WO2007065450A1 - Agent de prevention et de traitement de keratites et de conjonctivites d'etiologies differentes (et variantes) et procede de son utilisation - Google Patents

Agent de prevention et de traitement de keratites et de conjonctivites d'etiologies differentes (et variantes) et procede de son utilisation Download PDF

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Publication number
WO2007065450A1
WO2007065450A1 PCT/EA2006/000013 EA2006000013W WO2007065450A1 WO 2007065450 A1 WO2007065450 A1 WO 2007065450A1 EA 2006000013 W EA2006000013 W EA 2006000013W WO 2007065450 A1 WO2007065450 A1 WO 2007065450A1
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Prior art keywords
keratitis
treatment
conjunctivitis
water
eye
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PCT/EA2006/000013
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English (en)
Russian (ru)
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Leonid Andreevich Kozhemyakin
Olga Sergeevna Ketlinskaya
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Leonid Andreevich Kozhemyakin
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Publication of WO2007065450A1 publication Critical patent/WO2007065450A1/fr

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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
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/0048—Eye, e.g. artificial tears
    • 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
    • A61K31/095—Sulfur, selenium, or tellurium compounds, e.g. thiols
    • A61K31/10—Sulfides; Sulfoxides; Sulfones
    • 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
    • A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19—Carboxylic acids, e.g. valproic acid
    • A61K31/195—Carboxylic acids, e.g. valproic acid having an amino group
    • A61K31/197—Carboxylic acids, e.g. valproic acid having an amino group the amino and the carboxyl groups being attached to the same acyclic carbon chain, e.g. gamma-aminobutyric acid [GABA], beta-alanine, epsilon-aminocaproic acid or pantothenic acid
    • A61K31/198—Alpha-amino acids, e.g. alanine or edetic acid [EDTA]
    • 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
    • A61K31/38—Heterocyclic compounds having sulfur as a ring hetero atom
    • A61K31/385—Heterocyclic compounds having sulfur as a ring hetero atom having two or more sulfur atoms in the same ring
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/04—Peptides having up to 20 amino acids in a fully defined sequence; Derivatives thereof
    • A61K38/06—Tripeptides
    • A61K38/063—Glutathione
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/08—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
    • A61K47/12—Carboxylic acids; Salts or anhydrides thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/20—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing sulfur, e.g. dimethyl sulfoxide [DMSO], docusate, sodium lauryl sulfate or aminosulfonic acids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P27/00—Drugs for disorders of the senses
    • A61P27/02—Ophthalmic agents

