WO2020229878A1 - Composición de uso tópico para terapia fotodinámica - Google Patents
Composición de uso tópico para terapia fotodinámica Download PDFInfo
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- WO2020229878A1 WO2020229878A1 PCT/IB2019/054042 IB2019054042W WO2020229878A1 WO 2020229878 A1 WO2020229878 A1 WO 2020229878A1 IB 2019054042 W IB2019054042 W IB 2019054042W WO 2020229878 A1 WO2020229878 A1 WO 2020229878A1
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- photodynamic therapy
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P17/00—Drugs for dermatological disorders
- A61P17/12—Keratolytics, e.g. wart or anti-corn preparations
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K41/00—Medicinal preparations obtained by treating materials with wave energy or particle radiation ; Therapies using these preparations
- A61K41/0057—Photodynamic therapy with a photosensitizer, i.e. agent able to produce reactive oxygen species upon exposure to light or radiation, e.g. UV or visible light; photocleavage of nucleic acids with an agent
- A61K41/0061—5-aminolevulinic acid-based PDT: 5-ALA-PDT involving porphyrins or precursors of protoporphyrins generated in vivo from 5-ALA
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
- A61K31/19—Carboxylic acids, e.g. valproic acid
- A61K31/195—Carboxylic acids, e.g. valproic acid having an amino group
- A61K31/197—Carboxylic acids, e.g. valproic acid having an amino group the amino and the carboxyl groups being attached to the same acyclic carbon chain, e.g. gamma-aminobutyric acid [GABA], beta-alanine, epsilon-aminocaproic acid or pantothenic acid
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
- A61K31/19—Carboxylic acids, e.g. valproic acid
- A61K31/195—Carboxylic acids, e.g. valproic acid having an amino group
- A61K31/197—Carboxylic acids, e.g. valproic acid having an amino group the amino and the carboxyl groups being attached to the same acyclic carbon chain, e.g. gamma-aminobutyric acid [GABA], beta-alanine, epsilon-aminocaproic acid or pantothenic acid
- A61K31/198—Alpha-amino acids, e.g. alanine or edetic acid [EDTA]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/21—Esters, e.g. nitroglycerine, selenocyanates
- A61K31/215—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
- A61K31/22—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acyclic acids, e.g. pravastatin
- A61K31/221—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acyclic acids, e.g. pravastatin with compounds having an amino group, e.g. acetylcholine, acetylcarnitine
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
- A61K31/35—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having six-membered rings with one oxygen as the only ring hetero atom
- A61K31/352—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having six-membered rings with one oxygen as the only ring hetero atom condensed with carbocyclic rings, e.g. methantheline
- A61K31/353—3,4-Dihydrobenzopyrans, e.g. chroman, catechin
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- 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
- A61K47/16—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing nitrogen, e.g. nitro-, nitroso-, azo-compounds, nitriles, cyanates
- A61K47/18—Amines; Amides; Ureas; Quaternary ammonium compounds; Amino acids; Oligopeptides having up to five amino acids
- A61K47/183—Amino acids, e.g. glycine, EDTA or aspartame
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- 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
- A61K47/22—Heterocyclic compounds, e.g. ascorbic acid, tocopherol or pyrrolidones
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- A—HUMAN NECESSITIES
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- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P35/00—Antineoplastic agents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N5/0613—Apparatus adapted for a specific treatment
- A61N5/062—Photodynamic therapy, i.e. excitation of an agent
Definitions
- the invention aims at a photosensitizing formulation that can be used topically for use in photodynamic therapy (PDT), in the treatment of skin or mucosa.
- PDT photodynamic therapy
- Photodynamic therapy is, in general terms, a type of treatment for hyperproliferative diseases of the skin and internal epithelia, which comprises the administration, topically or systemically, of a photosensitive agent that will ideally be concentrated in the tissues proliferating of the body.
- the compound itself is inactive, but upon irradiation with light of a specific wavelength, the molecule is chemically activated and stimulated to undergo chemical reactions that directly damage the cell or result in the production of species that, in turn. Once, they are harmful to cells.
