tissues such as fibroblasts. It is also frequently used for the culture of
- AA-2G is a 2-0-a-D monodalcobilanosyl L-ascorbic acid formed by glycosidic linkage of one or more D-glucoses at the C-2 position in L-ascorbic acid. It is preferable to use a series of 2-darcobilanosyl-L-ascorbic acid such as AA-2G also liberates glycosyl L-ascorbic acid in aqueous media not limited to glycosyl monoascorbic acid as an organic acid, for example, sodium, potassium, calcium, magnesium, and ammonium salts. -Physiologically acceptable inorganic and organic salts such as um salt! /.
- the concentration of AA-2G in the tissue adhesion preventing solution is O. OlmM or higher, preferably in the range of 0.1 to 200 mM. If it is less than O.OlmM, a synergistic effect with the cytoprotective effect of trehalose cannot be expected.
- Antioxidants include minerals such as vitamin C, vitamin E, and selenium, body antioxidants such as SOD (superoxide dismutase), catarase, and glutathione peroxidase; power carotene, I Ichiriki carotene, contained in lycopene, carotenoids and flavonoids are liposoluble dyes xanthophylls such plants, catechin, tannin, Antoshianin, isoflavones, quercetin such as plant flowers and leaves ' ⁇ ' stalk like polyphenols Plant-derived anti-acid substances (SOD substances), phycocyanopirins, phycoerythalin pills, and the like can also be used.
- SOD superoxide dismutase
- catarase catarase
- power carotene I Ichiriki carotene, contained in lycopene
- carotenoids and flavonoids are liposoluble dyes xanthophylls such plants, cate
- the tissue adhesion preventing liquid may further contain a chelating agent.
- the chelating agents include DMPS (dimercaptopropanol sulfonic acid), DMSA (dimer-powered tosuccinic acid), ALA (alpha lipoic acid), EDTA (ethylene diamine tetraacetic acid), L-glutamic acid diacetic acid 'tetradium (GLDA ⁇ 4Na) , Sodium dulconate, etc. are used.
- DMPS dimercaptopropanol sulfonic acid
- DMSA dimer-powered tosuccinic acid
- ALA alpha lipoic acid
- EDTA ethylene diamine tetraacetic acid
- L-glutamic acid diacetic acid 'tetradium (GLDA ⁇ 4Na) Sodium dulconate, etc.
- Chelating agents can conjugated and metabolize divalent iron ions. By adding an agent, it is possible to prevent new free radicals from being generated by iron ions, and more effectively prevent delayed adhesion of tissues such as organs and wound healing after surgery. It becomes possible.
- the tissue adhesion preventing liquid may be further added with at least one of polysaccharides, mucopolysaccharides and salts thereof having lubricity.
- polysaccharide or a salt thereof for example, a polysaccharide containing a carboxyl group or a water-soluble salt thereof, or a carboxyl group-containing polysaccharide or a water-soluble salt thereof crosslinked by an ionic bond can be used.
- carboxyl group-containing polysaccharide carboxymethyl cellulose, carboxymethyl chitin, carboxymethyl chitosan, carboxymethyl starch, alginic acid, pectin, carboxymethyl dextran, etc.
- mucopolysaccharide hyaluronic acid (HA ), Heparin, heparin sulfate, chondroitin sulfate, etc. are included.
- the water-soluble salt can be used in the form of an alkali metal salt or alkaline earth metal salt such as a sodium salt.
- hyaluronic acid is preferably used.
- mucopolysaccharides such as hyaluronic acid have the ability to gel hundreds to thousands of water, and are known to impart water retention, viscosity, and lubricity to human body fluids.
- tissue adhesion prevention solution By adding to the tissue adhesion prevention solution, when the tissue surface such as a wound surface or organ is coated with the tissue adhesion prevention solution, it becomes possible to provide lubricity to the coating layer, and mechanically apply to the wound surface or tissue. An effect of preventing damage can be obtained.
- the tissue adhesion preventing liquid of the present embodiment has an osmotic pressure of 200 to 450 Osm and a pH of after mixing the above-described substances. Adjusted to be in the range of ⁇ 8.
- the osmotic pressure is set to 200 to 450 Osm in accordance with the osmotic pressure of the human tissue.