Definitions

  • conjunctivitis and keratitis of various etiologies (options), method of its application
  • the invention relates to the pharmaceutical industry and can be used in medical practice in monotherapy and in the complex treatment of conjunctivitis and keratitis of various etiologies.
  • Prolonged use of contact lenses leads to an increase in desquamation of the corneal epithelium, and the resulting epithelialopathy (microerosion) promotes adhesion of Pseudomonas aeruginosa. It was shown that the worse the oxygen transport through the lens, the stronger the desquamation of the epithelium and the greater the likelihood of adhesion of Pseudomonas aeruginosa [4].
  • the ratio of causative agents of ulcerative lesions is most reliably expressed by the following figures: staphylococcus - 45%, streptococcus - 12%, Pseudomonas aeruginosa - 10%, mushrooms - 7%, akantameba - 1.6, and for corneal ulcers in children: staphylococcus - 43.7 %, streptococcus - 18.8%, Pseudomonas aeruginosa - 9.4%, mushrooms - 17.2%, acanthamoeba - 1.6% [5].
  • Another feature of bacterial corneal ulcers is a large number of pathogen strains resistant to antibiotics of the aminoglycoside group: for example, according to published data, 63.6% of pathogens were resistant to gentamicin [7]. Of particular concern is information about the increase in resistance to the new antibiotics of the quinolone group. According to the results of studies in CIIIA 5, the number of staphylococcus strains resistant to cifrofloxacin increased from 5.8% in 1993 to 35% in 1997, and to ofloxacin, respectively, from 4.7 to 35% [6]. In India, 22 ciprofloxacin resistant strains of Pseudomonas aeruginosa were isolated [7]. It is believed that the widespread use of ciprofloxacin in general medical practice has led to a jump in the number of resistant pathogens to 76-82% [6].
  • Eye drops and eye ointment with 0.3% tobramycin are widely used in ophthalmic practice.
  • Tobrex eye drops are used 6-8 times, and eye ointment 3-4 times a day.
  • Tobrex's efficacy was convincingly shown by the example of eye drop installations after excimer laser refractive keratectomy.
  • Ocacin eye drops contain 0.3% lomefloxacin, a broad-spectrum antibiotic from the quinolone group. Drops have a pronounced therapeutic effect in the treatment of severe corneal ulcers, including those caused by Pseudomonas aeruginosa and gonococcus (instillation 6-8 times a day), in the treatment of staphylococcal, streptococcal and other bacterial corneal ulcers (instillation 6 times a day), in the treatment of bacterial conjunctivitis and blepharitis, in the prevention of infection with corneal injury and surgical interventions on the cornea. Ocacin eye drops are also effective in the treatment of chlamydial conjunctivitis.
  • Vimbabm - 0.05% piccloxidine is an antiseptic with a broad antibacterial spectrum of action. Vimbabm is effective against many types of bacteria that cause such widespread eye diseases as conjunctivitis, chronic and subacute, blepharoconjunctivitis, and blepharitis.
  • Colbiocin is an antibacterial drug produced in the form of eye drops and ointments.
  • Colbiocin includes 3 antibiotics: chloramphenicol, col ⁇ smin, romemetracycline. The drug is active against gram-positive and gram-negative bacteria, spirochetes, chlamydia, mycoplasmas, rickettsia and other pathogens [18].
  • Garazon - eye drops including gentamicin (0.3%) and betamethasone (0.1%). Drops have a double effect - a broad antibacterial and powerful anti-inflammatory. Most often, Garazon is used for postoperative management. Tobradex - eye drops, including mobramycin (0.3%) and dexamethasone (0.1%). The drug is used for inflammatory eye diseases, when a complex effect is necessary, for the prevention of infections tion and anti-inflammatory action after surgery on the conjunctiva and eyeball.
  • Eubetal - eye drops and ointment containing 3 antibiotics chloramphenicol, colistin, rometetracycline
  • betamethasone a group consisting of 3 antibiotics (chloramphenicol, colistin, rometetracycline) and betamethasone.
  • Antiviral agents chloramphenicol, colistin, rometetracycline
  • Balacyclovir is an acyclovir L-valyl ester.
  • Valacyclo ⁇ ir like acyclo ⁇ ir, is active against the herpes virus, but exceeds the latter by 4-5 times in bioavailability [19].
  • Lockferon is a human leukocyte a-interferon with an activity of 10,000 ME in a vial. It was developed and manufactured by Biomed JSC named after I.I. Mechnikov [20]. Lockferon eye drops are well tolerated, have a therapeutic effect in the treatment of herpetic keratitis, reducing the treatment duration by an average of 4 days compared to IMU drops, and in treating epidemic keratoconjunctivitis, reducing the treatment duration by an average of 4.3 days compared to interferon native.
