WO2011071722A1 - Methods of inhibiting metastatic cancer by administration of streptolysin o - Google Patents

Methods of inhibiting metastatic cancer by administration of streptolysin o Download PDF

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Publication number
WO2011071722A1
WO2011071722A1 PCT/US2010/058421 US2010058421W WO2011071722A1 WO 2011071722 A1 WO2011071722 A1 WO 2011071722A1 US 2010058421 W US2010058421 W US 2010058421W WO 2011071722 A1 WO2011071722 A1 WO 2011071722A1
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carcinoma
cancer
streptolysin
cell
disease
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PCT/US2010/058421
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English (en)
French (fr)
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John Mcmichael
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Beech Tree Labs, Inc.
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Priority to EP10836433.2A priority Critical patent/EP2510358B1/de
Publication of WO2011071722A1 publication Critical patent/WO2011071722A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/164—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from bacteria
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents
    • A61P35/02—Antineoplastic agents specific for leukemia
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents
    • A61P35/04—Antineoplastic agents specific for metastasis

Definitions

  • the present invention relates to methods for treatment of various conditions by the administration of streptolysin O including connective tissue disorders, reproductive fibroses and conditions mediated by the CD44 receptor.
  • the invention also provides methods for protecting nerve cells from the effects of neurotoxic agents by the administration of streptolysin O.
  • the invention further provides methods of alleviating symptoms of a connective tissue disorder, such as tendonitis, by the administration of streptolysin O.
  • methods of treating cancer comprising the administration of streptolysin O.
  • Connective tissue is the material between the cells of the body that gives tissues form and strength. This "cellular glue" is also involved in delivering nutrients to the tissue, and in the special functioning of certain tissues. Connective tissue is made up of dozens of proteins, including coUagens, proteoglycans, and glycoproteins. The combination of these proteins can vary between tissues. The genes that encode these proteins can harbor defects or mutations, which can affect the functioning of certain properties of connective tissue in selected tissues. As described below, there are a number of different disease states where connective tissue play an important role in the pathological manifestations of the particular disease including Dupuytren's contracture, scleroderma, Peyronie's disease, claudication due to peripheral arterial disease and mastitis in animals.
  • the present invention relates to methods for treatment of connective tissue disorders including Dupuytren's contracture, scleroderma, Peyronie's disease, and lower limb claudication. These diseases take an enormous toll on people's ability to work, perform physical and sexual activity, maintain normal living standards, and perform everyday activities. In addition, post chronic mastitis infections in bovines have huge economic implications on the viability of livestock and the food supply, specifically the dairy industry. - 9 -
  • Peripheral arterial disease involves damage to or blockage of the blood vessels distant from the heart (usually in the arms and the legs) and includes several clinical syndromes in the extremities characterized by pain, inflammation, and ischemic damage to soft tissues from partial or complete occlusion of major arteries.
  • the most characteristic symptom of PAD is intermittent claudication, which is described as cramping, aching, and numbness of the extremities induced by exercise. Intermittent claudication subsides by ending the exercise regiment.
  • the symptoms of claudication result from atherosclerosis, which is a condition where plaque consisting of cholesterol, fats, calcium, and fibrin (blood clotting agent) build up on the inside of the artery wall.
  • the artery wall consists of three layers: a layer of connective tissue, a second layer of smooth muscle cells and elastic connective tissue, and a third layer of endothelial cells. Damage to these cells leads to thrombocyte adhesion, aggregation, and formation of thrombi or intima in the arterial wall. This formation allows monocytes to stick to the arterial wall and maturate into macrophages, while recruiting LDL cholesterol to create a foam cell formation or fatty streaks. This interruption in the arterial endothelial lining causes platelets to become activated and recruit smooth medial muscle cells into the initma leading to connective tissue proliferation and lipid uptake. This cycle of inflammation and proliferation of connective tissue in the arterial wall of the blood vessel leads to narrowing of the arterial lumen, restricting blood flow.
  • Claudication is often a sign of atherosclerosis of both the coronary and carotid arteries.
  • physicians should focus on evaluation, risk factor modi fication (quitting smoking and reducing cholesterol), and exercise (stimulate carotid arteries and condition muscles) (see Carmen et al, Am Fam. Physician 61 : 1027- 1034 (2000); Gardner et al., JAMA 274:975-980 (1995); Patterson et al, J. Vase. Surg. 25 :3 12-3 19 (1997)).
  • Antiplatelet agents which prevent the recruiting activities of platelet cells, such as aspirin, ticlopidine, or clopidogrel, reduce the risk of vascular death, myocardial infarction, and stroke as much as 24% (see Goldhaber et al. Lancet 340: 143-145 (1992); Janzon et al, J. Intern. Med.
  • Dupuytren's contracture is a painless thickening and contracture of tissue beneath the skin on the palm of the hand.
  • the cause of the contracture is unknown, but minor trauma and genetic predisposition may play a role.
  • One or both hands may be affected.
  • the ring finger is affected most often, followed by the little, middle and index finger.
  • a small, painless nodule develops in the connective tissue and eventually develops into a cord-like band.
  • other nodules may develop and extend a contracture across the first joint into the finger.
  • the overlying skin begins to pucker, and rough cords of tissue extend into the finger. As the process continues, these cords tighten and pull the finger in toward the palm.
  • the ring finger is usually affected first, followed by the little, long and index fingers.
  • the problem is not pain, but the restriction of motion and the deformity i t causes.
  • the progress of the disease is often sporadic and unpredictable. Exactly what triggers the formation of nodules and cords is unknown. As the disease progresses, the diseased nodules wraps itself around and between the normal tissue.
  • Fasciectomy is a corrective surgery performed by removing the fascia tissue and stitching up the wound in a zigzag manner (See Visa el uL , Romanian Journal of Hand and Reconstructive
  • Dermo fasciectomy is a corrective procedure of an advanced state of Dupuytren's contracture, where the skin and the fascia bands and nodules are removed. The removed skin is replaced by a skin graft. Fasciotomy is a medical procedure for elderly patients unfit for complicated surgery where the bands are cut. Finally, in rare cases, fingers in which the bands have returned many times and previous nerve and tissue damage exist, amputation of the finger is an option. While surgery usually restores normal movement to the fingers, the disease can reoccur following surgery and the risk of nerve damage increases after each surgery. Therefore, there remains a need for a less drastic method for treating Dupuytren's contracture.
  • Peyronie's disease is a disorder of the connective tissue within the penis that can cause curvature during erection.
  • the disease is characterized by a plaque, or a hard lump, that forms in the erectile tissue of the penis. It begins as a localized inflammation and can then mature into a hardened scar.
