WO2021185342A1 - 线粒体用于治疗及/或预防肌腱受损或其相关疾病的用途 - Google Patents

线粒体用于治疗及/或预防肌腱受损或其相关疾病的用途 Download PDF

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WO2021185342A1
WO2021185342A1 PCT/CN2021/081687 CN2021081687W WO2021185342A1 WO 2021185342 A1 WO2021185342 A1 WO 2021185342A1 CN 2021081687 W CN2021081687 W CN 2021081687W WO 2021185342 A1 WO2021185342 A1 WO 2021185342A1
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tendon
mitochondria
cells
damage
prp
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PCT/CN2021/081687
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French (fr)
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郑汉中
许智凯
曾惠卿
郑安玲
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台湾粒线体应用技术股份有限公司
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Priority to EP21770630.8A priority Critical patent/EP4122474A4/en
Priority to US17/912,458 priority patent/US20230165899A1/en
Priority to CN202180014777.1A priority patent/CN115103683B/zh
Publication of WO2021185342A1 publication Critical patent/WO2021185342A1/zh

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Definitions

  • the present invention relates to a second use of mitochondria, in particular to the use of a mitochondria to treat and/or prevent tendon damage or related diseases.
  • Tendons are dense connective tissues that connect bones and muscles. They can transmit muscle power to bones and make joints move. Therefore, where muscles connect to tendons or where tendons connect to bones, they will bear a greater mechanical load, resulting in a relatively large area. It is easy to be injured and affect the function of the tendon. Tendon injury usually occurs when the tendon is overused, repeated similar actions for a long time, repeated excessive compression or pulling on the tendon, resulting in a laceration of the tendon.
  • Tendinopathy occurs, and depending on the location where the force or pain cannot be applied, such as biceps tendinitis, rotator rotator tendinitis, knee patellar tendinitis, Achilles tendinitis, calcific tendinitis, lateral epicondyle of the humerus Inflammation, intrahumeral epicondylitis, ligament injury, ligament inflammation, etc.
  • PRP Platinum-rich Plasma, which is rich in Platelet plasma
  • PRP proliferative therapy that is, when the patient's own blood coagulation function
  • the effect of PRP treatment is limited when the tendon is poor or damaged too severely.
  • the main purpose of the present invention is to provide a second use of mitochondria. Because mitochondria have the ability to repair damaged tendon cells, improve or inhibit tendon cell inflammation, and increase the healing rate of tendon cells, when a body When there are diseases or symptoms related to tendon damage, the effect of treating tendon damage-related diseases or/and preventing joint diseases caused by tendon damage can be achieved by administering a certain amount of mitochondria or a composition containing the same.
  • Another object of the present invention is to provide a composition containing mitochondria and other growth factors, which can greatly increase the efficiency of repairing tendon cells or improving tendon cell inflammation, so as to reduce complications related to tendon damage or inflammation Chance to happen.
  • an embodiment of the present invention discloses a composition comprising a mitochondria and a blood product, and the blood product contains at least one growth factor.
  • the blood product is a platelet-rich plasma (PRP), and the platelet-rich plasma contains a variety of growth factors, including PDGF-BB, IGF-1, TGF- ⁇ 1, VEGF, bFGF, etc.
  • PRP platelet-rich plasma
  • the composition of the present invention includes mitochondria and platelet-rich plasma, wherein the dose of the mitochondria is 5 to 80 ⁇ g, preferably 15 to 40 ⁇ g, and the concentration of PRP is preferably at least 5 volume percent .
  • mitochondria are used to prepare a composition for treating tendon damage-related diseases or preventing joint diseases. Therefore, by administering a certain amount of mitochondria to a damaged tendon, the repair of tendon damage can be accelerated And to improve the inflammation of the tendon, so as to achieve the effect of treating tendon damage related diseases or preventing joint diseases.
  • the dose of the mitochondria in the composition is 40 ⁇ g or more.
  • the disease related to tendon damage is tendinitis.
  • the disease associated with damage to the tendon has symptoms of inflammation or swelling of the tendon.
  • the disease related to tendon damage is tendinopathy.
  • the composition further includes a platelet-rich plasma, wherein the platelet-rich plasma concentration It is 5% or more, and preferably a composition composed of a platelet-rich plasma concentration of 5% or more and the dose of the mitochondria of 40 ⁇ g or more.
  • joint diseases or ligament injury related diseases are caused by tendon damage or tendon inflammation, such as arthritis, joint swelling, ligament inflammation, and ligament damage.
  • the disease related to tendon damage is tendinopathy, tendinitis, or any disease with signs of tendon inflammation or swelling, such as biceps tendinitis, rotator tendonitis, knee patellar tendinitis, and Achilles tendon. Inflammation, calcifying tendinitis, external humeral epicondylitis, internal humeral epicondylitis, ligament injury, ligament inflammation, etc.
  • the mitochondria is isolated from an autologous cell or an allogeneic cell, and the mitochondria is isolated from a stem cell, such as adipose stem cells, mesenchymal stem cells, CD34+ hematopoietic stem cells, bone marrow stem cells, umbilical cord stem cells, amniotic stem cells , Amniotic fluid stem cells, placental stem cells, iPS, neural stem cells.