  • Affinoleukin is a drug containing transfer factor proteins isolated from human leukocytes. Subcutaneous injections of Affinoleukin in the complex treatment of herpetic keratitis can reduce treatment time by an average of 5-7 days [21].
  • Ophthalmoferon - 1 ml of eye drops contains a recombinant human interferon alfa-2b of at least 10,000 IU, an antihistamine - diphenhydramine - 0.001 g, an artificial tear.
  • Antiallergic and anti-inflammatory drugs Allergodil - eye drops containing 0.05% acecelastine hydrochloride.
  • the drug is a histamine Hi receptor blocker. In addition, it inhibits the release of inflammatory mediators from mast cells.
  • Spersallerg eye drops contain an antazolin, which has an antihistamine effect, and tetrizolin, a vasoconstrictor. It is this combination that provides the fastest and most pronounced effect.
  • Alomide - eye drops containing 0.1% lodoxamide tromethamine Drops stabilize mast cell membranes, prevent antigen-induced secretion of histamine and other allergy mediators. At the same time, Alomid inhibits the migration of eosinophils and the release of enzymes and cytotoxic factors from them. Alomid eye drops were effective in the complex treatment of dry eye syndrome, adenoviral conjunctivitis, chlamydial conjunctivitis.
  • Prenacid - eye drops and eye ointment containing disodium phosphate desonide Prenacid - eye drops and eye ointment containing disodium phosphate desonide.
  • Naklof - eye drops containing diclofenac sodium Like other non-steroidal anti-inflammatory drugs, Naklof inhibits the synthesis of prostaglandins.
  • the objective of the invention is to provide a means for the prevention and treatment of conjunctivitis and keratitis of various etiologies, having both antibacterial and antiviral activity, immunocorrective effect with activation of the local immunity system, including resistant macrophages of eye tissues.
  • the technical result of the claimed invention is the development of funds in the form of eye drops with a cytoprotective effect (capable of restoring cell metabolism), and also capable of inducing apoptosis of virus-infected cells and increasing the resistance of uninfected cells to infection by bacteria, viruses and other gami agents, as well as the development of a method of using this tool.
  • the technical result is achieved due to the use of substances obtained on the basis of the interaction of disulfide-containing peptides and nitrogen bases and / or nucleosides of purine or pyrimidine nature, other disulfide-containing peptides and pharmacologically acceptable solvents.
  • compositions including:
  • a method has been developed for the prevention and treatment of conjunctivitis and keratitis of various etiologies, in accordance with which the indicated agent (options) is used as instillations 3 times a day, as the inflammatory process is stopped, the number of instillations is reduced to 2 times a day, treatment is carried out for the time necessary to achieve a therapeutic effect.
  • the ionized carboxyl group of the glycine residue of the disulfide glutathione molecule acts as the anion-forming salt, and the protonated nitrogen atom inside the heterocycle of the nitrogenous base molecule (for example cytosine) or nucleosides (e.g., inosine or adenosine) with a protonated nitrogen atom N 1 .
  • the nitrogenous base molecule for example cytosine
  • nucleosides e.g., inosine or adenosine
  • a calculated amount of a 0.1% solution of DMSO in water for injection is prepared and heated to a temperature of 45 ° C.
  • the lithium salt of lipic acid and the organic salt of adenine and the lithium salt of disulfide glutathione are successively dissolved in the resulting solution at this temperature.
  • the resulting solution is subjected to sterile filtration and poured into vials. Bottles are hermetically sealed.
  • a calculated amount of a 0.1% solution of DMSO in water for injection is prepared and heated to a temperature of 45 ° C.
  • cystine and the inosine organic salt and the disulfide glutathione lithium salt are successively dissolved. Then proceed as described in example 1 (formulation 1).
  • a calculated amount of a 0.1% DMSO solution in water for injection is prepared and heated to a temperature of 45 ° C.
  • the lithium salt of lipoic acid and the organic salt of adenosine and the lithium salt of disulfide glutathione are successively dissolved in the resulting solution. Then proceed as described in example 1 (formulation 1).
