WO2017159700A1 - 神経再生誘導材 - Google Patents
神経再生誘導材 Download PDFInfo
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- WO2017159700A1 WO2017159700A1 PCT/JP2017/010274 JP2017010274W WO2017159700A1 WO 2017159700 A1 WO2017159700 A1 WO 2017159700A1 JP 2017010274 W JP2017010274 W JP 2017010274W WO 2017159700 A1 WO2017159700 A1 WO 2017159700A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/14—Macromolecular materials
- A61L27/20—Polysaccharides
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/14—Macromolecular materials
- A61L27/18—Macromolecular materials obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/38—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells
- A61L27/3804—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells characterised by specific cells or progenitors thereof, e.g. fibroblasts, connective tissue cells, kidney cells
- A61L27/383—Nerve cells, e.g. dendritic cells, Schwann cells
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/40—Composite materials, i.e. containing one material dispersed in a matrix of the same or different material
- A61L27/44—Composite materials, i.e. containing one material dispersed in a matrix of the same or different material having a macromolecular matrix
- A61L27/48—Composite materials, i.e. containing one material dispersed in a matrix of the same or different material having a macromolecular matrix with macromolecular fillers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/50—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
- A61L27/58—Materials at least partially resorbable by the body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/02—Drugs for disorders of the nervous system for peripheral neuropathies
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/28—Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
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- C—CHEMISTRY; METALLURGY
- C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
- C08K—Use of inorganic or non-macromolecular organic substances as compounding ingredients
- C08K5/00—Use of organic ingredients
- C08K5/16—Nitrogen-containing compounds
- C08K5/34—Heterocyclic compounds having nitrogen in the ring
- C08K5/3412—Heterocyclic compounds having nitrogen in the ring having one nitrogen atom in the ring
- C08K5/3415—Five-membered rings
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- C—CHEMISTRY; METALLURGY
- C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
- C08L—COMPOSITIONS OF MACROMOLECULAR COMPOUNDS
- C08L5/00—Compositions of polysaccharides or of their derivatives not provided for in groups C08L1/00 or C08L3/00
- C08L5/04—Alginic acid; Derivatives thereof
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- C—CHEMISTRY; METALLURGY
- C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
- C08L—COMPOSITIONS OF MACROMOLECULAR COMPOUNDS
- C08L67/00—Compositions of polyesters obtained by reactions forming a carboxylic ester link in the main chain; Compositions of derivatives of such polymers
- C08L67/04—Polyesters derived from hydroxycarboxylic acids, e.g. lactones
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2430/00—Materials or treatment for tissue regeneration
- A61L2430/32—Materials or treatment for tissue regeneration for nerve reconstruction
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- C—CHEMISTRY; METALLURGY
- C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
- C08L—COMPOSITIONS OF MACROMOLECULAR COMPOUNDS
- C08L2203/00—Applications
- C08L2203/02—Applications for biomedical use
Definitions
- the present invention relates to a nerve regeneration-inducing material for regenerating a damaged part of a nerve.
- a nerve suture that directly sutures the cut nerves or an autologous nerve transplantation that collects the patient's own healthy nerve and transplants it to the damaged part is performed.
- the method of directly suturing the nerve may apply tension and cause sensory abnormalities and pain, and autologous nerve transplantation may sacrifice nerves at a healthy site, and pain and numbness may appear in the nerve sampling part.
- Nearbridge TM is a nerve regeneration induction tube made of polyglycolic acid and collagen.
- the Nerbridge is a cylindrical material with a hard outer material covering the collagen in the lumen, and nerves in parts with large movable thresholds such as joints such as hands and toes and in the vicinity of joints and parts that require three-dimensional curvature. Difficult to use for reconstruction.
- the operation is complicated because the end of the torn nerve is drawn into the tube and needs to be fixed by suturing, and the inner diameter thereof is also fixed.
- NEUROLAC registered trademark
- a nerve regeneration effect on a linear nerve defect is disclosed using an alginate sponge produced by covalent crosslinking with ethylenediamine (Patent Document 1).
- Non-Patent Document 1 a material obtained by covering an alginate gel with polyglycolic acid processed into a tubular shape and lyophilized regenerated a 50 mm gap in the femoral sciatic nerve.
- Alginate gel is said to have no difference in effect between tubular and non-tubular devices in the regeneration of the cat sciatic nerve gap.
- a non-tubular device was installed with a nerve gap between two sponges (Non-Patent Document 2). Techniques related to these are disclosed (Non-Patent Documents 3 to 6).
- Non-patent Document 7 There is an example in which an alginate sponge is used for a 2 mm gap in the spinal cord of a rat (Non-patent Document 7).
- Non-patent Document 8 It is disclosed that a 5 mm gap in the posterior branch of the cat's facial nerve was regenerated using an alginate sponge. However, the nerve cut site was not a bifurcation (Non-patent Document 8).
- Non-patent Documents 9 to 14 There is a document that a 2 mm gap of rat cavernosal nerve was regenerated using an alginate gel sponge sheet (Non-patent Documents 9 to 14). Since the nerve cutting site is the cavernous nerve 1 mm downstream from the pelvic ganglion, it is difficult to consider it as a branched nerve. Regarding the regeneration of the penile cavernous nerve, there is an example in which an alginate gel sponge sheet is used as a base material for administration of human bone marrow-derived CD133 + cells, but the alginate gel sponge sheet alone does not provide a significant regeneration effect (non- Patent Document 15).
- Non-patent Documents 16 and 17 there is an example in which an alginic acid gel is applied to a nerve defect portion of about 2 mm of the rat pelvic plexus to regenerate it.
- Non-patent Documents 16 and 17 the details of the alginate sheet used are not clear, and the effect is not yet sufficient.
- the alginate sponge in the above findings uses sodium alginate that has not been treated with low endotoxin, and was not produced using low endotoxin sodium alginate.
- nerve regeneration that has been attempted using devices so far is mostly for straight nerve defects, and promotes regeneration of nerve branches and plexus defects.
- a biological tissue reinforcing material kit containing a non-woven fabric made of a bioabsorbable material and sodium alginate is disclosed (Patent Document 2).
- sodium alginate is used without being cross-linked and is not a material intended for nerve regeneration.
- Patent Document 3 discloses a gel obtained by irradiating a gel formed of hyaluronic acid alone with gamma rays, electron beams, plasma, or the like.
- the gel of hyaluronic acid alone is described as meaning a gel that is self-crosslinked without using a chemical crosslinking agent or the like other than hyaluronic acid.
- Patent Document 4 discloses an implant made of a biodegradable polymer under conditions such as chemical, heat or radiation.
- Non-Patent Document 18 discloses a technique for irradiating alginate nanofibers for tissue engineering with ⁇ -rays and controlling the decay rate by the amount of ⁇ -ray irradiation. Moreover, in the literature on the nerve regeneration material using alginic acid, it is described that the bioresorbability of alginic acid gel can be controlled by the dose of ⁇ -ray irradiation (Non-patent Document 19). However, until now, the relationship between the irradiation of ⁇ -rays and electron beams onto materials and nerve regeneration has not been clarified.
- One of the objects of the present invention is to provide a medical material capable of inducing regeneration of a nerve branch and / or a damaged part of a plexus.
- Another subject of the present invention is applicable to a damaged portion of a straight nerve, a damaged portion of a nerve branch portion and / or a plexus portion, has a high nerve regeneration inducing effect, is safe and biocompatible. It is providing the medical material which is excellent in.
- Another object of the present invention is to provide a non-tubular nerve regeneration guide that can be applied to damages in various places and shapes that can exhibit a nerve regeneration effect even when it is not sutured, while having an appropriate strength that can be sutured. Is to provide materials.
- the present invention relates to a nerve regeneration-inducing material containing a xerogel-like alginic acid crosslinked product prepared by covalently crosslinking low endotoxin sodium alginate with a compound represented by the following general formula (I) and / or a salt thereof:
- a nerve regeneration-inducing material of the present invention induces nerve regeneration by connecting one nerve stump and a plurality of nerve stumps in the gap at the branch of the sciatic nerve. It was amazing that I could't imagine.
- low endotoxin sodium alginate is covalently crosslinked with a compound represented by the following general formula (I) and / or a salt thereof, and a neuron comprising a xerogel-like alginic acid crosslinked product irradiated with an electron beam.
- a compound represented by the following general formula (I) and / or a salt thereof e.g., a compound represented by the following general formula (I) and / or a salt thereof
- a neuron comprising a xerogel-like alginic acid crosslinked product irradiated with an electron beam.
- the in vivo disappearance (residual) time of the nerve regeneration-inducing material containing the alginate crosslinked body affects the nerve regeneration induction effect
- the in vivo disappearance of the material can be controlled by electron beam or ⁇ -ray dose, etc.
- the disappearance pattern of the crosslinked product desirable for regeneration was found.
- the nerve regeneration-inducing material containing the bioabsorbable polymer has fewer examples of insufficient regeneration than the material not containing the bioabsorbable polymer, and stably regenerates the nerve damage part. The possibility was suggested. This was an unexpected effect. Further, it has been found that the nerve regeneration-inducing material containing the bioabsorbable polymer can be sutured as necessary, can suppress deformation of the material at the time of freeze-drying, and is excellent in handleability. completed.
- the present invention provides the following nerve regeneration-inducing material as a first aspect.
- the bioabsorbable polysaccharide having a carboxyl group in the molecule of low endotoxin is at least one cross-linking reagent selected from a compound represented by the following general formula (I) and a salt thereof:
- R 1 HN— (CH 2 ) n —NHR 2 (I) [Wherein R 1 and R 2 each independently represent a hydrogen atom or a group represented by the formula: —COCH (NH 2 ) — (CH 2 ) 4 —NH 2 , and n represents an integer of 2 to 18] Show. ] (1-2) The nerve regeneration induction according to (1-1), wherein the bioabsorbable polysaccharide having a carboxyl group in the molecule is at least one selected from the group consisting of alginic acid, an ester thereof, and a salt thereof. Materials.
- N-hydroxysuccinimide salt of the compound represented by the above general formula (I) is diaminoethane 2N-hydroxysuccinimide salt, diaminohexane 2N-hydroxysuccinimide salt, N , N′-di (lysyl) -diaminoethane 4N-hydroxysuccinimide salt and N- (lysyl) -diaminohexane 3N-hydroxysuccinimide salt
- the material for inducing nerve regeneration according to (1-3).
- the nerve regeneration-inducing material according to any one of (1-1) to (1-4), which is in the form of a xerogel.
- the bioabsorbable polysaccharide having a carboxyl group in the molecule has an endotoxin content of 100 EU / g or less, according to any one of (1-1) to (1-5) Material for inducing nerve regeneration.
- Nerve bifurcations and / or damaged parts of the plexus from the prostate, arms, brain, spinal cord, face, neck, hips, sacrum, lumbosacrum, genital area, heart, abdominal cavity, and intestinal wall
- Nerve bifurcations and / or damaged parts of the plexus include prostate, bladder, penile cavernosa, arms, limbs, brain, spinal cord, face, neck, waist, sacrum, lumbosacrum, pudendal, heart
- the nerve regeneration induction according to any one of (1-1) to (1-6) which is present in at least one selected from the group consisting of: abdominal cavity, lower lower abdomen, pelvis, intrathoracic cavity and intestinal wall Materials.
- the material for inducing nerve regeneration according to any one of (1-1) to (1-7a), which is used for regeneration of a nerve damage part associated with lymph node dissection.
- the bioabsorbable polysaccharide having a carboxyl group in the molecule of low endotoxin is at least one cross-linking reagent selected from the compound represented by the above general formula (I) and a salt thereof.
- (1-9a) including a step of applying the nerve regeneration-inducing material described in any one of (1-1) to (1-8) to a nerve branching part and / or a damaged part of a plexus part
- the bioabsorbable polysaccharide having a carboxyl group in the molecule of low endotoxin is covalently crosslinked with a crosslinking agent selected from the compound represented by the above general formula (I) and a salt thereof.
- Bioabsorbability having a carboxyl group in the molecule of the low endotoxin for producing the nerve regeneration-inducing material according to any one of (1-1) to (1-8)
- the bioabsorbable polysaccharide having a carboxyl group in the molecule of low endotoxin is at least one cross-linking reagent selected from a compound represented by the following general formula (I) and a salt thereof:
- a material for inducing nerve regeneration comprising a crosslinked product that is covalently crosslinked and irradiated with an electron beam and / or ⁇ -ray.
- R 1 HN— (CH 2 ) n —NHR 2 (I) [Wherein R 1 and R 2 each independently represent a hydrogen atom or a group represented by the formula: —COCH (NH 2 ) — (CH 2 ) 4 —NH 2 , and n represents an integer of 2 to 18] Show. ] (2-2) The nerve regeneration induction according to (2-1), wherein the bioabsorbable polysaccharide having a carboxyl group in the molecule is at least one selected from the group consisting of alginic acid, an ester thereof, and a salt thereof. Materials.
- N-hydroxysuccinimide salt of the compound represented by the above general formula (I) is diaminoethane 2N-hydroxysuccinimide salt, diaminohexane 2N-hydroxysuccinimide salt, N , N′-di (lysyl) -diaminoethane 4N-hydroxysuccinimide salt and N- (lysyl) -diaminohexane 3N-hydroxysuccinimide salt
- the bioabsorbable polysaccharide having a carboxyl group in the molecule has an endotoxin content of 100 EU / g or less, according to any one of (2-1) to (2-5) Material for inducing nerve regeneration.
- (2-7) The nerve regeneration-inducing material according to any one of (2-1) to (2-6), wherein the electron beam and / or ⁇ -ray is irradiated at an absorbed dose of 1 kGy to 100 kGy.
- (2-8) The material for inducing nerve regeneration according to any one of (2-1) to (2-7), which disappears from the application site from 7 days to 270 days.
- (2-10) The material for inducing nerve regeneration according to any one of (2-1) to (2-9), which is used for regeneration of a damaged portion of a peripheral nerve and / or a central nerve.
- (2-11) The nerve regeneration-inducing material according to any one of (2-1) to (2-10), which is used for regeneration of a nerve damage part associated with lymph node dissection.
- (2-13a) The low endotoxin for use in regeneration of an injured part of a nerve damaged part using the material for inducing nerve regeneration according to any one of (2-1) to (2-12)
- (2-13b) In vivo absorbability having a carboxyl group in the molecule of the low endotoxin for producing the nerve regeneration-inducing material according to any one of (2-1) to (2-12)
- the bioabsorbable polysaccharide having a carboxyl group in the molecule of low endotoxin is at least one cross-linking reagent selected from the compound represented by the above general formula (I) and a salt thereof.
- a method for adjusting a remaining time in a nerve regeneration-inducing material in a body which comprises a step of irradiating an electron beam and / or ⁇ -ray to a nerve regeneration-inducing material containing a covalently crosslinked product.
- a method for producing a nerve regeneration-inducing material comprising at least a step of irradiating an electron beam and / or ⁇ -ray to a material containing a cross-linked product covalently crosslinked by using.
- this invention provides the following materials for nerve regeneration induction as a 3rd aspect.
- (3-1) At least one selected from the group consisting of alginic acid of low endotoxin having a weight average molecular weight measured by GPC-MALS of 90,000 to 700,000, its ester and its salt is represented by the following general formula (I
- a material for inducing nerve regeneration comprising a crosslinked product covalently crosslinked with at least one crosslinking agent selected from a compound represented by (1) and a salt thereof.
- R 1 HN— (CH 2 ) n —NHR 2 (I) [Wherein R 1 and R 2 each independently represent a hydrogen atom or a group represented by the formula: —COCH (NH 2 ) — (CH 2 ) 4 —NH 2 , and n represents an integer of 2 to 18] Show. ] (3-2) The nerve according to (3-1), wherein the M / G ratio of at least one selected from the group consisting of low endotoxin alginic acid, an ester thereof, and a salt thereof is 0.5 to 3.0. Regeneration induction material.
- (3-3) including a step of applying the nerve regeneration-inducing material described in (3-1) or (3-2) to a nerve damage site, in a subject in need of regeneration of the nerve damage site.
- (3-3b) The low endotoxin alginic acid or ester thereof for use in regeneration of an injured part of a nerve damaged part using the nerve regeneration-inducing material described in (3-1) or (3-2) Or its salt.
- the bioabsorbable polysaccharide having a carboxyl group in the molecule of low endotoxin is at least one cross-linking reagent selected from a compound represented by the following general formula (I) and a salt thereof:
- R 1 HN— (CH 2 ) n —NHR 2 (I) [Wherein R 1 and R 2 each independently represent a hydrogen atom or a group represented by the formula: —COCH (NH 2 ) — (CH 2 ) 4 —NH 2 , and n represents an integer of 2 to 18] Show.
- N-hydroxysuccinimide salt of the compound represented by the above general formula (I) is diaminoethane 2N-hydroxysuccinimide salt, diaminohexane 2N-hydroxysuccinimide salt, N , N′-di (lysyl) -diaminoethane 4N-hydroxysuccinimide salt and N- (lysyl) -diaminohexane 3N-hydroxysuccinimide salt (4-3)
- the nerve regeneration-inducing material described in the above. (4-5) The nerve regeneration-inducing material according to any one of (4-1) to (4-4), which is in the form of a xerogel.
- the weight average molecular weight measured by at least one GPC-MALS selected from the group consisting of low endotoxin alginic acid, its ester and its salt is 90,000 to 700,000, (4-1) Or the nerve regeneration-inducing material according to any one of (4-5).
- the bioabsorbable polysaccharide having a carboxyl group in the molecule has an endotoxin content of 100 EU / g or less, according to any one of (4-1) to (4-7) Material for inducing nerve regeneration. (4-9) any one of (4-1) to (4-8), further comprising at least one selected from the group consisting of polyglycolic acid, polylactic acid, and copolymers thereof The material for inducing nerve regeneration as described. (4-10) The material for inducing nerve regeneration according to any one of (4-1) to (4-9), which disappears from the application site from 7 days to 270 days.
- (4-11) The material for inducing nerve regeneration according to any one of (4-1) to (4-10), which is irradiated with an electron beam and / or ⁇ -ray.
- (4-12) The material for inducing nerve regeneration according to (4-11), wherein the electron beam and / or ⁇ -ray is irradiated at an absorbed dose of 1 kGy to 100 kGy.
- (4-13) The nerve regeneration-inducing material according to any one of (4-1) to (4-12), which is used for regeneration of a damaged portion of a peripheral nerve and / or a central nerve.
- (4-14) The material for inducing nerve regeneration according to any one of (4-1) to (4-10), which is used for regeneration of a nerve branch and / or a damaged part of a plexus.
- the material for inducing nerve regeneration according to (4-14), present in at least one selected from the group consisting of: (4-15a) Nerve bifurcations and / or damaged parts of the plexus include prostate, bladder, penile corpus cavernosum, arms, extremities, brain, spinal cord, face, neck, waist, sacrum, lumbosacrum, pudendal, heart
- the material for inducing nerve regeneration according to (4-14) present in at least one selected from the group consisting of: abdominal cavity, lower lower abdomen, pelvis, intrathoracic cavity and intestinal wall.
