WO2011038116A2 - Composition comprising pomegranate polyphenols for improving bone health - Google Patents

Abstract

Pomegranate extracts comprising polyphenols useful in improving health and methods of use thereof are described. Specifically, a pharmaceutical composition comprising a pomegranate extract that contains polyphenols having antioxidant properties is disclosed. The disclosure further includes methods for maintaining or increasing bone mineral content or bone density, or for preventing bone loss in humans and animals.

Description

Composition Comprising Pomegranate Polyphenols for Improvin Bone Health

Field of the Invention

[0001 ] The present invention relates to pomegranate extracts comprising polyphenols useful in improving health and methods of use thereof. Specifically, the present invention relates to a pharmaceutical composition comprising a pomegranate extract containing polyphenols having antioxidant properties. The invention further includes methods for maintaining or increasing bone mineral content or bone density, as well as for preventing bone loss in humans and animals.

Background of the Invention

[0002] Pomegranate (Punica granatum) has long been recognized as a fruit with many benefits for health. The plant is botanically unique, having only one true botanical relative, the pomegranate precursor, Punica protopunica. Punica protopunica is restricted to the isolated island of Socotra, located off the coast of Yemen. Corresponding to this botanical uniqueness is a parallel distinctiveness in terms of biochemistry. For example, pomegranate has long been recognized as the richest plant source of the female steroid hormone estrone, which can be found in dried pomegranate seeds. Another female steroid, estriol, and the male hormone testosterone have been discovered in pomegranate seed oil. The dried pomegranate seeds also contain the isoflavonic phytoestrogens genistein and daidzein and the phytoestrogenic coumestrol.

[0003] The pomegranate fruit has both non-edible and edible parts. Non-edible parts of the fruit include the skin and the pericarp. Edible parts of pomegranate fruits (about 50% of total fruit weight) comprise 80% juice and 20% seeds. Fresh juice contains 85% moisture, 10% total sugars, 1.5% pectin, ascorbic acid, and polyphenolic flavonoids. Pomegranate seeds are a rich source of lipids, proteins, crude fibers, pectin, and sugars. In pomegranate juice, fructose and glucose are present in similar quantities to each other, calcium is about 50% of the ash content of the juice, and the principal amino acids are glutamic and aspartic acid.

[0004] A wide range of polyphenolic compounds have been characterized both in pomegranate juice and the pericarp, including flavonoids, anthocyanins and tannins.

Concentrations of these polyphenols extracted both from the fermented juice and the oil have been shown to be potently antioxidant in vitro. These antioxidant polyphenols also inhibit the eicosanoid enzyme lipoxygenase, and in the case of the polyphenols extracted from pomegranate seed oil, also significantly inhibit another eicosanoid pathway enzyme, cyclooxygenase. The content of soluble polyphenols in pomegranate juice can vary within the limits of 0.2% to 1.0%, depending on the variety of pomegranate used to juice, and include mainly anthocyanins (such as cyanidin-3-glycoside, cyanidin-3, 3-diglycoside and delphindin-3-glucosid), catechins, ellagic tannins, and gallic and ellagic acids. The polyphenol compounds found in pomegranates are known to have antioxidant properties. (Gil et ai , Antioxidant Activity of Pomegranate Juice and Its Relationship with Phenolic Composition and Processing, 48 J. Agric. Food Chem. 4581-4589 (2000); Lansky, Beware of Pomegranates Bearing 40% Ellagic Acid, 9(1) J. Med. Food 1 19-122 (2006); Seeram et ai , In vitro antiproliferative, apoptotic and antioxidant activities of pimicalagin, ellagic acid and a total pomegranate tannin extract are enhanced in combination with other polyphenols as found in pomegranate juice, 16 J. Nutr. Biochem. 360-367 (2005); Singh et ai , Studies on the Antioxidant Activity of Pomegranate (Punica granatum) Peel and Seed Extracts Using In Vitro Models,"50 J. Agric. Food Chem. 81 -86 (2002); and Halvorsen et al. , A Systematic Screening of Total Antioxidants in Dietary Plants, J. Nutr. 461-471 (2002).

[0005] Bone tissue in a normal human undergoes continuous remodeling to maintain the equilibrium in the bone metabolism. Bone remodeling is the natural process whereby bone tissue is replaced over periods of time ranging from 120 to 150 days, preferably without accompanying any change in the total amount thereof, while maintaining a good balance between bone resorption and bone forming. Bone resorption is the destruction and absorbing of tissues that are calcified by the osteoclasts. Osteogenesis, or bone formation, occurs when the osteoblasts and osteocytes deposit collagen and/or calcium, as bone substrates, onto the bone.

[0006] In osteoporosis, however, there exists an abnormality in bone metabolism where the bone absorption ability gets ahead of the osteogenetic function. This abnormality can lead to the reduction in the amount of the bone, which in turn causes the bone to become fragile. It is also known that estrogen plays an important role in skeletal growth and bone homeostasis. Estrogen deficiency can have a direct effect on bone tissues. (Weitzman et al. , ''Estrogen deficiency and bone loss: an inflammatory tale," 1 14(5) J. Clin. Invest. 1186-1 194 (2006)). In particular, in post-menopausal women, estrogen function and production is rapidly impaired. Estrogen has a bone absorption-inhibitory action and an osteogenesis-promoting action; estrogen depletion can cause a susceptibility to abnormal bone metabolism. For this reason, post- menopausal women are more likely to suffer from osteoporosis. In fact, one out of three women who are 45 -years-old or older suffers from osteoporosis or considerable bone reduction.

Therefore, compounds having an effect of improving or eliminating such abnormality in bone metabolism can be expected as prophylactic agents or therapeutic agents for diseases related to bone, such as osteoporosis.

