Classifications

• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
  • C07K16/18—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against material from animals or humans
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K41/00—Medicinal preparations obtained by treating materials with wave energy or particle radiation ; Therapies using these preparations
  • A61K41/0004—Homeopathy; Vitalisation; Resonance; Dynamisation, e.g. esoteric applications; Oxygenation of blood
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/14—Drugs for disorders of the nervous system for treating abnormal movements, e.g. chorea, dyskinesia
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K16/00—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
  • C07K16/40—Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against enzymes
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K39/00—Medicinal preparations containing antigens or antibodies
  • A61K2039/505—Medicinal preparations containing antigens or antibodies comprising antibodies
  • A61K2039/507—Comprising a combination of two or more separate antibodies

Definitions

• the present invention relates to the field of medicine and can be used for the treatment of attention deficit hyperactivity disorder.
• ADHD Attention deficit hyperactivity disorder
• Neurotropic drugs having antiserum to brain-specific protein S-100 are known. (RU 2156621 C1 , A61 K39/395, 9/27/2000). However, these medicines do not provide sufficient therapeutic efficiency for treatment of neurobehavioral diseases, including attention deficit hyperactivity disorder. Thus, there is a continuing need for new drug products with the desired therapeutic efficacy for the treatment of attention deficit hyperactivity disorder.
• U.S. Patent No. 7,582,294 discloses a medicament for treating Benign Prostatic Hyperplasia or prostatitis by administration of a homeopathically activated form of antibodies to prostate specific antigen (PSA).
• PSA prostate specific antigen
• U.S. Patent No. 7,700,096 discloses a homeopathically potentized form of antibodies to endothelial NO-synthase.
• the S-100 protein is a cytoplasmic acidic calcium binding protein found predominantly in the gray matter of the brain, primarily in glia and Schwann cells.
• the protein exists in several homo-or heterodimeric isoforms consisting of two immunologically distinct subunits, alpha and beta.
• the S-100 protein has been suggested for use as an aid in the diagnosis and assessment of brain lesions and neurological damage due to brain injury, as in stroke. Yardan et al., Usefulness of S100B Protein in Neurological Disorders, J Pak Med Assoc Vol. 61 , No. 3, March 201 1 , which is incorporated herein by reference.
• Ultra-low doses of antibodies to S-100 protein have been shown to have anxiolytic, anti-asthenic, anti-aggressive, stress-protective, anti-hypoxic, anti- ischemic, neuroprotective and nootropic activity.
• Antibodies to S100 proteins have anxiolytic-like activity at ultra-low doses in the adult rat, J Pharm Pharmacol. 2008, 60(3):309-16; Epstein O. I., Antibodies to calcium-binding SWOB protein block the conditioning of long-term sensitization in the terrestrial snail, Pharmacol Biochem Behav., 2009, 94(1 ):37-42; Voronina T.A. et al., Chapter 8.
• Nitric oxide is a gaseous molecule that has been shown to acts in the signaling of different biological processes.
• Endothelium-derived NO is a key molecule in regulation of vascular tone and its association with vascular disease has long been recognized. NO inhibits many processes known to be involved in the formation of atherosclerotic plaque, including monocyte adhesion, platelet aggregation and vascular smooth muscle cell proliferation.
• Another important role of endothelial NO is the protection of the vascular wall from the oxidative stress induced by its own metabolic products and by the oxidation products of lipids and lipoproteins. Endothelial dysfunction occurs at very early stages of atherosclerosis.
• NO availability has been shown to modulate metabolism of lipoproteins. Negative correlation has been reported between plasma concentrations of NO metabolic products and plasma total and Low Density Lipoprotein [LDL] cholesterol levels while High Density Lipoprotein [HDL] improves vascular function in hypercholesterolaemic subjects.
• LDL Low Density Lipoprotein
• HDL High Density Lipoprotein
• the loss of NO has considerable effect on the development of the disease. Diabetes mellitus is associated with increased rates of morbidity and mortality caused primarily by the accelerated development of atherosclerotic disease.
