WO2019078349A1 - 癒着防止材 - Google Patents
癒着防止材 Download PDFInfo
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- WO2019078349A1 WO2019078349A1 PCT/JP2018/038977 JP2018038977W WO2019078349A1 WO 2019078349 A1 WO2019078349 A1 WO 2019078349A1 JP 2018038977 W JP2018038977 W JP 2018038977W WO 2019078349 A1 WO2019078349 A1 WO 2019078349A1
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Definitions
- the present invention relates to an adhesion preventing material excellent in adhesion preventing effect (particularly, adhesion preventing effect of tendon).
- Adhesion refers to a state in which continuity exists between organs or tissues that are inherently close to each other but are free. Suture adhesion after surgery is a kind of artificially produced inflammatory adhesion, and it is a complication that is caused with a high probability by the operation to some extent. In particular, it is also known that when adhesion of a tendon occurs after treatment of tendon injury, tendon tear, fracture, etc., the joint becomes immobile or the range of movement of the joint decreases, and the adhesion preventive material causes the post-operative tendon. Taking anti-adhesion prevention is important for the normal recovery of damaged tissue.
- the adhesion prevention material is required to be administered to a site where adhesion prevention is required, and to stay at the site for a certain period to function as a physical barrier.
- the surrounding tissue of the tendon is fine and complex, and that it has excellent diffusive properties so as to spread over the entire target site at the time of administration. After administration, it is required to stay at the target site for a certain period to function as a physical barrier.
- Patent Document 1 discloses a solid adhesion preventive material containing a gelling agent, a salt of an organic acid and / or an inorganic acid and a divalent metal, and polyethylene glycol, which is mixed with water at the time of use.
- an adhesion preventing material which is in a liquid state at the time of administration and changes to a gel state after administration has been proposed (see Patent Document 1).
- the anti-adhesion material which is liquid at the time of administration and shows a gel-like shape after administration can diffuse to the applied tissue even if it is applied to fine and complex tissues and can exert a physical barrier function, thus preventing adhesion of tendon. It is considered to be effective.
- Patent Document 2 a polymer obtained by condensing a collagen-like peptide oligomer consisting of-(Pro-Y-Gly) n- [Y is Pro or Hyp, n is an integer of 1 or more] and a polysaccharide is attached. It is disclosed that it can be used as a preventive material.
- Patent Document 3 discloses that a medical material obtained by crosslinking gelatin with succinimidated poly-L-glutamic acid can be used as an adhesion preventing material.
- An object of the present invention is to provide an anti-adhesion material having an excellent anti-adhesion effect.
- the present inventors diligently studied to solve the above problems, and (A) (A-1)-(X-Pro-Y) n- [X is any amino acid, Pro is proline, Y is Hydroxyproline or proline is shown, and n is an integer of 1 to 10. And / or (A-2)-(Pro-Y) m- [Pro is proline, Y is hydroxyproline or proline, and m is an integer of 1 to 10.].
- the anti-adhesion agent using the peptide containing the amino acid sequence of the present invention in combination with (B) gelatin gel dramatically improves the anti-adhesion effect as compared with the case where these components are used alone, and in particular for adhesion of tendon. It has been found that the present invention has a remarkably superior prevention effect. The present invention has been completed by further studies based on such findings.
- the adhesion preventing material according to Item 1 wherein in the amino acid sequence of (A-1), X is a hydrophobic amino acid, a hydrophilic basic amino acid, or a hydrophilic neutral amino acid.
- Item 3 The adhesion preventing material according to Item 1 or 2, wherein in the amino acid sequence of (A-1), X is glycine, isoleucine, asparagine, arginine, tyrosine, alanine, valine or leucine.
- Item 4. The adhesion preventing material according to any one of Items 1 to 3, wherein in the amino acid sequence of (A-1) above, Y is hydroxyproline.
- Item 5 The adhesion preventing material according to any one of Items 1 to 3, wherein in the amino acid sequence of (A-1) above, Y is hydroxyproline.
- Item 6. The adhesion preventing material according to any one of Items 1 to 5, wherein n is an integer of 1 to 5 in the amino acid sequence of (A-1).
- Item 7 The adhesion preventing material according to Item 1, wherein m is an integer of 1 to 5 in the amino acid sequence of (A-2).
- Item 10 The antiadhesive material according to any one of Items 1 to 9, wherein the gelatin gel is a powdery airgel or a granular hydrogel.
- Item 11 The adhesion preventing material according to any one of Items 1 to 10, further comprising an aqueous solvent, and in the form of a hydrogel comprising the peptide and the gelatin gel.
- Item 13 The adhesion preventing material according to any one of Items 1 to 10, which is a one-component type consisting of a solid preparation containing the peptide and the gelatin gel without containing an aqueous solvent.
- Item 14. 14 The adhesion preventing material according to item 13, wherein the first agent is a liquid containing an aqueous solvent, and the second preparation is in the form of a hydrogel containing an aqueous solvent.
- Item 15. 14 The adhesion preventing material according to item 13, wherein the first agent is a liquid containing an aqueous solvent, and the second preparation is in the form of an airgel. Item 16. 14.
- Item 17. 14 The adhesion preventing material according to item 13, wherein the first agent is powdery and the second preparation is airgel-like.
- Item 18. (A) (A-1)-(X-Pro-Y) n- [X is any amino acid, Pro is proline, Y is hydroxyproline or proline, and n is 1 for the production of an adhesion-preventing agent It is an integer of ⁇ 10. And / or (A-2)-(Pro-Y) m- [Pro is proline, Y is hydroxyproline or proline, and m is an integer of 1 to 10.].
- the interaction between a peptide containing a specific amino acid sequence and a gelatin gel can exhibit a remarkably excellent adhesion preventing effect.
- excellent adhesion preventing can be achieved even for a tendon where the surrounding tissue is fine and complicated. It can produce an effect.
- FIG. 7 is a diagram showing an Achilles site where the degree of adhesion was evaluated in Test Examples 1 and 2.
- Experiment 1 it is a figure which shows the result of having evaluated the adhesion preventing effect in an Achilles tendon.
- Experiment 2 it is a figure which shows the result of having evaluated the adhesion preventing effect in an Achilles tendon.
- Experiment 3 it is a figure which shows the result of having evaluated the adhesion preventing effect in a flexor tendon.
- Experiment 4 it is a figure which shows the result of having evaluated the adhesion preventing effect in a flexor tendon.
- Experiment 5 it is a figure which shows the result of having evaluated the adhesion preventing effect in a flexor tendon.
- Experiment 6 it is a figure which shows the result of having evaluated the adhesion preventing effect in a flexor tendon.
- Experiment 7 it is a figure which shows the result of having measured the joint movable range.
- Experiment 7 it is a figure which shows the result of having measured the joint movement range of a PIP joint and a DIP joint.
- Experiment 7 it is a figure which shows the result of having measured the adhesion score.
- Experiment 7 it is a figure which shows the result of having observed the state of the flexor tendon at the end of a test.
- Experiment 7 it is a figure which shows the result of having analyzed the correlation of the joint movement range and the adhesion score.
- Experiment 8 it is a figure which shows the result of having measured the joint movable range.
- Experiment Example 8 it is a figure which shows the result of having measured the joint movement range of a PIP joint and a DIP joint.
- Experiment 9 it is a figure which shows the result of having evaluated the adhesion preventing effect in a flexor tendon.
- Experiment 9 it is a figure which shows the result of having observed the state of the flexor tendon at the end of a test.
- Experiment 10 it is a figure which shows the result of having evaluated the adhesion preventing effect in a flexor tendon.
- Experiment 10 it is a figure which shows the result of having observed the state of the flexor tendon at the end of a test.
- Experiment 11 it is a figure which shows the result of having evaluated the adhesion preventing effect in a flexor tendon.
