Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
  • A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
  • A61K35/30—Nerves; Brain; Eyes; Corneal cells; Cerebrospinal fluid; Neuronal stem cells; Neuronal precursor cells; Glial cells; Oligodendrocytes; Schwann cells; Astroglia; Astrocytes; Choroid plexus; Spinal cord tissue
• • 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
  • A61L27/3604—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 characterised by the human or animal origin of the biological material, e.g. hair, fascia, fish scales, silk, shellac, pericardium, pleura, renal tissue, amniotic membrane, parenchymal tissue, fetal tissue, muscle tissue, fat tissue, enamel
  • A61L27/3633—Extracellular matrix [ECM]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
  • A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
  • A61K35/22—Urine; Urinary tract, e.g. kidney or bladder; Intraglomerular mesangial cells; Renal mesenchymal cells; Adrenal gland
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
  • A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
  • A61K35/34—Muscles; Smooth muscle cells; Heart; Cardiac stem cells; Myoblasts; Myocytes; Cardiomyocytes
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
  • A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
  • A61K35/37—Digestive system
  • A61K35/38—Stomach; Intestine; Goblet cells; Oral mucosa; Saliva
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K38/00—Medicinal preparations containing peptides
  • A61K38/01—Hydrolysed proteins; Derivatives thereof
  • A61K38/012—Hydrolysed proteins; Derivatives thereof from animals
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K38/00—Medicinal preparations containing peptides
  • A61K38/01—Hydrolysed proteins; Derivatives thereof
  • A61K38/012—Hydrolysed proteins; Derivatives thereof from animals
  • A61K38/014—Hydrolysed proteins; Derivatives thereof from animals from connective tissue peptides, e.g. gelatin, collagen
• • 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
  • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
• • 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
  • A61L27/3683—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 subjected to a specific treatment prior to implantation, e.g. decellularising, demineralising, grinding, cellular disruption/non-collagenous protein removal, anti-calcification, crosslinking, supercritical fluid extraction, enzyme treatment
• • 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
  • A61L27/54—Biologically active materials, e.g. therapeutic substances
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P9/00—Drugs for disorders of the cardiovascular system
• • 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
  • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
  • A61K47/26—Carbohydrates, e.g. sugar alcohols, amino sugars, nucleic acids, mono-, di- or oligo-saccharides; Derivatives thereof, e.g. polysorbates, sorbitan fatty acid esters or glycyrrhizin
• • 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
  • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
  • A61K9/0024—Solid, semi-solid or solidifying implants, which are implanted or injected in body tissue
• • 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
  • A61L2400/00—Materials characterised by their function or physical properties
  • A61L2400/06—Flowable or injectable implant compositions
• • 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
  • A61L2430/20—Materials or treatment for tissue regeneration for reconstruction of the heart, e.g. heart valves

Definitions

• the present invention relates to an infusable soluble extracellular matrix composition and therapy for minimally invasive delivery to tissues/organs/cells, including ischemic or injured heart, brain, skeletal muscle, blood vessels, and endothelial cells.
• Extracellular matrix therapies include native tissue components providing a scaffold for tissue regeneration.
• Current decellularized extracellular matrix therapies are restricted to patches or direct injections.
• No extracellular matrix therapy is capable of intravascular/infusion delivery to a tissue of interest.
• ECM hydrogels made from decellularized and digested tissue have been created, but they are not fully soluble or transparent colloids.
• MI myocardial infarction
• LV left ventricular
• a minimally-invasive tissue engineering therapy could repair the heart post-MI.
• stem cell and growth factor therapies have reached clinical trials; however, these therapies have displayed poor efficacy, likely due to the inadequate retention of non-encapsulated therapies.
• Extracellular matrix (ECM) hydrogels have shown great promise in the field of cardiac tissue engineering; in particular, a tissue-specific hydrogel derived from decellularized porcine myocardium, termed myocardial matrix (MM), has shown increases in cardiac muscle, neovascularization of the infarct region, and improved regional and global cardiac function in MI models [2-4]. Furthermore, mechanisms of repair were investigated through whole transcriptome analysis on RNA isolated from the infarct region of rat hearts injected with MM, indicating upregulated pathways associated with cardiac repair (e.g. neovascularization and heart development) and downregulated pathways associated with negative LV remodeling (e.g. hypertrophy, apoptosis, and fibrosis) [6].
• cardiac repair e.g. neovascularization and heart development
• negative LV remodeling e.g. hypertrophy, apoptosis, and fibrosis
• Intracoronary infusion is an alternative approach to transendocardial injections. Intracoronary delivery is feasible in an acute MI, as it can accompany a balloon angioplasty that typically occurs shortly after the patient is admitted to a hospital. Such a technique is standard in interventional cardiology and does not require specialized training. Intracoronary infusion takes advantage of the leaky vasculature following an acute MI permitting a biomaterial to pass through the coronary vasculature and enter the infarct region [5].