- (4-16) The material for inducing nerve regeneration according to (4-13), which is used for regeneration of a nerve damage part accompanying lymph node dissection.
- (4-17) Necessary to regenerate a nerve damage part, including the step of applying the nerve regeneration inducing material according to any one of (4-1) to (4-14) to the nerve damage part.
- (4-17a) The low endotoxin for use in regeneration of an injured part of a nerve damaged part using the nerve regeneration inducing material according to any one of (4-1) to (4-14) A bioabsorbable polysaccharide having a carboxyl group in the molecule.
- this invention provides the following nerve regeneration induction material as a 5th aspect.
- 5-1 The bioabsorbable polysaccharide having a carboxyl group in the molecule of low endotoxin is at least one cross-link selected from the compound represented by the following general formula (I) and a salt thereof:
- R 1 HN— (CH 2 ) n —NHR 2 (I) [Wherein R 1 and R 2 each independently represent a hydrogen atom or a group represented by the formula: —COCH (NH 2 ) — (CH 2 ) 4 —NH 2 , and n represents an integer of 2 to 18] Show. ] (5-2) The nerve regeneration according to (5-1), wherein the bioabsorbable polysaccharide having a carboxyl group in the molecule is at least one selected from the group consisting of alginic acid, an ester thereof and a salt thereof. Guiding material.
- N-hydroxysuccinimide salt of the compound represented by the above general formula (I) is diaminoethane 2N-hydroxysuccinimide salt, diaminohexane 2N-hydroxysuccinimide salt, N , N′-di (lysyl) -diaminoethane 4N-hydroxysuccinimide salt and N- (lysyl) -diaminohexane 3N-hydroxysuccinimide salt
- the bioabsorbable polymer is at least one selected from the group consisting of polyglycolic acid, polylactic acid, copolymers thereof, and polycaprolactone, (5-1) to (5-1) The material for inducing nerve regeneration according to any one of 5-5).
- Double clip so that the material is cut to a size of 2 cm (length) x 2 cm (width does not matter) and the material is sandwiched at a position 5 mm away from one of the cut surfaces (Gripping part A), and after immersing the region from the cut surface (B) to 10 mm facing the grip part A of the material in physiological saline for 15 minutes, 5 mm from the cut surface (B) of the material
- a tear test is performed in which a suture with a needle is passed through the center of the distant position, both ends of the suture are fixed to the instrument, and the gripping part A is pulled horizontally at a speed of 10 mm / min on the square surface of the material.
- the content of the bioabsorbable polymer in the material is 0.05 mg / cm 2 to 30 mg / cm 2 , or any one of (5-1) to (5-9) The material for nerve regeneration-inducing agents as described.
- Nerve bifurcations and / or damaged parts of the plexus include prostate, bladder, penile corpus cavernosum, arms, extremities, brain, spinal cord, face, neck, waist, sacrum, lumbar sacrum, pudenda, heart
- the material for inducing nerve regeneration according to (5-12) which is present in at least one selected from the group consisting of: abdominal cavity, lower lower abdomen, pelvis, intrathoracic cavity and intestinal wall.
- the nerve regeneration-inducing material according to any one of claims (5-1) to (5-13), which is used for regeneration of a damaged part.
- At least one selected from the group consisting of alginic acid of low endotoxin, ester thereof and salt thereof has a weight average molecular weight (absolute molecular weight) measured by GPC-MALS method of 80,000 or more.
- (5-2) to (5), wherein the M / G ratio of at least one selected from the group consisting of alginic acid of low endotoxin, ester thereof and salt thereof is 0.4 to 3.0.
- Nerve injury including a step of applying the nerve regeneration-inducing material described in any one of (5-1) to (5-16) to a nerve damage part of a subject in need of treatment To induce the renewal of parts.
- (5-18) Applying the nerve regeneration-inducing material according to any one of (5-1) to (5-16) to a nerve injury site of a subject in need of treatment, A bioabsorbable polysaccharide having a carboxyl group in a molecule of the low endotoxin for use in regeneration of an injured part.
- a method of adjusting the remaining time in the body of the nerve regeneration-inducing material including at least the following steps.
- the bioabsorbable polysaccharide having a carboxyl group in the molecule of low endotoxin is covalently bonded with at least one cross-linking reagent selected from the compound represented by the above general formula (I) and a salt thereof
- this invention provides the manufacturing method of the following nerve regeneration induction material as a 6th aspect.
- (6-1) A method for producing a nerve regeneration-inducing material including at least the following steps. (1) A solution containing a bioabsorbable polysaccharide having a carboxyl group in the molecule of low endotoxin, and at least one cross-linking reagent selected from the compound represented by the above general formula (I) and a salt thereof Mixing with (2) A step in which the mixture obtained in (1) and the bioabsorbable polymer are placed in a mold and allowed to stand for a certain period of time to form a crosslinked product, (3) a step of washing the cross-linked product obtained in (2) and then freeze-drying; (4) A step of irradiating the crosslinked product obtained in (3) with an electron beam and / or ⁇ -ray.
- the bioabsorbable polysaccharide having a carboxyl group in the molecule of low endotoxin is at least one cross-linking reagent selected from a compound represented by the following general formula (I) and a salt thereof:
- a non-tubular nerve regeneration-inducing material comprising a covalently crosslinked product, R 1 HN— (CH 2 ) n —NHR 2 (I) [Wherein R 1 and R 2 each independently represent a hydrogen atom or a group represented by the formula: —COCH (NH 2 ) — (CH 2 ) 4 —NH 2 , and n represents an integer of 2 to 18] Show.
- the nerve regeneration-inducing material according to any one of (7-1) and (7-2), wherein, in the degradability test, a residual rate after 4 hours from the start is 55% or more.
- the bioabsorbable polysaccharide having a carboxyl group in the molecule is at least one selected from the group consisting of alginic acid, its ester and its salt, (7-1) to (7-3) )
- the crosslinkable reagent is any one of (7-1) to (7-4), which is an N-hydroxysuccinimide salt of the compound represented by the general formula (I). Material for inducing nerve regeneration.
- N-hydroxysuccinimide salt of the compound represented by the above general formula (I) is 2N-hydroxysuccinimide salt of diaminoethane, 2N-hydroxysuccinimide salt of diaminohexane, N , N′-di (lysyl) -diaminoethane 4N-hydroxysuccinimide salt and N- (lysyl) -diaminohexane 3N-hydroxysuccinimide salt
- (7-7) The material for inducing nerve regeneration according to any one of (7-1) to (7-6), which is in the form of a xerogel.
- the bioabsorbable polymer is at least one selected from the group consisting of polyglycolic acid, polylactic acid, copolymers thereof, and polycaprolactone, according to (7-9). Material for inducing nerve regeneration.
- Double clip so that the material is cut to a size of 2 cm in length x 2 cm in width (regardless of thickness) and the material is sandwiched at a position 5 mm away from one of the cut surfaces (Gripping part A), and after immersing the region from the cut surface (B) to 10 mm facing the grip part A of the material in physiological saline for 15 minutes, 5 mm from the cut surface (B) of the material
- a tear test is performed in which a suture with a needle is passed through the center of the distant position, both ends of the suture are fixed to the instrument, and the gripping part A is pulled horizontally at a speed of 10 mm / min on the square surface of the material.
- (7-1) to (7-10) for inducing nerve regeneration wherein the maximum test force (load) is 0.10 (N) to 10.0 (N) material.
- the content of the bioabsorbable polymer in the material is 0.05 mg / cm 2 to 30 mg / cm 2 , or any one of (7-1) to (7-12) The material for inducing nerve regeneration as described.
- Nerve bifurcations and / or damaged parts of the plexus include prostate, bladder, penile cavernosa, arms, limbs, brain, spinal cord, face, neck, waist, sacrum, lumbosacrum, pudendal, heart
- the material for inducing nerve regeneration according to (7-15) present in at least one selected from the group consisting of: abdominal cavity, lower lower abdomen, pelvis, intrathoracic cavity and intestinal wall.
- At least one selected from the group consisting of alginic acid of low endotoxin, its ester and its salt has a weight average molecular weight (absolute molecular weight) measured by GPC-MALS method of 80,000 or more.
- Nerve injury comprising a step of applying the nerve regeneration-inducing material according to any one of (7-1) to (7-19) to a nerve damage part of a subject requiring treatment. To induce the renewal of parts.
- (7-21) Applying the nerve regeneration-inducing material according to any one of (7-1) to (7-19) to a nerve injury site of a subject in need of treatment, A bioabsorbable polysaccharide having a carboxyl group in the molecule of the low endotoxin for use in a method for inducing regeneration of a damaged part.
- a method for adjusting the remaining time in the body of a nerve regeneration-inducing material comprising at least the following steps.
- the bioabsorbable polysaccharide having a carboxyl group in the molecule of low endotoxin is covalently crosslinked with at least one crosslinking reagent selected from the compound represented by the above general formula (I) and a salt thereof.
- the material for inducing nerve regeneration according to the present invention can currently promote regeneration of nerve bifurcations and / or damaged parts of plexus without useful treatment methods other than autologous nerve transplantation and the like.
- a therapeutic means may be provided.
- the nerve regeneration-inducing material has a controlled body elimination time and is excellent in nerve regeneration-inducing effect.
- the nerve regeneration-inducing material of the present invention can be used even when the damaged part of the nerve is linear, bifurcated and / or plexus, or when the stump of the defect is not visible. Applicable and induces nerve regeneration, so clinical application range is wide.
- the nerve regeneration-inducing material is in the form of a xerogel and / or a sheet and is flexible, so that the nerve stumps and joints are covered with the nerve regeneration-inducing material. Can do. Since it is in the form of a xerogel and / or a sheet, it can be cut and used on the spot in a size suitable for the affected area to be used, so there is no need to prepare a plurality of standards according to the inner diameter of the nerve in advance. It is also possible to apply the material of the present invention to the damaged part of the nerve under an endoscope or a laparoscope.
- the nerve regeneration-inducing material further containing a bioabsorbable polymer has an appropriate strength and can be used by being sutured with a suture when applied to the affected area.
- the material of the present invention can be used without suturing, and when not sewn, there is an advantage that the treatment can be performed relatively easily. Since the nerve regeneration-inducing material of the present invention disappears from the body after a lapse of a certain period, it is excellent in safety and biocompatibility.
- the nerve regeneration-inducing material further containing a bioabsorbable polymer has an appropriate strength, and the material is difficult to tear even in a movable part such as a knee, so that a nerve damage part can be stably formed. It is possible to play.
- the manufacturing process has the advantage that the shape is not easily deformed, the handling property is excellent, and the manufacturing efficiency is high.
- the nerve regeneration-inducing material of the present invention satisfies any one or more of the above effects.
- FIG. 1 The schematic diagram of the test which observes the reproduction
- a cylindrical shape represents a nerve, and a rectangle represents an alginate cross-linked body.
- the crosslinked body was placed so that the nerve cut portion was sandwiched between two alginate crosslinked bodies.
- the arrow indicates a portion where the regenerated nerve axon is thin and considered not to be sufficiently regenerated.
- Bioabsorbable polysaccharide having a carboxyl group in the molecule In one of several embodiments of the present invention, one or more bioabsorbable polysaccharides having a carboxyl group in the molecule are used to induce nerve regeneration.
- a material can be made.
- the bioabsorbable polysaccharide having a carboxyl group in the molecule include polysaccharides such as alginic acid, carboxymethyl starch, hyaluronic acid, carboxymethyl cellulose, esters thereof and salts thereof.
- the bioabsorbable polysaccharide is preferably decomposed and absorbed in vivo.
- the polysaccharide is preferably a bioabsorbable polysaccharide having no cell adhesion. Preferably, it is at least one selected from alginic acid, its ester and its salt.
- the material for inducing nerve regeneration may be referred to as “the material of the present invention”.
- Alginic acid, ester thereof and salt thereof Alginic acid, ester thereof and salt thereof.
- Alginic acid alginic acid ester and alginate used in the present invention may be naturally derived or synthesized, and are preferably naturally derived. In the present specification, “at least one selected from alginic acid, its ester and its salt” may be referred to as “alginic acid”.
- Alginic acids preferably used in the present invention are bioabsorbable polysaccharides extracted from brown algae such as Lessonia, Macrocystis, Laminaria, Ascophyllum, Davilia, Kajika, Alame, Kombu and the like, and D-mannuronic acid A polymer obtained by linearly polymerizing two types of uronic acids (M) and L-guluronic acid (G). More specifically, D-mannuronic acid homopolymer fraction (MM fraction), L-guluronic acid homopolymer fraction (GG fraction), and D-mannuronic acid and L-guluronic acid are randomly arranged. This is a block copolymer in which the fractions (M / G fraction) are arbitrarily bound.
- the composition ratio (M / G ratio) of D-mannuronic acid and L-guluronic acid of alginic acids varies depending on the type of organisms that are mainly derived from seaweeds, etc., and is also affected by the location and season of the organism. , Ranging from a high G type with an M / G ratio of about 0.2 to a high M type with an M / G ratio of about 5. It is known that the gelation ability of alginic acids is affected by the M / G ratio, and generally the gel strength increases when the G ratio is high. In addition, the M / G ratio affects the hardness, brittleness, water absorption, flexibility, and the like of the gel.
- the M / G ratio of alginic acids and / or salts thereof used in the present invention is usually 0.2 to 4.0, more preferably 0.4 to 3.0, still more preferably 0.5 to 3. .0.
- a numerical range indicated by using “to” indicates a range including the numerical values described before and after “to” as the minimum value and the maximum value, respectively.
- alginate and “alginate” used in the present invention are not particularly limited, but it is necessary to have no functional group that does not inhibit the crosslinking reaction in order to react with the crosslinking agent.
- the alginic acid ester is preferably propylene glycol alginate.
- alginates include monovalent salts of alginic acid and divalent salts of alginic acid.
- the monovalent salt of alginic acid is preferably sodium alginate, potassium alginate, ammonium alginate and the like, more preferably sodium alginate or potassium alginate, and particularly preferably sodium alginate.
- Preferred examples of the divalent salt of alginic acid include calcium alginate, magnesium alginate, barium alginate, and strontium alginate.
- Alginic acids are high molecular polysaccharides, and it is difficult to accurately determine the molecular weight, but generally the weight average molecular weight is 10 to 10 million, preferably 10,000 to 8 million, more preferably 20,000 to 300. It is in the range of 10,000.
- the value may vary depending on the measurement method.
- the weight average molecular weight measured by gel permeation chromatography (GPC) or gel filtration chromatography (also referred to as size exclusion chromatography) is preferably 100,000 or more, more preferably 500,000 or more, Preferably, it is 5 million or less, more preferably 3 million or less.
- the preferable range is 100,000 to 5,000,000, more preferably 500,000 to 3.5 million.
- the absolute weight average molecular weight can be measured.
- the weight average molecular weight (absolute molecular weight) measured by GPC-MALS method is preferably 10,000 or more, more preferably 80,000 or more, further preferably 90,000 or more, and preferably 1,000,000 or less, more preferably 80 10,000 or less, more preferably 700,000 or less, and particularly preferably 500,000 or less.
- the preferable range is 10,000 to 1,000,000, more preferably 80,000 to 800,000, still more preferably 90,000 to 700,000, and particularly preferably 90,000 to 500,000.
- a measurement error of 10 to 20% may occur.
- the value may vary in the range of about 32 to 480,000 for 400,000, 400,000 to 600,000 for 500,000, and about 800 to 1,200,000 for 1,000,000.
- the molecular weight of alginic acids can be measured according to a conventional method. Typical conditions when gel permeation chromatography is used for molecular weight measurement are as described in Example 1 herein. For example, GMPW-XL ⁇ 2 + G2500PW-XL (7.8 mm ID ⁇ 300 mm) can be used as the column.
- the eluent can be, for example, a 200 mM sodium nitrate aqueous solution, and pullulan can be used as a molecular weight standard. Can be used.
- Typical conditions when GPC-MALS is used for molecular weight measurement are as described in Example 1 of this specification.
- the detector for example, an RI detector and a light scattering detector (MALS) can be used.
- the viscosity of the alginic acid used in the present invention is not particularly limited, but is preferably 10 mPa ⁇ s to 1000 mPa ⁇ s, more preferably 50 mPa ⁇ s when the viscosity is measured as an aqueous solution of 1 w / w% alginic acid. -800 mPa ⁇ s.
- the viscosity of the aqueous solution of alginic acids can be measured according to a conventional method. For example, using a rotational viscometer method such as a coaxial double cylindrical rotational viscometer, a single cylindrical rotational viscometer (Brookfield viscometer), a cone-plate rotational viscometer (cone plate viscometer), etc.
- Alginic acids are initially high in molecular weight and high in viscosity when extracted from brown algae, but in the process of drying and purification by heat, the molecular weight decreases and the viscosity decreases.
- Alginic acids having different molecular weights can be produced by techniques such as temperature control in the production process, selection of brown algae as a raw material, and molecular weight fractionation in the production process. Furthermore, it is possible to obtain alginic acids having a target molecular weight by mixing with another lot of alginic acids having different molecular weights or viscosities.
- the bioabsorbable polysaccharide having a carboxyl group in the molecule used in the present invention is preferably a low endotoxin bioabsorbable polysaccharide.
- Low endotoxin refers to a low endotoxin level that does not substantially cause inflammation or fever. More preferably, it is a bioabsorbable polysaccharide treated with a low endotoxin.
- the low endotoxin treatment can be performed by a known method or a method analogous thereto.
- the method of Takada et al. See, for example, JP-A-9-32001 for purifying sodium hyaluronate
- the method of Yoshida et al. Eg, JP-A-8-269102 for purifying ⁇ 1,3-glucan. Etc.
- a method of William et al. for example, see JP-T-2002-530440, etc.
- biopolymer salts such as alginate, gellan gum, etc.
- James et al. For example, international publication for purifying polysaccharides, etc.
- Lewis et al. See, for example, US Pat. No. 5,589,591), Herman Frank et al. (Eg, ApplAMicrobiol Biotechnol (1994) 40: 638) for purifying alginate. -643 etc.) or similar It can be implemented by a method.
- the low endotoxin treatment of the present invention is not limited thereto, but is washed, filtered with a filter (such as an endotoxin removal filter or a charged filter), ultrafiltration, a column (an endotoxin adsorption affinity column, a gel filtration column, a column with an ion exchange resin, etc.) ), Adsorption to hydrophobic substances, resin or activated carbon, organic solvent treatment (extraction with organic solvent, precipitation / precipitation by addition of organic solvent, etc.), surfactant treatment (for example, JP-A-2005-036036) It can be carried out by a known method such as a gazette) or a combination thereof. These processing steps may be appropriately combined with known methods such as centrifugation. It is desirable to select appropriately according to the type of alginic acid.
