WO2022177516A1 - Nutritional powder compositions for promoting wound healing - Google Patents

Nutritional powder compositions for promoting wound healing Download PDF

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Publication number
WO2022177516A1
WO2022177516A1 PCT/TR2021/050151 TR2021050151W WO2022177516A1 WO 2022177516 A1 WO2022177516 A1 WO 2022177516A1 TR 2021050151 W TR2021050151 W TR 2021050151W WO 2022177516 A1 WO2022177516 A1 WO 2022177516A1
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composition according
hmb
powder
oil
nutritional
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PCT/TR2021/050151
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French (fr)
Inventor
Aydan OZDEN
Nur PEHLIVAN AKALIN
Fatih Sunel
Gulcan Kaplan
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Montero Gida Sanayi Ve Ticaret Anonim Sirketi
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Priority to PCT/TR2021/050151 priority Critical patent/WO2022177516A1/en
Publication of WO2022177516A1 publication Critical patent/WO2022177516A1/en

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    • 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
    • A61P17/02—Drugs for dermatological disorders for treating wounds, ulcers, burns, scars, keloids, or the like
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L3/00—Preservation of foods or foodstuffs, in general, e.g. pasteurising, sterilising, specially adapted for foods or foodstuffs
    • A23L3/40—Preservation of foods or foodstuffs, in general, e.g. pasteurising, sterilising, specially adapted for foods or foodstuffs by drying or kilning; Subsequent reconstitution
    • A23L3/46—Spray-drying
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • A23L33/115—Fatty acids or derivatives thereof; Fats or oils
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • A23L33/125—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives containing carbohydrate syrups; containing sugars; containing sugar alcohols; containing starch hydrolysates
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • A23L33/15—Vitamins
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • A23L33/16—Inorganic salts, minerals or trace elements
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • A23L33/17—Amino acids, peptides or proteins
    • A—HUMAN NECESSITIES
    • A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • A23L33/17—Amino acids, peptides or proteins
    • A23L33/175—Amino acids
    • 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
    • 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, pantothenic acid
    • A61K31/198—Alpha-aminoacids, e.g. alanine, edetic acids [EDTA]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
    • 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
    • A61K9/0087—Galenical forms not covered by A61K9/02 - A61K9/7023
    • A61K9/0095—Drinks; Beverages; Syrups; Compositions for reconstitution thereof, e.g. powders or tablets to be dispersed in a glass of water; Veterinary drenches

Definitions

  • the present invention relates nutritional powder compositions intented to benefit people who need nutritional therapy for hard-to-heal wounds.
  • Wound healing is a complex bodily process which requires specific nutrients to promote the healing process and repair the tissue.
  • Optimal wound healing demands that a person consume adequate nutrition, as nutrient deficiencies have shown a delay in the healing process and potential for infections. Malnutrition and micronutrient deficiencies can negatively affect wound healing due to the missing building blocks for tissue repair.
  • the main goal for adequate wound healing is to optimize recovery in the shortest time, with minimal discomfort, scarring, and pain for the patient.
  • Protein and carbohydrates are the main macronutrients needed to stimulate tissue synthesis. High-protein diets have been shown to aid in healing of pressure ulcers and other open wounds.
  • Nutritional powders are well known for use in providing various individuals with sole or supplemental nutrition. These powders are reconstituted with water or other aqueous liquid by the ultimate user to form a nutritional liquid or beverage. These powders most often contain varying amounts and types of proteins, carbohydrates, lipids, vitamins, and minerals, all depending largely upon the nutritional needs of the intended user.
  • Nutrition is a critical factor in the wound healing process, with adequate protein intake essential to the successful healing of a wound.
  • High protein nutritional supplements and drinks have been used for years by individuals with increased needs, such as athletes, pregnant women, patients recovering from illness or surgery and the elderly.
  • low serum albumin and body mass index BMI
  • low serum albumin and high Waterlow score have a positive association.
  • the body automatically renews tissue while we are asleep but this does not mean that protein synthesis does not take place during our wakeful hours. Holistic assessment of nutrition and early detection of malnutrition are essential to promote effective wound healing.
  • patent document numbered WO2013/106570 is directed to methods of promoting the healing of diabetic ulcers in diabetic individuals who are malnourished and/or who have a reduced blood flow to the lower extremities using a nutritional composition including beta-hydroxy-beta-methylbutyrate in combination with L-arginine and L-glutamine.
  • WO2011/094549 discloses relates to nutritional powders comprising spray dried beta-hydroxy-beta-methylbutyrate (HMB).
  • the composition as disclosed comprises L-glutamine and L-arginine.
  • This method of preparing the nutritional powder comprises forming an aqueous slurry or liquid comprising HMB and at least one of protein, carbohydrate, and fat, and then spray drying the slurry or liquid to produce a spray dried nutritional powder comprising spray dried HMB and having improved sensory properties which is very advantageous in solubilizing the raw materials.
  • the production method performed by dissolving the raw materials in solvent, forming a slurry and drying rapidly may cause chemical form transformation and chemical degradation. These conversions may alter the solubility and stability properties of the product during the process or during shelf life.
  • Homogeneous and porous powder particles are obtained by spray drying method.
  • the process is carried out by combining the material dispersed in the liquid with a sufficient volume of hot air to produce homogeneous droplets. Subsequent evaporation of the liquid leads to the formation of solid particles.
  • the feed liquid can be a solution, suspension or emulsion. This process requires complete or partial dissolution of the drug in a solvent. Therefore, it increases the possibility of phase transitions that technically involve solution mechanism. Removal of solvent from droplets takes place within seconds. This can lead to rapid crystallization of a metastable phase or the formation of an amorphous phase through the solution mechanism.
  • the solid active pharmaceutical ingredient is dissolved or partially dissolved in a solvent (typically water). If subsequent removal of solvent induces a transition, this transition mechanism is called solution transition. It is important to note that the transition molecule can evolve from the semi-unstable stage to the stable stages, or vice versa, from the stable stage to the unstable stages. After the solvent is quickly removed, the solid will regenerate from solution. The regenerated solid may not be in the same crystalline form as the original phase and may consist of a mixture of phases. Therefore, a phase transition may occur by removal of the solvent.