- the adhesion preventing material of the present invention includes a peptide containing a specific amino acid sequence and a gelatin gel, and the adhesion preventing material of the present invention will be described in detail below.
- amino acids use the following three-letter abbreviations.
- Ala alanine Arg: arginine Asn: asparagine Asp: aspartate Cys: cysteine Gln: glutamine Glu: glutamate Gly: glycine His: histidine Hyp: hydroxyproline
- Ile isoleucine
- Leu leucine
- Lys lysine
- Met methionine
- Phe phenylalanine
- Pro proline
- Ser Serine Thr: Threonine Trp: Tryptophan Tyr: Tyrosine Val: Valine
- the notation of dipeptide and tripeptide indicates that the left end is located at the N-terminus and the right end is located at the C-terminus.
- the tripeptide designation "X-Pro-Y" indicates that the left amino acid residue (X) is N-terminal and the right amino acid residue (Y) is C-terminal.
- the adhesion preventing material of the present invention includes a peptide containing an amino acid sequence of the following (A-1) and / or a peptide containing an amino acid sequence of the following (A-2).
- A-1)-(X-Pro-Y) n- [X is any amino acid, Pro is proline, Y is hydroxyproline or proline, and n is an integer of 1 to 10.
- A-2)-(Pro-Y) m- [Pro represents proline, Y represents hydroxyproline or proline, and m is an integer of 1 to 10. ]
- X is any amino acid.
- examples of X in the amino acid sequence of (A-1) include hydrophobic amino acids, hydrophilic basic amino acids, hydrophilic neutral amino acids and the like.
- Specific examples of the hydrophobic amino acids include Gly, Ala, Val, Leu, Tyr, Ile, Met, Pro, Phe, Trp and Cys.
- Specific examples of the hydrophilic basic amino acid Arg, Lys, His are mentioned.
- Specific examples of the hydrophilic neutral amino acid include Asn, Gln, Ser, and Thr.
- amino acids constituting X from the viewpoint of further improving the adhesion preventing effect, preferably Gly, Ile, Asn, Arg, Tyr, Ala, Val, Leu, Met, Pro, Phe; more preferably Gly, Ile , Asn, Arg, Tyr, Ala, Val, Leu, Phe; more preferably Gly, Ile, Asn, Arg, Tyr, Ala, Val, Leu; particularly preferably Gly, Ile, Asn, Arg, Tyr; most preferably Are Gly, Ile, Asn and Arg.
- Y is Hyp or Pro. From the viewpoint of further improving the adhesion preventing effect, preferably Hyp is mentioned as an amino acid constituting Y.
- tripeptide unit “X-Pro-Y” in the amino acid sequence of (A-1) include Gly-Pro-Hyp, Ile-Pro-Hyp, Asn-Pro-Hyp, Arg-Pro-Hyp, Tyr-Pro-Hyp, Ara-Pro-Hyp, Leu-Pro-Hyp, Val-Pro-Hyp, Phe-Pro-Hyp, Gly-Pro-Pro, Ile-Pro-Pro, Asn-Pro-Pro, Arg- Pro-Pro, Tyr-Pro-Pro, Ara-Pro-Pro, Leu-Pro-Pro, Val-Pro-Pro, Phe-Pro-Pro and the like.
- Gly-Pro-Hyp preferably Gly-Pro-Hyp, Ile-Pro-Hyp, Asn-Pro-Hyp, Arg-Pro-Hyp, Tyr-Pro-Hyp, Gly -Pro-Pro, Ile-Pro-Pro, Asn-Pro-Pro, Arg-Pro-Pro, Tyr-Pro-Pro; more preferably Gly-Pro-Hyp, Ile-Pro-Hyp, Asn-Pro-Hyp Particularly preferred are Gly-Pro-Hyp, Ile-Pro-Hyp, Asn-Pro-Hyp, and Arg-Pro-Hyp.
- n is the number of tripeptide units “X-Pro-Y” and is an integer of 1 to 10. That is, when n is 2, the amino acid sequence of (A-1) has "X-Pro-Y-X-Pro-Y". From the viewpoint of further improving the adhesion preventing effect, n is preferably 1 to 7, more preferably 1 to 5, still more preferably 1 to 3, or 1 or 2, particularly preferably 1.
- the peptide having the amino acid sequence of (A-1) described above has an N-terminal and / or a C-terminal of the amino acid sequence shown in-(X-Pro-Y) n -as long as the desired adhesion preventing effect is exerted.
- One or more amino acids may be added to
- the number of amino acids that can be added to the N-terminus is, for example, 1 to 40, preferably 1 to 20.
- the number of amino acids that can be added to the C-terminus is, for example, 1 to 40, preferably 1 to 20.
- Y is Hyp or Pro. From the viewpoint of further improving the adhesion preventing effect, preferably Hyp is mentioned as an amino acid constituting Y.
- m is the number of dipeptide units “Pro-Y” and is an integer of 1 to 10. That is, when m is 2, the amino acid sequence of (A-2) has "Pro-Y-Pro-Y". From the viewpoint of further improving the adhesion preventing effect, m is preferably 1 to 7, more preferably 1 to 5, still more preferably 1 to 3, or 1 or 2, particularly preferably 1.
- the peptide having the amino acid sequence of the above (A-2) can be added to the N-terminal and / or C-terminal of the amino acid sequence shown in-(Pro-Y) m -as long as the desired adhesion preventing effect is exerted.
- the above amino acids may be added.
- the number of amino acids that can be added to the N-terminus is, for example, 1 to 40, preferably 1 to 20.
- the number of amino acids that can be added to the C-terminus is, for example, 1 to 40, preferably 1 to 20.
- one of the peptide having the amino acid sequence of (A-1) and the peptide having the amino acid sequence of (A-2) may be used alone.
- two or more peptides may be used in combination.
- peptides having other amino acid sequences may be included together with the peptide having the above amino acid sequence.
- the amino acid sequence of collagen includes tripeptide unit "Gly-Pro-Hyp” and dipeptide unit "Pro-Hyp”, and tripeptide mixtures obtained by hydrolyzing collagen include Gly-Pro.
- the antiadhesion material of the present invention uses such a tripeptide mixture or dipeptide mixture because it contains -Hyp and the dipeptide mixture obtained by hydrolyzing collagen contains Pro-Hyp. You can also
- the tripeptides and dipeptides used in the present invention can be obtained by hydrolyzing naturally occurring polypeptides or polypeptides obtained using biotechnological techniques, and also by chemical synthesis. You can also get it.
- the tripeptide "Gly-Pro-Hyp” and the dipeptide "Pro-Hyp” can be obtained by hydrolyzing collagen or the like, as well as chemical synthesis methods.
- collagens of mammals such as cows and pigs, and fish, sharks, tilapias, salmons and pangasius have amino acid sequences of tripeptide unit "Gly-Pro-Hyp" and dipeptide unit "Pro-Hyp".
- These tripeptides and dipeptides can be obtained from these collagens, which contain amino acid sequences.
- the adhesion prevention material of the present invention includes gelatin gel.
- Gelatin is a water-soluble protein obtained by denaturing collagen of mammals such as cows and pigs, and fish, sharks, tilapias, salmon and pangasius with heat, acid, alkali, enzymes, etc. It is a highly biocompatible material because it hydrolyzes and disappears.
- the gelatin gel used in the present invention may be either an uncrosslinked gelatin gel or a crosslinked gelatin gel, but from the viewpoint of further improving the adhesion preventing effect, preferably a crosslinked gelatin gel is mentioned.
- a crosslinked gelatin gel By using a crosslinked gelatin gel, the degradation of gelatin in vivo can be suppressed, and the anti-adhesion agent of the present invention can remain in the administration section for a period necessary for preventing adhesion.
- a crosslinked gelatin gel is a gel in which gelatin is crosslinked.