- a filter such as an endotoxin removal filter or a charged filter
- ultrafiltration such as an endotoxin removal filter or a charged filter
- a column an endotoxin
- the endotoxin level can be confirmed by a known method, and can be measured, for example, by a method using Limulus reagent (LAL), a method using Enspercy (registered trademark) ES-24S set (Seikagaku Corporation), or the like. .
- LAL Limulus reagent
- Enspercy registered trademark
- ES-24S set Seikagaku Corporation
- the method for treating the endotoxin of the bioabsorbable polysaccharide used in the present invention is not particularly limited.
- LAL Limulus reagent
- EU endotoxin units
- Low endotoxin-treated sodium alginate can be obtained from commercially available products such as Sea Matrix (registered trademark) (Mochida Pharmaceutical Co., Ltd.), PRONOVA TM UP LVG (FMCBioPolymer), and the like.
- crosslinking reagent preferably used in the present invention is at least one selected from amine-based compounds and salts thereof included in the compounds represented by the following general formula (I).
- a compound represented by the following general formula (I) may be referred to as an amine compound (I).
- R 1 HN— (CH 2 ) n —NHR 2 (I) [Wherein R 1 and R 2 each independently represent a hydrogen atom or a group represented by the formula: —COCH (NH 2 ) — (CH 2 ) 4 —NH 2 , and n represents an integer of 2 to 18] Show.
- diaminoalkanes such as diaminoethane, diaminopropane, diaminobutane, diaminopentane, diaminohexane, diaminoheptane, diaminooctane, diaminononane, diaminodecane, diaminododecane, diaminooctadecane and / or their salts
- Mono- or di (lysyl) such as N- (lysyl) -diaminoethane, N, N′-di (lysyl) -diaminoethane, N- (lysyl) -diaminohexane, N, N′-di (lysyl) -diaminohexane )
- Diaminoalkanes and / or their salts, and one or more of these diamines and their salts can be used.
- amine compound (I) and / or a salt thereof a compound in which n is 2 to 8 in the above general formula (I) and / or a salt thereof is preferably used.
- crosslinkable reagent is a salt of amine compound (I)
- N-hydroxysuccinimide is preferably used as a component for forming the salt.
- ) -Diaminoethane 4N-hydroxysuccinimide, N- (lysyl) -diaminohexane 3N-hydroxysuccinimide have higher safety and biocompatibility and are shared by the cross-linking reagents It is preferably used since the nerve regeneration action of the acid cross-linked product obtained by bond cross-linking is better.
- nerve regeneration-inducing material containing an alginic acid cross-linked body using alginic acids as an example of a bioabsorbable polysaccharide having a carboxyl group in the molecule. These polysaccharides can also be prepared according to the following.
- the xerogel-like alginic acid cross-linked product of the present invention is, for example, an aqueous solution of alginic acids, the cross-linking reagent, and a dehydrating condensing agent such as water-soluble carbodiimide mixed and dissolved, poured into a mold and gelled, After washing the gel, it can be obtained by lyophilization.
- the temperature of the crosslinking reaction can usually be in the range of 4 ° C. to 37 ° C., but it is preferably in the range of 20 ° C. to 30 ° C. from the viewpoint of reaction efficiency.
- the order of the steps of containing the other components is not particularly limited.
- the step of containing the other components is lyophilized. It may be before or after lyophilization.
- the nerve regeneration-inducing material of the present invention is preferably in the form of a xerogel.
- Xerogel refers to a dried gel.
- a gel contains a solvent such as water in a three-dimensional network structure, while a xerogel refers to one that has lost the solvent and becomes only a network.
- xerogel is sometimes referred to as “sponge”.
- the solution of alginic acids can be prepared by a known method or a method analogous thereto.
- the solvent is not particularly limited as long as it is a solvent applicable to a living body, but is preferably an aqueous solvent, for example, purified water, distilled water, ion exchange water, milli-Q water, physiological saline, phosphate buffered physiological saline. DMSO and the like are preferable. These are preferably sterilized and preferably treated with a low endotoxin.
- the crosslinking rate can be controlled by the molar ratio of the crosslinking agent used and the crosslinking reaction time. When the crosslinking rate is lowered, a flexible and high moisture content crosslinked product is obtained, and when the crosslinking rate is increased, it is strong and the moisture content is lowered.
- the crosslinking rate can be appropriately selected depending on the use of the crosslinked product.
- the molar ratio of the cross-linking reagent used is not particularly limited, but is preferably in the range of 1 mol% to 50 mol%, more preferably 5 mol% to 40 mol, based on the total of carboxyl groups of alginic acids. % Range.
- the reaction time can be lengthened when a high crosslinking rate is required.
- the reaction time is usually in the range of 6 hours to 96 hours, and preferably in the range of 24 hours to 72 hours in terms of reaction efficiency.
- the concentration of the alginic acid solution is preferably in the range of 0.1% to 5%, and more preferably in the range of 0.5% to 3%.
- crosslinked product obtained by the crosslinking reaction itself shows practical strength and stability, but may be used in combination with other gelation methods such as ionic bond crosslinking and hydrophobic bond crosslinking depending on applications.
- the present invention nerve regeneration-inducing material is alginic acid, if it contains at least one (alginic acid) is selected from the group consisting of the esters and salts thereof, the material 1cm per 2 the content of alginic acids, in terms of sodium alginate is preferably from 0.2mg / cm 2 ⁇ 12mg / cm 2, more preferably 0.5mg / cm 2 ⁇ 7mg / cm 2, more preferably 1 mg / cm 2 to 6 mg / cm 2 , particularly preferably 1 mg / cm 2 to 5 mg / cm 2 .
- the term “alginic acid content” represents a value obtained by converting the amount of alginic acid contained in the material into the amount of sodium alginate.
- the nerve regeneration-inducing material of the present invention includes, for example, polyglycolic acid, polylactic acid, and their co-polymers in addition to the bioabsorbable polysaccharide having a carboxyl group in the molecule.
- the polymer may contain one or more bioabsorbable polymers such as polycaprolactone.
- a copolymer of polyglycolic acid and polylactic acid (also referred to herein as “PLGA”) is known as, for example, polyglactin. These polymers are used as suture materials and the like, have bioabsorbability, and are excellent in biocompatibility.
- bioabsorbable polymers is not particularly limited, but preferably, a nonwoven fabric, a woven fabric, a mesh, or a needle punch can be used, and more preferably in the form of a nonwoven fabric, a mesh, or a needle punch.
- a sheet-like nonwoven bioabsorbable polymer may be laid on a tray, and the tray may be filled with a solution in which the bioabsorbable polysaccharide and a crosslinking agent are dissolved.
- the arrangement of the bioabsorbable polysaccharide having a carboxyl group in the molecule and the bioabsorbable polymer in the nerve regeneration-inducing material of the present invention is not particularly limited.
- a bioabsorbable polysaccharide layer having a carboxyl group in the molecule and a bioabsorbable polymer layer are laminated, or a biomolecule having a carboxyl group in the molecule between two layers of the bioabsorbable polymer.
- the body absorbable polysaccharide layer may be sandwiched, or both may be mixed in one layer.
- materials other than PGA were similarly used instead of PGA. Is possible.
- These bioabsorbable polymers can increase the strength of the crosslinked body and improve the handleability of the nerve regeneration-inducing material.
- the cross-linked product prepared using PLGA having the same content as the cross-linked product prepared using PGA showed the same degradability. It was suggested that the functional polymer can be used in the present invention as well.
- the bioabsorbable polymer used for the nerve regeneration-inducing material of the present invention is preferably a polymer containing polyglycolic acid, preferably polyglycolic acid and / or polyglycol. It is also desirable to be a copolymer of acid and polylactic acid (PLGA).
- the nerve regeneration-inducing material of the present invention may contain 0.05 mg / cm 2 to 30 mg / cm 2 of the bioabsorbable polymer, more preferably 0.1 mg. / Cm 2 to 10 mg / cm 2 , more preferably 0.5 mg / cm 2 to 7 mg / cm 2 , and particularly preferably 1 mg / cm 2 to 5 mg / cm 2 .
- the nerve regeneration-inducing material of the present invention contains these bioabsorbable polymers, it has a strength capable of suturing, can prevent deformation of the material due to freeze-drying, and can increase production efficiency.
- examples of the nerve regeneration-inducing material containing these bioabsorbable polymers are insufficient regeneration of nerve damage as compared with materials not containing the bioabsorbable polymers. Therefore, the strength of the cross-linked body is increased by adding a bioabsorbable polymer, and the cross-linked body is difficult to break even in movable parts such as knees, and axons can be stably regenerated. The possibility of obtaining was suggested.
- the nerve regeneration-inducing material may contain other polysaccharides and polymers in a range that does not interfere with the effects of the nerve regeneration-inducing material of the present invention.
- the nerve regeneration-inducing material of the present invention can also contain heparin. In some embodiments of the present invention, the nerve regeneration-inducing material does not contain heparin.
- the nerve regeneration-inducing material may contain a factor useful for nerve growth.
- factors useful for nerve growth include, but are not limited to, basic fibroblast growth factor (bFGF), nerve growth factor (NGF), and the like.
- bFGF basic fibroblast growth factor
- NVF nerve growth factor
- the nerve regeneration-inducing material of the present invention can exert an effect of inducing nerve regeneration even when a factor useful for nerve growth is not included. In some embodiments of the present invention, the nerve regeneration-inducing material does not contain these factors.
- the material containing a crosslinked alginate obtained by a crosslinking reaction can be purified usually by removing unreacted reagents and dehydrating condensing agent with a washing solution.
- the cleaning liquid is not particularly limited, and for example, water, ECF (Extra Cellular Fluid), or the like can be used.
- ECF can be prepared by dissolving CaCl 2 (2.5 mM) and NaCl (143 mM) in purified water.
- the ECF may be used after passing through a filter for sterilization as necessary.
- the nerve regeneration-inducing material of the present invention may be used in a gel state before lyophilization.
- freeze-drying of the alginic acid cross-linked product can be carried out by using common technical knowledge known to those skilled in the art. Freeze-drying conditions can be adjusted as appropriate, and a primary drying step, a secondary drying step, and the like may be provided.
- the shape of the nerve regeneration-inducing material of the present invention is not particularly limited, and can be appropriately selected in consideration of the range of the damaged portion of the nerve to be applied.
- it when it is in the form of a xerogel, it can take a non-tubular shape (for example, a flat plate shape, a curved shape, a flat plate shape with projections and depressions), and a tubular shape, preferably a non-tubular shape, more preferably It is flat.
- the size of the plate is not particularly limited because the nerve regeneration-inducing material can be further cut and applied to the damaged part according to the range of the damaged part of the nerve.
- the length of the length and width is not particularly limited, and the height (thickness) is preferably 0.2 mm to 30 mm. More preferably 0.3 mm to 15 mm, still more preferably 0.5 mm to 10 mm, and particularly preferably 1 mm to 10 mm. More preferably, in addition to such height (thickness), the vertical and horizontal lengths are 1 mm to 300 mm ⁇ 1 mm to 300 mm, respectively, particularly preferably 3 mm to 200 mm ⁇ 3 mm to 200 mm, More preferably, it is 5 mm to 150 mm ⁇ 5 mm to 150 mm. Note that the thickness may not be uniform, and an inclined structure in which one is thick and the other is thin may be used.
- the nerve regeneration-inducing material is preferably sterilized.
- Sterilization includes, but is not limited to, ⁇ -ray sterilization, electron beam sterilization, ethylene oxide gas sterilization, ethanol sterilization, and the like.
- a sterilization effect can also be obtained.
- the bioabsorbable polysaccharide having a carboxyl group in the molecule of low endotoxin is the amine compound (I) described above.
- a nerve regeneration-inducing material comprising a crosslinked product that is covalently crosslinked with and / or a salt thereof and irradiated with an electron beam and / or a ⁇ -ray is provided.
- the target irradiated with the electron beam and / or ⁇ -ray may be only a crosslinked body in which a bioabsorbable polysaccharide is covalently bonded with the crosslinking agent, or the nerve regeneration-inducing material is a bioabsorbable polymer.
- other components such as nerve growth factor, a cross-linked product containing other components may be used.
- another component can also be included in the crosslinked body after irradiating an electron beam and / or a gamma ray.
- Electron beam is one of the charged particle beams in radiation and is used for sterilization purposes.
- the electron beam can be irradiated using an electron accelerator or the like. Since the electron beam permeates the substance, it is possible to sterilize a complicated shape or a closed portion, and there is no worry about a residue after the treatment.
- Factors such as voltage, current, and irradiation time (conveyance speed of the object to be irradiated) are related to the electron beam dose. Since the electron beam has a lower penetrating power than the ⁇ -ray, the necessary penetrating power can be controlled.
- the dose rate dose per hour
- ⁇ -ray is one of electromagnetic waves in radiation and is used for sterilization purposes.
- Gamma rays can be irradiated using a radiation source exposure device or the like.
- Gamma rays are highly transmissive, and the dose of gamma rays is related to factors such as heat source intensity, distance from the heat source, and irradiation time, and the processing time takes several hours, so that the irradiated object is relatively deteriorated.
- both electron beams and ⁇ rays can be used.
- the nerve regeneration-inducing material of the present invention is preferably irradiated with an electron beam and / or ⁇ -ray at an absorbed dose of 1 kGy to 100 kGy, more preferably 3 kGy to 60 kGy, more preferably 5 kGy to 40 kGy, particularly preferably 5 kGy to 25 kGy, and still more preferably 10 kGy to 24 kGy.
- the nerve regeneration-inducing material irradiated with the electron beam and / or ⁇ -ray has a shorter time until disappearance from the application site in the body than the material not irradiated. In other words, it has a feature that the remaining time in the body is short.
- “Disappearance from the application site” means that when a cross-linked body is placed on the application site and the application site is observed after a certain time, the cross-linked product cannot be visually recognized by visual observation.
- the application site in the body at this time is preferably a nerve injury site, but for example, a disappearance from the application site may be confirmed by performing a subcutaneous or intramuscular implantation test in an animal such as a rat. .
- Such a nerve regeneration-inducing material irradiated with an electron beam and / or ⁇ -ray has a feature that it has a higher nerve regeneration-inducing effect than a material that has not been irradiated.
- the nerve regeneration-inducing material of the present invention preferably has a disappearance from the application site of 7 to 270 days, more preferably 14 to 180 days, and still more preferably It is 14 to 150 days, and particularly preferably 14 to 120 days.
- the nerve regeneration-inducing material of the present invention is made of 0.7 cm in length and 1.5 cm in width (regardless of thickness) according to the description in Example 6 of the present specification.
- the nerve regeneration-inducing material of the present invention has a size of 1 cm in length and 1 cm in width (regardless of thickness) according to the description in Example 7 of the present specification.
- 4 pieces of the cut material and 25 mL of physiological saline are placed in a 50 mL centrifuge tube, and shaken at a temperature of 50 ° C. at a temperature of 50 ° C. in a constant temperature shaking water tank.
- the residual ratio of the material 72 hours after the start of shaking is desirably 10% to 80%, and more preferably 20% to 80%.
- the “residual rate” as used herein refers to the mass of the material after drying under reduced pressure (60 ° C.) until the material after the decomposability test for a certain period of time has reached a constant weight relative to the mass of the material before starting the degradability test.
- the ratio of In addition, the length and width of the cut surface of the material are perpendicular to each other. At this time, the thickness of the material is used as the thickness of the material to be tested, but it is desirable that the thickness is typically about 1 mm to about 10 mm.
- the nerve regeneration-inducing material of the present invention shows a decrease in the residual rate after 72 hours from the start in the degradability test compared to the residual rate after 4 hours from the start. It is preferable. In the examples of the present invention, it was found that the ethanol-sterilized alginate crosslinked product did not have sufficient nerve regeneration-inducing effect. However, in the degradability test of Example 7, the crosslinked product having the same composition was 72 hours from the start. Even after that, the residual rate exceeded 100%. In one embodiment of the present invention, the nerve regeneration-inducing material of the present invention may have a residual rate of 55% or more, more preferably 60% or more after 4 hours from the start in the degradability test. desirable.
- the nerve regeneration-inducing material of the present invention has a residual rate of 55% or more after 4 hours from the start in the degradability test, and then the residual rate decreases and 72 hours after the start. It is desirable that the residual ratio is 10% to 80%.
- the nerve regeneration-inducing material of the present invention has a maximum test force of 0.10 (N) to 10 when the tear test described below (the tear test described in Example 10) is performed.
- 0.0 (N) is preferable, and 0.10 (N) to 5.0 (N) is more preferable.
- the tear test in the present invention is performed as follows. The target material is cut so as to have a size of 2 cm long ⁇ 2 cm wide (regardless of thickness). Here, the vertical and horizontal cut surfaces intersect perpendicularly. At this time, since the thickness of the material is a test for checking the tear strength of the material itself, the thickness of the material to be tested is used as it is, but it is desirable that the thickness is typically about 1 mm to about 10 mm. .
- Grip with a double clip so as to sandwich the material at a position 5 mm away from one of the cut surfaces of the material (gripping part A).
- a region from the cut surface (B) to 10 mm facing the gripping portion A of the material is immersed in physiological saline for 15 minutes.
- a suture with a needle is passed through the central portion at a position 5 mm away from the cut surface (B) of the material, and both ends of the suture are fixed to the instrument.
- the grip portion A is pulled horizontally on the square surface of the material at a speed of 10 mm / min until the material is torn, and the tensile load is measured as a test force (N).
- the maximum test force is defined as the maximum test force (N).
- the tensile load is preferably measured using a small physical property tester (EZ-graph, manufactured by Shimadzu Corporation), but if it is not available, a similar load measuring machine may be used.
- the width of the gripping portion is preferably 15 to 19 mm. It is preferable to use “Bikrill (registered trademark)” as the suture used in the test and “4-0” as the thickness of the yarn.
- the material is polyglactin 910 (glycolic acid / lactic acid polyester: 90). / 10), and a suture having a thread thickness of 4-0 may be used.
- the needle it is preferable to use a round needle SH-1, but if it is not available, a needle that matches a similar suture may be used.
- the present invention is also directed to inducing nerve regeneration, wherein the bioabsorbable polysaccharide having a carboxyl group in the molecule of low endotoxin comprises a crosslinked product covalently crosslinked with the above-mentioned amine compound (I) and / or a salt thereof.
- a method for adjusting the remaining time in the body of a nerve regeneration-inducing material comprising at least a step of irradiating the material with an electron beam and / or ⁇ -ray.
- the present invention also provides that (A) the bioabsorbable polysaccharide having a carboxyl group in the molecule of low endotoxin is at least one cross-link selected from the compounds represented by the above general formula (I) and salts thereof
- Body of nerve regeneration-inducing material comprising at least a step of irradiating an electron beam and / or ⁇ -ray to a crosslinked body covalently crosslinked with a sex reagent and (B) a crosslinked body containing a bioabsorbable polymer
- a method for adjusting the remaining time is provided. In order to shorten the remaining time in the body of the material of the present invention, the irradiation dose of electron beam and / or ⁇ -ray is increased. Conversely, in order to increase the remaining time in the body, the irradiation dose of electron beam and / or ⁇ -ray is increased. By making it low, the remaining time in the body of the nerve regeneration-inducing material can be adjusted.