  • a solvent typically water
  • the final solid can be found as a single phase or a transformation of amorphous and crystalline phases.
  • Common mechanisms of drug degradation include thermolytic degradation, hydrolysis, and oxidation. Hydrolysis is the most common drug degradation mechanism in both solution and solid state, but it is catalyzed / activated better in solution and in the presence of temperature.
  • L-Arginine and L-GLutamine contain reactive functional groups such as carboxylic acid and amine. Hydrolysis of such derivatives is expected to occur in the presence of water. In particular, the presence of hydrogen or hydroxyl ions as well as high temperature catalyze hydrolytic reactions.
  • W099/66917 discloses the composition comprising beta -hydroxy-beta-methylbutyric acid (HMB) and at least one amino acid.
  • the present invention also provides a method for the treatment of disease-associated wasting of an animal, a method for decreasing the serum-level of triglycerides of an animal, a method for decreasing the serum viral load of an animal, a method for redistributing fat in an animal having a visceral region and a subcutaneous region, a method for increasing the lean tissue mass of an animal without substantially decreasing the fat mass of the animal, and a method for increasing the HDL cholesterol-level of an animal.
  • HMB beta -hydroxy-beta-methylbutyric acid
  • the state of the art does not contain any mention or motivation for a process to reduce the undesirable taste and texture caused by high protein content as much as possible to ensure complete and timely healing of wounds.
  • the high protein contents used to ensure wound healing while providing a technical solution, on the other hand creates such technical problems.
  • the state of art is insufficient for a specific process to minimize chemical form transformation and chemical degradation.
  • Another challenge with nutritional compositions is providing of mixture homogeneity which is one of the main issues while obtaining nutritional powders that rebuild lean mass and promote wound healing.
  • the main object of the present invention is to provide a production method for preparing nutritional powder compositions which eliminates all aforesaid problems and brings additional advantages to the relevant prior art.
  • the main object of the present invention is to provide a production method for preparing nutritional powder compositions intended for people who have non-healing wounds eg, pressure ulcers, venous leg ulcers, diabetic foot ulcers, burn injury, non-healing surgical incisions.
  • Another object of the present invention is to provide a production method to minimize or eliminate the undesirable taste and texture caused by the high protein content as much as possible to ensure complete and timely healing of wounds.
  • Another object of the present invention is to provide a production method to minimize chemical degradation such as hydrolysis, thermolytic degradation, oxidation.
  • Another object of the present invention is to provide a production method to obtain nutritional powder compositions which allows the powder to be wetted and dried simultaneously.
  • Another object of the present invention is to provide a production method to reduce sludge formation and over wetting problems that may occur in other granulation methods.
  • Another object of the present invention is to provide a production method to obtain nutritional powder compositions to enhance the stability and prolonged shelf-life.
  • Another object of the present invention is to provide a production method for enhancing the homogeneity of powder mixtures.
  • Another object of the present invention is to provide a production method to obtain particles with similar particle size from raw materials that are quite different in terms of particle shape, size and surface area.
  • Another object of the present invention is to provide a production method that improves the volumetric distribution of bulk raw material powders and minimizes the dusting tendency.
  • Another object of the present invention is to obtain a nutritional powder composition having balanced carbohydrate content, ensuring patient’s daily energy need.
  • Another object of the present invention is to obtain a powder nutritional composition essentially comprising water, at least one source of protein, beta-hydroxy-beta-methylbutyrate (HMB), at least one source of carbohydrate, at least one source of fat, vitamins, minerals, colorants, sweeteners, acidifiers, flavors.
  • HMB beta-hydroxy-beta-methylbutyrate
  • Another object of the present invention is to obtain a nutritional powder composition comprising beta-hydroxy-beta-methylbutyrate in combination with L-arginine, L-glutamine to rebuild lean mass and promote wound healing.
  • the present invention relates to a nutritional powder composition intented to benefit people who need nutritional therapy for hard-to-heal wounds, comprising;
  • HMB is not spray dried with fat, protein, carbohydrate and colorants.
  • nutritional powder refers to nutritional powders comprising HMB and at least one of fat, protein, and carbohydrate, which are reconstitutable with an aqueous liquid, and which are suitable for oral administration to a human.
  • hard-to-heal wounds refers to diabetic ulcer wounds, diabetic foot ulcer wounds, pressure ulcers, venous leg ulcers, burn injury, non healing surgical incisions.
  • HMB refers to beta-hydroxy-beta- methylbutyrate (also referred to as beta-hydroxyl-3-methyl butyric acid, beta-hydroxy isovaleric acid) and sources thereof.
  • the nutritional composition includes beta-hydroxy-beta-methylbutyrate, L- glutamine, and L-arginine.
  • HMB is desirably present as calcium HMB.
  • the nutritional compositions as described herein may also include one or more additional nutritional ingredients such as protein, carbohydrate, fat, vitamins, minerals, and the like along with other optional ingredients such as sweeteners, flavors, acidifiers.
  • HMB is a minor metabolite of an essential amino acid called leucine.
  • An HMB supplement contributes to protein homeostasis by downregulating degradation and increasing synthesis.
  • HMB is a precursor for cholesterol formation in the cellular membranes of skeletal muscle. Accordingly, HMB supplements are clinically recommended as a means of increasing muscular strength and lean body mass.
  • HMB supplementation has received attention due to its anti-catabolic properties, through inhibition of muscle proteolysis and enhancement of protein synthesis.
  • the aims of HMB supplementation are to counteract catabolic conditions, as well to enhance skeletal muscle mass and strength.
  • HMB has been shown to produce an important effect in reducing muscle damage induced by mechanical stimuli of skeletal muscle.
  • HMB acts as precursor to the rate-limiting enzyme HMG-coenzyme, a reductase in cholesterol synthesis, which can enhance sarcolemmal integrity.
  • HMB supplementation has a critical importance for patients with diseases associated with muscle-wasting syndromes.
  • HMB is also a proven metabolite in terms of cardiovascular health.
  • HMB supplementation resulted in a net decrease in total cholesterol (5.8%, P ⁇ 0.03), a decrease in LDL cholesterol (7.3%, P ⁇ 0.01) and a decrease in systolic blood pressure (4.4 mm Hg, P ⁇ 0.05).
