WO2023183816A2 - Compositions and methods for promoting wound healing and minimizing scarring - Google Patents
Compositions and methods for promoting wound healing and minimizing scarring Download PDFInfo
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- WO2023183816A2 WO2023183816A2 PCT/US2023/064780 US2023064780W WO2023183816A2 WO 2023183816 A2 WO2023183816 A2 WO 2023183816A2 US 2023064780 W US2023064780 W US 2023064780W WO 2023183816 A2 WO2023183816 A2 WO 2023183816A2
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0014—Skin, i.e. galenical aspects of topical compositions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K38/00—Medicinal preparations containing peptides
- A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
- A61K38/18—Growth factors; Growth regulators
- A61K38/1808—Epidermal growth factor [EGF] urogastrone
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K38/00—Medicinal preparations containing peptides
- A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
- A61K38/177—Receptors; Cell surface antigens; Cell surface determinants
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- A—HUMAN NECESSITIES
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- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K38/00—Medicinal preparations containing peptides
- A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
- A61K38/19—Cytokines; Lymphokines; Interferons
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- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/44—Oils, fats or waxes according to two or more groups of A61K47/02-A61K47/42; Natural or modified natural oils, fats or waxes, e.g. castor oil, polyethoxylated castor oil, montan wax, lignite, shellac, rosin, beeswax or lanolin
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/06—Ointments; Bases therefor; Other semi-solid forms, e.g. creams, sticks, gels
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- 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
- A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
- A61K9/4841—Filling excipients; Inactive ingredients
- A61K9/4866—Organic macromolecular compounds
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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
Definitions
- SUMMARY Controlled delivery methods and compositions that enhance wound healing (such as wound closure) and reduce fibrotic scarring are described.
- methods of treating a wound such as a dermal wound or a mucosal wound, in a subject by administering to the subject a therapeutically effective amount of a first agent that promotes wound closure and a therapeutically effective amount of a second agent that inhibits scarring.
- the first agent is administered to the subject prior to administration of the second agent, for example 1 day to 3 weeks prior to administration of the second agent.
- the first agent and the second agent are administered concurrently in a controlled delivery composition that permits rapid release of the first agent and delayed release of the second agent.
- the controlled delivery composition includes a hydrogel, and the hydrogel includes (i) the first agent, and (ii) the second agent which is encapsulated in a coacervate, such that upon administration of the controlled delivery composition, the first agent is released from the hydrogel at a faster rate than the second agent is released from the coacervate.
- the controlled delivery composition includes a first coacervate that includes the first agent; a second coacervate that includes the second agent, wherein the second coacervate is encapsulated by lipids, thereby forming a lipo-coacervate, such that upon administration of the controlled delivery composition, the first agent is released from the first coacervate prior to release of the second agent from the lipo-coacervate.
- the controlled delivery composition includes a first coacervate that includes the first agent, wherein the first coacervate is encapsulated by lipids, thereby forming a first lipo-coacervate; and a second coacervate that includes the second agent, wherein the second coacervate is encapsulated by lipids, thereby forming a second lipo- coacervate, such that upon administration of the controlled delivery composition, the first agent is released from the first lipo-coacervate prior to release of the second agent from the second lipo-coacervate.
- controlled delivery compositions for treating a wound that include a therapeutically effective amount of a first agent that promotes wound closure and a therapeutically effective amount of a second agent that inhibits scarring, such that the controlled delivery compositions permit rapid release of the first agent and delayed release of the second agent.
- the controlled delivery composition includes a hydrogel, wherein the hydrogel includes the first agent and the second agent encapsulated in a coacervate, such that upon administration of the controlled delivery composition, the first agent is released from the hydrogel prior to release of the second agent from the coacervate.
- the controlled delivery composition includes a first coacervate that includes the first agent, a second coacervate that includes the second agent, wherein the second coacervate is encapsulated by lipids, thereby forming a lipo-coacervate, such that upon administration of the controlled delivery composition, the first agent is released from the first coacervate prior to release of the second agent from the lipo-coacervate.
- the controlled delivery composition includes a first coacervate that includes the first agent, wherein the first coacervate is encapsulated by lipids, thereby forming a first lipo-coacervate; and a second coacervate that includes the second agent, wherein the second coacervate is encapsulated by lipids, thereby forming a second lipo-coacervate, such that upon administration of the controlled delivery composition, the first agent is released from the first lipo-coacervate prior to release of the second agent from the second lipo-coacervate.
- FIGS.1A-1D Tenascin-C (TNC) protects mesenchymal stem cells (MSCs) against ischemic conditions in vitro. MSCs were seeded onto either plastic, collagen type 1 (Col-1), or TNC+Col-1 coated plates and placed under hypoxia and nutrient deprivation (H/ND) conditions for up to 9 days.
- FIG.1A Flow cytometry dot blot of MSCs stained with Annexin V and propidium iodide (PI) at day 7 H/ND where apoptosis begins to take effect.
- FIG.1B Quantification of flow data normalized to counting beads expressed as cells negatively stained for Annexin and PI.
- FIG.1C MSC live cell staining at day 7 for caspase 3/7 and
- FIG.1D quantification using ImageJ software to find % positive caspase 3/7 staining. Quantification in FIG.1C and FIG.1D are shown as mean ⁇ SD. *p ⁇ 0.05, **p ⁇ 0.01, ***p ⁇ 0.001. The scale bar for all images is 100 ⁇ m. Cytometry was performed three times, staining was performed three times, each in duplicate.
- FIGS.2A-2D MSC-TNC conditioned media (CM) improves endothelial cell cord formation and motility.
- CM MSC-TNC conditioned media
- FIG.2A Cord assay was performed by collecting 96-hour CM and mixing with human dermal microvascular endothelial cells (HMEC-1) at 2x10 5 cells per well onto growth factor reduced Matrigel in ibidi angiogenesis slides. Images were taken 6 hours post-seeding and quantified using ImageJ Angiogenesis Analyzer for (FIG.2B) the total number of cords, total cord length, number of meshes, total mesh area.
- HMEC-1 human dermal microvascular endothelial cells
- FIG.2C CM was also used to determine the pro-migration effects on HMEC-1 across a denuded area with images being taken at 0- and 24-hour time points and
- FIG.2D ImageJ quantification for % wound closure for each treatment group. Quantification in FIG.2B and FIG.2D are shown as mean ⁇ s.e.m. *p ⁇ 0.05, **p ⁇ 0.01, ***p ⁇ 0.001. The scale bar for all images is 400 ⁇ m. The experiments were performed twice, each in triplicate.
- FIGS.3A-3C Evaluation and comparison of pro-angiogenic factors for MSC paracrine activity. MSCs were seeded onto either plastic, Col-1, or TNC+Col-1 coated plates and placed under H/ND conditions.
- FIG.3A CM was collected at 96 hours and analyzed using a Human Angiogenesis Array Kit and (FIG.3B) quantified for relative expression compared to positive control spots.
- FIG.3C Parallel run treatment plates were harvested at 48 hours for mRNA, processed into cDNA, and quantified using qPCR for expression differences in cytokine targets found in the CM. Gene expression profiles are displayed in terms of fold-regulation. Quantification in FIG.3B is shown as mean ⁇ SD. *p ⁇ 0.05, **p ⁇ 0.01, ***p ⁇ 0.001. All experiments were performed twice, in duplicate.
- FIGS.4A-4G Assessment of the tissue replacement phase of CXCR3 -/- mice treated with matricellular protein TNC and MSCs embedded in coacervate. Representative histological sections of Day 30 wounds stained with (FIG.4A) H&E and (FIG.4B) Masson's trichrome (MT) at 10x and 40x magnification. (FIG.4C) Immunohistochemistry of CD31 at 20x magnification to assess capillary density 8123-107870-02 and (FIG.4D) quantification of capillary density (Capillaries / mm 2 ) using 5 sample images per treatment group.
- FIGS.4A-4G Assessment of the tissue replacement phase of CXCR3 -/- mice treated with matricellular protein TNC and MSCs embedded in coacervate. Representative histological sections of Day 30 wounds stained with (FIG.4A) H&E and (FIG.4B) Masson's trichrome (MT) at 10x and 40x
- FIG.4E Quantification of wound healing score and wound thickness measurement for (FIG.4F) dermal and (FIG.4G) epidermal skin layers. Quantification in FIG.4E is shown as mean ⁇ SD, whereas FIGS.4D, 4F, and 4G are shown as mean ⁇ SEM. *p ⁇ 0.05, **p ⁇ 0.01, ***p ⁇ 0.001. Scale bar for all images is 100 ⁇ m. There were four mice per group.
- FIGS.5A-5F Assessment of collagen alignment and maturation in CXCR3 -/- mice treated with matricellular protein TNC and MSCs embedded in coacervate.
- FIGS.5A-5F Assessment of collagen alignment and maturation in CXCR3 -/- mice treated with matricellular protein TNC and MSCs embedded in coacervate.
- FIGS.5A-5F Assessment of collagen alignment and maturation in CXCR3 -/- mice treated with matricellular protein TNC and MSCs embedded in coacervate.
- FIG.5B Polarized light microscopy of picrosirius red-stained sections reveals the birefringence properties of collagen type 1 and collagen type III.
- FIG.5C OrientationJ color survey of PSR polarized images pseudo-colored for orientation alignment.
- FIG.6 Confirmation of hypoxia in Biospherix culture system. MSCs were seeded onto either plastic, Col-1, or TNC+Col-1 coated plates and placed under H/ND conditions. A live cell hypoxia probe was used on parallel plated immortalized bone marrow mesenchymal stem cell (IHMSC) plates, one at 21% ambient oxygen levels and one at 1% hypoxic oxygen levels. Images were taken 6 hours post exposure to hypoxia conditions. This served as a back-up method for checking if the Biospherix instrumentation was working properly.
- IHMSC immortalized bone marrow mesenchymal stem cell
- FIGS.7A-7C Coacervate delivery study of matricellular protein TNC and MSCs on delayed wound healing mouse model.
- FIG.7A Overview schematic demonstrating the preparation of the coacervate-TNC + MSC delivery to an in vivo mouse skin wound model.
- FIG.7B ELISA exhibited a % cumulative release of TNC from coacervate over 14 days.
- FIG.7C Overview of mouse wound healing timeline for wounding procedure and harvesting. There were 5 treatment groups (coacervate (CO) only, CO+TNC, CO+MSC, TNC+MSC, or CO+TNC+MSC), with each group having 4 animals.
- FIGS.8A-8B Time course comparison of culture treatments on MSC survival during H/ND in vitro. MSCs were seeded onto either plastic, Col-1, or TNC+Col-1 coated plates and placed under H/ND conditions for up to 9 days.
- FIG.8A PI analysis to assess percent survival among the different MSC treatment groups.
- FIG.8B Flow cytometry dot plot of MSCs stained with Annexin V and PI at days 5, 7, and 9 where MSCs start to undergo apoptosis. Quantification using ImageJ software to find % positive PI staining in FIG.8A and is expressed as mean ⁇ SD. Two-way ANOVA was used to distinguish significance during the time course.
- FIGS.9A-9C RT-PCR analysis of MSCs on different seeding conditions during H/ND. MSCs were seeded onto either plastic, Col-1, or TNC+Col-1 coated plates and placed under H/ND growth 8123-107870-02 conditions for 48 hours. mRNA was isolated and reverse transcribed to generate cDNA of each sample and run on a (FIG.9A) human angiogenesis profiler array and a (FIG.9B) human wound healing profiler array. Gene expression profiles are displayed in terms of fold-regulation.
- FIGS.10A-10C Coacervate delivery study of matricellular proteins on hypertrophic mouse scarring model.
- FIG.10A Overview schematic demonstrating the preparation of the coacervate-decorin delivery to an in vivo mouse skin wound model.
- ELISA exhibited % cumulative release of (FIG.10B) decorin and
- FIG.10C heparin-binding EGF-like growth factor (HB-EGF) from coacervate over 14 days.
- FIGS.11A-11H Early wound healing phase assessment of CXCR3 -/- mice treated with matricellular proteins embedded in coacervate.