[0007] Currently, the treatments available for osteoporosis and other degenerative bone disorders include bisphosphonates, vitamin K, selective estrogen receptor modulators (SERMs), calcitonin, ipriflavone, activated vitamin D3, and estrogens. These "therapeutic" agents are administered at known strengths and dosage forms. However, these conventional therapeutic agents suffer from a variety of drawbacks or can cause various harmful side effects.

(0008] Bisphosphonates are commonly prescribed drugs for treatment of bone disorders. Examples of bisphosphonates include alendronate, risedronate, etidronate, zoledronic acid, and tiludronate. Despite their benefits, bisphosphonates can exhibit very poor oral bioavailability. For example, alendronate has less than 1% bioavailability. (Gert et al , Studies of The Oral Bioavailability of Alendronate, 58 Clinical Pharmacology & Therapeutics, 288-298 (1995)). Alendronate's absorption is inhibited by foods and beverages other than water. Patients who have failed to follow the recommended dosing instructions for alendronate have

experienced irritation of the upper gastrointestinal mucosa. (Liberman et al. , Esophagitis and Alendronate, 335 N. Engl. J. Med. 1069-70 (1996)). In rare instances, the irritation associated with the administration of alendronate can be serious.

]0009] Additional options to treat osteoporosis include hormone replacement therapy and calcium supplementation therapy. (Kleerekoper et al., Comparative Safety of Bone

Remodeling Agents with A Focus on Osteoporosis Therapies, 41 J. Clin. Pharmacol., 239 (2001)). Increased calcium levels can potentially improve the state of bone mineralization in patients with osteoporosis. Over the last thirty years, calcium supplementation, along with vitamin D or vitamin D derivatives such as calcitriol, has been one of the options for treating osteoporosis. (Cannigia et al , Effects of 1 ,25-Dihydroxycholecalciferol on Calcium Absorption in Postmenopausal Osteoporosis, 1 1 Clin. Endocrinol. 99 (1979)). The vitamin D derivative calcitrol ( 1 ,25-dihydroxy vitamin D₃) used to treat calcium deficiency. Calcitrol is the biologically active form of vitamin D₃, and is active in the regulation of the absorption of calcium from the gastrointestinal tract and stimulates intestinal calcium transport. Other options include administration of vitamin K, which also exhibits a blood coagulation effect. Therefore, the administration of vitamin K is limited to specific patients.

|0010] Another mode of treatment of osteoporosis is the use of hormone receptor modulators. In particular, raloxifene (Evista™, Eli Lilly), a selective estrogen receptor modulator (SERM), is a benzothiophene non-steroidal estrogen antagonist related to tamoxifen, and is indicated for the prevention and treatment of osteoporosis in post-menopausal women. Raloxifene activity is mediated by its selective binding to certain estrogen receptors, thus activating or blocking various estrogenic pathways. Activation of these receptors offsets estrogen-induced bone loss. As a result, raloxifene has been shown to increase bone density in the spine and hip, and reduce bone turnover, thus significantly decreasing the incidence of new vertebral fractures by 30-50% among post-menopausal women with osteoporosis. Raloxifene is absorbed rapidly after oral administration. Approximately 60% of the oral dose is absorbed, but due to extensive presystemic glucuronide conjugation (to the metabolites, raloxifene-4- glucuronide, raloxifene-6-glucuronide and raloxifene-6,4-diglucuronide), the oral bioavailability of raloxifene is only 2%.

[0011] Other treatments include administration of the peptide calcitonin, ipriflavone, and activated vitamin D₃. However, calcitonin is generally administered through injection, and administration of ipriflavone can cause gastro-intestinal disorders. Also, activated vitamin D₃ can induce hypercalcemia, urolithiasis, and digestive disorders.

[0012] Estrogen itself can also be administered. However, the administration of estrogen, or estrogen-like compounds, can result in menstrual-like bleeding and other unpleasant side effects, such as swelling of the breast, and can increase the incidence of uterine cancer, thrombosis, pulmonary embolism and myocardial infarction. Estrogen, as discussed above, is an important hormone, and estrogen levels are important for bone health. Decreases in estrogen levels after menopause can lead to increases in bone resorption and accelerated bone loss.

[0013] Many plants contain compounds related to the estrogen found in human subjects. Examples of these compounds include isoflavones (e.g. , genistein and daidzein).

Many researchers have studied plant estrogens as a replacement to estrogens in warm-blooded animals, including humans. For example, Mori-Okamoto et al. (Pomegranate extract improves a depressive state and bone properties in menopausal syndrome model ovariectomized mice, 92 J. Ethnopharmacology 92- 101 (2004)) investigated the use of pomegranate extracts to improve bone properties. In the Mori-Okamoto study, pomegranate extracts prepared from the pomegranate seeds and unconcentrated juice were administered to ovariectomized (OVX) mice and the bone mineral density (BMD) was measured, along with analysis of bone

histomorphometry. The pomegranate extract used in these experiments was confirmed to contain estradiol, estrone, and estriol, as well as the isoflavones genistein and daidzein. Mori- Okamoto found that the measured parameters in the OVX animals that ingested the pomegranate extract were close to those in the intact group and also found that the administration of pomegranate extracts reduced ovariectomy-induced uterine weight loss. Mori-Okamoto postulated that the pomegranate extract containing estrogens was pharmacologically effective on the menopausal symptoms induced in mice.

[0014] Puel et al. similarly studied the effect of the apple polyphenol compound phloridzin on bone loss in ovariectomized rats. (Puel et al. , Prevention of Bone Loss by

Phloridzin, an Apple Polyphenol, in Ovariectomized Rats under Inflammation Conditions, 77 Calcif. Tissue Int. 31 1-318 (2005)). Phloridzin, a flavonoid polyphenol, showed a positive effect on bone health in the OVX rat study. Puel attributed the effect of phloridzin to the estrogenic activity of this compound, still he noted that the phloridzin also had antioxidant properties.