- the reason why the pH is set to 8 to 8 is to prevent acid degradation of cells of tissues such as wounds and organs to which the tissue adhesion preventing solution is administered.
- colloid osmotic agents such as hydroxyethyl starch and dextran starch are used.
- the osmotic pressure is adjusted to a low value in consideration of concentration due to drying during the operation.
- the tissue adhesion preventing liquid of this embodiment is adjusted so that the temperature during use is about the body temperature, that is, 35 ° C. to 38 ° C.
- the tissue adhesion preventing solution of this embodiment can be administered at any time before the healing of the wound progresses, but is preferably administered during the surgery or immediately before the wound is sutured. It can also be administered continuously during surgery.
- tissue adhesion preventing solution of this embodiment is directly administered to a tissue surface such as a wound surface or an organ that has been opened by surgery and exposed to air.
- Administration may be carried out by impregnating a liquid tissue adhesion prevention solution into a carrier such as gauze or non-woven fabric to coat the tissue surface such as the wound surface or organ! However, it may be applied directly to the tissue surface such as the wound surface or organ. It is preferable to use an injection method or a method in which the tissue adhesion preventing liquid of this embodiment is constituted as a spray liquid and sprayed using a spray device.
- the tissue adhesion prevention liquid is configured as a spray liquid and sprayed onto the target part, so that a solution that functions as a tissue adhesion prevention liquid on the wound surface can be supplied to the target part widely and uniformly. It is possible to cover the target portion to prevent damage with a certain thickness.
- a two-fluid nozzle spray that transports droplets with air or carbon dioxide gas or a one-fluid nozzle spray that applies pressure to the solution to form fine particles can be used.
- a one-fluid nozzle does not use gas to supply droplets. Therefore, when a single fluid nozzle is used, it is desirable from the viewpoint of preventing damage to the wound surface or tissue by preventing the tissue surface such as the wound surface or organ from being dried, temperature decrease due to oxidation or heat of vaporization.
- a holo-cone nozzle or a full cone nozzle that gives a swirling flow to the liquid and ejects it in a conical shape
- a nozzle that changes the cone angle of ejection a flat nozzle that ejects the liquid droplet in a plane
- a liquid droplet forward Various nozzles can be applied, such as a solid nozzle that goes straight and a fine spray that makes droplets fine.
- tissue adhesion prevention solution ⁇ When directly injecting onto the surface of tissue such as iij or organs, a certain degree of viscosity is required. Therefore, gums such as mucopolysaccharides and heteropolysaccharides, polyvinyl alcohol and poly The viscosity is adjusted using thickeners such as synthetic organic polymer compounds such as acrylic acid, cellulose derivatives and starch derivatives.
- the tissue adhesion preventing liquid of the present embodiment is configured as a spray for spraying or vaporizing administration 'spraying liquid agent, and this spraying' spraying liquid agent is atomized using a nebulizer, a humidifier or the like. It is preferable to administer the mist by spraying.
- the tissue adhesion preventing liquid is used as a spray for spraying or vaporizing administration, and it is configured to be sprayable on the target portion in the state of atomized mist, so that it can be used as a tissue adhesion preventing liquid.
- the functioning solution can be supplied to the target part extensively and uniformly, and the target part to be prevented from being damaged can be coated with a certain thickness.
- the nebulizer or the humidifier there are an ultrasonic type that vibrates and atomizes with an ultrasonic vibrator, a dripping type that conveys the dropped liquid as a gas, and a pressure applied to the liquid to form fine particles. Use a misalignment of the jet type that sprays.
- the tissue adhesion prevention liquid is composed of two liquids, water and a concentration solution of the tissue adhesion prevention liquid, and is a two-phase type equipped with a water tank equipped with a heater and a concentrate tank equipped with an ultrasonic transducer.
- a humidifier may be used. When a two-phase humidifier is used, the steam generated by heating with the heater and the concentrated liquid mist atomized by the ultrasonic vibrator are joined together in the passage, and the combined tissue adhesion prevention liquid The mist is also sprayed.
- the tissue adhesion preventing liquid of the present embodiment is configured as a foam aerosol preparation, and the foam aerosol preparation is administered in the form of a foam using an aerosol apparatus equipped with a heater, a pressurizing device, and a nozzle. May be.