  • HMB Since HMB is most often administered to individuals to support the development and maintenance of muscle mass and strength, many HMB products have been formulated with additional nutrients that may also be helpful in promoting healthy muscle. Some of these HMB products contain additional nutrients such as fat, carbohydrate, protein, vitamins, minerals and so forth.
  • the HMB component of the nutritional powders may be obtained from any HMB source suitable for use in a nutritional product.
  • HMB sources include HMB as a free acid, a salt, an anhydrous or hydrated salt, an ester, a lactone, or other forms that otherwise provide a bioavailable form of HMB from the nutritional powder
  • HMB sources include HMB salts, hydrated or anhydrous, of sodium, potassium, magnesium, chromium, calcium, or other non-toxic salt form.
  • Calcium HMB is preferred, and is most typically formulated.
  • HMB is in a form selected from the group consisting of a free acid, a salt, an ester, and a lactone.
  • HMB is in the form of a salt selected from the group consisting of a sodium salt, an anhydrous or hydrated salt, a potassium salt, a magnesium salt, a chromium salt, and a calcium salt.
  • the composition comprises calcium HMB.
  • Calcium HMB is a commonly used form of HMB when formulated in oral nutritional products, which products include tablets, capsules, reconstitutable powders, and nutritional liquids and emulsions.
  • Reconstitutable powders are particularly useful in this regard because such powders are often more shelf-stable than their liquid counterparts for extended periods even when formulated with multiple ingredients such as amino acids, carbohydrates, protein, and fat. These powders, however, often give off an undesirable taste or odor, which is especially pronounced in the headspace of packaged product immediately after opening prior to use.
  • the nutritional powders may be prepared by any collection of known or otherwise effective techniques, suitable for making and formulating a nutritional powder provided that the techniques include or are modified to include a spray drying step.
  • the spray drying step may likewise include any spray drying technique that is known for or otherwise suitable for use in the production of nutritional powders. Many different spray drying methods and techniques are known for use in the nutrition field, all of which are suitable for use in the manufacture of the nutritional powders herein.
  • One method of preparing the nutritional powder comprises obtaining a powder mixture comprising at least one of protein, carbohydrate, fat and colorant, and then spray granulation is applied by spraying a medium chain triglyceride/water mixture into the powder mixture.
  • the method may further comprise the step of spray drying, dry mixing, or otherwise adding additional nutritional ingredients, including any one or more of the ingredients described herein, to the spray dried nutritional powder.
  • the composition comprises HMB that is not spray dried with fat, protein, carbohydrate and colorants.
  • said source of protein is selected from the group comprising L- tryptophan, L-glutamine, Ltyrosine, L-methionine, L-cysteine, taurine, L-arginine, L-carnitine or mixtures thereof.
  • the composition comprises L-glutamine and L-arginine as protein sources.
  • L-glutamine is the most abundant amino acid in the plasma and is a primary metabolic fuel for rapidly proliferating cells. Although utilized by immunologically active cells and cells that are involved in wound repair, L-glutamine supplementation has not been shown to benefit wound healing.
  • L-glutamine supplementation decreases infectious complications, which is one of the clinical hallmarks of its use of immunonutrition.
  • L-glutamine protects against inflammatory injury by inducing the expression of heat shock proteins, which provide cellular protection in states of inflammation, injury, and stress.
  • L-glutamine besides being an important metabolic fuel, can also be considered an important nutritional mediator of the inflammatory response.
  • L-glutamine While L-glutamine is considered non-essential in healthy individuals, it is considered conditionally essential in metabolically stressed individuals. Injury, surgery, wounds, burns and trauma cause an increased uptake and demand for L-glutamine that exceed the body’s L- glutamine stores as well as the body’s ability to synthesize enough L-glutamine to maintain homeostasis. This adds to the cascade of decline during periods of metabolic stress.
  • L-arginine has numerous effects on immune function and wound healing. Metabolically, L-arginine is a precursor to proline, and is thus recruited specifically for collagen synthesis. It is also a precursor for ornithine, which is critical for polyamine synthesis, and for nitric oxide.
  • L-arginine availability can affect the immune response in injured states and other disease processes, establishing its role as an immunonutrient.
  • L-arginine is included in most oral, tube or parenteral feeding formulas. As a single agent, it is the best-studied component of immunonutrition, and the weight of evidence suggests that L-arginine is beneficial to wound healing.
  • HMB is combined spesifically with L-glutamine and L-arginine to rebuild lean mass and promote wound healing. They are all biocompatible components with no redundancy or competitive absorption. It has been surprisingly seen that when HMB is not spray dried with fat, protein, carbohydrate and colorants, it minimizes or eliminates undesirable taste and texture.
  • said source of carbohydrate is selected from the group comprising orange juice powder, lactose, glucose, sucrose, maltodextrin, fructose, hydrolyzed corn starch, corn syrup solids, high fructose corn syrup or mixtures thereof.
  • the composition comprises orange juice powder and sucrose.
  • Orange juice powder can be commercially included under names such as orange powder flavor, orange extract, orange dry product.
  • said source of fat is selected from the group comprising medium chain triglycerides, long-chain triglycerides, fish oil, rapeseed oil, sunflower oil, high oleic sunflower oil, safflower oil, rapeseed oil, soy oil, olive oil, canola oil, corn oil, peanut oil, rice bran oil, butter fat, hazelnut oil, structured lipids or mixtures thereof.
  • the composition comprises medium chain triglyceride.
  • said vitamins are selected from the group comprising palmitat, beta carotene, vitamin D3, vitamin E, vitamin K1 , vitamin C, folic acid, vitamin B1 , vitamin B2, vitamin B3, vitamin B5, vitamin B6, vitamin B7, vitamin B12 or mixtures thereof.
  • said minerals are selected from the group comprising sodium, potassium, chloride, calcium, phosphorus, magnesium, iron, zinc, manganese, copper, iodine, selenium, chromium, molybdenum or mixtures thereof.
  • said colorants are selected from the group comprising curcumin (turmeric), beet powder, riboflavin, carotenoids, iron oxides, lutein or mixtures thereof.
  • the composition comprises curcumin and beet powder.
  • Curcumin is the main active ingredient in turmeric. It has powerful anti-inflammatory effects and is a very strong antioxidant. It is also commercially available under the name Turmeric.