  • a stem cell such as adipose stem cells, mesenchymal stem cells, CD34+ hematopoietic stem cells, bone marrow stem cells, umbilical cord stem cells, amniotic stem cells , Amniotic fluid stem cells, placental stem cells, iPS, neural stem cells.
  • the present invention provides a use of mitochondria for treating and/or preventing tendon damage or other related diseases.
  • the mitochondria or a composition containing mitochondria such as a composition composed of mitochondria and PRP, indeed have the ability to improve tendon inflammation or swelling , And can promote the efficiency of tendon repair, in a short time, the damaged tendon can restore its force and elasticity, and achieve the effect of treating or preventing tendon damage-related diseases; the mitochondria or the composition containing mitochondria of the present invention can Promote or accelerate the healing of tendon wounds to achieve the effect of accelerating the repair of damaged tendon cells or treating tendinopathy.
  • Figure 1 shows the results of cell viability analysis after human tenocytes were treated with hydrogen oxide and cultured under different dosing conditions.
  • Figure 2 shows the results of cell viability analysis after human tenocytes were treated with tBHP (tert-butyl hydroperoxide) and cultured under different dosing conditions.
  • tBHP tert-butyl hydroperoxide
  • Figure 3A shows the results of the cell migration test after observing human tenocytes treated under different conditions.
  • Figure 3B is a statistical analysis of the results of the cell migration test of human tenocytes treated with different conditions.
  • the present invention provides a second use of mitochondria, which can be used to treat diseases related to tendon damage and prevent diseases caused by tendon damage.
  • the mitochondria of the present invention have the effect of repairing damaged tendon cells and increasing the healing rate of tendon cells. Therefore, by administering a predetermined amount of mitochondria or a composition containing a predetermined amount of mitochondria to the damaged tendon, it can promote The wound at the damaged area of the tendon is healed to achieve the effect of repairing the damaged tendon, and thereby prevent the occurrence of joint diseases caused by the damage or inflammation of the tendon.
  • the dose of mitochondria administered is 5 to 80 ⁇ g, such as 5, 15, 20, 25, 30, 40, 55, 60, 70, 80 ⁇ g, and the mitochondria are prepared as a combination with different components.
  • mitochondria are preferably matched with growth factors or a mixture containing growth factors.
  • mitochondria and PRP or components with growth factors, such as blood products, are mixed to form a composite.
  • the mitochondria of the present invention combined with other components are administered to the wound, such as mitochondria combined with platelet-rich plasma, which can greatly increase the healing speed of the damaged tendon.
  • composition refers to a substance containing an effective amount of mitochondria, which is prepared into different forms and dosage forms according to usage requirements or usage methods, and can be matched with different components, carriers, excipients, etc. .
  • the "mitochondria" referred to in the present invention is isolated from a cell, and the separation technology or method used should be able to maintain the integrity of the mitochondrial structure and function. According to the general knowledge of the technical field of the present invention, the separation technology or The method can be physical or chemical.
  • Cells in the present invention refer to cells with mitochondria, such as adipose stem cells, mesenchymal stem cells, skeletal muscle cells, liver cells, kidney cells, fibroblasts, nerve cells, skin cells, blood cells, etc.
  • blood product in the present invention refers to a product prepared from blood as a raw material, and contains a certain amount of growth factors, such as platelet-rich plasma (PRP) isolated from whole blood, supplemented with growth factors Factors such as blood, etc.; and the "a certain amount” referred to here is the amount available to those skilled in the art to which the present invention belongs based on existing common sense; for example, the number of platelets in the PRP of the present invention is at least 1,000,000/ ⁇ l, And it contains PDGF-BB (155.2 ⁇ 57.67ng/ml), IGF-1 (236.07 ⁇ 222.1ng/ml), TGF- ⁇ 1 (488.76 ⁇ 240.77ng/ml), VEGF (242.29 ⁇ 97.64ng/ml), The growth factor of bFGF (82.24 ⁇ 64.51 ng/ml); the growth factor content of the blood product referred to in the present invention is at least 522.54 ng/ml, and there are platelets in it, the number of which
  • administration refers to contacting the mitochondria of the present invention to the damaged tendon site, and the method of contacting the damaged tendon site is not limited to smearing, dripping, injection, introduction, etc., and assisting external force strengthening or Accelerate cell absorption, such as ultrasound, shock waves, heating, etc.
  • diseases related to tendon damage refers to diseases caused by tendon tearing, decreased elasticity, and decreased ability to bear force, such as tendinitis, and because tendon exists between muscle and bone, tendon Damage-related diseases can occur in various parts of the body with tendons. Clinically, there are different indications according to the location of the tendon, such as biceps tendinitis, rotator tendonitis, knee patellar tendinitis, Achilles heel Tendinopathy, calcified tendinitis of the shoulder joint, etc.
  • joint disease in the present invention refers to a disease caused by inflammation or damage of the tendon, that is, when the tendon is damaged or inflamed, it will affect the movement ability of the place where the tendon is located (that is, the joint), and will As the time of tendon damage or inflammation increases, the chance of joint disease or joint disease is greatly increased. For example, if the tendon at the knee is damaged, it will affect the knee movement ability, such as bending, walking, etc. Therefore, if it can be accelerated Repairing damaged tendons can effectively prevent joint diseases caused by long-term damage to tendons, such as fifty shoulders, degenerative arthritis, and knee arthritis.
