WO2012137166A1 - Composé d'oxoborolidine et ses utilisations - Google Patents
Composé d'oxoborolidine et ses utilisations Download PDFInfo
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- WO2012137166A1 WO2012137166A1 PCT/IB2012/051693 IB2012051693W WO2012137166A1 WO 2012137166 A1 WO2012137166 A1 WO 2012137166A1 IB 2012051693 W IB2012051693 W IB 2012051693W WO 2012137166 A1 WO2012137166 A1 WO 2012137166A1
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
- A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
-
- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07F—ACYCLIC, CARBOCYCLIC OR HETEROCYCLIC COMPOUNDS CONTAINING ELEMENTS OTHER THAN CARBON, HYDROGEN, HALOGEN, OXYGEN, NITROGEN, SULFUR, SELENIUM OR TELLURIUM
- C07F5/00—Compounds containing elements of Groups 3 or 13 of the Periodic Table
- C07F5/02—Boron compounds
- C07F5/025—Boronic and borinic acid compounds
Definitions
- the present invention in some embodiments thereof, relates to pharmacology, and, more particularly, but not exclusively, to a novel boron-containing compound and uses thereof as an antibacterial agent.
- Antibiotics which are also referred to herein and in the art as antibacterial or antimicrobial agents, are natural substances of relatively small size in molecular terms, which are typically released by bacteria or fungi. These natural substances, as well as derivatives and/or modifications thereof, are used for many years as medications for treating infections caused by bacteria. However, over the decades, almost all the prominent infection-causing bacterial strains have developed resistance to antibiotics.
- Biofilms are a multicellular high density ecological environment of mostly bacteria and/or fungi and their secretions, but it is not considered a multicellular organism per se. Once a microorganism attach to a surface it undergoes a series of changes, the most obvious of which is the excretion of a slimy material consisting mostly of extra-cellular polysaccharides (EPS).
- EPS extra-cellular polysaccharides
- EPS soluble microbiological products
- SMP soluble microbiological products
- NOM natural organic matter
- Biofilm bacteria have been found to remain viable at MICs (minimal inhibitory concentration) up to 1,000 times higher than those of their planktonic counterparts. Biofilms have been shown to alter the local environment to enhance their survival, changing such properties as pH and the dissolved oxygen concentration. These changes can reduce the effectiveness of some treatments. For example, biofilms are known to vary the local pH, and some oral biofilms have regions of pH less than 4.9.
- biofilms are also dynamic hydrogels which capriciously move, detach and reform on a wide variety of environmental or engineered surfaces.
- biofouling can be defined as the unspecific adsorption of biological material onto surfaces upon their immersion in a fluid.
- EPS secreted by bacteria and other colonizing microorganisms envelope and anchor them to the substrate thereby altering the local surface chemistry which can stimulate further growth such as the recruitment and settlement of microorganisms.
- Biofouling via biofilm formation causes the deterioration in the microbiological quality of water by inducing biocorrosion termed microbiologically influenced corrosion and biofouling of piping, membranes, containers and reservoirs.
- Biofilms also interrupt the flow of ions and water to and from the substrate surface by acting as a diffusion barrier.
- the reduction of localized oxygen by cathodic reactions within the electrolyte can accelerate the corrosion of a metallic substrate by creating a differential aeration concentration cell.
- the corrosion and weathering caused by biofilm can lead to considerable damage to heat exchangers, unexpected corrosion of stainless steel, and premature destruction of membranes, and many other technological, industrial and homestead aliments.
- Streptococcus mutans is a cardinal member of the oral biofilm associated with dental caries while Candida albicans is associated with oral candidiasis.
- Quorum sensing which is effected by secreting small molecules termed auto inducers (AFs) into their environment. Quorum sensing takes place especially in biofilms were the microbes are at close proximity to one another. This phenomenon affects many physiological and metabolic pathways of bacteria, including the formation of biofilms and antibacterial resistance.
- Inter species QS may affect microbes' physiology and virulence properties resulting in enhanced virulent properties of biofilms.
- Small peptides, AI-2 (furanosyl borate diester), AI-1 (N-acylhomoserine lactones) and C-AI (Cholera AI) have been shown to act as signal molecules in QS in many types of bacteria, including oral bacteria.
- Eukaryotic cells such as fungi have also been shown to communicate with each other by producing signal molecules (AIs), however, the AIs of bacteria and fungi differ chemically; production of farnesol by C. albicans at high cell densities is the first QS system which has been discovered in eukaryotes.
- Farnesol has been identified as QS agent that blocks the morphological transition from yeast to the filament form and affects bio film formation in C. albicans. The mechanism by which farnesol is sensed by C. albicans is not yet known.
- Farnesoic acid and tyrosol were also shown to posses AI properties in C. albicans.
- Eukaryotes seem to have evolved efficient mechanisms to manipulate bacterial QS and thereby protect themselves from pathogenic bacterial attack and competition [Hogan, D.A., 2006, Eukaryot Cell, 5, 613-9].
- QSIs quorum sensing inhibitors
- the eukaryotic host may be simultaneously conversing with a variety of different bacterial strains that it encounters in its natural habitat, potentially encouraging the beneficial ones and antagonizing the harmful strains.
- certain bacteria have evolved mechanisms to fine-tune gene regulation of eukaryotic with their QS signals [Hogan D.A. et al, 2004, Mol. Microbiol, 54, 1212-23]. This eukaryote-bacterial cross talk could be exploited to model manipulative techniques that interfere with bacterial QS.
- Boron containing compounds have received increasing attention as therapeutic agents over the past few years as technology in organic synthesis has expanded to include this atom. Boron containing compounds have been shown to have various biological activities, including an antibacterial activity [Bailey et al., Antimicrobial Agents and Chemotherapy, (1980), 17, 549-553].
- U.S. Patent Nos. 6,075,014 and 6,184,363 disclose that a number of phenyl boronic acids are effective against bacteria resistant to beta-lactam antibiotics. These compounds, or pharmaceutically acceptable salts thereof, are antibacterial by themselves, although at higher concentrations than beta-lactam antibiotics.
- WO 2005/021559 discloses a novel family of oxazaborolidines which can act as antibacterial agents, particularly in preventing or reducing biofilm formation.
- the present inventors have now designed a novel boron-containing compound, which was found to exhibit an antibacterial activity and moreover, was found to exhibit a synergistic activity when used in combination with clinical antibiotics, in inhibiting a growth of various bacterial strains and importantly, in preventing or reducing biofilm formation.
- an antimicrobial composition comprising Compound K as described herein.
- the composition is packaged in a packaging material and identified in print, in or on the packaging material, for use in inhibiting a growth of a pathogenic microorganism in or on a substrate.
- the substrate is selected from the group consisting of a living tissue and an inanimate object.
- the substrate is a living tissue
- the composition being a pharmaceutical composition which further comprises a pharmaceutically acceptable carrier.
- the composition is packaged in a packaging material and identified in print, in or on the packaging material, for use in the treatment of a medical condition associated with a pathogenic microorganism in a subject comprising the living tissue.
- an antibiofilm composition comprising Compound K as described herein.
- the composition is packaged in a packaging material and identified in print, in or on the packaging material, for use in reducing or preventing the formation of a biofilm and/or disrupting a biofilm in or on a substrate.
- the substrate is selected from the group consisting of a living tissue and an inanimate object.
- the substrate is a living tissue, the composition being identified for use in the treatment of a medical condition in which reducing or preventing the formation of the biofilm and/or disrupting the biofilm in the living tissue is beneficial.
- composition as described herein is being for use in combination with an additional active agent.
- composition as described herein is further comprising an additional active agent.
- the additional active agent is an antimicrobial agent, and in some embodiments, an antibacterial agent.
- the compound and the antimicrobial or antibacterial agent act in synergy.
- a method of inhibiting a growth of a pathogenic microorganism in or on a substrate comprising contacting the substrate with an antimicrobial effective amount of Compound K as described herein.
- the substrate is selected from the group consisting of a living tissue and an inanimate object.
- the substrate is a living tissue
- the method being for use in the treatment of a medical condition associated with the pathogenic microorganism in a subject comprising the living tissue.
- a method of reducing or preventing the formation of a biofilm and/or disrupting a biofilm in or on a substrate comprising contacting the substrate with an antimicrobial effective amount of Compound K as described herein.
- the substrate is selected from the group consisting of a living tissue and an inanimate object.
- the substrate is a living tissue
- the method being for treating a medical condition in which reducing or preventing the formation of the biofilm and/or disrupting the biofilm in the living tissue is beneficial.
- any of the methods described herein further comprises contacting the substrate with an additional active agent.
- the additional active agent is an antimicrobial agent, and in some embodiments, an antibacterial agent.
- the compound and the antimicrobial or antibacterial agent act in synergy.
- a compound K as described herein for use in a method of inhibiting a growth of a pathogenic microorganism in or on a substrate.
- the substrate is selected from the group consisting of a living tissue and an inanimate object.
- the substrate is a living tissue, the compound being for use in the treatment of a medical condition associated with the pathogenic microorganism in a subject comprising the living tissue.
- the substrate is a living tissue and the product is a medicament for treating a medical condition associated with the pathogenic microorganism in a subject comprising the living tissue.
- a compound K as described herein for use in a method of reducing or preventing the formation of a biofilm and/or disrupting a biofilm in or on a substrate.
- the substrate is selected from the group consisting of a living tissue and an inanimate object.
- the substrate is a living tissue, the compound being for use in a method of treating a medical condition in which reducing or preventing the formation of the biofilm and/or disrupting the biofilm in the living tissue is beneficial.
- the substrate is a living tissue and the product is a medicament for treating a medical condition in which reducing or preventing the formation of the biofilm and/or disrupting the biofilm in the living tissue is beneficial.
- the compound is being for use in combination with an additional active agent.
- the product is for use in combination with an additional active agent.
- the product further comprises an additional active agent.
- the additional active agent is an antimicrobial agent, and in some embodiments, an antibacterial agent.
- the compound and the antimicrobial or antibacterial agent act in synergy.
- composition comprising Compound K as described herein, an antimicrobial (e.g., antibacterial) agent and a pharmaceutically acceptable carrier.
- an antimicrobial agent e.g., antibacterial
- the composition is packaged in a packaging material and identified in print, in or on the packaging material, for use in inhibiting a growth of a pathogenic microorganism in or on a substrate.
- the substrate is a living tissue, the composition being identified for use in the treatment of a medical condition associated with the pathogenic microorganism in a subject comprising the living tissue.
- the composition is packaged in a packaging material and identified in print, in or on the packaging material, for use in reducing or preventing the formation of a biofilm and/or disrupting a biofilm in or on a substrate.
- the substrate is a living tissue
- the composition being identified for use in the treatment of a medical condition in which reducing or preventing the formation of the biofilm and/or disrupting the biofilm in the living tissue is beneficial.
- the compound and the antibacterial agent act in synergy.
- a method of inhibiting a growth of a pathogenic microorganism in or on a substrate comprising co-contacting the substrate with an antimicrobial effective amount of Compound K as described herein and an antimicrobial (e.g., antibacterial) agent.
- an antimicrobial agent e.g., antibacterial
- the substrate is a living tissue
- the method being for treating a medical condition associated with the pathogenic microorganism in a subject comprising the living tissue.
- a method of reducing or preventing the formation of a biofilm and/or disrupting a biofilm in or on a substrate comprising co-contacting the substrate with an antimicrobial effective amount of Compound K as described herein and an antimicrobial (e.g., antibacterial) agent.
- an antimicrobial agent e.g., antibacterial
- the substrate is a living tissue
- the method being for treating a medical condition in which reducing or preventing the formation of the biofilm and/or disrupting the biofilm in the living tissue is beneficial.
- the compound and the antimicrobial or antibacterial agent act in synergy
- an antimicrobial e.g., antibacterial
- the substrate is a living tissue and the product is a medicament for treating a medical condition associated with the pathogenic microorganism in a subject comprising the living tissue.
- the substrate is a living tissue and the product is a medicament for treating a medical condition in which reducing or preventing the formation of the biofilm and/or disrupting the biofilm in the living tissue is beneficial.
- the compound and the antimicrobial or antibacterial agent act in synergy.
- an article e.g., an article-of-manufacturing or product, comprising a substrate (e.g., an inanimate substrate) and Compound K as described herein incorporated in or on the substrate.
- a substrate e.g., an inanimate substrate
- Compound K as described herein incorporated in or on the substrate.