• the intracoronary delivery of a biomaterial has shown feasibility with alginate hydrogels in a porcine MI model [9] and has progressed to Phase II clinical trials (ClinicalTrials.gov Identifier: NCT01226563). However, this material did not show significant improvements in cardiac function, possibly due to the limited bioactivity of alginate [10].
• the invention provides a method of preparing a soluble extracellular matrix (ECM) composition, comprising enzymatically digesting ECM material with an acid protease, such as pepsin; neutralizing the digested ECM material in liquid to a pH of 7.0-8.0; processing the liquid ECM to produce soluble and insoluble fractions; and separating at least a portion of the soluble fraction from the insoluble fraction, to yield a soluble ECM composition.
• ECM extracellular matrix
• the invention provides that processing the liquid ECM to produce soluble and insoluble fractions is achieved by centrifugation. In embodiments, the invention provides that the soluble ECM composition is dialyzed and/or filtered to remove insoluble materials. In embodiments, the invention provides that the soluble ECM composition is further lyophilized for storage and re-hydrated for use.
• the soluble ECM composition is substantially isolated from ECM solids in the liquid ECM.
• the soluble ECM composition is more transparent than the digested unseparated ECM material.
• the soluble ECM composition includes transparent ECM colloids, which can pass through a 0.25 pm filter.
• the invention provides a method of treating a subject in need thereof comprising administering to the subject an effective amount of the soluble ECM composition, to promote tissue repair or cell recruitment.
• the infusion is through a catheter, intravenously, or intravascularly.
• the invention provides that when delivered in vivo, the soluble fraction will then form a gel in tissue.
• the soluble fraction will coat the lining of blood vessels.
• the soluble fraction will fill the pores, fenestrations, endothelial disruptions, open intercellular junctions, or gaps of leaky or damaged vasculature.
• the invention provides that the soluble fraction of ECM is further crosslinked with glutaraldehye, formaldehyde, bis-NHS molecules, or other crosslinkers. In embodiments, the invention provides that the soluble fraction of ECM is combined and/or crosslinked with a synthetic polymer or biologically derived material. In embodiments, the invention provides that the soluble fraction of ECM is combined with cells, peptides, proteins, DNA, drugs, nanoparticles, antibiotics, growth factors, nutrients, survival promoting additives, proteoglycans, and/or glycosaminoglycans.
• the invention provides that the soluble fraction of ECM is used in combination with above described components for endogenous cell ingrowth, angiogenesis, and regeneration. In embodiments, the invention provides that the soluble fraction of ECM is used in combination with above described components as a matrix to change mechanical properties of the tissue. In embodiments, the invention provides that the soluble fraction of ECM is delivered with cells alone or in combination with above described components for regenerating or repairing damaged tissue.
• the invention provides that after adjusting the concentration and/or sterile filtration, the soluble fraction of ECM can be lyophilized and stored frozen (e.g. -20C, -80C) for at least 3 months.
• the soluble ECM composition, or fraction can then be resuspended and/or sterile filtrated prior to injection or infusion.
• the invention provides that after adjusting the concentration and/or sterile filtration, the soluble fraction of ECM can be lyophilized and stored in the refrigerator (e.g. 4C) for at least 3 months. The soluble ECM fraction can then be resuspended and/or sterile filtrated prior to injection or infusion.
• the refrigerator e.g. 4C
• the invention provides that after adjusting the concentration and/or sterile filtration, the soluble fraction of ECM can be lyophilized and stored at room temperature for at least 3 months. The soluble ECM fraction can then be resuspended and/or sterile filtrated prior to injection or infusion.
• the invention provides that the method of separating at least a portion of the soluble and insoluble fractions of liquid extracellular matrix (pre-gel solution) can be performed by high-speed centrifugation, dialysis, filtration, or adjusting pH or salinity. In embodiments, the separation of soluble fraction is performed by removing at least a portion of solids from the ECM material. In embodiments, the separation of soluble fractions is performed with a filter having a size limitation of less than lpm, 0.5pm, 0.25pm, 0.22pm, or 0.2pm. In embodiments, the invention provides a soluble ECM composition that is derived from decellularized tissue and processed to isolate a soluble fraction prior to gelation in vivo. In embodiments, the invention provides that the composition of soluble ECM is prepared for intravascular infusion.
• the invention provides that the composition of soluble extracellular matrix is derived from human, animal, embryonic, and/or fetal tissue sources. In embodiments, the invention provides that the composition of soluble extracellular matrix is derived from heart, brain, bladder, small intestine, skeletal muscle, kidney, liver, lung, blood vessels, and other tissues/organs tissue sources.