Isoflavones, with or without calcium, and n-3 polyunsaturated fatty acids also appear to protect against bone loss in ovariectomized rats. See Watkins et al , Protective actions of soy

isoflavones and n-3 PUFAs on bone mass in ovariectomized rats, \6 J. Nutr. Biochem. 479-488 (2005); and Breitman et al. , Isoflavones with supplemental calcium provide greater protection against the loss of bone mass and strength after ovariectomy compared to isoflavones alone, 33 Bone 597-605 (2001).

[0015] The therapeutic agents described above are not sufficient in the establishment of the balance between the efficacy as pharmaceutical agents and the convenience or their price. For this reason, there has recently been focused attention on the development of novel pharmaceutical agents and foods and beverages developed from such standpoints. The need still exists for treatments for bone health and the health of other body components that are effective, yet non-toxic to warm-blooded animals, especially to humans.

[0016] Although the pomegranate components discussed above are also non-toxic to warm-blooded animals, the naturally-occurring polyphenol compounds found in the pomegranate can be specifically extracted and/or isolated and formulated into a pharmaceutical composition for the treatment of various bone diseases, such as osteoporosis, as well as for improving the overall health of subjects.

Summary of the Invention

[0017] The invention relates to a pharmaceutical composition comprising a pomegranate extract containing pomegranate polyphenols, and optionally a pharmaceutically acceptable excipient.

[0018] The invention further relates to a method for maintaining or increasing bone mineral content or bone density in a warm-blooded animal, such as a human, comprising administering an effective amount of a pharmaceutical composition comprising a pomegranate extract containing polyphenols and an optional pharmaceutically acceptable excipient to the animal.

[0019] Other systems, methods, features, and advantages of the present invention will be or will become apparent to one with skill in the art upon examination of the following detailed description. It is intended that all such additional systems, methods, features, and advantages be included within this description, be within the scope of the invention, and be protected by the claims.

Brief Description of the Figures

[0020] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate an implementation of the present invention and, together with the description, serve to explain the advantages and principles of the invention. In the drawings:

[0021] Fig. 1 depicts a flow diagram of the pomegranate extraction process.

[0022] Fig. 2 depicts a flow diagram of the pomegranate polyphenol freeze drying process.

[0023] Figs. 3a-3f list the individual animal (rats) body weights (as well as the overall mean and standard deviation) for Groups 1 , 2, and 4-7 at the term of the experiment, and also measured on days 1 , 8, 15, 22, 29, 36, 43, 50, 57, 64, 71 , 78, and 85. .

[0024] Figs. 4a-4f list the individual animal (rats) bone mineral density (BMD) and bone mass calcium (BMC), as well as the mean and the standard deviation, for Groups 1 , 2, and 4-7.

[0025] Figs. 5a-5f list the individual animal (rats) uterine/femur-to-body weight percent for Groups 1 , 2, and 4-7. The term body weight (BW), uterine weight, and left femur weight are listed for each rat by group, as well as the mean and the standard deviation. The uterine % body weight (BW) and Femur % BW are also listed for each rat.

[0026] Figs. 6a-6f list the individual animal (rats) total plasma oxygen radical absorbence capacity (ORAC) in μιηοΙε/ΤΕ (Trolox Equivalents/L) for Groups 1 , 2, and 4-7.

[0027] Figs. 7a-7f list the individual animal (rats) tensile strength measurements for Groups 1, 2, and 4-7, and the average of each group.

[0028] Figs. 8a-8d list the individual animal (rats) clinical chemistry measurements for Groups 1 , 2, 4, and 5. The chemistry screen assayed for alkaline phosphatase, SGPT (ALT) (testing for alanine aminotrasferase, an enzyme associated with liver function), SGOT (AST), cholesterol, calcium, chloride, potassium, sodium, and triglycerides.

Detailed Description of the Invention

[0029] The invention relates to a pharmaceutical composition comprising a pomegranate extract containing pomegranate polyphenols. Polyphenols are compounds that contain more than one phenol group and have several properties that are of interest for their potential pharmaceutical uses. Polyphenol compounds generally possess antioxidant properties that have beneficial health properties. In particular, pomegranate extracts and juices containing these polyphenol compounds have been used as anti-atherosclerotics, anti-viral, and anti-cancer treatments. It has now been surprisingly discovered in studies involving rats that the antioxidant properties of the pomegranate polyphenol compounds are useful for treating bone disorders. Specifically, these compounds can be formulated into a pharmaceutical composition useful for maintaining or increasing bone mineral content or bone density, as well as for preventing bone loss.

[0030] Pomegranates contain several different polyphenols found in various parts of the pomegranate. Analyses of antioxidant properties of pomegranate constituents other than the juice include the outer and inner peels and the seeds. Analysis of the polyphenol concentration revealed that aqueous solutions of the concentrated pomegranate juice, the inner and outer peels and the seeds contain 22,830; 10,320; 6314; and 630 μΜ of total polyphenols, respectively. The major polyphenol ingredient in pomegranates is punicalagin. Pomegranates also contain the punicalin, ellagitannin compounds, such as ellagic acid, gallotannin compounds, such as gallic acid, and anthocyanins. [0031] Generally pomegranate polyphenols from juice can be categorized into four groups: anthocyanins, gallagyl-type hydrolysable tannins; ellagic acid derivatives, and other hydrolysable tannins. (See Gil et al.) The anthocyanins comprise approximately 6% of the polyphenols, and include, for example, delphinidin, cyaniden, and pelargonidin. The gallagyl- type hydrolysable tannins comprise about 66% of the polyphenols and include, for example, punicalagin and punicalin. Ellagic acid derivatives comprise approximately 9% of the polyphenols. These compounds include, for example, ellagic acid glucoside and ellagic acid. Other hydrolysable tannins comprise about 19% of the polyphenols, and include, for example, galloyl glucose.