- the substrate further comprises an additional active agent, as described herein, incorporated therein or thereon.
- compositions, method or structure may include additional ingredients, steps and/or parts, but only if the additional ingredients, steps and/or parts do not materially alter the basic and novel characteristics of the claimed composition, method or structure.
- a compound or “at least one compound” may include a plurality of compounds, including mixtures thereof.
- range format is merely for convenience and brevity and should not be construed as an inflexible limitation on the scope of the invention. Accordingly, the description of a range should be considered to have specifically disclosed all the possible subranges as well as individual numerical values within that range. For example, description of a range such as from 1 to 6 should be considered to have specifically disclosed subranges such as from 1 to 3, from 1 to 4, from 1 to 5, from 2 to 4, from 2 to 6, from 3 to 6 etc., as well as individual numbers within that range, for example, 1, 2, 3, 4, 5, and 6. This applies regardless of the breadth of the range.
- method refers to manners, means, techniques and procedures for accomplishing a given task including, but not limited to, those manners, means, techniques and procedures either known to, or readily developed from known manners, means, techniques and procedures by practitioners of the chemical, pharmacological, biological, biochemical and medical arts.
- treating includes abrogating, substantially inhibiting, slowing or reversing the progression of a condition, abrogating, substantially inhibiting or slowing the propagation of at least one cause of a (medical) condition, substantially ameliorating clinical or aesthetical symptoms of a condition or substantially preventing the appearance of clinical or aesthetical symptoms of a condition.
- a subject in need thereof as used herein describes a human, or mammal, who has bacterial infection or is at the risk of developing microbial infection (i.e., predisposed).
- microbial infection encompasses diseases and conditions resulting from or associated with presence of pathogenic microorganism in a subject.
- FIG. 1 is a comparative bar plot presenting the results of the optical density measurements (blue) and bacterial count (light blue) of methicillin resistant Staphylococcus aureus US A300 strain with different concentrations of Compound K;
- FIG. 2 is a comparative bar plot presenting the results of the optical density measurements (orange) and bacterial count (yellow) of Pseudomonas aeruginosa ATCC27312 strain with different concentrations of Compound K;
- FIG. 3 is a bar graph presenting methicillin resistant Staphylococcus aureus US A300 strain inhibition zones by different concentrations of Compound K (denoted EDP-5), measured in cm 2 using planimetry method;
- FIG. 4 is a bar graph presenting the Pseudomonas aeruginosa ATCC27312 strain inhibition zones by different concentrations of Compound K, measured in cm 2 using planimetry method;
- FIGs. 5A-D present representative photographs of wounds induced in tested pigs during, before and after treatments (following inoculation with bacterial strains), as well as throughout the assessment days, wherein gauze in all treatment groups were in place and moist on day 1 showing a slight adherence to the wound bed (FIG. 5A), while reinjury was not observed (FIG. 5B), and wherein wound fluid was observed from all treatment groups after 24 hours biofilm formation in wounds assigned to biofilm elimination assessment (FIG. 5C and FIG. 5D);
- FIGs. 6A-B present photographs of a wound induced in a tested pig andinfected with methicillin resistant Staphylococcus aureus (FIG. 6B), and treated within 20 minutes after inoculation with vehicle (FIG. 6A);
- FIG. 7 is a bar graph showing methicillin resistant Staphylococcus aureus USA300 biofilm inhibition in the presence of 100 mg/ml (light blue bars), 40 mg/ml (yellow bars), and 10 mg/ml (green bars) of Compound K (denoted EDP-5), of vehicle only (purple bars), and of mupirocin (blue bars), tratments, compared to control untreated wounds (orange bars);
- FIG. 8 is a bar graph showing inhibition of biofilm of methicillin resistant S. aureus US A300 in the presence of various concentrations of Compound K (denoted EDP-5) and control treatments following 24 hours (Day 1) of a first treatment (1 Rx) (light blue bars) and following additional 24 hours (Day 2) of a second treatment (2 Rx);
- FIGs. 9A-B are bar graphs showing bacterial counts of methicillin resistant Staphylococcus aureus US A300 biofilm in wounds (light blue bars) compared with bacterial count in gauze (red bars), 24 hours (Day 1) after one treatment application (1 Rx) of various concentrations of Compound K (denoted EDP-5) and control treatments (FIG. 9A), and bacterial counts of S. aureus USA300 in wounds (yellow bars) compared with bacterial count in gauze (orange bars) 24 hours (Day 2) after a second treatment application (2 Rx) of various concentrations of Compound K (denoted EDP- 5) and control treatments (FIG. 9B);
- FIG. 10 is a bar graph showing elimination of methicillin resistant Staphylococcus aureus USA300 biofilm after 24 hours of biofilm formation, following treatment of various concentrations of Compound K (denoted EDP-5) and control treatments;
- FIG. 11 is a bar graph showing bacterial count of methicillin resistant
- Staphylococcus aureus US A300 after 24 hours of biofilm formation in wounds (different color bars), compared with bacterial count in gauze (green bars), following one treatment with various concentrations of Compound K (denoted EDP-5) and control treatments;
- FIG. 12 is a bar graph showing inhibition of Pseudomonas aeruginosa ATCC 27312 bio film formation after one application (Day 1, 1 Rx) and two applications (Day 2, 2 Rx) of treatment with 40 mg/ml (light blue bars), 10 mg/ml (yellow bars), 4 mg/ml (green bars) of Compound K (denoted EDP-5) and vehicle (purple bars), silver sulfasiazine (blue bars) and control (brown bars) treatments;
- FIG. 13 is bar graph comparing inhibition of Pseudomonas aeruginosa ATCC 27312 bio film after one application (Day 1, 1 Rx; light blue bars) and two applications (Day 2, 2 Rx; yellow bars) of treatment with various concentrations of Compound K (denoted EDP-5) and control treatments;
- FIGs. 14A-B are bar graphs showing bacterial count of Pseudomonas aeruginosa ATCC 27312 in wounds (light blue bars), compared with bacterial count in gauze (red bars), 24 hours (Day 1) after one treatment application (1 Rx) (FIG. 14A) and bacterial count of Pseudomonas aeruginosa ATCC 27312 in wounds (yellow bars), compared with bacterial count in gauze (orange bars), additional 24 hours (Day 2) after second treatment application (2 Rx) (FIG. 14B) of treatment with various concentrations of Compound K (denote EDP-5) and control treatments;
- FIG. 15 is a bar graph showing elimination of Pseudomonas aeruginosa ATCC 27312 bio film after 24 hours of bio film formation, following treatment of various concentrations of Compound K (denoted EDP-5) and control treatments;
- FIG. 16 is a bar graph showing bacterial count of Pseudomonas aeruginosa ATCC 27312 after 24 hours of bio film formation in wounds (different color bars), compared with bacterial count in gauze (green bars), following one treatment with various concentrations of Compound K (denoted EDP-5) and control treatments;
- FIGs. 17A-B present a bar graph showing inhibition of bio film formation Pseudomonas aeruginosa ATCC27312 after one treatment with 20 mg/ml (lavender bars) and 60 mg/ml (pink bars) of BL 6030 (Compound K) in 30 % PEG vehicle, with 20 mg/ml (dark yellow bars) and 60 mg/ml (violet bars) of BL 6030 (Compound K) in 30 % PG vehicle, of Tobramycin 100 ⁇ g/ml (purple bars) and 50 ⁇ g/ml (blue bars) and in untreated wound (brown bars) (FIG.
- FIGs. 18A-B present bar graphs showing inhibition of bio film formation of Pseudomonas aeruginosa ATCC27312 in wounds (light blue bars), compared with bacterial count in gauze (red bars), following one treatment with various concentrations of BL 6030 (Compound K) and control treatments, 24 hours (Day 1) following one treatment application (1 Rx) (FIG. 18 A) and additional 24 hours (Day 2) following a second treatment application (FIG. 18B) (see, Design 1);
- FIGs. 19A-B present bar graphs showing inhibition of methicillin resistant
- Staphylococcus aureus MRSA biofilm formation 24 hours after application of treatment with Gentamicin 200 ⁇ g/ml (green bars) and 100 ⁇ g/ml (yellow bars), with 150 mg/ml (red bars) and 75 mg/ml (light blue bars) of BL 6030 (Compound K) in 30 % PG vehicle, with 150 mg/ml (bright green bars) and 75 mg/ml (brown bars) of BL 6030 (Compound K) in 30 % PEG vehicle, with Mupirocin (purple bars) and in untreated wound (sea green bars) (FIG.
- Gentamicin 200 ⁇ g/ml (green bars) and 100 ⁇ g/ml (yellow bars) with 150 mg/ml (red bars) and 75 mg/ml (light blue bars) of BL 6030 (Compound K) in 30 % PG vehicle, with 150 mg/ml (bright green bars) and 75 mg/ml (brown bars) of BL 60
- FIGs. 20A-B present bar graphs showing elimination of methicillin resistant Staphylococcus aureus (MRSA) US A300 biofilm 24 hours after application of treatment with Gentamicin 200 ⁇ g/ml (green bars) and 100 ⁇ g/ml (yellow bars), with 150 mg/ml (red bars) and 75 mg/ml (light blue bars) of BL 6030 (Compound K) in 30 % PG vehicle, with 150 mg/ml (bright green bars) and 75 mg/ml (brown bars) of BL 6030 (Compound K) in 30 % PEG vehicle, with Mupirocin (purple bars) and in untreated wound (sea green bars) (FIG.
- MRSA methicillin resistant Staphylococcus aureus
- FIGs. 20A shows elimination of MRSA biofilm in wounds (yellow bars), compared with bacterial count in gauze (orange bars), following treatment with various preparations of BL 6030 (Compound K) and control treatments (FIG. 20B), after 24 hours of biofilm formation, and additional 24 hours (Day 2) following one treatment application (1 Rx) (see, Design 2); FIGs.
- 21A-B present bar graphs showing inhibition of Pseudomonas aeruginosa ATCC27312 biofilm formation 24 hours after application of treatment with 20 mg/ml (green bars) and 60 mg/ml (yellow bars) of BL 6030 (Compound K), with Tobramycin 200 ⁇ g/ml (red bars), 100 ⁇ g/ml (light blue bars) and 50 ⁇ g/ml (bright green bars), with 30 % PEG vehicle (brown bars), with Silver Sulfadiazine (purple bars) and of untreated wound (sea green bars) (FIG.
- FIGs. 22A-B present bar graphs showing elimination of Pseudomonas aeruginosa ATCC27312 biofilm 24 hours after application of treatment with 20 mg/ml (green bars) and 60 mg/ml (yellow bars) of BL 6030 (Compound K), with Tobramycin 200 ⁇ g/ml (red bars), 100 ⁇ g/ml (light blue bars) and 50 ⁇ g/ml (bright green bars), with 30 % PEG vehicle (brown bars), with Silver Sulfadiazine (purple bars) and of untreated wound (sea green bars) (FIG.
- the present invention in some embodiments thereof, relates to pharmacology, more particularly, but not exclusively, to a novel boron-containing compound and uses thereof as an antibacterial and/or anti-biofilm agent.
- the present inventors have prepared exemplary compounds having a 6-methyl- 2-phenyl-l,3,6,2-dioxazaborocane motif, and have uncovered that such compounds exert antimicrobial activity perse as well as quorum sensing inhibitory activity, and hence can be used as antimicrobial and/or anti-biofilm agents, as defined herein.
- the present inventors have uncovered that these compounds are particularly effective as antimicrobial and/or anti-biofilm agents when used in combination with other antimicrobial agents, showing additive or synergistic activity effect.
- a synergistic (or additive) effect was demonstrated when these compounds were used in combination with various antibiotics.
- Compound K can be used effectively both in antimicrobial compositions, and in compositions for preventing, reducing and eliminating biofilms both ex-vivo and in-vivo, and that these activities can be enhanced synergistically in combination with antibacterial agents.
- Compound K can be used as an antimicrobial agent per se.
- antibacterial refers to a property of a substance (e.g., a compound or a composition) that can effect a parameter of microorganism, including death, eradication, elimination, reduction in number, reduction of growth rate, inhibition of growth, change in population distribution of one or more species of microbial life forms.
- a parameter of microorganism including death, eradication, elimination, reduction in number, reduction of growth rate, inhibition of growth, change in population distribution of one or more species of microbial life forms.
- antibacterial agents which are also referred to herein as antibiotics.