  • Formulation of poorly soluble drugs can be very challenging and problems related to content uniformity and physical stability may arise and need to be controlled. Therefore, to be able to successfully develop a process, it is necessary to pay attention to the details of every step of the whole process including formulation selection, pre blending, and granulation and drying.
  • Fluidized bed granulation is an important process to solubilize poorly soluble drugs for the pharmaceutical industry. Good content uniformity and stability can be achieved. Granules produced by fluidized bed usually have low particle density with good particle size distribution. The compressibility is usually excellent.
  • Fluidized bed granulation is also known as spray granulation, can be used in the entire powder processing industry.
  • this innovative method has known as produce smaller and porous granules than high shear wet granulation. Therefore, fluid bed granulation may be more appealing choice to process poorly soluble compounds when slow dissolution is of primary compounds.
  • Fluidized bed granulation is an innovative granulation technology, not drying technology. In this respect, it also differs from spray drying, which is one of the drying technologies.
  • the process for the preparation of powder a nutritional composition comprises the following steps:
  • the spray granulation solution is spray dried into the powder mixture, wherein HMB is not spray dried with fat, protein, carbohydrate and colorants.
  • the composition further comprises the step of adding and mixing HMB and additional ingredients after spray granulation.
  • said the additional ingredients are selected from the group comprising preservatives, anti-oxidants, buffers, pharmaceutical actives, sweeteners, prebiotics, flavors, acidifiers, thickening agents, stabilizers, emulsifying agents, lubricants, or mixtures thereof.
  • said sweeteners are selected from the group comprising sucrose, aspartame, acesulfame potassium, sodium cyclamate, sodium saccharin, sorbitol or mixtures thereof.
  • the composition comprises aspartame and acesulfame potassium.
  • a flavor as used in the pharmaceutical industry for inactive ingredients, refers to natural or artificial tastes, which may include fragrances and colors of the flavoring.
  • the composition comprises orange flavor as flavor.
  • the composition comprises citric acid as acidifier.
  • the nutritional composition includes L- Glutamine, L-Arginine, calcium HMB, orange juice powder, curcumin, beet powder, medium chain triglyceride, aspartame, sugar (sucrose), acesulfame potassium, orange flavor, citric acid, water.
  • the exemplified composition can be manufactured by blending L-arginine, L- glutamine, orange juice powder, curcumin, beet powder in the fluid bed dryer, preparing purified water and medium chain triglyceride mixture and spraying this granulation solution into the powder mixture.
  • the granules reach the desired size, they are dried until they reach the desired moisture value and taken into the mixer, adding and mixing respectively aspartame, orange flavor, acesulfame potassium, sucrose, Calcium HMB, citric acid.
  • the below given formulations can be used in the powder composition subjected to the invention.
  • Example 1 Powder composition providing complete and balanced nutrition intended to benefit people who need nutritional therapy for hard-to-heal wounds These analytically selected ratios ensure the required effective doses for the complete nutrition, toxic safety and patient compliance. Furthermore, they enhance the stability and prolonged shelf-life.

Abstract

The present invention relates nutritional powder compositions intented to benefit people who need nutritional therapy for hard-to-heal wounds.

Description

NUTRITIONAL POWDER COMPOSITIONS FOR PROMOTING WOUND HEALING
Field of Invention
The present invention relates nutritional powder compositions intented to benefit people who need nutritional therapy for hard-to-heal wounds.
The background of the invention
Wound healing is a complex bodily process which requires specific nutrients to promote the healing process and repair the tissue. Optimal wound healing demands that a person consume adequate nutrition, as nutrient deficiencies have shown a delay in the healing process and potential for infections. Malnutrition and micronutrient deficiencies can negatively affect wound healing due to the missing building blocks for tissue repair. The main goal for adequate wound healing is to optimize recovery in the shortest time, with minimal discomfort, scarring, and pain for the patient. Protein and carbohydrates are the main macronutrients needed to stimulate tissue synthesis. High-protein diets have been shown to aid in healing of pressure ulcers and other open wounds.
Nutritional powders are well known for use in providing various individuals with sole or supplemental nutrition. These powders are reconstituted with water or other aqueous liquid by the ultimate user to form a nutritional liquid or beverage. These powders most often contain varying amounts and types of proteins, carbohydrates, lipids, vitamins, and minerals, all depending largely upon the nutritional needs of the intended user.
Currently, there are a great variety of complete nutritional supplement products, of which most are targeted at routine nutrient supplement of ordinary people and some are aimed at nutrient enrichment of specific groups, like children, pregnant women, mid-aged and old people and so on. There are complete nutritional products available for meeting the metabolic needs of individuals who have wounds or are at risk for skin breakdown.
Nutrition is a critical factor in the wound healing process, with adequate protein intake essential to the successful healing of a wound. Patients with both chronic and acute wounds, such as postsurgical wounds or pressure ulcers, require an increased amount of protein to ensure complete and timely healing of their wounds. High protein nutritional supplements and drinks have been used for years by individuals with increased needs, such as athletes, pregnant women, patients recovering from illness or surgery and the elderly.
Good nutritional status is essential for wound healing to take place. Ignoring nutritional status may compromise the patient's ability to heal and subsequently prolong the stages of wound healing. Glucose provides the body with its power source for wound healing and this give energy for angiogenesis and the deposition of new tissue. Therefore, it is vital that the body receives adequate amounts of glucose to provide additional energy for wound healing. Fatty acids are essential for cell structure and have an important role in the inflammatory process. Wound healing is dependent on good nutrition and the presence of suitable polyunsaturated fatty acids in the diet. Protein deficiency has been demonstrated to contribute to poor healing rates with reduced collagen formation and wound dehiscence. Vitamins are also important in wound healing. Vitamin C deficiency contributes to fragile granulation tissue. There is a correlation between low serum albumin and body mass index (BMI) and the development of pressure ulcers. Also, low serum albumin and high Waterlow score have a positive association. The body automatically renews tissue while we are asleep but this does not mean that protein synthesis does not take place during our wakeful hours. Holistic assessment of nutrition and early detection of malnutrition are essential to promote effective wound healing.
Several high protein liquid, semi-liquid or powder products have been described or are available on the market. However, they are usually provided in a large volume necessary to achieve a high protein content. As a result, patients generally have difficulties consuming food in large volumes. Further, it is well known that a high protein content in liquid, semi-liquid or powder products results in an undesirable taste and texture.