• reports show that diabetics have impaired lung functions. It has been proposed that insulin resistance leads to airway inflammation. Habib et al., Nitric Oxide Measurement From Blood To Lungs, Is There A Link? Pak J Physiol 2007; 3(1 ).
• Nitric oxide is synthesized by the endothelium from L-arginine by nitric oxide synthase (NO synthase). NO synthase occurs in different isoforms, including a constitutive form (cNOS) and an inducible form (iNOS). The constitutive form is present in normal endothelial cells, neurons and some other tissues.
• the invention is directed on increase of efficiency of treatment of attention deficit hyperactivity disorder (ADHD) and attention deficit disorder (ADD).
• ADHD attention deficit hyperactivity disorder
• ADD attention deficit disorder
• the present invention provides pharmaceutical composition for treatment of attention deficit hyperactivity disorder, comprising activated-potentiated form of antibodies to brain-specific protein S-100 and activated-potentiated form of antibodies to endothelial NO synthase as an additional strengthening component.
• the present invention provides pharmaceutical composition for treatment of attention deficit disorder, comprising activated-potentiated form of antibodies to brain-specific protein S-100 and activated-potentiated form of antibodies to endothelial NO synthase as an additional strengthening component.
• the present invention provides a combination pharmaceutical composition comprising activated-potentiated form of antibodies to brain-specific protein S-100 and activated-potentiated form of antibodies to endothelial NO synthase, wherein the antibody is to the entire protein S-100 or fragments thereof.
• the present invention provides a combination pharmaceutical composition comprising activated-potentiated form of antibodies to brain-specific protein S-100 and activated-potentiated form of antibodies to endothelial NO synthase, wherein the antibody is to the entire endothelial NO synthase or fragments thereof.
• the combination pharmaceutical composition of this aspect of the invention includes activated-potentiated form of an antibody to protein S-100 which is in the form of a mixture of (C12, C30, and C50) or (C12, C30 and C200) homeopathic dilutions impregnated onto a solid earner.
• the activated-potentiated form of an antibody to endothelial NO synthase is in the form of mixture of (C12, C30, and C50) or (C12, C30 and C200) homeopathic dilutions may be subsequently impregnated onto the solid carrier.
• the combination pharmaceutical composition of this aspect of the invention includes activated-potentiated form of an antibody to NO synthase which is in the form of a mixture of (C12, C30, and C50) or (C12, C30 and C200) homeopathic dilutions impregnated onto a solid carrier.
• the activated-potentiated form of an antibody to protein S-100 is in the form of mixture of (C12, C30, and C50) or (C12, C30 and C200) homeopathic dilutions may be subsequently impregnated onto the solid carrier.
• the activated-potentiated form of an antibody to protein S-100 is a monoclonal, polyclonal or natural antibody, more preferably, a polyclonal antibody.
• the activated-potentiated form of an antibody to a protein S-100 is prepared by successive centesimal dilutions coupled with shaking of every dilution. Vertical shaking is specifically contemplated.
• the activated-potentiated form of an antibody to endothelial NO synthase is a monoclonal, polyclonal or natural antibody, more preferably, a polyclonal antibody.
• the activated-potentiated form of an antibody to endothelial NO synthase is prepared by successive centesimal dilutions coupled with shaking of every dilution. Vertical shaking is specifically contemplated.
• the invention provides a method of treating attention deficit hyperactivity disorder, said method comprising administering to a patient in need threof a combination pharmaceutical composition comprising a) an activated-potentiated form of an antibody to brain-specific protein S-100 and b) activated-potentiated form of antibodies to endothelial NO synthase.
• administering from one to two unit dosage forms of the activated-potentiated form of an antibody to protein S-100 and one to two unit dosage forms of the activated-potentiated form of an antibody to NO synthase, each of the dosage form being administered from once daily to four times daily.
• the one to two unit dosage forms of each of the activated-potentiated forms of antibodies is administered twice daily.
• Fig. 1 - Shows the reduction of evidence of ADHD symptoms (total score by the scale ADHDRS-IV-Home Version) over 2, 4, 6, 8, 12 weeks of therapy in comparison with baseline value.
