WO2016182455A1 - Nouveaux procédés de traitement utilisant des compositions de lactose - Google Patents

Nouveaux procédés de traitement utilisant des compositions de lactose Download PDF

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Publication number
WO2016182455A1
WO2016182455A1 PCT/NZ2016/050075 NZ2016050075W WO2016182455A1 WO 2016182455 A1 WO2016182455 A1 WO 2016182455A1 NZ 2016050075 W NZ2016050075 W NZ 2016050075W WO 2016182455 A1 WO2016182455 A1 WO 2016182455A1
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WO
WIPO (PCT)
Prior art keywords
lactose
wound
disorder
pain
epithelial tissue
Prior art date
Application number
PCT/NZ2016/050075
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English (en)
Inventor
Alan Smith
Original Assignee
Ouch-Ie Powder Company Limited
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Ouch-Ie Powder Company Limited filed Critical Ouch-Ie Powder Company Limited
Priority to AU2016262318A priority Critical patent/AU2016262318A1/en
Publication of WO2016182455A1 publication Critical patent/WO2016182455A1/fr
Priority to AU2021107560A priority patent/AU2021107560A4/en
Priority to AU2021236476A priority patent/AU2021236476A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
    • A61K31/7016—Disaccharides, e.g. lactose, lactulose
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P17/00—Drugs for dermatological disorders
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P17/00—Drugs for dermatological disorders
    • A61P17/02—Drugs for dermatological disorders for treating wounds, ulcers, burns, scars, keloids, or the like
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]