  • the cause of Peyronie's disease can be attributed to the septum connective tissue, which lines the inner membrane of each erectile cylinder that runs the length of the penis and attaches at the top and bottom of the penis.
  • the area where the septum attaches to the elastic fibers may over-stretch, injuring the lining of the erective chamber and rupturing small blood vessels.
  • the area where the septum attaches to the elastic fibers may over-stretch, injuring the lining of the erective chamber and rupturing small blood vessels.
  • diminished elasticity, disease of the arteries, diabetes, or radical prostatectomy further increase the chance of injury.
  • Peyronie's disease is diagnosed in only 26 out of 100,000 men each year; however, the ratio increases to 3 out of 64 patients who develop Peyronie's disease after a radical prostatectomy ( .(arrow et ah, J. of Urology 158: 1388-1390 ( 1997 )).
  • Men with Peyronie's disease usually seek medical attention because of painful erections or difficulty with intercourse.
  • the goal of any treatment is to keep the Peyronie's patient sexually active. Providing education about the disease and its course is often all that is required. There is no strong evidence that any treatments other than surgery are effective.
  • Experts usually recommend surgery only in long- term cases where the disease has stabilized and where the deformity prevents intercourse.
  • the two most common surgical methods are removal or expansion of the plaque followed by a placement of a patch of skin or artificial material and removal of pinching tissue from the side of the penis. Both procedures have the disadvantage of side effects including loss of erectile function or shortening of the erect penis.
  • Scleroderma is an autoimmune disease of the connective tissue, which affects many body systems such as the gastrointestinal tract, the respiratory, renal, cardiovascular, and genitourinary systems, but is primarily characterized by thickening and tightening of the skin. This disease may either be visible, as when the skin is affected, or invisible, as when only internal organs are involved, but is usually a highly-individualized disease wherein its involvement may range from mild symptoms to life-threatening symptoms. The symptoms result from progressive tissue fibrosis and occlusion of the microvasculature by excessive production and deposition of types 1 and 11 collagens.
  • vascular alternations show a predilection for affecting the small arteries, arterioles, and capillaries.
  • the small vessel cytoskeleton is affected by structural defects that lead to collapse. Next, the tight junctions become altered and are no longer functional, allowing the endothelium to slip into the vessel lumen.
  • scleroderma An estimated 300,000 persons in the United States have scleroderma with more women (4 times more) than men developing the disease usually between the ages of 20 to 50.
  • Symptoms of scleroderma include one or more of the following: Raynaud's Phenomenon (abnormal sensitivity to cold in the extremities), swelling of the hands and feet, pain and stiffness of the joints, thickening of the skin, joint contractures, digestive system and gastrointestinal tract problems, Sjogren's Syndrome (dry mucus membranes), oral, facial and dental problems, kidney, heart, and lung involvement, and non-specific symptoms such as extreme fatigue, generalized weakness, weight loss, and vague aching of muscles, joints and bones.
  • Raynaud's Phenomenon abnormal sensitivity to cold in the extremities
  • swelling of the hands and feet swelling of the hands and feet
  • pain and stiffness of the joints thickening of the skin, joint contractures, digestive system and gastrointestinal tract problems
  • Sjogren's Syndrome dry mucu
  • scleroderma The most serious side effect of scleroderma is pulmonary hypertension, and its complications are the most frequent causes of mortality.
  • the lungs are affected in 70- 80% of patients, and develop either fibrosis or change in the blood vessels, which leads to increased pressure in the pulmonary arteries (Harrison et al, Am. Rev. Respir. Dis. 144:706-713 (1991 ); Silver ef al., Am. J. Med. 88:470-476 (1990)).
  • the fibrosis usually starts with an increase in lung fiber density near the posterior (back) regions of the lungs. Later stages of fibrosis are characterized by the emergence of a network of fibrous lines. These fibrous lines eventually develop into regions containing large numbers of small cysts. The end-stage effect is sometimes referred to as
  • the goal for treating scleroderma is to prevent further complications (i.e. fibrosis) and reduce morbidity if complications exist.
  • Primary treatment consists of inhibiting the immune system alterations, which may be responsible for the wide variety of systemic morbidity associated with this disease.
  • Skin thickening can be treated with D-penicillamine and methotrexate, which both increases the effects of immunosuppressants and slows down the formation of collagen.
  • the experimental drug relaxin has also shown promise reducing the extent and severity of skin thickening in patients with di ffuse scleroderma (Seibold et al.. Ann. intern. Med. 132:871 -879 (2000)).
  • Relaxin attenuates the actions of profibrotic cytokines including transforming growth factor- ⁇ and interleukin- ⁇ ⁇ , and increases secretion of dermal fibroblast collagenase, while reducing levels of tissue inhibitor of
  • metalloproteinase (Unemori et al . J. Biol. Chem. 265: 1 0681 - 10685 ( 1990)). Raynaud phenomenon can be treated with calcium blockers or topical nitrates. Gastrointestinal symptoms may be treated with antacids, pump inhibitors, and laxatives. More severe complications, like fibrosis in the lungs or pulmonary hypertension, require more drastic measures. For example, scleroderma and alveolitis (hypersensitive inflammation of alveolar cells in the lung) can cause severe damage to lung tissues. Treatment with experimental drugs such as cyclophosphamide work to inhibit inflammation, but is not effective against only scleroderma in the lungs.
  • Pulmonary hypertension is a relatively common complication of systemic sclerosis with a lack of viable treatment options and a high mortality rate.
  • the use of intravenous epoprostenol has shown some promise (Badesch et al, Ann. Intern. Med. 132:425-434 (2000)). but may have limited applicability due to possible acute and potentially fatal side effects such as pulmonary edema in patients suffering with veno-occlusive disease as well as scleroderma (Barst et al, N. Eng. J. Med. 334:296-301 ( 1996)).
  • Streptococcus uteris, colorless algae and corneybacterium can cause the initial infection via numerous vectors such as flies, flowing water, standing water, water tanks, water runoff from silage, well water, manure, teat dip containers, milking machine liners, teat end swabs and feed troughs. These bacteria are able to invade the mammary gland, multiply therein, and produce harmful substances that result in an in flammatory response. Once infection begins, the teats can become so infected that the milk first becomes yellow and then watery.
  • a fter infection, chronic mastitis can occur which is the after-effect of repeated bouts of mastitis at the level of the teat where humps, lesions, hardenings, damaged teats, lost quarters, nodularthelitis, and a drop in milk production occur.
  • Reproductive fibrosis in the form of fibroids affects the reproductive organs of female mammals, most notably the uterus and the fallopian tubes. Fibroids can grow inside, within the muscle wall and on the outside surface of the uterus. Reproductive fibrosis can result in various symptoms including pain, bleeding, urinary tract, bladder and kidney infection, infertility and difficulties with pregnancy. Reproductive fibroids do not occur prior to puberty and frequently cease having symptoms after the conclusion of menopause. Fibroids that do not cause symptoms or that cause only minor symptoms usually do not require treatment.