- the method for crosslinking gelatin is not particularly limited. For example, thermal crosslinking for crosslinking by heating; electron beam crosslinking for crosslinking by electron beam irradiation such as ultraviolet rays and far infrared rays; glutaraldehyde, tannin, alum, aluminum sulfate, Chemical cross-linking to be treated with succinimidated poly-L-glutamic acid or the like; enzyme cross-linking to be treated with an enzyme such as glutaminase or the like may be used.
- the cross-linked gelatin used in the present invention preferably includes a cross-linked gelatin gel obtained by thermal cross-linking, from the viewpoint of biocompatibility, adhesion prevention effect, and the like.
- the gelatin gel used in the present invention is preferably a porous body.
- the adhesion preventing effect can be further enhanced by using a porous gelatin gel.
- porous gelatin gels include gelatin sponges (sponge-like gelatin gels).
- the porous gelatin gel can be obtained according to known production methods.
- a gelatin sponge for example, it is marketed as Spongel (Spongel), gel foam (Gelfoam) etc., In the present invention, such a commercial product can also be used.
- gelatin gel used in the present invention one containing hyaluronic acid, trehalose, pectin, cyclodextrin, chitosan and the like can also be used.
- Such gelatin gels can be produced by known methods.
- the form of gelatin gel used in the present invention may be either airgel or hydrogel.
- the aerogel refers to a gel containing air as a dispersion medium (i.e., a dried gel), a dried gel obtained by using a supercritical drying method (aerogel in a narrow sense), drying under atmospheric pressure Dried gel (xerogel), and dried gel (cryogel) obtained by lyophilization.
- a hydrogel refers to a gel (that is, a water-containing gel) containing an aqueous solvent as a dispersion medium.
- adhesion prevention material of the present invention which of an aerogel or a hydrogel is used as a gelatin gel is appropriately set according to the form of preparation described later.
- the shape of the gelatin gel used in the present invention is not particularly limited as long as it is molded so as to conform to the shape of the application site, but in the case of airgel, it is powdery, and in the case of hydrogel Preferably, they are in the form of granules (in the form of hydrated powder hydrogel).
- the adhesion preventing material of the present invention exhibits a gel form having fluidity in the affected area, so that the diffusivity at the application target site becomes good after administration.
- an airgel in which a gelatin sponge is powdered and a hydrogel in which the airgel has been hydrated are preferably used because they can exhibit an extremely excellent adhesion preventing effect.
- gelatin gel may be shape
- the particle size thereof is not particularly limited, but for example, the particle size of the powdery airgel (in a state of not absorbing water) is It may be in the range of 200 to 750 ⁇ m, preferably 250 to 750 ⁇ m, and more preferably 250 to 500 ⁇ m. Adjustment to such a particle size can be performed by classifying the desired particle size using a sieve.
- the ratio of the peptide to the gelatin gel is not particularly limited as long as the desired adhesion preventing effect is exerted.
- the dry weight equivalent of gelatin gel to the weight of gelatin itself 2 to 500 parts by weight, preferably 50 to 400 parts by weight, and more preferably 100 to 300 parts by weight of the peptide per 100 parts by weight of reduced).
- adhesion-preventing hydrogel The adhesion-preventing effect of the adhesion-preventing material of the present invention is applied to a target site where adhesion-prevention is required, wherein the hydrogel containing the peptide, gelatin gel and aqueous solvent (hereinafter referred to as "adhesion-preventing hydrogel") Played by doing.
- aqueous solvent used for the adhesion preventing hydrogel examples include water, physiological saline and the like.
- the adhesion-preventing hydrogel may contain an appropriate amount of aqueous solvent to be in the form of a hydrogel while satisfying the above-mentioned ratio of the peptide and the gelatin gel.
- the following range is illustrated as a mixture ratio.
- Blending ratio of the peptide for example, 1 to 50% by weight, preferably 3 to 40% by weight, and more preferably 10 to 30% by weight.
- Blending ratio of gelatin gel for example, 5 to 50% by weight, preferably 10 to 40% by weight, more preferably 15 to 30% by weight in terms of dry weight (in terms of weight of gelatin itself).
- Blending ratio of aqueous solvent For example, 10 to 90% by weight, preferably 30 to 80% by weight, more preferably 40 to 55% by weight.
- the adhesion prevention material of the present invention when using a peptide mixture containing a peptide of another amino acid sequence together with the peptide having the amino acid sequence, it is preferable to make the peptide having the amino acid sequence to have the above mixing ratio.
- the adhesion preventing material of the present invention may contain the adhesion preventing hydrogel itself.
- adhesion preventing hydrogel may be prepared prior to administration or may be formed at the application target site.
- adhesion preventing material for preparation at use a preparation in which the adhesion preventing hydrogel can be prepared or formed at a target site before administration.
- adhesion prevention material for preparation at use specifically, a preparation containing the peptide and a gelatin gel in the same composition (hereinafter, one-component type), and the peptide and the gelatin gel as separate compositions Formulations (hereinafter referred to as two-agent type) can be mentioned.
- the adhesion preventing material of the present invention will be described by dividing it into a one-agent type adhesion preventing material for in-use preparation and a two-agent type adhesion preventing material for in-use preparation.
- One-agent type adhesion prevention material for preparation at use In the adhesion preparation material for one-agent type preparation, the tripeptide and the aerogel-like gelatin gel are contained in the same composition in the absence of water.
- the solid formulation is used by adding an aqueous solvent at the time of use.
- the gelatin gel is a powdery airgel, a mixture of the airgel and the peptide, or a support of the tripeptide on the airgel If it is
- the peptide may be supported on the airgel.
- the peptide and the gelatin gel may be contained so as to satisfy the ratio described above, but in the single-agent type preparation for anti-adhesion material
- the following range is illustrated as content of a component.
- the content of the peptide for example, 10 to 90% by weight, preferably 40 to 80% by weight, and more preferably 50 to 70% by weight.
- Gelatin gel content for example, 10 to 90% by weight, preferably 20 to 60% by weight, more preferably 30 to 50% by weight in terms of dry weight (in terms of the weight of gelatin itself).
- a method of using the adhesion preventing material of this embodiment for example, a method of preparing the adhesion preventing hydrogel after adding an aqueous solvent before administration, and administering to the application target site; or directly administered to the application target site Later, an aqueous solvent is added to form the adhesion preventing hydrogel on the application target site.
- the amount of the aqueous solvent used at the time of administration may be appropriately set so as to finally form the adhesion-preventing hydrogel, but specifically, it is an airgel-like gelatin
- the aqueous solvent used is preferably 10 to 90 parts by weight, preferably 30 to 80 parts by weight, more preferably 40 to 55 parts by weight, per 100 parts by weight of the gel.
- Anti-adhesion agent for preparation when using 2-agent type In the anti-adhesion material for preparing when using 2-agent type, the agent I containing the tripeptide and the agent II containing gelatin gel are separated respectively Included. In the adhesion prevention material of this embodiment, the agent I, the agent II, and, if necessary, the aqueous solvent are used by mixing or impregnating at the time of use.
- the first agent may be in the form of a liquid containing an aqueous solvent, or may be in the form of a powder not containing an aqueous solvent.
- the agent II may be in the form of a hydrogel including an aqueous solvent, or may be in the form of an airgel free of an aqueous solvent. That is, as a combination embodiment of the first agent and the second agent in the adhesion preventing material for preparation when using two-agent type, (1) combination of liquid first agent and hydrogel second agent, (2) liquid Combination of the first agent of the present invention and the airgel-like second agent, (3) the combination of the first agent of the powdery and the second agent of the hydrogel-like, and (4) the first agent of the powdery and the airgel-like II A combination of agents.
- these combination modes will be described.
- liquid agent I contains the tripeptide and an aqueous solvent.
- the hydrogel-form agent II contains a gelatin gel and an aqueous solvent.