- FIG.11A Representative histological sections of wounds stained with (FIG.11A) H&E and (FIG.11B) MT at 10x and 40x magnification.
- FIG.11C Quantification of % wound closure obtained from ImageJ distance analysis on H&E and MT image sets between the leading edge of the epidermal tongues on each side of the eschar.
- FIG.11D Immunofluorescent stain of Involucrin at 10x magnification for epidermal maturation evaluation. Quantification of (FIG.11E) wound healing score and (FIG.11F) wound thickness measurement for epidermal and dermal skin layers.
- FIGS.12A-12H Assessment of the tissue replacement phase of CXCR3 -/- mice treated with matricellular proteins embedded in coacervate. Representative histological sections of wounds stained with (FIG.12A) H&E and (FIG.12B) MT at 10x and 40x magnification.
- FIG.12C Quantification of (FIG.12C) wound healing score and (FIG.12D) wound thickness measurement for epidermal and dermal skin layers.
- FIG. 12E Immunohistochemistry of Collagen IV at 60x magnification to assess the formation of the basement membrane.
- FIG.12F Immunofluorescent stain of Involucrin at 10x magnification for epidermal maturation evaluation.
- FIG.12G Immunofluorescent stain of CD31 at 40x magnification with vasculature highlighted by white arrows.
- FIG.12H Quantification of capillary density (capillaries/mm 2 ). Quantification in FIG.
- FIGS.13A-13J Assessment of the resolution phase of CXCR3 -/- mice treated with matricellular proteins embedded in coacervate. Representative histological sections of wounds stained with (FIG.13A) H&E and (FIG.13B) MT at 10x and 40x magnification. Quantification of (FIG.13C) wound healing score and (FIG.13D) wound thickness measurement for epidermal and dermal skin layers. Quantification in FIG.
- FIG.13E Brightfield images of PSR staining at 20x magnification.
- FIG.13F Polarized light microscopy of PSR-stained sections revealing the birefringence properties of collagen type 1 and collagen type III.
- FIG.13G Image J Quantification of PSR polarized images to assess collagen maturation as displayed by the Col-1/Col-III ratio shown as mean ⁇ SD (n > 7).
- FIG.13H OrientationJ color survey of PSR polarized images pseudo-colored 8123-107870-02 for orientation alignment.
- FIG.14 Illustration overview of wound healing score assessment for cutaneous wound healing. Epidermal and dermal skin layers are assessed independently and given a score on a scale of 0 to 4, depending on the current wound healing phase being observed.
- FIGS.15A-15G Additional staining to assess treatment groups on tissue replacement phase during wound healing.
- FIGS.15A-15G Additional staining to assess treatment groups on tissue replacement phase during wound healing.
- FIGS.15A-15G Additional staining to assess treatment groups on tissue replacement phase during wound healing.
- FIGS.15A-15G Additional staining to assess treatment groups on tissue replacement phase during wound healing.
- FIGS.15A-15G Additional staining to assess treatment groups on tissue
- FIG.15B Polarized light microscopy of PSR-stained sections reveals the birefringence properties of collagen type 1 and collagen type III.
- FIG.15C Image J Quantification of PSR polarized images to assess collagen content displayed by the Col-1/Col-III ratio shown as mean ⁇ SD (n > 5).
- FIG.15D Quantification of collagen orientation displayed as percent coherency where a score of 1 is total alignment and 0 is complete isotropy; shown as mean ⁇ SD (n > 5).
- FIG.15E Immunohistochemistry of collagen IV at 40x magnification as a supplemental assessment for vasculature.
- FIGS.16A-16D Quantification of collagen fibrils among different matricellular treatment groups in the resolution phase of CXCR3 -/- mice.
- FIG.16A Polarized light microscopy of picrosirius red-stained sections at X100 magnification with collagen type 1 and collagen type III.
- FIG.16B CT-FIRE extracted fibers highlighted by lines overlayed on the PSR image. Quantification of collagen fibril diameter (FIG.
- SEQ ID NO: 1 is a nucleotide sequence encoding human TNC (GENBANK TM Accession No.
- NP_002151.2 1 MGAMTQLLAG VFLAFLALAT EGGVLKKVIR HKRQSGVNAT LPEENQPVVF NHVYNIKLPV 61 GSQCSVDLES ASGEKDLAPP SEPSESFQEH TVDGENQIVF THRINIPRRA CGCAAAPDVK 121 ELLSRLEELE NLVSSLREQC TAGAGCCLQP ATGRLDTRPF CSGRGNFSTE GCGCVCEPGW 181 KGPNCSEPEC PGNCHLRGRC IDGQCICDDG FTGEDCSQLA CPSDCNDQGK CVNGVCICFE 241 GYAGADCSRE ICPVPCSEEH GTCVDGLCVC HDGFAGDDCN KPLCLNNCYN RGRCVENECV 301 CDEGFTGEDC SELICPNDCF DRGRCINGTC YCEEGFTGED CGKPTCPHAC HTQGRCEEGQ 361 CVCDEGFAGV DCSEKRCPAD CHNRGRCVDG
- NP_001936.1 1 MKLLPSVVLK LFLAAVLSAL VTGESLERLR RGLAAGTSNP DPPTVSTDQL LPLGGGRDRK 61 VRDLQEADLD LLRVTLSSKP QALATPNKEE HGKRKKKGKG LGKKRDPCLR KYKDFCIHGE 121 CKYVKELRAP SCICHPGYHG ERCHGLSLPV ENRLYTYDHT TILAVVAVVL SSVCLLVIVG 181 LLMFRYHRRG GYDVENEEKV KLGMTNSH
- SEQ ID NO: 5 is a nucleotide sequence encoding human decorin (GENBANK TM Accession No. NM_001920.5).
- NP_001911.1 1 MKATIILLLL AQVSWAGPFQ QRGLFDFMLE DEASGIGPEV PDDRDFEPSL GPVCPFRCQC 61 HLRVVQCSDL GLDKVPKDLP PDTTLLDLQN NKITEIKDGD FKNLKNLHAL ILVNNKISKV 121 SPGAFTPLVK LERLYLSKNQ LKELPEKMPK TLQELRAHEN EITKVRKVTF NGLNQMIVIE 181 LGTNPLKSSG IENGAFQGMK KLSYIRIADT NITSIPQGLP PSLTELHLDG NKISRVDAAS 241 LKGLNNLAKL GLSFNSISAV DNGSLANTPH LRELHLDNNK LTRVPGGLAE HKYIQVVYLH 301 NNNISVVGSS DFCPPGHNTK KASYSGVSLF SNPVQYWEIQ PSTFRCVYVR SAIQLGNYK SEQ ID NO: 7 is a nucleotide sequence
- NP_002407.1 1 MKKSGVLFLL GIILLVLIGV QGTPVVRKGR CSCISTNQGT IHLQSLKDLK QFAPSPSCEK 61 IEIIATLKNG VQTCLNPDSA DVKELIKKWE KQVSQKKKQK NGKKHQKKKV LKVRKSQRSR 121 QKKTT
- SEQ ID NO: 9 is a nucleotide sequence encoding human CXCL10 (GENBANK TM Accession No. NM_001565.4).
- SEQ ID NO: 11 is a nucleotide sequence encoding human CXCL11 (GENBANK TM Accession No. NM_005409.5).
- NP_005400.1 1 MSVKGMAIAL AVILCATVVQ GFPMFKRGRC LCIGPGVKAV KVADIEKASI MYPSNNCDKI 61 EVIITLKENK GQRCLNPKSK QARLIIKKVE RKNF
- SEQ ID NO: 13 is a nucleotide sequence encoding human CXCL4 (GENBANK TM Accession No. NM_002619.4).
- an antigen includes singular or plural antigens and can be considered equivalent to the phrase “at least one antigen.”
- the term “comprises” means “includes.” It is further to be understood that any and all base sizes or amino acid sizes, and all molecular weight or molecular mass values, given for nucleic acids or polypeptides are approximate, and are provided for descriptive purposes, unless otherwise indicated. Although many methods and materials similar or equivalent to those described herein can be used, particular suitable methods and materials are described herein. In case of conflict, the present specification, including explanations of terms, will control. In addition, the materials, methods, and examples are illustrative only and not intended to be limiting.
- Administration The introduction of a composition (such as a controlled delivery composition disclosed herein) to a subject by a chosen route.
- routes of administration for the agents and compositions disclosed herein include, but are not limited to, topical (including on a wound dressing, such as a single-use bandage), transdermal, oral, sublingual, injection (such as subcutaneous or intradermal injection), intranasal, inhalation and via a medical implant.
- “administered concurrently” means administered at the same time (including in the same composition or in separate compositions) or during the same session.
- Amphiregulin (AREG) A member of the epidermal growth factor family.
- the AREG protein is an autocrine growth factor as well as a mitogen for astrocytes, Schwann cells and fibroblasts. It is related to epidermal growth factor (EGF) and transforming growth factor alpha (TGF-alpha). The protein interacts with the EGF/TGF-alpha receptor to promote the growth of normal epithelial cells, and it inhibits the growth of certain aggressive carcinoma cell lines.
- AREG also functions in mammary gland, oocyte and bone tissue development.
- the AREG gene is associated with a psoriasis-like skin phenotype, and is also associated with other pathological disorders, including various types of cancers and inflammatory conditions.
- Nucleic acid and amino acid sequences for human AREG are publicly available, such as under NCBI Gene ID 374.
- Angiogenesis The physiological process involving the growth of new blood vessels from pre- existing vessels. Angiogenesis is a normal and vital process in growth and development, as well as in wound healing.
- CX-C chemokine receptor 3 A G protein-coupled receptor with selectivity for four chemokines, CXCL4/PF4 (platelet factor 4), CXCL9/Mig (monokine induced by interferon- ⁇ ), CXCL10/IP- 10 (interferon- ⁇ -inducible 10 kDa protein) and CXCL11/I-TAC (interferon-inducible T cell a- chemoattractant). Binding of chemokines to this protein induces cellular responses that are involved in 8123-107870-02 leukocyte trafficking, most notably integrin activation, cytoskeletal changes and chemotactic migration.
- CXCL4 Chemokine (C-X-C motif) ligand 4 (CXCL4): A small cytokine belonging to the CXC chemokine family.
- CXCR4 also known as platelet factor 4 (PF4), is a 70-amino acid protein that is released from the alpha-granules of activated platelets and binds with high affinity to heparin. Its primary physiologic role is neutralization of heparin-like molecules on the endothelial surface of blood vessels, thereby inhibiting local antithrombin III activity and promoting coagulation.
- CXCL4 As a strong chemoattractant for neutrophils and fibroblasts, CXCL4 is believed to play a role in inflammation and wound repair. CXCL4 binds the B isoform of CXCR3 (CXCR3-B). Sequences for CXCL4 are publicly available (see, for example, GENBANK TM Gene ID 5196). Exemplary human CXCL4 nucleic acid and protein sequence are set forth herein as SEQ ID NOs: 13 and 14, respectively.
- Chemokine (C-X-C motif) ligand 9 (CXCL9) A member of the CXC chemokine family. The CXCL9 protein is thought to be involved in T cell trafficking.
- CXCL9 binds to CXCR3 and is a chemoattractant for lymphocytes, but not for neutrophils.
- Nucleic acid and amino acid sequences for human CXCL9 (and homologs thereof) are publicly available, such as under NCBI Gene ID 4283. Exemplary human CXCL9 nucleic acid and protein sequence are set forth herein as SEQ ID NOs: 7 and 8, respectively.
- Chemokine (C-X-C motif) ligand 10 (CXCL10) A chemokine of the CXC subfamily and a ligand for the receptor CXCR3.
- CXCL10 is also known as interferon- ⁇ -inducible 10 kDa protein (IP-10).
- CXCL10 nucleic acid and amino acid sequences are publicly available, such as under NCBI Gene ID 3627 (see also GENBANK TM Accession No. P02778).
- Exemplary human CXCL10 nucleic acid and protein sequence are set forth herein as SEQ ID NOs: 9 and 10, respectively.
- Chemokine (C-X-C motif) ligand 11 (CXCL11) A chemokine of the CXC subfamily and a ligand for the receptor CXCR3.