- the present invention also relates to a material comprising a cross-linked product covalently crosslinked using a bioabsorbable polysaccharide having a carboxyl group in the molecule of low endotoxin and an amine compound (I) and / or a salt thereof.
- a method for producing a nerve regeneration-inducing material including at least a step of irradiating an electron beam and / or ⁇ -ray.
- the “material containing a cross-linked body” is optionally useful for the growth of the above-mentioned bioabsorbable polymer and nerves in addition to the cross-linked body made of a bioabsorbable polysaccharide having a carboxyl group in the molecule.
- Other components such as factors may be included. Specific preferred embodiments are as described above.
- the present invention also provides a method for producing a nerve regeneration-inducing material including at least the following steps.
- (1) A solution containing a bioabsorbable polysaccharide having a carboxyl group in the molecule of low endotoxin, and at least one cross-linking reagent selected from the compound represented by the above general formula (I) and a salt thereof Mixing with (2)
- a step in which the mixture obtained in (1) and the bioabsorbable polymer are placed in a mold and allowed to stand for a certain period of time to form a crosslinked product, (3) a step of washing the cross-linked product obtained in (2) and then freeze-drying;
- (4) A step of irradiating the crosslinked product obtained in (3) with an electron beam and / or ⁇ -ray.
- a preferred embodiment of this production method is as described in this specification.
- the nerve regeneration-inducing material is applied to nerve damage caused by trauma, tumor resection, or the like to induce nerve regeneration and / or reconstruction.
- the material for inducing nerve regeneration according to the present invention is excellent in safety because it is absorbed and decomposed after several months necessary for nerve reconstruction, and is finally metabolized and excreted.
- “nerve damage” includes a state in which nerve continuity is lost (deficiency) and a state in which nerve continuity is maintained but nerve function is impaired, including rupture and the like. Including.
- the “defect” may be referred to as “gap”, “cut”, or the like, and also includes “rupture”.
- Nerve damage is caused by, for example, trauma, tumor resection, lymph node dissection, central nervous system or peripheral nervous system diseases, etc., but in the present invention, the cause of nerve damage does not matter.
- the part where the nerve and the nerve are joined at the part where the suture thread is not applied can be in a state where a gap is formed. Materials can also be applied. In addition, for example, it can be used for regeneration of a nerve damaged part when reconstructing a tissue that has been deficient, dropped, or excised due to various factors.
- “apply” means that a nerve regeneration-inducing material is placed in a damaged part of a nerve.
- the contact between the nerve regeneration-inducing material and the nerve stump is not essential, but preferably, the nerve stump is deficient in the nerve regeneration-inducing material. It is desirable to place the material of the present invention so as to come into contact, and more preferably, the material of the present invention is placed so that the nerve regeneration-inducing material and the stump of the nerve overlap. When the nerve stump cannot be visually recognized, the nerve regeneration-inducing material and the nerve stump need not necessarily be brought into contact with each other.
- nerve regeneration-inducing material may be performed, for example, by placing the nerve regeneration-inducing material in one direction with respect to both ends of the nerve to be reconstructed.
- both ends may be sandwiched vertically or horizontally, and for example, the entire periphery of both ends of the nerve may be covered with a nerve regeneration-inducing material.
- the nerve regeneration-inducing material is non-tubular, it is easier to supply the nutrients and oxygen necessary for nerve axon elongation than the tubular material, while preventing the invasion of fibrous tissue that works for tissue repair It is advantageous for nerve axon extension, preferably non-tubular, and more preferably flat. In this case, the fibrous tissue that acts on tissue repair impairs normal tissue repair due to scarring.
- the alginate cross-linked product of the present invention has an effect of suppressing adhesion and proliferation of fibroblasts as compared with a collagen sponge, and has a preferable performance as a material for inducing nerve regeneration. It was found to provide.
- induction of nerve regeneration means to promote proliferation of nerve cells and / or elongation of nerve axons.
- the damaged part of the nerve is a defective part, it means to promote the extension of the nerve axon so as to restore the nerve continuity.
- the nerve axon on the distal side (distal from the cut end) from the defect is degenerated because the continuity from the nerve cell body is cut off (in the peripheral nerve it is called Waller degeneration) ) Occurs and nerve function is lost.
- Degenerated nerve axons far from the defect are phagocytosed by macrophages as remnants.
- a number of nerve axons sprouting from the central stump extend to the peripheral stump side.
- an axon extending from the central side is preferably connected to the distal stump.
- induction of nerve regeneration can be indicated by at least partially restoring lost nerve function and perception. Induction of nerve regeneration in the present invention does not necessarily mean that the state before injury is completely restored.
- the nerve regeneration-inducing material of the present invention preferably achieves any one or more of the above effects.
- the method for using the nerve regeneration-inducing material of the present invention exposes the target nerve site to be reconstructed, and reconstructs the nerve regeneration-inducing material of an appropriate size according to the length and width of the nerve to be reconstructed. Applies to damaged nerve parts.
- a “subject” is a human or non-human organism, such as avian and non-human mammals (eg, cows, monkeys, cats, mice, rats, guinea pigs, hamsters, pigs, dogs, rabbits, sheep, and horses). is there.
- the nerve regeneration-inducing material When the nerve regeneration-inducing material is in a xerogel form, it may be applied in a dry state as it is, or may be applied in a gel state after containing physiological saline or purified water. That is, the nerve regeneration-inducing material of the present invention may be in a gel form.
- the nerve regeneration-inducing material After the nerve regeneration-inducing material is applied to the nerve damage part, it is not necessary to stitch the nerve regeneration-inducing material and the nerve damage part, but if necessary, the nerve regeneration-inducing material and the nerve damage part (for example, the nerve damage part) A stump or the like) may be sewn.
- the nerve regeneration-inducing material is applied to a nerve branch and / or a damaged part of the plexus.
- the nerve plexus is also called a nerve collection network, and is a portion where branched nerves form a network structure.
- the nerve regeneration-inducing material of the present invention is preferably applied to nerve branches and / or damaged parts of the plexus, for example, prostate, bladder, penile corpus cavernosum, arms, extremities, brain, spinal cord, face, neck, hips. Applicable to sacrum, lumbar sacrum, pubic area, heart, abdominal cavity, lower lower abdomen, pelvis, thoracic cavity, intestinal wall, etc.
- the site to which the nerve regeneration-inducing material can be applied is not particularly limited as long as it is a nerve damaged part. It can be used to induce regeneration of damaged parts of peripheral nerves and / or central nerves, and can be applied to linear nerves, nerve branch parts and / or damaged parts of plexus parts, and the like. In the case of the central nervous system, for example, damaged parts of the brain and spinal cord can be mentioned.
- the nerve regeneration-inducing material of the present invention may be used in combination with factors useful for nerve regeneration or growth, humoral factors such as physiologically active substances, or cells.
- humoral factors such as physiologically active substances, or cells.
- the humoral factor is not particularly limited as long as it is a factor that can be used supplementarily to the regenerated tissue, and examples thereof include bFGF, NGF, hepatocyte growth factor, immunosuppressive agent, and anti-inflammatory agent.
- Examples of the cells include mesenchymal stem cells, bone marrow mesenchymal stem cells, neural stem cells, bone marrow-derived mononuclear cells, adipose-derived stem cells, in vivo pluripotent stem cells, ES cells, neural progenitors by autologous or autologous culture Examples include, but are not limited to, cells, iPS cells, CD133 + cells. In another aspect of the present invention, it is also preferable that the material for inducing nerve regeneration of the present invention is not used in combination with these cells and factors, and more preferably not used in combination with CD133 + cells.
- the method for evaluating nerve regeneration is not particularly limited.
- the elongation of nerve axons can be observed under an optical microscope, such as by observing axon elongation at a target site.
- nerves are embedded with Epon resin, and reached between the gap or the peripheral stump by staining with reagents such as toluidine blue, anti-beta tubulin class 3 antibody, or anti-S100 antibody. It can be shown by counting the number of myelinated axons.
- Epon resin After embedding by an appropriate method such as Epon resin, it is possible to observe and evaluate the state of the regenerating axon with a transmission electron microscope (TEM) or a scanning electron microscope (SEM).
- TEM transmission electron microscope
- SEM scanning electron microscope
- electrophysiological measurements for example, electrophysiological measurements, histopathological evaluations, walking patterns, tracer tests to examine axon transport, tracer detection, and two-point discrimination It may be evaluated by a visual inspection (Two-point discrimination) or the like.
- CMAP compound muscle action potentials
- SEP somatosensory energy voluntary potentials
- the present invention also provides a method for inducing regeneration of a nerve damaged part in a subject in need of regeneration of the nerve damaged part, including the step of applying the above-described nerve regeneration inducing material to the nerve damaged part. .
- the present invention also requires regeneration of nerve bifurcation and / or plexus injury including the step of applying the aforementioned nerve regeneration-inducing material to nerve bifurcation and / or plexus injury.
- a method for inducing regeneration of a nerve branch and / or a damaged part of a plexus The specific method is as described above.
- the present invention further provides a bioabsorbable polysaccharide having a carboxyl group in the molecule of low endotoxin and / or a compound represented by the above general formula (I) for producing the above-mentioned material for inducing nerve regeneration. And at least one cross-linking reagent selected from the salts thereof, wherein the nerve regeneration-inducing material is applied to a nerve damage site, preferably a nerve branch and / or a nerve plexus injury site
- a nerve damage site preferably a nerve branch and / or a nerve plexus injury site
- the present invention further provides that the bioabsorbable polysaccharide having a carboxyl group in the molecule of low endotoxin is covalently crosslinked with a crosslinking agent selected from the compound represented by the above general formula (I) and a salt thereof.
- a crosslinking agent selected from the compound represented by the above general formula (I) and a salt thereof.
- Example 1 Preparation of Alginate Crosslinker and Evaluation of Properties Alginate in the form of a xerogel using sodium alginate, (i) calcium chloride, (ii) a mixture of calcium chloride and sodium chloride, and (iii) ethylenediamine as a crosslinking agent.
- a crosslinked product was prepared and evaluated for properties.
- Sodium Alginate As the sodium alginate, six kinds of low endotoxin sodium alginate (Sea Matrix (registered trademark), Mochida Pharmaceutical Co., Ltd.) having an endotoxin content of less than 50 EU / g were used.
- A-1, A-2 and A-3 have a sodium / alginate M / G ratio in the range of 0.4 to 1.8, and B-1, B-2 and B-3 are sodium alginate M
- the / G ratio was in the range of 0.1 to 0.4.
- Table 1 shows the viscosity and weight average molecular weight of a 1 w / w% aqueous solution of each sodium alginate.
- the viscosity of sodium alginate was measured using the rotational viscometer method (cone plate type rotational viscometer) according to the viscosity measurement method of the Japanese Pharmacopoeia (16th edition). Specific measurement conditions are as follows.
- the sample solution was prepared using MilliQ water.
- a cone plate type rotational viscometer visco-viscoelasticity measuring device Rheostress RS600 (Thermo Haake GmbH) sensor: 35/1 was used.
- the number of revolutions was 1 rpm when measuring a 1 w / w% sodium alginate solution.
- the reading time was measured for 2 minutes, and an average value from 1 minute to 2 minutes from the start.
- the average value of three measurements was taken as the measurement value.
- the measurement temperature was 20 ° C.
- the weight average molecular weight of each sodium alginate was measured by two types of measurement methods, gel permeation chromatography (GPC) and GPC-MALS.
- the measurement conditions are as follows.
- a tube containing 1 mL of an aqueous sodium alginate solution (Falcon2054) was layered with 1 mL of 50 mM calcium chloride aqueous solution and allowed to stand overnight, then the gelled one was washed three times with Milli-Q water, freeze-dried, and a xerogel-like solution. A cross-linked alginate was obtained.
- a tube containing 1 mL of sodium alginate aqueous solution (Falcon2054) was layered with 1 mL of calcium-sodium crosslinker aqueous solution and allowed to stand overnight, and then the gelled one was washed three times with milli-Q water, freeze-dried, and xerogel-like A crosslinked alginic acid product was obtained.
- a cross-linking agent aqueous solution in which the calcium ion of the calcium-sodium cross-linking agent aqueous solution is 10 mM, 20 mM, or 50 mM is prepared, and an alginate cross-linked product is obtained by the same procedure using A-1 or A-2 sodium alginate. It was.
- ECF Extra Cellular Fluid
- the mixture was allowed to stand in a Falcon 2054 tube at room temperature for 2 days to gel.
- the gel was washed 3 times / day with ECF for about 7 days, then 3 times with milliQ water, and then lyophilized to obtain a xerogel-like alginate crosslinked product.
- ECF Extra Cellular Fluid
- Table 2 shows the evaluation results of the alginic acid crosslinked product using ethylenediamine as a crosslinking agent.
- A-1 had about 1/2 remaining after one week, whereas A-2, A-3, B-1, B-2, B-3 Almost all of the transparent hydrogel remained after 1 week.
- A-1, A-2 and B-3 are compared with sodium alginate of B-1, B-2 and B-3 (M / G ratio is 0.1 to 0.4). It has been found preferable to use sodium alginate of A-3 (M / G ratio of 0.6 to 1.8).
- the sodium alginate of A-2 and A-3 that is, GPS-MALS from the viewpoint of gelation and gel remaining in PBS. It was found that it is preferable to use sodium alginate having a weight average molecular weight of 90,000 or more.
- Example 2 Evaluation of Survival Rate of Nerve-Like Cells
- the alginic acid crosslinked product (about 1.0 cm ⁇ 1.0 cm) prepared in Example 1 was impregnated with 1 mL of PC12 cells (50,000 cells / mL).
- Nerve growth factor (NGF) final 100 ng / mL
- NGF Nerve growth factor
- DOJINDO WST-8 reagent
- the alginate cross-linked product is obtained by cross-linking A-2 with (i) calcium chloride (iii) with ethylenediamine (referred to as A-2Ca and A-2EDA, respectively), and A-3 with (i) calcium chloride (iii) with ethylenediamine.
- A-2Ca and A-2EDA ethylenediamine
- A-3 calcium chloride (iii) with ethylenediamine.
- A-3Ca and A-3EDA Four types of cross-linked products (referred to as A-3Ca and A-3EDA, respectively) were used.
- a tissue culture plate was used as a control.
- A-2EDA, A-3Ca, and A-3EDA were all 98% or higher when the survival rate of nerve-like cells in the control was 100%.
- A-2Ca showed a low survival rate (63%).
- A-2Ca the reason why the survival rate of nerve-like cells was low was presumed to be due to the toxicity of eluted calcium and insufficient supply of oxygen due to increased viscosity in the medium due to dissolved alginic acid.
- Example 3 Evaluation of electron beam irradiated alginic acid crosslinked product 3- (1) Electron beam irradiation to alginate crosslinked material Using low endotoxin sodium alginate A-2 and A-3, calcium chloride and sodium chloride were used as crosslinking agents. Alginic acid crosslinked bodies (respectively A-2CaNa and A-3CaNa) and alginate crosslinked bodies using ethylenediamine as a crosslinking agent (respectively A-2EDA and A-3EDA) were prepared according to Example 1- (4).
- Alginate cross-linked product using calcium chloride and sodium chloride as a cross-linking agent is a 25 ml calcium-sodium cross-linking agent aqueous solution (calcium chloride anhydrous 50 mM, sodium chloride 300 mM) filled with 3.15 ml each of 1% sodium alginate aqueous solution. It was made to gel by dipping, washed and freeze-dried.
- Each alginate crosslinked body was irradiated with 20 kGy, 40 kGy, and 60 kGy of an electron beam.
- a Dynamitron electron accelerator manufactured by RDI was used as the electron beam irradiation device, and a Shimadzu UV1800 spectrophotometer for CTA dosimeter was used as the dose measurement device.
- CTA dosimeter FRR-125 manufactured by Fuji Photo Film Co., Ltd. Lot No. 459 was used as a dosimeter.
- the electron beam was irradiated under the conditions of an acceleration voltage of 4.8 MV and a current of 20.0 mA while adjusting the irradiation time so as to obtain a target irradiation dose.
- each cross-linked body is cut into about 7 mm ⁇ about 7 mm, put into a 50 ml centrifuge tube containing 25 ml of physiological saline, and placed in a 37 ° C. incubator with the centrifuge tube laid sideways. The mixture was shaken at 60 rpm, and the time until the crosslinked body completely disintegrated was measured.
- alginic acid crosslinked products (A-2CaNa, A-3CaNa) using calcium chloride and sodium chloride as crosslinking agents, there was no constant relationship between the electron dose and the time until dissolution.
- alginic acid crosslinked products (A-2EDA and A-3EDA) using ethylenediamine as a crosslinking agent, the time until dissolution was shortened as the electron dose increased.
- Example 4 Induction of regeneration of rat sciatic nerve injury using alginate crosslinked body An ethylenediamine-crosslinked alginate crosslinked body was placed at the cut site of the rat sciatic nerve (peripheral nerve) to evaluate the effect of nerve regeneration induction.
- Example 4- Preparation of Ethylenediamine Crosslinked Alginic Acid Crosslinked Product
- a xerogel-like alginic acid crosslinked product obtained by covalently crosslinking ethylenediamine with A-2 and A-3 low endotoxin sodium alginate ( A-2EDA and A-3EDA, respectively) were produced.
- the content of alginic acid in the crosslinked product was 3.0 mg / cm 2 .
- the thickness of the crosslinked body was about 2 mm to about 8 mm.
- alginate cross-linked body was placed on the nerve cutting site, so that the nerve cut portion was sandwiched between the two alginate cross-linked bodies.
- Two alginate cross-linked bodies were used in a size that could cover both the central and peripheral nerve stumps.
- the cross-linked alginate was not fixed by suture.
- the open muscle was sutured and the skin was also sutured.
- Another alginate cross-linked body was placed on the nerve cutting site, so that the nerve cut portion was sandwiched between the two alginate cross-linked bodies.
- the two cross-linked alginates were used in a size that could cover the central and peripheral nerve stumps.
- the cross-linked alginate was not fixed by suture. The open muscle was sutured and the skin was also sutured.
- Example 5 Induction of regeneration of a rat sciatic nerve lesion using a cross-linked alginate containing polyglycolic acid irradiated with an electron beam 5- (1) An ethylenediamine cross-linked alginate containing polyglycolic acid irradiated with an electron beam Preparation According to Example 1- (4), EDA ⁇ 2HOSu and EDC ⁇ HCl were dissolved in a low endotoxin sodium alginate aqueous solution of A-2.
- the obtained solution is filled in a tray on which a sheet-like nonwoven polyglycolic acid (PGA) (100 mg / cc, 3.0 mg / cm 2 Non-woven PGA Biofelt, Biomedical Structures (USA)) is laid and freeze-dried.