  • Hydroxyurea (HU) is used as a cell proliferation inhibitor to perform cell migration tests.
  • Human tenocytes were cultured in TEN-1 Growth Medium (zenbio). Before human tenocytes were cultured, 250 ⁇ g/ml matrix gel (matrixgel, brand: Corning, model: 354234) ) Carry out coating treatment. After treatment for 1 hour, remove the base glue and wash with phosphate buffer. Then, the human tendon cells can be coated with base glue in TEN-1 growth medium at 37°C. Culture in an incubator (in a 5% carbon dioxide environment). When the human tendon cells grow to 9 minutes full, remove the cell culture medium and wash with phosphate buffer, remove the phosphate buffer, and add 0.25% pancreas The protease was reacted at 37°C for 5 minutes.
  • matrix gel matrix gel, brand: Corning, model: 354234
  • TEN-1 growth medium was added to neutralize the trypsin effect, and centrifuged at 1000 rpm for 5 minutes. After centrifugation, the supernatant was removed, and new TEN-1 growth medium was added. Perform cell counts to facilitate subsequent examples.
  • a separation tube containing anticoagulant brand: BD; model: REF362761.
  • the blood sample is divided into four layers, with red blood cells in each layer from bottom to top.
  • Layer separating gel, white buffy coat layer (containing monocytes and platelets) and a slightly yellow transparent plasma layer, collect buffy coat layer and plasma layer, and collect buffy coat layer and plasma
  • the layer is transferred to another separation tube, centrifuged at 900g for 10 minutes, after centrifugation, the upper 2/3 of the plasma is removed, and the remaining product is evenly mixed and becomes PRP.
  • the number of platelets in the PRP prepared in this example is greater than 1,000,000 per ⁇ l, and contains a variety of growth factors, such as PDGF-BB (155.2 ⁇ 57.67ng/ml), IGF-1 (236.07 ⁇ 222.1ng/ml), TGF - ⁇ 1 (488.76 ⁇ 240.77ng/ml), VEGF (242.29 ⁇ 97.64ng/ml), bFGF (82.24 ⁇ 64.51ng/ml).
  • growth factors such as PDGF-BB (155.2 ⁇ 57.67ng/ml), IGF-1 (236.07 ⁇ 222.1ng/ml), TGF - ⁇ 1 (488.76 ⁇ 240.77ng/ml), VEGF (242.29 ⁇ 97.64ng/ml), bFGF (82.24 ⁇ 64.51ng/ml).
  • the prepared PRP was added to the cell culture medium or the animal solvent to be injected at 5% by volume to prepare a PRP solution with a concentration of 5% by volume.
  • Example 1 The human tenocytes in Example 1 were subcultured in a 24-well plate and cultured at a concentration of 5 ⁇ 10 4 cells/500 ⁇ L per well for 8 hours. The supernatant was removed and phosphate buffer was added for washing, and then Remove the phosphate buffer, add 500 ⁇ L of TEN-1 growth medium to each well and incubate for 8 hours. After incubation, treat with 300 ⁇ M hydrogen peroxide. After reacting for 4 hours, remove the supernatant.
  • H 2 O 2 group the cell survival rate was 59.97 ⁇ 12.83%; the cell survival rate of human tendon cells treated with hydrogen peroxide and administered PRP (hereinafter referred to as H 2 O 2 /PRP group) was 80.12 ⁇ 9.19%; the cell survival rate of human tendon cells treated with hydrogen peroxide and administered to mitochondria (hereinafter referred to as H 2 O 2 /mitochondrial group) was 85.22 ⁇ 11.46%; treated with hydrogen peroxide and mitochondria and administered The cell survival rate of mitochondria and PRP human tendon cells (hereinafter referred to as H 2 O 2 /PRP/mitochondria group) was 99.16 ⁇ 11.83%.
  • the cell survival rate of the H 2 O 2 group is significantly lower than that of the blank group, indicating that hydrogen peroxide does damage human tendon cells and cause the death of tendon cells; while the cell survival rate of the mitochondria or PRP group is administered Both are significantly higher than the hydrogen peroxide group, and the cell survival rate of the H 2 O 2 /mitochondria group is higher than that of the H 2 O 2 /PRP group, that is, although both mitochondria and PRP can improve tendon cell damage and reduce cell death, However, mitochondria has a better effect on improving the damage of tendon cells. Moreover, the cell survival rate of the H 2 O 2 /PRP/mitochondria group is almost equal to that of the blank group. Damaged human tendon cells are more able to repair damaged human tendon cells and achieve the effect of treating damaged human tendon cells or related diseases.
  • the cell survival rate of human tendon cells without tBHP treatment was 93.38 ⁇ 7.65%; human tendon cells treated with tBHP but not administered with mitochondria or/and PRP (hereinafter referred to as The cell survival rate of the tBHP group) was 63.3 ⁇ 16.03%; the cell survival rate of human tenocytes treated with tBHP and then administered with PRP (hereinafter referred to as tBHP/PRP group) was 76.4 ⁇ 19.55%; after treatment with tBHP, the survival rate was 76.4 ⁇ 19.55%.
  • tBHP/mitochondria group The cell survival rate of mitochondrial human tendon cells (hereinafter referred to as tBHP/mitochondria group) was 90.2 ⁇ 11.09%; the human tendon cells treated with tBHP/mitochondria and administered with mitochondria and PRP (hereinafter referred to as tBHP/PRP/mitochondrial group) The cell survival rate was 97 ⁇ 2.29%.