  • Reproductive fibroses that cause more severe symptoms are treated with medications such as oral contraceptives or gonadotropin-releasing hormone agonists (GnRH-As).
  • Non-surgical treatments such as uterine fibroid embolization which is a radiological procedure may be carried out to treat fibroids.
  • surgical treatments such as myomectomy (which is intended to retain fertility) or hysterectomy (which will not retain fertility) may be carried out.
  • myomectomy which is intended to retain fertility
  • hysterectomy which will not retain fertility
  • the CD44 family of surface receptors which regulate various cellular activities is the CD44 family of surface receptors which regulate various cellular activities.
  • the CD44 receptor protein is a
  • the CD44 receptor protein is also known as the lymph node homing receptor and is homologous to the "cartilage link protein.”
  • Hyaluronic acid (HA) is one of its ligands. Altered expression of the D44 receptor is believed to be associated with tumor progression and metastases in v arious cancers. In addition, degradation of HA may play a critical role in promoting the formation of scar tissue in the damaged nervous system that inhibits axonal regeneration following injury to the brain or spinal cord. In contrast, the
  • HA may contribute to the pathogenesis of various neurodegenerative diseases, including multiple sclerosis and Alzheimer's disease.
  • multiple sclerosis and Alzheimer's disease Also of interest to the present invention is the observation that the CD44 receptor on fibrous astrocytes appears to be up-regulated in Multiple Sclerosis. Accordingly, there exists a desire for agents and methods to intervene with the biological activities of the CD44 receptor as well as the effects of hyaluronic acid on that receptor. Further, there also exists a need for neuroprotective agents to protect neurons against both natural and synthetic neurotoxic agents in the environment and which result in vivo as a result of metabolic processes.
  • Streptolysin O is one of a group of filterable hemolysins derived from Group A beta-hemolytic streptococci. Specifically, streptolysin O is a 60-kD peptide, which is hemolytic in its reduced state, but is inactivated upon oxidation. Group A streptococci produce streptolysin O. Streptolysin O is used in the art generally as an analytical reagent for permeabilizing cells (e.g. Razin et al., Proc. Nat'l. Acad. Sci. (USA) 91 :7722-7726 (1994).
  • an analytical reagent for permeabilizing cells e.g. Razin et al., Proc. Nat'l. Acad. Sci. (USA) 91 :7722-7726 (1994).
  • Streptolysin O is hemolytic in its reduced state but is inactivated upon oxidation (Johnson et al., Infect. Immun., 27:97- 10 1 , 1980; Alouf et al., Pharmacol. Ther., 3:661 -717, 1984; Bhakdi et al, Infect. Immun., 47:52-60, 1985, the disclosures of which are incorporated herein by reference in their entirety)
  • Streptolysin O may also interact with CD-44 receptors on keratinocytes and dissolve collagen to allow streptococci to get in the blood stream. It has recently been reported that streptolysin O enhances keratinocyte migration and proliferation and promotes skin organ culture wound healing in vitro (Tomic-Canic et al., Wound Rep. Reg., 15:71 - 79. 2007).
  • Tendonitis is perhaps one of the most frustrating athletic injuries involving the lower leg of a horse.
  • Tendonitis is defined as the inflammation of the tendon and tendon-muscle attachments.
  • a "bowed tendon" is caused by an injury to the superficial digital flexor tendon, the tendon lying closest to the skin on the abck portion of the leg between the carpus (knee) and the fetlock (ankle).
  • Tendonitis usually results from a severe strain or hyperextension of this tendon during excessive loading during work. Poor footing in the arena, excessive pastern slope, improper shoeing, and tight fitting leg wraps may place extra stresses on this tendon.
  • Clinical signs include, di ffuse swelling on the back of the leg, heat, pain on palpation, and varying degrees of lameness depending on the severity of the injury. Tendon injuries can vary from mild inflammation of the surrounding tendon structures, to more severe tears of the tendon fibers, to partial or complete rupture. An aggressive approach to therapy may make the difference in the horse ' s ability to return to its previous level of performance. Inappropriate therapy may lead to chronic lameness problems due to re-injury of the tendon. Surgical options include:
  • the goal of medical treatment is to keep the inflammatory response to a minimum, ideally the aim is to limit the amount of inflammation to that necessary to repair the injury and keep the inflammation from affecting the remaining normal tendon (reduce unwanted scar tissue).
  • Current therapy includes one or more of the following: cold therapy (application of cold water or ice four to six times a day); bandaging to provide counter pressure against the swelling; stall rest; and anti -inflammatory medication.
  • MMP neutral matrix metalloproteinases
  • MMP Metal loelastase
  • MMP-7 MMP- 1 1 , M M P 12. MMP- 19, MMP-20 and MMP-23.
  • MMPs especially MMP-2 and -9
  • MMP-9 pro-oncogenic events
  • tumor cell invasion a tumor cell metastasis.
  • MMP-9 the majority of human metastatic tumor cells (i.e., melanoma, fibrosarcoma, breast adenocarcinoma, glioma, etc.) that have been tested consistently show elevated MMP- 9 activity compared with benign control cells.
  • Tumor cells stably expressing the MMP-9 cDNA have been shown to widely metastasize in nude mice, whereas inhibition of the MMP-9 activity has been demonstrated to prevent metastasis in other models.
  • MMPs2 and - 9 have been shown to be up-regulated at the mRNA and protein levels in the SNB 19 and the U87MG human glioma cell lines.
  • the rat C6 glioma cell line also expresses M.MP2 and -9 at the mRNA and protein level.
  • U.S. Patent Nos. 5,576,289 and 5,736,508 disclosures are hereby incorporated by re ference.
  • U.S. Patent No. 5,576,289 discloses the use of streptolysin O in methods for treating disease states characterized by motor deficit including multiple sclerosis and autism.
  • U.S. Patent No. 5,736,508 discloses the use of streptolysin O in methods for treating scarring.
  • streptolysin O is used to treat connective tissue disorders such as tendonitis, Dupuytren's contracture, scleroderma, Peyronie's disease, mastitis in animals, and claudication due to peripheral arterial disease, that streptolysin O has direct neuroprotective effects or therapeutic effects on reproductive fibroses or that it has the effect of inhibiting hyaluronic acid binding to CD44 receptors or otherwise inhibits CD44 mediated processes.
  • Neither the '289 patent nor the '508 patent disclose or suggest the use of streptolysin O for the treatment of cancer.
  • the present invention provides methods for treating connective tissue disorders by administering streptolysin O.