• antibody as used herein shall mean an immunoglobulin that specifically binds to, and is thereby defined as complementary with, a particular spatial and polar organization of another molecule.
• Antibodies as recited in the claims may include a complete immunoglobulin or fragment thereof, may be natural, polyclonal or monoclonal, and may include various classes and isotypes, such as IgA, IgD, IgE, lgG1 , lgG2a, lgG2b and lgG3, IgM, etc. Fragments thereof may include Fab, Fv and F(ab')2, Fab', and the like.
• the singular "antibody” includes plural "antibodies”.
• activated-potentiated form or “potentiated form” respectively, with respect to antibodies recited herein is used to denote a product of homeopathic potentization of any initial solution of antibodies.
• Homeopathic potentization denotes the use of methods of homeopathy to impart homeopathic potency to an initial solution of relevant substance.
• 'homeopathic potentization may involve, for example, repeated consecutive dilutions combined with external treatment, particularly vertical (mechanical) shaking. In other words, an initial solution of antibody is subjected to consecutive repeated dilution and multiple vertical shaking of each obtained solution in accordance with homeopathic technology.
• the preferred concentration of the initial solution of antibody in the solvent ranges from about 0.5 to about 5.0 mg/ml.
• the preferred procedure for preparing each component, i.e. antibody solution is the use of the mixture of three aqueous or aqueous-alcohol dilutions of the primary matrix solution (mother tincture) of antibodies diluted 100 12 , 100 30 and 100 200 times, respectively, which is equivalent to centesimal homeopathic dilutions (C12, C30, and C200) or the use of the mixture of three aqueous or aqueous- alcohol dilutions of the primary matrix solution of antibodies diluted 100 12 , 100 30 and 100 times, respectively, which is equivalent to centesimal homeopathic dilutions (C12, C30 and C50).
• an antibody is in the "activated-potentiated” or “potentiated” form when three factors are present.
• the "activated- potentiated” form of the antibody is a product of a preparation process well accepted in the homeopathic art.
• the "activated-potentiated” form of antibody must have biological activity determined by methods well accepted in modern pharmacology.
• the biological activity exhibited by the "activated potentiated” form of the antibody cannot be explained by the presence of the molecular form of the antibody in the final product of the homeopathic process.
• the activated potentiated form of antibodies may be prepared by subjecting an initial, isolated antibody in a molecular form to consecutive multiple dilutions coupled with an external impact, such as mechanical shaking.
• the external treatment in the course of concentration reduction may also be accomplished, for example, by exposure to ultrasonic, electromagnetic, or other physical factors.
• V. Schwabe "Homeopathic medicines", M., 1967, U.S. Patents Nos. 7,229,648 and 4,311 ,897 which are incorporated by reference in their entirety and for the purpose stated, describe such processes that are well accepted methods of homeopathic potentiation in the homeopathic art. This procedure gives rise to a uniform decrease in molecular concentration of the initial molecular form of the antibody.
• the required homeopathic potency can be determined by subjecting the intermediate dilutions to biological testing in the desired pharmacological model.
• 'homeopathic potentization may involve, for example, repeated consecutive dilutions combined with external treatment, particularly (mechanical) shaking.
• an initial solution of antibody is subjected to consecutive repeated dilution and multiple vertical shaking of each obtained solution in accordance with homeopathic technology.
• the preferred concentration of the initial solution of antibody in the solvent preferably, water or a water-ethyl alcohol mixture, ranges from about 0.5 to about 5.0 mg/ml.
• the preferred procedure for preparing each component i.e.
• antibody solution is the use of the mixture of three aqueous or aqueous- alcohol dilutions of the primary matrix solution (mother tincture) of antibodies diluted 100 12 , 100 30 and 100 200 times, respectively, which is equivalent to centesimal homeopathic dilutions C 12, C30 and C200 or the mixture of three aqueous or aqueous-alcohol dilutions of the primary matrix solution (mother tincture) of antibodies diluted 100 12 , 1 00 30 and 100 50 times, respectively, which is equivalent to centesimal homeopathic dilutions C 12, C30 and C50.