[0032] The pomegranate extract of the invention has the following approximate polyphenol composition: about 4% punicalin, about 16% punicalagin, about 6% ellagic acid, and about 74% oligomers (repeating units (2-10) of gallic acid + ellagic acid + glucose in different combinations). Table 1 , below, shows a breakdown of pomegranate polyphenol profiles derived from a variety of pomegranate products. The formulation described in this application is shown in the table as extract powder. The other formulations, including the liquid extract, the concentrate and the arils juice, are presented for comparison purposes. The arils juice is obtained by compressing only the aril portion of the pomegranate; no rind or connective tissue is present.

Table 1 : Pomegranate Polyphenol Profiles¹

¹ All samples are from the 2008 harvest.

² Remaining polyphenols are oligomeric and polymeric polyphenols based on ellagic and gallagic base structure.

³ ncludes anthocyanidin color compounds

⁴ Includes anthocyanidin color compounds [0033] Pomegranate extracts containing these components can be prepared from the juice and solids, including the pericarp, inner membrane, and seeds, using a variety of extraction procedures, such as a hot water extraction, extraction using alcohols, and enzymatic protocols. Specifically, the polyphenols are extracted from the husks and rinds of pomegranate fruit (Punica granatum of the Wonderful variety) that have been pressed for the production of the pomegranate juice.

[0034] Fig. 1 depicts a flow diagram of the pomegranate polyphenol extraction process (100). The husks and rinds of the fruit are blanched, de-seeded, enzymatically dissolved, and concentrated by evaporation. The concentrate can be held in a freezer for further processing, then the pomegranate material, or concentrate, can be delivered to a processing plant, unloaded, and thawed (1 10). The concentrate is purified to provide the extract containing phytochemicals.

[0035] Next, the pomegranate concentrate is diluted and heated (120). The aqueous mixture can be processed by heating to about 60 °F to about 210 °F, or to about 85 °F to about 185 °F, or to about 1 10 °F to about 160 °F. Enzymes can be added to the mixture in an amount sufficient to at least partially degrade the pomegranate solids and liberate the phytochemicals from the plant tissues and/or cells. Once liberated, the phytochemicals can react and/or polymerize to create new phytochemical compounds and/or reaction products. Next, the residual insoluble solid materials can then be removed from the mixture by filtration, which can be ultrafiltration (130). Then, the filtered material can be purified over resin (140), distilled (150) and concentrated by evaporation (160). The purified, concentrated liquid can then be packaged into containers, such as totes (170), and then shipped or placed into storage, preferably cold storage (180) for further processing.

[0036] Fig. 2 depicts a flow diagram of a freeze drying process for the pomegranate polyphenols (200). The purified extract material as a liquid concentrate (210) is lyophilized by freezing the liquid extract and drying under conditions to allow the water in the solid state to sublimate at low temperature. The extract material can be tempered and agitated (220) prior to lyophilization. The pomegranate concentrate can be spread onto drying trays (230), and then the lyophilization procedure can be performed (240), preferably under vacuum. After freeze-drying, the composition is in a powder form. The dried product can be packaged (250). The product can be stored in drums, such as 20 kg fiber drums. The dried pomegranate polyphenol extract may be shipped or stored (260), preferably in cold storage, or may be processed into a drug product. [0037] These extracts are characterized by a significantly higher total polyphenol content, particularly those with high molecular weights (e.g. , punicalagin) than is found in pomegranate juice.

[0038] The present invention relates to a pharmaceutical composition comprising polyphenol compounds and, optionally, at least one pharmaceutically acceptable excipient.

These polyphenol compounds include, but are not limited to punicalagin, punicalin,

ellagitannins, and gallotannins and combinations thereof. The polyphenol compounds can be formulated so as to have a similar proportion as that found in nature. In addition, the relative potency of the polyphenol-containing pomegranate extract is greater than many other available supplements. For example, the present invention relates to a pharmaceutical composition having a relative potency of 100. Other extracts have a relative potency of between 1 for lycopene and 50 for resveratrol (a red wine extract). The relative potency of the supplements was measured by three leading antioxidant potency tests (2,2-Diphenyl-l -pikrylhydrazyl (DPPH), oxygen radical absorbance capacity (ORAC), and ferric reducing ability of plasma (FRAP)) on a per-gram basis). The results of all three tests were combined into an index score. The extract of the present invention had the highest score, and was therefore indexed.

]0039] The pharmaceutical composition can be prepared so that the polyphenols are present in the composition an amount from about 1 ,000 mg to about 4,000 mg per day.

[0040] The compositions for use in accordance with the present invention can be formulated in a conventional manner using one or more pharmaceutically acceptable carriers or excipients. Thus, the pharmaceutical composition can be formulated for administration by oral, buccal, parenteral, or rectal routes.

[0041] For oral administration, the pharmaceutical compositions can take the form of, for example, tablets or capsules prepared by conventional means with pharmaceutically acceptable excipients such as binding agents (e.g. , pregelatinized starch, polyvinylpyrrolidone or hydroxypropyl methylcellulose); fillers (e.g., lactose, microcrystalline cellulose or calcium hydrogen phosphate); lubricants (e.g., magnesium stearate, talc or silica); disintegrants (e.g. , potato starch or sodium starch glycolate); or wetting agents (e.g. , sodium lauryl sulfate). Tablets can be prepared using direct compression, wet granulation, dry granulation, or fluid bed granulation. The tablets can be coated by methods well known in the art using a

pharmaceutically acceptable coating. These compositions can also be formulated as granules, a powder, pellets, microspheres, or microcapsules. In one embodiment, the pharmaceutical composition of the invention is prepared by mixing dried pomegranate extract with magnesium stearate and filling gelatin capsules.