- PGA sheet-like nonwoven polyglycolic acid
- A-2EDA ⁇ PGA100 the content of alginic acid in the crosslinked product was 2.0 mg / cm 2 .
- the alginic acid solution was filled in a tray laid with PGA, and after the gelation sufficiently proceeded, the gel was washed to remove unreacted crosslinking agent and reaction byproducts.
- the washing solution was prepared by dissolving CaCl 2 (2.5 mM, for example 0.28 g / 1 L) and NaCl (143 mM, for example 8.36 g / 1 L) in ECF (Extra Cellular Fluid: purified water), and using a 0.22 ⁇ m filter (Millipore, Milli-Pak 20 etc.) and endotoxin removal filter (prepared by Millipore, prep-scale UF cartridge PLGC CDUF 001 LG) were used.Replace the washing solution as appropriate, and then wash with distilled water to remove excess salts.
- the resulting crosslinked product had a thickness of about 2 mm to about 8 mm.
- A-3EDA ⁇ PGA100 a cross-linked alginate produced using A-3 low endotoxin sodium alginate was designated as A-3EDA ⁇ PGA100.
- the two types of crosslinked products obtained were irradiated with an electron beam at an absorbed dose of 20 kGy.
- the number of regenerated myelinated nerves was 1,001 on average for A-2EDA ⁇ PGA100 and 7010 on average for A-3EDA ⁇ PGA100.
- the number of regenerated myelinated nerves was obtained by counting all myelinated nerves in the nerve bundles judged to be regenerated sites in the collected tissue specimens.
- the number of axons in healthy rats was about 6700, indicating that a sufficient number of myelinated nerves were regenerated.
- Example 5- (3) Regeneration induction effect on sciatic nerve branch defect According to Example 5- (1), low endotoxin sodium alginate (A-2 or A-3) and sheet-like non-woven polyglycolic acid (PGA) (50 mg / cc, 1.5 mg / cm 2 ) was used to prepare alginate crosslinked bodies containing two types of PGA, which were designated as A-2EDA ⁇ PGA50 and A-3EDA ⁇ PGA50, respectively.
- the alginic acid content in the crosslinked product was 2.0 mg / cm 2 .
- the thickness of the obtained crosslinked product was about 2 mm to about 8 mm.
- the two types of crosslinked products obtained were irradiated with an electron beam at an absorbed dose of 20 kGy.
- the treatment was performed according to 4), and the regeneration induction effect on the gap at the bifurcation of the sciatic nerve was evaluated 8 weeks after the application of the crosslinked body.
- FIGS. 1 and 2 photographs taken 8 weeks after the operation of A-3EDA ⁇ PGA50 and A-2EDA ⁇ PGA100 are shown in FIGS. 1 and 2, respectively.
- FIG. 3 and 4 show the result of staining a cross section of the nerve distal to the distal stump using toluidine blue according to Example 4- (3).
- FIG. 3 shows a photograph of a regeneration axon on the tibial nerve side
- FIG. 4 shows a photograph of a regeneration axon on the radial nerve side.
- Example 1- (4) an ethylenediamine-crosslinked alginate (alginate content 2.0 mg / cm 2 ) was prepared using low endotoxin sodium alginate of A-2, irradiated with 20 kGy of electron beam, did.
- Example 5- (3) The results obtained in Example 5- (3) are shown with sample numbers 2 and 3 respectively for A-2EDA / PDA50 and A-2EDA / PDA100 used in Example 5- (3).
- Example 5- (1) a cross-linked product was prepared using A-3 low endotoxin sodium alginate and PGA100 (A-3EDA ⁇ PGA100).
- a crosslinked product with an alginic acid content of 2.0 mg / cm 2 was designated as sample number 4
- a crosslinked product with an alginic acid content of 4.0 mg / cm 2 was designated as sample number 5
- an electron beam of 15 kGy was used for these crosslinked products. Irradiated.
- the cross-linked alginate containing no PGA was distorted during freeze-drying, and it was difficult to obtain a cross-linked product having a certain shape.
- the cross-linked alginate containing PGA had a shape filled in a plate. It was possible to maintain and freeze-dry and increase the production efficiency.
- FIG. 5 shows a schematic diagram of a test in which an alginate cross-linked product is applied to a defect in a nerve branch.
- Sample Nos. 1 to 5 showed sufficient regeneration of nerve axons on both the tibia side and the radius side, and the number of regenerating axons compared to the group of Sample No. 6 where only the bifurcation was cut. There were many. Even when compared with the untreated group (sample No. 7) in which the nerve branch was not cut, it was found that a sufficient regenerative effect was obtained at 8 weeks after the operation.
- the number of regenerative axons of the cross-linked body containing no PGA was not significantly different from the number of cross-linked bodies containing the PGA (sample numbers 2 and 3). From this, it was shown that the presence or absence of PGA in the crosslinked product does not significantly affect the nerve regeneration effect. On the other hand, comparing the proportion of regeneration-incomplete axons with 400 or less regeneration axons in each group, the cross-linked product (sample number 1) containing no PGA was 33%, whereas the sample number Cross-linked products containing 2-5 PGA were 0% -19%.
- the alginic acid crosslinked body containing PGA tended to have fewer examples of insufficient regeneration than the alginic acid crosslinked body not containing PGA.
- insufficient regeneration there was an example in which the regenerating nerve was thinned at a portion close to the knee of the rat. This is thought to be due to pressure applied to the crosslinked body due to the movement of the knee and tearing (rupture), continuity of the crosslinked body was lost, and regeneration was insufficient.
- Algaic acid cross-linked product containing PGA is stronger than cross-linked product not containing PGA, and the gel is not easily torn (torn) even in movable parts such as knees, and the possibility of stably regenerating axons Was suggested.
- FIG. 6 shows an example of insufficient regeneration when a crosslinked product not containing PGA (Sample No. 1) is used.
- Example 1- (4) a cross-linked alginate (A-2EDA, alginic acid content 2 mg / cm 2 ) prepared using A-2 low endotoxin sodium alginate and containing 40 kGy or 60 kGy electron beam irradiation. ),
- A-2EDA alginic acid content 2 mg / cm 2
- the regenerative effect on the linear nerve gap at 8 weeks after surgery was evaluated according to Example 5- (2).
- the average number of regenerating axons was as small as 267 on average and 275 on average, respectively.
- no cross-linked body remained in the affected area.
- Example 5- (2) the cross-linked product containing PGA irradiated with 20 kGy of electron beam is a linear nerve. It showed a sufficient nerve regeneration effect for the gap, and (ii) the presence or absence of PGA in the cross-linked product did not significantly affect the nerve regeneration effect, although it was for the gap at the branch (Table 4). In view of these, it was suggested that increasing the electron dose to 40 kGy or 60 kGy may have affected the nerve regeneration effect.
- Example 6 Subcutaneous Implantation Test of Alginic Acid Crosslinked Body 6- (1) Rat Long-Term Subcutaneous Implantation Test (1) Since previous studies suggested a relationship between the rate of disappearance of the alginic acid crosslinked body in the body (remaining rate) and the nerve regeneration effect, rat crosslinked implantation tests were conducted on various crosslinked bodies to examine the body disappearance rate.
- the sample was prepared by irradiating with changing the electron dose.
- Table 5 shows the sample types.
- sample numbers 43 and 44 only PGA (50 mg / cc, 1.5 mg / cm 2 ) and PLGA (50 mg / cc, 1.5 mg / cm 2 ) were used as samples.
- Each sample having a size of 0.7 cm in length and 1.5 cm in width (regardless of thickness) was implanted subcutaneously on the back of the rat and evaluated histologically after 4 weeks. The histological evaluation was performed using a specimen prepared as follows.
- paraffin-embedded blocks were prepared according to a conventional method, and hematoxylin / eosin staining and safranin-O staining were performed.
- Sample Nos. 52 and 53 are sample Nos. 4 and 5 in Table 4, and sample No. 54 is a crosslinked product whose nerve regeneration effect was confirmed in Example 5- (3).
- sample Nos. 52 and 53 are sample Nos. 4 and 5 in Table 4, and sample No. 54 is a crosslinked product whose nerve regeneration effect was confirmed in Example 5- (3).
- Example 7 Underwater Degradability Test of Alginic Acid Crosslinked Product Degradability of the alginic acid crosslinked product was evaluated by an in vitro test.
- the liquid after the measurement was filtered under reduced pressure with a membrane filter (Merck, Omnipore) having a pore diameter of 10 ⁇ m, and after collecting the image of the filtered residue, it was dried under reduced pressure (60 ° C.) until a constant weight was obtained. . The remaining sample was weighed, and the ratio to the sample amount before the start of the test was calculated as the remaining rate (%).
- a membrane filter Merck, Omnipore
- the number of shakes of the constant temperature shaking water tank was 120 round-trips.
- the solvent temperature was 50 ° C. as the set temperature of the constant temperature shaking water tank.
- Example 5- (3) and (4) the sample numbers 61 to 64 in which the rat nerve regeneration effect was confirmed and the crosslinked body not irradiated with the electron beam were evaluated. Table 7 shows the evaluated crosslinked products.
- Sample No. 66 has the same composition as the crosslinked product used after ethanol sterilization in the rat test in Example 4- (2).
- Sample 68 was a cross-linked product similarly prepared using PLGA (50 mg / cc, 1.5 mg / cm 2 ) instead of PGA according to Example 5- (1).
- the cross-linked samples Nos. 61 to 64 tended to have a residual rate that decreased with time, and the residual rate after 3 days (72 hours) from the start of the test was in the range of about 20% to about 70%. Indicated.
- the residual ratios of the samples 65 and 66 which are cross-linked bodies not containing PGA and not irradiated with an electron beam increased.
- Samples 67 and 68, which are cross-linked products containing PGA or PLGA and not irradiated with an electron beam showed a decrease in the residual rate over time, but the residual rate after 3 days (72 hours) from the start of the test. Showed 80% or more. From the above, it was suggested that in this test, a cross-linked product having a residual ratio of the cross-linked product 3 days after the start of the test (72 hours later) in the range of about 20% to about 80% is preferable for nerve regeneration.
- Sample No. 71 is a cross-linked product whose rat nerve regeneration effect was confirmed in Example 5- (4).
- the residual rate of sample 75 with a ⁇ -ray dose of 50 kGy decreased to about 50% after 4 hours immediately after the start. From this result, it was suggested that the residual rate of electron beam and ⁇ -ray immediately after the start decreases by increasing the irradiation dose.
- a cross-linked body is placed in a nerve gap to promote nerve regeneration, it is considered that if the cross-linked body disappears early after installation, it cannot be an initial scaffold for nerve regeneration.
- the crosslinked body irradiated with an electron dose of 40 kGy or 60 kGy did not have a high regeneration effect of the linear nerve gap because the crosslinked body disappeared from the beginning of installation. There was a possibility that it could not serve as a nerve scaffold.
- Example 5- (1) the degradability was similarly compared between the cross-linked product prepared in the same manner using PLGA (50 mg / cc, 1.5 mg / cm 2 ) instead of PGA and the cross-linked product containing PGA. did.
- Table 9 shows the evaluated crosslinked products.
- Sample number 84 is a crosslinked product in which the nerve regeneration effect was confirmed in Example 5- (3) and sample number 85 in Example 5- (4).
- EXAMPLE 1 Evaluation of cell adhesion and cell proliferation of normal human skin fibroblasts (NHDF) using a commercially available collagen sponge crosslinked with ethylenediamine cross-linked with ethylenediamine prepared according to Example 1- (4) And compared. It is considered that fibroblasts such as NHDF move and proliferate into a space for nerve regeneration and prevent nerve regeneration.
- NHDF normal human skin fibroblasts
- Samples consisted of four groups: (1) A-2EDA, (2) A-3EDA, (3) bovine collagen sponge (SpongeCol®, Advanced BioMatrix), (4) 2D control (tissue culture dish) did.
- the size of each sample was about 5 mm in length ⁇ about 5 mm in width ⁇ about 2 mm to about 7 mm in thickness in (1) and (2), and (3) in a circle of 4 mm in diameter ⁇ about 1 mm in thickness. It was seeded 10 4 cells per sample, one day in culture, after 4 days of culture, in order to separate the cells not adhering to the sample, after moving each sample to a new well, and adhered to each sample.
- the number of cells present was evaluated with the absorbance at 450 nm using WST-8 reagent.
- the medium was 10% FCS / EMEM.
- Example 9 Nerve regeneration effect on rat cavernous plexus removal model 9- (1) Preparation of rat cavernous plexus removal model Rats were fixed in the supine position under anesthesia by inhalation of 2% isoflurane. A midline incision was made in the lower abdomen, and the inside of the pelvis was expanded under a microscope to expose the pelvic plexus and cavernous nerve. In the treatment group and the non-treatment group, after securing the cavernous nerve, about 2 mm of the cavernous nerve was excised so as to cross the plexus branched in a mesh form. The left and right were treated in the same manner.
- a cross-linked alginate (A-3EDA ⁇ PGA100) containing PGA prepared according to Example 5- (1) was placed so as to sufficiently cover the nerve excision stump, and then sutured and fixed.
- the normal control group did not perform cavernosal nerve resection. Thereafter, the muscle layer and skin of the lower abdomen were sutured.
- benzylpenicillin potassium was injected intramuscularly at a dose of 20000 units / kg.
- Example 10 Tear test of cross-linked alginate A tear test was performed on the six types of cross-linked alginate in Table 11 assuming that the cross-linked body was sutured by surgery, and the strength of each sample was compared.
- Sample numbers 101 and 104 are alginic acid crosslinked bodies not containing PGA, and the other samples are alginic acid crosslinked bodies containing PGA, which were obtained in Example 1- (4) and Example 5- (1), respectively. Prepared as described. Sample numbers 101 to 103 were not irradiated with an electron beam, and sample numbers 104 to 106 were irradiated with an electron beam at 15 kGy.
- the test method is as follows. A schematic diagram of the test method is shown in FIG.
- Each sample was cut so as to have a size of 2 cm in length ⁇ 2 cm in width (regardless of thickness).
- the vertical and horizontal cut surfaces intersect each other vertically.
- the thickness of each sample was about 2 mm to about 8 mm.
- the material was held with a double clip (the width of the holding portion was about 15 mm) so as to sandwich the material at a position 5 mm away from one of the cut surfaces (gripping portion A).
- the entire part from the cut surface (B) to 10 mm facing the gripping part A of the sample was immersed in physiological saline for 15 minutes.
- a needle-attached suture thread (Bikerill (registered trademark), 4-0, round needle SH-1) is passed through the center of the sample at a position 5 mm away from the cut surface (B), and both ends of the suture thread are attached to the instrument. Fixed.
- the grip portion A was pulled horizontally at a speed of 10 mm / min on the square surface of the sample. Pulling was continued until each sample was torn near the suture, and the pulling load was measured as a test force.