• Examples of how to obtain the desired potency are also provided, for example, in U .S. Patent Nos. 7,229,648 and 4,31 1 ,897, which are incorporated by reference for the purpose stated .
• the procedure applicable to the "activated potentiated" form of the antibodies described herein is described in more detail below.
• the claimed "activated-potentiated” form of antibody encompasses only solutions or solid preparations the biological activity of which cannot be explained by the presence of the molecular form of the antibody remaining from the initial, starting solution.
• the "activated-potentiated” form of the antibody may contain traces of the initial molecular form of the antibody, one skilled in the art could not attribute the observed biological activity in the accepted pharmacological models to the remaining molecular form of the antibody with any degree of plausibility due to the extremely low concentrations of the molecular form of the antibody remaining after the consecutive dilutions.
• the biological activity of the "activated-potentiated' form of the antibodies of the present invention is not attributable to the initial molecular form of the antibody.
• Preferred is the "activated-potentiated” form of antibody in liquid or solid form in which the concentration of the initial molecular form of the antibody is below the limit of detection of the accepted analytical techniques, such as capillary electrophoresis and High Performance Liquid Chromatography.
• Particularly preferred is the "activated-potentiated” form of antibody in liquid or solid form in which the concentration of the initial molecular form of the antibody is below the Avogadro number.
• the "activated-potentiated" form of the antibodies contains molecular antibody, if any, at a concentration below the threshold dose for the molecular form of the antibody in the given biological model.
• the ADHD Rating Scale-IV refers to a tool both for diagnosing ADHD and for measuring improvements with treatment. (DuPaul G., et al. 1998).
• the ADHS Rating Scale has been developed and standardized as a rating scale for children.
• ADHD can be divided into 3 subtypes: predominantly inattentive; predominantly hyperactive-impulsive; and the combined type, for which a patient must fully meet the criteria for both of the other 2 subtypes.
• Inattentive symptoms include failure to pay close attention to detail, difficulty sustaining attention, not listening when spoken to, failure to follow through on instructions or finish tasks, difficulty organizing, reluctance to engage in activities that require sustained mental effort, often losing things, being easily distracted, and often being forgetful. A patient must have at least 6 of these 9 symptoms to be considered to have the inattentive subtype.
• the ADHD Rating Scale is available through Guilford Press.
• CGI-ADHD-Severity questionnaire refers to the Clinical Global Impression rating scales that are commonly used to measure of symptom severity, treatment response and the efficacy of treatments in treatment studies of patients with mental disorders (Guy, W., 1976).
• the present invention provides a method of treating attention deficit hyperactivity disorder, the method comprising administering to a subject in need thereof a combination pharmaceutical composition consisting of a) an activated-potentiated form of an antibody to endothelial NO synthase and b) an activated-potentiated form of an antibody to brain-specific protein S- 100.
• a combination pharmaceutical composition consisting of a) an activated-potentiated form of an antibody to endothelial NO synthase and b) an activated-potentiated form of an antibody to brain-specific protein S- 100.
• the combination pharmaceutical composition is administered from once daily to four times daily, each administration including one or two combination unit dosage forms.
• the pharmaceutical composition of the present application for the purpose of treatment of attention deficit hyperactivity disorder contains active components in volume primarily in 1 :1 ratio.
• the components of the pharmaceutical composition may be administered separately.
• the simultaneous administration of the combined components in one form of solutions and/or solid dosage form (tablet), which contains activated-potentiated form of antibodies to brain-specific protein S-100 and, accordingly, activated-potentiated form of antibodies to endothelial NO synthase is preferred.
• the medical product is prepared mainly as follows.
• the combination pharmaceutical composition in accordance with the present invention may be in the liquid form or in solid form.
• Each of the activated potentiated forms of the antibodies included in the pharmaceutical composition is prepared from an initial molecular form of the antibody via a process accepted in homeopathic art.
• the starting antibodies may be monoclonal, or polyclonal antibodies prepared in accordance with known processes, for example, as described in Immunotechniques, G. Frimel, M., “Meditsyna", 1987, p. 9-33; "Hum. Antibodies. Monoclonal and recombinant antibodies, 30 years after" by Laffly E., Sodoyer R. - 2005 - Vol. 14. - N 1 -2. P.33-55, both incorporated herein by reference.