  • the proposed tool has unique biological and pharmacological effects, providing immunomodulating effect, including activation of anti-infectious immunity, normalization of metabolic processes in the cells of the eye tissue, therefore, activation of reparative processes, ie, epithelization of damage sites, along with the development of anti-inflammatory cytokines.
  • disulfide-containing peptides (lipoic acid, cystine) regulate the thiol disulfide exchange of cells, which is the basis of their bioenergy, therefore, they determine resistance to damaging factors.
  • these compounds correct the ratio of the production of Thl / Th2 class cytokines with the predominant activation of ThI cells, due to the stimulation of the endogenous production of IL-12, which provides a stable level of cell-mediated immune response, including the functional capacity of resident macrophages.
  • Dimethyl sulfoxide being a unique transporter of ingredients, provides the functions of a pharmaceutically acceptable carrier and also has a bactericidal effect.
  • the proposed tool (options) is used in the form of eye drops for the prevention and treatment of the following nosological forms:
  • V anterior uveitis corneal dystrophy, especially with bullous phenomena and severe corneal edema
  • S keratitis and keratouveitis are allergic (autoimmune) with metabolic lesions of the cornea;
  • the agent for the treatment of keratitis and keratouveitis with metabolic lesions of the cornea, corneal dystrophy, especially with bullous phenomena and severe edema of the cornea, conditions after photorefractive keratectomy, dry eye syndrome, dry keratoconjunctivitis with severe lesion of the cornea, it is preferable to use the agent in accordance with example 1 (recipe 1).
  • the agent in accordance with Example 4 in the acute period and the agent in accordance with Example 1 (formulation 1) in the re-convalescence period.
  • a method of treating conjunctivitis and keratitis of various etiologies consists in administering the proposed pharmaceutical compositions to a patient in need thereof, moreover, they are used at least three times a day for the period necessary to achieve a therapeutic effect.
  • the proposed agent (options) is used in the form of instillations 3 times a day, as the inflammatory process is stopped, the number of instillations is reduced to 2 times a day, the treatment is continued until the symptoms of the disease disappear.
  • Diagnosis OD - Adenoviral keratoconjunctivitis.
  • Anamnesis of the disease Sick a week ago, when I noticed a feeling of a foreign body in the eye, then redness of the eyeball. The next morning, he noticed edema of the upper and lower eyelids, more intense redness of the eyeball, and lacrimation. I went to the ophthalmologist at the place of residence. A therapy was prescribed that did not lead to a positive effect, and visual impairment in the right eye was added from the complaints.
  • Eye ointment tetracycline, 2 times a day.
  • the tool in accordance with example 3 (formulation 3): instilled 2 times a day in the right and left eye for 5-7 days in monotherapy.
  • Diagnosis OS - herpetic tree keratitis.
  • the course of therapy is Means in accordance with example 1 (steom formulation according to 1): instilled 3 times a day in the left eye for 5 times with examples 1, 2 pails, 3 drops in the right eye for 7 days for - and 3 (with formulations 1, 2, barely passed to the tool according to example 2 (recipes and 3): round 2).
  • the tool in accordance with example 3 (formulation 3): instilled in the left eye 5 drops 3 times a day for 14 days in monotherapy.
  • TNF alpha in a tear TNF alpha in a tear.
  • Diagnosis OS - corneal ulcer, iridocyclitis, hypopion.
  • Diagnosis OD - dry eye syndrome, filamentous keratitis.
  • Anamnesis of the disease There was a decrease in vision more than a month ago. I went to the ophthalmologist who was diagnosed (see above) and prescribed treatment (see below). After a month of therapy, corneal epithelization was not noted, the feeling of dryness decreased slightly.
  • Prior SoI. Taufopi 2% (diluted in a ratio of 1: 1 with treatment: polyglucin solution) 1 drop 3 times a day - 30 days.
  • the course of therapy Means in accordance with example 1 (prescription according to swarm 1): instilled 3 times a day in the right eye in example 1 (prescription for 14 days in monotherapy mode.
  • the apple is pale pink, there are tender filamentous corneal opacities that are not stained with fluorescein.
  • the visual acuity of the right eye is 0.9 (not corrected), the left eye is 1.0.