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Abstract
Description
また、本発明の別の課題は、直線状の神経の損傷部にも、神経分岐部及び/又は神経叢部の損傷部にも適用可能で、神経再生誘導効果が高く、安全で生体適合性に優れる医療用材料を提供することである。
また、本発明のまた別の課題は、縫合可能な適度な強度を備えつつ、縫合しない場合でも神経再生効果を発揮しうる、様々な場所や形状の損傷に適用しやすい非管状の神経再生誘導用材料を提供することである。
(1-1)低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類が、下記の一般式(I)で表される化合物およびその塩から選択される少なくとも1種の架橋性試薬で共有結合架橋された架橋体を含む、神経の分岐部及び/又は神経叢部の損傷部の再生のために用いられる神経再生誘導用材料。
R1HN-(CH2)n-NHR2 (I)
[式中、R1およびR2はそれぞれ独立して水素原子または式:-COCH(NH2)-(CH2)4-NH2で表される基を示し、nは2~18の整数を示す。]
(1-2)分子内にカルボキシル基を有する生体内吸収性多糖類が、アルギン酸、そのエステルおよびその塩からなる群から選択される少なくとも1種である(1-1)に記載の神経再生誘導用材料。
(1-3)架橋性試薬が、上記の一般式(I)で表される化合物のN-ヒドロキシコハク酸イミド塩である(1-1)または(1-2)のいずれかに記載の神経再生誘導用材料。
(1-4)上記の一般式(I)で表される化合物のN-ヒドロキシコハク酸イミド塩が、ジアミノエタンの2N-ヒドロキシコハク酸イミド塩、ジアミノヘキサンの2N-ヒドロキシコハク酸イミド塩、N,N’-ジ(リジル)-ジアミノエタンの4N-ヒドロキシコハク酸イミド塩、および、N-(リジル)-ジアミノヘキサンの3N-ヒドロキシコハク酸イミド塩からなる群から選択される少なくとも1種である(1-3)に記載の神経再生誘導用材料。
(1-5)キセロゲルの形態である、(1-1)ないし(1-4)のいずれか1つに記載の神経再生誘導用材料。
(1-6)分子内にカルボキシル基を有する生体内吸収性多糖類が、100EU/g以下のエンドトキシン含有量である、(1-1)ないし(1-5)のいずれか1つに記載の神経再生誘導用材料。
(1-7)神経の分岐部及び/又は神経叢部の損傷部が、前立腺、腕、脳、脊髄、顔面、頸、腰、仙骨、腰仙骨、陰部、心臓、腹腔、及び腸壁内からなる群から選択される少なくとも1種に存在する、(1-1)ないし(1-6)のいずれか1つに記載の神経再生誘導用材料。
(1-7a)神経の分岐部及び/又は神経叢部の損傷部が、前立腺、膀胱、陰茎海綿体、腕、四肢、脳、脊髄、顔面、頸、腰、仙骨、腰仙骨、陰部、心臓、腹腔、下下腹、骨盤、胸腔内及び腸壁内からなる群から選択される少なくとも1種に存在する、(1-1)ないし(1-6)のいずれか1つに記載の神経再生誘導用材料。
(1-8)リンパ節の郭清に伴う神経損傷部の再生のために用いられる(1-1)ないし(1-7a)のいずれか1つに記載の神経再生誘導用材料。
(1-9)低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類が、上記の一般式(I)で表される化合物及びその塩から選択される少なくとも1種の架橋性試薬で共有結合架橋された架橋体を含む神経再生誘導用材料を、神経の分岐部及び/又は神経叢部の損傷部に適用する工程を含む、神経の再生を必要とする対象において神経の分岐部及び/又は神経叢部の損傷部の再生を誘導する方法。
(1-9a)(1-1)ないし(1-8)のいずれか1項に記載の神経再生誘導用材料を、神経の分岐部及び/又は神経叢部の損傷部に適用する工程を含む、神経の再生を必要とする対象において神経の分岐部及び/又は神経叢部の損傷部の再生を誘導する方法。
(1-10)低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類が、上記の一般式(I)で表される化合物及びその塩から選択される架橋性試薬で共有結合架橋された架橋体を含む神経再生誘導用材料を用いる、神経の分岐部及び/又は神経叢部の損傷部の損傷部の再生において使用されるための前記低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類。
(1-10a)(1-1)ないし(1-8)のいずれか1項に記載の神経再生誘導用材料を用いる、神経の分岐部及び/又は神経叢部の損傷部の損傷部の再生において使用されるための前記低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類。
(1-11)(1-1)ないし(1-8)のいずれか1項に記載の神経再生誘導用材料を製造するための、前記低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類及び/又は前記一般式(I)で表される化合物およびその塩から選択される少なくとも1種の架橋性試薬の使用であって、前記神経再生誘導用材料が神経の分岐部及び/又は神経叢部の損傷部に適用し神経を再生するように用いられる、前記使用。
(2-1)低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類が、下記の一般式(I)で表される化合物およびその塩から選択される少なくとも1種の架橋性試薬で共有結合架橋され、電子線及び/又はγ線が照射された架橋体を含む、神経再生誘導用材料。
R1HN-(CH2)n-NHR2 (I)
[式中、R1およびR2はそれぞれ独立して水素原子または式:-COCH(NH2)-(CH2)4-NH2で表される基を示し、nは2~18の整数を示す。]
(2-2)分子内にカルボキシル基を有する生体内吸収性多糖類が、アルギン酸、そのエステルおよびその塩からなる群から選択される少なくとも1種である(2-1)に記載の神経再生誘導用材料。
(2-3)架橋性試薬が、上記の一般式(I)で表される化合物のN-ヒドロキシコハク酸イミド塩である(2-1)または(2-2)のいずれかに記載の神経再生誘導用材料。
(2-4)上記の一般式(I)で表される化合物のN-ヒドロキシコハク酸イミド塩が、ジアミノエタンの2N-ヒドロキシコハク酸イミド塩、ジアミノヘキサンの2N-ヒドロキシコハク酸イミド塩、N,N’-ジ(リジル)-ジアミノエタンの4N-ヒドロキシコハク酸イミド塩、および、N-(リジル)-ジアミノヘキサンの3N-ヒドロキシコハク酸イミド塩からなる群から選択される少なくとも1種である(2-3)に記載の神経再生誘導用材料。
(2-5)キセロゲルの形態である、(2-1)ないし(2-4)のいずれか1つに記載の神経再生誘導用材料。
(2-6)分子内にカルボキシル基を有する生体内吸収性多糖類が、100EU/g以下のエンドトキシン含有量である、(2-1)ないし(2-5)のいずれか1つに記載の神経再生誘導用材料。
(2-7)電子線及び/又はγ線が、吸収線量1kGy~100kGyで照射された、(2-1)ないし(2-6)のいずれか1つに記載の神経再生誘導用材料。
(2-8)7日~270日で適用部位から消失する、(2-1)ないし(2-7)のいずれか1つに記載の神経再生誘導用材料。
(2-9)さらにポリグリコール酸、ポリ乳酸、およびそれらの共重合体からなる群から選択される少なくとも1種を含有する、(2-1)ないし(2-8)のいずれか1つに記載の神経再生誘導用材料。
(2-10)末梢神経及び/又は中枢神経の損傷部の再生のために用いられる、(2-1)ないし(2-9)のいずれか1つに記載の神経再生誘導用材料。
(2-11)リンパ節の郭清に伴う神経損傷部の再生のために用いられる(2-1)ないし(2-10)のいずれか1つに記載の神経再生誘導用材料。
(2-12)体内の適用部位から消失するまでの時間が、電子線及び/又はγ線が照射されていない材料と比較して短い、(2-1)ないし(2-11)のいずれか1つに記載の神経再生誘導用材料。
(2-13)(2-1)ないし(2-12)のいずれか1つに記載の神経再生誘導用材料を神経の損傷部に適用する工程を含む、神経の損傷部の再生を必要とする対象において神経の損傷部の再生を誘導する方法。
(2-13a)(2-1)ないし(2-12)のいずれか1項に記載の神経再生誘導用材料を用いる、神経の損傷部の損傷部の再生において使用されるための前記低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類。
(2-13b)(2-1)ないし(2-12)のいずれか1項に記載の神経再生誘導用材料を製造するための、前記低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類及び/又は前記一般式(I)で表される化合物およびその塩から選択される少なくとも1種の架橋性試薬の使用であって、前記神経再生誘導用材料が神経の損傷部に適用し神経を再生するように用いられる、前記使用。
(2-14)低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類が、上記の一般式(I)で表される化合物及びその塩から選択される少なくとも1種の架橋性試薬で共有結合架橋された架橋体を含む神経再生誘導用材料に対して、電子線及び/又はγ線を照射する工程を含む、神経再生誘導用材料の体内残存時間を調節する方法。
(2-15)低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類と、上記の一般式(I)で表される化合物及びその塩から選択される少なくとも1種の架橋性試薬とを用いて共有結合架橋した架橋体を含む材料に対して電子線及び/又はγ線を照射する工程を少なくとも含む、神経再生誘導用材料を製造する方法。
(3-1)GPC-MALSにより測定された重量平均分子量が9万~70万の低エンドトキシンのアルギン酸、そのエステルおよびその塩からなる群から選択される少なくとも1種が、下記の一般式(I)で表される化合物およびその塩から選択される少なくとも1種の架橋性試薬で共有結合架橋された架橋体を含む、神経再生誘導用材料。
R1HN-(CH2)n-NHR2 (I)
[式中、R1およびR2はそれぞれ独立して水素原子または式:-COCH(NH2)-(CH2)4-NH2で表される基を示し、nは2~18の整数を示す。]
(3-2)低エンドトキシンのアルギン酸、そのエステルおよびその塩からなる群から選択される少なくとも1種のM/G比が0.5~3.0である、(3-1)に記載の神経再生誘導用材料。
(3-3)(3-1)または(3-2)に記載の神経再生誘導用材料を神経の損傷部に適用する工程を含む、神経の損傷部の再生を必要とする対象において神経の損傷部の再生を誘導する方法。
(3-3b)(3-1)または(3-2)に記載の神経再生誘導用材料を用いる、神経の損傷部の損傷部の再生において使用されるための前記低エンドトキシンのアルギン酸、そのエステルまたはその塩。
(3-3c)(3-1)または(3-2)に記載の神経再生誘導用材料を製造するための、前記低エンドトキシンのアルギン酸、そのエステルまたはその塩及び/又は前記一般式(I)で表される化合物およびその塩から選択される少なくとも1種の架橋性試薬の使用であって、前記神経再生誘導用材料が神経の損傷部に適用し神経を再生するように用いられる、前記使用。
(4-1)低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類が、下記の一般式(I)で表される化合物およびその塩から選択される少なくとも1種の架橋性試薬で共有結合架橋された架橋体を含む、神経再生誘導用材料。
R1HN-(CH2)n-NHR2 (I)
[式中、R1およびR2はそれぞれ独立して水素原子または式:-COCH(NH2)-(CH2)4-NH2で表される基を示し、nは2~18の整数を示す。]
(4-2)分子内にカルボキシル基を有する生体内吸収性多糖類が、アルギン酸、そのエステルおよびその塩からなる群から選択される少なくとも1種である、(4-1)に記載の神経再生誘導用材料。
(4-3)架橋性試薬が、上記の一般式(I)で表される化合物のN-ヒドロキシコハク酸イミド塩である(4-1)または(4-2)のいずれかに記載の神経再生誘導用材料。
(4-4)上記の一般式(I)で表される化合物のN-ヒドロキシコハク酸イミド塩が、ジアミノエタンの2N-ヒドロキシコハク酸イミド塩、ジアミノヘキサンの2N-ヒドロキシコハク酸イミド塩、N,N’-ジ(リジル)-ジアミノエタンの4N-ヒドロキシコハク酸イミド塩、および、N-(リジル)-ジアミノヘキサンの3N-ヒドロキシコハク酸イミド塩からなる群から選択される少なくとも1種である(4-3)記載の神経再生誘導用材料。
(4-5)キセロゲルの形態である、(4-1)ないし(4-4)のいずれか1つに記載の神経再生誘導用材料。
(4-6)低エンドトキシンのアルギン酸、そのエステルおよびその塩からなる群から選択される少なくとも1種のGPC-MALSにより測定された重量平均分子量が9万~70万である、(4-1)ないし(4-5)のいずれか1つに記載の神経再生誘導用材料。
(4-7)低エンドトキシンのアルギン酸、そのエステルおよびその塩からなる群から選択される少なくとも1種のM/G比が0.5~3.0である、(4-1)ないし(4-6)のいずれか1つに記載の神経再生誘導用材料。
(4-8)分子内にカルボキシル基を有する生体内吸収性多糖類が、100EU/g以下のエンドトキシン含有量である、(4-1)ないし(4-7)のいずれか1つに記載の神経再生誘導用材料。
(4-9)さらにポリグリコール酸、ポリ乳酸、およびそれらの共重合体からなる群から選択される少なくとも1種を含有する、(4-1)ないし(4-8)のいずれか1つに記載の神経再生誘導用材料。
(4-10)7日~270日で適用部位から消失する、(4-1)ないし(4-9)のいずれか1つに記載の神経再生誘導用材料。
(4-11)電子線及び/又はγ線が照射された、(4-1)ないし(4-10)のいずれか1つに記載の神経再生誘導用材料。
(4-12)電子線及び/又はγ線が、吸収線量1kGy~100kGyで照射された、(4-11)に記載の神経再生誘導用材料。
(4-13)末梢神経および/または中枢神経の損傷部の再生のために用いられる、(4-1)ないし(4-12)のいずれか1つに記載の神経再生誘導用材料。
(4-14)神経の分岐部および/または神経叢の損傷部の再生のために用いられる、(4-1)ないし(4-10)のいずれか1つに記載の神経再生誘導用材料。
(4-15)神経の分岐部および/または神経叢部の損傷部が、前立腺、腕、脳、脊髄、顔面、頸、腰、仙骨、腰仙骨、陰部、心臓、腹腔、及び腸壁内からなる群から選択される少なくとも1種に存在する、(4-14)に記載の神経再生誘導用材料。
(4-15a)神経の分岐部および/または神経叢部の損傷部が、前立腺、膀胱、陰茎海綿体、腕、四肢、脳、脊髄、顔面、頸、腰、仙骨、腰仙骨、陰部、心臓、腹腔、下下腹、骨盤、胸腔内及び腸壁内からなる群から選択される少なくとも1種に存在する、(4-14)に記載の神経再生誘導用材料。
(4-16)リンパ節の郭清に伴う神経損傷部の再生のために用いられる、(4-13)に記載の神経再生誘導用材料。
(4-17)(4-1)ないし(4-14)のいずれか1つに記載の神経再生誘導用材料を神経の損傷部に適用する工程を含む、神経の損傷部の再生を必要とする対象において神経の損傷部の再生を誘導する方法。
(4-17a)(4-1)ないし(4-14)のいずれか1項に記載の神経再生誘導用材料を用いる、神経の損傷部の損傷部の再生において使用されるための前記低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類。
(4-17c)(4-1)ないし(4-14)のいずれか1項に記載の神経再生誘導用材料を製造するための、前記低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類及び/又は前記一般式(I)で表される化合物およびその塩から選択される少なくとも1種の架橋性試薬の使用であって、前記神経再生誘導用材料が神経の損傷部に適用し神経を再生するように用いられる、前記使用。
(5-1)(A)低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類が、下記の一般式(I)で表される化合物およびその塩から選択される少なくとも1種の架橋性試薬で共有結合架橋された架橋体、並びに(B)生体内吸収性高分子を含む、神経の損傷部の再生のために用いられる非管状の神経再生誘導用材料。
R1HN-(CH2)n-NHR2 (I)
[式中、R1およびR2はそれぞれ独立して水素原子または式:-COCH(NH2)-(CH2)4-NH2で表される基を示し、nは2~18の整数を示す。]
(5-2)分子内にカルボキシル基を有する生体内吸収性多糖類が、アルギン酸、そのエステルおよびその塩からなる群から選択される少なくとも1種である、(5-1)に記載の神経再生誘導用材料。
(5-3)架橋性試薬が、上記の一般式(I)で表される化合物のN-ヒドロキシコハク酸イミド塩である(5-1)または(5-2)のいずれかに記載の神経再生誘導用材料。
(5-4)上記の一般式(I)で表される化合物のN-ヒドロキシコハク酸イミド塩が、ジアミノエタンの2N-ヒドロキシコハク酸イミド塩、ジアミノヘキサンの2N-ヒドロキシコハク酸イミド塩、N,N’-ジ(リジル)-ジアミノエタンの4N-ヒドロキシコハク酸イミド塩、および、N-(リジル)-ジアミノヘキサンの3N-ヒドロキシコハク酸イミド塩からなる群から選択される少なくとも1種である(5-3)記載の神経再生誘導用材料。
(5-5)キセロゲルの形態である、(5-1)ないし(5-4)のいずれか1項に記載の神経再生誘導用材料。
(5-6)生体内吸収高分子が、ポリグリコール酸、ポリ乳酸、およびそれらの共重合体、並びに、ポリカプロラクトンからなる群から選択される少なくとも1種である、(5-1)ないし(5-5)のいずれか1項に記載の神経再生誘導用材料。
(5-7)電子線及び/又はγ線が吸収線量1kGy~100kGyで照射された、(5-1)ないし(5-6)のいずれか1項に記載の神経再生誘導用材料。
(5-8)前記材料を、縦2cm×横2cmのサイズ(厚さは問わない)となるように裁断し、その裁断面の1つから5mm離れた位置で該材料を挟むようにダブルクリップで把持し(把持部A)、該材料の把持部Aに相対する裁断面(B)から10mmまでの領域を生理食塩水に15分間浸漬した後、該材料の該裁断面(B)から5mm離れた位置の中央部に、針付き縫合糸を貫通させて、縫合糸の両端を器具に固定し、該把持部Aを材料の正方形面に水平に、速度10mm/分で引っ張る引き裂き試験を行ったときの最大試験力(荷重)が、0.10(N)~10.0(N)である、(5-1)ないし(5-7)のいずれか1項に記載の神経再生誘導用材料。
(5-9)前記材料中のアルギン酸、そのエステルおよびその塩からなる群から選択される少なくとも1種の含量が、アルギン酸ナトリウムに換算して、0.2mg/cm2~12mg/cm2である、(5-2)ないし(5-8)のいずれか1項に記載の神経再生誘導剤用材料。
(5-10)前記材料中の生体内吸収性高分子の含量が、0.05mg/cm2~30mg/cm2である、(5-1)ないし(5-9)のいずれか1項に記載の神経再生誘導剤用材料。
(5-11)末梢神経および/または中枢神経の損傷部の再生のために用いられる、(5-1)ないし(5-10)のいずれか1項に記載の神経再生誘導剤用材料。
(5-12)神経の分岐部および/または神経叢部の損傷部の再生のために用いられる、(5-1)ないし(5-11)のいずれか1項に記載の神経再生誘導剤用材料。
(5-13)神経の分岐部および/または神経叢部の損傷部が、前立腺、膀胱、陰茎海綿体、腕、四肢、脳、脊髄、顔面、頸、腰、仙骨、腰仙骨、陰部、心臓、腹腔、下下腹、骨盤、胸腔内及び腸壁内からなる群から選択される少なくとも1種に存在する、(5-12)に記載の神経再生誘導用材料。
(5-14)腫瘍切除、リンパ節の郭清、および/または外傷に伴う神経損傷部の再生、並びに、組織再建に伴う神経損傷部の再生、からなる群から選択される少なくとも1種の神経損傷部の再生のために用いられる、請求項(5-1)ないし(5-13)のいずれか1項に記載の神経再生誘導用材料。
