WO2019235466A1 - B型肝炎ワクチン経鼻投与システム - Google Patents
B型肝炎ワクチン経鼻投与システム Download PDFInfo
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- WO2019235466A1 WO2019235466A1 PCT/JP2019/022136 JP2019022136W WO2019235466A1 WO 2019235466 A1 WO2019235466 A1 WO 2019235466A1 JP 2019022136 W JP2019022136 W JP 2019022136W WO 2019235466 A1 WO2019235466 A1 WO 2019235466A1
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- hepatitis
- vaccine
- spray
- nozzle
- nasal
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- SPSXSWRZQFPVTJ-ZQQKUFEYSA-N hepatitis b vaccine Chemical compound C([C@H](NC(=O)[C@H]([C@@H](C)O)NC(=O)[C@H]([C@@H](C)O)NC(=O)[C@H](CO)NC(=O)[C@H](CC(N)=O)NC(=O)[C@H](CC=1C2=CC=CC=C2NC=1)NC(=O)[C@H](CCC(N)=O)NC(=O)[C@@H](N)CCSC)C(=O)N[C@@H](CC1N=CN=C1)C(=O)N[C@@H](CCC(N)=O)C(=O)N[C@@H]([C@@H](C)O)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](CCC(N)=O)C(=O)N[C@@H](CC(O)=O)C(=O)N1[C@@H](CCC1)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N[C@@H](C(C)C)C(=O)OC(=O)CNC(=O)CNC(=O)[C@H](C)NC(=O)[C@H]1N(CCC1)C(=O)[C@H](CC=1C=CC=CC=1)NC(=O)[C@H](CC=1C=CC(O)=CC=1)NC(=O)[C@H](CC(C)C)NC(=O)CNC(=O)[C@@H](N)CCCNC(N)=N)C1=CC=CC=C1 SPSXSWRZQFPVTJ-ZQQKUFEYSA-N 0.000 title claims abstract description 61
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Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K39/12—Viral antigens
- A61K39/29—Hepatitis virus
- A61K39/292—Serum hepatitis virus, hepatitis B virus, e.g. Australia antigen
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K39/12—Viral antigens
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K39/12—Viral antigens
- A61K39/29—Hepatitis virus
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
- A61K47/32—Macromolecular compounds obtained by reactions only involving carbon-to-carbon unsaturated bonds, e.g. carbomers, poly(meth)acrylates, or polyvinyl pyrrolidone
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0043—Nose
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/06—Ointments; Bases therefor; Other semi-solid forms, e.g. creams, sticks, gels
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/10—Dispersions; Emulsions
- A61K9/12—Aerosols; Foams
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
- A61P31/12—Antivirals
- A61P31/20—Antivirals for DNA viruses
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B05—SPRAYING OR ATOMISING IN GENERAL; APPLYING FLUENT MATERIALS TO SURFACES, IN GENERAL
- B05B—SPRAYING APPARATUS; ATOMISING APPARATUS; NOZZLES
- B05B1/00—Nozzles, spray heads or other outlets, with or without auxiliary devices such as valves, heating means
- B05B1/34—Nozzles, spray heads or other outlets, with or without auxiliary devices such as valves, heating means designed to influence the nature of flow of the liquid or other fluent material, e.g. to produce swirl
- B05B1/3405—Nozzles, spray heads or other outlets, with or without auxiliary devices such as valves, heating means designed to influence the nature of flow of the liquid or other fluent material, e.g. to produce swirl to produce swirl
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B05—SPRAYING OR ATOMISING IN GENERAL; APPLYING FLUENT MATERIALS TO SURFACES, IN GENERAL
- B05B—SPRAYING APPARATUS; ATOMISING APPARATUS; NOZZLES
- B05B11/00—Single-unit hand-held apparatus in which flow of contents is produced by the muscular force of the operator at the moment of use
- B05B11/01—Single-unit hand-held apparatus in which flow of contents is produced by the muscular force of the operator at the moment of use characterised by the means producing the flow
- B05B11/02—Membranes or pistons acting on the contents inside the container, e.g. follower pistons
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K39/00—Medicinal preparations containing antigens or antibodies
- A61K2039/54—Medicinal preparations containing antigens or antibodies characterised by the route of administration
- A61K2039/541—Mucosal route
- A61K2039/543—Mucosal route intranasal
-
- C—CHEMISTRY; METALLURGY
- C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
- C12N—MICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
- C12N2730/00—Reverse transcribing DNA viruses
- C12N2730/00011—Details
- C12N2730/10011—Hepadnaviridae
- C12N2730/10111—Orthohepadnavirus, e.g. hepatitis B virus
- C12N2730/10134—Use of virus or viral component as vaccine, e.g. live-attenuated or inactivated virus, VLP, viral protein
Definitions
- the present invention relates to a nasal administration system combined with a medical nozzle device for administering a hepatitis B vaccine composition for nasal mucosal spray administration to the nasal mucosa for use in the prevention and treatment of hepatitis B.