- the CXCL11 protein induces a chemotactic response in activated T-cells and is the dominant ligand for CXCR3.
- the CXCR11 gene contains 4 exons and at least three polyadenylation signals which may reflect cell-specific regulation of expression. IFN- ⁇ is a potent inducer of transcription of this gene.
- Nucleic acid and amino acid sequences for CXCL11 are publicly available, such as under NCBI Gene ID 6373. Exemplary human CXCL11 nucleic acid and protein sequence are set forth herein as SEQ ID NOs: 11 and 12, respectively.
- Cholesterol A type of lipid molecule classified as a sterol. Cholesterol is an important structural component of biological membranes.
- Coacervate Spherical aggregates of colloidal droplets held together (and apart from their surrounding liquid environment) by hydrophobic forces. Coacervate droplets are generally about 0.1 to about 100 ⁇ m in diameter. Coacervates typically aggregate over time to form a bulk phase separation from the aqueous compartment. Coacervates can be used as controlled delivery vehicles for small molecules and 8123-107870-02 protein therapeutics.
- the coacervate includes a positively charged synthetic biodegradable poly(ethylene arginyl aspartate diglyceride) (PEAD) and a negatively charged heparin, which forms a 3-dimensional coacervate that envelopes around the protein cargo to be administered.
- PEAD synthetic biodegradable poly(ethylene arginyl aspartate diglyceride)
- heparin negatively charged heparin
- Collagen type I alpha 1 chain (COL1A1): A gene encoding the pro-alpha1 chains of type I collagen whose triple helix comprises two alpha1 chains and one alpha2 chain.
- Type I is a fibril-forming collagen found in most connective tissues and is abundant in bone, cornea, dermis and tendon. Mutations in the COL1A1 gene are associated with osteogenesis imperfecta types I-IV, Ehlers-Danlos syndrome type VIIA, Ehlers-Danlos syndrome Classical type, Caffey Disease and idiopathic osteoporosis.
- Reciprocal translocations between chromosomes 17 and 22, where this gene and the gene for platelet-derived growth factor beta are located, are associated with a particular type of skin tumor called dermatofibrosarcoma protuberans, resulting from unregulated expression of the growth factor.
- Two transcripts, resulting from the use of alternate polyadenylation signals, have been identified for this gene.
- Nucleic acid and amino acid sequences for human COL1A1 (and homologs thereof) are publicly available, such as under NCBI Gene ID 1227.
- Collagen type I alpha 2 chain (COL1A2) A gene encoding the pro-alpha2 chain of type I collagen whose triple helix comprises two alpha1 chains and one alpha2 chain.
- Type I is a fibril-forming collagen found in most connective tissues and is abundant in bone, cornea, dermis and tendon. Mutations in this gene are associated with osteogenesis imperfecta types I-IV, Ehlers-Danlos syndrome type VIIB, recessive Ehlers-Danlos syndrome Classical type, idiopathic osteoporosis, and atypical Marfan syndrome. Symptoms associated with mutations in this gene, however, tend to be less severe than mutations in the gene for the alpha1 chain of type I collagen (COL1A1) reflecting the different role of alpha2 chains in matrix integrity. Three transcripts, resulting from the use of alternate polyadenylation signals, have been identified for this gene.
- Collagen type III alpha chain (COL3A1): A gene encoding the pro-alpha1 chains of type III collagen, a fibrillar collagen that is found in extensible connective tissues such as skin, lung, uterus, intestine and the vascular system, frequently in association with type I collagen. Mutations in this gene are associated with Ehlers-Danlos syndrome types IV, and with aortic and arterial aneurysms. Two transcripts, resulting from the use of alternate polyadenylation signals, have been identified for this gene.
- Nucleic acid and amino acid sequences for human COL3A1 are publicly available, such as under NCBI Gene ID 1281.
- Conservative variants “Conservative" amino acid substitutions are those substitutions that do not substantially affect or decrease an activity or antigenicity of a protein or peptide.
- a protein 8123-107870-02 disclosed herein can include at most about 1, at most about 2, at most about 3, at most about 4 or at most about 5 conservative substitutions (such as 1, 2, 3, 4, or 5 conservative substitutions, and retain biological activity, such as the ability to promote wound healing.
- a conservative substitution include the following examples: Original Residue Conservative Substitutions Ala Ser Arg Lys Asn Gln, His Asp Glu Cys Ser Gln Asn Glu Asp His Asn; Gln Ile Leu, Val Leu Ile; Val Lys Arg; Gln; Glu Met Leu; Ile Phe Met; Leu; Tyr Ser Thr Thr Ser Trp Tyr Tyr Trp; Phe Val Ile; Leu
- the term conservative variant also includes the use of a substituted amino acid in place of an unsubstituted parent amino acid. Non-conservative substitutions are those that reduce an activity or antigenicity.
- Controlled delivery composition A composition in which the rate of release of the component(s) (e.g., drugs, therapeutic agents) is regulated, for example to achieve rapid release and/or delayed release of the component(s).
- rapid release of the first agent that promotes wound closure occurs prior to (or more rapidly than) delayed (or less rapid) release of the second agent that inhibits scarring.
- Decorin (DCN) A member of the small leucine-rich proteoglycan family of proteins. Alternative splicing results in multiple transcript variants, at least one of which encodes a preproprotein that is proteolytically processed to generate the mature protein. The DCN protein plays a role in collagen fibril assembly.
- EGF Epidermal growth factor
- the EGF preproprotein is proteolytically processed to generate the 53-amino acid epidermal growth factor peptide.
- This protein acts a potent mitogenic factor that plays an important role in the growth, proliferation and 8123-107870-02 differentiation of numerous cell types.
- the EGF protein acts by binding with high affinity to the cell surface receptor, EGFR. Defects in this gene are the cause of hypomagnesemia type 4. Dysregulation of the EGF gene has been associated with the growth and progression of certain cancers. Alternative splicing results in multiple transcript variants, at least one of which encodes a preproprotein that is proteolytically processed. Nucleic acid and amino acid sequences for human EGF (and homologs thereof) are publicly available, such as under NCBI Gene ID 1950. Fibrosis: A condition associated with the thickening and scarring of connective tissue.
- Fibrosis occurs in response to an injury, such as from a disease or condition that damages tissue. Fibrosis is an exaggerated wound healing response that when severe, can interfere with normal organ function. Fibrosis can occur in almost any tissue of the body, including in the lung (pulmonary fibrosis, cystic fibrosis, radiation-induced lung injury), liver (cirrhosis, biliary atresia), heart (arterial fibrosis, endomyocardial fibrosis, prior myocardial infarction), brain, skin (scleroderma, sclerosis), kidney, joints and intestine (Crohn’s disease).
- Growth factor protein A type of protein that is capable of stimulating cell proliferation, cell survival, wound healing and/or cellular differentiation.
- growth factor proteins include, but are not limited to, vascular endothelial growth factor (VEGF), a member of the fibroblast growth factor (FGF) family (e.g., FGF1, FGF2, FGF3, FGF4, FGF5, FGF6, FGF7, FGF8, FGF9, FGF10, FGF16, FGF17, FGF18, FGF19, FGF20, FGF21, FGF22, FGF23), insulin growth factor (IGF), epidermal growth factor (EGF), heparin binding EGF-like growth factor (HB-EGF), transforming growth factor (TGF)- ⁇ , TGF- ⁇ , amphiregulin, nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and platelet-derived growth factor (PDGF).
- VEGF vascular endothelial growth factor
- FGF fibroblast growth factor family
- the growth factor is EGF, TGF- ⁇ , amphiregulin, VEGF, FGF, or PDGF.
- Heparin binding EGF like growth factor (HB-EGF): A growth factor with both growth factor and heparin binding activity.
- HB-EGF is involved in several processes, including epidermal growth factor receptor signaling pathway, positive regulation of protein kinase B signaling, and positive regulation of wound healing.
- HB-EGF is also implicated in glomerulosclerosis and perinatal necrotizing enterocolitis. Nucleic acid and amino acid sequences for human HB-EGF (and homologs thereof) are publicly available, such as under NCBI Gene ID 1839.
- Exemplary human HB-EGF nucleic acid and protein sequence are set forth herein as SEQ ID NOs: 3 and 4, respectively.
- Hydrogel A macromolecular polymer gel comprised of a network of crosslinked polymer chains.
- Interleukin-1 beta (IL-1 ⁇ ) A cytokine produced by activated macrophages as a proprotein, which is proteolytically processed to its active form by caspase 1 (CASP1/ICE). This cytokine is an important mediator of the inflammatory response, and is involved in a variety of cellular activities, including cell proliferation, differentiation, and apoptosis.
- Nucleic acid and amino acid sequences for human IL-1 ⁇ (and homologs thereof) are publicly available, such as under NCBI Gene ID 3553.
- Interleukin-2 A secreted cytokine produced by activated CD4+ and CD8+ T lymphocytes important for the proliferation of T and B lymphocytes.
- the IL-2 receptor is a heterotrimeric protein 8123-107870-02 complex whose gamma chain is also shared by IL-4 and IL-7. Nucleic acid and amino acid sequences for human IL-2 (and homologs thereof) are publicly available, such as under NCBI Gene ID 3558.
- Interleukin-4 (IL-4) A pleiotropic cytokine produced by activated T cells. The IL-4 receptor also binds to IL-13, which may contribute to the many overlapping functions of IL-4 and IL-13.
- IL-4 plays an important role tissue repair, promotes allergic airway inflammation, and regulates a variety of human host responses such as allergic, anti-parasitic, wound healing, and acute inflammation. This cytokine has also been reported to promote resolution of neutrophil-mediated acute lung injury. Two alternatively spliced transcript variants of the IL-4 gene encoding distinct isoforms have been reported. Nucleic acid and amino acid sequences for human IL-4 (and homologs thereof) are publicly available, such as under NCBI Gene ID 3565. Interleukin-10 (IL-10): A cytokine produced primarily by monocytes and to a lesser extent by lymphocytes. IL-10 has pleiotropic effects in immunoregulation and inflammation.
- IL-10 Interleukin-10
- IL-10 can block NF- ⁇ B activity and is involved in the regulation of the JAK-STAT signaling pathway.
- Nucleic acid and amino acid sequences for human IL-10 (and homologs thereof) are publicly available, such as under NCBI Gene ID 3586.
- Laminin subunit beta 1 (LAMB1) An extracellular matrix glycoprotein that is a major noncollagenous constituent of basement membranes. Laminins have been implicated in a wide variety of biological processes including cell adhesion, differentiation, migration, signaling, neurite outgrowth and metastasis.
- Laminins are composed of 3 non identical chains: laminin alpha, beta and gamma (formerly A, B1, and B2, respectively) and they form a cruciform structure consisting of 3 short arms, each formed by a different chain, and a long arm composed of all 3 chains.
- Each laminin chain is a multidomain protein encoded by a distinct gene.
- the beta 1 chain has 7 structurally distinct domains which it shares with other beta chain isomers.
- the C-terminal helical region containing domains I and II are separated by domain alpha, domains III and V contain several EGF-like repeats, and domains IV and VI have a globular conformation.
- LAMB1 is expressed in most tissues that produce basement membranes.
- Lipid An inclusive term for fats and fat-derived materials. Lipids include esters of fatty acids (simple lipids, such as fats, sterols, waxes, and triglycerides) or closely related substances (compound lipids, such as phospholipids). In the context of the present disclosure, the lipids include cholesterol as well as saturated or unsaturated lipids. A “saturated lipid” refers to a lipid in which the fatty acid chains all have single bonds.
- an “unsaturated lipid” refers to a lipid containing a high proportion of fatty acid molecules with at least one double bond.
- Non-limiting examples of lipids that can be used in the disclosed controlled delivery compositions include cholesterol and any one or more the following: 8123-107870-02 Lipid Chemical Name Type 18:1 ( ⁇ 9-Cis) PC (DOPC) 1,2-dioleoyl-sn-glycero-3-phosphocholine
- Unsaturated L p ds or use n t e dsc osed met ods and compos t ons are descr bed n, or examp e, Des pande et al., Nat Commun 7:10447, 2016; Deshpande et al., Biomicrofluidics 11:034106, 2017; Deshpande et al., Nat Commun 10:1800, 2019; Last et al., ACS Nano 14:4487-4498, 2020; Cakm
- Matricellular proteins A class of non-structural, secreted proteins found in the extracellular matrix. Matricellular proteins have a variety of different functions mediated by interacting with cell-surface receptors, proteases, hormones, and structural matrix proteins (e.g., collagen).