- an antimicrobial substance e.g., a compound or a composition
- an antimicrobial substance can be manifested, for example, by reducing or increasing adhesion of the microorganism to the substrate; by effecting enzymatic activity; and/or by effecting the viability of the microorganism (e.g., bacteria), as further discussed herein.
- composition which includes, as an active ingredient, Compound K and optionally a carrier.
- composition is referred to herein an antimicrobial or an antibacterial composition.
- the composition is packaged in a packaging material and is identified in print, in or on the packaging material, for use in inhibiting a growth of a pathogenic microorganism in or on a substrate.
- Microorganisms can exist on living tissues or on non-living, organic or inorganic substrates, referred to herein an inanimate objects or substrates, and constitute a prevalent mode of microbial life in natural, industrial and medical settings.
- a substrate as defined herein encompasses living tissues and inanimate objects.
- the phrase "living tissue” is meant to encompass any part of a living organism, a bodily site or a living organ.
- the phrase “bodily site” includes any organ, tissue, membrane, cavity, blood vessel, tract, biological surface or muscle, which contacting therewith (e.g., delivering thereto or applying thereon) the compound disclosed herein is beneficial.
- Exemplary bodily sites include, but are not limited to, the skin, a dermal layer, the scalp, an eye, an ear, a mouth, a throat, a stomach, a small intestines tissue, a large intestines tissue, a kidney, a pancreas, a liver, the digestive system, the respiratory tract, a bone marrow tissue, a mucosal membrane, a nasal membrane, the blood system, a blood vessel, a muscle, a pulmonary cavity, an artery, a vein, a capillary, a heart, a heart cavity, a male or female reproductive organ and any visceral organ or cavity. Any organ or tissue onto which microorganism can exist in contemplated.
- living tissue encompasses also samples of a living organism or subject, namely a human or an animal, which have been removed from the organism and maintained viable for any purpose, and encompasses the living subject itself as a whole, e.g., a plant, a human or an animal (e.g., a mammal).
- the phrase "inanimate object” is meant to encompass any surface of an object which may harbor a microorganism, such as, but not limited to, an implantable medical device such as a gastric or duodenal sleeve, a topical medical device such as a wound dressing, a subcutaneous medical device such as a subcutaneous injection port, a percutaneous medical device such as a catheter, a syringe needle or an endoscopic device, a vessel, a tube, a lid, a wrap, a package, a work surface or area, a warehouse, a package and the like.
- a microorganism such as, but not limited to, an implantable medical device such as a gastric or duodenal sleeve, a topical medical device such as a wound dressing, a subcutaneous medical device such as a subcutaneous injection port, a percutaneous medical device such as a catheter, a syringe needle or an endoscopic device, a vessel, a tube, a lid, a
- the phrase "inhibiting the growth of a microorganism” refers to an effect of a compound, a composition or a combination of a compound with another active agent, which stops and/or reverses the propagation of a microorganism, such that at least one cell or a culture thereof is no longer multiplying or growing and/or is killed as a result of coming in contact with the compound.
- the effect of inhibiting the growth thereof is oftentimes beneficial.
- the antimicrobial composition is packaged in a packaging material and is identified in print, in or on the packaging material for use in inhibiting a growth of a microorganism in or on inanimate objects, as discussed herein.
- a composition may be in a form of, for example, solution, paste, liquid, spray and powder.
- the composition when the substrate is a living tissue, the composition is a pharmaceutical composition.
- a pharmaceutical composition which comprises Compound K as described herein and a pharmaceutically acceptable carrier.
- pharmaceutical composition refers to a preparation of Compound K, with other chemical components such as pharmaceutically acceptable and suitable carriers and excipients, and optionally with additional active agents, such as another antimicrobial agent.
- additional active agents such as another antimicrobial agent.
- the purpose of a pharmaceutical composition is to facilitate administration of the compound to a subject, or optionally to facilitate its application (contacting) in or on an inanimate object.
- pharmaceutically acceptable carrier refers to a carrier or a diluent that does not cause significant irritation to an organism and does not inhibit the distribution, therapeutic properties or otherwise does not abrogate the biological activity and properties of the administered or applied compound.
- excipient refers to an inert substance added to a pharmaceutical composition to further facilitate administration or application of a drug.
- compositions for use in accordance with the present invention thus may be formulated in conventional manner using one or more pharmaceutically acceptable carriers comprising excipients and auxiliaries, which facilitate processing of the active ingredient(s) into preparations which can be used pharmaceutically. Proper formulation is dependent upon the route of administration chosen. The dosage may vary depending upon the dosage form employed and the route of administration utilized.
- the pharmaceutical composition may be formulated for administration in either one or more of routes depending on whether local or systemic treatment or administration is of choice, and on the area to be treated. Administration may be done orally, by inhalation, or parenterally, for example by intravenous drip or intraperitoneal, subcutaneous, intramuscular or intravenous injection, or topically (including ophtalmically, vaginally, rectally, intranasally).
- the pharmaceutical composition is formulated as a wound dressing, using methods known in the art.
- compositions to be administered or otherwise applied will, of course, be dependent on the subject being treated, the severity of the affliction, the manner of administration, the judgment of the prescribing physician, etc.
- compositions of the present invention may, if desired, be presented in a pack or dispenser device, such as an FDA (the U.S. Food and Drug Administration) approved kit, which may contain one or more unit dosage forms containing the active ingredient.
- the pack may, for example, comprise metal or plastic foil, such as, but not limited to a blister pack or a pressurized container (for inhalation).
- the pack or dispenser device may be accompanied by instructions for administration.
- the pack or dispenser may also be accompanied by a notice associated with the container in a form prescribed by a governmental agency regulating the manufacture, use or sale of pharmaceuticals, which notice is reflective of approval by the agency of the form of the compositions for human or veterinary administration. Such notice, for example, may be of labeling approved by the U.S.
- compositions comprising active ingredient(s) according to embodiments of the invention formulated in a compatible pharmaceutical carrier may also be prepared, placed in an appropriate container, and labeled for treatment of a particular medical condition, disease or disorder (e.g, a condition associated with pathogenic microorganism), as is detailed herein.
- a particular medical condition, disease or disorder e.g, a condition associated with pathogenic microorganism
- the pharmaceutical composition presented herein is packaged in a packaging material and identified in print, in or on the packaging material, for use in inhibiting a growth of a pathogenic microorganism in a subject in need thereof. Further according to an aspect of some embodiments of the present invention, there is provided a use of Compound K in the manufacture of a product for inhibiting a growth of a pathogenic microorganism in or on a substrate, as defined herein.
- the product is a medicament.
- the term “medicament” is used interchangeably with the phrase “pharmaceutical composition”.
- a Compound K as described herein for use in a method of inhibiting a growth of a pathogenic microorganism in or on a substrate, as defined herein.
- Compound K as described herein is for use in a method of inhibiting a growth of a pathogenic microorganism in a subject which comprises the living tissue.
- a method of inhibiting a growth of a pathogenic microorganism in or on a substrate which is effected by contacting the substrate with an antimicrobial effective amount of Compound K as described herein.
- an antimicrobial effective amount describes an amount of an antimicrobial agent which will effect one or more parameters of a microorganism, including death, eradication, elimination, reduction in number, reduction of growth rate, inhibition of growth, change in population distribution of one or more species of microbial life forms, as described herein.
- an antimicrobial effective amount is an amount that reduces to some extent the population of a microorganism in or on a substrate.
- an antimicrobial effective amount is an amount that reduces by 10 %, 20 %, 30 %, 40 %, 50 % or to a higher extent, the population of a microorganism in or on a substrate.
- reduction in the population of a microorganism in or on a substrate is determined by measuring the number of colony forming units of the microorganism grown upon contacting an antimicrobial agent and comparing it to the number of colony forming units of the microorganism when grown without an antimicrobial agent.
- a substrate can be a living tissue or an inanimate object, as these terms are defined hereinabove.
- the method is effected by administering to the subject an antimicrobial effective amount of Compound K.
- the administration can be effected orally, rectally, intravenously, topically, intranasally, intradermally, transdermally, subcutaneous ly, intramuscularly, intrperitoneally or by intrathecal catheter.
- Compound K can administered either per se or as a part of a pharmaceutical composition as described herein.
- the mode of administration is selected to suite the medical condition which is being treated. For example, in treating a systemic infection where rapid distribution of the therapeutic agent(s) is needed, drug(s) are typically administered orally or intravenously. When treating a local infection, the drug is administered locally, topically, transdermally, subcutaneously or intramuscularly.
- an exemplary method of inhibiting a growth of a pathogenic microorganism in a subject is effected topically by applying a composition containing the active compound onto a wound.
- the mode of inhibiting a growth of a pathogenic microorganism in or on the substrate is effected typically by dipping, spraying, coating, or otherwise applying the active compound or a composition comprising the same, as described herein, in or on the substrate.
- a catheter for prolonged percutaneous use can be coated with a composition containing Compound K so as to inhibit the growth of a pathogenic microorganism therein or thereon.
- Other medical devices can be similarly coated, as is detailed hereinbelow.
- pathogenic microorganism is used to describe any microorganism which can cause a disease or infection in a higher organism, such as humans or any animals grown for commercial or recreational purposes, fish, poultry, insects (e.g., bees) and mammals.
- a pathogenic microorganism is one that causes diseases and adverse effects in humans, hence, a pathogenic microorganism in the context of embodiments of the present invention is regarded as a cause of a medical condition associated therewith.
- the pathogenic microorganism may belong to any family of organisms such as, but not limited to, prokaryotic organisms, eubacterium, archaebacterium, eukaryotic organisms, yeast, fungi, algae, protozoa, and other microscopic parasites.
- Compound K was found to be a highly efficient agent against a wide spectrum of bacteria, including Gram-negative bacteria and Gram-positive bacteria.
- the phrase "pathogenic microorganism” refers to a bacterium (or a bacterial strain).
- bacteria refers to all prokaryotic organisms, including those within all of the phyla in the Kingdom Procaryotae. It is intended that these terms encompass all microorganisms considered to be bacteria including Mycoplasma, Chlamydia, Actinomyces, Streptomyces, and Rickettsia. All forms of bacteria are included within this definition including cocci, bacilli, spirochetes, spheroplasts, protoplasts, etc. Also included within these terms are prokaryotic organisms that are Gram-negative or Gram-positive.
- Gram-negative and “Gram- positive” refer to staining patterns with the Gram-staining process, which is well known in the art. (See e.g., Finegold and Martin, Diagnostic Microbiology, 6th Ed., CV Mosby St. Louis, pp. 13-15 (1982)).
- Gram-positive bacteria are bacteria that retain the primary dye used in the Gram stain, causing the stained cells to generally appear dark blue to purple under the microscope.
- Gram-negative bacteria do not retain the primary dye used in the Gram stain, but are stained by the counterstain. Thus, Gram- negative bacteria generally appear red.
- bacteria are continuously cultured.
- bacteria are uncultured and existing in their natural environment (e.g., at the site of a wound or infection) or obtained from patient tissues (e.g., via a biopsy). Bacteria may exhibit pathological growth or proliferation.
- Non-limiting examples of bacteria include bacteria of a genus selected from the group including Salmonella, Shigella, Escherichia, Enterobacter, Serratia, Proteus, Yersinia, Citrobacter, Edwardsiella, Providencia, Klebsiella, Hafnia, Ewingella, Kluyvera, Morganella, Planococcus, Stomatococcus, Micrococcus, Staphylococcus, Vibrio, Aeromonas, Plessiomonas, Haemophilus, Actinobacillus, Pasteurella, Mycoplasma, Ureaplasma, Rickettsia, Coxiella, Rochalimaea, Ehrlichia, Streptococcus, Enterococcus, Aerococcus, Gemella, Lactococcus, Leuconostoc, Pedicoccus, Bacillus, Corynebacterium, Arcanobacterium, Actinomyces, Rhodococcus, Listeria, Er
- the pathogenic bacteria are of one or more of the following species: Acinetobacter baumanii, Belicobacter pylori, Burkholderia multivorans, Campylobacter jejuni, Deinococcus radiodurans , E.
- the bacteria are of the species Staphylococcus aureus. In some embodiments the bacteria are of the species Pseudomonas aeruginosa. In some embodiments the bacteria are of the species Staphylococcus epidermidis
- a wide-spectrum activity range is oftentimes indicative of activity in inhibiting the growth of eukaryotic microorganisms such as fungi, as well as prokaryotic microorganisms such as bacteria.