In the patent literature also, there are nutritional compositions which are specifically formulated for different age ranges and for different objectives. They can be supplementary to a malnourishment, they can provide a complete nutrition for patients with disabilities or they can promote wound healing.
For example, in patent document numbered WO2013/106570, is directed to methods of promoting the healing of diabetic ulcers in diabetic individuals who are malnourished and/or who have a reduced blood flow to the lower extremities using a nutritional composition including beta-hydroxy-beta-methylbutyrate in combination with L-arginine and L-glutamine. Another patent document numbered WO2011/094549 discloses relates to nutritional powders comprising spray dried beta-hydroxy-beta-methylbutyrate (HMB). The composition as disclosed comprises L-glutamine and L-arginine.
This method of preparing the nutritional powder comprises forming an aqueous slurry or liquid comprising HMB and at least one of protein, carbohydrate, and fat, and then spray drying the slurry or liquid to produce a spray dried nutritional powder comprising spray dried HMB and having improved sensory properties which is very advantageous in solubilizing the raw materials.
The production method performed by dissolving the raw materials in solvent, forming a slurry and drying rapidly (possibly at very high temperature as fast drying is required) may cause chemical form transformation and chemical degradation. These conversions may alter the solubility and stability properties of the product during the process or during shelf life.
Homogeneous and porous powder particles are obtained by spray drying method. The process is carried out by combining the material dispersed in the liquid with a sufficient volume of hot air to produce homogeneous droplets. Subsequent evaporation of the liquid leads to the formation of solid particles. The feed liquid can be a solution, suspension or emulsion. This process requires complete or partial dissolution of the drug in a solvent. Therefore, it increases the possibility of phase transitions that technically involve solution mechanism. Removal of solvent from droplets takes place within seconds. This can lead to rapid crystallization of a metastable phase or the formation of an amorphous phase through the solution mechanism.
In the spray drying method, very often the solid active pharmaceutical ingredient is dissolved or partially dissolved in a solvent (typically water). If subsequent removal of solvent induces a transition, this transition mechanism is called solution transition. It is important to note that the transition molecule can evolve from the semi-unstable stage to the stable stages, or vice versa, from the stable stage to the unstable stages. After the solvent is quickly removed, the solid will regenerate from solution. The regenerated solid may not be in the same crystalline form as the original phase and may consist of a mixture of phases. Therefore, a phase transition may occur by removal of the solvent.
The final solid can be found as a single phase or a transformation of amorphous and crystalline phases. Common mechanisms of drug degradation include thermolytic degradation, hydrolysis, and oxidation. Hydrolysis is the most common drug degradation mechanism in both solution and solid state, but it is catalyzed / activated better in solution and in the presence of temperature.
L-Arginine and L-GLutamine contain reactive functional groups such as carboxylic acid and amine. Hydrolysis of such derivatives is expected to occur in the presence of water. In particular, the presence of hydrogen or hydroxyl ions as well as high temperature catalyze hydrolytic reactions.
Another patent document numbered W099/66917 discloses the composition comprising beta -hydroxy-beta-methylbutyric acid (HMB) and at least one amino acid. The present invention also provides a method for the treatment of disease-associated wasting of an animal, a method for decreasing the serum-level of triglycerides of an animal, a method for decreasing the serum viral load of an animal, a method for redistributing fat in an animal having a visceral region and a subcutaneous region, a method for increasing the lean tissue mass of an animal without substantially decreasing the fat mass of the animal, and a method for increasing the HDL cholesterol-level of an animal.
However, the state of the art does not contain any mention or motivation for a process to reduce the undesirable taste and texture caused by high protein content as much as possible to ensure complete and timely healing of wounds. In the state of the art, while the high protein contents used to ensure wound healing, while providing a technical solution, on the other hand creates such technical problems. Also, the state of art is insufficient for a specific process to minimize chemical form transformation and chemical degradation.
Another challenge with nutritional compositions is providing of mixture homogeneity which is one of the main issues while obtaining nutritional powders that rebuild lean mass and promote wound healing.
Considering the state of art, a specific manufacturing method is still needed for the production of customized nutritional compositions for malnourished patients who need to rebuild lean mass and repair damaged tissues, as well as provide complete and balanced nutrition.
Objects and Brief Description of the Invention
The main object of the present invention is to provide a production method for preparing nutritional powder compositions which eliminates all aforesaid problems and brings additional advantages to the relevant prior art. The main object of the present invention is to provide a production method for preparing nutritional powder compositions intended for people who have non-healing wounds eg, pressure ulcers, venous leg ulcers, diabetic foot ulcers, burn injury, non-healing surgical incisions.
Another object of the present invention is to provide a production method to minimize or eliminate the undesirable taste and texture caused by the high protein content as much as possible to ensure complete and timely healing of wounds.
Another object of the present invention is to provide a production method to minimize chemical degradation such as hydrolysis, thermolytic degradation, oxidation.
Another object of the present invention is to provide a production method to obtain nutritional powder compositions which allows the powder to be wetted and dried simultaneously.
Another object of the present invention is to provide a production method to reduce sludge formation and over wetting problems that may occur in other granulation methods.
Another object of the present invention is to provide a production method to obtain nutritional powder compositions to enhance the stability and prolonged shelf-life.
Another object of the present invention is to provide a production method for enhancing the homogeneity of powder mixtures.
Another object of the present invention is to provide a production method to obtain particles with similar particle size from raw materials that are quite different in terms of particle shape, size and surface area.
Another object of the present invention is to provide a production method that improves the volumetric distribution of bulk raw material powders and minimizes the dusting tendency.
Another object of the present invention is to obtain a nutritional powder composition having balanced carbohydrate content, ensuring patient’s daily energy need.
Another object of the present invention is to obtain a powder nutritional composition essentially comprising water, at least one source of protein, beta-hydroxy-beta-methylbutyrate (HMB), at least one source of carbohydrate, at least one source of fat, vitamins, minerals, colorants, sweeteners, acidifiers, flavors.
Another object of the present invention is to obtain a nutritional powder composition comprising beta-hydroxy-beta-methylbutyrate in combination with L-arginine, L-glutamine to rebuild lean mass and promote wound healing.