- Matricellular proteins are further characterized by high levels of expression during development, tissue remodeling and response to injury, as well as induction of de-adhesion (see, e.g., Bornstein, J Cell Commun Signal 3(3-4):163-165, 2009).
- Examples of matricellular proteins include, but are not limited to, secreted protein acidic and cysteine rich (SPARC), thrombospondin (e.g., TSP-1), laminin B1, collagen III and tenascin-C. 8123-107870-02 Mucosa: Moist tissue that covers the inside surface of some parts of the body, such as the nose, mouth, anus/rectum, vagina, lungs, urinary tract and digestive tract.
- parenteral formulations usually comprise injectable fluids that include pharmaceutically and physiologically acceptable fluids such as water, physiological saline, balanced salt solutions, aqueous dextrose, glycerol or the like as a vehicle.
- non-toxic solid carriers can include, for example, pharmaceutical grades of mannitol, lactose, starch, or magnesium stearate.
- pharmaceutical compositions to be administered can contain minor amounts of non-toxic auxiliary substances, such as wetting or emulsifying agents, preservatives, and pH buffering agents and the like, for example sodium acetate or sorbitan monolaurate.
- PDGFA Platelet derived growth factor subunit alpha
- the PDGFA preproprotein is proteolytically processed to generate platelet-derived growth factor subunit A, which can homodimerize, or alternatively, heterodimerize with the related platelet-derived growth factor subunit B. These proteins bind and activate PDGF receptor tyrosine kinases, which play a role in a wide range of developmental processes. Nucleic acid and amino acid sequences for human PDGFA (and homologs thereof) are publicly available, such as under NCBI Gene ID 5154.
- Platelet derived growth factor subunit beta (PDGFB) A member of the protein family comprised of both platelet-derived growth factors (PDGF) and vascular endothelial growth factors (VEGF).
- the PDGFB preproprotein is proteolytically processed to generate platelet-derived growth factor subunit B, which can homodimerize, or alternatively, heterodimerize with the related platelet-derived growth factor subunit A. These proteins bind and activate PDGF receptor tyrosine kinases, which play a role in a wide range of developmental processes. Nucleic acid and amino acid sequences for human PDGFA (and homologs thereof) are publicly available, such as under NCBI Gene ID 5155. Poly(lactic-co-glycolic acid) (PLGA): A biodegradable and biocompatible co-polymer of glycolic acid and lactic acid. Scarring: The formation of fibrous tissue in response to a wound, injury or disease.
- SPARC Secreted protein acidic and cysteine rich
- Nucleic acid and amino acid sequences for human SPARC are publicly available, such as under NCBI Gene ID 6678.
- Sequence identity The similarity between nucleic acid or amino acid sequences is expressed in terms of the similarity between the sequences, otherwise referred to as sequence identity. Sequence identity is frequently measured in terms of percentage identity (or similarity or homology); the higher the percentage, the more similar the two sequences are. Homologs or variants of a particular polypeptide will possess a relatively high degree of sequence identity when aligned using standard methods. Methods of alignment of sequences for comparison are well known in the art. Various programs and alignment algorithms are described in: Smith and Waterman, Adv. Appl. Math.2:482, 1981; Needleman and Wunsch, J.
- Biol.215:403, 1990 is available from several sources, including the National Center for Biotechnology Information (NCBI, Bethesda, MD) and on the internet, for use in connection with the sequence analysis programs blastp, blastn, blastx, tblastn and tblastx.
- NCBI National Center for Biotechnology Information
- a description of how to determine sequence identity using this program is available on the NCBI website on the internet.
- Homologs and variants of a polypeptide are typically characterized by possession of at least about 75%, for example at least about 80%, 90%, 95%, 96%, 97%, 98% or 99% sequence identity counted over the full length alignment with the amino acid sequence of the polypeptide using the NCBI Blast 2.0, gapped blastp set to default parameters.
- the Blast 2 sequences function is employed using the default BLOSUM62 matrix set to default parameters, (gap existence cost of 11, and a per residue gap cost of 1).
- the alignment can be performed using the Blast 2 sequences function, employing the PAM30 matrix set to default parameters (open gap 9, extension gap 1 penalties). Proteins with even greater similarity to the reference sequences will show increasing percentage identities when assessed by this method, such as at least 80%, at least 85%, at least 90%, at least 95%, at least 98%, or at least 99% sequence identity.
- homologs and variants When less than the entire sequence is being compared for sequence identity, homologs and variants will typically possess at least 80% sequence identity over short windows of 10-20 amino acids, and may possess sequence identities of at least 85% or at least 90% or 95% depending on their similarity to the reference sequence. Methods for determining sequence identity over such short windows are available at the NCBI website on the internet. One of skill in the art will appreciate that these sequence identity ranges are provided for guidance only; it is entirely possible that strongly significant homologs could be obtained that fall outside of the ranges provided.
- Subject Living multi-cellular vertebrate organisms, a category that includes both human and veterinary subjects, including human and non-human mammals.
- TNC Tenascin-C
- the TNC protein is homohexameric with disulfide-linked subunits and contains multiple EGF- like and fibronectin type-III domains. It is implicated in guidance of migrating neurons as well as axons during development, synaptic plasticity, and neuronal regeneration.
- Nucleic acid and amino acid sequences for human TNC are publicly available, such as under NCBI Gene ID 3371.
- Exemplary human TNC nucleic acid and protein sequence are set forth herein as SEQ ID NOs: 1 and 2, respectively (see also UniProt P24821).
- the TNC protein is a biologically active fragment of TNC that includes the EGF-like repeats. In some aspects, the TNC protein is a biologically active fragment of TNC that includes the integrin-binding domains. In other aspects, the TNC protein is full-length TNC.
- Therapeutically effective amount A quantity of a specified agent, such as an agent that promotes wound closure (e.g., HB-EGF, TNC, a matricellular protein, or a growth factor) or an agent that inhibits scarring (e.g., DCN, a CXCR3 ligand, collagen type I, or IL-10), sufficient to achieve a desired effect in a subject being treated with that agent.
- a specified agent such as an agent that promotes wound closure (e.g., HB-EGF, TNC, a matricellular protein, or a growth factor) or an agent that inhibits scarring (e.g., DCN, a CXCR3 ligand, collagen type I, or IL-10), sufficient to
- the therapeutically effective amount is an amount necessary to increase wound closure by at least 10%, at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, or at least 100% or more, relative to wound closure in the absence of treatment. In other examples, the therapeutically effective amount is an amount necessary to inhibit scarring by at least 10%, at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, or at least 100% or more, relative to scarring in the absence of treatment.
- THBS1 Thrombospondin 1
- the THBS1 protein is an adhesive glycoprotein that mediates cell-to-cell and cell-to-matrix interactions. This protein can bind to fibrinogen, fibronectin, laminin, type V collagen and integrins alpha-V/beta-1.
- the THSB1 protein has been shown to play roles in platelet aggregation, angiogenesis, and tumorigenesis. Nucleic acid and amino acid sequences for human THBS1 (and homologs thereof) are publicly available, such as under NCBI Gene ID 7057.
- THBS2 Thrombospondin 2
- the THBS2 protein is a disulfide-linked homotrimeric glycoprotein that mediates cell-to-cell and cell-to-matrix interactions. This protein has been shown to function as a potent inhibitor of tumor growth and angiogenesis. Studies of the mouse counterpart suggest that this protein may modulate the cell surface properties of mesenchymal cells and be involved in cell adhesion and migration. Nucleic acid and amino acid sequences for human THBS2 (and homologs thereof) are publicly available, such as under NCBI Gene ID 7058.
- Transforming growth factor alpha (TGFA) A growth factor that is a ligand for the epidermal growth factor receptor, which activates a signaling pathway for cell proliferation, differentiation and development.
- the TGF- ⁇ protein may act as either a transmembrane-bound ligand or a soluble ligand.
- the TGFA gene has been associated with many types of cancers, and it may also be involved in some cases of cleft lip/palate. Alternatively spliced transcript variants encoding different isoforms have been found for this gene. Nucleic acid and amino acid sequences for human TGFA (and homologs thereof) are publicly available, such as under NCBI Gene ID 7039. 8123-107870-02 Vascular endothelial growth factor A (VEGFA): A member of the PDGF/VEGF growth factor family. VEGFA is a heparin-binding protein that exists as a disulfide-linked homodimer.
- VEGFB Vascular endothelial growth factor B
- VEGFB is a ligand for VEGFR-1 (vascular endothelial growth factor receptor 1) and NRP-1 (neuropilin- 1).
- Nucleic acid and amino acid sequences for human VEGFB (and homologs thereof) are publicly available, such as under NCBI Gene ID 7423.
- Vascular endothelial growth factor C A member of the PDGF/VEGF family. VEGFC promotes angiogenesis and endothelial cell growth, and can also affect the permeability of blood vessels. The VEGFC proprotein is further cleaved into a fully processed form that can bind and activate VEGFR-2 and VEGFR-3 receptors. Nucleic acid and amino acid sequences for human VEGFC (and homologs thereof) are publicly available, such as under NCBI Gene ID 7424. Wound: Any type of damage or breakage on the surface of the skin or mucosa.
- the would is a dermal wound, such as a laceration, a puncture wound, an abrasion, a surgical wound, a burn, an ulcer or a pressure sore.
- the wound is a mucosal wound, such as a wound in the nose, mouth, anus/rectum, vagina or lung.
- Wound closure The process of how an excisional wound (loss of epidermal and/or dermal tissue) heals over time. A schematic of wound closure is shown in FIG.14. III. Overview of Several Aspects The present disclosure describes controlled delivery methods and compositions that enhance wound healing (for example, improve, enhance or accelerate wound closure) and reduce fibrotic scarring.
- a wound such as a dermal wound or a mucosal wound
- methods of treating a wound by administering to the subject a therapeutically effective amount of a first agent that promotes wound closure and a therapeutically effective amount of a second agent that inhibits scarring.
- the first agent is administered prior to the second agent (such as at least one day to three weeks prior to the second agent), or the two agents are administered concurrently in a controlled delivery composition that allows rapid release of the first agent and delayed release of the second agent.
- Controlled delivery compositions that permit rapid release of the first agent and delayed release of the second agent are also described. 8123-107870-02 A.
- Methods for Treating a Wound Provided herein are methods of treating a wound in the subject by administering to the subject a therapeutically effective amount of a first agent that promotes wound closure and a therapeutically effective amount of a second agent that inhibits scarring.
- the first agent includes heparin binding EGF-like growth factor (HB-EGF), tenascin-C (TNC), a growth factor, a matricellular protein, interleukin (IL)-1, IL-2 or IL-4.
- Growth factors include, for example, epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), members of the fibroblast growth factor (FGF) family, transforming growth factor (TGF)- ⁇ , amphiregulin, and platelet-derived growth factor (PDGF).
- Matricellular proteins include, for example, secreted protein acidic and cysteine rich (SPARC), thrombospondin, laminin B1, and collagen type III.
- the first agent is a biologically active fragment of HB-EGF, TNC, a growth factor (such as EGF, VEGF, PDGF, TGF- ⁇ , amphiregulin, or PDGF), a matricellular protein (such as SPARC, thrombospondin, laminin B1 or collagen type III), IL-1, IL-2 or IL-4, wherein the fragment retains the biological activity of the respective full-length protein.
- the biologically active fragment includes one or more EGF-like repeats or one or more integrin binding domains.
- the first agent is TNC.
- the amino acid sequence of TNC is at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% or 100% identical to SEQ ID NO: 2.
- the amino acid sequence of TNC consists of SEQ ID NO: 2.
- the first agent is HB-EGF.
- the amino acid sequence of HB-EGF is at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% or 100% identical to SEQ ID NO: 4.