- a granular hydrogel hydrated in powdered airgel is used as the gelatin gel, the agent II exhibits a flowable gel.
- the agent II becomes a sheet or film.
- composition of the hydrogel for preventing adhesion may be appropriately set, but specifically, the following range is exemplified.
- Compounding ratio of the above-mentioned peptide in the first agent for example, 1 to 80% by weight, preferably 3 to 50)% by weight.
- Blending ratio of the aqueous solvent in the first agent for example, 20 to 99% by weight, preferably 50 to 97.
- Compounding ratio of gelatin gel in the agent II for example, 1 to 80% by weight, preferably 10 to 50% by weight on a dry weight basis (converted to the weight of gelatin itself).
- Blending ratio of the aqueous solvent in the agent II for example, 20 to 99% by weight, preferably 50 to 90% by weight.
- the ratio of the agent I to the agent II to be administered may be appropriately adjusted to become the composition of the hydrogel for adhesion prevention after mixing the agent I and the agent II, for example, the agent I 100
- the amount of the agent II is 75 to 125 parts by weight, preferably 90 to 120 parts by weight, more preferably 95 to 105 parts by weight, per part by weight.
- the agent I and the agent II are mixed before administration, and an aqueous solvent is added as necessary to prepare the adhesion preventing hydrogel.
- the method of mixing the agent I and the agent II prior to administration and adding an aqueous solvent as necessary to prepare the adhesion preventing hydrogel and then administering it to the application site is the simplicity of administration. It is preferable from the viewpoint of
- liquid agent I contains the peptide and an aqueous solvent.
- the airgel-like agent II contains an airgel-like gelatin gel.
- the agent II is powdered.
- the agent II becomes a sheet or film.
- the blending ratio of the tripeptide and the aqueous solvent in the liquid agent I may be appropriately set so as to be the composition of the adhesion preventing hydrogel when the agent I and the agent II are mixed at the time of use. Specifically, the following range is exemplified. Blending ratio of the tripeptide in the first agent : for example, 1 to 80% by weight, preferably 3 to 50% by weight. Blending ratio of the aqueous solvent in the first agent : for example, 20 to 99% by weight, preferably 50 to 97.
- the ratio of the agent I to the agent II to be administered may be appropriately adjusted to become the composition of the hydrogel for adhesion prevention after mixing the agent I and the agent II, for example, the agent I 100
- the amount of the agent II is 75 to 125 parts by weight, preferably 90 to 110 parts by weight, more preferably 95 to 105 parts by weight, per part by weight.
- the application target site Method of administering the agent I after administration of the agent I to the application site, further adding an aqueous solvent as necessary, to form the adhesion preventing hydrogel on the application site Or the method of administering the agent I after administering the agent II to the application site, and further adding an aqueous solvent as necessary to form the adhesion preventing hydrogel on the application site, etc.
- the powdered first agent contains the tripeptide.
- the hydrogel-like agent II contains a gelatin gel and an aqueous solvent.
- a granular hydrogel hydrated in powdered airgel is used as the gelatin gel, the agent II exhibits a flowable gel.
- the agent II becomes a sheet or film.
- the mixing ratio of the gelatin gel and the aqueous solvent in the hydrogel-form agent II may be appropriately set so as to be the composition of the adhesion preventing hydrogel when the agent I and the agent II are mixed at the time of use. Although it is good, specifically, the following range is illustrated.
- Blending ratio of gelatin gel in the agent II for example, 1 to 50% by weight, preferably 10 to 30% by weight.
- Compounding ratio of the aqueous solvent in the agent II for example, 50 to 99% by weight, preferably 70 to 90.
- the ratio of the agent I to the agent II to be administered may be appropriately adjusted so as to become the composition of the hydrogel for adhesion prevention after mixing the agent I and the agent II, for example, agent II 100
- the amount of the first agent is 75 to 125 parts by weight, preferably 90 to 110 parts by weight, and more preferably 95 to 105 parts by weight.
- the agent I and the agent II are mixed before administration, and an aqueous solvent is added as necessary to prepare the adhesion preventing hydrogel.
- the method of mixing the agent I and the agent II prior to administration and adding an aqueous solvent as necessary to prepare the adhesion preventing hydrogel and then administering it to the application site is the simplicity of administration. It is preferable from the viewpoint of
- the powdered first agent contains the tripeptide.
- the airgel-like agent II contains an airgel-like gelatin gel.
- the agent II is powdered.
- the agent II becomes a sheet or film.
- the ratio of the agent I to the agent II to be administered may be appropriately adjusted so as to become the composition of the adhesion preventing hydrogel after mixing the agent I, agent II and the aqueous solvent to be administered.
- 75 to 125 parts by weight, preferably 90 to 110 parts by weight, more preferably 95 to 125 parts by weight of the agent II can be mentioned per 100 parts by weight of the agent I.
- the agent for preventing adhesion, the agent II, and the aqueous solvent are mixed to prepare the hydrogel for preventing adhesion, and then the agent is administered to the application site.
- Method of forming a gel Method II of administering an agent II to an application site, and then administering an agent I to which an aqueous solvent is added to form the adhesion preventing hydrogel on the application site; or Agent is administered to the application site, then an aqueous solvent is added to the second agent to form a hydrogel and administered to the application site to form the adhesion preventing hydrogel on the application site.
- Agent is administered to the application site, then an aqueous solvent is added to the second agent to form a hydrogel and administered to the application site to form the adhesion preventing hydrogel on the application site.
- the anti-adhesion agent of the said aspect can be used, without using an aqueous solvent.
- a method of use for example, a method in which the agent I and the agent II are mixed before administration and then administered to the application site; the agent I is administered to the application site; A method of administering the agent II; or a method of administering the agent I after administering the agent II to the application site, and the like. It is preferred from the viewpoint of the convenience of administration that the method of mixing the agent I and the agent II prior to administration and then administer to the site of application.
- blood or the like present at the application site is used as an aqueous solvent for producing the adhesion preventing hydrogel.
- the composition of the adhesion-preventing hydrogel when the agent I, the agent II and the aqueous solvent are mixed at the time of use is 10 to 900 parts by weight, preferably 20 to 250 parts by weight, based on 100 parts by weight of the total amount of the agent I and the agent II. And more preferably 80 to 150 parts by weight.
- the adhesion-preventing material of the present invention comprises, in addition to the above-mentioned components, an antibacterial agent, an antibiotic agent, an anti-inflammatory agent, a blood circulation improving agent, a steroid agent, for the purpose of promoting therapeutic effect and preventing bacterial infection. It may contain pharmacological components such as enzyme inhibitors, growth factors, and various vitamins.
- the adhesion preventing material of the present invention can be used as a kind of drug delivery system aiming at controlled release of a pharmacological component by containing the above-mentioned pharmacological component because it stays at a target site for a fixed period.
- additives such as excipients, binders, lubricants, pH adjusters, buffers, preservatives, antioxidants, coloring agents, moisture proofing agents, etc. are added to the adhesion preventing material of the present invention, if necessary. May be included.
- the anti-adhesion agent of the present invention is a two-agent type anti-adhesion agent for in-use preparation
- these pharmacological components and additives may be contained in any one of the first agent and the second agent. It may well be included in both of these.
- the adhesion preventing material of the present invention prevents adhesion of living tissue when performing surgery such as incision or endoscopic treatment in the surgical field such as intra-abdominal organs or in the field of orthopedics to tendons, nerves, and joints.
- the tendon has fine and complex surrounding tissue, and therefore the adhesion prevention material is required to have excellent diffusibility so as to extend to the entire surrounding tissue of the tendon.
- the anti-adhesion material of the present invention should sufficiently satisfy the requirements as an anti-adhesion material for tendon. it can.
- a tendon is preferably mentioned as an application target of adhesion prevention.