- the chemotherapeutic action is physically limited to an area of interest instead of spreading to the entire body of the patient with unpleasant and harmful side effects.
- the field of applicability of PDT is naturally limited by the accessibility of the tissue to the light source.
- hyperproliferative diseases of the skin are cancers, where only one of them, melanoma, is seriously life threatening and is not a candidate for PDT.
- NSCLC non-melanoma skin cancers
- basal cell carcinoma 80% of NSCLC cases
- elatively benign elatively benign
- squamous cell carcinoma 20% of NSCLC cases
- Hyperplasias such as actinic keratosis and Bowen's disease, are called precancerous lesions because they can lead to squamous cell carcinoma if left untreated.
- i formulation that comprises a photosensitizing compound (FS), where this compound, when irradiated or excited to light of a specific wavelength, generates reactive oxygen species (ROS), which are cytotoxic and induce the death of cells in which they are find.
- FS photosensitizing compound
- ROS reactive oxygen species
- the usual procedure is to apply an FS on the skin lesion to be treated, for example, using a cream, then let it incubate and, finally, irradiate the area with light so that ROS is generated in situ and the tissue is eliminated hyperproliferative.
- the invention corresponds to a composition for use in photodynamic therapy (PDT) on the skin, so one of its uses is in the clinical field, specifically, dermatology.
- PDT photodynamic therapy
- This therapy consists of applying the photosensitizing cream on the skin lesions and then irradiating the lesions with a light of a specific wavelength.
- PDT allows the treatment of non-melanoma skin cancer lesions, specifically, basal cell carcinoma and precursor lesions of squamous carcinoma of the skin. These lesions have a high incidence worldwide, since they occur in regions of the skin exposed to the sun, such as the face. It is estimated that, in the world, there are 2-3 million new cases of this type of cancer each year (see World Health Organization. Ultraviolet radiation and the INTERSUN Program. Http://www.who.int/uv/faq/ skincancer / en / index1 .html (2013)).
- photodynamic therapy is used in the treatment and prevention of inflammatory and infectious diseases of the skin and mucosa, and also in applications with purely dermo-cosmetic purposes.
- the present invention relates to the pharmaceutical and dermo-cosmetic industry.
- it relates to a composition for photodynamic therapy that increases its scope, enhancing the effect of known photosensitizing compounds, such as the compound methyl aminolevulinate (MAL) or aminolevulinic acid (ALA), for example.
- MAL methyl aminolevulinate
- ALA aminolevulinic acid
- PplX protoporphyrin IX
- MAL methyl aminolevulinate
- ALA aminolevulinic acid
- ferric ion sequestering agents could enhance the use of this photosensitizer, since said ion is a necessary substrate for the pathway of conversion of PplX into hemoglobin, which led to the incorporation of ferric ion chelating agents in photosensitizing compositions, in order to improve therapy.
- An agent used for this purpose is EDTA.
- Mun (Mun ST, Bae DH, Ahn WS. Photodiagnosis Photodyn Ther. 2014. Jun; 1 1 (2): 141 -7.) Suggests that PDT combined with EGCG could be useful for an effective treatment against cancer . Because both a decrease in the growth of the TC-1 cell line (derived from hybridoma) and the tumors of this line generated in C57BL / 6 mice was observed, after having treated them with PDT + EGCG, using Radachlorin as a photosensitizer.
- EGCG is not applied directly with the photosensitizer in in vivo tests as performed in the invention, but rather it was administered by injection into tumors for 20 days after PDT, with which they observed the best results regarding decreasing the size of tumors in mice. Therefore, the results obtained are based on a treatment where EGCG is applied after PDT, not simultaneously with the photosensitizer.
- a photosensitizer precursor protoporphyrin IX for example, methyl aminolevulinate (MAL) or aminolevulinic acid (ALA), combined with ethylenediaminetetraacetic acid (EDTA) and epigallocatechin gallate (EGCG).