- pathogenic fungi against which Compound K can be efficiently used according to the present embodiments include, without limitation, fungi of the genus Absidia: Absidia corymbifera; genus Ajellomyces: Ajellomyces capsulatus, Ajellomyces dermatitidis; genus Arthroderma: Arthroderma benhamiae, Arthroderma fulvum, Arthroderma gypseum, Arthroderma incurvatum, Arthroderma otae, Arthroderma vanbreuseghemii; genus Aspergillus: Aspergillus flavus, Aspergillus fumigatus, Aspergillus niger; genus Blastomyces: Blastomyces dermatitidis; genus Candida: Candida albicans, Candida glabrata, Candida guilliermondii, Candida krusei, Candida parapsilosis, Candida tropicalis, Candida pelliculosa; genus Absidia cor
- pathogenic parasites and protozoa against which Compound K may be used according to the present embodiments include, without limitation, various types of amoeba, Leishmania spp, Plasmodium falciparum Trypanosoma cruzi (causing Chagas' disease), Trypanosoma bucei (causing "sleeping sickness"), Plasmodium vivax (causing malaria), Cryptosporidium parvum (causing cryptosporidiosis), Cyclospora cayetanensis, Giardia lamblia (causing giardiasis) and many others.
- Resistance of microorganism to antimicrobial agents is the ability of a microorganism to withstand the antimicrobial effects of any given agents (antibiotics).
- the antimicrobial action of any given agent is putting an environmental pressure on the target (and also non-targeted) microorganisms.
- the microorganisms which have a mutation that will allow it to survive will live on to reproduce. These newly evolved strain(s) will then pass this trait to their offspring, which will constitute a fully resistant generation.
- Compound K was shown to be effective against methicillin resistant Staphylococcus aureus (MRS A). Since this strain is associated with severe medical conditions, the use of Compound K may be one of the means to combat this and other antibiotic resistant pathogens and ameliorate or cure the medical conditions associated therewith.
- the pathogenic microorganism is a pathogenic, drug-resistant microorganism.
- the pathogenic, drug resistant microorganism can be any of the microorganisms selected from the group consisting of prokaryotic organisms, eubacteria, archaebacteria, eukaryotic organisms, yeast, fungi, algae, protozoa and other parasites.
- the drug-resistant microorganism can be resistant to one or more conventionally used drug or other antimicrobial agent.
- conventional antimicrobial agent refers to antimicrobial agents commonly used in clinical therapies, and encompasses, for example, antibacterial agents commonly used in clinical therapies, which are also referred to herein as "clinical antibiotics”.
- Non-limiting examples of conventional antibacterial agents include, but are not limited to, gentamicin, ampicillin, amikacin (AK), cefazolin, ceftriaxone, clindamycin, cephalothin, ciprofloxacin, chloramphenicol, ceftazidime (CAZ), cefepime (CPE), erythromycin, trimethoprim/sulfamethoxazole Q7S), gatifloxacin, piperacillin/tazobactam (P/T), aztreonam (AZT), imipenem, levofloxacin, penicillin, oxacillin, nitrofurantoin, linezolid, moxifloxacin, meropenem (MER), tobramycin (TO), ciprofloxacin (CP), tetracycline, vancomycin, rifampin synercid, streptomycin Synergy, colistin (CT) and chloram
- antimicrobial agent examples include polyene-based antifungal agents such as amphotericin, amphotericin B, nystatin and pimaricin, amphotericin B liposomal formulations (AmBisome, Abelcet, Amphocil), azole-based antifungal agents such as fluconazole, itraconazole and ketoconazole, allylamine- or morpholine-based antifungal agents such as allylamines (naftifine, terbinafme), and antimetabolite-based antifungal agents such as 5-fluorocytosine, and fungal cell wall inhibitor such as echinocandins like caspofungin, micafungin and anidulafungin.
- polyene-based antifungal agents such as amphotericin, amphotericin B, nystatin and pimaricin, amphotericin B liposomal formulations (AmBisome, Abelcet, Amphocil)
- the pharmaceutical composition described herein is packaged in a packaging material and identified in print, in or on the packaging material, for use in the treatment of a medical condition associated with the pathogenic microorganism in a subject in need thereof.
- the medicament as described herein for inhibiting a growth of a pathogenic microorganism in a subject presented hereinabove is being for use in the treatment of a medical condition associated with the pathogenic microorganism in a subject in need thereof.
- Compound K as described herein is for use in a method of treating a medical condition associated with the pathogenic microorganism in a subject in need thereof.
- the method as described herein is being for treating a medical condition associated with the pathogenic microorganism in a subject in need thereof.
- a subject in need thereof describes a subject that has one or more tissues, organs or any bodily site, infected by the pathogenic microorganism.
- the subject is an animal, preferably a mammal, more preferably a human being.
- the term "associated" in the context embodiments of the present invention means that at least one adverse manifestation of the medical condition is caused by a pathogenic microorganism.
- the phrase "medical condition associated with a pathogenic microorganism” therefore encompasses medical conditions of which the microorganism may be the primary cause of the medical condition or a secondary effect of the main medical condition(s).
- Medical conditions associated with a pathogenic microorganism include infections, infestation, contaminations and transmissions by or of pathogenic microorganisms such as those described herein.
- a disease causing infection is the invasion into the tissues of a plant or an animal by pathogenic microorganisms.
- the invasion of body tissues by parasitic worms and other higher pathogenic organisms such as lice is oftentimes referred to as infestation.
- Invading organisms such as bacteria typically produce toxins that damage host tissues and interfere with normal metabolism; some toxins are actually enzymes that break down host tissues. Other bacterial substances may inflict their damage by destroying the host's phagocytes, rendering the body more susceptible to infections by other pathogenic microorganisms. Substances produced by many invading organisms cause allergic sensitivity in the host. Infections may be spread via respiratory droplets, direct contact, contaminated food, or vectors, such as insects. They can also be transmitted sexually and from mother to fetus.
- Examples of medical conditions and diseases caused by bacterial infections include, without limitation, actinomycosis, anthrax, aspergillosis, bacteremia, bacterial skin diseases, bartonella infections, botulism, brucellosis, burkholderia infections, Campylobacter infections, candidiasis, cat-scratch disease, chlamydia infections, cholera, Clostridium infections, coccidioidomycosis, cryptococcosis, dermatomycoses, diphtheria, ehrlichiosis, epidemic louse borne typhus, Escherichia coli infections, fusobacterium infections, gangrene, general infections, general mycoses, gonorrhea, gram-negative bacterial infections, gram-positive bacterial infections, histoplasmosis, impetigo, klebsiella infections, legionellosis, leprosy, lep
- Compound K mainly include fungal infections or mycoses.
- Fungal infections or mycoses are classified depending on the degree of tissue involvement and mode of entry into the host. Main classes are superficial, subcutaneous, systemic and opportunistic infections.
- Non-limiting examples of medical conditions associated with fungi or other eukaryotes include superficial mycoses infections, "ringworm” or “tinea”, candidiasis or “thrush”, subcutaneous mycoses, sporotrichosis, systemic mycoses, histoplasmosis, blastomycosis, coccidiomycosis, paracoccidiodomycosis, aspergillosis, systemic candidosis and cryptococcosis and Pneumocystis.
- Medical conditions associated with pathogenic parasites and protozoa which may be treatable by Compound K, include, without limitation, acanthamoeba infection, African trypanosomiasis (sleeping sickness), alveolar echinococcosis, amebiasis (entamoeba histolytica infection), American trypanosomiasis (Chaga's disease), ancylostoma infection (hookworm infection, cutaneous larva migrans, CLM), angiostrongylus infection (angiostrongyliasis), angiostrongyliasis (angiostrongylus infection), anisakis infection (anisakiasis), anisakiasis (anisakis infection), ascariasis (intestinal roundworms), babesia infection (babesiosis), babesiosis (babesia infection), balantidiasis (balantidium infection), balantidium infection (balantidiasis), bay
- ebiasis echinococcosis
- elephantiasis filamentariasis, lymphatic filariasis
- endolimax nana infection Entamoeba coli infection, Entamoeba dispar infection, Entamoeba heartmanni infection, Entamoeba histolytica infection (amebiasis), Entamoeba polecki infection, Enterobiasis (pinworm infection), fasciola infection (fascioliasis), fascioliasis (fasciola infection), fasciolopsiasis (fasciolopsis infection), fasciolopsis infection (fasciolopsiasis), filariasis (lymphatic filariasis, elephantiasis), foodborne diseases, giardiasis (giardia infection, "beaver fever”), gnathostoma infection (gnathost
- biofilm refers to an aggregate of living cells which are stuck to each other and/or immobilized onto a surface as colonies.
- the cells are frequently embedded within a self-secreted matrix of extracellular polymeric substance (EPS), also referred to as “slime”, which is a polymeric sticky mixture of nucleic acids, proteins and polysaccharides.
- EPS extracellular polymeric substance
- the living cells forming a biofilm can be cells of a unicellular microorganism (prokaryotes, archaea, bacteria, eukaryotes, protists, fungi, algae, euglena, protozoan, dinoflagellates, apicomplexa, trypanosomes, amoebae and the likes), or cells of multicellular organisms in which case the biofilm can be regarded as a colony of cells (like in the case of the unicellular organisms) or as a lower form of a tissue.
- a unicellular microorganism prokaryotes, archaea, bacteria, eukaryotes, protists, fungi, algae, euglena, protozoan, dinoflagellates, apicomplexa, trypanosomes, amoebae and the likes
- the biofilm can be regarded as a colony of cells (like in the case of the unicellular organisms)
- the cells are of microorganism origins, and the biofilm is a biofilm of microorganisms, such as bacteria and fungi.
- the cells of a microorganism growing in a biofilm are physiologically distinct from cells in the "planktonic form" of the same organism, which by contrast, are single-cells that may float or swim in a liquid medium.
- Biofilms can go though several life-cycle steps which include initial attachment, irreversible attachment, one or more maturation stages, and dispersion.
- anti-biofilm formation activity or "anti-quorum sensing activity”, as these equivalent terms are used herein interchangeably, refer to the capacity of a substance to effect the prevention of formation of a biofilm of bacterial, fungal and/or other cells; and/or to effect a disruption and/or the eradication of an established and/or matured biofilm of bacterial, fungal and/or other cells; and/or to effect a reduction in the rate of buildup of a biofilm of bacterial, fungal and/or other cells on a surface of a substrate.
- anti-bio film formation compound/composition/agent refers to a substance having an anti-bio film formation activity, as defined herein.
- Compound K exerts ABF activity and can thus prevent or reduce the formation or the mass of a biofilm, and/or disrupt an existing (established) biofilm. Therefore, Compound K can be used in methods and compositions which are directed at anti-bio film formation purposes, as detailed hereinbelow.
- the activity of preventing or reducing the formation of a biofilm, and the activity of disrupting a biofilm which has been established before treatment may be achieved by identical or different ABF agents.
- the prevention or reducing of forming a biofilm assumes that the biofilm has not yet been formed, and hence the presence of the ABF agent is required also in cases where no biofilm is present or detected.
- the biofilm has already been formed and the disruption thereof is desirable; thus in these cases the ABF agent according to embodiments of the present invention, may be introduced before, during or after the detection of presence of the biofilm.
- the term "preventing" in the context of the formation of a biofilm indicates that the formation of a biofilm is essentially nullified or is reduced by at least 20 % of the appearance of the biofilm in a comparable situation lacking the presence of the ABF agent. Alternatively, preventing means a reduction to at least 15 %, 10 % or 5 % of the appearance of the biofilm in a comparable situation lacking the presence of the ABF agent. Methods for determining a level of appearance of a biofilm are known in the art.
- the term “disrupting" in the context of the formation of a biofilm indicates that the mass of a biofilm is reduced to at least 20 % of its mass prior to the introduction of the ABF agent presented herein. Alternatively, disrupting means a reduction in the mass of the biofilm to at least 30 %, 40 % or 50 % of its original mass prior to the introduction of the ABF agent.
- disrupting a biofilm, or reducing a biofilm mass results in converting at least a portion of the biofilm (e.g., at least 20 %, 30 %, 40 %, 50 %, 60 %, 70 %, 80 %, 90 % and even 100 %) into planktonic cells that formed the biofilm.
- an anti-bio film composition which comprises Compound K as described herein, and can optionally further comprise a carrier.