  • the cell survival rate of the tBHP group was significantly lower than that of the blank group, it showed that tBHP would indeed damage human tenocytes and cause the death of tenocytes; the cell survival rate of the mitochondria or/and PRP group was significantly higher than that of the tBHP group.
  • Both mitochondria and PRP can improve the damage of human tendon cells induced by tBHP. Among them, the improvement effect of mitochondria alone is better than that of PRP alone; and when human tendon cells are treated with tBHP, the damage occurs.
  • administering mitochondria and PRP at the same time can make the damage of human tenocytes almost disappear, and the cell survival rate is almost the same as that of the blank group. That is, in the case of human tenocytes damaged, the simultaneous administration of mitochondria and PRP can effectively improve and repair Human tendon cells can promote or accelerate the treatment of damaged human tendon cells or related diseases.
  • Tenocytes were cultured in a 24-well plate at a cell number of 5x10 4 cells/500 ⁇ L. After 24 hours of culture, when the cells reached 9 minutes full, they were washed with phosphate buffer and then scraped out a fixed width in the middle of the cells. For straight wounds, remove the TEN-1 growth medium and suspended cells and replace them with a mixed cell culture medium containing 10 ⁇ M hydroxyurea (90% DMEM/F12+10% TEN-1 growth medium), and follow the experimental design The culture was carried out under the following different conditions for 24 hours: 40 ⁇ g mitochondria, 5% PRP, 5% PRP and 40 ⁇ g mitochondria were added, and the wound healing and healing were observed and analyzed after culture. The results are shown in Figure 3.
  • Fig. 3A and Fig. 3B show that simple administration of mitochondria to damaged human tendon cells can promote tendon wound healing, and its healing effect is equivalent to or even better than that of simple administration of PRP. If mitochondria and PRP can be administered simultaneously to damage
  • the human tendon cells can double the rate of wound healing, that is, the mitochondria or the composition containing mitochondria in this case can indeed promote or accelerate the healing of tendon wounds, so as to achieve the effect of accelerating the repair of damaged tendon cells or treating tendinopathy.