Detailed description of the invention
In accordance with the objects outlined above, detailed features of the present invention are given herein.
The present invention relates to a nutritional powder composition intented to benefit people who need nutritional therapy for hard-to-heal wounds, comprising;
- water
- at least one source of protein,
- at least one source of carbohydrate,
- at least one source of fat,
- HMB,
- vitamins,
- minerals,
- colorants, wherein HMB is not spray dried with fat, protein, carbohydrate and colorants.
The term "nutritional powder" as used herein, unless otherwise specified, refers to nutritional powders comprising HMB and at least one of fat, protein, and carbohydrate, which are reconstitutable with an aqueous liquid, and which are suitable for oral administration to a human.
The term "hard-to-heal wounds" as used herein, unless otherwise specified, refers to diabetic ulcer wounds, diabetic foot ulcer wounds, pressure ulcers, venous leg ulcers, burn injury, non healing surgical incisions.
The term "HMB" as used herein, unless otherwise specified, refers to beta-hydroxy-beta- methylbutyrate (also referred to as beta-hydroxyl-3-methyl butyric acid, beta-hydroxy isovaleric acid) and sources thereof. In one embodiment, the nutritional composition includes beta-hydroxy-beta-methylbutyrate, L- glutamine, and L-arginine. HMB is desirably present as calcium HMB. The nutritional compositions as described herein may also include one or more additional nutritional ingredients such as protein, carbohydrate, fat, vitamins, minerals, and the like along with other optional ingredients such as sweeteners, flavors, acidifiers.
In addition to achieving adequate protein intake, it is recommended that wound care patients take the HMB supplements. HMB is a minor metabolite of an essential amino acid called leucine. An HMB supplement contributes to protein homeostasis by downregulating degradation and increasing synthesis. Furthermore, HMB is a precursor for cholesterol formation in the cellular membranes of skeletal muscle. Accordingly, HMB supplements are clinically recommended as a means of increasing muscular strength and lean body mass.
This metabolite has received attention due to its anti-catabolic properties, through inhibition of muscle proteolysis and enhancement of protein synthesis. The aims of HMB supplementation are to counteract catabolic conditions, as well to enhance skeletal muscle mass and strength. Moreover, HMB has been shown to produce an important effect in reducing muscle damage induced by mechanical stimuli of skeletal muscle. HMB acts as precursor to the rate-limiting enzyme HMG-coenzyme, a reductase in cholesterol synthesis, which can enhance sarcolemmal integrity. For these reasons, HMB supplementation has a critical importance for patients with diseases associated with muscle-wasting syndromes.
Besides, HMB is also a proven metabolite in terms of cardiovascular health. In literature researches, compared with the placebo, HMB supplementation resulted in a net decrease in total cholesterol (5.8%, P < 0.03), a decrease in LDL cholesterol (7.3%, P < 0.01) and a decrease in systolic blood pressure (4.4 mm Hg, P < 0.05). These effects of HMB on surrogate markers of cardiovascular health could result in a decrease in the risk of heart attack and stroke.
Since HMB is most often administered to individuals to support the development and maintenance of muscle mass and strength, many HMB products have been formulated with additional nutrients that may also be helpful in promoting healthy muscle. Some of these HMB products contain additional nutrients such as fat, carbohydrate, protein, vitamins, minerals and so forth.
The HMB component of the nutritional powders may be obtained from any HMB source suitable for use in a nutritional product. Such sources include HMB as a free acid, a salt, an anhydrous or hydrated salt, an ester, a lactone, or other forms that otherwise provide a bioavailable form of HMB from the nutritional powder
Non-limiting examples of suitable HMB sources include HMB salts, hydrated or anhydrous, of sodium, potassium, magnesium, chromium, calcium, or other non-toxic salt form. Calcium HMB is preferred, and is most typically formulated.
According to an embodiment, HMB is in a form selected from the group consisting of a free acid, a salt, an ester, and a lactone.
According to an embodiment, HMB is in the form of a salt selected from the group consisting of a sodium salt, an anhydrous or hydrated salt, a potassium salt, a magnesium salt, a chromium salt, and a calcium salt.
According to an embodiment, the composition comprises calcium HMB.
Calcium HMB is a commonly used form of HMB when formulated in oral nutritional products, which products include tablets, capsules, reconstitutable powders, and nutritional liquids and emulsions. Reconstitutable powders are particularly useful in this regard because such powders are often more shelf-stable than their liquid counterparts for extended periods even when formulated with multiple ingredients such as amino acids, carbohydrates, protein, and fat. These powders, however, often give off an undesirable taste or odor, which is especially pronounced in the headspace of packaged product immediately after opening prior to use.
The nutritional powders may be prepared by any collection of known or otherwise effective techniques, suitable for making and formulating a nutritional powder provided that the techniques include or are modified to include a spray drying step.
The spray drying step may likewise include any spray drying technique that is known for or otherwise suitable for use in the production of nutritional powders. Many different spray drying methods and techniques are known for use in the nutrition field, all of which are suitable for use in the manufacture of the nutritional powders herein.
One method of preparing the nutritional powder comprises obtaining a powder mixture comprising at least one of protein, carbohydrate, fat and colorant, and then spray granulation is applied by spraying a medium chain triglyceride/water mixture into the powder mixture. The method may further comprise the step of spray drying, dry mixing, or otherwise adding additional nutritional ingredients, including any one or more of the ingredients described herein, to the spray dried nutritional powder.
According to an embodiment, the composition comprises HMB that is not spray dried with fat, protein, carbohydrate and colorants.
According to an embodiment, said source of protein is selected from the group comprising L- tryptophan, L-glutamine, Ltyrosine, L-methionine, L-cysteine, taurine, L-arginine, L-carnitine or mixtures thereof.
According to the preferred embodiment, the composition comprises L-glutamine and L-arginine as protein sources.
L-glutamine is the most abundant amino acid in the plasma and is a primary metabolic fuel for rapidly proliferating cells. Although utilized by immunologically active cells and cells that are involved in wound repair, L-glutamine supplementation has not been shown to benefit wound healing.