• Monoclonal antibodies may be obtained, e.g., by means of hybridoma technology.
• the initial stage of the process includes immunization based on the principles already developed in course of polyclonal antisera preparation. Further stages of work involve production of hybrid cells generating clones of antibodies with identical specificity. Their separate isolation is performed using the same methods as in case of polyclonal antisera preparation.
• Polyclonal antibodies may be obtained via active immunization of animals.
• suitable animals e.g. rabbits
• the animals' immune system generates corresponding antibodies, which are collected from the animals in a known manner. This procedure enables preparation of a monospecific antibody-rich serum.
• the serum containing antibodies may be purified, e.g., using affine chromatography, fractionation by salt precipitation, or ion-exchange chromatography.
• the resulting purified, antibody-enriched serum may be used as a starting material for preparation of the activated-potentiated form of the antibodies.
• the preferred concentration of the resulting initial solution of antibody in the solvent preferably, water or water-ethyl alcohol mixture, ranges from about 0.5 to about 5.0 mg/ml.
• each component is the use of the mixture of three aqueous-alcohol dilutions of the primary matrix solution of antibodies diluted 100 12 , 100 30 and 100 200 times, respectively, which is equivalent to centesimal homeopathic dilutions C12, C30 and C200.
• a solid carrier is treated with the desired dilution obtained via the homeopathic process.
• the carrier mass is impregnated with each of the dilutions. Both orders of impregnation are suitable to prepare the desired combination dosage form.
• the starting material for the preparation of the activated potentiated form that comprise the combination of the invention is polyclonal antibodies to brain-specific protein S-100 and endothelial NO synthase an initial (matrix) solution with concentration of 0.5 to 5.0 mg/ml is used for the subsequent preparation of activated-potentiated forms.
• an initial (matrix) solution with concentration of 0.5 to 5.0 mg/ml is used for the subsequent preparation of activated-potentiated forms.
• an initial (matrix) solution with concentration of 0.5 to 5.0 mg/ml is used for the subsequent preparation of activated-potentiated forms.
• To prepare the pharmaceutical composition preferably polyclonal antibodies to brain-specific protein S-100 and endothelial NO synthase are used.
• Polyclonal antibodies to endothelial NO synthase are obtained using adjuvant as immunogen (antigen) for immunization of rabbits and whole molecule of bovine endothelial NO synthase of the following sequence:
• Polyclonal antibodies to endothelial NO synthase may be obtained using the whole molecule of human endothelial NO synthase of the following sequence:
• endothelial NO synthase a fragment of endothelial NO synthase, selected, for example, from the following sequences:
• the exemplary procedure for preparation of starting polyclonal antibodies to endothelial NO synthase may be described as follows: 7-9 days before blood sampling 1 -3 intravenous injections are made to the rabbits to increase the level of polyclonal antibodies in the rabbit blood stream. Upon immunization, blood samples are taken to test the antibody level. Typically, the maximum level of the immune reaction of the soluble antigen is reached in 40- 60 days after the first injection. After the termination of the first immunization cycle, rabbits have a 30-day rehabilitation period, after which re-immunization is performed with another 1 -3 intravenous injections.
• the immunized rabbits' blood is collected from rabbits and placed in a 50ml centrifuge tube
• Product clots formed on the tube sides are removed with a wooden spatula, and a rod is placed into the clot in the tube center..
• the blood is then placed in a refrigerator for one night at the temperature of about 4°C.
• the clot on the spatula is removed, and the remaining liquid is centrifuged for 10 min at 13,000 rotations per minute. Supernatant fluid is the target antiserum.
• the obtained antiserum is typically yellow.
• the antibody fraction is determined by measuring the optical density of eluate at 280 nanometers.
• the isolated crude antibodies are purified using affine chromatography method by attaching the obtained antibodies to endothelial NO synthase located on the insoluble matrix of the chromatography media, with subsequent elution by concentrated aqueous salt solutions.