- the foamed aerosol preparation is prepared by adding a known surfactant to the tissue adhesion preventing liquid already described.
- endoscopic surgery is performed using a spray device in which a one-fluid spray nozzle is fixed to the tip of an extension tube.
- a spray device in which a one-fluid spray nozzle is fixed to the tip of an extension tube.
- the spray solution that also has the ability to prevent tissue adhesion according to the present embodiment.
- tissue adhesion preventing solution of this embodiment may be configured as a perfusion solution, an infusion preparation, an injection to be injected into the infusion preparation, or the like.
- the perfusate is configured as an aqueous solution in which trehalose and AA-2G are dissolved in a known infusion solution such as physiological saline or Ringer's solution, and is provided in an infusion bag.
- the perfusate is used by perfusion replacement in the surgical field during or after surgery.
- the infusion preparation is dissolved in a known solvent such as physiological saline and Ringer's solution together with a known isotonic agent such as trehalose salt sodium and glycerol, and a known buffer solution such as phosphate and acetate. Adjusted and provided in an infusion bag. Infusion preparations are used by infusion or other means in at least one of the pre-, intra- and post-operative processes.
- a known solvent such as physiological saline and Ringer's solution together with a known isotonic agent such as trehalose salt sodium and glycerol, and a known buffer solution such as phosphate and acetate.
- a known buffer solution such as phosphate and acetate
- the injection to be injected into the infusion preparation is composed of trehalose and a known isotonic agent such as AA-2G salt sodium salt and daliserine, a known buffer solution such as phosphate and acetate, and the like. It is prepared by dissolving in a known solvent such as water for injection, physiological saline, Ringer's solution.
- a known isotonic agent such as AA-2G salt sodium salt and daliserine
- a known buffer solution such as phosphate and acetate
- a known solvent such as water for injection, physiological saline, Ringer's solution.
- This injection is used as a mixture mixed with known infusions such as glucose injection, xylitol injection, physiological saline, dextran 40 injection, amino acid injection, Ringer's solution and the like.
- An injection is injected into an infusion preparation and used by means such as intravenous drip in at least one of the steps before, during and after surgery.
- trehalose prevents the tissue and wound surface from drying by directly administering the tissue adhesion preventing solution of this embodiment to the tissue and wound surface such as an organ during surgery, and also due to oxidative stress during surgery. Prevent acid damage.
- Trehalose also forms a chelate with a metal such as Fe to inactivate the metal ions that are the source of free radicals and suppress the generation of free radicals. In this way, prevention of dryness, prevention of oxidative damage due to oxidative stress, and suppression of free radical generation can prevent postoperative adhesion and healing delays due to oxidative damage. It becomes possible.
- the anti-tissue solution of this embodiment contains AA-2G, which is an anti-acidic substance that can prevent acidification by radical scavenging, a combination of trehalose and AA-2G with different mechanisms of action. When it becomes possible to protect the wound surface and exposed tissue more effectively, it has a synergistic effect.
- AA-2G is an anti-acidic substance that can prevent acidification by radical scavenging
- H-marked G2 cells human liver cancer-derived cell line
- reagent-grade products were used.
- the reagent ascorbic acid 2-darcoside (AA2G, Hayashibara Biochemical Laboratories) was dissolved in distilled water to obtain a 2.5 mM AA-2G solution.
- powdery high-purity water-containing crystal trehalose (Reagent Trehalose, Hayashibara Biochemical Laboratories Co., Ltd.) was dissolved in distilled water to obtain a 132 mM trehalose solution.
- the reagent ascorbic acid 2-dalcoside and powdery high-purity water-containing crystal trehalose were dissolved in distilled water to obtain a 2.5 mM AAA-2G + 132 mM trehalose mixed solution.
- the pH and osmotic pressure of each sample after adjustment are as follows. That is, PBS (+) solution is pH7.2, osmotic pressure 279mOsm, 2.5mM AA-2G solution is pH6.8, osmotic pressure 265mOsm, 132mM trehalose solution is pH7.2, osmotic pressure 283mOsm, 2.5mM AA -The 2G + 132mM trehalose mixed solution had pH 7.0 and osmotic pressure 282mOsm.