L-glutamine supplementation decreases infectious complications, which is one of the clinical hallmarks of its use of immunonutrition. L-glutamine protects against inflammatory injury by inducing the expression of heat shock proteins, which provide cellular protection in states of inflammation, injury, and stress. L-glutamine, besides being an important metabolic fuel, can also be considered an important nutritional mediator of the inflammatory response.
While L-glutamine is considered non-essential in healthy individuals, it is considered conditionally essential in metabolically stressed individuals. Injury, surgery, wounds, burns and trauma cause an increased uptake and demand for L-glutamine that exceed the body’s L- glutamine stores as well as the body’s ability to synthesize enough L-glutamine to maintain homeostasis. This adds to the cascade of decline during periods of metabolic stress.
Multiple studies show that the translocation of L-glutamine from the gut to the liver and spleen creates a deficiency associated with atrophy of mucosa cells and loss of gut immune cells. This loss of gut integrity has a severe negative impact on wound healing due to decreased nutrient absorption, increased gut permeability and decreased immune function. Multiple studies show that endogenous L-glutamine supplementation at levels of 0.3 to 0.5 g/kg/d divided across two or three doses significantly increased the height of villi in both jejunum and ileum to restore gut function- an important factor in wound healing.
Similarly, L-arginine has numerous effects on immune function and wound healing. Metabolically, L-arginine is a precursor to proline, and is thus recruited specifically for collagen synthesis. It is also a precursor for ornithine, which is critical for polyamine synthesis, and for nitric oxide.
Numerous studies in rodents and humans show that supplemental L-arginine, administered either orally or parenterally, accelerates wound healing mainly by increasing collagen deposition in wounds. Not only is collagen accumulation increased by L-arginine supplementation, but peripheral blood lymphocytes show increased mitogenesis and activity as well.
L-arginine availability can affect the immune response in injured states and other disease processes, establishing its role as an immunonutrient. In clinical practice, L-arginine is included in most oral, tube or parenteral feeding formulas. As a single agent, it is the best-studied component of immunonutrition, and the weight of evidence suggests that L-arginine is beneficial to wound healing.
In the light of these information, HMB is combined spesifically with L-glutamine and L-arginine to rebuild lean mass and promote wound healing. They are all biocompatible components with no redundancy or competitive absorption. It has been surprisingly seen that when HMB is not spray dried with fat, protein, carbohydrate and colorants, it minimizes or eliminates undesirable taste and texture.
According to one embodiment, said source of carbohydrate is selected from the group comprising orange juice powder, lactose, glucose, sucrose, maltodextrin, fructose, hydrolyzed corn starch, corn syrup solids, high fructose corn syrup or mixtures thereof.
In the preferred embodiment; the composition comprises orange juice powder and sucrose.
Orange juice powder can be commercially included under names such as orange powder flavor, orange extract, orange dry product.
According to one embodiment, said source of fat is selected from the group comprising medium chain triglycerides, long-chain triglycerides, fish oil, rapeseed oil, sunflower oil, high oleic sunflower oil, safflower oil, rapeseed oil, soy oil, olive oil, canola oil, corn oil, peanut oil, rice bran oil, butter fat, hazelnut oil, structured lipids or mixtures thereof.
In the preferred embodiment; the composition comprises medium chain triglyceride.
According the one embodiment, said vitamins are selected from the group comprising palmitat, beta carotene, vitamin D3, vitamin E, vitamin K1 , vitamin C, folic acid, vitamin B1 , vitamin B2, vitamin B3, vitamin B5, vitamin B6, vitamin B7, vitamin B12 or mixtures thereof.
According the one embodiment, said minerals are selected from the group comprising sodium, potassium, chloride, calcium, phosphorus, magnesium, iron, zinc, manganese, copper, iodine, selenium, chromium, molybdenum or mixtures thereof.
According the preferred embodiment, said colorants are selected from the group comprising curcumin (turmeric), beet powder, riboflavin, carotenoids, iron oxides, lutein or mixtures thereof.
In the preferred embodiment; the composition comprises curcumin and beet powder.
Curcumin is the main active ingredient in turmeric. It has powerful anti-inflammatory effects and is a very strong antioxidant. It is also commercially available under the name Turmeric.
It has been also observed that the particle size and homogeneity of curcumin are improved by spray granulation.
Formulation of poorly soluble drugs can be very challenging and problems related to content uniformity and physical stability may arise and need to be controlled. Therefore, to be able to successfully develop a process, it is necessary to pay attention to the details of every step of the whole process including formulation selection, pre blending, and granulation and drying.
Fluidized bed granulation is an important process to solubilize poorly soluble drugs for the pharmaceutical industry. Good content uniformity and stability can be achieved. Granules produced by fluidized bed usually have low particle density with good particle size distribution. The compressibility is usually excellent.
Fluidized bed granulation, is also known as spray granulation, can be used in the entire powder processing industry. In the pharmaceutical industry, this innovative method has known as produce smaller and porous granules than high shear wet granulation. Therefore, fluid bed granulation may be more appealing choice to process poorly soluble compounds when slow dissolution is of primary compounds.
Fluidized bed granulation is an innovative granulation technology, not drying technology. In this respect, it also differs from spray drying, which is one of the drying technologies.
According to one embodiment, the process for the preparation of powder a nutritional composition comprises the following steps:
- mixing L-glutamine, L-arginine, orange juice powder, curcumin and beet powder to obtain a powder mixture in the fluid bed dryer,
- preparing of a spray granulation solution comprising water and medium chain triglyceride,
- and the spray granulation solution is spray dried into the powder mixture, wherein HMB is not spray dried with fat, protein, carbohydrate and colorants.
It has been surprisingly seen that the stability is enhanced by successively applying the process steps in this way.
In the preferred embodiment; the composition further comprises the step of adding and mixing HMB and additional ingredients after spray granulation.
In the preferred embodiment; said the additional ingredients are selected from the group comprising preservatives, anti-oxidants, buffers, pharmaceutical actives, sweeteners, prebiotics, flavors, acidifiers, thickening agents, stabilizers, emulsifying agents, lubricants, or mixtures thereof.
According to one embodiment, said sweeteners are selected from the group comprising sucrose, aspartame, acesulfame potassium, sodium cyclamate, sodium saccharin, sorbitol or mixtures thereof.
In the preferred embodiment; the composition comprises aspartame and acesulfame potassium.