- PplX photosensitizer precursor protoporphyrin IX
- MAL methyl aminolevulinate
- ALA aminolevulinic acid
- EDTA ethylenediaminetetraacetic acid
- EGCG epigallocatechin gallate
- These new formulations show a potentiating effect of the effect of photosensitizing compounds, MAL or ALA for example, which ensures a greater efficacy of photodynamic therapy, for example in the resolution of long-term preneoplastic or neoplastic dermatological or mucosal lesions, for example , Preneoplastic lesions of the cervix (intraepitalial lesions of the cervix) decreasing the recurrence rate of these lesions.
- Preneoplastic lesions of the cervix intraepitalial lesions of the cervix
- any other application of photodynamic therapy such as treatment or prevention of inflammatory diseases, in skin and mucosa, for example, acne, rosacea, cell rejuvenation, or infectious diseases to the skin or mucosa.
- Figure 1 Effect of EDTA and EGCG in MAL-PDT on the viability of HSC-1 cells resistant to PDT evaluated by MTT.
- the results represent the mean + SD. The experiments were carried out in technical and biological triplicate. * P ⁇ 0.05.
- Figure 2 Effect of the formulation of the invention, which combines EDTA and EGCG in MAL-PDT on the viability of HSC-1 cells resistant to PDT evaluated by MTT.
- the results represent the mean + SD.
- the experiments were carried out in technical and biological triplicate. * P ⁇ 0.05.
- Photodynamic therapy consists of the application of a cream on the skin lesion and subsequently irradiated with a specific light.
- the cream contains a photosensitizer that enters the cell and accumulates in it.
- the photosensitizer reacts with the 0 2 present in the cell and forms reactive oxygen species that cause cell damage, and consequently cell death.
- It is an outpatient treatment, which can be applied to large areas of skin, but for, Above all, its greatest advantage is that optimal cosmetic results are obtained, which is important, considering that lesions often develop in areas exposed to the sun.
- This type of therapy has multiple applications, for example, in neoplastic-non-melanoma or preneoplastic skin or mucosa lesions, additionally this therapy is also used in the treatment or prevention of inflammatory diseases, in skin and mucosa, for example, acne, rosacea , cell rejuvenation, or infectious diseases to the skin or mucous membranes.
- the invention aims at new photosensitizing pharmaceutical and dermo-cosmetic formulations for topical application for use in photodynamic therapy (PDT), based on PplX precursors, photosensitizers chosen from methyl aminolevulinate (MAL) and / or aminolevulinic acid (ALA), combined with acid ethylenediaminetetraacetic acid (EDTA) and epigallocatechin gallate (EGCG).
- PDT photodynamic therapy
- MAL methyl aminolevulinate
- ALA aminolevulinic acid
- EDTA acid ethylenediaminetetraacetic acid
- EGCG epigallocatechin gallate
- the inventors have included EDTA in the composition of the invention, since this compound has a chelating effect that contributes to increasing the cytotoxic effect, allowing the cellular accumulation of PplX (compound synthesized by cells from MAL and ALA), thus increasing the production of reactive oxygen species (ROS) that cause cell damage.
- PplX compound synthesized by cells from MAL and ALA
- the inventors have included EGCG, since its presence in the composition enhances and strengthens the efficacy of PDT, has a chelating, pro-oxidant and antiproliferative effect.
- the composition of the invention allows PDT to improve its efficacy by ensuring the destruction of preneoplastic and neoplastic cells of non-melanoma skin cancer.
- the composition contains the photosensitizer (MAL or ALA) in a concentration between 100 mg / g - 200 mg / g, EDTA in a concentration between 0.5 mg / g- 10 mg / g and EGCG in a concentration between 0.1 - 500 mg / g, in pharmacologically acceptable carriers and / or excipients.
- MAL or ALA photosensitizer
- MAL or ALA can be in free form or of a pharmacologically acceptable salt, as for example; Methyl aminolevunilate hydrochloride, methyl aminolevunilic acid ester or methyl 5-amino-4-oxopentanoate hydrochloride, among others.