- HepG2 cells were seeded at 4 ⁇ 10 4 cells / well in four 12-well plates, and cultured in DMEM medium (Nissui Pharmaceutical Co., Ltd.) containing 10% FCS (Gibco) for 4 days. did. Then, replace the DMEM medium containing 10% FCS with 4 sample solutions of PBS (+), 2.5mMAA-2G solution, 132mM trehalose solution, 2.5mMAA-2G + 132mM trehalose mixed solution at 37 ° C, respectively. It was allowed to act for 1 hour.
- the cell viability of the test plate after air drying for 3 minutes was 60.4% for PBS (+) solution, 61.8% for 2.5 mM AA-2G solution, 70.7% for 132 mM trehalose solution, and 2.5 mM AA-2G +, respectively.
- the 132 mM trehalose mixture it was 72.3%.
- the cell viability of the control plate was set to 100%.
- the cytoprotective effect was calculated, the 2.5 mMAA-2G solution did not show any cytoprotective effect, but the 132 mM trehalose solution and 2.5 mMAA-2G + 132 mM trehalose solution showed cytoprotective effect when air-dried for 3 minutes. It was done.
- the cell viability was calculated for the control plate of each sample solution that was not air-dried, and the result was as shown in the graph of the effect of each reagent on the cells in Fig. 2, that is, PBS (+) Calculate the cell viability of 2.5mMA A-2G solution, 132mM trehalose solution, 2.5mMAA-2G + 132mM trehalose mixture when the cell viability of the control plate was 100%, and let each reagent act on this
- the AA-2G solution was 101.6%
- the trehalose solution was 97.6%
- the AA-2G + trehalose mixture was 89.6%.
- Example 1 demonstrates that It was confirmed that an aqueous solution containing an oxidizing substance as an active ingredient acts as a tissue adhesion preventing solution.
- a rabbit was used to create an intraperitoneal adhesion model that dries the intestinal tract surface during abdominal surgery, and the effect of trehalose to prevent intestinal adhesion at that time was examined.
- Trehalose is powdered trehalose (reagent trehalose, Hayashibara Biochemical Laboratories) + NaCl dissolved in 250 ml of sterilized distilled water as a 2% solution, filtered and sterilized with a filter (Millex; Millpore Co., Bedford) The solution was poured into a sterile container and stored at room temperature.
- trehalose powdered trehalose (reagent trehalose, Hayashibara Biochemical Laboratories) + NaCl dissolved in 250 ml of sterilized distilled water as a 2% solution, filtered and sterilized with a filter (Millex; Millpore Co., Bedford) The solution was poured into a sterile container and stored at room temperature.
- test animals were 14 weeks old, weighing 2.85 to 3.2 kg, female New Zealand White (Std: NZW, Nippon SLC Co., Shizuoka), 5 birds were used. Usagi was bred in an animal laboratory (room temperature 24 ⁇ 1 ° C, humidity 30-70%) at the University of Tokyo graduate School of Agricultural and Life Sciences Animal Medical Center. In addition, after accustoming for one week after purchase, blood tests (total blood count, BUN, Cre, ALT, ALP) and X-ray examinations of the whole body were confirmed during that period, and it was confirmed that there was no abnormality in health. The experiment of this example was carried out according to the University of Tokyo animal experimentation manual.
- ketamine Korean 50; Sankyo Lifetic Co., Ltd., Tokyo
- medetomidine Dmitor; Meiji Seiyaku Co., Ltd., Tokyo
- 0.1 mg / kg are administered intramuscularly as pre-anesthetic medications.
- isoflurane Isoflu; Dainippon Pharmaceutical Co., Ltd., Osaka.
- enrofloxacin Botril; Bayer Medical Co., Ltd., Tokyo
- Ratato Ringer's solution Ratato Ringer's solution (Fuso; Fuso Pharmaceutical Co., Ltd., Osaka) is administered 10 ml during the operation.
- buprenorphine Repetan; Otsuka Pharmaceutical Co., Ltd., Tokyo
- 20 / z g / kg was administered subcutaneously once as an analgesic.
- the five rabbits were subjected to midline abdominal incision to expose the intestinal tract as much as possible and wipe off the serum with gauze.