- the composition presented herein is packaged in a packaging material and identified in print, in or on the packaging material, for use in reducing or preventing the formation of a biofilm and/or disrupting a biofilm in or on a substrate, as described herein.
- Biofilms may form on living tissues or form on non-living, organic or inorganic substrates, referred to herein an inanimate objects or substrates, and constitute a prevalent mode of microbial life in natural, industrial and medical settings.
- the substrate can be a living tissue or an inanimate object, as described herein.
- a composition comprising Compound K as described herein is referred to as a pharmaceutical composition, as described herein.
- the pharmaceutical composition presented herein is packaged in a packaging material and identified in print, in or on the packaging material, for use in reducing or preventing the formation of a biofilm and/or disrupting a biofilm in the living tissue or in a subject in need thereof, which comprises said living tissue, as described hereinabove.
- the pharmaceutical composition is identified for use in the treatment of a medical condition in which reducing or preventing the formation of the biofilm and/or disrupting the biofilm in the living tissue is beneficial. Further according to an aspect of some embodiments of the present invention there is provided a use of Compound K in the manufacture of a product for reducing or preventing the formation of a biofilm and/or disrupting a biofilm in or on a substrate.
- the product is a medicament for reducing or preventing the formation of a biofilm and/or disrupting a biofilm in the living tissue or in a subject in need thereof, which comprises said living tissue, as described hereinabove.
- the medicament is for the treatment of a medical condition in which reducing or preventing the formation of the biofilm and/or disrupting the biofilm in the living tissue is beneficial.
- Compound K as described herein for use in a method of reducing or preventing the formation of a biofilm and/or disrupting a biofilm in or on a substrate.
- Compound K is for use in a method of reducing or preventing the formation of a biofilm and/or disrupting a biofilm the living tissue or in a subject in need thereof, which comprises said living tissue, as described hereinabove.
- Compound K is identified for use in the treatment of a medical condition in which reducing or preventing the formation of the biofilm and/or disrupting the biofilm in the living tissue is beneficial.
- a method of reducing or preventing the formation of a biofilm and/or disrupting a biofilm in or on a substrate which is effected by contacting the substrate with an antimicrobial effective amount of Compound K as described herein.
- the phrase "antimicrobial effective amount” describes an amount of an anti-biofilm ingredient which will reduce, prevent and/or disrupt, at least to some extent, the formation of a biofilm of a microorganism, as described herein, in or on a substrate harboring the microorganism.
- the method when the substrate is a living tissue, such as a bodily site of a subject, the method is effected by administering to the subject an antimicrobial effective amount of Compound K.
- the administration can be effected orally, rectally, intravenously, topically, intranasally, intradermally, transdermally, subcutaneously, intramuscularly, intrperitoneally or by intrathecal catheter.
- Compound K can administered either per se or as a part of a pharmaceutical composition as described herein.
- the method is being for treating a medical condition in which reducing or preventing the formation of the biofilm and/or disrupting the biofilm in the living tissue is beneficial.
- the mode of administration in the context of reducing, preventing and/or disrupting a biofilm formation is similar to the mode of administration in the context of inhibiting the growth of a microorganism.
- an exemplary method of reducing, preventing and/or disrupting a biofilm in a subject is effected topically by applying a composition containing the active ingredients on a wound.
- This method is also effective in reducing, preventing and/or disrupting a biofilm formation on the wound dressing used to treat the wound.
- streptococcal infections which is the basis for the intense virulence of many streptococcal species.
- the mode of reducing, preventing and/or disrupting a biofilm formation in or on the substrate is effected typically by dipping, spraying, coating, or otherwise applying a formulation containing the active ingredients in or on the substrate.
- a catheter for prolonged percutaneous use can be coated with a formulation containing Compound K so as to reduce, prevent and/or disrupt, at least to some extent, the formation of a biofilm therein or thereon.
- the anti-biofilm composition as described herein is used to reduce, prevent and/or disrupt, at least to some extent, the formation of a biofilm in a medical device by coating or impregnating the device with an amount of the composition capable of reducing, preventing and/or disrupting formation of the biofilm.
- Medical device includes any material or device that is used on, in, or through a subject's body, for example, in the course of medical treatment (e.g., for a disease or injury).
- Medical devices include, but are not limited to, such items as medical implants, wound care devices, drug delivery devices, and body cavity and personal protection devices.
- the medical implants include, but are not limited to, urinary catheters, intravascular catheters, dialysis shunts, wound drain tubes, skin sutures, vascular grafts, implantable meshes, intraocular devices, heart valves, and the like.
- Wound care devices include, but are not limited to, general wound dressings, biologic graft materials, tape closures and dressings, and surgical incise drapes.
- Drug delivery devices include, but are not limited to, needles, drug delivery skin patches, drug delivery mucosal patches and medical sponges.
- Body cavity and personal protection devices include, but are not limited to, tampons, sponges, surgical and examination gloves, and toothbrushes.
- birth control devices include, but are not limited to, intrauterine devices (IUDs), diaphragms and condoms.
- Coating or impregnating the medical device with the anti-biofilm composition as described herein may be effected via various techniques known in the art (see, for example, in US Pat. Nos. 4,107,121; 4,442,133; 4,895,566; 4,917,686; 5,013,306; 5,624,704; 5,688,516; 5,756,145; 5,853,745; 5,902,283; 6,719,991).
- the antimicrobial and ABF activity of Compound K has been shown to be enhanced when acting in the presence of another active agent or bioactive agent, such as another antimicrobial agent.
- another active agent or bioactive agent such as another antimicrobial agent.
- antimicrobial and ABF activity of various antimicrobial agents e.g., antibiotics was shown to be enhanced when acting in the presence of Compound K.
- the compound, compositions or medicaments presented herein may be used in combination with an additional active agent, or alternatively, the compositions or medicaments presented herein may include an additional active agent.
- the additional active agent e.g., an additional antimicrobial agent
- the additional active agent is not an ingredient of the composition or medicament containing Compound K
- it can be held as a separate composition in a separate container and packaged together with the container holding the composition containing Compound K, or it can be packaged separately.
- the methods as described herein are effected by co-contacting the substrate with Compound K and an additional active agent as described herein.
- the additional agent can be administered or otherwise contacted concomitantly, concurrently, simultaneously, consecutively or sequentially with Compound K.
- composition which comprises both Compound K and an additional active agent, and optionally further comprises a carrier.
- the composition can be an antimicrobial composition, an anti-bio film composition or a pharmaceutical composition, as described herein.
- Compound K for use in any of the methods described herein, in combination with an additional active agent.
- a method as described herein which is effected by contacting the substrate with Compound K and with an additional active agent.
- a method as described herein is effected by coadministering to a subject in need thereof Compound K and an additional active agent.
- a method of inhibiting a growth of a pathogenic microorganism in a subject which is effected by co- administering to a subject in need thereof a synergistically effecting amount of Compound K and an antimicrobial agent.
- a method of reducing or preventing the formation of a biofilm and/or disrupting a biofilm in or on a substrate which is effected co- contacting the substrate with an antimicrobial effective amount of Compound K and an antimicrobial agent.
- the additional active agent is an antimicrobial agent, and according to some embodiments, the additional antimicrobial agent acts in synergy with Compound K in inhibiting a growth of a microorganism and/or within the ABF activity exhibited thereby.
- a synergy between two antimicrobial agents may be determined by methods well known in the art. An exemplary method is demonstrated in Example 2 in the Examples section that follows.
- a “synergistically effective amount” describes an amount of Compound K that when combined with an additional agent results in synergy, as defined herein.
- the antimicrobial agent is an antibacterial agent (an antibiotic).
- Non-limiting examples of antibacterial agents which are suitable for use in the context of these embodiments of the present invention include, without limitations, amikacin, amoxicillin, ampicillin, azithromycin, Aztreonam, cefepime, cefonicid, cefotetan, ceftazidine, cephalosporin, cephamycin, Chloramphenicol, chlortetracycline, ciprofloxacin, clarithromycin, clindamycin, colistin, cycloserine, dalfopristin, doxycycline, ephalothin, erythromycin, gentamycin, kanamycin, levofloxacin, lincosamide, linezolid, meropenem, moxifloxacin, mupirocin, neomycin, oxytetracycline, piperacillin, penicillin, quinupristin, rifampicin, spectinomycin, streptomycin,
- the additional antimicrobial agent used together with Compound K is other than a beta-lactam antibiotic agent, or a non beta-lactam antimicrobial agent.
- Beta-lactam antimicrobial/antibiotic agents are those agents having a "azetidin-
- 2-one motif, and include, without limitation, amoxicillin, ampicillin, azlocillin, aztreonam (Azactam), benzathine penicillin, benzylpenicillin (penicillin G), carbenicillin, cefaclor, cefamandole, cefazolin, cefepime, cefixime, cefotaxime, cefotetan, cefoxitin, cefpirome, cefpodoxime (ATDOX-200), ceftazidime, ceftriaxone, cefuroxime, cephalexin, cephalothin, clavulanic acid, cloxacillin, dicloxacillin, doripenem, ertapenem, faropenem, flucloxacillin, imipenem , meropenem, methicillin, mezlocillin, nafcillin, nocardicin A, oxacillin, penicillin, phenoxymethylpenicillin (penicillin V),
- non beta-lactam antimicrobial agent refers to a bacteriostatic or a bactericidic (antibiotic) agent which is not of the beta-lactam class of antibiotics or one not having a "azetidin-2-one" motif.
- exemplary non beta-lactam antibacterial agent include, without limitation, mafenide, cephalothin, vancomycin, cefazolin, imipenemen, clyndamycin, synercid, erythromycin, tetracycline, ciprofloxacin, tigecycline and ertapenem, and aminoglycosides such as gentamicin and tobramycin.
- Compound K (BL 6030) is utilized in combination with an antibacterial agent such as clinical non beta-lactam antibiotics.
- the antibiotic can be selected as effective for the condition being treated.
- the antibiotic is Gentamicin.
- the antibiotic is Tobramycin.
- a medical device as described herein, having Compound K incorporated thereon or thereon.
- an article, an article-of-manufacturing, or a product which comprises a substrate (e.g., an inanimate substrate as described herein) and Compound K incorporated therein or thereon.
- a substrate e.g., an inanimate substrate as described herein
- Compound K incorporated therein or thereon.
- substrate as used herein, is as described hereinabove, and further refers to any surface, structure, product or material which can support, harbor or promote the growth of a microorganism.
- Non-limiting examples include the inner walls of a storage container that is routinely treated with anti-microbial preferably anti-fungal agents, a soil and/or soil enrichment supplements, any agricultural product or crop such as wood, fiber, fruit, vegetable, flower, extract, horticultural crop and any other processed or unprocessed agricultural product or crop which are produced from organic origins such living plants or animals, a cosmetic product, a building, warehouse, compartment, container or transport vehicle, a dye or a paint and any other materials and industrial compounds used for which require protection of their surfaces against microbes, moulds and fungi attacks, such as, for example, construction materials.
- Such products include, for example, food products, agricultural products, cosmetic products and many more. Due to its effect in reducing the load of microorganisms, either by inhibiting growth of the microorganism or by preventing, distrupting and/or reducing biofilm formation, Compound K as described herein can be utilized as a preservative in such products.
- the substrate is a medical device or any other device which is intended for contacting a living tissue, as defined herein.
- a wound dressing having Compound K as described herein, either alone or in combination with an additional active agent (e.g., an antimicrobial agent, as described herein) incorporated therein or thereon.
- an additional active agent e.g., an antimicrobial agent, as described herein
- a method of reducing a load of a pathogenic microorganism in a substrate the method being effected by applying to the substrate an antimicrobial effective amount of Compound K as described herein, optionally in combination with an additional antimicrobial agent, as described herein.
- reducing the load refers to a decrease in the number of the microorganism(s), or to a decrease in the rate of their growth or both in the substrate as compared to a non-treated substrate.
- Phenyloxaboronidines are synthesized by reacting a respective phenylboronic acid with an equimolar amount of N-methyldiethanolamine in an organic solvent (e.g., toluene), optionally in the presence of a dehydrating agent (e.g., molecular sieves).
- an organic solvent e.g., toluene
- a dehydrating agent e.g., molecular sieves
- Compound K is also referred to as BL-6030 or EDP-5.
- Azeotropic distillation of the obtained oil was performed with two portions of 25 ml of toluene in order to remove water from the reaction until viscous oil was obtained.
- the product was dried under high vacuum for 24 hours, followed by drying under diaphragm vacuum pump for the weekend to afford colorless viscous oil.