• the resulting buffer solution is used as the initial solution for the homeopathic dilution process used to prepare the activated potentiated form of the antibodies.
• the preferred concentration of the initial matrix solution of the antigen-purified polyclonal rabbit antibodies to endothelial NO synthase is 0.5 to 5.0 mg/ml, preferably, 2.0 to 3.0 mg/ml.
• brain-specific S100 protein expressed by neurons and glial cells (astrocytes and oligodendrocytes), directly or through interactions with other proteins executes in the CNS a number of functions directed at maintaining normal brain functioning, including affecting learning and memory processes, growth and viability of neurons, regulation of metabolic processes in neuronal tissues and others.
• brain-specific protein S-100 is used, which physical and chemical properties are described in the article of M. V. Starostin, S. M. Sviridov, Neurospecific Protein S-100, Progress of Modern Biology, 1977, Vol. 5, P. 170- 178; found in the book M. B. Shtark, Brain-Specific Protein Antigenes and Functions of Neuron, "Medicine", 1985; P. 12-14.
• Brain-specific protein S-100 is allocated from brain tissue of the bull by the following technique:
• the homogenate is heated for 10 min at 60°C and then cooled to 4°C in an ice bath;
• thermolabile proteins are removed by centrifugation
• the fraction containing S-100 protein is precipitated using 100% saturated ammonium sulfate accomplished by pH drop to 4.0; the desired fraction is collected by centrifugation;
• the precipitate is dissolved in a minimum buffer volume containing EDTA and mercaptoethanol, the precipitate is dialyzed with deionized water and lyophilized;
• the molecular weight of the purified brain-specific protein S-100 is 21000
• brain-specific protein S-100 Owing to the high concentration of asparaginic and glutaminic acids brain- specific protein S-100 is highly acidic and occupies extreme anode position during electroendosmosis in a discontinuous buffer system of poiyacryiamide gel which facilitates its identification.
• polyclonal antibodies to S-100 protein may also be obtained by a similar methodology to the methodology described for endothelial NO synthase antibodies using an adjuvant.
• the entire molecule of S-100 protein may be used as immunogen (antigen) for rabbits' immunization:
• Bovine S l OOA l (SEQ ID NO: 1 2)
• brain-specific S-100 protein or the mixture of S-100 protein s (antigens) in complex with methylated bull seralbumin as the carrying agent with full Freund's adjuvant is prepared and added to allocated brain- specific protein S-100 which is injected subdermally to a laboratory animal - a rabbit into area of back in quantity of 1 -2 ml.
• 15th day repeated immunization is made. Blood sampling is made (for example, from a vein in the ear) on the 26th and the 28th day.
• the obtained antiserum titre is 1 :500 - 1 : 1000, forms single precipitin band with an extract of nervous tissue but does not react with extracts of heterological bodies and forms single precipitin peak both with pure protein S- 100 and with the extract of nervous tissue indicating that the antiserum obtained is monospecific.
• the activated potentiated form of each component of the combination may be prepared from an initial solution by homeopathic potentization, preferably using the method of proportional concentration decrease by serial dilution of 1 part of each preceding solution (beginning with the initial solution) in 9 parts (for decimal dilution), or in 99 parts (for centesimal dilution), or in 999 parts (for millesimal dilution - attenuation M) of a neutral solvent, starting with a concentration of the initial solution of antibody in the solvent, preferably, water or a water-ethyl alcohol mixture, in the range from about 0.5 to about 5.0 mg/ml, coupled with external impact.
• the external impact involves multiple vertical shaking (dynamization) of each dilution.
• separate containers are used for each subsequent dilution up to the required potency level, or the dilution factor. This method is well-accepted in the homeopathic art. See, e.g. V. Schwabe "Homeopathic medicines", M., 1967, p. 14-29, incorporated herein by reference for the purpose stated.
• a 12-centesimal dilution (denoted C12) one part of the initial matrix solution of antibodies to brain-specific protein S-100 (or to endothelial NO - synthase) with the concentration of 2.5 mg/ml is diluted in 99 parts of neutral aqueous or aqueous-alcohol solvent (preferably, 15%-ethyl alcohol) and then vertically shaken many times (10 and more) to create the 1 st centesimal dilution (denoted as C1 ).