  • the invention provides methods for alleviating symptoms of a connective tissue disorder such as Dupuytren's contracture, scleroderma, Peyronie's disease, mastitis in animals, and claudication due to peripheral arterial disease by administering to a patient in need thereof, streptolysin O in an amount effective to treat one or more symptoms of the connective tissue disorder.
  • streptolysin O shall include the streptolysin O molecule as well as acti ve fractions, analogs and derivatives thereof that maintain the biological activity of streptolysin O such as the ability to interact with the CD44 receptor or inhibit CD44 receptor mediated processes.
  • the invention comprises administration to a patient suffering from a connective tissue disorder such as tendonitis, Dupuytren's contracture, scleroderma, Peyronie's disease, mastitis in animals, and claudication due to peripheral arterial disease, an effective amount of streptolysin O.
  • a connective tissue disorder such as tendonitis, Dupuytren's contracture, scleroderma, Peyronie's disease, mastitis in animals, and claudication due to peripheral arterial disease, an effective amount of streptolysin O.
  • the tendonitis is equine tendonitis.
  • a preferred route of administration is sublingually, but other routes including bucal, oral drench, anal, vaginal, nasal, intralesional, subcutaneous, intradermal, intramuscular, intrathecal, intravenous, inhalation or topical, by capsules, tablets, spray, topical lotions, creams, patches, or by intradermal or dermal punctures are contemplated.
  • the invention also provides a pharmaceutical composition of streptolysin O and active fractions thereof for administering to a subject, or patient for alleviating symptoms of a connective tissue disorder such as tendonitis, Dupuytren's contracture, scleroderma, Peyronie's disease, claudication due to peripheral arterial disease, and mastitis wherein the streptolysin O is in an amount effective to treat one or more symptoms of said connective tissue disorder in combination with pharmaceutically- acceptable excipients.
  • the tendonitis is equine tendonitis.
  • Streptolysin O may be formulated in a number of pharmaceutically-acceptable excipients including, but not limited to, water, saline, albumin, dextrose or any other
  • fibrotic conditions such as but not limited to fibrosis of the kidney, liver, heart, lung, pancreas and other organs and further including reproductive fibrosis conditions such as uterine fibrosis and fallopian tube fibrosis are provided.
  • the methods comprise administering to a subject in need thereof, streptolysin O and active fractions thereof in an amount effective to treat one or more symptoms of the reproductive fibrosis including infertility and menstrual irregularities.
  • the method may be applied to all types of mammalian subjects and in particular to equine and human subjects.
  • the streptolysin O is formulated in a number of pharmaceutically-acceptable carriers or excipients including, but not limited to, water, saline, albumin, dextrose or any other pharmaceutically acceptable excipient known in the art. The precise dose will vary among patients and may readily be determined by those of ordinary skill in the art.
  • the streptolysin O is administered in a dosage amount ranging from about 0.0032 to 50 units (2 units/0.05 ml) per day and is preferably formulated in a liquid vehicle.
  • the streptolysin O is provided at a concentration of approximately 4 units as a single drop.
  • a single drop of streptolysin O is within the range of 0.05 to 10 units.
  • a drop of streptolysin O is in the amount of 2 units as a single drop.
  • the streptolysin O is more administered in an amount ranging from about 0.01 to 10 units per day.
  • the streptolysin O is administered in an amount ranging from about 0.1 to 8 units per day.
  • the administered dose of streptolysin O is from about 1 unit to about 5 units. In yet other embodiments, the administered dose of streptolysin O is about 2 units.
  • a preferred route of human administration is sublingually, but other routes, such as bucal, oral drench, subcutaneous, intradermal, intramuscular, intrathecal, intravenous, inhalation or topical, are contemplated.
  • routes such as bucal, oral drench, subcutaneous, intradermal, intramuscular, intrathecal, intravenous, inhalation or topical, are contemplated.
  • a preferred mode of administration is by subcutaneous administration at a dosage of 2 units per dose (0.2 cc).
  • Also provided by the invention are methods for protecting subjects from the effects of neurotoxic agents and conditions comprising the step of administering neuroprotective amounts of streptolysin O.
  • Neurotoxic agents are those capable of damaging or destroying neurons and include natural and synthetic agents present in the environment and further include natural metabolic products having neurotoxic properties.
  • Neurotoxic conditions are not limited to those of a chemical origin and include damaging radiation and thermal conditions.
  • the administration of streptolysin O may also be beneficial in repairing preexisting damage caused to neurons.
  • CD44 receptor mediated processes comprising administering streptolysin O to cells expressing the CD44 receptor in amounts effective to inhibit said CD44 receptor mediated processes including, but not limited to. mobilization and orientation of hyaluronic acid generally and as involved in wound healing.
  • Other CD44 mediated processes which may be susceptible to treatment with streptolysin O according to the invention include endometrial hyperplasia/carcinomas, orapharyngeal squamous cell carcinoma, breast carcinoma and panbronchiolitis.
  • the invention provides methods of inhibiting hyaluronic acid binding to the CD44 receptor, which method provides administering streptolysin O to cells expressing the CD44 receptor in an amount effective to inhibit said hyaluronic acid binding.
  • the methods may be carried out by administration of streptolysin O to subjects in which it is desired to inhibit CD44 receptor mediated processes including human subjects.
  • Another embodiment disclosed herein is based on the discovery that streptolysin O suppresses/inhibits the growth and/or invasion of a cancer cell that expresses a matrix metalloproteinasc gene.
  • described herein is a method of inhibiting metastasis of cancer in a subject comprising administering streptolysin O to the subject in an amount effective to inhibit metastasis of the tumor.
  • the cancer is selected from the group consisting of glioma, melanoma, fibrosarcoma, and adenosarcoma.
  • the cancer is selected from the group consisting of human sarcomas and carcinomas.
  • the cancer is selected from the group consisting of myxosarcoma, liposarcoma, chondrosarcoma, osteogenic sarcoma, chordoma, angiosarcoma, endothchosarcoma, lymphangiosarcoma, lymph angioendotheliosarcoma, synovioma, mesothelioma, Ewing's tumor, leiomyosarcoma, rhabdomyosarcoma, colon carcinoma, pancreatic cancer, breast cancer, ovarian cancer, prostate cancer, squamous cell carcinoma, basal cell carcinoma, adenocarcinoma, sweat gland carcinoma, sebaceous gland carcinoma, papillary carcinoma, papillary
  • adenocarcinomas cystadenocarcinoma, medullary carcinoma, bronchogenic carcinoma, renal cell carcinoma, hepatoma, bi le duct carcinoma, choriocarcinoma, seminoma, embryonal carcinoma, Wilms' tumor, cervical cancer, testicular tumor, lung carcinoma, small cell lung carcinoma, bladder carcinoma, epithelial carcinoma, astrocytoma, medulloblastoma, craniopharyngioma, ependymoma, pinealoma, hemangioblastoma, acoustic neuroma, oligodendroglioma, meningioma,
  • leukemias e.g.. acute lymphocytic leukemia and acute myelocytic leukemia (myeloblastic. promyelocyte, myelomonocytic. monocytic and erythroleukemia); chronic leukemia (chronic myelocytic
  • lymphoma Hodgkin's disease and non-Hodgkin's disease
  • multiple myeloma Waldenstrboom's macroglobulinemia, and heavy chain disease.