• the invention provides a method for treating acute myocardial infarction comprising injecting or infusing in a subject in need with myocardial infarction an effective amount of a composition comprising soluble decellularized extracellular matrix derived from muscle tissue.
• the invention provides that said soluble ECM composition is delivered intravascularly by infusion. In embodiments, the invention provides that said soluble ECM composition is delivered by intracoronary infusion with a balloon infusion catheter. In embodiments, the invention provides that said soluble ECM composition transitions to a gel form in tissue after delivery. In embodiments, the invention provides that said soluble ECM composition transitions to form a coating on the endothelium of injured blood vessels after delivery. In embodiments, the invention provides that said soluble ECM composition degrades within one to 14 days following injection or infusion.
• the invention provides that the injection or infusion of said composition repairs damage to cardiac muscle sustained by said subject, such as a myocardial infarction.
• the invention provides that the injection or infusion of said composition is used to treat muscular or neurological damage caused by disease, trauma, stroke and/or ischemia in said subject.
• said effective amount is an amount that increases blood flow, increases viable tissue mass, or induces new vascular formation in the area of the injection or infusion of the subject.
• said effective amount is an amount that promotes cell survival, reduces inflammation, and repairs damaged vasculature in the area of the injection or infusion of the subject.
• Figure 1A-1F show generation of soluble myocardial matrix.
• Figure 1A shows an isolated left ventricular myocardium is cut into pieces.
• Figure 1B shows decellularized after continuous agitation in 1% sodium dodecyl sulfate.
• Figure 1C shows lyophilized and milled into fine powder.
• Figure 1D shows partially digested myocardial matrix.
• E Fractionated myocardial matrix after centrifugation, (1) SolMM fraction in the supernatant and (2) insoluble pellet.
• Figure 2 shows PAGE comparing protein distribution of ladder (Full-Range
• Figure 3 shows distribution and retention of SolMM (red greyscales) at 12 hours post- intracoronary injection of 200 pL of 10 mg/mL SolMM in an ischemia- reperfusion rat model.
• Left Short axis view of infarcted heart stained with hematoxylin & eosin, infarct spanning across lower half of the heart, scale bar 3 mm;
• Light Inset on infarcted myocardium displaying SolMM micro-scale gels throughout the infarcted myocardium, scale bar 200 pm.
• Figure 4 shows distribution and retention of SolMM (red greyscales) 1 hour following intracoronary infusion in a porcine ischemia-reperfusion model.
• Left Short axis gross histology of infarcted pig heart. Infarct outlined in blue greyscales.
• Right Infarcted myocardium displaying SolMM micro-gels throughout the infarcted myocardium.
• Figure 5 shows mitigated negative left ventricular remodeling (preserved
• EDV and ESV following intracoronary infusions of SolMM in an ischemia-reperfusion model 24 hours and 5 weeks post-infusion.
• N l0-l l per group.
• Figure 10 shows confocal imaging of soluble matrix (red greyscales) and isolectin for endothelial cells (green greyscales) following an infusion of soluble matrix in an ischemia-reperfusion rat model.
• the panels are sequential images from a z-stack. Soluble matrix is coating the inside of a small (approx 5 um diameter) capillary, but the soluble matrix is not completely blocking the lumen.
• Figure 11 shows confocal imaging of soluble matrix (red greyscales) and isolectin for endothelial cells (green greyscales) following an infusion of soluble matrix in an ischemia-reperfusion rat model.
• Figure 12 show soluble matrix retention in soluble matrix infused hearts 24 hours post-infusion and ischemia-reperfusion. From left to right, hearts were infused with 1) saline, 2) 10 mg/ml soluble matrix conjugated with Vivo Tag 750, 3) 10 mg/ml trilysine conjugated with Vivo Tag 750, 4) 10 mg/ml soluble matrix conjugated with Vivo Tag 750. Trilysine was used as a small peptide control and showed minimal heart retention.
• Figure 13 shows a scanning electron microscope image of soluble matrix hydrogel. Scale bar left image 20 pm, scale bar right image 5 pm.
• Figure 14 shows dynamic light scattering data for soluble matrix (SolMM) and full matrix (MM) at 1:50 dilutions (1.0 mg/ml & 0.6 mg/ml respectively), showing soluble matrix particles less than 100 nm in diameter whereas full matrix has larger particles.
• Figure 15 shows dynamic light scattering data for soluble matrix (SolMM) at 1:10 and 1: 100 dilutions (1.0 mg/ml & 0.1 mg/ml respectively), showing particles less than 100 nm in diameter.