- the adhesion preventing material of the present invention When the adhesion preventing material of the present invention is administered in the form of a hydrogel, since it is excellent in diffusion after administration, it can be circulated around the entire target site if administered around the target site. In addition, when the adhesion preventing material of the present invention is administered in powder form, it may be administered to the entire target site.
- the dose of the anti-adhesion agent of the present invention may be suitably set according to the state of the application site, but an effective amount for adhesion prevention may be appropriately set.
- the anti-adhesion material of the present invention The amount may be set to an amount equivalent to about 20 to 120 mg in terms of the dry weight of gelatin gel (converted to the weight of gelatin itself) per 1 cm 2 of the site.
- test materials 1-1 Preparation and preparation of test materials 1-1.
- Preparation of Gelatin Sponge Gel Powder The crosslinked gelatin sponge gel powder used in the following test examples was prepared according to the following procedure.
- Cross-Linked Gelatin Sponge Gel Powder (A) Cross-linked Gelatin Sponge Gel (trade name "Sponsel", Astellas Pharmaceuticals Co., Ltd.) is ground to a particle size of 500 ⁇ m or less using an ultracentrifuge mill, and a particle size of 250 using a sieve. Only powder of ⁇ 500 ⁇ m was recovered to obtain a crosslinked gelatin sponge gel powder (A).
- Tripeptide mixture 1 A peptide mixture obtained by hydrolyzing collagen derived from pig skin (trade name “Tp-100”, Gelice Co., Ltd.). The peptide mixture contains 90% by weight of tripeptide. 33.3 parts by weight of Gly-Pro-Hyp, 3.7 parts by weight of Gly-Ala-Hyp, 14.8 parts by weight of Gly-Pro-Ala, and 100 parts by weight of the total amount of tripeptides contained The peptide is contained at 48.1 parts by weight.
- Tripeptide 2 A synthesized tripeptide consisting of Gly-Ala-Hyp (Bachem AG, H-3260).
- Tripeptide 3 A synthesized tripeptide consisting of Gly-Pro-Ala (Bachem AG, H-3615).
- Tripeptide 4 A synthesized tripeptide consisting of Gly-Pro-Hyp (Bachem AG, H-3630).
- Tripeptide 5 A synthesized tripeptide consisting of Ile-Pro-Hyp (consigned synthesis by Peptide Laboratories, Inc.).
- Tripeptide 6 A synthesized tripeptide consisting of Asn-Pro-Hyp (consigned synthesis by Peptide Laboratories, Inc.).
- Tripeptide 7 Synthesized tripeptide consisting of Arg-Pro-Hyp (consigned synthesis by Peptide Laboratories, Inc.).
- Tripeptide 8 Synthesized tripeptide consisting of Tyr-Pro-Hyp (consigned synthesis by Peptide Institute, Inc.).
- Oligopeptide 1 (Gly-Pro-Hyp) A synthesized oligopeptide consisting of 5 (amino acid residue number 15) (Peptide Research Institute, Inc., 4032).
- Polypeptide 1 (Gly-Pro-Hyp) A synthesized polypeptide consisting of 10 (amino acid residue number 30) (Peptide Research Institute, Inc., 4033).
- Dipeptide 1 Synthesized dipeptide consisting of Pro-Hyp (Bachem AG, G-3025).
- Dipeptide 2 A synthesized dipeptide consisting of Gly-Pro (Peptide Research Institute, Inc., 3052).
- Test Example 1 2-1. Preparation of Samples Samples of the compositions shown in Table 1 were prepared.
- buprenorphine (trade name "Lepetan indicament 0.2 mg” as an analgesic) was injected intramuscularly, and Enrofloxacin (Batoril 2.5% injection, Bayer drug) as an antibacterial agent Co., Ltd. 4 mg / kg body weight was injected subcutaneously.
- the left hind leg of the anesthetized animal was removed.
- the rabbit was fixed on a fixator (trade name "Kitajima Type Fixer", Natsume Seisakusho Co., Ltd.) and the area around the operation area was disinfected.
- the skin on the upper part of the Achilles tendon of the left hind leg was cut longitudinally to expose the Achilles tendon.
- the center of the exposed Achilles tendon was sharply cut with a scalpel.
- the cut site of the Achilles tendon was sutured by a modified kessler method using a suture (trade name “5-0 Mersilene”, Ethicon Co., Ltd.), and after hemostasis and washing with a physiological saline solution, it was exposed.
- Comparative Examples 1-1 and 1-2 a test is conducted with 6 rabbits each, and in Comparative Examples 1-3 and 1 each 5 rabbits, and the total score of 5 places is taken as the adhesion score of the individual. The average value of the adhesion score of the group was calculated. In addition, in the Achilles tendon two weeks after administration of the sample, the presence or absence of the remaining sample was visually confirmed.
- Test example 2 3-1. Preparation of Samples Samples of the compositions shown in Table 2 were prepared.
- Test Example 3 4-1 Preparation of Samples Samples of the compositions shown in Table 3 were prepared.
- the cut site of the deep flexor flexor tendon is sutured by a modified kessler method using a suture (trade name "6-0 prolene”, Ethicon Co., Ltd.), and after hemostasis and washing using a saline solution are performed.
- the samples were administered to the exposed flexor flexor tendon and its surroundings.
- 0.1 mL was administered in Comparative Example 3, and in Example 3-1, 0.08 mL of the first agent was administered on the second agent after administration of 0.02 g of the second agent, Example In 3-2, 0.1 mL was administered.
- the incision is sewn with a suture thread (trade name “Success thread with medical thread 5-0”, Matsuda Medical Industry Co., Ltd.), and a collar is wound around the neck to prevent self-harm. Bred.
- the rabbit was euthanized by excessive administration of somnopentyl (trade name "Pentobarbital sodium", Kyoritsu Pharmaceutical Co., Ltd.) from the auricle vein.
- somnopentyl trade name "Pentobarbital sodium", Kyoritsu Pharmaceutical Co., Ltd.
- the operative site was incised again, and the degree of adhesion was evaluated according to the following evaluation criteria for the deep finger flexor tendon and the floor, the deep finger flexor tendon and the flexor flexor tendon, the deep finger flexor tendon and other surrounding tissues according to the following evaluation criteria.
- the sum of the scores at three locations was taken as the individual value.
- the measurement of the joint movement range was performed in the following procedures. Two weeks after sample administration, the left hind limb of the rabbit was cut between the talus and the tibia. The cut left hind limb was placed on the measurement table. Next, a thread was tied to the deep flexors tendon proximal to the MP joint, and the thread and tension tester were tied via the hook.
- the tensile tester was composed of a load measuring device (trade name "Digital Force Gauge ZP-500N", Imada Co., Ltd.) and a measurement stand (trade name "Horizontal Motorized Measurement Stand MH2-500N", Imada Co., Ltd.). The tendon was then loaded (0.5, 1.0, 2.0 and 3.0 N) and photographs taken before and after loading were taken.
- the joint movement range was calculated by the following formula.
- FIG. 4 also shows a photograph of the flexor tendon observed at the end of the test.
- adhesion can be prevented and joint movable range is expanded by administering collagen-derived tripeptide mixture 1 containing Gly-Pro-Hyp and the cross-linked gelatin sponge gel.
- Test Example 4 5-1 Preparation of Samples Samples of the compositions shown in Table 4 were prepared.
- Test Example 5 6-1 Preparation of Samples Samples of the compositions shown in Table 5 were prepared.
- Test Example 6 7-1 Preparation of Samples Samples of the compositions shown in Table 6 were prepared.
- the dipeptide 2 (Gly-Pro) had a reduced adhesion-preventing effect as compared to the case where the tripeptide 4 (Gly-Pro-Hyp) and the dipeptide 1 (Pro-Hyp) were used. That is, from this result, it has become clear that the amino acid sequence of Gly-Pro-Hyp and the amino acid sequence of Pro-Hyp contribute to the adhesion preventing effect.