- Hepatitis B is hepatitis that develops by infection with hepatitis B virus (HBV), and HBV is transmitted through blood and body fluids. Persistent infection of HBV into hepatocytes causes chronic hepatitis, cirrhosis, and hepatocellular carcinoma.
- HBV hepatitis B virus
- interferon preparations IFN
- nucleic acid analog preparations NA
- IFN interferon preparations
- NA nucleic acid analog preparations
- hepatitis B virus HBs antigen hepatitis B surface antigen
- certain results have been achieved with a significant decrease in HBV carriers.
- CHB hepatitis B surface antigen
- trials of immunotherapy with an HBV vaccine have been performed, but a sufficient therapeutic effect has not yet been achieved.
- many attempts have been made from various aspects to date, and nasal administration vaccines have attracted attention as new B-type vaccination methods.
- the present invention aims to develop an effective administration system of a hepatitis B vaccine including an administration device, and an object thereof is to expect the cure of hepatitis B.
- a nasal mucosal spray administration gel base comprising a carboxyvinyl polymer treated by applying a shearing force from the outside in order to add spray performance and HBs antigen. It has been found that by combining with HBc antigen, the ability to induce immunity to humans can be enhanced without the need for an adjuvant, and this is applied to a metered syringe type ejector having an optimized nasal spray nozzle.
- a therapeutic system using an incorporated administration method can provide an excellent antibody titer to hepatitis B virus and an excellent therapeutic effect on hepatitis B. It came. That is, the present invention is as follows.
- Hepatitis B vaccine nasal filled with a hepatitis B vaccine composition for nasal mucosal spray administration containing a gel base containing a carboxyvinyl polymer treated in the above, into a syringe-type ejector having a nasal spray nozzle Dosing system.
- Syringe-type ejector A hollow nozzle body having a tip formed with a nozzle ejection hole; A solid filling rod disposed in the nozzle body, A nozzle chamber formed between the filling rod and the nozzle body, and in fluid communication between the tip opening and the nozzle ejection hole; [1] A medical syringe having a tip opening portion in fluid communication with a syringe barrel, having a nasal spray nozzle characterized in that the nozzle ejection hole has a diameter of 0.25 mm to 0.30 mm.
- the nasal administration system of hepatitis B vaccine as described.
- the formulation average particle size is in the range of 30 ⁇ m to 80 ⁇ m, and the particle size distribution is in the range of 10 ⁇ m to 100 ⁇ m.
- the spray density is a uniform full cone with no bias, and (3) Manufactured using a gel base with added spray performance with the spray angle controlled in the range of 30 ° to 70 ° [1]
- the nasal administration system for hepatitis B vaccine according to any of [6].
- At least a part of the inner wall of the nozzle body is formed in a cylindrical shape, and at least a part of the outer wall of the filling rod is formed in a cylindrical shape including a plurality of grooves provided in the circumferential direction.
- the nozzle chamber is formed between at least a part of the inner wall of the nozzle body and at least a groove of the outer wall of the filling rod,
- the nasal administration system for hepatitis B vaccine according to any one of [2] to [10], wherein the filling rod has a swirl forming portion facing the tip of the nozzle body.
- At least a part of the inner wall of the nozzle body is formed such that a cross section in a plane substantially perpendicular to the ejection direction becomes smaller continuously or stepwise toward the ejection direction [
- a hepatitis B vaccine composition is administered to a patient in need of prevention and / or treatment by the nasal administration system for hepatitis B vaccine according to any of [1] to [13] , A method for preventing and / or treating hepatitis B.
- hepatitis B surface antigen HBs antigen
- hepatitis B nucleocapsid antigen HBc antigen
- an effective immune response is induced with a smaller amount of antigen without requiring an adjuvant.
- an adjuvant since it is not necessary to use an adjuvant, it is possible to provide a nasal vaccine composition for hepatitis B vaccine with less side effects, and a quantitative syringe type ejector having an optimized nasal spray nozzle By using the method of administration, it is possible to accurately cope with the purpose of treatment and prevention of hepatitis B.
- the hepatitis B vaccine composition for nasal mucosal spray administration of the present invention contains a gel base composed of a carboxyvinyl polymer treated by applying an external shearing force in order to add spray performance. By spreading and staying for a long time, an effective immune response can be induced with a smaller amount of antigen. Hepatitis B is prevented by using the system of the present invention in which a hepatitis B vaccine composition for nasal mucosal spray administration is filled in a metered syringe type ejector having an optimized nasal spray nozzle. The effect can be expected not only for treatment.
- FIG. 5 is a horizontal sectional view when viewed from the line CC, line DD, and line DD.
- (A) And (b) is an expanded sectional view of the front-end
- the formulation of Example 4 is filled in the syringe-type ejector of the present invention, and the results of measuring the particle size distribution using a laser diffraction particle size distribution measuring device are shown.
- the formulation of Example 4 was filled in the syringe-type ejector of the present invention, and the results of measuring the spray angle from the nozzle tip using a high speed microscope are shown. The spray angle sprayed was 52.27 °.