  • the mitochondria or mitochondria-containing composition of the present invention such as a composition composed of mitochondria and PRP, does have the ability to improve tendon inflammation or swelling, and can promote the efficiency of tendon repair, which can make The damaged tendon restores its ability to bear force and elasticity to achieve the effect of treating or preventing diseases related to tendon damage.

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Abstract

线粒体在制备治疗肌腱受损相关疾病及预防由肌腱受损所引起的疾病的组合物中的用途。该线粒体具有修复受损肌腱细胞、增加肌腱细胞愈合速率的功效，能够促进肌腱受损处伤口愈合，达到修复受损肌腱的功效，进而预防因肌腱受损或发炎所导致关节疾病的发生。

Description

线粒体用于治疗及/或预防肌腱受损或其相关疾病的用途 技术领域
本发明是有关于一种线粒体的第二用途，特别是指一种线粒体用于治疗及/或预防肌腱受损或其相关疾病的用途。
背景技术
肌腱为将骨骼与肌肉连结在一起的密集结缔组织，能够将肌肉力量传递到骨骼并且使关节运动，因此，在肌肉连接肌腱处或在肌腱连接骨头处会承受较大机械载荷，导致上述区域较容易受伤而影响到肌腱功能。肌腱损伤通常会发生在过度使用肌腱、长期重复相似的动作、反复过度压迫或拉扯肌腱上，造成肌腱发生撕裂伤，若无法愈合，会使肌腱弹性下降，无法承受拉力，此时，则会发生肌腱病变的情形，而依据发生部位不同而使该部位无法使力或疼痛，如二头肌腱炎、肩旋转肌腱炎、膝盖髌腱炎、跟腱炎、钙化性肌腱炎、肱骨外上髁炎、肱骨内上髁炎、韧带损伤、韧带发炎等。
肌腱损伤的修复往往需要长时间治疗或复健才能慢慢改善，为能增加治疗效率，目前临床上有将再生疗法应用于肌腱、韧带与肌肉损伤修补，如PRP(Platelet-rich plasma，富含血小板的血浆)增生疗法，亦即通过将PRP投予至受伤的肌腱部位，能够有效地促进肌腱受损处愈合，但并非所有肌腱受损患者接受PRP增生疗法皆有效，即当患者本身凝血功能不佳或是肌腱受损过于严重时，PRP治疗效果有限。
基于肌腱和韧带损伤是目前普遍存在的健康问题，因此，目前当务之急是提供一种有效且能增加治疗效率的方法或组合物。
发明内容
本发明主要目的在于提供一种线粒体的第二用途，其由于线粒体在一定量下是具有修复受损肌腱细胞、改善或抑制肌腱细胞发炎反应及增加肌腱细胞愈合速率的能力，因此，当一个体具有肌腱受损相关疾病或是病征时，能够通过投予一定量的线粒体或含有其组合物达到治疗肌腱受损相关疾病或/及预防因肌腱受损所导致关节疾病的功效。
本发明另一目的在于提供一种组合物，其含有线粒体与其他含有生长因子之物，而能大幅提升修复肌腱细胞或改善肌腱细胞发炎的效率，以达到降低与肌腱受损或发炎相关并发症发生的机会。
为能达成前述目的，在本发明一实施例中揭露一种组合物，其包含有一 线粒体及一血液制品，而该血液制品中含有至少一生长因子。
其中，该血液制品为一富含血小板的血浆(PRP)，而该富含血小板的血浆中含有多种生长因子，包含有PDGF-BB、IGF-1、TGF-β1、VEGF、bFGF等。
举例来说，本发明所述组合物包含有线粒体与富含血小板的血浆，其中，该线粒体的剂量为5～80μg，又以15～40μg为佳，而PRP的浓度为5体积百分比以上为佳。
在本发明另一实施例中将线粒体用于制备治疗肌腱受损相关疾病或预防关节疾病组合物的用途，因此，通过投予一定量的线粒体至一肌腱受损处，能够加速修复肌腱受损且改善肌腱发炎的情形，借以达到治疗肌腱受损关疾病或预防关节疾病的功效。
其中，该线粒体在该组合物的剂量为40μg以上。
较佳地，所述肌腱受损相关疾病为肌腱炎。
较佳地，所述肌腱受损相关疾病具有肌腱发炎或肿胀的病征。
较佳地，肌腱受损相关疾病为肌腱病变。
为能增进治疗肌腱受损相关疾病、预防关节疾病或韧带损伤相关疾病的功效，于本发明一实施例中，该组合物更包含有一富含血小板的血浆，其中，该富含血小板的血浆浓度为5％以上，而又以富含血小板的血浆浓度为5％以上与该线粒体的剂量为40μg以上所组成的组合物为佳。
在本发明一实施例中，关节疾病或韧带损伤相关疾病是由肌腱受损或肌腱发炎所引起，如关节炎、关节肿胀、韧带发炎、韧带受损等。
在本发明一实施例中，该肌腱受损相关疾病为肌腱病变、肌腱炎或是任何具有肌腱发炎或肿胀病征的疾病，如二头肌腱炎、肩旋转肌腱炎、膝盖髌腱炎、跟腱炎、钙化性肌腱炎、肱骨外上髁炎、肱骨内上髁炎、韧带损伤、韧带发炎等。
在本发明实施例中，该线粒体是分离自一自体细胞或一异体细胞，并且，该线粒体是离自一干细胞，例如脂肪干细胞、间质干细胞、CD34+造血干细胞、骨髓干细胞、脐带干细胞、羊膜干细胞、羊水干细胞、胎盘干细胞、iPS、神经干细胞。
本发明的有益效果在于：