- the amino acid sequence of HB-EGF consists of SEQ ID NO: 4.
- the second agent includes decorin (DCN), a CXCR3 ligand, collagen type I, or IL- 10.
- CXCR3 ligands include, for example, CXCL4, CXCL9, CXCL10 and CXCL11.
- the second agent is a biologically active fragment of DCN, a CXCR3 ligand (such as CXCL4, CXCL9, CXCL10 or CXCL11), collagen type I or IL-10 that retains the biological activity of the respective full- length protein.
- the second agent is DCN.
- the amino acid sequence of DCN is at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% or 100% identical to SEQ ID NO: 6.
- the amino acid sequence of DNC consists of SEQ ID NO: 6.
- the second agent is CXCL9.
- the amino acid sequence of CXCL9 is at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% or 100% identical to SEQ ID NO: 8.
- the amino acid sequence of CXCL9 consists of SEQ ID NO: 8. 8123-107870-02
- the second agent is CXCL10.
- the amino acid sequence of CXCL10 is at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% or 100% identical to SEQ ID NO: 10.
- the amino acid sequence of CXCL10 consists of SEQ ID NO: 10.
- the second agent is CXCL11.
- the amino acid sequence of CXCL11 is at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% or 100% identical to SEQ ID NO: 12.
- the amino acid sequence of CXCL11 consists of SEQ ID NO: 12.
- the second agent is CXCL4.
- the amino acid sequence of CXCL4 is at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% or 100% identical to SEQ ID NO: 14.
- the amino acid sequence of CXCL4 consists of SEQ ID NO: 14.
- the first agent is administered to the subject prior to administration of the second agent.
- the first agent is administered at least one day prior to administration of the second agent, such as at least 2 days, at least 3 days, at least 4 days, at least 5 days, at least 6 days, at least 1 week, at least 2 weeks or at least 3 weeks prior to administration of the second agent.
- the first agent and/or second agent are encapsulated in a coacervate, hydrogel and/or liposome.
- the coacervate includes poly(ethylene arginyl aspartate diglyceride) (PEAD) and heparin.
- the first agent and the second agent are administered concurrently in a controlled delivery composition that permits rapid release of the first agent and delayed release of the second agent.
- the controlled delivery composition includes a hydrogel, and the hydrogel includes the first agent and the second agent encapsulated in a coacervate, such that upon administration of the controlled delivery composition, the first agent is released from the hydrogel prior to release of the second agent from the coacervate.
- the coacervate includes poly(ethylene arginyl aspartate diglyceride) (PEAD) and heparin.
- the controlled delivery composition includes a first coacervate that includes the first agent, and a second coacervate that includes the second agent, wherein the second coacervate is encapsulated by lipids, thereby forming a lipo-coacervate, such that upon administration of the controlled delivery composition, the first agent is released from the first coacervate prior to release of the second agent from the lipo-coacervate.
- the lipids of the lipo-coacervate include cholesterol and at least one unsaturated lipid and/or at least one saturated lipid.
- the at least one unsaturated lipid can be, for example, 18:1 ( ⁇ 9-Cis) PC (DOPC), 18:1 ( ⁇ 9-Cis) PG (DOPG), 18:1 ( ⁇ 9-Cis) PE (DOPE), 16:0-18:1 PE (POPE), 16:0-18:1 PC (POPC), 16:0-18:1 PS (POPS) and/or 18:1 DGS-NTA(Ni).
- the at least one saturated lipid can be, for example, 16:0 PC (DPPC), 18:0 PC (DSPC), 16:0 PS (DPPS), 18:0 PS (DSPS), 16:0 PE (DPPE), 18:0 PE (DSPE), 16:0 PG (DPPG), and/or 18:0 PG (DSPG).
- the 8123-107870-02 lipids of the lipo-coacervate include cholesterol, DOPC and DSPG. In another non-limiting example, the lipids of the lipo-coacervate include cholesterol, DPPC and DSPG.
- the controlled delivery composition includes a first coacervate that includes the first agent, wherein the first coacervate is encapsulated by lipids, thereby forming a first lipo-coacervate; and a second coacervate that includes the second agent, wherein the second coacervate is encapsulated by lipids, thereby forming a second lipo-coacervate.
- the first agent Upon administration of the controlled delivery composition, the first agent is released from the first lipo-coacervate prior to release of the second agent from the second lipo-coacervate.
- the first lipo-coacervate includes cholesterol and at least one unsaturated lipid selected from 18:1 ( ⁇ 9-Cis) PC (DOPC), 18:1 ( ⁇ 9-Cis) PG (DOPG), 18:1 ( ⁇ 9-Cis) PE (DOPE), 16:0- 18:1 PE (POPE), 16:0-18:1 PC (POPC), 16:0-18:1 PS (POPS) and 18:1 DGS-NTA(Ni).
- the first lipo-coacervate further includes a saturated lipid, such as, but not limited to 18:0 PG (DSPG).
- the first lipo-coacervate includes cholesterol, DOPC and DSPG.
- the second lipo-coacervate includes cholesterol and at least one saturated lipid selected from 16:0 PC (DPPC), 18:0 PC (DSPC), 16:0 PS (DPPS), 18:0 PS (DSPS), 16:0 PE (DPPE), 18:0 PE (DSPE), 16:0 PG (DPPG), and 18:0 PG (DSPG).
- the second lipo-coacervate includes cholesterol, DPPC and DSPG.
- the first coacervate and/or the second coacervate include poly(ethylene arginyl aspartate diglyceride) (PEAD) and/or heparin.
- the wound is a dermal wound.
- the dermal wound includes a laceration, a puncture wound, an abrasion, a surgical wound, a burn, an ulcer or a pressure sore.
- the wound is a mucosal wound.
- the mucosal wound is in the nose, mouth, rectum, anus, vagina or lung.
- the route of administration is topical.
- topical administration can include application of the agent or composition at or adjacent to the site of the wound, such as by spraying (spray or aerosol), swabbing, wiping, on a wound dressing (such as a single-use bandage) or any other means for applying the composition to the wound.
- administration includes injection at or near the site of the wound.
- Controlled Delivery Compositions Also provided herein are controlled delivery compositions for treating a wound, such as a dermal or mucosal wound.
- the controlled delivery compositions include a therapeutically effective amount of a first agent that promotes wound closure and a therapeutically effective amount of a second agent that inhibits scarring, such that the controlled delivery compositions permit rapid release of the first agent and delayed release of the second agent.
- the first agent includes heparin binding EGF-like growth factor (HB-EGF), tenascin-C (TNC), a growth factor, a matricellular protein, interleukin (IL)-1, IL-2 or IL-4.
- Growth factors include, for example, epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), members of the fibroblast growth factor (FGF) family, transforming growth factor (TGF)- ⁇ , amphiregulin, and platelet-derived growth factor (PDGF).
- Matricellular proteins include, for example, secreted protein acidic and cysteine rich (SPARC), thrombospondin, laminin B1, and collagen type III.
- the first agent is TNC.
- the amino acid sequence of TNC is at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% or 100% identical to SEQ ID NO: 2.
- the amino acid sequence of TNC consists of SEQ ID NO: 2.
- the first agent is HB-EGF.
- the amino acid sequence of HB-EGF is at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% or 100% identical to SEQ ID NO: 4.
- the amino acid sequence of HB-EGF consists of SEQ ID NO: 4.
- the second agent includes decorin (DCN), a CXCR3 ligand, collagen type I, or IL- 10.
- CXCR3 ligands include, for example, CXCL4, CXCL9, CXCL10 and CXCL11.
- the second agent is DCN.
- the amino acid sequence of DCN is at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% or 100% identical to SEQ ID NO: 6.
- the amino acid sequence of DNC consists of SEQ ID NO: 6.
- the second agent is CXCL9.
- the amino acid sequence of CXCL9 is at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% or 100% identical to SEQ ID NO: 8.
- the amino acid sequence of CXCL9 consists of SEQ ID NO: 8.
- the second agent is CXCL10.
- the amino acid sequence of CXCL10 is at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% or 100% identical to SEQ ID NO: 10.
- the amino acid sequence of CXCL10 consists of SEQ ID NO: 10.
- the second agent is CXCL11.
- the amino acid sequence of CXCL11 is at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% or 100% identical to SEQ ID NO: 12.
- the amino acid sequence of CXCL11 consists of SEQ ID NO: 12.
- the second agent is CXCL4.
- the amino acid sequence of CXCL4 is at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99% or 100% identical to SEQ ID NO: 14.
- the amino acid sequence of CXCL4 consists of SEQ ID NO: 14.
- the controlled delivery composition includes a hydrogel
- the hydrogel includes the first agent and the second agent encapsulated in a coacervate, such that upon administration of the controlled delivery composition, the first agent is released from the hydrogel prior to release of the second agent from the coacervate.
- the coacervate includes poly(ethylene arginyl aspartate diglyceride) (PEAD) and heparin.
- the controlled delivery composition includes a first coacervate that includes the first agent, and a second coacervate that includes the second agent, wherein the second coacervate is encapsulated by lipids, thereby forming a lipo-coacervate, such that upon administration of the controlled delivery composition, the first agent is released from the first coacervate prior to release of the second agent from the lipo-coacervate.
- the lipids of the lipo-coacervate include cholesterol and at least one unsaturated lipid and/or at least one saturated lipid.
- the at least one unsaturated lipid is selected from 18:1 ( ⁇ 9-Cis) PC (DOPC), 18:1 ( ⁇ 9-Cis) PG (DOPG), 18:1 ( ⁇ 9-Cis) PE (DOPE), 16:0-18:1 PE (POPE), 16:0-18:1 PC (POPC), 16:0-18:1 PS (POPS) and 18:1 DGS-NTA(Ni).
- the at least one saturated lipid is selected from 16:0 PC (DPPC), 18:0 PC (DSPC), 16:0 PS (DPPS), 18:0 PS (DSPS), 16:0 PE (DPPE), 18:0 PE (DSPE), 16:0 PG (DPPG), and 18:0 PG (DSPG).
- the lipids of the lipo-coacervate include cholesterol, DOPC and DSPG. In another non-limiting example, the lipids of the lipo-coacervate include cholesterol, DPPC and DSPG.
- the controlled delivery composition includes a first coacervate that includes the first agent, wherein the first coacervate is encapsulated by lipids, thereby forming a first lipo-coacervate; and a second coacervate that includes the second agent, wherein the second coacervate is encapsulated by lipids, thereby forming a second lipo-coacervate.
- the first agent Upon administration of the controlled delivery composition, the first agent is released from the first lipo-coacervate prior to release of the second agent from the second lipo- coacervate.
- the first lipo-coacervate includes cholesterol and at least one unsaturated lipid selected from 18:1 ( ⁇ 9-Cis) PC (DOPC), 18:1 ( ⁇ 9-Cis) PG (DOPG), 18:1 ( ⁇ 9-Cis) PE (DOPE), 16:0-18:1 PE (POPE), 16:0-18:1 PC (POPC), 16:0-18:1 PS (POPS) and 18:1 DGS-NTA(Ni).
- the first lipo-coacervate further includes a saturated lipid, such as, but not limited to 18:0 PG (DSPG).
- the first lipo-coacervate includes cholesterol, DOPC and DSPG.
- the second lipo-coacervate includes cholesterol and at least one saturated lipid selected from 16:0 PC (DPPC), 18:0 PC (DSPC), 16:0 PS (DPPS), 18:0 PS (DSPS), 16:0 PE (DPPE), 18:0 PE (DSPE), 16:0 PG (DPPG), and 18:0 PG (DSPG).
- the second lipo- coacervate includes cholesterol, DPPC and DSPG.
- the first coacervate and/or the second coacervate include poly(ethylene arginyl aspartate diglyceride) (PEAD) and/or heparin.
- the wound to be treated is a dermal wound.
- the dermal wound includes a laceration, a puncture wound, an abrasion, a surgical wound, a burn, an ulcer or a pressure sore. 8123-107870-02
- the wound to be treated is a mucosal wound.
- the mucosal wound is in the nose, mouth, rectum, anus, vagina or lung.