- the formulation of Example 4 was filled in the syringe-type ejector of the present invention, and the results confirmed using spray pattern test paper are shown. It was confirmed to be a full cone homogeneous circle.
- the present invention comprises a gel base comprising a carboxyvinyl polymer treated with an external shearing force to add spraying performance, a hepatitis B surface antigen (HBs antigen) and a hepatitis B nucleocapsid antigen (HBc antigen).
- a hepatitis B vaccine composition for nasal mucosal spray administration characterized in that it does not require an adjuvant, and a hollow nozzle body having a tip portion in which a nozzle ejection hole is formed, and in the nozzle body A solid filling rod disposed; and a nozzle chamber formed between the filling rod and the nozzle main body, and in fluid communication between the tip opening and the nozzle ejection hole.
- the nasal administration system for hepatitis B vaccine means that the vaccine composition of the present invention filled with the hepatitis B vaccine composition of the present invention is integrated with the syringe. Say something.
- the “gel base containing a carboxyvinyl polymer treated by applying an external shearing force to add spray performance” used in the present invention refers to, for example, “skin / mucosal adhesive agent disclosed in WO2007 / 123193.
- the term “containing gel base” means a base containing a carboxyvinyl polymer, containing gellan gum as appropriate, and adjusting the viscosity by applying a shearing force from the outside.
- the specific external shearing force described in WO2007 / 123193 is not simply stirring or shaking, but is performed by a device that gives a shearing force known to those skilled in the art.
- An emulsifying device a colloid mill type emulsifying device, a high pressure emulsifying device, a roll mill type emulsifying device, an ultrasonic emulsifying device, and a membrane emulsifying device can be used.
- homomixer type, comb-type and intermittent jet flow generation type high-speed rotation type emulsifiers are preferable.
- Such a base is characterized in that it can be adjusted to various viscosities by applying a shearing force from the outside and can be controlled so that the spray angle and spray density from the spray container or the like are suitable for the purpose.
- the metered syringe type ejector having the nasal spray nozzle of the optimized form of the present invention is similar to a pump type sprayer such as an airless sprayer as disclosed in WO2007 / 123193.
- the spray compatibility of the preparation spray dispersibility, uniformity of the preparation particle size, etc. becomes possible, and the spreadability of the hepatitis B antigen particles on the nasal mucosa is improved over a wide range over a long period of time. The nature is improved.
- the carboxyvinyl polymer used as a raw material for the gel base of the present invention is a hydrophilic polymer obtained by polymerizing acrylic acid as a main component, and uses pharmaceutical additives normally used for preparing an aqueous gel without limitation. can do.
- the content of the gel base containing the carboxyvinyl polymer treated by applying an external shearing force to add spraying performance is 0.1 to 1.0 w / v% in terms of the content of carboxyvinyl polymer. Yes, preferably 0.3 to 0.7 w / v%.
- the vaccine of the present invention is characterized by containing hepatitis B surface antigen (HBs antigen) and hepatitis B nucleocapsid antigen (HBc antigen) as antigens.
- HBs antigen hepatitis B surface antigen
- HBc antigen hepatitis B nucleocapsid antigen
- the hepatitis B virus antigen used in the present invention refers to hepatitis B surface antigen and hepatitis B nucleocapsid antigen produced by yeast by applying recombinant DNA technology.
- the hepatitis B virus antigen uses a virus stock solution purified or concentrated for mixing with a nasal mucosal spray administration gel base.
- the concentration of hepatitis B virus antigen is preferably 0.01 to 10 mg / mL, more preferably 0.05 to 5 mg / mL, per vaccine antigen.
- Hepatitis B surface antigen has a particle shape (diameter: about 50 to 60 nm) presenting many antigenic proteins on a lipid membrane.
- the presented antigen protein is originally a protein composed of three domains (S, Pre-S1, Pre-S2), and an antigen having all three domains is an L-type antigen (HBsAg L-protein). ), Those lacking Pre-S1 are distinguished from M-type antigens, and those lacking both Pre-S1 and Pre-S2 are distinguished from S-type antigens (HBsAg S-protein). In either case, the production of the antigen is carried out using genetically modified yeast.
- Adjuvant is a general term for substances that have regulatory activities such as enhancement and suppression of immune response, and is an immunopotentiator added to vaccines to enhance the immunogenicity of antigens. Many substances have been studied so far Has been. On the other hand, the use of an adjuvant improves the immune effect of the vaccine, but also has a drawback that side effects such as inflammation may occur. Of course, there are several candidates for nasal vaccine adjuvants. However, there are no adjuvants that have been widely recognized as safe, so there are no adjuvants that have established efficacy and safety. No nasal vaccine has yet been approved.
- the inventor of the present invention uses a nasal mucosal spray administration gel base having an excellent spray performance as described above and a high nasal mucosa spread rate for the hepatitis B child vaccine, thereby allowing other administration such as subcutaneous administration.
- a vaccine that does not require concomitant administration by administration route is effective with a smaller antigen amount and with fewer side effects without using an adjuvant, and is sprayed by combining it with a device that can spray even a highly viscous gel base.