- the excipients are chosen from water, sodium chloride, lanolin, beeswax, glycerol, petrolatum, propylene glycol, sodium lauryl sulfate, dimethylsulfoxide, imidazolidinyl urea, olivem 1000, propyl parahydroxybenzoate, Polawax, methyl paraben, almond oil, oil of ricino , cetyl alcohol, butylhydroxytoluene, and any other excipient available in the art.
- composition of the invention may contain other active compounds or formulation aids.
- composition of the invention can be used in any photodynamic therapy application that exists in the art, for example, in pharmaceutical or dermocosmetic applications.
- the composition of the invention can be used to prepare a drug useful for photodynamic therapy, useful in the treatment of preneoplastic and neoplastic cells of non-melanoma skin cancer.
- the composition of the invention is used in the treatment of cells or lesions resistant to photodynamic therapy.
- composition of the invention can be used in the treatment or prevention of inflammatory and / or infectious diseases of the skin and mucosa, for example, acne or rosacea, among others.
- composition of the invention can be used in photodynamic therapy for dermocosmetic purposes, for example, for cell rejuvenation.
- composition of the invention can be constituted in different pharmaceutical or dermo-cosmetic presentations such as cream, ointment, spray, lotion, foam or any other existing in the art.
- HSC-1 cells derived from squamous skin carcinoma were used. These cells previously received PDT cycles, to select those resistant to PDT. Therefore, the model used corresponds to HSC-1 cells resistant to MAL-PDT.
- the conventional in vitro photodynamic treatment consisted of incubating these cells with 150 mg / g MAL (photosensitizer) for 4 hours in the dark and subsequently irradiating them with 630 nm red light, with a fluence of 4 J / cm 2 . Cell viability was assessed 24 hours later by the MTT assay.
- MAL photosensitizer
- the cell viability is only 10%, and in the other 2 conditions it is 0% viability of cells resistant to MAL-PDT.
- protoporphyrin IX PDT-resistant HSC-1 cells when incubated with MAL and EGCG or EDTA
- the PDT-resistant cells obtained as indicated in example 1, were incubated with MAL 150 mg / g, plus EGCG (0.1 mg / g, 0.2 mg / g, 0.4 mg / g ) or EDTA (1 mg / g, 2 mg / g, 3 mg / g) for 4 hours in the dark. Subsequently, the content of PplX in resistant cells was detected by flow cytometry, because PplX is a fluorescent compound.
- ROS reactive oxygen species
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BR112021022973A BR112021022973A2 (pt) | 2019-05-15 | 2019-05-15 | Composição para utilização tópica para terapia fotodinâmica |
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Non-Patent Citations (7)
Title |
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FERRARIO, A. ET AL.: "Pro-apoptotic and anti-inflammatory properties of the green tea constituent epigallocatechin gallate increase photodynamic therapy responsiveness", LASERS SURG MED., vol. 43, no. 7, September 2011 (2011-09-01), pages 644 - 650, XP055759601, DOI: 10.1002/lsm.21081. * |
MUN STBAE DHAHN WS, PHOTODIAGNOSIS PHOTODYN THER, vol. 11, no. 2, June 2014 (2014-06-01), pages 141 - 7 |
MUN, ST ET AL.: "Epigallocatechin gallate with photodynamic therapy enhances anti-tumor effects in vivo and in vitro", PHOTODIAGNOSIS AND PHOTODYNAMIC THERAPY, vol. 11, 2014, pages 141 - 147, XP011257083, DOI: 10.1016/j.pdpdt. 2014.03.00 3 * |
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YANG, X. ET AL.: "Aminolevulinic Acid-Based Tumor Detection and Therapy: Molecular Mechanisms and Strategies for Enhancement", INT. J. MOL. SCI., vol. 16, 2015, pages 25865 - 25880, XP055759593, DOI: 1 0.3390/ijms1 61 025865 * |
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