- Test Example 7 8-1 Preparation of Samples Samples of the compositions shown in Table 7 were prepared.
- Test Example 8 9-1 Preparation of Samples Samples of the compositions shown in Table 8 were prepared.
- the results of measurement of the range of motion of the joint are shown in FIG. 13, the results of measurement of the range of motion of the PIP joint and the DIP joint are shown in FIG. 14.
- the results of adhesion score are shown in FIG. 15.
- the results of observing the condition of flexor tendon at the end of the test are shown in FIG.
- the result of analyzing the correlation between the area and the adhesion score is shown in FIG.
- Example 8-1 the tripeptide 4 consisting of Gly-Pro-Hyp and the cross-linked gelatin sponge gel were simultaneously administered in the form of mixed powder (Example 8-1), and the powder-form agent I and the hydrogel-form agent II were separately prepared.
- Example 8-2 and 8-3 the simultaneous administration in the hydrogel state
- Example 8-3 the adhesion preventing effect was observed.
- Example 8-1 administered as a mixed powder was smaller in DIP movable range than Examples 8-2 and 8-3.
- Test Example 9 10-1 Preparation of Samples Samples of the compositions shown in Table 9 were prepared.
- Test Example 10 11-1 Preparation of Samples Samples of the compositions shown in Table 10 were prepared.
- Test Example 11 12-1 Preparation of Samples Samples of the compositions shown in Table 11 were prepared.
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Abstract
Description
項1. (A)(A-1)-(X-Pro-Y)n-[Xは任意のアミノ酸、Proはプロリン、Yはヒドロキシプロリン又はプロリンを示し、nは1~10の整数である。]のアミノ酸配列を含むペプチド、及び/又は(A-2)-(Pro-Y)m-[Proはプロリン、Yはヒドロキシプロリン又はプロリンを示し、mは1~10の整数である。]のアミノ酸配列を含むペプチド、並びに
(B)ゼラチンゲル
を含有する、癒着防止材。
項2. 前記(A-1)のアミノ酸配列において、Xが疎水性アミノ酸、親水性塩基性アミノ酸、又は親水性中性アミノ酸である、項1に記載の癒着防止材。
項3. 前記(A-1)のアミノ酸配列において、Xがグリシン、イソロイシン、アスパラギン、アルギニン、チロシン、アラニン、バリン、又はロイシンである、項1又は2に記載の癒着防止材。
項4. 前記(A-1)のアミノ酸配列において、Yがヒドロキシプロリンである項1~3のいずれかに記載の癒着防止材。
項5. 前記(A-1)アミノ酸配列において、Xがグリシン、イソロイシン、アスパラギン、アルギニン、又はチロシンであり、且つYがヒドロキシプロリンである、項1~4のいずれかに記載の癒着防止材。
項6. 前記(A-1)のアミノ酸配列において、nが1~5の整数である、項1~5のいずれかに記載の癒着防止材。
項7. 前記(A-2)のアミノ酸配列において、mが1~5の整数である、項1に記載の癒着防止材。
項8. 前記ゼラチンゲルが架橋ゼラチンゲルである、項1~7のいずれかに記載の癒着防止材。
項9. 前記ゼラチンゲルが、ゼラチンスポンジゲルである、項1~8のいずれかに記載の癒着防止材。
項10. 前記ゼラチンゲルが、粉末状のエアロゲル、又は粒状のヒドロゲルである、項1~9のいずれかに記載の癒着防止材。
項11. 更に水性溶媒を含み、前記ペプチド及び前記ゼラチンゲルを含むヒドロゲル状である、項1~10のいずれかに記載の癒着防止材。
項12. 水性溶媒を含まず、前記ペプチド及び前記ゼラチンゲルを含む固体製剤からなる1剤タイプである、項1~10のいずれかに記載の癒着防止材。
項13. 前記ペプチドを含む第I剤と、前記ゼラチンゲルを含む第II剤とを含む2剤タイプである、項1~10のいずれかに記載の癒着防止材。
項14. 前記第I剤が水性溶媒を含む液状であり、且つ前記第II製剤が水性溶媒を含むハイドロゲル状である、項13に記載の癒着防止材。
項15. 前記第I剤が水性溶媒を含む液状であり、且つ前記第II製剤がエアロゲル状である、項13に記載の癒着防止材。
項16. 前記第I剤が粉末状であり、且つ前記第II製剤が水性溶媒を含むハイドロゲル状である、項13に記載の癒着防止材。
項17. 前記第I剤が粉末状であり、且つ前記第II製剤がエアロゲル状である、項13に記載の癒着防止材。
項18. 癒着防止材の製造のための、(A)(A-1)-(X-Pro-Y)n-[Xは任意のアミノ酸、Proはプロリン、Yはヒドロキシプロリン又はプロリンを示し、nは1~10の整数である。]のアミノ酸配列を含むペプチド、及び/又は(A-2)-(Pro-Y)m-[Proはプロリン、Yはヒドロキシプロリン又はプロリンを示し、mは1~10の整数である。]のアミノ酸配列を含むペプチド、並びに(B)ゼラチンゲルを含有する製剤の使用。
項19. 項1~17のいずれかに記載の癒着防止材の癒着防止に有効な量を、生体組織の癒着の防止が求められる部位に投与する、癒着防止方法。
本明細書において、アミノ酸は下記三文字表記の略号を使用する。
Ala:アラニン
Arg:アルギニン
Asn:アスパラギン
Asp:アスパラギン酸
Cys:システイン
Gln:グルタミン
Glu:グルタミン酸
Gly:グリシン
His:ヒスチジン
Hyp:ヒドロキシプロリン
Ile:イソロイシン
Leu:ロイシン
Lys:リシン
Met:メチオニン
Phe:フェニルアラニン
Pro:プロリン
Ser:セリン
Thr:トレオニン
Trp:トリプトファン
Tyr:チロシン
Val:バリン
本発明の癒着防止材には、下記(A-1)のアミノ酸配列を含むペプチド、及び/又は下記(A-2)のアミノ酸配列を含むペプチドが含まれる。
(A-1) -(X-Pro-Y)n-[Xは任意のアミノ酸、Proはプロリン、Yはヒドロキシプロリン又はプロリンを示し、nは1~10の整数である。]
(A-2) -(Pro-Y)m-[Proはプロリン、Yはヒドロキシプロリン又はプロリンを示し、mは1~10の整数である。]
本発明の癒着防止材にはゼラチンゲルが含まれる。