• the 2nd centesimal dilution (C2) is prepared from the 1 st centesimal dilution C1.
• the 12th centesimal dilution C12 represents a solution obtained by 12 serial dilutions of one part of the initial matrix solution of antibodies to brain-specific protein S-100 with the concentration of 2.5 mg/ml in 99 parts of a neutral solvent in different containers, which is equivalent to the centesimal homeopathic dilution C12. Similar procedures with the relevant dilution factor are performed to obtain dilutions C30, C50 and C 200. The intermediate dilutions may be tested in a desired biological model to check activity.
• the preferred activated potentiated forms for both antibodies comprising the combination of the invention are a mixture of C12, C30, and C200 dilutions or C12, C30 and C50 dilutions.
• each component of the composition e.g., C12, C30, C50, C200
• the mixture composition is prepared separately according to the above-described procedure until the next-to-last dilution is obtained (e.g., until C1 1 , C29, C49 and C199 respectively), and then one part of each component is added in one container according to the mixture composition and mixed with the required quantity of the solvent (e.g. with 97 parts for centesimal dilution).
• activated-potentiated form of antibodies to brain-specific protein S- 100 in ultra low dose is obtained by extra attenuation of matrix solution, accordingly in 100 12 , 100 30 and 100 200 times, equal to centesimal C12, C30 and C200 solutions or 100 12 , 100 30 and 100 50 times, equal to centesimal C12, C30 and C50 solutions prepared on homoeopathic technology.
• the combination pharmaceutical composition of the invention may be in the form of a liquid or in the solid unit dosage form.
• the preferred liquid form of the pharmaceutical composition is a mixture, preferably, at a 1 :1 ratio of the activated potentiated form of antibodies to endothelial NO synthase and the activated potentiated form of antibodies to protein S-100.
• the preferred liquid carrier is water or water-ethyl alcohol mixture.
• the solid unit dosage form of the pharmaceutical composition of the invention may be prepared by using impregnating a solid, pharmaceutically acceptable carrier with the mixture of the activated potentiated form aqueous or aqueous-alcohol solutions of active components that are mixed, primarily in 1 : 1 ratio and used in liquid dosage form.
• the carrier may be impregnated consecutively with each requisite dilution. Both orders of impregnation are acceptable.
• the pharmaceutical composition in the solid unit dosage form is prepared from granules of the pharmaceutically acceptable carrier which was previously saturated with the aqueous or aqueous-alcoholic dilutions of the activated potentiated form of antibodies.
• the solid dosage form may be in any form known in the pharmaceutical art, including a tablet, a capsule, a lozenge, and others.
• inactive pharmaceutical ingredients one can use glucose, sucrose, maltose, amylum, isomaltose, isomalt and other mono- olygo- and polysaccharides used in manufacturing of pharmaceuticals as well as technological mixtures of the above mentioned inactive pharmaceutical ingredients with other pharmaceutically acceptable excipients, for example isomalt, crospovidone, sodium cyclamate, sodium saccharine, anhydrous citric acid etc), including lubricants, disintegrants, binders and coloring agents.
• the preferred carriers are lactose and isomalt.
• the pharmaceutical dosage form may further include standard pharmaceutical excipients, for example, microcrystalline cellulose, magnesium stearate and citric acid.
• the example of preparation of the solid unit dosage form is set forth below.
• 100-300 ⁇ granules of lactose are impregnated with aqueous or aqueous-alcoholic solutions of the activated- potentiated form of antibodies to endothelial NO synthase and the activated potentiated form of antibodies to protein S-100 in the ratio of 1 kg of antibody solution to 5 or 10 kg of lactose (1 :5 to 1 :10).
• the lactose granules are exposed to saturation irrigation in the fluidized boiling . bed in a boiling bed plant (e.g.
• aqueous-alcohol solution (3.0-6.0 mg/pill) of the combination of the activated-potentiated form of antibodies.