• Figure 16 shows absorbance (left) and transmittance (right) of saline, soluble matrix (SolMM), and full matrix (MM).
• Figure 17 shows relative absorbance (left) and transmittance (right) of soluble matrix (SolMM) and full matrix (MM).
• the invention provides a method of preparing one or more biologically active soluble fractions of extracellular matrix (ECM) for therapeutic delivery, comprising:
• the invention provides that the soluble ECM composition is further lyophilized, dialyzed, and/or filtered. In embodiments, the invention provides that the soluble ECM composition is re-hydrated following lyophilization.
• the invention provides a method of treating a subject in need thereof comprising administering to the subject an effective amount of an intravascular infusion of a soluble ECM composition, to promote organ, tissue, or cell repair or cell recruitment.
• the infusion is through a catheter, intravenously, or intravascularly.
• the invention provides that when delivered in vivo, the soluble ECM composition will then form a gel in and/or around the microvasculature of the tissue.
• the invention provides a method for treating acute myocardial infarction comprising injecting or infusing in a subject in need with myocardial infarction an effective amount of a composition comprising soluble decellularized extracellular matrix derived from muscle tissue.
• the invention provides that said composition is delivered intravascularly. In embodiments, the invention provides that said composition is delivered with a balloon infusion catheter. In embodiments, the invention provides that said composition transitions to a gel form in tissue after delivery. In embodiments, the invention provides that said composition degrades within one to 14 days following injection or infusion. In embodiments, the invention provides that the injection or infusion of said composition repairs damage to cardiac muscle sustained by said subject. In embodiments, the invention provides that the injection or infusion of said composition repairs damage in non-cardiac tissues caused by trauma or ischemia in said subject.
• the invention provides that the effective amount is an amount that increases blood flow, increases viable tissue mass, or induces new vascular formation in the area of the injection or infusion of the subject.
• tissue sources e.g., heart, brain, bladder, small intestine, skeletal muscle, kidney, liver, lung, blood vessels and other tissues and organs.
• the tissue is first decellularized, leaving only the extracellular matrix such as disclosed in U.S. Patent Publication US2013/0251687, for example, which is incorporated by reference in its entirety.
• the matrix is then lyophilized, ground or pulverized into a fine powder, solubilized with pepsin or other enzymes, and subsequently neutralized and buffered as previously reported.
• the digestion pre-gel solution
• Processing the separation of soluble and insoluble fractions may be achieved by centrifugation, dialysis, filtration, or adjusting pH or salinity.
• the soluble fraction can be dialyzed to remove salts, lyophilized, and resuspended to adjust ECM concentration.
• ECM can be sterile filtered, lyophilized, and stored in sterile containers. ECM can be resuspended to appropriate/physiological concentration for infusion.
• a soluble ECM composition refers to extracellular matrix material which has been decellularized, lyophilized, ground, and digested and having at least a portion of the solid components removed therefrom.
• a soluble ECM composition is obtained from centrifugation supernatant.
• soluble ECM composition is able to pass through a filter size of less than lpm, 500 nm, 250 nm, 220 nm, or 200 nm.
• the soluble ECM composition having at least a portion of solid ECM components with which it naturally occurs removed therefrom is a more transparent material than before removal of the ECM solids.
• a soluble ECM composition has been substantially isolated when at least 50%, 60%, 70%, 80%, 90%, 95%, 98% or 99% of the naturally occurring ECM solids by volume have been removed therefrom.
• the soluble ECM composition can be lyophilized and stored frozen (e.g. -20C, -80C) for at least 3 months.
• the soluble ECM composition can then be rehydrated with sterile water prior to injection or infusion.
• the soluble ECM composition can be infused through a catheter, delivered intravenously, or by intravascular infusion with or without a balloon.
• the soluble ECM composition can pass through damaged leaky vasculature, such as that found in an acute myocardial infarction, stroke, other ischemic tissues, tumors, etc. Once in the tissue, the soluble ECM composition will then form into a gel.
• the soluble ECM composition can be infused through a catheter, delivered intravenously, or by intravascular infusion with or without a balloon.
• the soluble ECM composition can assemble into a coating on the lining of or fill the pores of leaky vasculature, such as that found in an acute myocardial infarction, stroke, other ischemic tissues, tumors, tissues suffering trauma, etc.
• the soluble ECM composition gel can be crosslinked with glutaraldehye, formaldehyde, bis-NHS molecules, or other crosslinkers.
• the soluble ECM composition can be combined with cells, peptides, proteins, DNA, drugs, nutrients, survival promoting additives, proteoglycans, and/or glycosaminolycans.
• the soluble ECM composition can be combined and/or crosslinked with a synthetic polymer.