Definitions

  • the present invention relates to methods of treating wounds and other conditions of the skin and mucosa.
  • Coagulation or blood clotting occurs soon after injury. Damage to the endothelium results in collagen being exposed to platelet cells circulating in the blood. The platelets bind directly to the collagen, thereby localising them at the site of the injury. Binding to the collagen results in activated platelets which release the contents of granulocytes which in turn activate further platelets, forming a platelet plug (primary hemostasis), as well is inducing a series of cascades which result in the formation f strengthening fibrin strands (secondary hemostasis). The binding of platelets to collagen, as well as epithelial damage triggers the secretion of inflammatory factors which result in the inflammatory phase.
  • the proliferative phase comprises processes such as angiogenesis (the generation of new blood vessels), fibroplasia and granulation tissue formation and epithelialisation. Fibroplasia begins with fibroblasts entering the wound site and proliferating as a result of the growth factors released during the inflammatory phase. The fibroblasts then proceed to lay down the extracellular matrix (ECM) and collagen (initially type III collagen) in the wound site, which then allows epithelialization.
  • ECM extracellular matrix
  • collagen initially type III collagen
  • the maturation phase of wound healing occurs as the initial type III collagen is replaced by type I collagen. It should be understood that while the four steps above are broadly consecutive in nature, there is considerable overlap between the phases. For instance proliferation begins before inflammation is completed. Fibroblasts are responsible for the generation of collagens, glycosaminoglycans, reticular and clastic fibers and glycoproteins which make up the ECM. Fibroblasts are one of the major cell types present in skin and play a key role in wound healing. The fibroblasts present in the wound during the proliferative phase are thought to primarily migrate from surrounding tissue.
  • the invention relates to a method of treating a disorder of epithelial tissue comprising topically administering a therapeutically effective amount of lactose to a subject suffering from the disorder.
  • the disorder of the epithelial tissue is a wound, preferably a skin wound.
  • the wound can be infected, or in a subject particularly susceptible to infection.
  • the subject is susceptible to reduced wound healing, such as a haemophiliac or diabetic.
  • the disorder is a burn or other injury to the flesh or skin.
  • the disorder of the epithelial tissue is a rash, particularly of the skin, preferably as a result of an allergic reaction or other inflammatory condition.
  • Another broad aspect of the invention relates to a method of treating pain, comprising topically administering a therapeutically effective amount of lactose to a subject suffering from the disorder.
  • the pain is associated with a wound or other disorder of the epithelial tissue.
  • the pain is not associated with a disorder of the epithelial tissue.
  • the pain is a headache.
  • inflammatory disease or condition comprising topically administering a therapeutically effect amount of lactose to a subject suffering from the disease or condition.
  • the lactose can be applied directly as powder, or alternatively can be applied as a solution. Where the lactose is applied as a solution, it is preferably applied as solution of lmg/mL or greater.
  • the lactose may also be applied as a spray, gel, cream, ointment or poultice.
  • the lactose can be incorporated in a device such as a bandage which is for topical application.
  • the lactose can be applied alone, or in combination with another active ingredient.
  • the treatment consists of, or consists essentially of topically administering a therapeutically effective amount of lactose.
  • the present invention provides for a composition comprising lactose, for topical application in the treatment of a disorder as described herein.
  • the present invention provides for the use of lactose in the manufacture of a medicament for the treatment of a disorder as described herein.
  • Figure 1 Shows the effect of test sample #1 Lactose A (Smith) at l .Omg/ml and test sample #2 Lactose A (Smith) at 0.25mg/ml) on wound healing in the control culture and the cultures containing the test sample preparation.
  • Each value is the mean ⁇ SEM of triplicate values.
  • phrases "consists essentially of and variations thereof, except where context requires otherwise, is used to specify the presence of the stated feature or step and to include other steps which do not materially affect the basic characteristic of the invention.
  • a method which consists essentially of administering a therapeutically effective amount of lactose may constitute administration with other carriers or aerosols, or even inclusion of lactose in a mechanical aid to wound healing such as a bandage.
  • phrases "consists of, "consisting of or other variations are used in an exclusive sense, i.e. to specify the presence of the stated step or feature and no other step, except to the extent that the step or feature would ordinarily be considered to contain variation.