- the injection angle from the device is in the range of 30 ° to 70 ° (preferably) so that it can be administered to a required site in the nasal cavity.
- the present invention has been accomplished by discovering a production method and a prevention method and a treatment method using the production method.
- a “full cone” representing a uniform spray density with no bias in the spray density is one of spray pattern shapes, meaning a uniform circular whole area, and the opposite term is a donut localized only in the periphery. It is a type of “holocon”.
- the vaccine of the present invention may further contain a pharmaceutically acceptable carrier in addition to the hepatitis B virus antigen and nasal mucosal spray administration gel base.
- a pharmaceutically acceptable carrier in addition to the hepatitis B virus antigen and nasal mucosal spray administration gel base.
- carriers commonly used in the production of vaccines and intranasal preparations can be used. Specifically, saline, buffered saline, dextrose, water, glycerin, isotonic aqueous buffer And combinations thereof.
- preservatives eg, thimerosal
- tonicity agents eg, pH adjusters, surfactants, stabilizers (eg, sodium edetate hydrate) and inactivators (eg, formalin) are appropriately added. Blended.
- the vaccine of the present invention is sprayed into the nasal cavity.
- Hepatitis B can be prevented or treated using the vaccine of the present invention.
- the nasal spray nozzle of the optimized form of the present invention can be applied to one or both nostrils and used as a disposable device.
- the dose is determined in consideration of the age, sex, weight, etc. of the subject, but the concentration of hepatitis B virus antigen is preferably 0.01-10 mg / mL per one vaccine antigen, 0.05 ⁇ 5 mg / mL is more preferred.
- the amount of antigen to be administered is preferably 0.1 to 5 mg, more preferably 0.5 to 2 mg per vaccine antigen.
- FIG. 1 is a partially broken side view showing a schematic configuration of an entire medical syringe 1 including a nasal spray nozzle 10 according to an embodiment of the present invention.
- the medical syringe 1 is roughly a syringe body 4 made of a synthetic resin or glass having a syringe barrel 3 that can be filled with the preparation 2, and a plunger inserted into the syringe barrel 3 of the syringe body 4.
- a rod 5 and a fixed portion 5 a provided at the distal end of the plunger rod 5 are attached and slid into the syringe barrel 3 to transfer the preparation in the syringe barrel 3 to the distal end opening on the distal side of the syringe body 4.
- a piston 7 for delivering from the proximal end of the syringe body 4 and a plunger 8 that transmits a force applied from a finger of a practitioner such as a doctor to the plunger rod 5.
- the medical syringe 1 shown in FIG. 1 is the same as the metered syringe type ejector described in WO2013 / 145789.
- the nasal spray nozzle 10 according to the present invention is applicable to the medical syringe 1 having an arbitrary form in which the preparation contained in the syringe barrel 3 is extruded by the plunger rod 5 (and the piston 7).
- the description regarding the detailed structure of the medical syringe (quantitative syringe type sprayer for nose) 1 is abbreviate
- the entire contents of WO2013 / 145789 are integrated here as a reference.
- FIGS. 2A and 2B are partially exploded exploded perspective views showing a schematic configuration of a nasal spray nozzle 10 according to an embodiment of the present invention.
- the nasal spray nozzle 10 is roughly composed of a hollow nozzle body 20 having a distal end portion 22 in which a nozzle ejection hole 21 is formed, and a solid filling disposed in the nozzle body 20.
- Rod (filling rod) 30 is shown in the figure.
- FIGS. 2A and 2B show the state before and after the filling rod 30 is disposed or inserted into the nozzle body 20.
- the tip portion 22 of the nozzle body 20 has a substantially circular shape, and the nozzle ejection hole 21 is formed at the center of the tip portion 22.
- FIG. 3A is a vertical sectional view of the nasal spray nozzle 10 shown in FIG. 2B when viewed from a vertical plane passing through the nozzle ejection holes 21.
- FIGS. 3B to 3D are horizontal sectional views when viewed from the BB line, the CC line, and the DD line in FIG. 3A, respectively.
- the hollow nozzle body 20 has an inner wall 24 with an inner wall 23 having a substantially cylindrical shape.
- the inner space 24 is formed of a hollow nozzle body 20 as shown in FIGS. 3 (c) and 3 (d).
- a nozzle shoulder 27 formed so as to be continuously or gradually reduced.
- the solid filling rod 30 to be inserted into the nozzle body 20 has an outer shape whose outer wall 33 is substantially complementary to the inner wall 23 (inner space 24) of the nozzle body 20, and FIG. As shown in FIGS. 3C and 3D, the diameters of the rod large diameter portion 36 and the rod small diameter portion 35 decrease continuously or stepwise from the rod large diameter portion 36 toward the rod small diameter portion 35. And a rod shoulder portion 37 formed on the surface.
- the inner wall 23 of the nozzle body 20 is provided with a protrusion 23a
- the outer wall 33 of the filling rod 30 is provided with a recess 33a for receiving the protrusion 23a.