- the obtained viscous oil was solidified to a white solid upon standing on the bench at 20 °C for several days. This solid was filtered under vacuum and washed with petroleum ether several times. The solid was dried on a sintered funnel, then transferred to a vial and dried for 24 hours in a desiccator connected to a diaphragm pump, so as to afford Compound K as a white solid powder (14.9 grams, 94 % yield).
- QSI quorum sensing inhibitors
- the bioFILM PATM developed by InnovotechTM Inc., Canada, is a broth dilution antimicrobial susceptibility panel test was designed for use in determining antimicrobial agent susceptibility of both planktonic and biofilm Pseudomonas aeruginosa. This test has a panel of various antimicrobial agents which are diluted in recovery buffer at categorical breakpoint concentrations defined by Clinical and Laboratory Standard InstituteTM (CLSI).
- CLSI Clinical and Laboratory Standard Institute
- Panel wells were inoculated with planktonic and biofilm Pseudomonas aeruginosa using a 95 peg inoculation lid. Panels and pegged lids were then incubated at 35 °C for a minimum of 16 hours. Planktonic susceptibility and resistance was determined by measuring inhibition and growth in the presence of antimicrobial agents after 16-24 hours incubation at 35 °C. The pegged lid containing the biofilm bacteria that have been exposed to the antimicrobial agents was placed in a recovery media. Biofilm susceptibility and resistance was determined by measuring inhibition and growth after incubation for additional 16-24 hours at 35 °C.
- the Gram-positive test panel was designed for use in determining antimicrobial agent susceptibility of both planktonic and bio films of Gram-positive organisms.
- This broth dilution antimicrobial susceptibility test had various antimicrobial agents which are diluted in recovery buffer at categorical breakpoint concentrations defined by Clinical and Laboratory Standard InstituteTM (CLSI).
- Panel wells were inoculated with planktonic and biofilm of clinically significant Gram-positive organisms of choice using a 96 peg inoculation lid. Panels and pegged lids were then incubated at 35 °C for a minimum of 16 hours. Planktonic susceptibility and resistance was determined by measuring inhibition and growth in the presence of antimicrobial agents after 16-24 hours incubation at 35 °C. The pegged lid containing the biofilm bacteria that have been exposed to the antimicrobial agents was placed in a recovery media. Biofilm susceptibility and resistance was determined by measuring inhibition and growth after incubation for additional 16-24 hours at 35 °C.
- Stock solutions were prepared by either weighing each test compound or by weighing the vial containing the test compound; dissolving the entire amount of the compound in a known volume of 100 % DMSO and weighting the empty vial to get the amount dissolved in the DMSO.
- the working concentrations of the compounds were made to be higher than the test concentration because the compounds were diluted when the inoculum was added.
- the compounds for the Gram-negative panels (A) were setup as follows:
- Compound A 0.1524 gram was dissolved in 24.764 ml of cation-adjusted Mueller-Hinton broth (CAMHB) with 2 % DMSO
- Compound B 0.1517 gram was dissolved in 24.651 ml of cation-adjusted Mueller-Hinton broth (CAMHB) with 2 % DMSO.
- Compound K was pre-dissolved in 100 % DMSO making a 3 ml solution of 0.3181 mg/ ⁇ of Compound K in DMSO. To make 25 ml of the working solution 0.484 ⁇ of the Compound K solution was added to 24.516 ml CAMHB.
- Compound B was pre-dissolved in 100 % DMSO making a 5.5 ml solution of 0.1022 mg/ ⁇ of Compound B in DMSO. To make 25 ml of the working solution 1.505 ⁇ of the Compound B solution was added to 23.495 ml CAMHB.
- Compound K was pre-dissolved in 100 % DMSO making a 3 ml solution of 0.3181 mg/ ⁇ of Compound K in DMSO. To make 25 ml of the working solution 484 ⁇ of the Compound K solution was added to 24.516 ml CAMHB.
- Compound A 0.1195 gram was dissolved in 25.021 ml of CAMHB with 2 % DMSO.
- Compound K was pre-dissolved in 100 % DMSO making a 3 ml solution of 0.3181 mg/ ⁇ of Compound K in DMSO. To make 25 ml of the working solution 375 ⁇ of the Compound K solution was added to 24.625 ml CAMHB.
- Compound A 0.1108 gram was dissolved in 23.199 ml of CAMHB with 2 % DMSO.
- Compound B was pre-dissolved in 100 % DMSO making a 5.5 ml solution of 0.1022 mg/ ⁇ of compound B in DMSO. To make 25 ml of the working solution 1.168 ⁇ of the Compound B solution was added to 23.832 ml CAMHB. Compound K was pre-dissolved in 100 % DMSO making a 3 ml solution of 0.3181 mg/ ⁇ of Compound K in DMSO. To make 25 ml of the working solution 375 ⁇ of the Compound K solution was added to 24.625 ml CAMHB.
- Each working solution of compound was used to make the 4 dilutions by serially diluting in 10 fold steps. From the working solution 2.5 ml was taken and mixed with 22.5 ml CAMHB, 2.5 ml was then removed from the second tube and mixed with 22.5 ml in the third tube. This was repeated until the fourth dilution, giving the five 10-fold dilutions. These dilutions end up being 4, 0.4, 0.04, 0.004 and 0.0004 gram/L after the antibiotics and organism are added.
- antibiotics were tested either alone or in combination with the tested compounds, as described hereinabove: Gentamicin (GM), Amikacin (AK), Ceftazidime (CAZ), Cefepime (CPE), trimethoprim/sulfamethoxazole (T/S), piperacillin/tazobactam (P/T), Aztreonam (AZT), Meropenem (MER), Tobramycin (TO), Ciprofloxacin (CP), Colistin (CT) and Chloramphenicol (ChA).
- Samples containing an antibiotic and a tested compound were prepared by mixing a sample of the tested compound with the antibiotic so as to afford the indicated concentration.
- Staphylococcus epidermidis Two exemplary microorganisms were tested: Staphylococcus epidermidis
- the first sub-cultures of the bacterial organisms listed above were streaked out on TSA.
- the organisms were incubated at 35 °C for 24 hours. Following growth the plate(s) were wrapped in parafilm at 4 °C.
- a second sub-culture was streaked out on TSA and incubated at 35 °C for 24 hours. The second sub-cultures were used within 24 hours starting from the time it was first removed from incubation.
- an inoculum in 3 ml sterile water that matches a 0.5 McFarland Standard (1.5 x 108 cells per ml) in a glass test tube using a sterile cotton swab was created.
- This solution was diluted 250 x 100 ml CAMHB.
- the diluted organism was gently stirred by swirling the flask to achieve uniform mixing of the organism.
- One sample (100 ⁇ ) of the diluted organism was used for an inoculum check by serially diluting and spot plating on Tyrptic Soy Agar (TSA).
- TSA Tyrptic Soy Agar
- Gram-negative panels 20 ⁇ of sterile CAMHB was added to well HI 2.
- Gram-positive panels 20 ⁇ of sterile CAMHB was added to well Al .
- the lid of the 95 peg MBEC device (Gram-Ve) or 96 peg MBEC device (G+Ve) was placed on the bottom plate containing organism, test compound and antibiotics.
- the device was placed on an orbital in a humidified incubator at 35 0 C for 24 hours set at 110 rpm. Following incubation the peg lid was rinsed by dipping it in a 96 well microtitre plate where each well contained 200 ⁇ of sterile saline for 1 minute. The peg lid was inserted into a recovery plate where each well contained 200 ⁇ of CAMHB. The device was incubated at 35 °C for 24 hours.
- the challenge plate was incubated at 35 °C for 24 hours and read visually to determine MIC values (minimum inhibitory concentration) for each of the tested compounds for each organism shed from the biofilm during the challenge incubation.
- MIC is defined as the minimum concentration of a compound that inhibits growth of the organism.
- the recovery plate was incubated at 35 °C for 24 hours and read visually to determine MBEC values.
- a microtiter plate reader was used to obtain optical density measurements at 630 nm (OD630). Clear wells (OD630 ⁇ 0.1) were evidence of biofilm eradication.
- the MBEC is defined as the minimum concentration of a compound that inhibits growth of the biofilm.
- MIC results were determined following the 24 hour incubation from the bioFILM PA and Gram+VE panels using the plate reader. To determine the minimum inhibitory concentration (MIC) values, turbidity (visually) in the wells of the challenge plate were looked for. Alternatively, a microtiter plate reader was used to obtain optical density measurements at 630 nm (OD 6 3o).
- the MIC is defined as the minimum concentration of the tested antibacterial agent that inhibits growth of the organism. Clear wells (OD 63 o ⁇ 0.1) were evidence of inhibition following a suitable period of incubation.
- MBC value represents the lowest concentration which kills 99.9 % of the microorganism population. Results were determined following the 24 hour incubation from the Test panels using the plate reader. To determine the minimum bactericidal concentration (MBC) values, turbidity (visually) in the wells of the challenge plate was looked for. Alternatively, a microtiter plate reader was used to obtain optical density measurements at 630 nm (OD 630 ).
- MBEC results were determined following the 24 hour incubation from the MBEC recovery panels using the plate reader to determine the minimum biofilm eradication concentration (MBEC) values. Turbidity (visually) in the wells of the recovery plate was looked for. Alternatively, a microtiter plate reader was used to obtain optical density measurements at 630 nm (OD 63 o). Clear wells (OD 63 o ⁇ 0.1) were evidence of biofilm eradication.
- the MBEC is defined as the minimum concentration of the antibacterial agent that inhibits growth of the biofilm.
- fractional inhibitory concentration (FIC) index is most frequently used to define or to describe drug interactions, it has some limitations when used for drugs against filamentous fungi (molds) and other biofilm- forming microbial life forms. These limitations include observer's bias in the determination of the MIC and lack of agreement on the endpoints (MIC-0, MIC-1 and MIC-2 or >95 %, >75 % and >50 % growth inhibition, respectively) when studying drug combinations. Furthermore, statistical analysis and comparisons are oftentimes difficult to make and standardize.
- FIC fractional inhibitory concentrations
- the MIC was determined for each test compound at each antibiotic concentration (i.e., at a particular antibiotic concentration, used as MICx c , the corresponding concentration of test compound which was the minimum compound concentration to result in bacterial growth inhibition at that antibiotic concentration was determined, and used as MICx c ).
- the FIC index was calculated using the MICs determined in both (c) and (d). MICs less than or equal to the value selected in (c) or (d) indicate that the MIC value selected was the lowest concentration tested. MICs greater than the value selected in (c) or (d) indicate that there was growth at the highest concentration tested.
- the combination is additive (designated AD in Tables 1 and 2 below); If 1.0 ⁇ FIC ⁇ 4.0, the combination is indifferent (designated IN in Tables 1 and 2 below);
- the lowest FIC index calculated for each compound-antibiotic combination was selected as the final FIC value to be tabulated.
- Table 1 below presents the Minimum Inhibitory Concentration (MIC) of antibacterial agents (tested compounds and clinical antibiotics) obtained for Pseudomonas aeruginosa ATCC 27853.
- Table 2 presents the Antibacterial-agent combinations (test compounds combined with clinical antibiotics) at minimal concentrations for inhibiting Pseudomonas aeruginosa ATCC 27853 (sorted by FIC) Table 2
- Table 4 presents the Antibacterial-agent combinations (test compounds combined with clinical antibiotics) at minimal concentrations for inhibiting Staphylococcus epidermidis ATCC 35984 (sorted by FIC) Table 4
- the bacterial strains were methicillin resistant Staphylococcus aureus (MRSA: USA300) and Pseudomonas aeruginosa (PA: ATCC27312).
- the freeze-dried bacteria culture was recovered per ATCC standard recovering protocol. All challenge inoculum suspensions were prepared by swabbing a 3-cm diameter area of the growth from a culture plate into 4.5 ml of sterile water, providing a suspension consisting of approximately 10 10 colony forming units/ml (CFU/ml). Two (2) ml of this suspension were diluted into 150 ml of sterile tryptic soy broth (TSB), making the inoculum suspension approximately 10 6 CFU/ml. The concentration was confirmed using historical optical density measurements.
- TTB sterile tryptic soy broth
- serial dilutions of the suspension were plated onto specific media for this microorganism using the Spiral Plater System that deposits a small amount (50 ⁇ ) of suspension over the surface of a rotating culture media agar plate to quantitate the exact concentration of viable organisms prior to the experiment.