A flavor, as used in the pharmaceutical industry for inactive ingredients, refers to natural or artificial tastes, which may include fragrances and colors of the flavoring.
In the preferred embodiment; the composition comprises orange flavor as flavor. In the preferred embodiment; the composition comprises citric acid as acidifier.
In one specific embodiment of the present disclosure, the nutritional composition includes L- Glutamine, L-Arginine, calcium HMB, orange juice powder, curcumin, beet powder, medium chain triglyceride, aspartame, sugar (sucrose), acesulfame potassium, orange flavor, citric acid, water.
In general, the exemplified composition can be manufactured by blending L-arginine, L- glutamine, orange juice powder, curcumin, beet powder in the fluid bed dryer, preparing purified water and medium chain triglyceride mixture and spraying this granulation solution into the powder mixture. When the granules reach the desired size, they are dried until they reach the desired moisture value and taken into the mixer, adding and mixing respectively aspartame, orange flavor, acesulfame potassium, sucrose, Calcium HMB, citric acid.
According to all these embodiments, the below given formulations can be used in the powder composition subjected to the invention.
Example 1 : Powder composition providing complete and balanced nutrition intended to benefit people who need nutritional therapy for hard-to-heal wounds
Figure imgf000014_0001
These analytically selected ratios ensure the required effective doses for the complete nutrition, toxic safety and patient compliance. Furthermore, they enhance the stability and prolonged shelf-life.

Claims

1. A nutritional powder composition intented to benefit people who need nutritional therapy for hard-to-heal wounds, comprising;
- water
- at least one source of protein,
- at least one source of carbohydrate,
- at least one source of fat,
- HMB,
- vitamins,
- minerals,
- colorants, wherein HMB is not spray dried with fat, protein, carbohydrate and colorants.
2. The composition according to claim 1, wherein said source of protein is selected from the group comprising L-tryptophan, L-glutamine, Ltyrosine, L-methionine, L-cysteine, taurine, L-arginine, L-carnitine or mixtures thereof.
3. The composition according to claim 2, wherein the composition comprises L-glutamine and L-arginine.
4. The composition according to claim 1 , wherein said source of carbohydrate is selected from the group comprising orange juice powder, lactose, glucose, sucrose, maltodextrin, fructose, hydrolyzed corn starch, corn syrup solids, high fructose corn syrup or mixtures thereof.
5. The composition according to claim 4, wherein the composition comprises orange juice powder and sucrose.
6. The composition according to claim 1, wherein said source of fat is selected from the group comprising medium chain triglycerides, long-chain triglycerides, fish oil, rapeseed oil, sunflower oil, high oleic sunflower oil, safflower oil, rapeseed oil, soy oil, olive oil, canola oil, corn oil, peanut oil, rice bran oil, butter fat, hazelnut oil, structured lipids or mixtures thereof.
7. The composition according to claim 6, wherein the composition comprises medium chain triglyceride.
8. The composition according to claim 1, wherein said HMB is in a form selected from the group consisting of a free acid, a salt, an ester, and a lactone.
9. The composition according to claim 8, wherein said HMB is in the form of a salt selected from the group consisting of a sodium salt, an anhydrous or hydrated salt, a potassium salt, a magnesium salt, a chromium salt, and a calcium salt.
10. The composition according to claim 8, wherein said HMB comprises calcium HMB.
11. The composition according to claim 1, wherein said colorants are selected from the group comprising curcumin, beet powder, riboflavin, carotenoids, iron oxides, lutein or mixtures thereof.
12. The composition according to claim 11, wherein the composition comprises curcumin and beet powder.
13. The process for the preparation of a nutritional powder composition according to claim 1, wherein the process comprises the following steps:
- mixing L-glutamine, L-arginine, orange juice powder, curcumin and beet powder to obtain a powder mixture in the fluid bed dryer,
- preparing of a spray granulation solution comprising water and medium chain triglyceride,
- and the spray granulation solution is spray dried into the powder mixture wherein HMB is not spray dried with fat, protein, carbohydrate and colorants.
14. The process for the preparation of a nutritional powder composition according to claim
13, the composition further comprises the step of adding and mixing HMB and additional ingredients after spray granulation.
15. The process for the preparation of a nutritional powder composition according to claim
14, wherein the additional ingredients are selected from the group comprising preservatives, anti-oxidants, buffers, pharmaceutical actives, sweeteners, prebiotics, flavors, acidifiers, thickening agents, stabilizers, emulsifying agents, lubricants, or mixtures thereof.
16. The composition according to claim 15, wherein said sweeteners are selected from the group comprising sucrose, aspartame, acesulfame potassium, sodium cyclamate, sodium saccharin, sorbitol or mixtures thereof.
17. The composition according to claim 16, wherein the composition comprises aspartame and acesulfame potassium.
18. The composition according to claim 15, wherein the composition comprises orange flavor.
19. The composition according to to claim 15, wherein the composition comprises citric acid.
PCT/TR2021/050151 2021-02-17 2021-02-17 Nutritional powder compositions for promoting wound healing WO2022177516A1 (en)

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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2013106570A1 (en) * 2012-01-11 2013-07-18 Abbott Laboratories Combination of beta-hydroxy-beta-methylbutyrate, arginine and glutamine for use in treating diabetic ulcers
US20140030420A1 (en) * 2010-01-29 2014-01-30 Abbott Laboratories Nutritional powders comprising spray dried hmb
JP2020184922A (en) * 2019-05-14 2020-11-19 オルガノフードテック株式会社 Hmb-containing composition, hmb-containing composition manufacturing method, hmb-containing preparation, hmb-containing preparation manufacturing method, hmb-containing food, and hmb-containing food manufacturing method

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20140030420A1 (en) * 2010-01-29 2014-01-30 Abbott Laboratories Nutritional powders comprising spray dried hmb
WO2013106570A1 (en) * 2012-01-11 2013-07-18 Abbott Laboratories Combination of beta-hydroxy-beta-methylbutyrate, arginine and glutamine for use in treating diabetic ulcers
JP2020184922A (en) * 2019-05-14 2020-11-19 オルガノフードテック株式会社 Hmb-containing composition, hmb-containing composition manufacturing method, hmb-containing preparation, hmb-containing preparation manufacturing method, hmb-containing food, and hmb-containing food manufacturing method

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