• the soluble ECM composition can be used alone or in combination with above described components for endogenous cell ingrowth, angiogenesis, and regeneration.
• the soluble ECM composition can be use alone or in combination with above described components as a matrix to change mechanical properties of the tissue.
• the soluble ECM composition can be delivered with cells alone or in combination with above described components for regenerating damaged tissue.
• the soluble ECM composition can be used for tissue repair following tissue injury such as due to myocardial infarction, stroke, traumatic brain injury, peripheral artery disease, liver chirrosis, cancerous tumors, or renal injury.
• the soluble ECM composition can be used alone or act as a therapeutic delivery vehicle.
• the invention provides soluble ECM compositions and methods for treatment of conditions with endothelial cell injury or dysfunction, leaky vasculature, disrupted endothelial cell junctions, inhibited vasodilation, and inflammation.
• the invention provides soluble ECM compositions and methods for treatment of conditions with potential reperfusion injury, including myocardial infarction, stroke, and peripheral artery and vascular disease.
• the soluble ECM compositions can serve as a tissue engineering scaffold to reduce reperfusion injury, reduce apoptosis, and promote tissue repair.
• the invention provides soluble ECM compositions and methods for treatment of excessive or persistent reactive oxygen species (ROS) production/signaling resulting in endothelial cell activation and inflammation.
• the soluble ECM compositions can protect cells and tissues from ROS injury and inflammation through physical shielding and/or ROS sequestration.
• the invention provides soluble ECM compositions and methods for treatment of heart disease, ischemia and perfusion.
• the soluble ECM compositions can promote neoangiogenesis and increase tissue perfusion.
• the invention provides soluble ECM compositions and methods for treatment of diabetes, insulin resistance.
• the soluble ECM compositions can treat endothelial cells, restoring endothelium-dependent vasodilation.
• the invention provides soluble ECM compositions and methods for treatment of cancer, including tumor growth, metastasis.
• the soluble ECM compositions can treat leaky vessels and endothelium dysfunction present in cancer. ECM degradation products have been shown to inhibit tumor growth and formation.
• the invention provides soluble ECM compositions and methods for treatment of pulmonary diseases, such as chronic obstructive pulmonary disease, asthma, pulmonary artery hypertension.
• pulmonary diseases such as chronic obstructive pulmonary disease, asthma, pulmonary artery hypertension.
• the soluble ECM compositions can be infused to treat injured tissues and/or endothelial cells of the lungs.
• the invention provides soluble ECM compositions and methods for treatment of chronic kidney failure.
• the soluble ECM compositions can treat vessels to restore vasodilation and constriction.
• the invention provides soluble ECM compositions and methods for treatment of venous thrombosis.
• the soluble ECM compositions infusion can coat vessels to prevent thrombosis and platelet aggregation.
• the invention provides soluble ECM compositions and methods for treatment of severe infectious diseases, specifically diseases that have a disrupted endothelial barrier, such as hemorrhagic fever viruses including dengue hemorrhagic fever and hantavirus pulmonary syndrome.
• the soluble matrix infusions can treat and restore the endothelial barrier.
• the invention provides soluble ECM compositions and methods for treatment of atherosclerosis.
• the soluble ECM compositions infusion can prevent plaque rupture by coating and stabilizing atherosclerotic plaques, or it can stick to endothelial cells and reduce inflammation ⁇
• the invention provides soluble ECM compositions and methods for treatment of liver cirrhosis, acute liver failure.
• the soluble ECM compositions can treat endothelial dysfunction in liver cirrhosis.
• the soluble ECM compositions can attenuate inflammation and oxidative stress.
• the invention provides soluble ECM compositions and methods for treatment of tissue hemorrhage and edema.
• the soluble matrix can coat endothelial cells, fill gaps in the endothelial cell layer, increase tissue perfusion through vasostimulatory effects, or reduce fluid entering a tissue.
• the invention provides soluble ECM compositions and methods for treatment of traumatic brain and other neurological injury.
• the soluble matrix can treat endothelial cells to repair leaky vessels, restore endothelial-dependent dilation and nitric oxide production, and reduce inflammation and oxidative stress.
• Intracoronary infusion is an alternative approach to transendocardial injections. Intracoronary delivery can accompany a balloon angioplasty during the typical course of treatment for a myocardial infarction (MI). Intracoronary infusion utilizes the leaky vasculature following an acute MI, therefore permitting a biomaterial to enter the infarct region [5].
• the matrix material (MM) is composed of a soluble fraction and insoluble submicron particles (>800 nm), which are too large to pass through or stick to leaky vasculature.
• soluble MM soluble MM
• SolMM soluble MM
• the SolMM will have similar therapeutic effects, including decreased cardiomyocyte apoptosis, neovascularization, and reduced negative LV remodeling.