- MIC Minimum Inhibitory Concentration
- the tube dilution test is the standard method for determining levels of resistance to a compound (antibiotic). Dilutions of the antibiotic were made in a liquid inoculum with a known number of organisms after overnight incubation. The lowest concentration (highest dilution) of antibiotic preventing appearance of turbidity was considered to be the minimum inhibitory concentration (MIC). At this dilution the antibiotic is bacteriostatic.
- test tubes Fourteen (14) sterile, capped test tubes were labeled 1 through 14. All steps were carried out using aseptic technique.
- test tubes All of the test tubes were incubated for 24 hours at 37 °C. After the incubation period, the tubes were examined for visible signs of bacterial growth, seen as turbidity in the suspension and were mixed by pipetting, and 200 ⁇ were deposited into 3 wells on a 96 wells plate. The optical density (OD) of the solution was measured in a spectrophotometer (BioRad Laboratories Inc.). As compared to the control diluted culture suspension, the without growth (no turbidity) was determined to be the minimum inhibitory concentration (MIC) for each strain of bacteria.
- MIC minimum inhibitory concentration
- MCC Minimum Bactericidal Concentration
- the contents of the tubes were also subcultured onto antibiotic free medium (TSA) to examine bacterial growth (MBC).
- TSA antibiotic free medium
- MSC bacterial growth
- a total of six plates for each concentration were evaluated.
- the inoculum was evenly spread on the total surface of the culture media plate in order to grow a continuous lawn of bacteria.
- one punch (10 mm) was made in the central area of the plates (agar was removed) and approximately 200 ⁇ of the testing compounds were placed in the well of the Tryptic Soy agar with 5 % sheep's blood culture media plates. The initial diameter of each test compound and the diameter to which it spreads were noted. All the media plates were incubated for 24 hours at 37 °C. After the incubation period, the zones of bacteria growth inhibition were measured using planimetry method.
- Figure 1 presents a bar graph presenting the results of the optical density measurements and bacterial count of methicillin resistant Staphylococcus aureus USA300 strain with different concentrations of Compound K (denoted as EDP-5).
- Figure 2 is a bar graph presenting the results of the optical density measurements and bacterial count of Pseudomonas aeruginosa ATCC27312 strain (PA) with different concentrations of Compound K.
- Figure 3 is bar graph presenting methicillin resistant Staphylococcus aureus US A300 strain inhibition zones by various concentrations of Compound K measured in cm 2 using planimetry method.
- FIG. 3 is a bar graph presenting the Pseudomonas aeruginosa ATCC27312 bacteria growth inhibition zones by various concentrations of Compound K, measured in cm 2 using planimetry method.
- Inhibition zone assay showed that 10 mg/ml Compound K had the largest zone of bacteria growth inhibition of methicillin resistant Staphylococcus aureus US A300 and Pseudomonas aeruginosa ATCC27312 (5.33 and 21.08 cm 2 , respectively) compared to any treatment. This concentration resulted in better inhibition zone than silver sulfadiazine when was tested against P. aeruginosa.
- Staphylococcus aureus MRSA; strain USA 400
- Staphylococcus epidermidis Strain ATCC 35984
- Pseudomonas aeruginosa strain ATCC 27853
- MIC values for each antibacterial agent (antibiotic), the tested compound and combination thereof were determined according to the procedure described by Ceri et al. (Methods Enzymol 337:377-85, 2001) using SENSITITRE ® Gram Positive and Gram Negative MIC Plates (TREC Diagnostics Systems, Cleveland, OH) and Bio filmTM test panels (Inovotech Inc., Edmonton, AB Canada).
- Table 5 below presents the Minimum Inhibitory Concentration (MIC) of Compound K and the known non-beta lactam antibacterial agents (clinical antibiotics) provided to bacterial strains Staphylococcus aureus strain USA 400 (MRSA), Staphilococcus epidermitis ATCC 35984 (S. epidermitis) and Psuedomonas aeruginosa ATCC 27853 (P. aeruginosa)
- Table 6 shows the effect of Compound K combined with clinical non beta-lactam antibiotics on the clinical bacterial strains tested (sorted by FIC). As shown therein, the combination of Compound K with Gentamycin, Ciprofloxacin, Tetracycline, Tobramycin or Vancomycin resulted in synergic inhibition of bacterial growth.
- FIC [(lowest MIC of compound K in combination) / (lowest MIC of compound K as single agent)] + [(lowest MIC of antibiotic in combination) / [(lowest MIC of antibiotic as single agent)].
- the bacterial strains were methicillin resistant Staphylococcus aureus (MRSA: USA300) and Pseudomonas aeruginosa (PA: ATCC27312).
- the freeze-dried bacteria culture was recovered per ATCC standard recovering protocol. All challenge inoculum suspensions were prepared by swabbing a 3-cm diameter area of the growth from a culture plate into 4.5 ml of sterile water, providing a suspension consisting of approximately 10 10 colony forming units/ml (CFU/ml). Two (2) ml of this suspension were diluted into 150 ml of sterile tryptic soy broth (TSB), making the inoculum suspension approximately 10 6 CFU/ml. The concentration was confirmed using historical optical density measurements.
- TTB sterile tryptic soy broth
- serial dilutions of the suspension were plated onto specific media for this microorganism using the Spiral Plater System that deposits a small amount (50 ⁇ ) of suspension over the surface of a rotating culture media agar plate to quantitate the exact concentration of viable organisms prior to the experiment.
- MIC Minimum Inhibitory Concentration
- the tube dilution test is the standard method for determining levels of resistance to a compound (antibiotic). Dilutions of the antibiotic were made in a liquid inoculum with a known number of organisms after overnight incubation. The lowest concentration (highest dilution) of antibiotic preventing appearance of turbidity was considered to be the minimum inhibitory concentration (MIC). At this dilution the antibiotic is bacteriostatic.
- test tubes Fourteen (14) sterile, capped test tubes were labeled 1 through 14. All steps were carried out using aseptic technique.
- test tubes All of the test tubes were incubated for 24 hours at 37 °C. After the incubation period, the tubes were examined for visible signs of bacterial growth, seen as turbidity in the suspension and were mixed by pipetting, and 200 ⁇ were deposited into 3 wells on a 96 wells plate. The optical density (OD) of the solution was measured in a spectrophotometer (BioRad Laboratories Inc.). As compared to the control diluted culture suspension, the without growth (no turbidity) was determined to be the minimum inhibitory concentration (MIC) for each strain of bacteria.
- MIC minimum inhibitory concentration
- Methicillin Resistant Staphylococcus aureus treated with Gentamicin showed the more lower OD with 4 ⁇ g/ml (0.025 OD) followed by 2 ⁇ g/ml (0.176 OD). Concentrations tested from 1.0 - 0.0625 ⁇ g/ml resulted in a higher OD measurement (between 0.387 - 0.440). Negative control and vehicle showed the largest OD measurement compared with all different concentrations tested for gentamicin. Data not shown.
- Compound K (EDP-5) described hereinabove was tested on meticillin resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa in vivo.
- Swine were used as experimental research animal since their skin is morphologically and biochemically similar to human skin.
- Two animals were studied: one (1) animal with S. aureus and another animal with P. aeruginosa.
- the young female specific pathogen free (SPF: Looper Farms, North Carolina) pigs weighing 35-40 kg were kept in-house for at least one week prior to initiating the experiment.
- the animals were fed a basal diet ad libitum and housed in animal facilities (American Association for Accreditation of Laboratory Animal accredited) with controlled temperature (19-21 °C) and lights (12 hour/12 hour LD).
- MRSA Methicillin Resistant Staphylococcus aureus
- PA Pseudomonas aeruginosa
- the wounds were inoculated with the appropriate bacterial strain as described in hereinbelow.
- the wounds were divided into six groups of nine wounds each. Six wounds were treated on day 0 within 20 minutes of inoculation to determine the biofilm inhibition.
- Treatments A, B, C and D were effected by adding 1.5 ml of the tested formulation to completely saturate a sterile gauze pad 2 x 2 inch in size and 4 ply thick (CurityTM Tyco Healthcare Group, Mansfield, MA). Gauze saturation with the formulation helped maintaining the formulation in direct contact with the wounds. Each saturated gauze pad was put on each wound, and covered with a polyurethane film dressing.
- Wounds that were treated with positive controls received about 150 - 200 ⁇ of material which was sufficient to completely cover the wound area and surrounding skin.
- Positive controls were spread out gently with a sterile Teflon spatula and covered with a sterile gauze pad and redressed with a polyurethane film dressing.
- the remaining three wounds were left untreated and remained in place for 24 hours to allow formation of a bacterial bio film in the wounds. All dressings were covered and secured by wrapping the animal with self-adherent elastic bandages (Coban; 3M, St. Paul, MN). After 24 hours (day 1), the dressings were removed. Three of the wounds were recovered as described hereinbelow. Three wounds were treated again (see above design "Biofilm inhibition”) and the remaining three wounds were treated to determine the "Biofilm elimination”.
- the challenge inoculum suspension was prepared by scraping the overnight growth from a culture plate into 5 ml of normal saline, so as to provide a suspension concentration of approximately 10 10 colony forming units/ml (CFU/ml) for each bacterial strain. Serial dilutions were made until a concentration of 10 6 CFU/ml was achieved.
- the inoculum was vortexed and 25 ml of the suspension were inoculated into each wound.
- serial dilutions of the suspension were plated onto culture media to quantify the exact concentration of viable organisms used for this experiment.
- the gauze materials from all three wounds were placed in a sterile 50 ml polyurethane tube. Five (5) ml of all purpose neutralizer solution was added, vortexed and serially diluted for quantitation using spiral plater method described above. After removal of gauze, three wounds for each treatment group were recovered on day 1 after first treatment application (within 20 minutes after inoculation). The remaining six wounds for each treatment group were recovered on day 2 after second treatment application and after 24 hours biofilm formation and first treatment application.
- a sterile surgical steel cylinder 22 mm inside diameter was placed around the wound area.
- One (1) ml of all purpose neutralizer solution was drawn into the cylinder and the site was scrubbed with a sterile Teflon spatula for 30 seconds.
- Serial dilutions were made from all culture samples and the extent of microbiological contamination assessed using the Spiral Plater System as described hereinabove.
- Oxicillin Resistance Screening Agar ORSAB
- a selective media for Pseudomonas aeruginosa Pseudomonas Agar with CN supplement
- All plates were incubated aerobically overnight (16-24 hours) at 37 °C, after which the number of viable colonies were counted.
- Figures 5A-D present photographs of wounds during, before and after treatments, as well as throughout the assessment days, wherein gauze in all treatment groups were in place and moist on day 1 showing a slight adherence to the wound bed (Figure 5A), while re-injury was not observed (Figure 5B), and wherein wound fluid was observed from all treatment groups after 24 hours bio film formation in wounds assigned to biofilm elimination assessment (Figure 5C and Figure 5D).
- Figures 6A-B present photographs of wounds infected with methicillin resistant Staphylococcus aureus and treated within 20 minutes after inoculation with vehicle ( Figure 6 A) and untreated wounds ( Figure 6B).
- FIG. 7 is a bar graph showing methicillin resistant Staphylococcus aureus US A300 bio film inhibition after treatment application.
- Figure 8 is a bar graph presenting data obtained for inhibition of biofilm of methicillin resistant S. aureus US A300 after treatment application.
- wounds treated with mupirocin had S. aureus log CFU/ml counts at day 1 and 2 recovery times of 5.12 ⁇ 0.79 and 4.42 ⁇ 0.18, respectively.
- Compound K reduced S. aureus counts (0.65 log CFU/ml) compared with day 1 after first treatment. Similar bacterial reduction was found with mupirocin (positive control) when this treatment was applied for 2 days (0.71 log CFU/ml).
- Treatment with either 40 mg/ml or 5 mg/ml Compound K and vehicle increased MRSA count as compared to same treatments on day 1.
- Figures 9A-B are bar graphs presenting the data obtained for biofilm inhibition of methicillin resistant Staphylococcus aureus US A300 strain, compared with bacterial count in gauze, after 1 treatment application ( Figure 9A), and biofilm inhibition of S. aureus USA300, compared with bacterial count in gauze, after 2 treatment applications ( Figure 9B).
- Figure 10 is a bar graph presenting the data obtained for elimination of methicillin resistant Staphylococcus aureus US A300 biofilm after 24 hours of biofilm formation, followed by treatment application.