本发明提供一种线粒体用于治疗及/豁预防肌腱受损或其他相关疾病的用途，该线粒体或含有线粒体的组合物，如线粒体与PRP组成的组合物，确实具有改善肌腱发炎或肿胀的能力，并且能够促进肌腱修复的效率，于短时间内 可以使受损肌腱恢复其受力能力及弹性，达到治疗或预防肌腱受损相关疾病的功效；本发明所述线粒体或含有线粒体的组合物能够促进或加速肌腱伤口愈合，以达到加速修复受损肌腱细胞或是治疗肌腱病变的功效。
附图说明
图1为人类肌腱细胞经过氧化氢处理后分别以不同投药条件进行培养后，进行细胞存活率分析的结果。
图2为人类肌腱细胞经tBHP(叔丁基过氧化氢，tert-butyl hydroperoxide)处理后分别以不同投药条件进行培养后，进行细胞存活率分析的结果。
图3A为观察人类肌腱细胞经不同条件处理后进行细胞迁移试验的结果。
图3B为统计分析人类肌腱细胞经不同条件处理后进行细胞迁移试验的结果。
具体实施方式
本发明提供一种线粒体的第二用途，其能够用于治疗肌腱受损相关疾病及预防由肌腱受损所引起的疾病。具体来说，本发明所述线粒体具有修复受损肌腱细胞并且增加肌腱细胞愈合速率的功效，故通过投予一预定量线粒体或是含有一预定量线粒体的组合物至肌腱受损处，能够促进肌腱受损处伤口愈合，达到修复受损肌腱的功效，并进而预防因肌腱受损或发炎所导致关节疾病的发生。
一般来说，投予的线粒体剂量为5～80μg，如5、15、20、25、30、40、55、60、70、80μg，并且，线粒体在搭配不同组成份而制备为一组合物，其中，以线粒体搭配生长因子或含有生长因子的混合物为佳，例如线粒体与PRP或具有生长因子的组成份，如血液制品，混合成为一组合物。
更进一步来说，本发明所述线粒体搭配其他组成份投予至伤处，如线粒体搭配富含血小板的血浆，能够大幅提升肌腱受损处的愈合速度。
本发明所称“组合物”，是指包含有一有效量的线粒体之物，并依据使用需求或使用方法而被制备为不同型态及剂型，且得搭配不同组成份、载体、赋形剂等。
本发明所指“线粒体”，是分离自一细胞，而所使用的分离技术或方法应要能维持线粒体结构及功能的完整性，依据本发明所属技术领域者的通常知识来说，分离技术或方法可为物理性或化学性。
本发明所指“细胞”，是指具有线粒体的细胞，如脂肪干细胞、间质干细胞、骨骼肌细胞、肝脏细胞、肾脏细胞、纤维母细胞、神经细胞、皮肤细胞、血球细胞等。
本发明所称“血液制品”，是指以血液作为原料所制备而成之物，并且其内含有一定量的生长因子，例如分离自全血的富含血小板的血浆(PRP)、添加有生长因子的血液等；而此所指“一定量”为本发明所属技术领域技术人员依据现有常识可得的量；举例来说，本发明所述PRP内的血小板数目至少为1000000颗/μl，并其中包含有PDGF-BB(155.2±57.67ng/ml)、IGF-1(236.07±222.1ng/ml)、TGF-β1(488.76±240.77ng/ml)、VEGF(242.29±97.64ng/ml)、bFGF(82.24±64.51ng/ml)的生长因子；又如本发明所指血液制品的生长因子含量至少为522.54ng/ml，并其内得具有血小板，数目至少为1000000颗/μl。
本发明所称“投予”，是指将本发明所述线粒体接触受损肌腱部位，而接触受损肌腱部位的方法不限于涂抹、滴入、注射、导入等，并且，辅以外力加强或加速细胞吸收，例如超声波、震波、加热等。
本发明所称“肌腱受损相关疾病”，是指由肌腱撕裂、弹性下降、受力能力下降所产生的疾病，如肌腱炎，并由于肌腱是存在于肌肉与骨骼之间，因此，肌腱受损相关疾病会发生在身体中具有肌腱的各部位，临床上会依据肌腱所处位置而有不同适应症名称，如二头肌腱炎、肩旋转肌腱炎、膝盖髌腱炎、阿基里斯跟腱病、肩关节钙化肌腱炎等。
本发明所称“关节疾病”，其是指由肌腱发炎或受损所产生的疾病，即当肌腱受损或发炎时，会影响到肌腱所处部位(即关节处)的动作能力，并且会随着肌腱受损或发炎时间增加，而使关节病变或关节疾病发生机会大幅提升，例如若膝盖处的肌腱受损，将会影响到膝盖动作能力，如弯曲、行走等，因此，若能加速修复肌腱受损处，能够有效地预防因肌腱长期受损导致的关节疾病发生，如五十肩、退化性关节炎、膝关节炎等。
以下，为能验证本发明所述技术特征的功效，将兹举若干实施例并搭配附图作详细说明如后。
下列实施例中是以羟基脲(Hydroxyurea，HU)作为细胞增生抑制剂，进行细胞迁移试验。
实施例一：培养人类肌腱细胞
将人类肌腱细胞培养在TEN-1生长培养基(Tenocyte Growth Medium，zenbio)，而人类肌腱细胞培养前，先在培养皿上以250μg/ml的基底胶(matrixgel，厂牌:Corning，型号:354234)进行涂布(coating)处理，处理1小时后，移除基底胶并以磷酸盐缓冲液进行清洗，接着即可将人类肌腱细胞在已经涂布基底胶的TEN-1生长培养基、37℃培养箱中(5％二氧化碳环境中) 进行培养，待人类肌腱细胞长至9分满时，移除细胞培养基，并以磷酸盐缓冲液进行清洗，移除磷酸盐缓冲液，加入0.25％胰蛋白酶在37℃下反应5分钟，反应结束后加入TEN-1生长培养基中和胰蛋白酶作用，并以1000rpm离心5分钟，离心后移除上清液，加入新的TEN-1生长培养基并进行细胞计数，以利进行后续实施例。
实施例二：制备PRP