  • a method consisting of administering a therapeutically effective amount of lactose is to be understood as also encompassing lactose in any level of purity (sec the definition of lactose below) and thus encompasses the administration of the impurities as well as the lactose.
  • disorder of epithelial tissue refers to any condition suffered by epithelial tissue, whether as a result of injury, disease or otherwise. It is intended to include within its scope disorders which are primarily of the epithelial tissue but extend to other tissues. Included within this term are wounds and burns of the skin, or other mucosa such as the eyes, mouth or nose, as well as other diseases whether as a result of external factors such as infection, or as a result of autoimmune disorders. As used herein the term “wound” refers to both open wounds and closed injuries.
  • therapeutically effective amount refers to an amount of the ingredient sufficient to achieve a therapeutic effect. In the case of wound healing this is, for example, an amount sufficient to result in increased healing, or in better healing, for example reduced scar formation. A therapeutically effective amount may differ depending on how the ingredient is applied, for instance by way of direct application of the powder, or as a solution or poultice.
  • topical administration “administered topically” or other variations thereof should be understood to mean that the compound or composition applied to body surfaces. Included in this term is administration to the skin and administration to other surfaces. The term is not intended to comment on the pharmacodynamic effect of the compound or composition and so is not intended to be limited to situations where the compound or composition has a topical effect.
  • lactose is intended to refer to the sugar P-D-galactopyranosyl-(l - 4)-D-glucose, however it is obtained and in any purity.
  • lactose shall be understood to include the application of a composition or product comprising lactose and other impurities as well as pure lactose.
  • the lactose is food grade lactose.
  • the lactose is pharmaceutical grade.
  • lactose is unmodified by the addition of other side chains.
  • Lactose is a disaccharide sugar common in milk. It is one of the major by-products of dairy processing where it can be precipitated from whey using cthanol at relatively high yields. Food or pharmaceutical grade lactose is generally available as a white powder.
  • Lactose is a common additive to foods such as infant formula, where it is broken down into its constituent monosaccharides, glucose and galactose by the enzyme ⁇ -D-galactosidase in order to produce energy. It is also commonly used as a filler in the pharmaceutical industry, for example in the making of tablets, due to its compressibility and low price. Topical compositions comprising lactose are also known. In EP 0498532, lactose is used in a composition for debriding wounds. The composition comprises a wound debriding enzyme such as subtilisin A and lactose as excipient and is applied di ectly to wound site.
  • a wound debriding enzyme such as subtilisin A and lactose
  • compositions comprising lactose and a collagcnasc powder again for topical application as a wound debriding composition. Again lactose is used as an excipient.
  • EP 1032364 discloses the use of sialyl lactose in regulating inflammatory responses, reducing skin irritation and treating skin reddening.
  • Sialyl lactose is a derivative of lactose whereby a lactose molecule is modified by the addition of a sialyl group. Sialyl lactose does not fall within the scope of the present invention.
  • lactose has a therapeutic effect when applied topically to a wound or other disorder of the epithelial tissue.
  • lactose aids in the healing of injuries to connective tissue such as ligaments.
  • the invention may be particularly of use in individuals who exhibit slow wound healing, such as haemophiliacs and diabetics, but is also of general use for both human and non- human animals.
  • lactose has beneficial effects at different stages of the wound healing process. It is thought that in the coagulation stage the lactose aids in the formation of the platelet plug. In addition it appears as though lactose also has an effect on fibroblast proliferation and migration, which are key components of the proliferation stage of wound healing. Surprisingly the application of lactose also shows a reduction of pain, not only in skin wounds, but more generally, for instance in headaches. This effect could indicate that lactose is also able to reduce inflammation. In fact, lactose has also been shown to have an effect on inflammatory skin conditions such as hives when applied to the affected area.
  • the present invention also relates to the use of lactose for the treatment of pain and inflammatory conditions by topical administration.
  • the present invention has shown that lactose is effective when administered topically.
  • the lactose can be applied in powder form. However it can also be administered as a poultice, for example in combination with water, or be included in a gel, cream, ointment or spray. Where there is no open wound, an application according to one of these means assists in the localisation of the lactose.