- the filling rod 30 is spaced apart in the circumferential direction at the rod small diameter portion 35 and the rod large diameter portion 36. It has the some groove part 38 and 39 arrange
- the filling rod 30 is inserted into the nozzle body 20 so that a gap 40 (FIG. 3A) is formed between the nozzle shoulder 27 and the rod shoulder 37. Therefore, the nasal spray nozzle 10 assembled as shown in FIG. 2B is formed with a nozzle chamber 42 that can be in fluid communication by the grooves 38 and 39 and the gap 40, and is delivered from the distal end opening 6 of the syringe body 4.
- the prepared preparation 2 can be guided to the tip 22 of the nasal spray nozzle 10 through the nozzle chamber 42.
- the filling rod 30 has a vortex forming portion 44 facing the tip portion 22 of the nasal spray nozzle 10.
- the vortex flow forming portion 44 is configured to form a vortex flow before the preparation 2 flowing in from each groove portion 38 of the rod small diameter portion 35 is jetted from the nozzle ejection hole 21 of the nozzle main body portion 20.
- the end portion of the rod small diameter portion 35 constituting the vortex forming portion 44 is formed so as to extend in a direction displaced from the vertical center axis of the nozzle ejection hole 21.
- the groove portion 38 of the rod small diameter portion 35 is designed to be smaller than the groove portion 39 of the rod large diameter portion 36 before being ejected from the nozzle ejection hole 21. It is preferable to increase the pressure of the preparation in the eddy current forming portion 44 of the liquid.
- the diameter of the rod large diameter portion 36 and the rod small diameter portion 35 is designed so as to decrease continuously or stepwise from the rod large diameter portion 36 toward the rod small diameter portion 35, it is inserted deeply into the nasal cavity of a patient or the like. Therefore, it is possible to facilitate the spraying of the preparation in the vicinity of the lower turbinates and the deep part of the patient. That is, it is preferable that the diameter of the rod small-diameter portion 35 is sufficiently smaller than the nostril of the patient or the like without giving fear to the patient or the like.
- a gel base for spray administration and a hepatitis B virus stock solution were respectively prepared by the following method, and both were mixed as follows to prepare a hepatitis B vaccine composition for nasal mucosal spray administration.
- the hepatitis B vaccine nasal inoculation preparation of Example 2 manufactured using a gel base prepared by applying a shearing force from the outside, a hollow nozzle body having a tip portion in which a nozzle ejection hole is formed And a solid filling rod disposed in the nozzle body, and a nozzle chamber formed between the filling rod and the nozzle body and in fluid communication between the tip opening and the nozzle ejection hole.
- the nasal spray nozzle is characterized in that the nozzle ejection hole has a diameter of 0.25 mm to 0.30 mm, and is used by filling a medical syringe having a tip opening in fluid communication with the syringe barrel.
- the preparation average particle size is in the range of 30 ⁇ m to 80 ⁇ m [59.7 ⁇ m], and the particle size distribution is in the range of 10 ⁇ m to 100 ⁇ m, which is 80% or more [88.8%], (2) It was confirmed that the spray density was a uniform full cone with no bias, and (3) a hepatitis B vaccine nasal inoculation system in which the spray angle was controlled in the range of 30 ° to 70 ° [55 °].
- the hepatitis B vaccine composition for nasal mucosal spray administration prepared in Example 2 was passed through a syringe-type ejector having a nasal spray nozzle in a total of 1.0 mL for each nose. A nasal spray was administered.
- the hepatitis B vaccine composition for nasal mucosal spray administration prepared in Example 2 was passed through a syringe-type ejector having a nasal spray nozzle in a total of 1.0 mL for each nose. A nasal spray was administered.
- HBV patients undergoing NA treatment Twenty-nine NAB-treated CHB patients received 10 nasal doses of vaccine. Six months after the final administration, the amount of HBV-DNA, the change rate of the HBs antigen amount, and the HBs antibody positive rate were evaluated. Because of NA treatment, HBV-DNA was below detection sensitivity before treatment in all cases, and HBV-DNA remained below detection sensitivity 6 months after treatment. The amount of HBs antigen was 79.3% when the pretreatment was taken as 100, and 11 out of 29 cases of HBs antibody were overturned, and the seroconversion rate was 37.9% (Table 5).
- SYMBOLS 1 Medical syringe, 2 ... Formulation, 3 ... Syringe barrel, 4 ... Syringe main body, 5 ... Plunger rod, 5a ... Fixed part, 6 ... Tip opening part, 7 ... Piston, 8 ... Finger hook part, 9 ... Plunger operation part DESCRIPTION OF SYMBOLS 10 ... Spray nozzle for nose, 20 ... Nozzle main body part, 21 ... Nozzle ejection hole, 22 ... Tip part, 23 ... Inner wall of nozzle main body part, 23a ... Projection part, 24 ... Internal space, 25 ... Nozzle small diameter part, 26 ... Nozzle large diameter portion, 27 ... Nozzle shoulder portion, 30 ...