  • the methods described herein further comprise administering a M MP inhibitor to said subject.
  • a method of inhibiting or suppressing metastasis of cancer in a subject comprising administering to said subject a combination therapy comprising streptolysin O and a MMP inhibitor wherein the combination therapy is administered in an amount effective to inhibit or suppress metastasis of cancer in the subject.
  • the cancer cell is from a cancerous tissue selected from the group consisting of glioma, melanoma, fibrosarcoma, and adenosarcoma. In some embodiments, the cancer cell is from a cancerous tissue selected from the group consisting of human sarcomas and carcinomas.
  • the cancer cell is from a cancerous tissue selected from the group consisting of myxosarcoma, liposarcoma, chondrosarcoma, osteogenic sarcoma, chordoma, angiosarcoma, endotheliosarcoma, lymphangiosarcoma, lymphangioendotheliosarcoma, synovioma, mesothelioma, Ewing's tumor, leiomyosarcoma, rhabdomyosarcoma, colon carcinoma, pancreatic cancer, breast cancer, ovarian cancer, prostate cancer, squamous cell carcinoma, basal cell carcinoma, adenocarcinoma, sweat gland carcinoma, sebaceous gland carcinoma, papillary carcinoma, papillary
  • adenocarcinomas cystadenocarcinoma, medullary carcinoma, bronchogenic carcinoma, renal cell carcinoma, hepatoma, bile duct carcinoma, choriocarcinoma, seminoma, embryonal carcinoma, Wilms' tumor, cervical cancer, testicular minor, lung carcinoma, small cell lung carcinoma, bladder carcinoma, epithelial carcinoma, astrocytoma, medulloblastoma, craniopharyngioma, ependymoma, pinealoma.
  • hemangioblastoma hemangioblastoma, acoustic neuroma, oligodendroglioma, meningioma,
  • leukemias e. g.. acute lymphocytic leukem ia and acute myelocytic leukemia (myeloblasts, promyelocyte, myelomonocytic. monocytic and erythroleukemia); chronic leukemia (chronic myelocytic
  • lymphoma Hodgkin's disease and non-Hodgkin's disease
  • multiple myeloma Waldenstrboom's macroglobulinemia, and heavy chain disease.
  • Still other embodiments involve combination therapy comprising the administration of streptolysin O to a subject in need thereof and standard of care therapeutics for the treatment of cancer.
  • standard of care refers to a treatment that is generally accepted by clinicians for a certain type of patient diagnosed with a type of illness.
  • Exemplary standard of care regimens for the treatment of cancer include, but are not limited to, a standard of care chemotherapeutic, a standard of care radiotherapeutic, or a standard of care radiation regimen.
  • chemotherapeutic chemotherapeutic
  • radiotherapeutic a standard of care radiotherapeutic
  • radiation regimen for all varieties of cancers, for example, in one aspect is to improve standard of care therapy with co-therapy with streptolysin O described herein.
  • Figure 1 depicts the effects of streptolysin O on the contraction frequency in a nerve muscle co-culture in a glutamate intoxication model
  • Figure 2 depicts the effects of streptolysin O on the contraction frequency in a nerve muscle co-culture in a glutamate intoxication model.
  • Figure 3 shows the results of the cell invasion assay with MDA MB 231 cells after administration of streptolysin O at varying concentrations.
  • Figure 4 shows the results of the cell invasion assay with BT549 cells after administration of streptolysin O at varying concentrations.
  • Figure 5 shows the results of the cell invasion assay with MDA M B 23 1 cells after administration of recombinant streptolysin O at varying concentrations.
  • the present invention provides methods for treating patients with symptoms of connective tissue disorders by any variety of modes of administration including, but not limited to, bucal, oral drench, anal, vaginal, nasal, intralesional, subcutaneous, intradermal, intramuscular, intrathecal, intravenous, inhalation or topical
  • a small amount of streptolysin () in a pharmaceutically acceptable excipient including water, saline, albumin, and dextrose.
  • Internal organs with ihc potential for fibrotic conditions include respiratory : lung, larynx, pharynx, nasal, sinisoids, Eustachian tubes, bronchioles (COPD, emphysema); gastric intestinal : intestinal adhesions, intestinal fibroids, "visceral", esophagus, liver, alimentary canal, hemorrhoids, rectal scarring, gall bladder ducts; circulatory and cardiac system heart, pericardia (pericardititis), ischemia, varicose veins, angina pectoralis, pancreas, lymph nodes; genital urinary kidneys, uterus and endometrium, polyps (vaginal and urethral,), penis, vagina, fallopian tubes, urethra, bladder
  • the present invention also provides methods for treating claudications due to peripheral arterial disease by administration of a small amount of streptolysin O. Methods of the invention are also useful for treating symptoms of peripheral arterial disease including, but not limited to, the intermittent claudication symptoms such as cramping, aching, numbness, lack of circulation, and/or pain of the extremities.
  • the present invention also provides methods for treating patients with symptoms of Peyronie's Disease by administration of a small amount of streptolysin O.
  • M ethods of the invention are also useful for treating Peyronie's disease complications su fficient to treat symptoms of Peyronie's Disease including, but not limited to, painful erections or difficulty with intercourse.
  • the present invention also provides methods for treating patients with symptoms of scleroderma by administration of a small amount of streptolysin O.
  • Methods of the invention are also useful for treating scleroderma complications, including, but not l imited to, Raynaud's Phenomenon, swelling of the hands and feet, pain and stiffness o f the joints, thickening of the skin, joint contracture, digestive and gastrointestinal tract problems, Sjogen's Syndrome, facial and dental problems, kidney disease, heart disease, lung disease, extreme fatigue, generalized weakness, weight loss, vague aching o f muscles, joints, and bones, and pulmonary hypertension.
  • the present invention also provides methods for treating symptoms of chronic mastitis in bovines by administration of a small amount of streptolysin (). Methods of the invention are also useful for treating mastitis complications characterized by redness, heat, pain, hardness or swel ling accompanied by fever, a loss o f appetite, and lower milk production of the bovine.
  • the invention also provides methods for treating symptoms of reproductive fibrosis including uterine and fallopian tube fibroses by administration of effective amounts of streptolysin O.