  • Inclusion in a gel or spray will also assist where the site of the injury is not on the skin, for instance in the mouth or nose.
  • lactose can be incorporated into a product such as a dressing, bandage or patch for application to a particular site on the skin. Inclusion in such a product, especially a dressing has the added benefit of single application of both lactose and the dressing.
  • lactose is not applied in powder form, a dosage of greater than 0.25mg/mL, more preferably lmg/mL is desirable.
  • lactose is applied directly to the site of in jury.
  • the lactose has some intradermal effect, thus it is possible to apply the lactose in a location remote from the injury. In certain cases lactose may also have a systemic effect.
  • Lactose may be combined with other active ingredients to further aid in the wound healing process.
  • Suitable compounds are those known in the art to have wound healing properties.
  • Powdered lactose was mixed into a poultice and applied to an ingrown toe-nail.
  • the ingrown toe-nail healed within approximately a week. This compared to regular medical intervention on another toe nail which took over three months to heal.
  • the headache diminished in seconds.
  • Test samples 1 and 2 were lactose obtained from Sapa to Cheese USA Inc, sourced from the Miraka Dairy Factory in Taupo New Zealand. Test sample 1 was diluted to a concentration of lmg/mL in HBSS (Hanks Balanced Salt Solution), while Test sample 2 was diluted to a concentration of 0.25mg/mL.
  • HBSS Horbal Balanced Salt Solution
  • TBL cell proliferative assay SOP: TBL-XCP 7.0.
  • Human skin fibroblasts Detroit 551 were retrieved from cryostorage and cultured to confluence in 24 well plates. Once confluence had been attained, a circular wound was created (6mm in diameter) and the cells removed from within the ring. The cells were then cultured in the presence of the test samples at one concentration, in triplicate with mean values and standard errors expressed graphically. The 'wounds' were photographed at TO, T24, T48 and T72hrs. The wound areas measured digitally and graphed. A bFGF (FGF-2) control and a blank were also run in triplicate.
  • Dulbecco's Modified Eagle's Medium GIBCO 121 00-038. 10% Foetal Bovine Serum (FBS), 1 OOU/ml Penicillin and 100 ⁇ 3 ⁇ 4/ ⁇ 1 Streptomycin (both are x 1 00 in stock) were added.
  • FBS Foetal Bovine Serum
  • Penicillin 100 ⁇ 3 ⁇ 4/ ⁇ 1 Streptomycin (both are x 1 00 in stock) were added.
  • Trypsin-EDTA solution 0.05% Trypsin/EDTA.
  • SIGMA Cat# 15400054 xl O in stock). Diluted with PBS.
  • HBBS Hanks Balanced Salt Solution
  • bFGF Fibroblast Growth Factor
  • the frozen stock cell line (D-55 1 fibroblasts) was removed from liquid nitrogen and immediately thawed in a 37°C water bath. The contents were then transferred to a 250ml (75cm 2 ) culture flask containing 20ml DMEM plus 10%FBS (pre- warmed to 37°C).
  • the cells were cultured at 37°C in 95% air/5% C0 2 for 24hr. The medium in the flask was then removed and fresh medium added. The cells were then cultured until the cells had reached approximately 80% density/confluence. Cells were examined daily for confluence under the microscope. Once 80% confluence was reached the cell culture was then split according to ATCC guidelines and fresh media added. The new flasks were grown at 37°C in 95% air/5% CO2 until the cells had reached approximately 80%
  • the medium was removed from the culture flasks and the adherent cells washed with PBS to remove any traces of FBS. Then 5ml of 0.25%
  • Trypsin/EDTA solution was added and incubated at 37°C for 5 min until all the cells had detached.
  • the trypsin was then neutralised by the addition of an equal volume f pre- warmed DMEM and centrifuged at 125g (500rpm) for 7 min at 4°C.
  • the plates were incubated at 37°C in an atmosphere of 95% air/5% C0 2 .
  • Table 1 Comparison of Wounds: Mean % of Original Wound Area and Standard Error of Mean (SEM) Sample TO SEM T24 SEM T48 SEM T72 SEM Hour Hours Hours Hours
  • Figure 1 presents the data in Table 1 in graphical form.
  • the lactose preparation had only reduced the wound size by 18.3%. This was somewhat less than expected.
  • the untreated wounds were 71.8% closed at this time.
  • the level of closure of this reference culture was greater than for any of the test samples and is unexpectedly high. It is certainly higher than observed in previous studies.
  • the wounds treated with this lactose had closed significantly. It was close to being completely closed (it was 89.4%> closed). Thus there is a very strong stimulatory effect during this second period.
  • lactose is effective at promoting wound closure and in particular fibroblast mediated wound closure.
  • the slower initial effect in this model may be advantageous.
  • the cell proliferation and migration is not an early stage of the overall wound healing process. It follows the earlier phases of coagulation and inflammation.