- the controlled delivery composition is formulated for topical administration, such as for spraying (spray or aerosol), swabbing, wiping, on a wound dressing (such as a single-use bandage) or any other means for applying the composition to the wound.
- the controlled delivery composition is formulated for administration by injection, such as injection at or near the site of the wound. IV.
- a method of treating a wound in a subject comprising administering to the subject a therapeutically effective amount of a first agent that promotes wound closure and a therapeutically effective amount of a second agent that inhibits scarring, wherein: (i) the first agent is administered to the subject prior to administration of the second agent; or (ii) the first agent and the second agent are administered concurrently in a controlled delivery composition that permits rapid release of the first agent and delayed release of the second agent.
- the first agent comprises heparin binding EGF-like growth factor (HB-EGF), tenascin-C (TNC), a growth factor, a matricellular protein or a biologically active fragment of a matricellular protein, interleukin (IL)-1, IL-2, or IL-4.
- HB-EGF heparin binding EGF-like growth factor
- TGF tenascin-C
- a growth factor a matricellular protein or a biologically active fragment of a matricellular protein
- IL-1 interleukin-1, IL-2, or IL-4.
- the growth factor is selected from epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), a member of the fibroblast growth factor (FGF) family, transforming growth factor (TGF)- ⁇ , amphiregulin, and platelet-derived growth factor (PDGF).
- EGF epidermal growth factor
- VEGF vascular endothelial growth factor
- TGF
- the matricellular protein is selected from secreted protein acidic and cysteine rich (SPARC), thrombospondin, laminin B1, and collagen type III.
- SPARC secreted protein acidic and cysteine rich
- the second agent comprises decorin (DCN), a CXCR3 ligand, collagen type I, or IL-10.
- DCN decorin
- the CXCR3 ligand is selected from CXCL4, CXCL9, CXCL10 and CXCL11, or is selected from a biologically active fragment of CXCL4, CXCL9, CXCL10 and CXCL11.
- Aspect 7 The method of aspect 1 (i), wherein the first agent is administered at least one day prior to administration of the second agent.
- Aspect 8123-107870-02 Aspect 8. The method of aspect 7, wherein the first agent is administered at least 2 days, at least 3 days, at least 4 days, at least 5 days, at least 6 days, at least 1 week, at least 2 weeks or at least 3 weeks prior to administration of the second agent.
- Aspect 9 The method of aspect 1(ii), wherein the controlled delivery composition comprises a hydrogel and the hydrogel comprises: the first agent; and the second agent encapsulated in a coacervate, wherein upon administration of the controlled delivery composition, the first agent is released from the hydrogel prior to release of the second agent from the coacervate.
- Aspect 10 Aspect 10.
- the controlled delivery composition comprises: a first coacervate comprising the first agent; a second coacervate comprising the second agent, wherein the second coacervate is encapsulated by lipids, thereby forming a lipo-coacervate, wherein upon administration of the controlled delivery composition, the first agent is released from the first coacervate prior to release of the second agent from the lipo-coacervate.
- the lipids of the lipo-coacervate comprise: cholesterol; and at least one unsaturated lipid and/or at least one saturated lipid.
- the at least one unsaturated lipid is selected from 18:1 ( ⁇ 9-Cis) PC (DOPC), 18:1 ( ⁇ 9-Cis) PG (DOPG), 18:1 ( ⁇ 9-Cis) PE (DOPE), 16:0-18:1 PE (POPE), 16:0-18:1 PC (POPC), 16:0-18:1 PS (POPS) and 18:1 DGS-NTA(Ni); and/or the at least one saturated lipid is select from 16:0 PC (DPPC), 18:0 PC (DSPC), 16:0 PS (DPPS), 18:0 PS (DSPS), 16:0 PE (DPPE), 18:0 PE (DSPE), 16:0 PG (DPPG), and 18:0 PG (DSPG).
- the at least one unsaturated lipid is selected from 18:1 ( ⁇ 9-Cis) PC (DOPC), 18:1 ( ⁇ 9-Cis) PG (DOPG), 18:1 ( ⁇ 9-Cis) PE (DOPE), 16:0-18:1 PE (POPE
- Aspect 13 The method of aspect 11 or aspect 12, wherein the lipids of the lipo-coacervate comprise cholesterol, DOPC and DSPG. Aspect 14. The method of aspect 11 or aspect 12, wherein the lipids of the lipo-coacervate comprise cholesterol, DPPC and DSPG. Aspect 15.
- the controlled delivery composition comprises: 8123-107870-02 a first coacervate comprising the first agent, wherein the first coacervate is encapsulated by lipids, thereby forming a first lipo-coacervate; and a second coacervate comprising the second agent, wherein the second coacervate is encapsulated by lipids, thereby forming a second lipo-coacervate, wherein upon administration of the controlled delivery composition, the first agent is released from the first lipo-coacervate prior to release of the second agent from the second lipo-coacervate.
- the first lipo-coacervate comprises cholesterol and at least one unsaturated lipid selected from 18:1 ( ⁇ 9-Cis) PC (DOPC), 18:1 ( ⁇ 9-Cis) PG (DOPG), 18:1 ( ⁇ 9-Cis) PE (DOPE), 16:0-18:1 PE (POPE), 16:0-18:1 PC (POPC), 16:0-18:1 PS (POPS) and 18:1 DGS- NTA(Ni).
- Aspect 17 The method of aspect 16, wherein the first lipo-coacervate further comprises a saturated lipid and/or cholesterol.
- Aspect 18 The method of aspect 17, wherein the saturated lipid comprises 18:0 PG (DSPG).
- Aspect 20 The method of any one of aspects 15-19, wherein the second lipo-coacervate comprises cholesterol and at least one saturated lipid selected from 16:0 PC (DPPC), 18:0 PC (DSPC), 16:0 PS (DPPS), 18:0 PS (DSPS), 16:0 PE (DPPE), 18:0 PE (DSPE), 16:0 PG (DPPG), and 18:0 PG (DSPG).
- Aspect 21 The method of aspect 20, wherein the second lipo-coacervate comprises cholesterol, DPPC and DSPG.
- Aspect 22 The method of aspect 20, wherein the second lipo-coacervate comprises cholesterol, DPPC and DSPG.
- the coacervate, the first coacervate and/or the second coacervate comprises poly(ethylene arginyl aspartate diglyceride) (PEAD) and heparin.
- Aspect 23. The method of any one of aspects 1-22, wherein the wound is a dermal wound or a mucosal wound.
- Aspect 24. The method of aspect 23, wherein the dermal wound comprises a laceration, a puncture wound, an abrasion, a surgical wound, a burn, an ulcer or a pressure sore. 8123-107870-02
- Aspect 25 The method of aspect 23, wherein the mucosal wound is in the nose, mouth, rectum, anus, vagina or lung.
- Aspect 26 The method of any one of aspects 1-25, wherein administration comprises topical administration.
- Aspect 27 The method of any one of aspects 1-25, wherein administration comprises injection at or near the site of the wound.
- Aspect 28 A controlled delivery composition for treating a wound, comprising: a therapeutically effective amount of a first agent that promotes wound closure selected from heparin binding EGF-like growth factor (HB-EGF), tenascin-C (TNC), a growth factor, a matricellular protein, interleukin (IL)-1, IL-2 and IL-4; and a therapeutically effective amount of a second agent that inhibits scarring selected from decorin (DCN), a CXCR3 ligand, collagen type I and IL-10, wherein the controlled delivery composition permits rapid release of the first agent and delayed release of the second agent.
- HB-EGF heparin binding EGF-like growth factor
- THC tenascin-C
- IL interleukin
- IL interleukin
- Aspect 29 The controlled delivery composition of aspect 28, wherein: the growth factor is selected from epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), a member of the fibroblast growth factor (FGF) family, transforming growth factor (TGF)- ⁇ , amphiregulin, and platelet-derived growth factor (PDGF); the matricellular protein is selected from secreted protein acidic and cysteine rich (SPARC), thrombospondin, laminin B1, and collagen type III; and/or the CXCR3 ligand is selected from CXCL4, CXCL9, CXCL10 and CXCL11.
- EGF epidermal growth factor
- VEGF vascular endothelial growth factor
- FGF fibroblast growth factor
- TGF transforming growth factor
- PDGF platelet-derived growth factor
- the matricellular protein is selected from secreted protein acidic and cysteine rich (SPARC), thrombospondin, laminin B1, and collagen type III
- the controlled delivery composition of aspect 28 or aspect 29, comprising a hydrogel, wherein the hydrogel comprises: the first agent; and the second agent encapsulated in a coacervate, wherein upon administration of the controlled delivery composition, the first agent is released from the hydrogel prior to release of the second agent from the coacervate.
- Aspect 32. The controlled delivery composition of aspect 31, wherein the lipids of the lipo- coacervate comprise: cholesterol; and at least one unsaturated lipid and/or at least one saturated lipid.
- the at least one unsaturated lipid is selected from 18:1 ( ⁇ 9-Cis) PC (DOPC), 18:1 ( ⁇ 9-Cis) PG (DOPG), 18:1 ( ⁇ 9-Cis) PE (DOPE), 16:0-18:1 PE (POPE), 16:0-18:1 PC (POPC), 16:0-18:1 PS (POPS) and 18:1 DGS-NTA(Ni); and/or the at least one saturated lipid is select from 16:0 PC (DPPC), 18:0 PC (DSPC), 16:0 PS (DPPS), 18:0 PS (DSPS), 16:0 PE (DPPE), 18:0 PE (DSPE), 16:0 PG (DPPG), and 18:0 PG (DSPG).
- the at least one unsaturated lipid is selected from 18:1 ( ⁇ 9-Cis) PC (DOPC), 18:1 ( ⁇ 9-Cis) PG (DOPG), 18:1 ( ⁇ 9-Cis) PE (DOPE), 16:0-18:1 PE (POPE
- Aspect 34 The controlled delivery composition of aspect 32 or aspect 33, wherein the lipids of the lipo-coacervate comprise cholesterol, DOPC and DSPG.
- Aspect 35 The controlled delivery composition of aspect 32 or aspect 33, wherein the lipids of the lipo-coacervate comprise cholesterol, DPPC and DSPG.
- Aspect 36 The controlled delivery composition of aspect 32 or aspect 33, wherein the lipids of the lipo-coacervate comprise cholesterol, DPPC and DSPG.
- the controlled delivery composition of aspect 28 or aspect 29, wherein the controlled delivery composition comprises: a first coacervate comprising the first agent, wherein the first coacervate is encapsulated by lipids, thereby forming a first lipo-coacervate; and a second coacervate comprising the second agent, wherein the second coacervate is encapsulated by lipids, thereby forming a second lipo-coacervate, wherein upon administration of the controlled delivery composition, the first agent is released from the first lipo-coacervate prior to release of the second agent from the second lipo-coacervate.
- the controlled delivery composition of aspect 36 wherein the first lipo-coacervate comprises cholesterol and at least one unsaturated lipid selected from 18:1 ( ⁇ 9-Cis) PC (DOPC), 18:1 ( ⁇ 9- Cis) PG (DOPG), 18:1 ( ⁇ 9-Cis) PE (DOPE), 16:0-18:1 PE (POPE), 16:0-18:1 PC (POPC), 16:0-18:1 PS (POPS) and 18:1 DGS-NTA(Ni). 8123-107870-02 Aspect 38.
- the controlled delivery composition of aspect 37, wherein the first lipo-coacervate further comprises a saturated lipid.
- the controlled delivery composition of aspect 38, wherein the saturated lipid comprises 18:0 PG (DSPG).
- Aspect 40 The controlled delivery composition of aspect 39, wherein the first lipo-coacervate comprises cholesterol, DOPC and DSPG.
- Aspect 41 The controlled delivery composition of any one of aspects 36-40, wherein the second lipo-coacervate comprises cholesterol and at least one saturated lipid selected from 16:0 PC (DPPC), 18:0 PC (DSPC), 16:0 PS (DPPS), 18:0 PS (DSPS), 16:0 PE (DPPE), 18:0 PE (DSPE), 16:0 PG (DPPG), and 18:0 PG (DSPG).
- Aspect 42 The controlled delivery composition of aspect 41, wherein the second lipo- coacervate comprises cholesterol, DPPC and DSPG.