  • the present invention also provides methods for treating tendonitis by administration of streptolysin O.
  • the tendonitis is equine tendonitis.
  • Methods of the invention are also useful for alleviating symptoms associated with equine tendonitis including, but not limited to, swelling, heat, and pain. If the tendonitis is more severe, the injury is usually accompanied by moderate lameness (2- 3 on a scale of 5) with obvious swelling.
  • the invention further provides neuroprotective methods for prevention of the negative effects of neurotoxic agents on nerve cells by administration of effective amounts of streptolysin O.
  • the invention provides methods for the intervention in ( " 1 )44 receptor mediated conditions comprising the administration of streptolysin O to cells expressing the CD44 receptor in amounts effective to inhibit those processes. Also provided are methods of inhibiting hyaluronic acid binding to the CD44 receptor comprising administering streptolysin O to cells expressing the CD44 receptor in an amount effective to inhibit such hyaluronic acid binding to the CD44 receptor.
  • Another embodiment disclosed herein is based on the discovery that streptolysin O suppresses/inhibits the growth and/or invasion of a cancer cell that expresses a matrix metal loproteinase gene.
  • the invention provides a method of inhibiting or suppressing metastasis of a cancer cell, the method comprising contacting the cancer cell with streptolysin O in an amount effective to inhibit or suppress metastasis of the cancer cell.
  • streptolysin O as used with respect to the methods described herein means streptolysin O which has been modified by oxidation to eliminate cytotoxic effects while retaining important cholesterol binding characteristics on the cell membrane. Streptolysin O is readily oxidized in solution (Sigma Product Catalog) .
  • inhibiting MMP includes inhibition of MMP activity, as well as inhibition of MMP production regardless of the mechanism of activity or production. This inhibition can be caused directly, e.g. by binding to MMP or its binding partner, by MMP inhibitors or MMP antibodies or by preventing it acting as a proteinase. The inhibition can also be caused indirectly, for example by inhibiting a pathway that results in MMP production. Inhibition causes a reduction in the MMP activity regardless of the exact mechanism of inhibition.
  • a method of inhibiting or suppressing metastasis of a tumor in a subject comprising administering streptolysin O to the subject in an amount effective to inhibit or suppress metastasis of the tumor in the subject.
  • the tumor is a solid tumor.
  • inhibiting or suppressing metastasis of the cancer cell (or tumor) comprises inhibiting the protein that contributes to metastasis of the cancer.
  • the protein is an enzyme that degrades extracellular matrix components and in some embodiments, the enzyme is a matrix
  • the matrix metalloprotemase protein is selected from the group consisting of MMP-2, MMP-9, and MMP-2 and MP-9.
  • the cancer cell is a cell from a cancerous tissue selected from the group consisting of glioma, melanoma, fibrosarcoma, and adenosarcoma.
  • the cancer cel l is from a cancerous tissue selected from the group consisting, but not limited to. human sarcomas and carcinomas, including but not limited to myxosarcoma, liposarcoma, chondrosarcoma, osteogenic sarcoma, chordoma, angiosarcoma, endotheliosarcoma,
  • lymphangiosarcoma lymphangioendotheliosarcoma. synovioma, mesothelioma, Ewing's tumor, lei myosarcoma, rhabdomyosarcoma, colon carcinoma, pancreatic cancer, breast cancer, ovarian cancer, prostate cancer, squamous cell carcinoma, basal cell carcinoma, adenocarcinoma, sweat gland carcinoma, sebaceous gland carcinoma, papillary carcinoma, papillary adenocarcinomas, cystadenocarcinoma, medullary carcinoma, bronchogenic carcinoma, renal cell carcinoma, hepatoma, bile duct carcinoma, choriocarcinoma, seminoma, embryonal carcinoma, Wilms' tumor, cervical cancer, testicular tumor, lung carcinoma, small cell lung carcinoma, bladder carcinoma, epithelial carcinoma, astrocytoma, medulloblastoma, craniopharyngioma, ependymoma, pinealoma
  • myelomonocytic, monocytic and erythroleukemia chronic leukemia (chronic myelocytic (granulocytic) leukemia and chronic lymphocytic leukemia); and polycythemia vera, lymphoma (Hodgkin's disease and non-Hodgkin's disease), multiple myeloma, Waldenstrboom's macroglobulinemia, and heavy chain disease.
  • embodiments are desirably human subjects, although it is to be understood that the principles of the presently disclosed subject matter indicate that the presently disclosed subject matter is effective with respect to invertebrate and to all vertebrate species, including mammals, which are intended to be included in the term "subject". Moreover, a mammal is understood to include any mammalian species in which treatment or prevention of cancer is desirable, particularly agricultural and domestic mammalian species.
  • streptolysin O is administered 1 , 2, 3, 4, 5, 6, 7, 8, 9, 10 or more times daily for a period of 1 , 2, 3, 4, 5, 6 or more weeks. Additional therapy may be administered on a period basis, for example, daily, weekly or monthly.
  • the dose of streptolysin O administered to the subject can be determined by the physician, taking into account, age, sex, weight, etc. of the subject.
  • the administered dose of streptolysin O is at least 0.01 , 0.1 , 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8. 0.9, 1 .0, 1.1 , 1.2, 1.3, 1.4, 1 .5, 1 .6, 1 .7, 1.8, 1.9, 2, 2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8, 2.9. 3.0, 4.0, 5.0, 6.0, 7.0, 8.0. 9.0, 10.0 or more International units.
  • the administered dose of streptolysin O is 2 units.
  • the methods described herein further comprise administering a MMP-2 and/or MMP-9 inhibitor to the subject.
  • MMP inhibitor is an agent that directly or indirectly inhibits M MP activity. This includes an agent that blocks MMP activity or an agent that blocks a pathway of MMP production. The agent causes a reduction in MMP activity in a cancer cell (or cancerous tissue) regardless of the mechanism of its action.
  • MMP Inhibitors include Tissue Inhibitors of Metalloproteinases (TIMPs) (e.g., TIMP- 1 , T1MP-2, T1MP-3, or TIMP-4), 0 2 -macroglobulin, tetracyclines (e.g., tetracycline, minocycline, and doxycycline), hydroxamates (e.g., BATIMASTAT, MARIMISTAT and TROCADE), chelators (e.g., EDTA, cysteine, acetylcysteine, D- penicillamine, and gold salts), synthetic MMP fragments, succinyl mercaptopurines, phosphonamidates, and hydroxaminic acids.
  • TIMPs Tissue Inhibitors of Metalloproteinases
  • TIMPs TIMP- 1 , T1MP-2, T1MP-3, or TIMP-4
  • 0 2 -macroglobulin e.g., tetracycl
  • Broad-speetrum inhibitors that inhibit more than one type of MMP, such as are also contemplated.