• the expression“A and/or B” is intended to mean either or both of A and B, i.e. A alone, B alone or A and B in combination.
• the expression“A, B and/or C” is intended to mean A alone, B alone, C alone, A and B in combination, A and C in combination, B and C in combination or A, B, and C in combination.
• range format is merely for convenience and brevity and should not be construed as an inflexible limitation on the scope of the invention. Accordingly, the description of a range should be considered to have specifically disclosed all the possible sub-ranges as well as individual numerical values within that range. For example, description of a range such as from 1 to 6 should be considered to have specifically disclosed sub-ranges such as from 1 to 3, from 1 to 4, from 1 to 5, from 2 to 4, from 2 to 6, from 3 to 6 etc., as well as individual numbers within that range, for example, 1, 2, 3, 4, 5, and 6. This applies regardless of the breadth of the range.
• Values or ranges may be also be expressed herein as“about,” from“about” one particular value, and/or to“about” another particular value. When such values or ranges are expressed, other embodiments disclosed include the specific value recited, from the one particular value, and/or to the other particular value. Similarly, when values are expressed as approximations, by use of the antecedent“about,” it will be understood that the particular value forms another embodiment. It will be further understood that there are a number of values disclosed therein, and that each value is also herein disclosed as “about” that particular value in addition to the value itself. In embodiments,“about” can be used to mean, for example, within 10% of the recited value, within 5% of the recited value, or within 2% of the recited value.
• the term “pharmaceutical composition” refers to a pharmaceutical acceptable compositions, wherein the composition comprises a pharmaceutically active agent, and in some embodiments further comprises a pharmaceutically acceptable carrier.
• the pharmaceutical composition may be a combination of pharmaceutically active agents and carriers.
• the term“combination” refers to either a fixed combination in one dosage unit form, or a kit of parts for the combined administration where one or more active compounds and a combination partner (e.g., another drug as explained below, also referred to as“therapeutic agent” or“co-agent”) may be administered independently at the same time or separately within time intervals.
• the combination partners show a cooperative, e.g., synergistic effect.
• co-administration or“combined administration” or the like as utilized herein are meant to encompass administration of the selected combination partner to a single subject in need thereof (e.g., a patient), and are intended to include treatment regimens in which the agents are not necessarily administered by the same route of administration or at the same time.
• pharmaceutical combination as used herein means a product that results from the mixing or combining of more than one active ingredient and includes both fixed and non-fixed combinations of the active ingredients.
• fixed combination means that the active ingredients, e.g., a compound and a combination partner, are both administered to a patient simultaneously in the form of a single entity or dosage.
• non-fixed combination means that the active ingredients, e.g., a compound and a combination partner, are both administered to a patient as separate entities either simultaneously, concurrently or sequentially with no specific time limits, wherein such administration provides therapeutically effective levels of the two compounds in the body of the patient.
• cocktail therapy e.g., the administration of three or more active ingredients.
• the term“pharmaceutically acceptable” means approved by a regulatory agency of the Federal or a state government or listed in the U.S. Pharmacopoeia, other generally recognized pharmacopoeia in addition to other formulations that are safe for use in animals, and more particularly in humans and/or non human mammals.
• “pharmaceutically acceptable carrier” refers to an excipient, diluent, preservative, solubilizer, emulsifier, adjuvant, and/or vehicle with which demethylation compound(s), is administered.
• Such carriers may be sterile liquids, such as water and oils, including those of petroleum, animal, vegetable or synthetic origin, such as peanut oil, soybean oil, mineral oil, sesame oil and the like, polyethylene glycols, glycerine, propylene glycol or other synthetic solvents.
• Antibacterial agents such as benzyl alcohol or methyl parabens; antioxidants such as ascorbic acid or sodium bisulfite; chelating agents such as ethylenediaminetetraacetic acid; and agents for the adjustment of tonicity such as sodium chloride or dextrose may also be a carrier.
• Methods for producing compositions in combination with carriers are known to those of skill in the art.
• the language“pharmaceutically acceptable carrier” is intended to include any and all solvents, dispersion media, coatings, isotonic and absorption delaying agents, and the like, compatible with pharmaceutical administration. The use of such media and agents for pharmaceutically active substances is well known in the art.
• terapéuticaally effective refers to an amount of a pharmaceutically active compound(s) that is sufficient to treat or ameliorate, or in some manner reduce the symptoms associated with diseases and medical conditions.
• the method is sufficiently effective to treat or ameliorate, or in some manner reduce the symptoms associated with diseases or conditions.
• an effective amount in reference to age-related eye diseases is that amount which is sufficient to block or prevent onset; or if disease pathology has begun, to palliate, ameliorate, stabilize, reverse or slow progression of the disease, or otherwise reduce pathological consequences of the disease.