取新鲜血液至含有抗凝剂的分离管内(厂牌:BD；型号:REF362761)，以1500-2000g离心10分钟后，血液样品被分为四层，由下至上各层分别为呈红色的红血球层、分离胶、呈白色的buffy coat层(含有单核球细胞与血小板)及略为呈现黄色透明的血浆(plasma)层，收集buffy coat层与plasma层，并将所收集的buffy coat层与plasma层转移至另一分离管内，以900g离心10分钟，离心后将上层2/3的血浆移除，剩余产物均匀混匀后即为PRP。
本实施例中所制备的PRP内血小板数目每μl大于1000000颗，并包含多种生长因子，如PDGF-BB(155.2±57.67ng/ml)、IGF-1(236.07±222.1ng/ml)、TGF-β1(488.76±240.77ng/ml)、VEGF(242.29±97.64ng/ml)、bFGF(82.24±64.51ng/ml)。
为了以下实施例使用，将所制备好的PRP以5％体积加入细胞培养基或是所要注射的动物溶剂内，制备为体积百分浓度为5％的PRP溶液。
实施例三：制备线粒体
将人体脂肪干细胞培养至细胞数量为1.5x10 8个细胞，以杜氏缓冲液(DPBS)冲洗细胞后移除杜氏缓冲液，再加入胰蛋白酶反应3分钟后，加入干细胞培养液(Keratinocyte SFM(1X)液体、bovine pituitary extract、10wt％胎牛血清)终止反应，而后，收集细胞后进行离心(600g、10分钟)，移除上清液，加入80毫升的IBC-1缓冲液(缓冲液(225mM甘露醇、75mM蔗糖、0.1mM EDTA、30mMTris-HCl pH 7.4)至细胞中，进行均质后离心，得到的沉淀物即为线粒体(下称线粒体沉淀物)。将线粒体沉淀物中加入1.5毫升IBC-1缓冲液及蛋白质分解酶抑制剂，并置于4℃，供以下实施例使用。
实施例四：肌腱细胞损伤试验(一)
将实施例一中的人类肌腱细胞继代后培养在24孔盘，以每孔5×10 4cells/500μL的浓度培养8小时后，移除上清液并加入磷酸盐缓冲液进行清洗，而后移除磷酸盐缓冲液，在每孔加入体积500μL的TEN-1生长培养基并培养8小时，培养后以浓度为300μM的过氧化氢进行处理，反应4小时后将上清液移除，以磷酸盐缓冲液进行清洗，接着依组别不同而分别以下列给 药条件进行处理：加入PRP、加入线粒体(40μg)、加入线粒体(40μg)及PRP，而后各组分别进行培养24小时，培养结束后以磷酸盐缓冲液清洗后，加入含有10％阿尔玛蓝(alamarBlue)的TEN-1生长培养基(250μL/孔)，在37℃环境下培养3～4小时，培养结束后进行荧光信号测量(Excitation/Emission:560/590nm)，结果如图1所示。
由图1结果可知，未经过氧化氢处理的人类肌腱细胞(下称空白组)的细胞存活率为100.4±1.83％；以过氧化氢处理后而未投予线粒体或/及PRP的人类肌腱细胞(下称H 2O 2组)的细胞存活率为59.97±12.83％；以过氧化氢处理后而投予PRP的人类肌腱细胞(下称H 2O 2/PRP组)的细胞存活率为80.12±9.19％；以过氧化氢处理后而投予线粒体的人类肌腱细胞(下称H 2O 2/线粒体组)的细胞存活率为85.22±11.46％；以过氧化氢及线粒体处理后而投予线粒体及PRP的人类肌腱细胞(下称H 2O 2/PRP/线粒体组)的细胞存活率为99.16±11.83％。
由上述结果显示，H 2O 2组的细胞存活率明显较空白组下降，显示过氧化氢确实会使人类肌腱细胞受损而导致肌腱细胞死亡；而投予线粒体或PRP组别的细胞存活率皆明显高于过氧化氢组，并且，H 2O 2/线粒体组的细胞存活率高于H 2O 2/PRP组，亦即线粒体与PRP虽然都可以改善肌腱细胞受损而减少细胞死亡，但是线粒体对于改善肌腱细胞受损的效果较好；又，H 2O 2/PRP/线粒体组的细胞存活率几乎等于空白组，表示若在人类肌腱细胞损伤时，同时给予线粒体与PRP不仅能够改善人类肌腱细胞受损情形，更能够修复受损的人类肌腱细胞，达到治疗受损人类肌腱细胞或其相关疾病的功效。
实施例五：肌腱细胞损伤试验(二)
本实施例的流程大致等同于实施例四，但不同在于除空白组外，各组人类肌腱细胞先以浓度为300μM的tBHP(叔丁基过氧化氢，tert-butyl hydroperoxide)处理后，再依据给予各组不同给药条件并进行培养，培养结束后进行荧光信号测量(Excitation/Emission:560/590nm)，结果如图2所示。
由图2结果可知，未经tBHP处理的人类肌腱细胞(下称空白组)的细胞存活率为93.38±7.65％；以tBHP处理后而未投予线粒体或/及PRP的人类肌腱细胞(下称tBHP组)的细胞存活率为63.3±16.03％；以tBHP处理后而投予PRP的人类肌腱细胞(下称tBHP/PRP组)的细胞存活率为76.4±19.55％；以tBHP处理后而投予线粒体的人类肌腱细胞(下称tBHP/线粒体组)的细胞存活率为90.2±11.09％；以tBHP/线粒体处理后而投予线粒体及PRP的人类肌腱细胞(下称tBHP/PRP/线粒体组)的细胞存活率为97±2.29％。
由于tBHP组的细胞存活率明显较空白组下降，显示tBHP确实会使人类肌腱细胞受损而导致肌腱细胞死亡；投予线粒体或/及PRP组别的细胞存活率皆明显高于tBHP组，显示线粒体与PRP皆可以改善人类肌腱细胞经tBHP诱导所产生的损伤情形，其中，又以单独投予线粒体的改善效果优于单纯投予PRP；而当在人类肌腱细胞经tBHP处理而产生受损情形时，同时投予线粒体与PRP能够使人类肌腱细胞受损情形几乎消失，细胞存活率几乎如同空白组，亦即在人类肌腱细胞受损的情形下，同时给予线粒体与PRP能够有效地改善及修复人类肌腱细胞，达到促进或加速治疗受损人类肌腱细胞或其相关疾病的功效。