- the control group (3 birds), it was dried as it was, and in the trehalose group (2 birds), trehalose was sprayed on the entire intestine several times. During this time, a total ovarian hysterectomy was performed based on the standard method. The laparotomy time for both groups was 30-60 minutes.
- the patient was observed for health and wounds, and euthanized by overdose of pentobarbital two weeks later.
- the adhesion state in the abdominal cavity was confirmed and recorded macroscopically, and the tissue at the adhesion site was removed as a histopathological examination material and fixed in formalin.
- Table 1 shows the clinical findings after 2 weeks and the macroscopic findings of adhesion after laparotomy in each case.
- adhesions all patients in both groups showed clear adhesion with surrounding tissues at the uterine vaginal stump at the time of total ovariectomy.
- intestinal adhesions light to moderate adhesions were confirmed in multiple cases (more than 3) in all three control subjects.
- the trehalose group was suspected to have mild adhesions at two strength sites in one bird, but this could be a normal intestinal adhesion. In the remaining one, the adhesion site that was clearly visible to the naked eye could not be confirmed.
- Trehalose has high hydration power, and it is thought that trehalose, which has become amorphous, coats the serosal surface of the intestine and stabilizes cells, thereby preventing adhesions
- a rabbit was used to create an intraperitoneal adhesion model that dries the intestinal tract surface during abdominal surgery, and the effect of trehalose to prevent intestinal adhesion at that time was examined.
- powdered trehalose (reagent trehalose, Hayashibara Biochemical Laboratories Co., Ltd.) is dissolved as a 7% solution in 250 ml of sterilized distilled water, filtered and sterilized with a filter (Millex; MillporeCo., Bedford), and then sterilized container. And stored at room temperature.
- a filter Millex; MillporeCo., Bedford
- As test animals 14 weeks old, body weight 2.6-3.2 kg, female New Zealand White (Std: NZW, Nippon SLC, Shizuoka), 20 birds were used. Usagi was bred in an animal laboratory (room temperature 24 ⁇ 1 ° C, humidity 30-70%) at the University of Tokyo graduate School of Agricultural and Life Sciences Animal Medical Center.
- ketamine Korean 50; Sankyo Lifetic Co., Ltd., Tokyo
- medetomidine Dmitor; Meiji Seiyaku Co., Ltd., Tokyo
- Isoflu Dainippon Pharmaceutical Co., Ltd., Osaka
- any 10 were used as the control group, and the remaining 10 were used as the trehalose group.
- the control group (10 birds) was dried as it was.
- the laparotomy time was 60 minutes.
- trehalose solution was sprayed throughout the abdominal cavity every 15 minutes (0 minutes, 15 minutes, 30 minutes, 45 minutes, 60 minutes) during the operation.
- the laparotomy time was 60 minutes.
- the patient was observed for health and wounds, and euthanized by overdose of bentpalpital two weeks later.
- the adhesion state in the abdominal cavity was visually confirmed and recorded, and the tissue at the adhesion site was removed as a histopathological examination material and fixed in formalin.
- Table 2 shows the clinical findings after 2 weeks and the macroscopic findings of adhesion after laparotomy in each case.
- Trehalose can clearly prevent and reduce adhesions against adhesions between organs in the abdominal cavity due to drying, and is effective.
- Trehalose has a high hydrating power and is thought to prevent adhesion by covering the serosal surface of the organ and stabilizing the cells.
- diffusion and penetration of the organ into the serosal surface of the organ was easy by solution spraying, and it was possible to cover the entire organ with trehalose.