- wounds treated with 100 mg/ml Compound K and mupirocin after 24 hours of biofilm formation showed the largest reduction of wound-associated bacteria compared to untreated wounds.
- the results indicate that wounds treated with 100 mg/ml Compound K had (1.46 ⁇ 0.22 log CFU/ml) reduction of S. aureus compared to untreated wounds. These values corresponded to a 96.56 % reduction of S. aureus associated bacteria count.
- Figure 11 is a bar graph presenting the data obtained for elimination of biofilm of methicillin resistant Staphylococcus aureus USA300, compared with bacterial count in gauze, after 24 hours of biofilm formation followed by treatment application.
- Figure 12 is a bar graph presenting the data obtained for inhibition of Pseudomonas aeruginosa ATCC 27312 bio film formation after treatment application.
- aeruginosa on day 1 when compared to wounds untreated.
- Bacterial counts observed in wounds treated Compound K followed a dose-response mode going from 40 mg/ml Compound K, to 10 mg/ml Compound K (5.88 ⁇ 0.14 log CFU/ml), to 4 mg/ml Compound K (7.29 ⁇ 0.49 log CFU/ml), and vehicle (7.76 ⁇ 0.11 log CFU/ml).
- Untreated wounds had the highest bacterial count (8.49 ⁇ 0.35 log CFU/ml).
- wounds treated with silver sulfadiazine (positive control) exhibited the lowest bacterial count at day 1 and 2 recovery times (4.33 ⁇ 0.54 and 5.20 ⁇ 0.62 log CFU/ml, respectively). Similar P. aeruginosa count reduction with silver sulfadiazine was observed on both day 1 and day 2 (4.16 ⁇ 0.19 and 4.44 ⁇ 0.58 log CFU/ml, respectively). These values represent a 99.99 % reduction P. aeruginosa on day 1 and 2 when compared to untreated wounds.
- Figure 13 is a bar graph presenting the data obtained for inhibition of
- Figures 14A-B are bar graphs presenting the data obtained for Pseudomonas aeruginosa ATCC 27312 bio film inhibition, compared with bacterial count in gauze, after 1 treatment application ( Figure 14 A), and bio film inhibition of Pseudomonas aeruginosa ATCC 27312, compared with bacterial count in gauze, after 2 treatment applications ( Figure 14B).
- Figure 15 is a bar graph presenting the data obtained for elimination of Pseudomonas aeruginosa ATCC 27312 biofilm after 24 hours of biofilm formation and treatment application.
- wounds colonized with P. aeruginosa after 24 hours of biofilm formation treated once with Compound K at different concentrations and recovered after 24 hours, showed a reduction in P. aeruginosa counts compared with untreated wounds.
- Treatment with 40 mg/ml Compound K resulted in the lowest P. aeruginosa count (5.28 ⁇ 0.94 log CFU/ml) compared with untreated wounds (9.10 ⁇ 0.06 log CFU/ml).
- Vehicle and untreated wounds had similar P. aeruginosa counts (8.89 ⁇ 0.32 and 9.10 ⁇ 0.06 log CFU/ml, respectively).
- Figure 16 is a bar graph presenting the data obtained for elimination of Pseudomonas aeruginosa ATCC 27312 biofilm, compared with bacterial count in gauze, after 24 hours of biofilm formation and treatment application.
- Bacterial reduction was by 1.84 ⁇ 0.09 log CFU/ml compared with untreated wounds.
- Wounds assessed on day 2 resulted in a biofilm elimination count of S. aureus with 100 mg/ml Compound K of 6.46 ⁇ 0.16 log CFU/ml with a reduction of 1.60 ⁇ 0.04 log CFU/ml compared with untreated wounds. This value represents a 97.47 % reduction of S. aureus on day 2 when compared to wounds untreated.
- Compound K reduced bacterial count of MRSA USA300 (0.65 log CFU/ml) compared with day 1 after first treatment. Similar bacterial reduction were found with mupirocin (positive control) when this treatment was applied per 2 days (0.71 log CFU/ml).
- Treatment with 40 mg/ml Compound K showed a lowest bacterial count (4.73 ⁇ 0.51 log CFU/ml) of P. aeruginosa in wounds compared with untreated wounds. Percentage of reduction with this concentration was 99.98 %. P. aeruginosa counts after second treatment application with the same 40 mg/ml concentration of Compound K was lowest (5.60 ⁇ 0.40 log CFU/ml) compared with 1 treatment application.
- P. aeruginosa biofilm elimination in wounds treated with 40 mg/ml Compound K after 24 hours of biofilm formation was 5.28 ⁇ 0.94 log CFU/ml.
- 40 mg/ml Compound K showed a considerable reduction in P. aeruginosa counts compared with the results obtained in the untreated wounds and wounds treated with silver sulfadiazine (3.82 ⁇ 0.88 and 2.52 ⁇ 0.75 log CFU/ml, respectively). These values corresponded to a 99.98 % and 99.70 % reduction of P. aeruginosa after a 24 hours treatment application when compared to untreated wounds or wounds treated with silver sulfadiazine, respectively.
- Compound K also referred to as BL 6030
- MRSA meticillin resistant Staphylococcus aureus
- Pseudomonas aeruginosa in vivo in swine, similarly to the procedure described in Example 6 hereinabove.
- mice Five animals were studied: two (2) animals were inoculated with meticillin resistant Staphylococcus aureus (MRSA; S. aureus) and three (3) animals with P. aeruginosa.
- MRSA meticillin resistant Staphylococcus aureus
- SPPF Looper Farms, North Carolina
- the animals were fed a basal diet ad libitum and housed in animal facilities (American Association for Accreditation of Laboratory Animal accredited) with controlled temperature (19-21 °C) and lights (12 hour/12 hour LD).
- Wounds were divided into ten (10) groups to animal treated with the tested compound alone or combined with antibiotic, respectively. Immediately after wounding, the wounds were inoculated with the appropriate bacterial strain as described hereinbelow. Wounds were then inoculated and treated as described hereinbelow.
- the challenge inoculum suspension was prepared by scraping the overnight growth from a culture plate into 5 ml of normal saline, so as to provide a suspension concentration of approximately 10 10 colony forming units/ml (CFU/ml) for each bacteria. Serial dilutions were made until a concentration of 10 6 CFU/ml was achieved.
- the inoculum was vortexed and 25 ml of the suspension were inoculated into each wound.
- serial dilutions of the suspension were plated onto culture media to quantify the exact concentration of viable organisms used for this experiment.
- Treatment was applied within 30 minutes after inoculation for 30 wounds, for assessment of Biofilm inhibition, and the remaining 30 wounds were inoculated and were covered with polyurethane film for 24 hours so as to allow biofilm formation. Thereafter, treatment was applied and Biofilm elimination was assessed 24 hours following treatment.
- Treatment was applied within 30 minutes after inoculation for 30 wounds, for assessment of Biofilm inhibition. The remaining 30 wounds were inoculated and were covered with polyurethane film for 24 hours so as to allow biofilm formation. Treatment was thereafter applied and after 24 hours Biofilm elimination was assessed.
- wounds were inoculated with the appropriate bacterial strain as described in hereinbelow.
- the wounds were divided into 10 groups of six wounds each.
- Treatments were applied by adding 1.5 ml up to complete saturation of sterile 2"x2" gauze sponge 4ply (CurityTM Tyco Healthcare Group, Mansfield, MA). Gauze saturation with the treatment helped maintaining the treatment in direct contact with the wounds. Each of saturated gauzes was put on each wound, and was covered with a polyurethane film dressing.
- Wounds that were treated with positive controls received about 150 - 200 mg preparation, so as to completely cover the wounded area and surrounding normal skin.
- Positive controls were spread out gently with a sterile Teflon spatula and covered with a sterile 2"x2" gauze sponge 4ply (CurityTM Tyco Healthcare Group, Mansfield, MA) and redressed with a polyurethane film dressing.
- the gauze materials from all three wounds were placed in a sterile 50 ml polyurethane tube. Five (5) ml of all purpose neutralizer solution was added, vortexed and serially diluted for quantitation using spiral plater method described above. After removal of gauze, three wounds for each treatment group were recovered on day 1 after first treatment application (within 30 minutes after inoculation). The remaining three wounds for each treatment group were recovered on day 2 after second treatment application (see, Design 1) or after 24 hours biofilm formation and 24 hours treatment application (see, Designs 2, 3, 4 and 5).
- a sterile surgical steel cylinder (22 mm inside diameter) was placed around the wound area.
- One (1) ml of all purpose neutralizer solution was drawn into the cylinder and the site was scrubbed with a sterile Teflon spatula for 30 seconds.
- Oxicillin Resistance Screening Agar was used to isolate MRSA USA 300 from the wounds and a selective media for Pseudomonas aeruginosa (Pseudomonas Agar with CN supplement) was used to quantify Pseudomonas aeruginosa present in the suspension. All plates were incubated aerobically overnight (16-24 hours) at 37 °C, after which the number of viable colonies were counted.
- Positive control silver sulfadiazine showed a 6.11 Log CFU/ml of PA27312 in wounds after 24 hours of biofilm inhibition.
- Tobramycin 100 and 50 ⁇ g/ml resulted in 4.40 ⁇ 0.68 and 4.90 ⁇ 0.19 Log CFU/ml of PA27312 in wounds, respectively.
- Untreated wounds had the higher Log CFU/ml (8.22 ⁇ 0.43).
- wounds treated with Silver sulfadiazine had similar bacterial inhibition counts at day 1 and 2 recovery times (6.11 ⁇ 0.12 and 6.01 ⁇ 0.55 Log CFU/ml, respectively).
- Tobramycin at 100 and 50 ⁇ g/ml resulted in 5.16 ⁇ 0.49 and 5.79 ⁇ 0.17 Log CFU/ml of PA27312, respectively.
- BL 6030 in 30 % PEG at a concentration of 20 mg/ml resulted in similar PA27312 bacteria counts after 2 treatment applications for biofilm inhibition.
- bacterial count was increased after the second treatment application in at least 0.23 Log CFU/ml compared with day 1 after first treatment. Similar bacterial count increase was observed in wounds treated with Tobramycin at 100 and 50 ⁇ g/ml when treatment was applied for 2 days (0.75 and 0.89 Log CFU/ml).
- Figures 18 A and 18B present the bacterial counts in the treated wounds and in the gauzes after 24 hours (Day 1) from the first treatment (lRx) ( Figure 18 A) and after 24 hours (Day 2) from the second treatment (2Rx) ( Figure 18B).
- FIG. 19B presents the MRS A counts in gauze (red bars) and in wounds (light blue bars) 24 hours after first treatment, and show that bacterial counts in gauze were lower than bacterial count in wounds, for all tested compounds.
- the bacterial count in gauze associated for Gentamicin 200 and 100 ⁇ g/ml was higher than bacterial counts in wounds. Similar lowers count was observed in wounds or gauze with Mupirocin.
- FIG 20 A wounds inoculated with MRS A for 24 hours, and then treated once and recovered after 24 hours showed a reduction in MRSA counts compared with untreated wounds, for all tested compounds.
- Figure 20B presents the bacterial count of MRSA in gauze (orange bars) and in wounds (yellow bars) after 24 hours of biofilm formation, following by treatment application. Mupirocin (positive control) in gauze showed the lowest bacterial count compared with MRSA counts in wounds.
- Figure 2 IB presents PA27312 counts in gauze (blue bars) and in wounds (green bars) on day 1 after treatment application for biofilm inhibition, showing bacterial counts in gauze were higher than bacterial count in wounds, for all tested compounds except for BL 6030 in PEG-400 30 % at a concentration of 60 mg/ml and Silver sulfadiazine (positive control).
- Figure 22B presents PA27312 counts in gauze (violet bars) and in wounds (pink bars) on day 1 after treatment application for biofilm inhibition, showing bacterial counts in gauze were lower than bacterial count in wounds, for all tested compounds.
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Abstract
L'invention concerne un composé contenant du bore, le 2-(4-fluorophényl)-6-méthyl-1,3,6,2-dioxazaborolane (composé K), qui montre une activité antimicrobienne et anti-formation de biofilm, ainsi que des procédés et des compositions l'utilisant, seul ou en combinaison avec un agent actif supplémentaire, pour inhiber la croissance d'un microorganisme pathogène et/ou pour prévenir et/ou réduire la formation de biofilms microbiens et/ou pour disloquer des biofilms microbiens dans des tissus vivants ou des objets inanimés.
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