- Filling rod (filling rod), 33 ... Outer wall of filling rod, 33a ... Recess, 35 ... Rod small diameter portion, 36 ... Rod large diameter portion, 37 ... Rod shoulder Part, 38, 39 ... groove part, 40 ... gap, 42 ... nozzle chamber, 44 ... vortex forming part, 4 6 ... curved portion, 50 ... protective cap.
Abstract
Description
このような問題点から現在までに多種多様な側面から多くの試みがなされており、新たなB型ワクチン接種方法として、経鼻投与型ワクチンが着目されている。しかしながら、現在汎用されている皮下および筋肉内接種ワクチンをそのまま経鼻投与した場合においては、B型肝炎ウイルスに対する良好な免疫応答を誘導できず、治療効果が十分でないことが実験動物およびヒトで報告されている。
(ii)噴霧性能を付加するために外部からせん断力を与えて処理したカルボキシビニルポリマーを含有するゲル基剤
を含む、経鼻粘膜スプレー投与用B型肝炎ワクチン組成物を、点鼻用噴霧ノズルを有するシリンジ型噴出器に充填した、B型肝炎ワクチン経鼻投与システム。
ノズル噴出孔が形成された先端部を有する中空のノズル本体部と、
ノズル本体部内に配設される中実の充填ロッドと、
充填ロッドとノズル本体部との間に形成され、先端開口部とノズル噴出孔との間で流体連通するノズルチャンバとを備え、
ノズル噴出孔が0.25mm~0.30mmの径を有することを特徴とする点鼻用噴霧ノズルを備えた、シリンジバレルに流体連通する先端開口部を有する医療用シリンジである、[1]に記載のB型肝炎ワクチン経鼻投与システム。
ノズルチャンバは、ノズル本体部の内壁の少なくとも一部と充填ロッドの外壁の少なくとも一部の溝部との間に形成され、
充填ロッドは、ノズル本体部の先端部に対向する渦流形成部を有することを特徴とする[2]~[10]のいずれかに記載のB型肝炎ワクチン経鼻投与システム。
本発明の経鼻粘膜スプレー投与用B型肝炎ワクチン組成物は、噴霧性能を付加するために外部からせん断力を与えて処理したカルボキシビニルポリマーからなるゲル基剤を含有するため、鼻腔粘膜に広く長く展着・滞留することにより、より少ない抗原量で有効な免疫応答を誘導可能とする。
経鼻粘膜スプレー投与用B型肝炎ワクチン組成物を、最適化された形態の点鼻用噴霧ノズルを有する定量シリンジ型噴出器に充填した本発明のシステムを用いることで、B型肝炎を予防するだけでなく、治療にもその効果が期待できる。
なお、本発明において、B型肝炎ワクチン経鼻投与システムとは、本発明のB型肝炎ワクチン組成物を、本発明のシリンジ型噴出器に充填した、ワクチン組成物とその投与器が一体となったものをいう。
噴霧性能を付加するために外部からせん断力を与えて処理したカルボキシビニルポリマーを含有するゲル基剤の含量は、カルボキシビニルポリマーの含量に換算して、0.1~1.0w/v%であり、好ましくは0.3~0.7w/v%である。
本発明のワクチンを用いて、B型肝炎を予防または治療することができる。
図1は、本発明の一実施形態に係る点鼻用噴霧ノズル10を備えた医療用シリンジ1全体の概略的構成を示す部分破断側面図である。医療用シリンジ1は、図1に示すように、概略、製剤2を充填可能なシリンジバレル3を有する合成樹脂またはガラスからなるシリンジ本体4と、シリンジ本体4のシリンジバレル3内に挿通されるプランジャロッド5と、プランジャロッド5の遠位端に設けた固定部5aを介して取り付けられ、シリンジバレル3内に摺動してシリンジバレル3内の製剤をシリンジ本体4の遠位側の先端開口部6から送出するためのピストン7と、シリンジ本体4の近位端の周りに配設された指掛け部8と、医者等の施術者の指から加わった力をプランジャロッド5に伝えるプランジャ操作部9を有する。図1に示す医療用シリンジ1は、WO2013/145789に記載の定量シリンジ型噴出器と同様のものである。
また医療用シリンジ1は、図1に示すように、シリンジ本体4の先端開口部6に対向して配置される点鼻用噴霧ノズル10と、その殺菌処理された先端部22を汚染物質および機械的衝撃から保護するための保護キャップ50とをさらに有する。図2(a)および(b)は、本発明の一実施形態に係る点鼻用噴霧ノズル10の概略的構成を示す部分破断分解斜視図である。図示のように、点鼻用噴霧ノズル10は、概略、ノズル噴出孔21が形成された先端部22を有する中空のノズル本体部20と、ノズル本体部20内に配設される中実の充填ロッド(充填棒)30とを有する。図2(a)および(b)は、充填ロッド30がノズル本体部20に配設または挿入される前後の状態を示すものである。ノズル本体部20の先端部22は実質的な円形形状を有し、ノズル噴出孔21は先端部22の中心に形成されている。