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Abstract
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Priority Applications (16)
Application Number | Priority Date | Filing Date | Title |
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SI200630948T SI1905443T1 (sl) | 2005-06-08 | 2006-06-08 | Tekoäśina, ki vsebuje trehalozo, za preventivo tkivne adhezije |
CA 2611441 CA2611441C (en) | 2005-06-08 | 2006-06-08 | Solution for tissue adhesion prevention and method for tissue adhesion prevention |
US11/917,026 US20090098061A1 (en) | 2005-06-08 | 2006-06-08 | Solution for tissue adhesion prevention and method for tissue adhesion prevention |
PL06766477T PL1905443T3 (pl) | 2005-06-08 | 2006-06-08 | Ciecz zawierająca trehalozę do zastosowania przy zapobieganiu przywieraniu tkanek |
JP2007520155A JP4447640B2 (ja) | 2005-06-08 | 2006-06-08 | 組織癒着防止液及び組織癒着防止方法 |
EP20060766477 EP1905443B1 (en) | 2005-06-08 | 2006-06-08 | Liquid comprising trehalose for use in preventing tissue adhesion |
DE200660018936 DE602006018936D1 (de) | 2005-06-08 | 2006-06-08 | Flüssigkeit enthaltend trehalose zur verwendung bei der prävention von gewebeadhäsion |
DK06766477T DK1905443T3 (da) | 2005-06-08 | 2006-06-08 | Væske omfattende trehalose til anvendelse ved forhindring af vævsadhæsion |
CN2006800201413A CN101193645B (zh) | 2005-06-08 | 2006-06-08 | 组织粘连防止液 |
NZ564399A NZ564399A (en) | 2005-06-08 | 2006-06-08 | Liquid for preventing tissue adhesion and method of preventing tissue adhesion using trehalose |
AU2006256084A AU2006256084B2 (en) | 2005-06-08 | 2006-06-08 | Liquid for preventing tissue adhesion and method of preventing tissue adhesion |
BRPI0610889A BRPI0610889A8 (pt) | 2005-06-08 | 2006-06-08 | Solução para prevenção de adesão do tecido e método para prevenção de adesão do tecido |
NO20080106A NO20080106L (no) | 2005-06-08 | 2008-01-07 | Opplosning for vevsadhesjonsforhindring og fremgangsmate for vevsadhesjonsforhindring |
HK08109025A HK1113746A1 (en) | 2005-06-08 | 2008-08-14 | Solution for tissue adhesion prevention |
HR20110150T HRP20110150T1 (hr) | 2005-06-08 | 2011-02-28 | Tekućina koja sadrži trehalozu, namijenjena upotrebi u sprječavanju adhezije tkiva |
US13/047,551 US9155751B2 (en) | 2005-06-08 | 2011-03-14 | Solution for tissue adhesion prevention and method for tissue adhesion prevention |
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JP2005-168744 | 2005-06-08 | ||
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US11/917,026 A-371-Of-International US20090098061A1 (en) | 2005-06-08 | 2006-06-08 | Solution for tissue adhesion prevention and method for tissue adhesion prevention |
US13/047,551 Division US9155751B2 (en) | 2005-06-08 | 2011-03-14 | Solution for tissue adhesion prevention and method for tissue adhesion prevention |
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US (2) | US20090098061A1 (ja) |
EP (1) | EP1905443B1 (ja) |
JP (1) | JP4447640B2 (ja) |
KR (1) | KR101004551B1 (ja) |
CN (1) | CN101193645B (ja) |
AU (1) | AU2006256084B2 (ja) |
BR (1) | BRPI0610889A8 (ja) |
CA (1) | CA2611441C (ja) |
CY (1) | CY1111453T1 (ja) |
DE (1) | DE602006018936D1 (ja) |
DK (1) | DK1905443T3 (ja) |
ES (1) | ES2363674T3 (ja) |
HK (1) | HK1113746A1 (ja) |
HR (1) | HRP20110150T1 (ja) |
MY (1) | MY142987A (ja) |
NO (1) | NO20080106L (ja) |
NZ (1) | NZ564399A (ja) |
PL (1) | PL1905443T3 (ja) |
PT (1) | PT1905443E (ja) |
RU (1) | RU2395287C2 (ja) |
SI (1) | SI1905443T1 (ja) |
TW (1) | TWI340645B (ja) |
WO (1) | WO2006132310A1 (ja) |
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-
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- 2006-06-07 MY MYPI20062634A patent/MY142987A/en unknown
- 2006-06-08 WO PCT/JP2006/311501 patent/WO2006132310A1/ja active Application Filing
- 2006-06-08 RU RU2007149561A patent/RU2395287C2/ru not_active IP Right Cessation
- 2006-06-08 NZ NZ564399A patent/NZ564399A/en not_active IP Right Cessation
- 2006-06-08 BR BRPI0610889A patent/BRPI0610889A8/pt not_active Application Discontinuation
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