本発明の癒着防止材において、前記ペプチドとゼラチンゲルの比率については、所望の癒着防止効果が奏されることを限度として特に制限されないが、例えば、ゼラチンゲルの乾燥重量換算(ゼラチン自体の重量に換算)100重量部当たり、前記ペプチドが2~500重量部、好ましくは50~400重量部、更に好ましくは100~300重量部が挙げられる。
本発明の癒着防止材による癒着防止効果は、前記ペプチド、ゼラチンゲル、及び水性溶媒を含むハイドロゲル(以下、「癒着防止用ハイドロゲル」と表記する)を、癒着防止が求められる対象部位に適用することによって奏される。
前記ペプチドの配合割合:例えば、1~50重量%、好ましくは3~40重量%、更に好ましくは10~30重量%。
ゼラチンゲルの配合割合:例えば、乾燥重量換算(ゼラチン自体の重量に換算)で5~50重量%、好ましくは10~40重量%、更に好ましくは15~30重量%。
水性溶媒の配合割合:例えば、10~90重量%、好ましくは30~80重量%、更に好ましくは40~55重量%。
本発明の癒着防止材は、前記癒着防止用ハイドロゲルそのものを含むものであってもよい。
1剤タイプの用時調製用の癒着防止材では、同一組成物中で、前記トリペプチド及びエアロゲル状のゼラチンゲルが水非存在下で含まれている固形製剤であり、用時に水性溶媒を添加することによって使用される。
前記ペプチドの含有量:例えば、10~90重量%、好ましくは40~80重量%、更に好ましくは50~70重量%。
ゼラチンゲルの含有量:例えば、乾燥重量換算(ゼラチン自体の重量に換算)で10~90重量%、好ましくは20~60重量%、更に好ましくは30~50重量%。
2剤タイプの用時調製用の癒着防止材では、前記トリペプチドを含む第I剤と、ゼラチンゲルを含む第II剤が、それぞれ分離した状態で含まれる。当該態様の癒着防止材では、第I剤、第II剤、及び必要に応じて水性溶媒を、用時に混合又は含浸させることによって使用される。
液状の第I剤は、前記トリペプチド及び水性溶媒を含有する。
第I剤中の前記ペプチドの配合割合:例えば、1~80重量%、好ましくは3~50)重量%。
第I剤中の水性溶媒の配合割合:例えば、20~99重量%、好ましくは50~97。
第II剤中のゼラチンゲルの配合割合:例えば、乾燥重量換算(ゼラチン自体の重量に換算)で1~80重量%、好ましくは10~50重量%。
第II剤中の水性溶媒の配合割合:例えば、20~99重量%、好ましくは50~90重量%。
液状の第I剤は、前記ペプチド及び水性溶媒を含有する。
第I剤中の前記トリペプチドの配合割合:例えば、1~80重量%、好ましくは3~50重量%。
第I剤中の水性溶媒の配合割合:例えば、20~99重量%、好ましくは50~97。
粉末状の第I剤は、前記トリペプチドを含有する。
第II剤中のゼラチンゲルの配合割合:例えば、1~50重量%、好ましくは10~30重量%。
第II剤中の水性溶媒の配合割合:例えば、50~99重量%、好ましくは70~90。
粉末状の第I剤は、前記トリペプチドを含有する。
本発明の癒着防止材は、前記成分の他に、必要に応じて、治療効果の促進や細菌感染の防止等を目的として、抗菌剤、抗生剤、抗炎症剤、血行改善剤、ステロイド剤、酵素阻害剤、増殖因子、各種ビタミン等の薬理成分を含んでいてもよい。本発明の癒着防止材は、適用対象部位で一定期間留まることから、上記薬理成分を含有することによって、薬理成分の徐放を目的とするドラッグデリバリーシステムの一種として利用することもできる。
本発明の癒着防止材は、腹腔内臓器等の外科分野や、腱、神経、関節への整形外科分野において、切開や内視鏡処理等の手術を行った際の生体組織の癒着を防止するために使用される。特に、癒着防止が求められる部位の中でも、腱は、周辺組織が微細で複雑なため、癒着防止材には、腱の周辺組織全体に行き渡るように優れた拡散性を有していることが求められるが、本発明の癒着防止材は、エアロゲル状のゼラチンゲル粉末又はこれを含水させた粒状のハイドロゲルを使用する場合には、腱の癒着防止材としての要求特性を十分に満足させることができる。このような本発明の効果を鑑みれば、癒着防止の適用対象として、好ましくは腱が挙げられる。
1-1.ゼラチンスポンジゲル粉末の作製
以下の試験例に使用した架橋ゼラチンスポンジゲル粉末は、以下の手順で作製した。
架橋ゼラチンスポンジゲル(商品名「スポンゼル」、アステラス製薬株式会社)を、超遠心ミルを用いて500μm以下の粒子径に粉砕し、ふるいを用いて粒子径250~500μmの粉体のみを回収し、架橋ゼラチンスポンジゲル粉末(A)を得た。
ゼラチン(商品名「RM-100」、ゼライス株式会社)2.5重量%を蒸留水に溶解してゼラチン溶液を調製した。これを予備凍結(-40℃、12時間)した後に凍結乾燥(約-45℃、40時間)してゼラチンスポンジを得た。得られたゼラチンスポンジを定温乾燥機を用いて熱架橋(140℃、48時間)した後、超遠心ミルを用いて500μm以下の粒子径に粉砕し、ふるいを用いて粒子径250~500μmの粉体のみを回収し、架橋ゼラチンスポンジゲル粉末(B)を得た。
ゼラチン溶液におけるゼラチン濃度を10重量%としたこと以外は、前記架橋ゼラチンスポンジゲル粉末(B)と同条件で製造を行い、架橋ゼラチンスポンジゲル粉末(C)を得た。
ゼラチンとして、商品名「BeMatrix ゼラチンLS-H」(新田ゼラチン株式会社)を使用したこと以外は、前記架橋ゼラチンスポンジゲル粉末(A)と同条件で製造を行い、架橋ゼラチンスポンジゲル粉末(D)を得た。
下記の各種ペプチドを準備した。
・トリペプチド混合物1
豚皮由来のコラーゲンを加水分解したペプチド混合物(商品名「Tp-100」、ゼライス株式会社)。
当該ペプチド混合物にはトリペプチドが90重量%含まれている。
含まれるトリペプチドの総量100重量部当たり、Gly-Pro-Hypが33.3重量部、Gly-Ala-Hypが3.7重量部、Gly-Pro-Alaが14.8重量部、その他のトリペプチドが48.1重量部含まれている。
Gly-Ala-Hypからなる合成したトリペプチド(Bachem AG、H-3260)。
Gly-Pro-Alaからなる合成したトリペプチド(Bachem AG、H-3615)。
Gly-Pro-Hypからなる合成したトリペプチド(Bachem AG、H-3630)。
Ile-Pro-Hypからなる合成したトリペプチド(株式会社ペプチド研究所による委託合成)。
Asn-Pro-Hypからなる合成したトリペプチド(株式会社ペプチド研究所による委託合成)。
Arg-Pro-Hypからなる合成したトリペプチド(株式会社ペプチド研究所による委託合成)。
Tyr-Pro-Hypからなる合成したトリペプチド(株式会社ペプチド研究所による委託合成)。
(Gly-Pro-Hyp)5からなる合成したオリゴペプチド(アミノ酸残基数15)(株式会社ペプチド研究所、4032)。
(Gly-Pro-Hyp)10からなる合成したポリペプチド(アミノ酸残基数30)(株式会社ペプチド研究所、4033)。
Pro-Hypからなる合成したジペプチド(Bachem AG、G-3025)。
Gly-Proからなる合成したジペプチド(株式会社ペプチド研究所、3052)。
供給動物として13週齢のウサギ(Kbl:JW、雄)を用いた。麻酔薬として、ケタミン(商品名「ケタラール筋注用500mg」、第一三共プロファーマ株式会社)とキシラジン(商品名「セラクタール2%注射液」、)をケタミン100液量あたりキシラジン20液量の割合で混合し、ウサギに混合液1.45ml/kg体重を筋肉内注射した。次いで、鎮痛薬としてブプレノルフィン(商品名「レペタン注0.2mg」、大塚製薬株式会社)20μg/kg体重を筋肉内注射し、抗菌薬としてエンロフロキサシン(バイトリル2.5%注射液、バイエル薬品株式会社)4mg/kg体重を皮下注射した。
<癒着スコア>
0:癒着なし
1:鈍的剥離により周囲組織から容易に剥離可能
2:鈍的剥離により周囲組織から剥離可能
3:周囲組織からの剥離には、わずかな鋭的剥離が必要
4:周囲組織からの剥離には、完全な鋭的剥離が必要
13週齢のウサギ(Kbl:JW、雄)を用いて、前記試験例1と同様の方法で、アキレス腱の切断及び縫合を行い、止血及び生理食塩水を用いた洗浄を行った後に、露出したアキレス腱とその周囲に検体を投与した。検体の投与は、比較例2では0.5mLを投与し、実施例2では、第II剤0.1gの投与後に、第II剤の上に第I剤0.4mLを投与した。