  • Exemplary broad spectrum MMP inhibitors include, but are not limited to, GM600 L batimastat, marimastat, prinomastat, BAY 12-9566, MMI270(B), BMS-275291 , and metastat.
  • Inhibitors that are capable of inhibiting M.MP2, MMP9 or both MMP2 and MMP9 are speci fical ly contemplated.
  • Exemplary MMP-2/MMP-9 inhibitors includes, but is not limited to, SB-3CT.
  • combination therapy comprising the administration of streptolysin O and a MMP-2/MMP-9 inhibitor is specifically contemplated.
  • Assays for measuring MMP inhibition/suppression are readily known in the art, and include, for example, the following: Cawston T. E., Barrett A. J., "A rapid and reproducible assay for collagenase using [ l 4 C] acetylaled collagen," Anal.
  • the methods described herein further comprise administering a standard of care cancer therapy to the subject.
  • standard of care refers to a treatment that is generally accepted by clinicians for a certain type of patient diagnosed with a type of illness.
  • exemplary standard of care anti-cancer agents include, but are not limited to, a standard of care chemotherapeutic, a standard of care radiotherapeutic, or a standard of care radiation regimen.
  • one aspect is to improve standard of care therapy with co-therapy with the streptolysin O described herein.
  • chemotherapeutic and radiotherapeutic agents include, but are not limited to: an anti-metabolite; a DNA-damaging agent; a cytokine useful as a chemotherapeutic agent; a covalent DNA-binding drug; a topoisomerase inhibitor; an anti-mitotic agent; an anti-tumor antibiotic; a differentiation agent; an alkylating agent; a methylating agent; a hormone or hormone antagonist; a nitrogen mustard; a radiosensitizer; a photosensitizer; a radiation source, optionally together with a radiosensitizer or photosensitizer; or other commonly used therapeutic agents.
  • Specific examples of chemotherapeutic agents useful in methods of the present invention are listed in Table 1 below.
  • Cytokines that are effective in inhibiting tumor metastasis are also contemplated for use in the combination therapy.
  • Such cytokines, lymphokines, or other hematopoietic factors include, but are not limited to, M-CSF, GM-CSF, TNF, IL- 1 , 1L-2, IL-3, IL-4. IL-5, I L-6, IL-7, 1L-8, IL-9, lL- 10, IL- l 1 , IL-12, IL-13, IL-14, 1L-15, IL-16, IL-17, IL- 18.
  • T F2 G-CSF, Mcg-CSF, GM-CSF, thrombopoietin, stem cell factor, and erythropoietin.
  • the method also includes monitoring the effect of treatment on the tumor. For example, the size of the tumor can be determined.
  • the therapeutic described herein and/or standard of care therapy would be provided in a combined amount effective to kill or inhibit proliferation of the cancer by killing and/or inhibiting the proliferation of the cancer cells and/or the endothelia of blood and lymphatic vessels supplying and serving the cancer cells. This process may involve contacting the cells with streptolysin O as described herein and one or more standard of care therapies at the same time.
  • the therapeutic treatment employing streptolysin O as described herein may precede or follow the standard of care therapy by intervals ranging from minutes to weeks.
  • the standard of care therapy and streptolysin O are administered separately, one would generally ensure that a significant period of time did not expire between the times of each delivery, such that the standard of care therapy and the streptolysin O would still be able to exert an advantageously combined effect.
  • the modalities w ould be administered within 6-12 hours of each other.
  • the modalities are administered within 1 -6 hours of each other. Repeated treatments with one or both agents are specifical ly contemplated.
  • streptolysin (either alone or in combination with an MMP inhibitor or standard of care therapeutic as described herein) is delivered directly to the subject (or cancer cell) or in compositions along with suitable carriers or excipients, as is well known in the art.
  • streptolysin O was used to treat these various psychological disorders.
  • streptolysin O was purchased from Sigma Chemicals, St. Louis, MO. Numerous improvements and further aspects of the invention are apparent to the skilled artisan upon consideration of the Examples, which follows.
  • Examples 1 -8 illustrate the methods of the invention with respect to treatment of connective tissue disorders, including example 8 which illustrates a method of treating bovine mastitis.
  • Examples 9 and 1 0 illustrate methods of administering streptolysin O to subjects suffering from reproductive fibrosis.
  • Examples 1 1 and 12 illustrate methods of protecting nerve cells from the effects of neurotoxic agents.
  • Example 13 shows the results of competitive inhibition assays carried out between hyaluronic acid and streptolysin O on human keratinocyte CD44 receptors.
  • Examples 14-16 illustrate methods of administering streptolysin O to subjects suffering from tendonitis.
  • Example 17 demonstrates that streptolysin O inhibits/suppresses cancer metastases in two metastastic cancer cell lines (MBA MB23 1 and BT549 cells).
  • a 72-year old male was diagnosed with lower leg pain due to peripheral arterial disease by his physician. He began treatment with streptolysin O at a rate and amount of one (2 units/0.05 ml) drop, four times daily by sublingual administration. The treatment regimen has signi ficantly decreased the leg pain and further improved his energy, ability to work, and improved his overall quality of life.
  • a male patient was diagnosed with Peyronie's disease by his physician. He began treatment with streptolysin O at a rate and amount of one (2 units/0.05 ml) drop, three times daily by sublingual administration. After 3 ⁇ i days of treatment, improvements in the contracture of his penis were noted by the patient and his physician.
  • Bovines which have lost one or more quarters to mastitis, were treated using one dose of streptolysin O (2 units/0.05 ml) drop, twice daily for thirty days by subcutaneous administration. The quarters damaged due to mastitis were reclaimed and produced milk after treatment.
  • streptolysin O was administered to a 27 year old human female with a history of failure to conceive. The subject was diagnosed as suffering with fibroid scarring on the uterus and fallopian tubes and was assessed as having less than a 20% chance of becoming pregnant. Specifically, streptolysin O was administered at the rate of one (2 units/0.05ml) drop, four times daily by sublingual administration. The subject became pregnant within six weeks of the initiation of therapy and successfully delivered a healthy child.
  • streptolysin O was administered to ten mares diagnosed as suffering from periglandular or uterine fibrosis. Mares can become in fertile after several pregnancies as a consequence of periglandular or uterine fibrosis which prevents implantation and/or dilation of the uterus such as to be insufficient to accommodate the growing fetus.
  • histopathological evaluation was available but three had conceived after treatment according to the invention.
  • the neuroprotective effects of streptolysin O were determined in a glutamate intoxication model utilizing the nerve nerve-muscle co- culture developed by Askanas and Engel, Neurology 25 :58-67 ( 1975).