[0042] Alternatively, the pharmaceutical composition can be prepared from the pomegranate extract alone. In this instance, the composition does not contain any sugar, artificial colors, preservatives, or additives.

[0043] Liquid preparations for oral administration can take the form of, for example, solutions, syrups, or suspensions. Liquid preparations can also be presented as a dry product for constitution with water or other suitable vehicle before use (e.g. , saline). Such liquid

preparations can be prepared by conventional means with pharmaceutically acceptable additives such as suspending agents (e.g. , sorbitol syrup, cellulose derivatives or hydrogenated edible fats); emulsifying agents (e.g., lecithin or acacia); non-aqueous vehicles (e.g. , almond oil, oily esters, ethyl alcohol or fractionated vegetable oils); and preservatives (e.g. , methyl or propyl-p- hydroxybenzoates or sorbic acid). The preparations can also contain buffer salts, flavoring, coloring, and sweetening agents as appropriate.

[0044] Preparations for oral administration can also be formulated to provide controlled release of the active compound. For buccal administration the composition can take the form of tablets, which can be orally disintegrating tablets, or lozenges formulated in conventional manner.

[0045] The pomegranate extracts of the present invention can additionally be formulated for parenteral administration by injection, e.g. , by bolus injection or continuous infusion. Formulations for injection can be presented in unit dosage form, e.g. , in ampules or multi-dose containers with an added preservative. These compositions can take such forms as suspensions, solutions or emulsions in oily or aqueous vehicles, and can contain formulatory agents such as suspending, stabilizing, and/or dispersing agents. Alternatively, the active ingredient can be in powder form for constitution with a suitable vehicle, e.g. , sterile pyrogen- free water, before use.

[0046] The compounds can also be formulated in rectal or vaginal compositions such as suppositories or retention enemas, e.g. , which can contain conventional suppository bases such as cocoa butter or other glycerides. [0047] In addition to the formulations described previously, the pomegranate extracts of the present invention can also be formulated as depot preparations. Such long-acting formulations can be administered by implantation (for example subcutaneously or

intramuscularly) or by intramuscular injection. For example, the compounds can be formulated with suitable polymeric or hydrophobic materials (e.g. , as an emulsion in an acceptable oil) or ion exchange resins, or as sparingly soluble derivatives, such as a sparingly soluble salt.

[0048] The compositions can, if desired, be presented in a pack or dispenser device which can contain one or more unit dosage forms containing the active ingredient. For example, the pack can comprise metal or plastic foil, such as a blister pack. The pack or dispenser device can be accompanied by instructions for administration.

[0049] The pharmaceutical composition of the invention comprising pomegranate extracts can be used in a method for maintaining or increasing bone mineral content or bone density in a warm-blooded animal, comprising administering an effective amount of a pharmaceutical composition comprising a pomegranate extract containing polyphenols to the animal. The composition can also be used for preventing these conditions and other bone diseases or conditions, including but not limited to, osteoporosis, bone fractures, or osteopenia.

[0050] Osteopenia can be caused by a variety of reasons including, but not limited to, an anemic state, steroids, heparin, a bone marrow disorder, scurvy, malnutrition, calcium deficiency, idiopathic osteoporosis, congenital osteopenia, congenital osteoporosis, alcoholism, chronic liver disease, senility, post-menstrual state, oligomenorrhea, amenorrhea, pregnancy, diabetes mellitus, hyperthyroidism, Cushing's disease, acromegaly, hypogonadism,

immobilization or disuse, reflex sympathetic dystrophy syndrome, transient regional

osteoporosis, or osteomalacia.

[0051] The pharmaceutical composition can be administered to a warm-blooded animal, including but not limited to, a human subject, cat, cow, dog, or horse. Most preferably, the warm-blooded animal is a human subject.

[0052] The method of the invention relates to the administration of the

pharmaceutical composition comprising a pomegranate extract containing polyphenol compositions in a dosage form that can be, but is not limited to, capsules, tablets, powders, granules, pellets, microspheres, and microcapsules. [0053] The pharmaceutical composition of the invention can be administered on any desired dosing schedule, but preferably, administered once or twice daily.

[0054] The present invention is described in further detail in the following non-limiting examples. The variety of options falling within the scope of the invention will be readily determinable by those skilled in the art upon consideration of the general methods and compositions described above and exemplified below.

EXAMPLE

Experimental Background

[0055] Ovariectomy (OVX) causes bone demineralization and resorption primarily through loss of estrogenic tone. Estrogen deficiency leads to elevations in bone mineral units that increases cortical porosity primarily due to increased osteoclast (OC) formation.

Ovariectomy is associated with an increase of inflammatory activity characterized by

increased released of IL-1 , IL-6, and TNF which limit the activity of mature osteoblasts (OB) and eventually causing OB apoptosis. The increased TNF is likely due to increased T-cell production of this factor. Also of interest, reactive oxygen species (ROS) can play a role in postmenopausal bone loss by generating a more oxidized bone environment. OVX is associated with impaired antioxidant capacity and agents that increase glutathione prevent OVX induced bone loss. Reactive oxygen species (ROS) can activate osteoclasts and glutathione peroxidase is upregulated in osteoclasts by estrogen and estrogen deficiency will be associated with osteoclasts with reduced ability to scavenge ROS.

[0056] Plant polyphenols had been shown to reduce bone resorption following OVX and this can be due to antioxidant activity. Pomegranate extracts are rich in polyphenols that have potent antioxidant activity. The goal of this experiment was to determine the effect of pomegranate polyphenols on antioxidant power in plasma and relate that to bone mineral density, calcium content, and bone weight in OVX rats.