- Aspect 43 The controlled delivery composition of aspect 41, wherein the second lipo- coacervate comprises cholesterol, DPPC and DSPG.
- Example 1 Background, Materials and Methods This example provides the background, materials and methods for Examples 2-5. Background Mesenchymal stem cells/multipotent stromal cells (MSCs) have emerged as a promising candidate therapy for chronic skin wounds due to their genuine involvement in the early phases of routine wound healing.
- MSCs multipotent stromal cells
- endogenous bone marrow MSCs Upon injury, endogenous bone marrow MSCs home to the site of injury and secrete paracrine signals to modulate the inflammation process and promote angiogenesis (Sylakowski et al., Am J Pathol. Jul 2020;190(7):1370-1381; Bradshaw et al., Curr Pathobiol Rep. Jun 2018;6(2):109-115; Rustad et al., Adv Wound Care (New Rochelle). Aug 2012;1(4):147-152.; Li et al., Front Med. Mar 2011;5(1):33-39).
- the chronic wound microenvironment is a hostile culmination of damaged extracellular matrix (ECM), cellular debris, hyper inflammation, and an impaired vasculature (Hu et al., Plast Surg Int.2015;2015:383581; Rodrigues et al., Stem Cell Res Ther. Oct 262010;1(4):32). These factors induce MSC death through various mechanisms, including anoikis, ischemic insult, or increased signaling from death cytokines (Sylakowski et al., Am J Pathol. Jul 2020;190(7):1370-1381; Song et al., Expert Opin Biol Ther. Mar 2010;10(3):309-319).
- TNC Tenascin-C
- TNC is a six-armed glycoprotein composed of four main domains: the TNC assembly domain, the epidermal growth factor-like (EGF-L) repeat domain, the fibronectin type III (FNIII) domain, and a fibrinogen globe domain.
- EGF-like repeats are found on each arm of the TNC hexamer (Midwood and Orend, J Cell Commun Signal. Dec 2009;3(3-4):287-310). These EGF-like repeats bind to the epidermal growth factor receptor (EGFR) through low affinity/high avidity interactions, allowing for the sequestering of the EGFR to the cell membrane preventing its internalization and degradation (Iyer et al., J Cell Physiol. Jun 2007;211(3):748-758; Swindle et al., J Cell Biol. Jul 232001;154(2):459-468).
- EGFR epidermal growth factor receptor
- TNC promotes MSC survival in the face of Fas ligand-induced cell death by binding and sequestering the EGFR, resulting in prolonged activation of the AKT and ERK pro-survival signaling pathways (Rodrigues et al., Stem Cell Res Ther. Oct 262010;1(4):32; Rodrigues et al., Tissue Eng Part A. Sep 2013;19(17-18):1972-1983).
- MSCs in a TNC-based polymer system in vivo were able to survive out to 21 days post-transplantation within the wound bed (Yates et al., Cell Transplant. Jan 242017;26(1):103-113). The studies disclosed herein investigate the use of MSCs to promote healing.
- TNC-supported MSC culture conditions subjected to H/ND were evaluated for angiogenic influence on endothelial cells, as reestablishing new vasculature is necessary to overcome ischemia and progress the wound healing process forward.
- the last set of experiments were designed to determine how 8123-107870-02 TNC-MSC systems would translate in vivo.
- MMPs metalloproteinases
- coacervate a protein delivery system called coacervate was used to help protect TNC against early degradation post-implantation.
- This system is an injectable in vivo delivery vehicle that uses a positively charged synthetic biodegradable poly(ethylene arginyl aspartate diglyceride) (PEAD) and a negatively charged heparin to form a 3- dimensional coacervate that envelopes around the protein cargo of choice (Johnson and Wang, J Control Release.
- PEAD synthetic biodegradable poly(ethylene arginyl aspartate diglyceride)
- the animal model used for this study is an impaired wound healing CXCR3 -/- mouse model. This mouse model exhibits a delayed healing response within the dermal and epidermal layers of the skin, leading to an immature dermal matrix, a weakened basement membrane, and hypercellularity (Huen and Wells, Adv Wound Care (New Rochelle).
- the IHMSC cell line was a human bone marrow-derived cell line that what immortalized by using human telomerase reverse transcriptase (Shima et al., Biochem Biophys Res Commun. Feb 22007;353(1):60-66). IHMSCs were cultured using the following proliferation media formulation: DMEM with L-Glutamine, 1g/L Glucose and Sodium Pyruvate from Corning (Cat. No.10-014-CV), supplemented with 10% FBS (Cat.
- PrhMSCs were obtained from the repository at the Darwin Prockop laboratory at Texas A&M University, a National Institute of Health-funded stem cell repository. PrhMSCs were cultured using the following proliferation media formulation: ⁇ -MEM (Cat. No.15-012-CV, Corning) supplemented with 16.5% FBS (Cat. No. S11550H, Atlanta Biologicals), 2 mM L-glutamine, and 100 units per mL penicillin/streptomycin.
- ⁇ -MEM Cat. No.15-012-CV, Corning
- FBS Cat. No. S11550H, Atlanta Biologicals
- 2 mM L-glutamine and 100 units per mL penicillin/streptomycin.
- MSCs For hypoxia and nutrient deprivation conditions (H/ND) to mimic ischemia in vitro, MSCs were expanded and seeded near confluence onto one of three treatment coatings (Plastic, Col-1 or TNC+Col-1) and cultured in their fully supplemented DMEM for one day at ambient air conditions (37°C at 5% CO 2 and 21% O2) to stabilize after passaging. Meanwhile, basal DMEM and ⁇ -MEM without supplementation or FBS were placed into BioSpherix incubators at 1% oxygen to acclimate the media 24 hours prior to adding to the cells.
- H/ND hypoxia and nutrient deprivation conditions
- H/ND experiments Upon the start of H/ND experiments of MSCs, the complete culture medias were aspirated, the plates were washed twice with PBS to remove residual media, and pre-equilibrated H/ND media was added 8123-107870-02 to the MSCs. The MSCs were then placed into the BioShperix incubators at 1% oxygen. At no point in the culture of cells at 1% were the cells exposed to ambient oxygen conditions, as microscopes to monitor cells were also contained in the BioSpherix chamber. Positive confirmation of hypoxia on MSCs was confirmed through a live cell green hypoxia dye (Cat. No. SCT033, EMD Millipore) as instructed by the company's protocol at the beginning stages of each H/ND experiment (FIG.6).
- a live cell green hypoxia dye Cat. No. SCT033, EMD Millipore
- HMEC-1 Immortalized Human Microvascular Endothelial Cell Culture – Immortalized Human Microvascular Endothelial Cells (HMEC-1) were obtained through ATCC (Cat. No. CRL-3242; Ades et al., J Invest Dermatol. Dec 1992;99(6):683-690.) and cultured using the following proliferation media formulation: MCDB131 basal media without L-glutamine (Fisher Scientific) supplemented with 10% FBS, 10 ng/mL epidermal growth factor, 1 ⁇ g/mL hydrocortisone, and 10 mM glutamine. HMEC-1 were thawed and expanded up to passage 3 in proliferation media, then transitioned to either IHMSC or PrhMSC media conditions over a two-week period for functional endpoint experiments.
- ATCC Cat. No. CRL-3242; Ades et al., J Invest Dermatol. Dec 1992;99(6):683-690.
- HMEC-1s By Passage 6 HMEC-1s were fully transitioned to MSC media conditions and used for cell migration and cord formation studies. Coating Culture Plates with Col-1 and TNC Cell culture plate coating procedures and concentrations used for Tenascin-C (TNC) (Cat. No. CC065, EMD Millipore) and type 1 rat tail collagen (Col-1)(Cat. No.354236, BD Biosciences) were as previously described (Rodrigues et al., Tissue Eng Part A. Sep 2013;19(17-18):1972-1983).
- TNC Tenascin-C
- Col-1 Cat. No.354236
- cell culture dishes were coated for 12 hours at 37°C with 1 ⁇ g/cm 2 Col-1, or 1 ⁇ g/cm 2 Col-1 and 1 ⁇ g/cm 2 TNC diluted in PBS. After the incubation period, the PBS was aspirated, and the coated surfaces were placed under UV light for 30 minutes before seeding any cells.
- the Col-1 was required for the TNC-coated plates, as TNC is anti-adhesive and requires additional integrin-binding epitopes as provided by the collagens (Rodrigues et al., Tissue Eng Part A. Sep 2013;19(17-18):1972-1983).
- Apoptosis Assessment Two methods determined cell death.
- flow cytometry combined with an Annexin V and propidium iodide (PI) kit (Cat. No. V13242, Thermo Fisher Scientific) were performed as per manufacturers' instruction.
- MSCs cultured under H/ND growth conditions on either plastic, Col-1, or TNC+Col-1 were harvested by collecting adherent cells and floating cells in the supernatant. The floating and adherent cells were combined and stained for PI and Annexin V for 15 minutes at room temperature.
- An appropriate volume of 1X annexin-binding buffer and counting beads (Cat. No. C36950, Thermo Fisher Scientific) were added and the tubes placed on ice.
- CM Conditioned Media Conditioned media
- HMEC-1 cells While the gel was polymerizing, low passage fully transitioned HMEC-1 cells were trypsinized, counted, and mixed with a ratio of 50% basal media and 50% freshly thawed CM for each treatment condition. Basal media alone was used as the negative control, while basal media with 10% FBS was used as the positive control. Cells were then seeded into the Ibidi angiogenesis chamber at 2x10 5 and placed into a 37°C incubator with ambient growth conditions. Cords were allowed to form over the next 6 hours before being quantified using ImageJ Angiogenesis Analyzer (Carpentier et al., Sci Rep. Jul 14 2020;10(1):11568) and expressed as a total number of cords, total cord length, the total number of meshes, and total mesh area.
- ImageJ Angiogenesis Analyzer Carlot al., Sci Rep. Jul 14 2020;10(1):11568
- Cords are the sum of segments (elements bordered by two junctions) and branches (elements bordered by a junction and one extremity); and a mesh is defined as an area enclosed by segments (Carpentier et al., Sci Rep. Jul 142020;10(1):11568).
- Scratch Assay Cell migration was assessed using the wound healing (or scratch) assay. HMEC-1 were seeded into 24 well plates and allowed to grow to confluence. Upon reaching confluence, the cells were washed in PBS and then cultured in basal media containing 1% dialyzed FBS for 24 hours to limit proliferation during the study. The next day using a 1000 mL pipette tip, scratches were made down the middle of each plate to create a denuded area.
- a semi-quantitative human angiogenesis antibody array (Cat. No. AAH-ANG-1000-2, RayBiotech) was used according to the instructions as outlined in their protocol.
- 1 mL of CM from each MSC treatment group was placed on a specialized PVDF membrane with specific angiogenic capture antibodies and incubated overnight at 4°C.
- a series of washes and conjugation of biotinylated antibodies were performed following the incubation period.
- membranes were washed 3 times more and detected using labeled streptavidin and chemiluminescence. Radiographs were processed and analyzed using ImageJ Dot Blot analyzer plug-in.
- RNA samples were seeded onto 6-well plates for each condition (plastic, Col-1, or TNC+Col-1) and subjected to H/ND. At 48 hours, MSC treatment conditions were washed with PBS, trypsinized and pelleted, and RNA was isolated using RNeasy kit (Cat. No.74004, Qiagen). Quality and concentration analysis of RNA samples was assessed using a nanodrop instrument and stored at -80°C. Next, the Isolated RNA samples were synthesized into cDNA using The RT 2 First Strand c-DNA Synthesis Kit from Qiagen (Cat. No.330404, Qiagen). MSC angiogenic and wound healing genes were assessed using Qiagen RT 2 Profiler Array System (Cat.
- RT-PCR was performed on the Stratagene Mx3000P Real-Time PCR System with the Qiagen RT2 SYBR Green qPCR Master Mix (Cat. No.330523, Qiagen). Samples were analyzed using the ⁇ CT method plus or minus standard error and expressed in terms of fold regulation. MSCs grown on Col-1 and TNC+Col-1 were normalized back to MSCs grown on plastic, and GAPDH was used as the reference gene. Fold-regulation is similar to fold change in that positive values greater than one indicate up-regulation; however, fold-change values less than one that indicates down-regulation have now been transcribed to the negative inverse.