以下に示す方法にて、スプレー投与用ゲル基剤およびB型肝炎ウイルス原液をそれぞれ調製し、両者を以下のように混合して、経鼻粘膜スプレー投与用B型肝炎ワクチン組成物を調製した。
上記のゲル基剤例1とウイルス原液例1を(1:1)の比率で混合撹拌し、均質な経鼻粘膜スプレー投与用B型肝炎ワクチン組成物を得た(実施例1)。同様に上記のゲル基剤例2とウイルス原液例2を(2:8)の比率で混合撹拌し、均質な経鼻粘膜スプレー投与用B型肝炎ワクチン組成物を得た(実施例2)。この混合撹拌はB型肝炎ワクチン抗原に熱・圧力等のストレスを与えることなく、緩やかな混合撹拌で短時間に達成できる。得られた経鼻粘膜スプレー投与用B型肝炎ワクチン組成物の成分分量及び物性値並びに適切なデバイスを用いて噴霧した場合の付加された噴霧性能を示す。
(被験者)
予防効果の検証は、皮下および筋肉内接種ワクチンにて事前に被験者の免疫応答試験を行い、(1)抗体誘導がみられなかったワクチン無反応者、(2)抗体誘導がみられたワクチン反応者、並びに(3)ワクチン未接種者に分類し、対象とした。治療効果の検証は、(4)HBV血症があるも肝炎を発症していない無症候性キャリア、(5)NA治療中のCHB患者を対象とした。
各症例とも実施例2で調製された経鼻粘膜スプレー投与用B型肝炎ワクチン組成物を、点鼻用噴霧ノズルを有するシリンジ型噴出器にて、片鼻0.5mLずつ合計1.0mLを経鼻噴霧投与した。(1)ワクチン無反応者、(2)ワクチン反応者、(3)ワクチン未接種者は2週おきに計3回経鼻投与を行った。
皮下および筋肉内接種ワクチンにて免疫応答のなかった13例のワクチン無反応者に3回のワクチンの経鼻投与を行い、最終投与の1か月後にHBs抗体価、HBc抗体価の測定を行った。13症例ともHBs抗体ならびにHBc抗体が陽転化した(表1)。
19例のワクチン反応者に3回のワクチンの経鼻投与を行い、最終投与の1か月後にHBs抗体価、HBc抗体価の測定を行った。19症例とも、HBs抗体が測定限界上限以上となり、HBc抗体が陽転化した(表2)。
7例のワクチン未接種者に3回のワクチンの経鼻投与を行い、最終投与の1か月後にHBs抗体価、HBc抗体価の測定を行った。1症例を除いて6症例でHBs抗体ならびにHBc抗体が陽転化した(表3)。
各症例とも実施例2で調製された経鼻粘膜スプレー投与用B型肝炎ワクチン組成物を、点鼻用噴霧ノズルを有するシリンジ型噴出器にて、片鼻0.5mLずつ合計1.0mLを経鼻噴霧投与した。(4)無症候性キャリア、(5)NA治療中のCHB患者は2週おきに計10回経鼻投与を行った。
41例の無症候性キャリアに10回のワクチンの経鼻投与を行った。投与前、最終投与の6か月後のHBV-DNA量、HBs抗原量の変化率、HBs抗体陽性率を評価した。投与終了6か月後のHBV-DNA量は明確な変化を認めなかったが、HBs抗原量は治療前を100とした場合、78.6%に低下した。HBs抗体は41例中20例が陽転したことから、陽転率は48.8%であった(表4)。
6…湾曲部、50…保護キャップ。
Claims (16)
- (i)B型肝炎表面抗原(HBs抗原)とB型肝炎ヌクレオキャプシド抗原(HBc抗原)の両方またはどちらか一方、および
(ii)噴霧性能を付加するために外部からせん断力を与えて処理したカルボキシビニルポリマーを含有するゲル基剤
を含む、経鼻粘膜スプレー投与用B型肝炎ワクチン組成物を、点鼻用噴霧ノズルを有するシリンジ型噴出器に充填した、B型肝炎ワクチン経鼻投与システム。 - シリンジ型噴出器が、
ノズル噴出孔が形成された先端部を有する中空のノズル本体部と、
ノズル本体部内に配設される中実の充填ロッドと、
充填ロッドとノズル本体部との間に形成され、先端開口部とノズル噴出孔との間で流体連通するノズルチャンバとを備え、
ノズル噴出孔が0.25mm~0.30mmの径を有することを特徴とする点鼻用噴霧ノズルを備えた、シリンジバレルに流体連通する先端開口部を有する医療用シリンジである、請求項1に記載のB型肝炎ワクチン経鼻投与システム。 - (i)のB型肝炎ワクチンが1種の抗原当り0.01~10mg/mLである[1]または請求項2に記載のB型肝炎ワクチン経鼻投与システム。
- 組成物中0.1w/v%から1.0w/v%のカルボキシビニルポリマーを含有する、請求項1~3のいずれかに記載のB型肝炎ワクチン経鼻投与システム。
- 噴霧性能としての、(1)製剤粒度分布範囲、(2)噴霧密度均一性、および/または(3)噴射角度制御を付加するために、外部からせん断力を与えて処理したカルボキシビニルポリマーを含有するゲル基剤を用いた請求項1~4のいずれかに記載のB型肝炎ワクチン経鼻投与システム。
- ゲル基剤中0.5w/v%から2.0w/v%のカルボキシビニルポリマーを含有するゲル基剤を用い、噴霧性能としての、(1)製剤粒度分布範囲、(2)噴霧密度均一性、および/または(3)噴射角度制御を付加するために外部からせん断力を与えて処理し、ゲル基剤を得た後、B型肝炎表面抗原(HBs抗原)とB型肝炎ヌクレオキャプシド抗原(HBc抗原)を含むウイルス原液とストレスを与えることなく短時間で均一に混和して得られる、請求項1~3のいずれかに記載のB型肝炎ワクチン経鼻投与治療システム。