Experimental Methods

[0057] The purpose of the first part of the study related to product safety and efficacy. The study was performed to determine if extracts containing novel polyphenols inhibit post-menopausal loss of bone mineral density in ovariectomized rats. A total of five (5) pomegranate extract compositions were tested in this study. The test compounds were analyzed to characterize the compounds and to validate their stability. The compounds were stored at ambient room temperature and humidity unless otherwise noted. The extracts were administered as an unencapsulated oral powder. The compounds administered to the rats were purified, powdered polyphenol extracts. Although the extracts administered in this study were prepared prior to those shown in Table 1 above, these were substantially similar to those described above because of the reproducibility of the extraction process.

[0058] For this study, 70 female Sprague-Dawley rats were either ovariectomized or subjected to sham operations. At the time of surgery, the rats were 12 weeks of age and weighed between 200 and 250 grams. There were seven (7) test groups, with ten (10) animals per group. Ovariectomized Sprague-Dawley rats are a well-accepted model for the study of estrogen- deficient osteoporosis and other bone diseases and conditions.

[0059] The animals were housed singly in suspended stainless steel cages which conformed to the size recommendations in the most recent Guide for the Care and Use of Laboratory Animals DFIEW (NIH). Litter paper placed beneath the cage was changed at least three times per week. The animal room was temperature-controlled, had a 2-hour light:dark cycle, and was kept clean and vermin free. The animals were conditioned to the housing facilities for at least three (3) days prior to testing. The animals were fed a Purina 5K95 diet and received filtered tap water ad-libitum. There were no known contaminants reasonably expected to be found in the food or water at levels which would interfere with the results of this study.

Experimental Design

[0060] The pomegranate test compounds were administered either perorally (PO) or subcutaneously (SC). General procedures associated with the balanced design and conduct of this study were employed to control bias. The test compounds were mixed thoroughly prior to dosing. Sixty (60) ovariectomized and ten (10) sham operated Sprague-Dawley rats were weighed and examined for health. Only those rats falling within the designated weight range were used. The following dosage schedule was used, with the first six groups being dosed at 5 ml/kg perorally twice a day (early morning and late afternoon), seven days per week. The animals were equally distributed into the following groups: • Group 1 - Vehicle PO (tap water) twice per day in sham operated female Sprague- Dawley rats

• Group 2 - Vehicle PO (tap water) twice per day in OVX rats

• Group 3⁵ - Not relevant to study.

• Group 4 - Pure polyphenol (active) PO (1 x, 10 mg/kg/day) twice per day in OVX

• Group 5 - Pure polyphenol (active) PO (3 x, 30 mg/kg/day) twice per day in OVX

• Group 6 - Pure polyphenol (active) PO (6 x, 60 mg/kg/day) twice per day in OVX

• Group 7 - 17-beta estradiol 3-benzoate given SC at 100 μg/kg in 100 μΐ sesame oil once per week in OVX

[0061] Drug treatments were begun ten (10) days after OVX or sham treatment. The animals were treated according to their group assignment for 12 weeks. Body weights were taken throughout the procedure, each week, and at term. At this time, serum (0.5ml) samples were taken for a chemical screen including liver function test (AST, ALT), alkaline phosphatase, electrolytes (sodium, potassium, calcium, chloride), and lipids (total cholesterol, triglycerides). The plasma was collected at approximately 2 hours after the morning dose for a trolox assay. Trolox is a water soluble vitamin E analog used as the calibration standard. The animals were then sacrificed using carbon monoxide. The right femurs were removed along with lumbar vertebrae 1 and 2, all of which were fixed for histological analysis using 10% phosphate buffered formalin for histomorphometry. The left femurs were removed and biomechanical properties (e.g. , tensile strength) determined. Wet and dry weights were also determined. Also, the left femurs were used for bone mineral density (BMD testing by dual energy X-ray absorptiometry (DEXA). The remaining bone material was assayed for calcium and phosphorus content. All animals had their uterine weights taken and compared to body weight. Seventy (70) serum samples were used for a chemistry screen. In addition, a Trolox assay was performed as described by Henning et al , Bioavailability and antioxidant activity of tea flavanols after consumption of green tea, black tea, or a green tea extract supplement, 80 Am. J. Clin. Nutr. 1558 (2004). At the end of the study, uterine weights were measured and

⁵ Group 3 related to the testing of a different and unrelated solution, which is not relevant to the present specification, and thus, is not included herein. The remaining 6 groups (60 rats) are discussed. the right femur was removed for potential histological analysis. Blood samples were taken for determination of plasma ORAC or antioxidant capacity and serum osteocalcin levels.

Experimental Results

[0062] Individual animal observations were made on days 1-58 and 60-85 .

[0063] Group 1 - Vehicle PO (tap water) twice per day in sham operated female Sprague-Dawley rats. The rats (9160-9169) were active and healthy throughout the study period. Necropsy observations of the left and right femurs and L1-L2 vertebrae showed no gross abnormalities, except one rat (9163) had a fluid-filled uterus and fallopian tubes.

[0064] Group 2 - Vehicle PO (tap water) twice per day in OVX female rats. The rats (9170-9179) were active and healthy throughout the study period. Necropsy observations of the left and right femurs and L1-L2 vertebrae showed no gross abnormalities.

[0065] Group 3 - related to the testing of a different and unrelated solution, which is not relevant to the present specification, and thus, the rat observation is not included herein.

[0066] Group 4 - Pure polyphenol (active) PO (1 x, 10 mg/kg/day) twice per day in OVX female rats. The rats (9190-9199) were active and healthy throughout the study period. Necropsy observations of the left and right femurs and L1-L2 vertebrae showed no gross abnormalities.