  • This culture makes it possible to create striated human muscle fiber innervations with rat spinal chord explants and dorsal root ganglions. After 15 days of co-culture, the muscle fibers show spontaneous contractile activity. In this co-culture, it is then possible to induce cell death by intoxication using neurotoxic agents such as glutamate or hydrogen peroxide.
  • Such intoxications are time dependent and the viability and functionality of the motoneurons can be studied from two parameters: muscle contractile activity and apoptosis induction, quantified by an ELISA method on the basis of quantification of cytoplasmic histone-associated DNA fragments.
  • Glutamate is the main excitatory neurotransmitter in the mammalian CNS, but over-stimulation of its receptors causes neuro-degeneration .
  • 10 mM of glutamate in the medium decreases contractile activity after one day and cause motoneuron cell death by apoplosis after 1 week. This motoneuron cell death induces muscle fiber
  • streptolysin O at two concentrations, 0.01 % and 1 % (four wells per condition) was incubated for 9 days in an established nerve-muscle co-culture. The conditioned culture media was replaced each day. Cultures were then intoxicated with either glutamate 10 niM or hydrogen peroxide (H 2 O 2 ) 80() ⁇ and the neurotoxic effects were evaluated by (1 ) quantification of the frequency of contractions and (2) by cell death level as measured by quantification of apoptosis.
  • the contraction frequency of the cells was then measured and recorded by image analysis software respectively before incubation, after 1 hour, 24 hours, 48 hours and 72 hours of intoxication with or without incubation with streptolysin O 0.01 % and 1 % on their own. The results are given as a percentage of the contraction frequency compared to the contraction frequency before incubation expressed as 100%. Two co-incubations were tested, glutamate l OmM and H 2 O 2 800(M with the product SO 0.01%o and 1 % (4 wells per condition). These results show that streptolysin O was responsible for a dramatic increase of the contraction frequency reaching a plateau after 24 hours, 48 hours and 72 hours.
  • Fig. 2 illustrates that the contraction frequency after 1 hour and 24 hours of incubation with lOmM L-glutamate dramatically increased and shows wide standard deviations. After 48 hours incubation, the contraction frequency of the muscle fiber decreased to recover its basic level (100%,).
  • [0 1 07 ] the neuroprotective effects of streptolysin O were analyzed by quantification of cell apoptosis after 9 days of hydrogen peroxide intoxication (80() ⁇ ) and Glutamate ( 1 OmM L-glutamate) intoxication. Negative and apoptosis controls were respectively (a) culture media, (b) glutamate l OmM and ( e l Hi0 2 800 ⁇ and apoptosis was evaluated using a Cell Death Detection EL IS A kit" (Roche).
  • HA hyaluronic acid
  • streptolysin O streptolysin O on the keratinocyte CD44 receptor.
  • MIL001 streptolysin O
  • This culture were treated with at (1 ) streptolysin O concentration (0.01X) and at six (6) different hyaluronic acid HA concentrations (0%, 0.0001 %, 0.0005%, 0.001 %, 0.005% and 0.01 %) and at 3 different incubation times (1 , 20, and 44 hours).
  • the inhibition was measured by an immunofluorescence labeling perfonned with the anti Human CD44 monoclonal antibody using microscopic analysis.
  • Streptolysin O 100X (200 units) was diluted at 0.0 I X. was added or not (control placebo) in 96 well microplates 24 hours after the cell seeding and maintained in culture for 1 hour, 20 hours and 44 hours.
  • Different concentrations of hyaluronic acid solution at 0.1 %, 0.05%. 0.01 %, 0.005% and 0.001 % were diluted at 1 /10 in the different culture wells and added to the wells.
  • the keratinocytes were washed and fixed 5 minutes with ethanol/acetic acid (95/5) at -20°C. Cells were then extensively washed with buffer solution and were stored at 4°C until staining with monoclonal antibodies to human CD44 antigen phycoerythrin labeled (Caltag Laboratories).
  • HA inhibits the increased expression of CD44 receptor on keratinocytes induced by MILOOl 0.0 IX incubation and thereby shows competition between streptolysin O (MIL001) and hyaluronic acid (HA) for CD44 receptor binding after 44 hours of culture.
  • [0012 1 1 A 3-year old thoroughbred gelding suffered an acute tear of the medial branch of the right front suspensory ligament. After being treated for 30 days with strepl lysin-0 (0.2 cc streptolysin O tw ice daily (2 Units per dose) by subcutaneous administration) the attending veterinarian reported "significant resolution" of the medial branch.
  • a 3-year old thoroughbred colt had a small tear in the superficial digital flexor tendon. After being treated for 30 days with streptolysin-0 (0.2 cc streptolysin O twice daily (2 Units per dose) by subcutaneous administration), the tear had significantly improved and the horse was being hand-walked daily.
  • Cancer cells (either MDA MB 23 1 malignant metastatic breast cancer cells or BT549 malignant metastatic breast cancer cells) were added to the Matrigel (BD Biosciences) at concentrations of 100,000; 1 50,000 or 250,000 cells per plate for 90 minutes prior to addition of either streptolysin O (Sigma-Aldrich) or recombinant streptolysin O (rSLO, Capricorn Corporation LLC), which was diluted in deionized water to various concentrations (0.2, 2, 5, 1 and 20 International Units per plate) which thereby oxidized streptolysin O to eliminate its cytotoxic effects.
  • streptolysin O Sigma-Aldrich
  • rSLO recombinant streptolysin O
  • the cells were allowed to migrate into and through the gel towards the "attractant" ( 10% Fetal Bovine Serum) for 22 hours at 37°C. Migrating cells were captured on a filter at the end of the gel, stained with crystal violet and counted. Data were plotted as cells per square area vs. concentration of streptolysin (in which cells were incubated).
  • "attractant" 10% Fetal Bovine Serum
  • the experimental results show a measurable effect on cell migration by incubating the metastatic cancer cells with both streptolysin O and rSLO.
  • the reduction in cell number reflects fewer cells migrating to the filter, which could be due to a reduction in the number of cells migrating or a slowing of the rate of migration.
  • the effect i s a reduction in the number of cancer cells vs control (no streptolysin O) and it is dose dependent.
  • Figure 3 shows that all concentrations of streptolysin O assayed (2, 1 0 and 20 units) demonstrated a reduction of cell migration in MDA MB 231 cells, with 20 units demonstrating the greatest inhibitory effect.
  • Figure 5 shows that all concentrations of rSLO assayed (0.2, 2, 5, 10 and 20 units) reduced cell migration of MDA MD 231 cells, with 20 units demonstrating the greatest inhibitory effect.
  • Figure 4 shows that 10 units streptolysin O reduced cell migration of BT549 cells.

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