• an effective amount may be given in single or divided doses.
• the terms“treat,”“treatment,” or“treating” embraces at least an amelioration of the symptoms associated with diseases in the patient, where amelioration is used in a broad sense to refer to at least a reduction in the magnitude of a parameter, e.g. a symptom associated with the disease or condition being treated.
• “treatment” also includes situations where the disease, disorder, or pathological condition, or at least symptoms associated therewith, are completely inhibited (e.g. prevented from happening) or stopped (e.g. terminated) such that the patient no longer suffers from the condition, or at least the symptoms that characterize the condition.
• preventing and “prevention” refer to the prevention of the onset, recurrence or spread of a disease or disorder, or of one or more symptoms thereof.
• the terms refer to the treatment with or administration of a compound or dosage form provided herein, with or without one or more other additional active agent(s), prior to the onset of symptoms, particularly to subjects at risk of disease or disorders provided herein.
• the terms encompass the inhibition or reduction of a symptom of the particular disease.
• subjects with familial history of a disease are potential candidates for preventive regimens.
• subjects who have a history of recurring symptoms are also potential candidates for prevention.
• prevention may be interchangeably used with the term “prophylactic treatment.”
• a prophylactically effective amount of a compound is an amount sufficient to prevent a disease or disorder, or prevent its recurrence.
• a prophylactically effective amount of a compound means an amount of therapeutic agent, alone or in combination with one or more other agent(s), which provides a prophylactic benefit in the prevention of the disease.
• the term “prophylactically effective amount” can encompass an amount that improves overall prophylaxis or enhances the prophylactic efficacy of another prophylactic agent.
• the term "subject” is defined herein to include animals such as mammals, including, but not limited to, primates (e.g., humans), cows, sheep, goats, horses, dogs, cats, rabbits, rats, mice, and the like. In specific embodiments, the subject is a human.
• the terms "subject” and “patient” are used interchangeably herein in reference, for example, to a mammalian subject, such as a human.
• MM myocardial matrix
• Fig 1A The formulation of myocardial matrix
• SDS sodium dodecyl sulfate
• the MM is centrifuged at 15,000 RCF at 4°C to separate the soluble and insoluble fractions (Fig 1E).
• the supernatant is isolated from the insoluble pellet, and this supernatant will be referred to as the soluble MM fraction (SolMM).
• SolMM is then dialyzed and lyophilized to adjust the concentration and ratio of salts to maintain physiological conditions for SolMM.
• the SolMM is then resuspended at a high concentration (16 mg/mL), passed through 0.22 pm filters into sterile containers, lyophilized, weighed, and stored at -80°C until needed.
• the SolMM is then resuspended to the appropriate concentration in sterile water approximately 30 minutes before injection.
• This suspension can then gel upon subcutaneous injection in a rat within 5 minutes (Fig 1F, 10 mg/mL, 500 pL). Material consistency can be assessed by polyacrylamide gel electrophoresis for protein distribution, Picogreen assay for DNA content, dimethylmethylene blue assay for sulfated glycosaminoglycan (sGAG) content, and methylene blue assay for SDS content. Due to the digestion process to generate the MM and the resulting SolMM, one cannot get accurate data from mass spectrometry. However, PAGE shows an overlapping distribution of proteins between MM and SolMM, excluding high molecular weight proteins in SolMM (Fig 2, lane 4).
• Aggregation is assessed following stasis (MO) or a low shear rate (3 Hz; Ml) while absorbance (800 nm) is measured for 5 seconds.
• platelet aggregation is measured with isolated platelet rich plasma on a lumi-aggregonometer (Chrono-log).
• high concentration coagulation cascade agonists adenosine diphosphate, epinephrine, and collagen
• platelet aggregation is measured via absorbance (600-620 nm).
• Table 1 shows hemocompatibility of soluble matrix. 1:1 dilution of 10 mg/ml soluble matrix to human blood represents the highest ratio, whereas as the 1:10 dilution (1 mg/ml) represents a physiologically relevant dilution.
• Yield is particularly limited based on the filtration step noted in Experiment 1, as SolMM was resuspended at 16 mg/mL and subsequently filtered resulting in approximate concentrations of 10 mg/mL. Resuspended concentrations above 16 mg/mL would typically not pass through the filter.
• Ejection fraction showed a trending increase over saline controls.
• matrix infused LV volumes were also significantly reduced compared to saline infused controls, showing that a matrix infusion mitigates negative left ventricular remodeling.
• Experiment 4 Infusible extracellular matrix using a balloon infusion catheter to repair the heart following myocardial infarction.