- カルボキシビニルポリマーを含有する基剤に外部からせん断力を与えて、(1)製剤粒度分布において製剤平均粒子径が30μmから80μmの範囲、粒度分布が10μmから100μmの範囲に80%以上であり、(2)噴霧密度が偏りのない均等なフルコーンとなり、(3)噴射角度が30°から70°の範囲に制御した噴霧性能を付加されたゲル基剤を用いて製造する請求項1~6のいずれかに記載のB型肝炎ワクチン経鼻投与システム。
- カルボキシビニルポリマーを含有する基剤に外部からせん断力を与えて、(1)製剤粒度分布において製剤平均粒子径が40μmから70μmの範囲、粒度分布が10μmから100μmの範囲に90%以上であり、(2)噴霧密度が偏りのない均等なフルコーンとなり、(3)噴射角度が40°から60°の範囲に制御した噴霧性能を付加されたゲル基剤を用いて製造する請求項1~6のいずれかに記載のB型肝炎ワクチン経鼻投与システム。
- ノズル噴出孔が実質的に湾曲部を有さないことを特徴とする請求項2~8のいずれかに記載のB型肝炎ワクチン経鼻投与システム。
- ノズル噴出孔が形成された先端部において、製剤の噴出方向における厚みが0.20mm~0.30mmであることを特徴とする請求項2~9のいずれかに記載のB型肝炎ワクチン経鼻投与システム。
- ノズル本体部の内壁の少なくとも一部が円筒形状に形成され、充填ロッドの外壁の少なくとも一部が周方向に設けられた複数の溝部を含む円筒形状に形成され、
ノズルチャンバは、ノズル本体部の内壁の少なくとも一部と充填ロッドの外壁の少なくとも一部の溝部との間に形成され、
充填ロッドは、ノズル本体部の先端部に対向する渦流形成部を有することを特徴とする請求項2~10のいずれかに記載のB型肝炎ワクチン経鼻投与システム。
- 渦流形成部において、製剤が充填ロッドの溝部から流入する方向が中心軸から位置ずれし、製剤の渦流を形成することを特徴とする請求項11に記載のB型肝炎ワクチン経鼻投与システム。
- ノズル本体部の内壁の少なくとも一部が、噴出方向に実質的に垂直な平面における断面が噴出方向に向かって連続的または段階的に小さくなるように形成されたことを特徴とする請求項11または12に記載のB型肝炎ワクチン経鼻投与システム。
- B型肝炎を予防および/または治療するための、請求項1~13のいずれかに記載のB型肝炎ワクチン経鼻投与システム。
- 予防および/または治療が必要な患者に、請求項1~13のいずれかに記載のB型肝炎ワクチン経鼻投与システムでB型肝炎ワクチン組成物を投与することを特徴とする、B型肝炎の予防および/または治療方法。
- B型肝炎の予防および/または治療に用いる、請求項1~13のいずれかに記載のB型肝炎ワクチン経鼻投与システム。
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BR112020022784-6A BR112020022784A2 (pt) | 2018-06-05 | 2019-06-04 | sistema de administração transnasal de vacina contra hepatite b |
CU2020000097A CU24686B1 (es) | 2018-06-05 | 2019-06-04 | Composición de vacuna contra la hepatitis b, proceso de obtención de dicha composición y sistema de rinovacunación para prevenir y tratar la hepatitis b |
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IL278415A IL278415B2 (en) | 2018-06-05 | 2019-06-04 | Transnasal administration system of hepatitis B vaccine |
JP2020523114A JPWO2019235466A1 (ja) | 2018-06-05 | 2019-06-04 | B型肝炎ワクチン経鼻投与システム |
CN201980035576.2A CN112368018A (zh) | 2018-06-05 | 2019-06-04 | 乙肝疫苗的经鼻给药系统 |
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IL278415B2 (en) | 2023-10-01 |
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JPWO2019235466A1 (ja) | 2021-06-24 |
CU20200097A7 (es) | 2021-07-02 |
KR20210022009A (ko) | 2021-03-02 |
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