  • the creamed clover honey sample was tested at a concentration of 0.20 mg/ml. After 24 hours, there was no change to the size of the wounds. After 48 hours, the wound sizes had decreased by only 13.6% and there was a further small decrease of 9.6% after 72 hours. This means that at the end of the 72 hours, the wounds were 76.8% of their original size. So the wound closure effect of this honey is minimal. As a result, the creamed clover honey was one of the least effective samples in this study at promoting wound healing.
  • Rata Honey was also tested at a concentration of 0.20 mg/ml and was found to be moderately effective at promoting wound healing. After the first 24 hours, the wound sizes had only decreased to 90.5% of their original size (a 9.5% reduction in size). However, after a further 24 hours the wound sizes had decreased to 50.6% of their original size. That is, they were almost half the size of what they were at the start of the study. After 72 hours, there had been an 84.8% reduction in wound size - they were 15.2% of their original size. So although better than clover honey, rata honey was significantly less effective than lactose.
  • the Active Manuka Honey sample was the most effective honey sample in this study. At a concentration of 0.20 mg/ml, the wounds had almost halved in size after 24 hours (49.2% size reduction). After another 24 hours o incubation the wound had almost halved again. That is, the wound areas were only 21.6% of their original size. By 72 hours, the wounds were almost fully closed; they were only 2.6% of the original size. Thus manuka honey, is initially more effective than lactose at promoting wound closure.
  • Manuka Honey B (supplied by TBL) was the second manuka honey sample tested in this study. It was Airborne Manuka Honey purchased from a retail outlet. Like the Active Manuka Honey A sample, at a concentration of 0.20 mg/ml Manuka Honey B was effective at promoting wound healing however not to the same extent. At both 24 and 48 hours the wound sizes were slightly smaller than those seen for Active Manuka Honey A (42.9% (24 hours) and 17.6% (48 hours) respectively of the original size compared to 50.8%> and 21..6% for the former). However, after 72 hours the wound areas for Manuka Honey B were 4.9% of their original size which was only slightly bigger than those seen for Active Manuka Honey A. As lactose was a common disaccharide, a comparison of the effect of other common low molecular weight sugars was undertaken.
  • D-(+VGLUCOSE (Sigma) D-(+)-glucose was tested at a concentration of 1.00 mg/ml and almost completely closed the wounds after 72 hours. It was the only sample other than lactose to do this.
  • Sucrose at a concentration of 1.00 mg/ml was effective at promoting the healing of
  • wounds After 24 hours, the wound sizes had decreased by more than 50% (53.8% size reduction) which was slightly less than that achieved with the same concentration of glucose but certainly better than lactose at the same time. It further decreased in size at both 48 and 72 hours. By 72 hours the wounds were only 3.2% of their original size meaning there had been a 96.8% reduction. Therefore, overall, sucrose was slightly less effective as D-(+)- glucose or Lactose.
  • Kawakawa has been traditionally used as a natural treatment of wounds and so was included in this study in the presence of the oil at 1 mg/ml. After 24 hours, the wound area had decreased to less than 50% of its original size (55.5%). This indicates that the initial rate of closure is fairly similar to a number of other test samples. The wound was only 17.2% of its original size at 48 hours. By 72 hours, the wound area had decreased to 2.4% of what it was at the start of the experiment. This shows that Kawakawa Oil is effective in the promotion of wound healing. However Lactose at the same concentration was slightly more effective as it closed the wound completely and even after 48 hours it reduced the wound size more than the kawakawa oil.
  • the green tea solution (10% v/v) was prepared and tested for its wound healing properties. It was the least effecti ve of all the samples at decreasing the size of the wounds. A fter 24 hours. the wound areas had only decreased by 7.5% and 15.8% after 48 hours. At the last time point (72 hours) the wounds had only decreased by 19.8%. That is, they were still 80.2% of their original si/e. Thus it was rather ineffective as an agent for promoting the cell migration and proliferation associated with wound healing.
  • lactose Over a 72 hour period, lactose compared favourably to all of the samples tested. In fact only the positive control, FGF-2 showed similar properties. Thus the test establishes that lactose has a positive effect on fibroblast growth and proliferation, and consequently wound healing. This effect is particularly noticeable between the 24-48 hour time period, where lactose out performed all of the other samples.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Chemical & Material Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Chemical & Material Sciences (AREA)
  • Organic Chemistry (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Engineering & Computer Science (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Dermatology (AREA)
  • Rheumatology (AREA)
  • Pain & Pain Management (AREA)
  • Molecular Biology (AREA)
  • Epidemiology (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Medicines Containing Material From Animals Or Micro-Organisms (AREA)