(5-15)前記低エンドトキシンのアルギン酸、そのエステルおよびその塩からなる群から選択される少なくとも1種は、GPC-MALS法により測定された重量平均分子量(絶対分子量)が8万以上である、(5-2)ないし(5-14)のいずれか1項に記載の神経再生誘導用材料。
(5-16)前記低エンドトキシンのアルギン酸、そのエステルおよびその塩からなる群から選択される少なくとも1種のM/G比が0.4~3.0である、(5-2)ないし(5-15)のいずれか1項に記載の神経再生誘導用材料。
(5-17)(5-1)ないし(5-16)のいずれか1項に記載の神経再生誘導用材料を、治療を必要とする対象の神経損傷部に適用する工程を含む、神経損傷部の再生を誘導する方法。
(5-18)(5-1)ないし(5-16)のいずれか1項に記載の神経再生誘導用材料を、治療を必要とする対象の神経損傷部に適用することを含む、神経の損傷部の再生において使用されるための前記低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類。
(5-18a)(5-1)ないし(5-16)のいずれか1項に記載の神経再生誘導用材料を製造するための、前記低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類及び/又は前記一般式(I)で表される化合物およびその塩から選択される少なくとも1種の架橋性試薬の使用であって、前記神経再生誘導用材料が神経の損傷部に適用し神経を再生するように用いられる、前記使用。
(5-19)少なくとも以下の工程を含む神経再生誘導用材料の体内残存時間を調節する方法。
(A)低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類が、上記の一般式(I)で表される化合物およびその塩から選択される少なくとも1種の架橋性試薬で共有結合架橋された架橋体、並びに(B)生体内吸収性高分子を含む架橋体に対して、電子線および/またはγ線を照射する工程。
(6-1)少なくとも以下の工程を含む神経再生誘導用材料を製造する方法。
(1)低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類を含む溶液と、上記の一般式(I)で表される化合物およびその塩から選択される少なくとも1種の架橋性試薬とを混合する工程、
(2)(1)で得られた混合物と、生体内吸収性高分子とを型に入れて一定時間静置し、架橋体とする工程、
(3)(2)で得られた架橋体を洗浄し、その後、凍結乾燥する工程、
(4)(3)で得られた架橋体に対して、電子線および/またはγ線を照射する工程。
(7-1)低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類が、下記の一般式(I)で表される化合物およびその塩から選択される少なくとも1種の架橋性試薬で共有結合架橋された架橋体を含む、非管状の神経再生誘導用材料であって、
R1HN-(CH2)n-NHR2 (I)
[式中、R1およびR2はそれぞれ独立して水素原子または式:-COCH(NH2)-(CH2)4-NH2で表される基を示し、nは2~18の整数を示す。]
前記材料を縦1cm×横1cmのサイズ(厚さは問わない)となるように裁断した該材料4個と生理食塩水25mLを50mLの容遠沈管に入れて、恒温振とう水槽で、振とう数を往復120回/分、温度50℃で振とうする分解性試験を行うとき、振とう開始から72時間後の材料の残存率が10%~80%である、該材料。
(7-2)前記分解性試験において、開始から72時間後の残存率が、開始から4時間後の残存率と比較して低下を示す、(7-1)に記載の神経再生誘導用材料。
(7-3)前記分解性試験において、開始から4時間後の残存率が55%以上である、(7-1)または(7-2)のいずれかに記載の神経再生誘導用材料。
(7-4)分子内にカルボキシル基を有する生体内吸収性多糖類が、アルギン酸、そのエステルおよびその塩からなる群から選択される少なくとも1種である、(7-1)ないし(7-3)のいずれか1項に記載の神経再生誘導用材料。
(7-5)架橋性試薬が、上記の一般式(I)で表される化合物のN-ヒドロキシコハク酸イミド塩である(7-1)ないし(7-4)のいずれか1項に記載の神経再生誘導用材料。
(7-6)上記の一般式(I)で表される化合物のN-ヒドロキシコハク酸イミド塩が、ジアミノエタンの2N-ヒドロキシコハク酸イミド塩、ジアミノヘキサンの2N-ヒドロキシコハク酸イミド塩、N,N’-ジ(リジル)-ジアミノエタンの4N-ヒドロキシコハク酸イミド塩、および、N-(リジル)-ジアミノヘキサンの3N-ヒドロキシコハク酸イミド塩からなる群から選択される少なくとも1種である(7-5)記載の神経再生誘導用材料。
(7-7)キセロゲルの形態である、(7-1)ないし(7-6)のいずれか1項に記載の神経再生誘導用材料。
(7-8)電子線及び/又はγ線が、吸収線量1kGy~100kGyで照射された、(7-1)ないし(7-7)のいずれか1項に記載の神経再生誘導用材料。
(7-9)さらに、生体内吸収性高分子を含有する、(7-1)ないし(7-8)のいずれか1項に記載の神経再生誘導用材料。
(7-10)生体内吸収性高分子が、ポリグリコール酸、ポリ乳酸、およびそれらの共重合体、並びにポリカプロラクトンからなる群から選択される少なくとも1種である、(7-9)に記載の神経再生誘導用材料。
(7-11)前記材料を、縦2cm×横2cmのサイズ(厚さは問わない)となるように裁断し、その裁断面の1つから5mm離れた位置で該材料を挟むようにダブルクリップで把持し(把持部A)、該材料の把持部Aに相対する裁断面(B)から10mmまでの領域を生理食塩水に15分間浸漬した後、該材料の該裁断面(B)から5mm離れた位置の中央部に、針付き縫合糸を貫通させて、縫合糸の両端を器具に固定し、該把持部Aを材料の正方形面に水平に、速度10mm/分で引っ張る引き裂き試験を行ったときの最大試験力(荷重)が、0.10(N)~10.0(N)である、(7-1)ないし(7-10)のいずれか1項に記載の神経再生誘導用材料。
(7-12)前記材料中のアルギン酸、そのエステルおよびその塩からなる群から選択される少なくとも1種の含量が、アルギン酸ナトリウムに換算して、0.2mg/cm2~12mg/cm2である、(7-4)ないし(7-11)のいずれか1項に記載の神経再生誘導用材料。
(7-13)前記材料中の生体内吸収性高分子の含量が、0.05mg/cm2~30mg/cm2である、(7-1)ないし(7-12)のいずれか1項に記載の神経再生誘導用材料。
(7-14)末梢神経および/または中枢神経の損傷部の再生のために用いられる、(7-1)ないし(7-13)のいずれか1項に記載の神経再生誘導用材料。
(7-15)神経の分岐部および/または神経叢部の損傷部の再生のために用いられる、(7-1)ないし(7-14)のいずれか1項に記載の神経再生誘導用材料。
(7-16)神経の分岐部および/または神経叢部の損傷部が、前立腺、膀胱、陰茎海綿体、腕、四肢、脳、脊髄、顔面、頸、腰、仙骨、腰仙骨、陰部、心臓、腹腔、下下腹、骨盤、胸腔内及び腸壁内からなる群から選択される少なくとも1種に存在する、(7-15)に記載の神経再生誘導用材料。
(7-17)腫瘍切除、リンパ節の郭清、および/または外傷に伴う神経損傷部の再生、並びに、組織再建に伴う神経損傷部の再生からなる群から選択される少なくとも1種の神経損傷部の再生のために用いられる、(7-1)ないし(7-16)のいずれか1項に記載の神経再生誘導用材料。
(7-18)前記低エンドトキシンのアルギン酸、そのエステルおよびその塩からなる群から選択される少なくとも1種は、GPC-MALS法により測定された重量平均分子量(絶対分子量)が8万以上である、(7-4)ないし(7-17)のいずれか1項に記載の神経再生誘導用材料。
(7-19)前記低エンドトキシンのアルギン酸、そのエステルおよびその塩からなる群から選択される少なくとも1種のM/G比が0.4~3.0である、(7-4)ないし(7-18)のいずれか1項に記載の神経再生誘導用材料。
(7-20)(7-1)ないし(7-19)のいずれか1項に記載の神経再生誘導用材料を、治療を必要とする対象の神経損傷部に適用する工程を含む、神経損傷部の再生を誘導する方法。
(7-21)(7-1)ないし(7-19)のいずれか1項に記載の神経再生誘導用材料を、治療を必要とする対象の神経損傷部に適用することを含む、神経の損傷部の再生誘導方法において使用されるための前記低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類。
(7-21a)(7-1)ないし(7-19)のいずれか1項に記載の神経再生誘導用材料を製造するための、前記低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類及び/又は前記一般式(I)で表される化合物およびその塩から選択される少なくとも1種の架橋性試薬の使用であって、前記神経再生誘導用材料が神経の損傷部に適用し神経を再生するように用いられる、前記使用。
(7-22)少なくとも以下の工程を含む神経再生誘導用材料の体内残存時間を調節する方法。
低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類が、上記の一般式(I)で表される化合物およびその塩から選択される少なくとも1種の架橋性試薬で共有結合架橋された架橋体を含む材料に対して、電子線および/またはγ線を照射する工程。
また、本発明の態様のひとつでは、神経再生誘導用材料は、体内消失時間がコントロールされており、神経再生誘導効果に優れる。
本発明の神経再生誘導用材料は、神経の損傷部が、直線状であっても、分岐部及び/又は神経叢部であっても、あるいは、欠損部の断端部が視認できない場合にも適用でき、神経再生を誘導するため、臨床上応用範囲が広い。
本発明のいくつかの態様では、神経再生誘導用材料はキセロゲル状及び/又はシート状であり柔軟性に富むため、神経の断端部や接合部を神経再生誘導用材料で覆うように包むことができる。キセロゲル状及び/又はシート状であるため、使用する患部に適した大きさに、その場で切断して使用できるため、予め神経の内径に応じた規格を複数用意する必要が無い。また、内視鏡下、腹腔鏡下等で本発明の材料を神経の損傷部へ適用することも可能である。
本発明のいくつかの態様のひとつでは、さらに生体内吸収性高分子を含む神経再生誘導用材料は、適度な強度を備え、患部への適用時に縫合糸で縫合して用いることも可能である。一方で、本発明の材料は縫合しなくても使用でき、縫合しない場合には、比較的簡易に施術を行うことができるという利点がある。
本発明の神経再生誘導用材料は、一定期間経過後は体内から消失するため、安全性及び生体適合性に優れる。
本発明の態様のひとつでは、さらに生体内吸収性高分子を含む神経再生誘導用材料は、適度な強度を有し、膝などの可動部でも該材料がちぎれにくく、安定的に神経損傷部を再生することが可能である。また、製造過程で、形状が変形しにくく、取扱い性に優れ、製造効率も高いという利点を有する。
本発明の神経再生誘導用材料は、上記のいずれか1以上の効果を満たす。
本発明のいくつかの態様のひとつでは、分子内にカルボキシル基を有する生体内吸収性多糖類を1種又は2種以上用いて神経再生誘導用材料を作製することができる。分子内にカルボキシル基を有する生体内吸収性多糖類は、例えば、アルギン酸、カルボキシメチルデンプン、ヒアルロン酸、カルボキシメチルセルロース等の多糖類、そのエステルおよびその塩が挙げられる。生体内吸収性多糖類は、生体内で分解され吸収されることが好ましい。また、多糖類は、細胞接着性のない生体内吸収性の多糖類であることが好ましい。好ましくは、アルギン酸、そのエステル及びその塩から選択される少なくとも1種である。なお、本明細書において、「神経再生誘導用材料」は「本発明の材料」という場合がある。
本発明で用いられる「アルギン酸」「アルギン酸エステル」「アルギン酸塩」は、天然由来でも合成物であってもよく、天然由来であるのが好ましい。本明細書において「アルギン酸、そのエステルおよびその塩から選択される少なくとも1種」を「アルギン酸類」と記載する場合がある。本発明で好ましく用いられるアルギン酸類は、レッソニア、マクロシスティス、ラミナリア、アスコフィラム、ダービリア、カジカ、アラメ、コンブなどの褐藻類から抽出される生体内吸収性の多糖類であって、D-マンヌロン酸(M)とL-グルロン酸(G)という2種類のウロン酸が直鎖状に重合したポリマーである。より具体的には、D-マンヌロン酸のホモポリマー画分(MM画分)、L-グルロン酸のホモポリマー画分(GG画分)、およびD-マンヌロン酸とL-グルロン酸がランダムに配列した画分(M/G画分)が任意に結合したブロック共重合体である。
分子量測定にゲル浸透クロマトグラフィーを用いる場合の代表的な条件は、本明細書の実施例1に記載のとおりである。カラムは、例えば、GMPW-XL×2+G2500PW-XL(7.8mm I.D.×300mm)を用いることができ、溶離液は、例えば、200mM硝酸ナトリウム水溶液とすることができ、分子量標準としてプルランを用いることができる。
アルギン酸類の水溶液の粘度の測定は、常法に従い測定することができる。例えば、回転粘度計法の、共軸二重円筒形回転粘度計、単一円筒形回転粘度計(ブルックフィールド型粘度計)、円すい-平板形回転粘度計(コーンプレート型粘度計)等を用いて測定することができる。好ましくは、日本薬局方(第16版)の粘度測定法に従うことが望ましい。本発明においては、より好ましくは、コーンプレート型粘度計を用いることが好ましい。この場合の代表的な測定条件は、本発明の実施例1に記載のとおりである。
本発明において好ましく用いられる架橋性試薬は、下記の一般式(I)で表される化合物に包含されるアミン系化合物およびその塩から選択される少なくとも1種である。本明細書において、下記の一般式(I)で表される化合物は、アミン系化合物(I)という場合がある。
R1HN-(CH2)n-NHR2 (I)
[式中、R1およびR2はそれぞれ独立して水素原子または式:-COCH(NH2)-(CH2)4-NH2で表される基を示し、nは2~18の整数を示す。]
具体例としては、例えば、ジアミノエタン、ジアミノプロパン、ジアミノブタン、ジアミノペンタン、ジアミノヘキサン、ジアミノヘプタン、ジアミノオクタン、ジアミノノナン、ジアミノデカン、ジアミノドデカン、ジアミノオクタデカンなどのジアミノアルカン類および/またはそれらの塩、N-(リジル)-ジアミノエタン、N,N’-ジ(リジル)-ジアミノエタン、N-(リジル)-ジアミノヘキサン、N,N’-ジ(リジル)-ジアミノヘキサンなどのモノまたはジ(リジル)ジアミノアルカン類および/またはそれらの塩などを挙げることができ、これらのジアミンおよびその塩の1種または2種以上を用いることができる。
以下に、分子内にカルボキシル基を有する生体内吸収性多糖類の例として、アルギン酸類を用いたアルギン酸架橋体を含む神経再生誘導用材料の作製を説明するが、他の多糖類についても下記に準じて作製することができる。
本発明のいくつかの態様では、低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類が、上述のアミン系化合物(I)および/またはその塩で共有結合架橋され、電子線及び/又はγ線が照射された架橋体を含む、神経再生誘導用材料を提供する。この態様において、電子線及び/又はγ線を照射する対象は、生体吸収性多糖類が前記架橋剤で共有結合された架橋体のみでもよいし、神経再生誘導用材料が生体内吸収性高分子や神経成長因子など他の成分を含む場合には、他の成分を含む架橋体であってもよい。また、他の成分は、電子線及び/又はγ線を照射した後の架橋体に含ませることもできる。
また、本発明の一態様では、本発明の神経再生誘導用材料は、前記分解性試験において、開始から4時間後の残存率が55%以上であり、より望ましくは60%以上であることが望ましい。本明細書の実施例において、電子線を40kGy、60kGyと高い線量で照射した架橋体は神経再生効果が十分ではないことが分かったが、これは、高い電子線量を照射した架橋体が分解性試験の開始直後(4時間後)に残存率が低下したことに示されるように、架橋体を損傷部に設置した当初から架橋体が消失してしまい、神経の足場としての役目を果たせなかったことに起因すると考えられた。
本発明の一態様では、本発明の神経再生誘導用材料は、前記分解性試験において、開始から4時間後の残存率は55%以上であり、その後残存率が低下し、開始から72時間後には残存率が10%~80%を示すことが望ましい。
本発明における引き裂き試験は、次のように実施する。対象とする材料は、縦2cm×横2cmのサイズ(厚さは問わない)となるように裁断する。ここで縦と横の裁断面は垂直に交わるものとする。このとき材料の厚さは、材料自体の引き裂き強度をみる試験であるため、試験対象とする材料の厚さのまま用いるが、標準的には約1mm~約10mmの厚さであることが望ましい。該材料の裁断面の1つから5mm離れた位置で該材料を挟むようにダブルクリップで把持する(把持部A)。該材料の把持部Aに相対する裁断面(B)から10mmまでの領域を生理食塩水に15分間浸漬する。該材料の裁断面(B)から5mm離れた位置の中央部に針付き縫合糸を貫通させて、縫合糸の両端を器具に固定する。把持部Aを、材料の正方形面に水平に、速度10mm/分で、該材料が裂けるまで引っ張り、この引っ張る荷重を試験力(N)として測定する。試験力の最大点を最大試験力(N)とする。引っ張り荷重の測定は、小型物性試験機(EZ-graph,島津製作所製)を用いて行うことが望ましいが、入手できない場合には、これに類する荷重測定機械を用いてもよい。
把持部Aに使用するダブルクリップの大きさは、把持部の幅が15mm~19mmであることが望ましい。試験に用いる縫合糸は「バイクリル(登録商標)」、糸の太さは「4-0」を用いることが好ましいが、入手できない場合には、材質が、ポリグラクチン910(グリコール酸/乳酸ポリエステル:90/10)であり、糸の太さが4-0である縫合糸を用いてもよい。針は、丸針SH-1を用いることが好ましいが、入手できない場合には、これと類似の縫合糸に合う針を用いてもよい。
好ましくは、材料の最大試験力を求める場合には、材料を裁断し、n=3~10で試験力を測定し、その最大試験力の平均値を求め、該材料の最大試験力とすることが望ましい。
(1)低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類を含む溶液と、上記の一般式(I)で表される化合物およびその塩から選択される少なくとも1種の架橋性試薬とを混合する工程、
(2)(1)で得られた混合物と、生体内吸収性高分子とを型に入れて一定時間静置し、架橋体とする工程、
(3)(2)で得られた架橋体を洗浄し、その後、凍結乾燥する工程、
(4)(3)で得られた架橋体に対して、電子線および/またはγ線を照射する工程。
この製造方法の好ましい態様は、本明細書に記載のとおりである。
本発明のいくつかの態様では、神経再生誘導用材料は、外傷や腫瘍切除等により生じた神経の損傷部に適用して、神経の再生および/または再建を誘導する。本発明の神経再生誘導用材料は、通常神経再建に必要な数ヶ月後に吸収分解され、最終的には代謝・排出されてなくなるため、安全性に優れる。
アルギン酸ナトリウムと、架橋剤として(i)塩化カルシウム、(ii)塩化カルシウムと塩化ナトリウムの混合物、(iii)エチレンジアミンをそれぞれ用いて、キセロゲルの形態のアルギン酸架橋体を作製し、性状を評価した。
アルギン酸ナトリウムは、いずれもエンドトキシン含量は50EU/g未満の低エンドトキシンのアルギン酸ナトリウム(Sea Matrix(登録商標)発売元 持田製薬株式会社)6種を用いた。
試料に溶離液を加え溶解後、0.45μmメンブランフィルターろ過したものを測定溶液とした。
(1)ゲル浸透クロマトグラフィー(GPC)測定
[測定条件(相対分子量分布測定)]
カラム:TSKgel GMPW-XL×2+G2500PW-XL(7.8mm I.D.×300mm×3本)
溶離液:200mM硝酸ナトリウム水溶液
流量:1.0mL/min
濃度:0.05%
検出器:RI検出器
カラム温度:40℃
注入量:200μL
分子量標準:標準プルラン、グルコース
[屈折率増分(dn/dc)測定(測定条件)]
示唆屈折率計:Optilab T-rEX
測定波長:658nm
測定温度:40℃
溶媒:200mM硝酸ナトリウム水溶液
試料濃度:0.5~2.5mg/mL(5濃度)