[0067] Group 5 - Pure polyphenol (active) PO (3 x, 30 mg/kg/day) twice per day in OVX female rats. All but one of the rats (9200-9208) were active and healthy on days 1-58 and 60-85. The single other rat (9209) was active and healthy through day 41 , but was found dead on day 42. Necropsy observations of the left and right femurs and L1-L2 vertebrae showed no gross abnormalities in the rats that survived the entire experiment.

[0068] Group 6 - Pure polyphenol (active) PO (6 x, 60 mg/kg/day) twice per day in OVX female rats. All but two of the rats (9210-9215; 9217-9218) were active and healthy on days 1 -58 and 60-85. One of the rats (9216) was active and healthy through day 24, but was found dead on day 25; the other rat (9219) was active and healthy through day 34, but was found dead on day 35. Necropsy observations of the left and right femurs and L1-L2 vertebrae showed no gross abnormalities in the rats that survived the entire experiment.

[0069] Group 7 - 17-beta estradiol 3-benzoate given SC at 100 μg kg in 100 μΐ sesame oil once per week in OVX femal rats. The rats (9220-9229) were active and healthy throughout the study period. Necropsy observations of the left and right femurs and L1-L2 vertebrae showed no gross abnormalities.

[0070] Body weights are shown in Table 2 below for all groups on day 1 and the last day of the study (day 85). OVX animals had significantly increased body weight over the course of the study, except in the estradiol group, which did not demonstrate significant weight gain. Table 2 lists the average weight of the rats in each group, while Figures 3a-3f show the individual weights of the rats by group.

Table 2. Body weights just before drug treatment and after 12 weeks of drug treatment

(averaged)

'OVX: ovariectomized, the animals were ovariectomized for days before drug initiation. ²PP: polyphenol.

[0071] Bone mineral densities (BMD) for the left femurs of all groups are shown in Table 3 below. BMD was significantly reduced by OVX, and none of the test compounds affected this parameter. Only estradiol increased BMD back to sham levels in

ovariectomized rats. Table 3 lists the average bone mineral density of the rats in each group. Figs. 4a-4f are complete lists of the bone mineral density and the bone mass calcium of each individual rat.

Table 3. Averaged bone mineral densities were measured using DEXA on the left femurs

'OVX: ovariectomized, the animals were ovariectomized for days before drug initiation. ²PP: polyphenol.

[0072] Calcium and phosphorus contents of the left femurs are shown in Table 4 below. Phosphorus was only measured for sham, OVX, OVX + 30 mg/kg twice-a-day polyphenol extract, and OVX estradiol groups.

Table 4. Calcium and phosphorus measurements

'OVX: ovariectomized, the animals were ovariectomized for days before drug initiation. ²PP: polyphenol.

[0073] Uterine weights alone or as a percent of body weight are shown for all groups in Table 5 below. Figures 5a-5f show the uterine/femur-to-body weight percent for individual rats. OVX induced significant loss of uterine weight alone and relative to body weight compared to the sham animals. Unlike the Mori-Okamoto study discussed previously, no drug treatment except estradiol brought uterine weights back up to sham group levels. This is indicative of a difference in the pomegranate extract composition of our study and the Mori- Okamoto, which is likely attributable to compositional differences between the Japanese extract (prepared from pomegranate juice and seeds only) and the extract of the present invention (prepared from the entire pomegranate).

Table 5. Uterine weights and uterine weights normalized for body weight after 12 weeks of drug treatment

'OVX: ovariectomized, the animals were ovariectomized for days before drug initiation. ²PP: polyphenol.

[0074] Serum osteocalcin is a hormone released by osteoblasts under conditions of bone formation. Under conditions of bone resorption, osteocalcin is released from the bone matrix and this is typically seen after OVX or estrogen deficiency. OVX caused a significant increase in osteocalcin, which when observed in the presence of reduced bone calcium levels, is consistent with bone resorption, as shown in Table 6 below. Table 6 shows the serum osteocalcin levels in ng/mL Estradiol and the 60 mg/kg twice-a-day dose of polyphenol extract maintained serum osteocalcin at sham group levels, suggesting inhibition of bone resorption. Since the polyphenol extract had no effect on uterine weight, this effect is likely not related to activation of estrogen receptors. The antioxidant properties of the polyphenols can be the mechanism for this exhibited ability to increase bone calcium levels.

Table 6. Serum osteocalcin levels (ng/mL) after 12 weeks of drug treatment

'OVX: ovariectomized, the animals were ovariectomized for days before drug initiation. ²PP: polyphenol. [0075] Since polyphenols increase calcium concentration in bones, but have no effect on uterine weights, the increased calcium levels are likely not secondary to estrogenic activity.

Given that estrogen deficiency is associated with an inflammatory response and reactive oxygen species (ROS) generation, effect of the test compounds on plasma antioxidant capacity

(antioxidant activity) was investigated. As can be seen in Table 7below, OVX was

associated with a significantly reduced antioxidant capacity, suggesting the increased presence of reactive oxidative species (ROS). The polyphenol extracts caused a dose-dependent increase in antioxidant capacity. It should be noted that the animals were put on a diet otherwise low in polyphenols, providing low antioxidant background levels. Table 7 shows the average

antioxidant levels per group. Figs. 6a-6g show antioxidant levels in individual rats. The ORAC analysis provides a measure of the scavenging capacity of antioxidants against the peroxyl radical, which is one or the most common reactive oxygen species (ROS) found in the body

ORAChy_dro reflects water-soluble antioxidant capacity. Trolox, a water-soluble Vitamin E analog, is used as the calibration standard and the ORAC result is expressed as micromole Trolox

equivalent (TE) per liter. The acceptable precision of the ORAC assay is 15% relative standard deviation (see Ou et al. , Development and Validation of an Improved Oxygen Radical Absorbance Capacity Assay using Fluorescein as the Fluorescent Probe, 49(10) Journal of Agriculture and Food Chemistry 44619-4626 (2001).