供給動物として、13週齢のウサギ(Kbl:JW、雄)を用いた。前記試験例1と同様の方法で、麻酔、除毛、固定及び消毒を実施した。次いで、麻酔下で、左後肢の中足指の上部の皮膚を縦切開し、屈筋腱を露出させた。露出した屈筋腱の内、深指屈筋腱をメスで鋭的に切断した。その後、深指屈筋腱の切断部位を、縫合糸(商品名「6-0 prolene」、Ethicon株式会社)を用いてmodified kessler法で縫合し、止血及び生理食塩液を用いた洗浄を行った後に、露出した深指屈筋腱とその周囲に検体を投与した。検体の投与は、比較例3では0.1mLを投与し、実施例3-1では第II剤0.02gの投与後に、第II剤の上に第I剤0.08mLを投与し、実施例3-2では0.1mLを投与した。その後、切開部を縫合糸(商品名「医療用糸付き縫合糸5-0号」、松田医科工業株式会社)で縫合した、自傷行為の予防のために、首の周りにカラーを巻いて飼育した。
<評価基準>
0:癒着なし
1:鈍的剥離により周囲組織から容易に剥離可能
2:鈍的剥離により周囲組織から剥離可能
3:周囲組織からの剥離には、わずかな鋭的剥離が必要
4:周囲組織からの剥離には、完全な鋭的剥離が必要
前記試験例3と同様の方法で癒着防止効果を評価した。なお、検体の投与量は0.2mLに設定した。また、比較例4では12匹のウサギ、実施例4-1では8匹のウサギ、実施例4-2では9匹のウサギで試験を行った。
前記試験例3と同様の方法で癒着防止効果を評価した。なお、検体の投与量は0.15mLに設定した。また、比較例5-1、実施例5-1及び5-2では6匹のウサギ、比較例5-2、5-3及び5-4では7匹のウサギで試験を行った。
前記試験例3と同様の方法で癒着防止効果を評価した。なお、検体の投与量は0.15mLに設定した。また、比較例6-1、及び実施例6-1及び6-2では9匹のウサギ、比較例6-2では5匹のウサギで試験を行った。
前記試験例3と同様の方法で癒着防止効果を評価した。なお、検体の投与量は0.15mLに設定した。また、試験では、PIP関節及びDIP関節の可動域についても、下記算出式に従って算出した。なお、比較例7では11匹のウサギ、実施例7-1及び7-2では7匹のウサギ、実施例7-3では8匹のウサギで試験を行った。
前記試験例3と同様の方法で癒着防止効果を評価した。なお、検体は、比較例8では0.15mL投与、実施例8-1では75mg投与、実施例8-2では第I剤45mgを投与後に第II剤0.15mLを投与、実施例8-2では第I剤0.075mLと第II剤0.075mLとを混合した後に投与した。また、試験では、PIP関節及びDIP関節の可動域についても、前記試験例7と同様の方法で求めた。
前記試験例3と同様の方法で癒着防止効果を評価した。なお、検体の投与量は0.15mLに設定した。なお、比較例9及び実施例9-3では9匹のウサギ、実施例9-1では6匹のウサギ、実施例9-2、9-4、及び9-5では8匹のウサギで試験を行った。
前記試験例3と同様の方法で癒着防止効果を評価した。なお、検体の投与量は0.15mLに設定した。なお、比較例10-1では9匹のウサギ、実施例10では7匹のウサギ、比較例10-2では6匹のウサギで試験を行った。
前記試験例3と同様の方法で癒着防止効果を評価した。なお、検体の投与量は0.15mLに設定した。また、比較例11では10匹のウサギ、実施例11-1では9匹のウサギ、実施例11-2では6匹のウサギで試験を行った。
Claims (19)
- (A)(A-1)-(X-Pro-Y)n-[Xは任意のアミノ酸、Proはプロリン、Yはヒドロキシプロリン又はプロリンを示し、nは1~10の整数である。]のアミノ酸配列を含むペプチド、及び/又は(A-2)-(Pro-Y)m-[Proはプロリン、Yはヒドロキシプロリン又はプロリンを示し、mは1~10の整数である。]のアミノ酸配列を含むペプチド、並びに
(B)ゼラチンゲル
を含有する、癒着防止材。 - 前記(A-1)のアミノ酸配列において、Xが疎水性アミノ酸、親水性塩基性アミノ酸、又は親水性中性アミノ酸である、請求項1に記載の癒着防止材。
- 前記(A-1)のアミノ酸配列において、Xがグリシン、イソロイシン、アスパラギン、アルギニン、チロシン、アラニン、バリン、又はロイシンである、請求項1又は2に記載の癒着防止材。
- 前記(A-1)のアミノ酸配列において、Yがヒドロキシプロリンである請求項1~3のいずれかに記載の癒着防止材。
- 前記(A-1)アミノ酸配列において、Xがグリシン、イソロイシン、アスパラギン、アルギニン、又はチロシンであり、且つYがヒドロキシプロリンである、請求項1~4のいずれかに記載の癒着防止材。
- 前記(A-1)のアミノ酸配列において、nが1~5の整数である、請求項1~5のいずれかに記載の癒着防止材。
- 前記(A-2)のアミノ酸配列において、mが1~5の整数である、請求項1に記載の癒着防止材。
- 前記ゼラチンゲルが架橋ゼラチンゲルである、請求項1~7のいずれかに記載の癒着防止材。
- 前記ゼラチンゲルが、ゼラチンスポンジゲルである、請求項1~8のいずれかに記載の癒着防止材。
- 前記ゼラチンゲルが、粉末状のエアロゲル、又は粒状のヒドロゲルである、請求項1~9のいずれかに記載の癒着防止材。
- 更に水性溶媒を含み、前記ペプチド及び前記ゼラチンゲルを含むヒドロゲル状である、請求項1~10のいずれかに記載の癒着防止材。
- 水性溶媒を含まず、前記ペプチド及び前記ゼラチンゲルを含む固体製剤からなる1剤タイプである、請求項1~10のいずれかに記載の癒着防止材。
- 前記ペプチドを含む第I剤と、前記ゼラチンゲルを含む第II剤とを含む2剤タイプである、請求項1~10のいずれかに記載の癒着防止材。
- 前記第I剤が水性溶媒を含む液状であり、且つ前記第II製剤が水性溶媒を含むハイドロゲル状である、請求項13に記載の癒着防止材。
- 前記第I剤が水性溶媒を含む液状であり、且つ前記第II製剤がエアロゲル状である、請求項13に記載の癒着防止材。
- 前記第I剤が粉末状であり、且つ前記第II製剤が水性溶媒を含むハイドロゲル状である、請求項13に記載の癒着防止材。
- 前記第I剤が粉末状であり、且つ前記第II製剤がエアロゲル状である、請求項13に記載の癒着防止材。
- 癒着防止材の製造のための、(A)(A-1)-(X-Pro-Y)n-[Xは任意のアミノ酸、Proはプロリン、Yはヒドロキシプロリン又はプロリンを示し、nは1~10の整数である。]のアミノ酸配列を含むペプチド、及び/又は(A-2)-(Pro-Y)m-[Proはプロリン、Yはヒドロキシプロリン又はプロリンを示し、mは1~10の整数である。]のアミノ酸配列を含むペプチド、並びに(B)ゼラチンゲルを含有する製剤の使用。
- 請求項1~17のいずれかに記載の癒着防止材の癒着防止に有効な量を、生体組織の癒着の防止が求められる部位に投与する、癒着防止方法。
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KR1020207013779A KR20200075844A (ko) | 2017-10-20 | 2018-10-19 | 유착 방지재 |
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JP2019548823A JP7283751B2 (ja) | 2017-10-20 | 2018-10-19 | 癒着防止材 |
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US11484564B2 (en) | 2022-11-01 |
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PH12020550231A1 (en) | 2021-02-08 |
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CN111295208A (zh) | 2020-06-16 |
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