• Each component of the combination used to impregnate the carrier is in the form of a mixture of centesimal homeopathic dilutions, preferably, C12, C30 and C200.
• 1 -2 tablets of the claimed pharmaceutical composition are administered 2-4 times a day.
• the claimed pharmaceutical composition as well as its components does not possess sedative and myorelaxant effect, does not cause addiction and habituation.
• the sigma-1 ( ⁇ 1 ) receptor is an intracellular receptor which is localized in the cells of central nervous system, the cells of the most of peripheral tissues and immune component cells. These receptors exhibit a unique ability to be translocated which is thought to be caused by many psychotropic medications.
• the dynamics of sigma-1 receptors is directly linked to various influences which are performed by preparations acting to the sigma-1 receptors. These effects include, the regulation of activity channels, ecocytosis, signal transferring, remodeling of the plasma membrane (formation of rafts) and lipid transportation/metabolism, all of which can contribute to the plasticity of neurons in a brain.
• Sigma-1 receptors have a modulating effect on all the major neuromediator systems: noradrenergic, serotonergic, dopaminergic, cholinergic systems and NMDA- adjustable glutamate effects.
• Sigma-1 receptors play an important role in the pathophysiology of neurodegenerative diseases (e.g., Alzheimer's disease, Parkinson's disease), psychiatric and affective disorders and stroke; and they also take part in the processes of learning and memory.
• the ability of drugs to influence the efficiency of interaction of ligands with sigma-1 receptor is indicative of the presence of neuroprotective, anti-ischemic, anxiolytic, antidepressant and anti astenic components in the spectrum of its pharmacological activity and permits the consideration of these drugs as effective preparations particularly for the treatment of cerebrovascular diseases.
• % of specific binding inhibition in control 100% - (specific binding during the test/specific binding in control) * 100%).
• Group 1 - the active drug group was given 300 mg tablets impregnated with an aqueous-alcohol solutions (6 mg/tab) of activated-potentiated form of polyclonal rabbit antibodies to brain specific S-100 protein (anti-S-100), and to endothelial NO-synthase (anti-eNOS) in ultra low dose (ULD anti-S-100 + ULD anti-eNOS), purified on antigen, obtained by super dilution of initial solution (with concentration of 2.5 mg/ml) in 100 12 , 100 30 , 100 200 time, equivalent to mixture of centesimal homeopathic dilutions C12, C30, C200;
• Group 2 the comparison group was given 300 mg tablets impregnated with an aqueous-alcohol solution (3 mg/tab) of activated-potentiated forms of polyclonal rabbit antibodies to brain-specific S-100 protein purified on antigen in ultra low dose (ULD anti-S100) obtained by super dilution of initial solution in 100 12 , 100 30 , 100 50 times, of equivalent mixture homeopathic dilutions C12, C30, C50.
• ULD anti-S100 ultra low dose
• Group 3 - the control group (placebo) was given of 300 mg tablets having excipients (lactose monohydrate - 267 mg, microcrystal cellulose - 30 mg, magnesium stearate - 3 mg).
• composition ULD anti-S100 + anti-eNOS or ULD anti-S100 influenced on both clusters of symptoms of ADHD which was confirmed by dynamics of assessments by two sections of the scale with ADHDRS-IV-Home Version (Table 3). Moreover, the treatment with the composition ULD anti- Si 00 + anti-eNOS was significantly higher than the effectiveness of therapy with monopreparation ULD anti-S100 in the degree of influence on the intensity of implications and attention deficit and hyperactivity/impulsivity.
• the study demonstrated the efficacy and safety of the compositions ULD anti-S100 + anti-eNOS and of monocomponent preparation ULD-S100 in the treatment of children with ADHD.
• the most pronounced therapeutic effect in the 12-week course was observed in complex drug (ULD anti-S100 + anti- eNOS) which was manifested by positive dynamics of clinical symptoms in the majority (75%) of children.
• the composition ULD anti-S100 + anti-eNOS had correcting influence to both of the clusters of symptoms of ADHD and as a result, the significant reduction of attention disorders and hyperactivity in patients with ADHD was noted.

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