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  • Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Public Health (AREA)
  • Medicinal Chemistry (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Epidemiology (AREA)
  • Engineering & Computer Science (AREA)
  • General Chemical & Material Sciences (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Ophthalmology & Optometry (AREA)
  • Oil, Petroleum & Natural Gas (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Proteomics, Peptides & Aminoacids (AREA)
  • Immunology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Organic Chemistry (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
  • Medicinal Preparation (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)

Abstract

L'invention concerne l'industrie chimico-pharmaceutique et peut s'utiliser dans la pratique médicale en monothérapie ou en traitement intégral de conjonctivites et de kératites d'étiologies différentes. L'agent de prévention et de traitement de conjonctivites et de kératites d'étiologies différentes (et variantes) se présente comme des gouttes oculaires et comprend les composants suivants: sel organique d'adénine et de disulfide-glutathion, sel de lithium de l'acide lipoïque, diméthylsulfoxyde et de l'eau pour injections, ou un sel organique de cytosine et de disulfide-glutathion, cystine, diméthylsulfoxyde et de l'eau pour injections, ou un sel organique d'inosine et de disulfide-glutathion, cystine, diméthylsulfoxyde et de l'eau pour injections, ou sel organique d'adénosine et de disulfide-glutathion, sel de lithium de l'acide lipoïque, diméthylsulfoxyde et de l'eau pour injections. Le procédé consiste à utiliser cet agent dans la prévention ou le traitement de conjonctivites et de kératites d'étiologies différentes.
PCT/EA2006/000013 2005-12-07 2006-09-11 Agent de prevention et de traitement de keratites et de conjonctivites d'etiologies differentes (et variantes) et procede de son utilisation WO2007065450A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
EA200600146 2005-12-07
EA200600146A EA008737B1 (ru) 2005-12-07 2005-12-07 Средство для профилактики и лечения конъюнктивитов и кератитов различной этиологии (варианты), способ его применения

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB1441017A (en) * 1972-10-13 1976-06-30 Bfb Soc Ophthalmological medicaments
RU2119922C1 (ru) * 1992-04-21 1998-10-10 Фудзисава Фармасьютикал Ко., Лтд. Производные пептидов или их фармацевтически приемлемые соли, способ их получения, фармацевтическая композиция и способ ингибирования действия тахикинина
RU2178710C1 (ru) * 2001-02-08 2002-01-27 Кожемякин Леонид Андреевич Индивидуальные вещества, полученные на основе химического взаимодействия дисульфидсодержащих пептидов с производными пуриновых или пиримидиновых оснований, фармацевтические композиции и препараты на их основе, способы их применения для лечения инфекционных заболеваний и профилактики осложнений
RU2191012C1 (ru) * 2001-06-20 2002-10-20 Научно-исследовательский испытательный центр (медико-биологической защиты) Государственного научно-исследовательского испытательного института военной медицины МО РФ Глазные капли для лечения эндотелиально-эпителиальной дистрофии роговицы
RU2223099C1 (ru) * 2002-07-31 2004-02-10 Московский научно-исследовательский институт глазных болезней им. Гельмгольца Глазные капли для терапии глаукомы

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2108112C1 (ru) * 1993-04-16 1998-04-10 Вакамото Фармасьютикал Ко., Лтд. Водная лекарственная композиция, обладающая свойством обратимого терморегулируемого гелеобразования
GB9413724D0 (en) * 1994-07-07 1994-08-24 Wellcome Found Therapeutic nucleosides

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB1441017A (en) * 1972-10-13 1976-06-30 Bfb Soc Ophthalmological medicaments
RU2119922C1 (ru) * 1992-04-21 1998-10-10 Фудзисава Фармасьютикал Ко., Лтд. Производные пептидов или их фармацевтически приемлемые соли, способ их получения, фармацевтическая композиция и способ ингибирования действия тахикинина
RU2178710C1 (ru) * 2001-02-08 2002-01-27 Кожемякин Леонид Андреевич Индивидуальные вещества, полученные на основе химического взаимодействия дисульфидсодержащих пептидов с производными пуриновых или пиримидиновых оснований, фармацевтические композиции и препараты на их основе, способы их применения для лечения инфекционных заболеваний и профилактики осложнений
RU2191012C1 (ru) * 2001-06-20 2002-10-20 Научно-исследовательский испытательный центр (медико-биологической защиты) Государственного научно-исследовательского испытательного института военной медицины МО РФ Глазные капли для лечения эндотелиально-эпителиальной дистрофии роговицы
RU2223099C1 (ru) * 2002-07-31 2004-02-10 Московский научно-исследовательский институт глазных болезней им. Гельмгольца Глазные капли для терапии глаукомы

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