カラム:TSKgel GMPW-XL×2+G2500PW-XL(7.8mm I.D.×300mm×3本)
溶離液:200mM硝酸ナトリウム水溶液
流量:1.0mL/min
濃度:0.05%
検出器:RI検出器、光散乱検出器(MALS)
カラム温度:40℃
注入量:200μL
以下の作業は、特に断らない限り、室温環境下(20~30℃)で実施した。表1中の各低エンドトキシンアルギン酸ナトリウム凍結乾燥品をミリQ水で溶解して1w/vol%アルギン酸ナトリウム水溶液とした。塩化カルシウム無水物をミリQ水で溶解して50mM塩化カルシウム水溶液とした。アルギン酸ナトリウム水溶液1mLを入れたチューブ(Falcon2054)に50mM塩化カルシウム水溶液1mLを重層して終夜静置した後、ゲル化したものについてはミリQ水で3回洗浄し、凍結乾燥して、キセロゲル状のアルギン酸架橋体を得た。
表1中の各低エンドトキシンアルギン酸ナトリウム凍結乾燥品をミリQ水で溶解して1w/vol%アルギン酸ナトリウム水溶液とした。塩化カルシウム無水物と塩化ナトリウムをミリQ水で溶解し、カルシウムイオン4mMとナトリウムイオン300mM含む水溶液を作製した(カルシウム-ナトリウム架橋剤水溶液)。アルギン酸ナトリウム水溶液1mLを入れたチューブ(Falcon2054)にカルシウム-ナトリウム架橋剤水溶液1mLを重層して終夜静置した後、ゲル化したものについてはミリQ水で3回洗浄し、凍結乾燥し、キセロゲル状のアルギン酸架橋体を得た。
N-ヒドロキシコハク酸イミド23gをメタノール1000mlに溶解した。エチレンジアミン6.7mlを100mlのメタノールに溶解して、N-ヒドロキシコハク酸イミドの溶液へ添加し混合した。生じた結晶をグラスフィルター上に濾取し、乾燥させて、約27.0gのエチレンジアミン2N-ヒドロキシコハク酸イミド塩(EDA・2HOSu)を得た。
上記1-(2)~1-(4)で得られたアルギン酸架橋体をゲル化、多孔性、及びPBS(Phosphate buffered saline)中の残存性の観点から評価した。
ゲル化は、転倒法にて目視観察し、全ての溶液がゲル化した場合を3点、約半分の溶液がゲル化した場合を2点、ほとんどの溶液がゲル化しなかった場合を1点とした。
多孔性は、アルギン酸架橋体の断面を走査型電子顕微鏡を用いて、金コーティング後に、100倍で(加速電圧15kV)測定し、100μm~500μmの均一な細孔を有している場合を3点、不規則な大きさの細孔を有している場合を2点、細孔を有していない場合を1点とした。
PBS中のゲル残存性試験は、各ゲル約5mm角をPBS5ml中に入れ、37℃、1週間後のゲルの状態を観察し、ほとんど全てが残存している場合を3点、およそ半分程度が残存している場合を2点、ほとんど全てが溶解した場合を1点とした。
実施例1において作製したアルギン酸架橋体(約1.0 cm x 1.0 cm)に、PC12細胞(50,000 cells/mL)1 mLを、含浸した。神経成長因子(NGF)(final 100 ng/mL)を加えて7日間培養(3日目に0.5mLの培地追加)後、WST-8試薬(DOJINDO)を150 μL/well添加し、37℃で3時間静置した。上清100 μLずつ96穴プレートに分注し、プレートリーダー(Tecan)を用いて450 nmの吸光度を測定した。
3-(1)アルギン酸架橋体に対する電子線照射
低エンドトキシンアルギン酸ナトリウムのA-2とA-3を用いて、塩化カルシウムと塩化ナトリウムを架橋剤としたアルギン酸架橋体(それぞれA-2CaNa、A-3CaNaという)、実施例1-(4)に従い、エチレンジアミンを架橋剤としたアルギン酸架橋体(それぞれA-2EDA、A-3EDAという)を作製した。塩化カルシウムと塩化ナトリウムを架橋剤としたアルギン酸架橋体は、1%アルギン酸ナトリウム水溶液を3.15mlずつ充填したプレートを25mlのカルシウム-ナトリウム架橋剤水溶液(塩化カルシウム無水和物50mM、塩化ナトリウム300mM)に浸漬してゲル化させ、洗浄後凍結乾燥して作製した。
実施例3-(1)で作製した、電子線照射されたアルギン酸架橋体、及び、電子線照射されていないアルギン酸架橋体について、生理食塩液中での崩壊時間を測定した。
ラットの坐骨神経(末梢神経)の切断部位にエチレンジアミン架橋のアルギン酸架橋体を設置し、神経再生誘導の効果を評価した。
実施例1-(4)に従い、A-2とA-3の低エンドトキシンアルギン酸ナトリウムを用いて、エチレンジアミンで共有結合架橋したキセロゲル状のアルギン酸架橋体(それぞれA-2EDA、A-3EDAという)を作製した。このとき架橋体におけるアルギン酸含量は3.0mg/cm2とした。架橋体の厚さは約2mm~約8mmであった。
上記4-(1)で作製したA-2EDAとA-3EDAをエタノール滅菌して下記実験に用いた。
4週齢の雄性Wistarラットを麻酔下で、分岐していない直線状の坐骨神経の周囲の皮膜を剥離して、神経を露出させた。神経の裏側へ糸を入れて神経を糸で結んで神経を上部へ持ちあげ、神経の下の空間に1枚のアルギン酸架橋体を置いた。アルギン酸架橋体の上に位置する神経を切断して、7~8mmの幅のギャップを作製した。その後、神経の切断部位の上にもう1枚のアルギン酸架橋体を置くことにより、2枚のアルギン酸架橋体で神経の切断部を挟むように設置した。2枚のアルギン酸架橋体は、中枢側及び末梢側の両神経断端をカバーできる大きさにして用いた。アルギン酸架橋体は縫合による固定は行わなかった。開いた筋肉を縫合し、皮膚も縫合した。
上記4-(2)の施術から8週目に手術部位からアルギン酸架橋体と神経を回収し、架橋体より末梢側の神経を取り出した。取り出した神経は、2.5%グルタールアルデヒドのPBS液で1次固定し、2.0%四酸化オスミウムのPBS液で2次固定を行った。脱水、置換後、エポン樹脂に包埋した。1μmの厚さで薄切して、0.5%トルイジンブルーで染色した。光学顕微鏡下に観察し、有髄軸索の数をカウントした。
その結果、8週目の末梢側神経において、A-2EDAでは平均493本、A-3EDAでは平均524本の有髄軸索が確認され、アルギン酸架橋体の神経再生誘導効果が確認された。しかし、8週時に回収したアルギン酸架橋体と神経の部分は、アルギン酸架橋体はほとんど吸収されておらず、組織が増大し塊となっていた。
比較例として実施した、神経の切断のみ行い、アルギン酸架橋体を設置しなかった群では、軸索本数は平均156本 であった。また、神経を切断していない無処置のコントロール群の軸索本数は平均8918本 であった。
上記4-(1)で作製したA-2EDAを下記実験に用いた。
4週齢の雄性Wistarラットを麻酔下で、坐骨神経から総腓骨神経と脛骨神経とにY字状に分岐している神経部位を確認し、周囲の皮膜を剥離して神経を露出させた。坐骨神経に糸を結んで神経を上に持ち上げ、神経の下の空間に1枚のアルギン酸架橋体を置いた。神経分岐部を含んで7~8mmのギャップが生じるように、坐骨神経と総腓骨神経と脛骨神経を切断した。その後、神経の切断部位の上にもう1枚のアルギン酸架橋体を置くことにより、2枚のアルギン酸架橋体で神経の切断部を挟むように設置した。2枚のアルギン酸架橋体は、中枢側及び末梢側の神経断端をカバーできる大きさにして用いた。アルギン酸架橋体は縫合による固定は行わなかった。開いた筋肉を縫合し、皮膚も縫合した。
4-(4)の施術から4週目に手術部位からアルギン酸架橋体と神経を回収し、架橋体より末梢側の神経を取り出した。抗ベータチューブリンクラス3抗体を軸索に対する抗体として、抗S100抗体(abcam社製)をシュワン細胞に対する抗体として用いて染色を行った。
5-(1)電子線が照射されたポリグリコール酸を含むエチレンジアミン架橋アルギン酸架橋体の作製
実施例1-(4)に従い、A-2の低エンドトキシンアルギン酸ナトリウム水溶液にEDA・2HOSuとEDC・HClを溶解させた。得られた溶液を、シート状の不織布のポリグリコール酸(PGA)(100mg/cc,3.0mg/cm2Non-woven PGA Biofelt ,Biomedical Structures (USA))を敷いたトレイに充填し、凍結乾燥することによりPGAを含むアルギン酸架橋体を作製し、A-2EDA・PGA100とした。このとき架橋体におけるアルギン酸の含量は2.0mg/cm2とした。より詳細には、PGAを敷いたトレイにアルギン酸溶液を充填し、十分にゲル化が進んだ後、未反応の架橋剤および反応副生成物を除去するためにゲルの洗浄を行った。洗浄液は、ECF(Extra Cellular Fluid:精製水に CaCl2(2.5 mM、例えば0.28 g/1 L)とNaCl(143 mM、例えば8.36 g/1 L)を溶解し、0.22μmフィルター(ミリポア社製、ミリパック20等)とエンドトキシン除去フィルター(ミリポア社製、プレップスケールUFカートリッジPLGC CDUF 001 LG)を通じたものを用いた。洗浄液は適宜交換し、その後蒸留水で洗浄し、過剰の塩類を除いてから凍結乾燥した。得られた架橋体の厚さは約2mm~約8mmであった。
得られた2種類の架橋体には、電子線を吸収線量20kGyで照射した。
実施例5-(1)で得られた2種類の架橋体(A-2EDA・PGA100、及びA-3EDA・PGA100)を、4-(2)、4-(3)に従い、直線状の坐骨神経のギャップに適用し、架橋体の適用から8週後に直線状の坐骨神経のギャップに対する再生誘導効果を評価した。
実施例5-(1)に準じて、低エンドトキシンアルギン酸ナトリウム(A-2又はA-3)と、シート状の不織布のポリグリコール酸(PGA)(50mg/cc,1.5mg/cm2)を用いて2種類のPGAを含むアルギン酸架橋体を作製し、それぞれA-2EDA・PGA50、A-3EDA・PGA50とした。架橋体におけるアルギン酸含量は2.0mg/cm2とした。得られた架橋体の厚さは約2mm~約8mmであった。得られた2種類の架橋体には電子線を吸収線量20kGyで照射した。実施例5-(1)で得られた2種類の架橋体(A-2EDA・PGA100、及びA-3EDA・PGA100)と合わせて計4種類のPGAを含むアルギン酸架橋体について、実施例4-(4)に従い施術を行い、架橋体の適用から8週後に坐骨神経の分岐部のギャップに対する再生誘導効果を評価した。
以下の各試料について、実施例4に従い、ラットの坐骨神経の分岐部のギャップに対する再生誘導効果を、架橋体の適用から8週後に評価した。
各群について、ギャップから末端の脛骨側と腓骨側の再生軸索本数を計数し、その平均値を算出した(n=6~8)。神経の分岐部の欠損部にアルギン酸架橋体を適用する試験の模式図を図5に示す。また、神経の分岐部の切断のみ行った群の平均再生本数が脛骨側で200本、腓骨側で138本であったことを参考に、各群において、脛骨および腓骨とも再生本数が400本以下の軸索は再生不十分として、各群における再生不十分と判断した再生部位の割合を求めた。結果を表4に示す。
6-(1)ラット長期間皮下埋植試験(1)
これまでの試験で、アルギン酸架橋体の体内消失速度(残存率)と神経再生効果の関連が示唆されたため、種々の架橋体について、ラット皮下埋植試験を行い、体内消失速度を検討した。
実施例1-(4)および実施例5-(1)に従い、表6のとおり試料を作製し、6-(1)と同様にラット背面部の皮下に埋植し、8週間後と12週間後に、試料の残存性について組織学的評価を行った。組織学的評価は、次のように作製した標本により評価した。すなわち、埋植した皮下組織を摘出し、10%中性緩衝ホルマリン溶液で固定後、組織を切り出し、パラフィン包埋ブロックを作製し、ヘマトキシリン・エオジン染色、およびサフラニン-O染色を行った。試料の残存性を5段階のスコアで評価した。すなわち、各試料について、試料残存なしを0、ごくわずかに残存を1、わずかに残存を2、中等度に残存を3、顕著に残存を4として、各群n=3で評価し、その平均値をその試料の残存スコアとした。
アルギン酸架橋体の分解性をin vitro試験で評価した。
以上より、当該試験において、試験開始から3日後(72時間後)の架橋体の残存率が、約20%~約80%を範囲とする架橋体が、神経再生にとって好ましいことが示唆された。
9-(1)ラット海綿体神経叢除去モデルの作製
ラットを2%イソフルランの吸入による麻酔下にて、仰臥位に固定した。下腹部を正中切開し、顕微鏡下で骨盤内を展開し、骨盤神経叢および海綿体神経を露出させた。治療群と無治療群は、海綿体神経を確保した後、網目状に分岐している神経叢を横断するように海綿体神経を約2mm切除した。左右同様に処置した。治療群は、実施例5-(1)に準じて作製したPGAを含有するアルギン酸架橋体(A-3EDA・PGA100)を、神経切除断端を十分被覆するように置き、縫合固定した。無治療群は、神経切除のみ行った。正常コントロール群は、海綿体神経切除を行わなかった。その後、下腹部の筋層および皮膚を縫合した。手術前に、ベンジルペニシリンカリウムを20000units/kg用量で筋肉内注射した。また、鎮痛剤ブプレノルフィン0.01mg/kg用量を1日2回3日間1mL/kgの容量で皮下投与した。各群n=3で行った。
9-(1)の処置から4週後、および7週後に、各群3匹は、発情を確認した雌と金網製の床網を敷いたケージで同居させた。翌日、メスの膣プラグ(copulatory plug)の有無により、交尾行動の有無を確認した。なお、プラグが確認できなかったラットは7日目まで観察を続けて判定した。
その結果、各群3匹中、交尾行動がみられた(メスの膣プラグ有り)ラットの割合を表10に示す。その結果、海綿体神経切除を行っていない正常コントロールは100%で交尾行動がみられたが、海綿体神経を切除した無治療群は、4週後および7週後とも交尾行動は全くみられなかった。一方、海綿体神経の切除後に前記アルギン酸架橋体を置いた治療群は、4週後および7週後とも2/3で交尾行動が見られた。このことから、アルギン酸を含有する架橋体は、海綿体神経における網目状構造の神経叢自体が切除された損傷部を、施術から4週後という早い時期に再生させ、正常な交尾行動を行うことができるまでに機能を回復させたことが示された。
表11の6種のアルギン酸架橋体について、手術で架橋体を縫合する場合を想定し、引き裂き試験を行い、各試料の強度を比較した。
試料番号101と104は、PGAを含有しないアルギン酸架橋体であり、その他の試料は、PGAを含有するアルギン酸架橋体であり、それぞれ、実施例1-(4)、実施例5-(1)の記載に従い作製した。試料番号101~103は、電子線を照射しておらず、試料番号104~106は、電子線を15kGyで照射した。
試験方法は以下のとおりである。試験方法の模式図を図11に示す。各試料を、縦2cm×横2cmのサイズ(厚さは問わない)となるように裁断した。ここで縦と横の裁断面は垂直に交わるものとした。このとき各試料の厚さは約2mm~約8mmであった。その裁断面の1つから5mm離れた位置で該材料を挟むようにダブルクリップ(把持部の幅が約15mm)で把持した(把持部A)。該試料の把持部Aに相対する裁断面(B)から10mmまでの部分全体を生理食塩水に15分間浸漬した。該試料の裁断面(B)から5mm離れた位置の中央部に、針付き縫合糸(バイクリル(登録商標)、4-0、丸針SH-1)を貫通させ、縫合糸の両端を器具に固定した。前記把持部Aを、試料の正方形面に水平に、速度10mm/分で引っ張った。縫合糸の付近で各試料が裂けるまで引っ張り続け、引っ張る荷重を試験力として測定した。引っ張り荷重の測定は、小型物性試験機(EZ-graph,島津製作所製)を用いて行った。各試料ともn=5で測定し、試験力の最大点(最大試験力)の平均値を求めた。
Claims (15)
- (A)低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類が、下記の一般式(I)で表される化合物およびその塩から選択される少なくとも1種の架橋性試薬で共有結合架橋された架橋体、並びに(B)生体内吸収性高分子を含む、神経の損傷部の再生のために用いられる非管状の神経再生誘導用材料。
R1HN-(CH2)n-NHR2 (I)
[式中、R1およびR2はそれぞれ独立して水素原子または式:-COCH(NH2)-(CH2)4-NH2で表される基を示し、nは2~18の整数を示す。] - 分子内にカルボキシル基を有する生体内吸収性多糖類が、アルギン酸、そのエステルおよびその塩からなる群から選択される少なくとも1種である、請求項1に記載の神経再生誘導用材料。
- 架橋性試薬が、上記の一般式(I)で表される化合物のN-ヒドロキシコハク酸イミド塩である請求項1または2のいずれかに記載の神経再生誘導用材料。
- 上記の一般式(I)で表される化合物のN-ヒドロキシコハク酸イミド塩が、ジアミノエタンの2N-ヒドロキシコハク酸イミド塩、ジアミノヘキサンの2N-ヒドロキシコハク酸イミド塩、N,N’-ジ(リジル)-ジアミノエタンの4N-ヒドロキシコハク酸イミド塩、および、N-(リジル)-ジアミノヘキサンの3N-ヒドロキシコハク酸イミド塩からなる群から選択される少なくとも1種である請求項3記載の神経再生誘導用材料。
- キセロゲルの形態である、請求項1ないし4のいずれか1項に記載の神経再生誘導用材料。
- 生体内吸収高分子が、ポリグリコール酸、ポリ乳酸、およびそれらの共重合体、並びに、ポリカプロラクトンからなる群から選択される少なくとも1種である、請求項1ないし5のいずれか1項に記載の神経再生誘導用材料。
- 電子線及び/又はγ線が吸収線量1kGy~100kGyで照射された、請求項1ないし6のいずれか1項に記載の神経再生誘導用材料。
- 前記材料を、縦2cm×横2cmのサイズ(厚さは問わない)となるように裁断し、その裁断面の1つから5mm離れた位置で該材料を挟むようにダブルクリップで把持し(把持部A)、該材料の把持部Aに相対する裁断面(B)から10mmまでの領域を生理食塩水に15分間浸漬した後、該材料の該裁断面(B)から5mm離れた位置の中央部に、針付き縫合糸を貫通させて、縫合糸の両端を器具に固定し、該把持部Aを材料の正方形面に水平に、速度10mm/分で引っ張る引き裂き試験を行ったときの最大試験力(荷重)が、0.10(N)~10.0(N)である、請求項1ないし7のいずれか1項に記載の神経再生誘導用材料。
- 前記材料中のアルギン酸、そのエステルおよびその塩からなる群から選択される少なくとも1種の含量が、アルギン酸ナトリウムに換算して、0.2mg/cm2~12mg/cm2である、請求項2ないし8のいずれか1項に記載の神経再生誘導剤用材料。
- 前記材料中の生体内吸収性高分子の含量が、0.05mg/cm2~30mg/cm2である、請求項1ないし9のいずれか1項に記載の神経再生誘導剤用材料。
- 末梢神経および/または中枢神経の損傷部の再生のために用いられる、請求項1ないし10のいずれか1項に記載の神経再生誘導剤用材料。
- 神経の分岐部および/または神経叢部の損傷部の再生のために用いられる、請求項1ないし11のいずれか1項に記載の神経再生誘導剤用材料。
- 神経の分岐部および/または神経叢部の損傷部が、前立腺、膀胱、陰茎海綿体、腕、四肢、脳、脊髄、顔面、頸、腰、仙骨、腰仙骨、陰部、心臓、腹腔、下下腹、骨盤、胸腔内及び腸壁内からなる群から選択される少なくとも1種に存在する、請求項12に記載の神経再生誘導用材料。
- 腫瘍切除、リンパ節の郭清、および/または外傷に伴う神経損傷部の再生、並びに、組織再建に伴う神経損傷部の再生からなる群から選択される少なくとも1種の神経損傷部の再生のために用いられる、請求項1ないし13のいずれか1項に記載の神経再生誘導用材料。
- 少なくとも以下の工程を含む神経再生誘導用材料を製造する方法。
(1)低エンドトキシンの分子内にカルボキシル基を有する生体内吸収性多糖類を含む溶液と、上記の一般式(I)で表される化合物およびその塩から選択される少なくとも1種の架橋性試薬とを混合する工程、
(2)(1)で得られた混合物と、生体内吸収性高分子とを型に入れて一定時間静置し、架橋体とする工程、
(3)(2)で得られた架橋体を洗浄し、その後、凍結乾燥する工程、
(4)(3)で得られた架橋体に対して、電子線および/またはγ線を照射する工程。
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US11464597B2 (en) | 2016-07-13 | 2022-10-11 | The University Of Tokyo | Adhesion-preventing composition |
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