Table 7. Average water soluble antioxidant capacity in plasma (ORAC).

'OVX: ovariectomized, the animals were ovariectomized for days before drug initiation. ²PP: polyphenol. TE is Trolox equivalents. Trolox is a water soluble vitamin E analog used as the calibration standard.

[0076] Ovariectomy in female rats is associated with bone resorption that is thought to be due, in part, to reactive oxidative species (ROS) effects on osteoblasts and osteoclasts. The reduced bone mineral density and calcium content are associated with significant release of osteocalcin from the bone matrix, further suggesting bone resorption. Other studies have shown antioxidant administration, including plant polyphenols, attenuates OVX-induced bone resorption.

[0077] The pomegranate polyphenol extracts were effective antioxidants and also increased bone calcium concentration, but had no effect on bone mineral density in this experiment, as measured by DEXA using equipment well-known in the art. It is probable that DEXA was not sensitive enough to detect the increased calcium concentrations.

Surprisingly, the polyphenols had no effect on uterine or body weight, unlike estradiol, so they seem to have little, if any, estrogenic effects. Therefore, it is doubtful that their positive effect on bone calcium and inhibition of osteocalcin release was due to activation of estrogen receptors. Thus, the most likely mechanism is the antioxidant activity of the polyphenol compounds of the present composition. Bone tensile strength was measured, but the values were not useful because of the significantly increased body weight of the OVX animals and the greater degree of growth of the femur that accompanied the weight gain. However, individual rat bone tensile strength measurements are included in Figures 8a-8f below. The results of the chemistry screen for Groups 1 , 2, 4, and 5 are shown in Figs. 9a-9d. The chemistry screen assayed for alkaline phosphatase, SGPT (ALT), SGOT (AST), cholesterol, calcium, chloride, potassium, sodium, and triglycerides.

[0078] While various embodiments of the present invention have been described above, it should be understood that such disclosures have been presented by way of example only, and are not limiting. Thus, the breadth and scope of the present invention should not be limited by any of the above-described exemplary embodiments, but should be defined only in accordance with the following claims and their equivalents.

[0079] Having now fully described the invention, those of ordinary skill in the art would understand that the same can be performed within a wide and equivalent range of conditions, formulations and other parameters without affecting the scope of the invention or any embodiment thereof. All patents, patent applications, and publications cited herein are fully incorporated by reference in their entirety.

Claims

What is claimed is:

1. A pharmaceutical composition comprising a pomegranate extract containing pomegranate polyphenols and, optionally, at least one pharmaceutically acceptable excipient.

2. The pharmaceutical composition of claim 1 , wherein the polyphenols are selected from the group consisting of punicalagin, punicalin, ellagitannins, gallotannins and combinations thereof.

3. The pharmaceutical composition of claim 2, wherein the punicalagin, punicalin, ellagitannins, and gallotannins are in a proportion about the same as found in pomegranates in nature.

4. The pharmaceutical composition of claim 1 , wherein the polyphenols comprise about 4% punicalin, about 16% punicalagin, about 6% ellagic acid, and about 74% oligomers having 2-10 repeating units of gallic acid, ellagic acid, and glucose.

5. The pharmaceutical composition of claim 1 , wherein the polyphenols are present in the composition an amount from about 1 ,000 mg to about 4,000 mg.

6. The pharmaceutical composition of claim 1, wherein the extract is in granulated form.

7. The pharmaceutical composition of claim 1 , wherein the extract is in a coated with a pharmaceutically acceptable coating.

8. The pharmaceutical composition of claim 1 , wherein the extract is encapsulated in a pharmaceutically acceptable capsule.

9. The pharmaceutical composition of claim 1, wherein the composition is in a form selected from the group consisting of a capsule, a tablet, a powder, granules, pellets, microspheres, and microcapsules.

10. A method for maintaining or increasing bone mineral content or bone density, in a warmblooded animal comprising administering an effective amount of a pharmaceutical composition comprising a pomegranate extract containing polyphenols and, optionally, at least one

pharmaceutically acceptable excipient to the animal.

1 1. The method of claim 10, wherein the warm-blooded animal is a human subject.

12. The method of claim 11 , wherein bone mineral content of the subject is maintained or increased.

13. The method of claim 1 1 , wherein bone density of the subject is maintained or increased.

14. The method of claim 1 1, wherein the subject exhibits symptoms of or has osteoporosis.

15. The method of claim 11, wherein the subject suffers from a bone fracture.

16. The method of claim 1 1 , wherein the subject exhibits symptoms of or has osteopenia.

17. The method of claim 1 1 , wherein the pharmaceutical composition is administered as a pharmaceutical dosage form selected from the group consisting of a capsule, a tablet, a powder, granules, pellets, microspheres, and microcapsules.

18. The method of claim 1 1, wherein the pharmaceutical composition is administered once or twice daily.

19. The method of claim 1 1, wherein the polyphenols are selected from the group consisting of punicalagin, punicalin, ellagitannins, gallotannins and combinations thereof.

20. The method of claim 19, wherein the punicalagin, punicalin, ellagitannins, gallotannins are in a proportion about the same as found in pomegranates in nature.

21. The method of claim 1 1 , wherein the polyphenols comprise about 4% punicalin, about 16% punicalagin, about 6% ellagic acid, and about 74% oligomers having 2-10 repeating units of gallic acid, ellagic acid, and glucose.

22. The method of claim 1 1 , wherein the polyphenols are present in the composition in an amount from about 1 ,000 mg to about 4,000 mg.