Abstract

La présente invention concerne l'utilisation de des compositions de lactose topiques et des procédés d'utilisation desdites compositions pour traiter les troubles/maladies inflammatoires, la douleur et les troubles du tissu épithélial (peau et muqueuses), y compris les plaies de la peau, l'urticaire et l'éruption cutanée.
PCT/NZ2016/050075 2015-05-12 2016-05-11 Nouveaux procédés de traitement utilisant des compositions de lactose WO2016182455A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
AU2016262318A AU2016262318A1 (en) 2015-05-12 2016-05-11 New treatment methods utilising lactose compositions
AU2021107560A AU2021107560A4 (en) 2015-05-12 2021-09-22 Treatment using lactose relating to accelerated wound closure
AU2021236476A AU2021236476A1 (en) 2015-05-12 2021-09-22 Specific treatment methods utilising lactose compositions

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Application Number Priority Date Filing Date Title
NZ70803815 2015-05-12
NZ708038 2015-05-12

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Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3512527A (en) * 1966-10-17 1970-05-19 Marguerite Desoye Dressing,in particular for natural cavities of the human body
US6183436B1 (en) * 1998-09-11 2001-02-06 Ultracell Medical Technologies Of Connecticut, Inc Article for packing body cavities
WO2004110461A1 (fr) * 2003-06-13 2004-12-23 Idh Holding Aps Traitement de symptomes associes a la vaginose bacterienne
WO2010008491A2 (fr) * 2008-06-25 2010-01-21 Ritter Natural Sciences, Llc Compositions de lactose ayant une teneur réduite en lactose
US20110223248A1 (en) * 2007-12-12 2011-09-15 Ritter Pharmaceuticals, Inc. Methods and compositions for treating lactose intolerance
WO2013062424A1 (fr) * 2011-10-26 2013-05-02 Anzamed International Limited Procédé et composition pour traiter la douleur et/ou l'inflammation
WO2014171873A1 (fr) * 2013-04-16 2014-10-23 Pegion Operations Limited Composition pulvérulente pour le traitement d'un trouble dans le canal auditif de mammifères et son utilisation

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3512527A (en) * 1966-10-17 1970-05-19 Marguerite Desoye Dressing,in particular for natural cavities of the human body
US6183436B1 (en) * 1998-09-11 2001-02-06 Ultracell Medical Technologies Of Connecticut, Inc Article for packing body cavities
WO2004110461A1 (fr) * 2003-06-13 2004-12-23 Idh Holding Aps Traitement de symptomes associes a la vaginose bacterienne
US20110223248A1 (en) * 2007-12-12 2011-09-15 Ritter Pharmaceuticals, Inc. Methods and compositions for treating lactose intolerance
WO2010008491A2 (fr) * 2008-06-25 2010-01-21 Ritter Natural Sciences, Llc Compositions de lactose ayant une teneur réduite en lactose
WO2013062424A1 (fr) * 2011-10-26 2013-05-02 Anzamed International Limited Procédé et composition pour traiter la douleur et/ou l'inflammation
WO2014171873A1 (fr) * 2013-04-16 2014-10-23 Pegion Operations Limited Composition pulvérulente pour le traitement d'un trouble dans le canal auditif de mammifères et son utilisation

Non-Patent Citations (3)

* Cited by examiner, † Cited by third party
Title
KHULY, P.: "Folliculitis", EMBRACE PETINSURANCE, 29 July 2013 (2013-07-29), XP055328888, Retrieved from the Internet <URL:http://www.embracepetinsurance.com/health/folliculitis> [retrieved on 20160615] *
PETMD: "Inflammation of the Middle Ear and External Ear Canal in Dogs", 6 September 2015 (2015-09-06), XP055328885, Retrieved from the Internet <URL:http://web.archive.org/web/20150906015150/http://www.petmd.com/dog/conditions/ears/cmultiotitisexternaandotitismedia?page=show> [retrieved on 20160610] *
SCARFF, D. ET AL.: "Skin: pyotraumatic folliculitis", 19 July 2014 (2014-07-19), Retrieved from the Internet <URL:http://web.archive.org/web/20140719233745> [retrieved on 20160615] *

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AU2021107560A4 (en) 2022-01-06
AU2016262318A1 (en) 2018-01-04
AU2021236476A1 (en) 2021-10-21
AU2016102480A4 (en) 2021-12-23

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