实施例六：肌腱细胞迁移试验
肌腱细胞以每5x10 4cells/500μL的细胞数培养于24孔盘中，培养24小时后，在细胞满度达9分满时，先以磷酸盐缓冲液清洗，接着在细胞中间刮出固定宽度的直线伤口，将TEN-1生长培养基及悬浮的细胞移除而更换成含有10μM羟基脲的混合细胞培养液(90％DMEM/F12+10％TEN-1生长培养基)，并依照试验设计而分别以下列不同条件进行培养24小时：加入40μg线粒体、加入5％PRP、加入5％PRP及40μg线粒体，培养后进行伤口修复愈合的观察与分析，结果如图3所示。
由图3A的结果可知，相较于未进行任何给药处理的空白组来说，给予线粒体、PRP或PRP及线粒体的人类肌腱细胞具有较好的修复效果，并且，由图3B结果可知，空白组的细胞迁移数量为100±27.58颗细胞；线粒体处理组的细胞迁移数量为211.31±42.18颗细胞；PRP处理组的细胞迁移数量为221.6±56.61颗细胞；PRP及线粒体处理组细胞迁移数量为302.06±84.97颗细胞。
由图3A及图3B的结果显示，单纯给予线粒体予受损的人类肌腱细胞能够促进肌腱伤口愈合，并且其愈合效果等同甚至优于单纯给予PRP，而若能同时投予线粒体与PRP至受损的人类肌腱细胞，能使伤口愈合的速率加倍，亦即本案所述线粒体或含有线粒体的组合物确实能够促进或加速肌腱伤口愈合，以达到加速修复受损肌腱细胞或是治疗肌腱病变的功效。
实施例七：动物试验
将12周大的雌性Sprague-Dawley(SD)大鼠饲养在22±2℃及湿度介于50％-70％的环境中，并以二型胶原蛋白酶(type 2 collagenase)诱导大鼠形成肌键损伤后，再以给予不同条件处理后观察分析其肌腱强度。
详言之，先麻醉各组大鼠后，将大鼠肩关节周围的毛发剃除干净并以70％ 酒精进行消毒，将二型胶原蛋白酶以针头及注射器以45度的角度注射至各大鼠喙突(coracoids)和锁骨(clavicle)之间的棘上肌肌腱(Supraspinatus tendon)上，其中，须以80U/8ul/1min的浓度与剂量在1分钟的时间完成注射。进行及完成注射二型胶原蛋白酶之日为试验第0天，在试验第0天开始观察及评估各大鼠肌腱损伤状况；在试验第3天分别依据组别给予不同投药条件，包含有不给药、给予线粒体(15μg)、给予PRP(5vol％)、给予线粒体(15μg)及PRP(5vol％)；在试验第7天及第14天进行肌腱强度分析；其中，本实施例中施以立式自动测试仪(JSV-H1000)评估肌腱损伤状况并分析肌腱强度，即将试验完成的各大鼠牺牲后，连同肱骨取下棘上肌腱，并将之设置在立式自动测试仪上，以10mm/min的速率进行测试，直到肌腱断裂为止的受力即为大鼠肌腱最大强度。本实施例结果如表1及表2所示。
由表1结果可知，投予二型胶原蛋白酶至第3天时，确实会观察到肌腱发炎与损伤的状况，并且，肌腱强度也明显下降，显示二型胶原蛋白酶确实会诱导肌腱发炎并肿胀，而至第7天与第14天时，观察到肌腱发炎及肿胀现象均有改善，肌腱强度也逐渐提升，但仍仅有注射当日(第0天)的一半不到。而如表2所示，试验第7天及第14天进行肌腱强度的结果可知，投予线粒体及/或PRP的大鼠肌腱发炎及受损情形较未投予任何药物来得佳，并且肌腱强度恢复得亦较好，其中，又以同时投予PRP及线粒体的肌腱强度恢复更佳。
由此结果显示，本发明所述线粒体或含有线粒体的组合物，如线粒体与PRP组成的组合物，确实具有改善肌腱发炎或肿胀的能力，并且能够促进肌腱修复的效率，在短时间内可以使受损肌腱恢复其受力能力及弹性，达到治疗或预防肌腱受损相关疾病的功效。
表1：评估肌腱损伤模式大鼠肌腱强度的结果(仅注射二型胶原蛋白酶且未投予线粒体及/或PRP)
试验天数 第0天 第3天 第7天 第14天
肌腱最大强度(N) 33.32±2.13 5.32±1.21 9.13±1.19 16.13±2.06
表2：各组大鼠于试验期间进行肌腱强度测试的结果
Figure PCTCN2021081687-appb-000001
Figure PCTCN2021081687-appb-000002

Claims (10)

  1. 一种组合物，其包含有一线粒体及一血液制品，其特征在于，该血液制品中至少包含有下列任一生长因子：PDGF-BB、IGF-1、TGF-β1、VEGF及bFGF。
  2. 如权利要求1所述组合物，其特征在于，该血液制品为一富含血小板的血浆。
  3. 如权利要求1所述组合物，其特征在于，该线粒体的剂量为5～80μg。
  4. 一种将线粒体作为制备治疗肌腱受损相关疾病组合物的用途。
  5. 如权利要求4所述用途，其特征在于，该肌腱受损相关疾病为肌腱炎。
  6. 如权利要求4所述用途，其特征在于，该肌腱受损相关疾病具有肌腱发炎或肿胀的病征。
  7. 如权利要求4所述用途，其特征在于，该肌腱受损相关疾病为肌腱病变。
  8. 如权利要求4所述用途，其特征在于，该组合物包含有一富含血小板的血浆。
  9. 一种将线粒体作为制备预防关节疾病或韧带损伤相关疾病组合物的用途，其特征在于，该关节疾病或该韧带损伤相关疾病是由肌腱受损或肌腱发炎所引起。
  10. 如权利要求9所述用途，其特征在于，该组合物包含有一富含血小板的血浆。
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