• FIG. 4 shows distribution and retention of soluble myocardial matrix (SolMM) 1 hour following intracoronary infusion in a porcine ischemia-reperfusion model using a balloon infusion catheter.
• Figure 4 left shows a short axis gross histology of infarcted pig heart. Infarct outlined in blue greyscales.
• Figure 4 right shows infarcted myocardium displaying SolMM micro-gels throughout the infarcted myocardium in the red greyscales channel.
• SolMM soluble myocardial matrix
• Satellite organs (brain, kidney, liver, lung, spleen) were evaluated by a blinded histopathologist and did not show any abnormal signs of ischemia or inflammation 1 hour following matrix infusions (Table 2). Soluble matrix gels were not observed in any of the satellite organs, suggesting a targeting ability of infusible matrix to ischemic tissue. Table 2
• Table 2 shows that intracoronary soluble matrix infusions in a porcine ischemia- reperfusion model shows no abnormal signs of ischemia or inflammation in satellite organs (brain, kidney, liver, lung, and spleen).
• Infusible matrix can be used as a scaffold to promote angiogenesis in ischemic or injured tissues.
• Figure 6 shows increased infarct arteriole density following matrix infusions in a myocardial infarction model. Infarcts were imaged 5 weeks following infusions in a rat ischemia-reperfusion model. Arterioles were identified by co-staining for alpha-smooth muscle actin and isolection and manually traced in ImageJ. Upregulation of angiogenic pathways are shown in Figure 6.
• FIG. 7 shows decreased cardiomyocyte apoptosis following matrix infusions in a myocardial infarction model. Infarcts and infarct border zones were stained with alpha-actinin for cardiomyocytes and cleaved-caspase 3 for apoptosis. Apoptotic cardiomyocytes were manually counted in ImageJ. Decreased apoptosis could extend to other cells types, but not limited to endothelial cells, immune cells, fibroblasts, neurons, and (cardio)myocytes. Decreased apoptosis/necrosis pathways are shown in Figure 9. Decreased apoptosis could be explained by increased reactive oxygen species (ROS) metabolism, as upregulated ROS metabolic pathways are shown in Figure 8.
• ROS reactive oxygen species
• Figures 8 and 9 show differential gene expression, suggesting pathways for repair of infusible extracellular matrix therapies.
• RNA was isolated from left ventricular free wall tissue 1 day and 3 days following matrix infusion and ischemia-reperfusion injury. At day 1, angiogenic and reactive oxygen species metabolic pathways were upregulated. At day 3, decreased apoptosis/necrosis and decreased fibrotic pathways were observed. LRG1 downregulation is implicated in cardiac fibrosis, and a trend was observed in the opposite direction. Saline infusions were used as controls.
• Matrix infusions can treat endothelial cell injury/dysfunction. Soluble matrix can coat endothelial cells to reduce reactive oxygen species injury, increase endothelial cell survival, and/or fill in leaky vasculature gaps following ischemic injury.
• FIG. 10 shows an endothelial cell (green greyscales) lumen coated with soluble matrix (red greyscales). Note, that the matrix does not block the lumen. Additionally, Figure 11 shows soluble matrix overlapping endothelial cells in a large vessel, while not blocking the lumen. Hearts were imaged using confocal microscopy up to 24 hours post-infusion and simulated myocardial infarction.
• Infusible matrix can be co-delivered with drug, growth factor, microRNA, or other therapeutic agent
• the soluble extracellular matrix composition has potential binding domains for growth factors, microRNAs, and other potential drugs or therapeutics.
• an infusible matrix can gel in tissue following an infusion, it can be used for slow release of a therapy.
• Figure 12 shows soluble ECM retention in infarcted tissue 24 hours following matrix infusion in an ischemia-reperfusion model. From left to right, hearts were infused with saline, matrix conjugated w/VivoTag 750, trilysine conjugated w/VivoTag750, and matrix conjugated w/VivoTag 750. Twenty four hours following infusion, hearts were harvested and imaged on a Licor Odyssey. Matrix infused hearts showed greater signal intensity as opposed to saline infused and trilysine infused hearts. Trilysine with VivoTag 750 was used as a small peptide control and showed no appreciable retention.
• Figure 13 shows the nanofibrous architecture of a soluble matrix hydrogel.
• a 10 mg/ml pre-gel solution was subcutaneously injected into the back of a rat, which then formed a gel and was harvested for scanning electron microscopy imaging. Gel structure is reminiscent of native extracellular matrix.
• Figure 16 shows absorbance (left) and transmittance (right) of saline, soluble matrix (SolMM), and full matrix (MM).
• Figure 17 shows relative absorbance (left) and transmittance (right) of soluble matrix (SolMM) and full matrix (MM).

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