- Animal Model C57BL/6J CXCR3-/- mice were generated as previously described (Hancock et al., J Exp Med. Nov 202000;192(10):1515-1520). The C57BL/6J CXCR3 -/- mice were then bred to FVB strain mice for at least 20 generations to yield germline transmission of the targeted allele and create CXCR3 devoid mice on the FVB background. For this study, CXCR3 -/- female mice were bred with CXCR3 -/- males, and all offspring 8123-107870-02 were screened for genotype through PCR before use.
- mice were housed in individual cages after wounding to limit fighting and further scarring and maintained under a 12-hour light/dark cycle.
- Mouse Wounding Male and female mice (8 to 9 months of age and weighing approximately 25 g) were anesthetized with an intraperitoneal injection containing ketamine (75 mg/kg) and xylazine (5 mg/kg). The backs were cleaned, shaved, and sterilized with betadine solution. Full-thickness wounds were performed using an 8 mm diameter punch biopsy through the epidermal and dermal layers along one side of the dorsal midline of the mouse (FIG.7A). The contralateral uninjured skin served as unwounded control skin.
- the heparin/TNC solution was then mixed with the PEAD stock solution to form protein-encapsulated coacervates at a final ratio of 1:100:500 mass ratio. Coacervation was determined by the rapid formation of a turbid solution once all components were added.
- the prepared coacervate mixture was then mixed with a prepared cell suspension of 50x10 4 IHMSCs per mouse for a total injection volume of 300 ⁇ L per mouse. Intradermal Injections were administered 72 hours post wounding.
- Each treatment group comprised of 4 animals each.
- Coacervate Release Coacervate was prepared as stated above to create three independent samples for coacervate containing TNC. Samples were incubated at 37oC for 14 days, and the supernatant was harvested on days 0, 1, 3, 7, and 14 through pelleting the coacervates by centrifugation (12,100g for 10 min). Supernatants were analyzed using pre-coated enzyme-linked immunosorbent assay (ELISA) kits (Cat.
- Wound healing score assessment Histopathological examination of mouse tissues was performed in a double-blind approach among three investigators, and their scores averaged. Qualitative assessments were based on epidermal and dermal maturation as outlined in previously established protocols (Yates et al., Wound Repair Regen. Jan-Feb 2009;17(1):34-41; Yates et al., Am J Pathol. Aug 2007;171(2):484-495; Yates et al., Am J Pathol. Sep 2008;173(3):643-652). In short, the samples were scored on a scale of 0 to 4 for both epidermal and dermal layers of tissue.
- Skin thickness measurements – H&E and MT sample images were analyzed using ImageJ line measurement tool to measure the thickness of the epidermal and dermal layers for each mouse specimen.
- the epidermal layers were measured from the stratum basale to the stratum granulosum (excluding the stratum corneum), and the dermal layer was measured from the top of the papillary layers to the bottom of the reticular layer. A total of 6 measurements per biological sample were scored for each layer.
- Collagen quantification – Polarized PSR images were quantified using ImageJ version 1.53K. Each image was split into red, green, and blue channels, from which the red and green channels were selected. The isolated red and green channels then underwent thresholding and follow-up measurements to determine the total staining area for each collagen type.
- PSR birefringence under polarized light reveals tightly packed thick and long fibrils of type 1 collagen as either bright red-orange intense birefringence in tissue and thin short loose fibrils as yellow-green (Coelho et al., An Bras Dermatol. Jun 2018;93(3):415-418).
- the overall ratio of type 1 collagen to type III collagen was analyzed by comparing the representative staining results for either collagen type back to the original image for total collagen content.
- Collagen orientation and alignment – Polarized PSR images were quantified using ImageJ plug-in: OrientationJ version 2.0.5.
- TNC has been shown to protect MSCs against inflammatory death signals (Rodrigues et al., Tissue Eng Part A. Sep 2013;19(17-18):1972-1983), and the current study aims to determine whether this matricellular protein also ameliorates the ischemia due to lack of angiogenesis.
- An ischemic environment was created in vitro using a Biospherix growth chamber (Nuschke et al., Stem Cell Res Ther. Dec 1 2016;7(1):179).
- a cell survival time course was made using Propidium Iodide (PI) as a marker for dead cells.
- PI Propidium Iodide
- PI can detect necrotic or late apoptotic cells through the loss in integrity of the plasma membrane
- a snapshot of this transition at day 7 revealed that only 2.09% of the MSCs on plastic did not transition through apoptosis (PI-/Annexin V-); compared to the survival rates of MSCs on Col-1 at 29.9% or MSCs on TNC+Col-1 at 40.2%; the survival on TNC+Col-1 was significantly higher than Col-1 alone (FIGS.1A, 1B and 8B).
- Example 3 Conditioned media from MSCs cultured on Tenascin-C improves endothelial cord formation and motility TNC can contribute to the wound angiogenic response by enhancing MSC-produced angiogenic factors.
- CM MSC conditioned media
- CM was harvested from MSCs cultured on either plastic, Col-1, or TNC+Col-1 under H/ND conditions and used with HMEC-1 plated on a reduced growth factor Matrigel surface to commence cord formation (FIG.2A).
- CM from all three treatment groups performed equal to or better than the positive control of basal media + 10% FBS across all metrics (FIG.2B).
- the CM from MSC cultured on TNC+Col-1 scored significantly higher than MSCs cultured on plastic for total cord length, the total number of meshes, and total mesh area.
- CM from MSCs cultured on TNC+Col-1 had significantly longer length and a higher number of cords compared to CM from MCSs cultured on Col-1 alone, and trended higher on the other matrices though the increases did not reach statistical significance.
- further studies sought to examine the cell motility effects of the different culture conditions through a wound-healing/scratch assay.
- CM harvested from the varying MSC culture conditions plastic, Col-1, TNC+Col-1) were placed into confluent HMEC-1 wells with a denuded strip in the center to allow for cell migration.
- Example 4 Assessment of culture conditions on MSC paracrine activity and gene expression during H/ND exposure The physiological outcomes of CM on endothelial function prompted exploration of what factors could be at play.
- angiogenic cytokines were measured utilizing an angiogenesis array for 43 protein targets (FIGS.3A, 3B).
- 43 protein targets 6 proteins were substantially expressed including IL-6, IL-8 (CXCL8), TIMP-1, TIMP-2, CCL2 (MCP-1), and Gro alpha/beta/gamma (CXCL1, CXCL2, CXCL3).
- Example 5 Coacervate with TNC and MSC improves wound healing in vivo in delayed wound healing mouse model Further studies were performed to determine whether the findings in vitro would improve the healing outcomes in a CXCR3 -/- mouse model of delayed wound healing (Yates et al., Wound Repair Regen. Jan-Feb 2009;17(1):34-41; Yates et al., Am J Pathol. Aug 2007;171(2):484-495).
- Wounds were made in the CXCR3 -/- mice, and one of five treatment groups (CO only, CO+TNC, CO+MSC, TNC+MSC, or CO+TNC+MSC) were administered 72 hours after the initial wounding.
- the wounds were harvested on D30 during the middle of the delayed tissue replacement phase of wound healing (Sylakowski et al., Am J Pathol. Jul 2020;190(7):1370-1381).
- histological stains using H&E and Mason’s Trichrome (MT) reveal complete migration and stratification of the epidermis, along with a fully intact basement membrane indicating complete wound healing of the epidermal layer with a wound score of a 4 (FIGS.4A, 4B, 4E).
- collagen alignment scoring can also help determine the maturity of collagen within the dermis.
- the dermal layer alignment becomes more horizontal as the collagen becomes more mature and contracted via the myofibroblasts.
- the overall alignment of the collagen fibrils was observed using the ImageJ color survey tool (FIG.5C). This allows the PSR stain to be pseudo-colored according to their alignment orientation. From this view, the orientation can be analyzed in two ways.
- the first collagen alignment method was to look at the total distribution of all collagen fibrils relative to their degree of alignment (FIG.5E). A skewed bimodal distribution was seen in all treatment groups with one peak around the -50 degree orientation mark and the other around the +50 degree orientation mark.
- mice treated with the CO + TNC + MSC group had the tallest peak out of all the treatment groups at the +50 mark, indicating it has the most alignment in that location. It is also the highest peak out of all peaks on the graph, signaling it is the most aligned of all treatment groups.
- the two treatment groups with the lowest collagen alignment score were CO + TNC and CO + MSCs.
- the second way to measure collagen alignment is through total measured coherency. This measures the overall coherency of the collagen fibrils within each image with a total coherency measure between 0 and 1, where 0 indicates complete isotropy and 1 indicates complete alignment (Rezakhaniha et al., Biomech Model Mechanobiol. Mar 2012;11(3-4):461-473).
- mice treated with CO + TNC + MSCs had a significantly higher coherency score compared to CO only, CO + TNC, or CO + MSCs (FIG.5F).
- the mice treated with TNC + MSC without coacervate also exhibited good alignment with coherency scores significantly higher than CO only and CO + TNC treatment groups.
- mice treated with CO + TNC + MSCs and TNC + MSCs presented significantly thinner dermal thickness scores than the other three treatment methods (FIG.4F).
- mice treated with CO + TNC + MSCs had the highest wound score, closely followed by TNC + MSCs without coacervate (FIG.4E), whereas mice treated with CO only and Co + MSCs exhibited the least amount of 8123-107870-02 maturation in most metrics.
- TNC inclusion improves the performance of MSCs in promoting maturation of wounds through the phases of healing.
- Example 6 Background, Materials and Methods Cutaneous wound healing is a highly complex and dynamic process that requires a successful transition through three phases of repair to reach a successful resolution. This process relies critically on the timing and balance of key cell types, growth factors, and extracellular matrix (ECM) molecules to maintain proper outcomes.
- ECM extracellular matrix
- HTS hypertrophic scars
- MMPs matrix metalloproteinases
- ECM structural proteins such as collagen in HTS patients
- matricellular proteins are also affected.
- These specialized ECM proteins do not provide structure or scaffolding support for cells; instead, they directly interact with cell signaling through the interaction of growth factors, growth factor receptors, and other ECM proteins within the wound microenvironment, driving a variety of biological signaling cascades.
- One of these vital matricellular proteins is called decorin, and it acts as a stop signal within the resolution phase of wound healing.
- Decorin (DCN) is a small leucine-rich proteoglycan roughly 100 kDa in size.
- DCN DCN
- VEGF vascular endothelial growth factor
- DCN also regulates transforming growth factor – beta-1 (TGF- ⁇ 1), a significant influencer of wound contraction, by either binding and neutralizing the growth factor directly or by downregulating its production from hypertrophic scar fibroblasts (Gubbiotti et al., Matrix Biol. Sep 2016;55:7-21; Zhang et al., Burns. Aug 2007;33(5):634-641; Zhang et al., Burns. Jun 2009;35(4):527-537).
- TGF- ⁇ 1 transforming growth factor – beta-1
- CXCR3 is a seven transmembrane G-protein coupled receptor that is the sole receptor for CXCL4, CXCL9, CXCL10 and CXCL11, the latter two of which are expressed during wound healing at the time of the transition from tissue replacement to wound resolution.
- DCN plays an important role in proper wound resolution, and its protein levels are found to be decreased roughly 75% in HTS compared to regular wound healing patients (Gauglitz et al., Mol Med. Jan-Feb 2011;17(1-2):113-125; Finnerty et al., Lancet. Oct 1 2016;388(10052):1427-1436).
- delivery of exogenous growth factors or other protein-based therapies is often limited in their efficacy due to extensive degradation once administered in vivo into the harsh wound microenvironment (Hwang et al., Front Bioeng Biotechnol.2020;8:69).
- DCN was encapsulated in a heparin-mediated coacervate system.
- This system is an injectable in vivo delivery vehicle that uses a positively charged synthetic biodegradable poly(ethylene arginyl aspartate diglyceride) (PEAD) and a negatively charged heparin to form a 3-dimensional coacervate (Johnson and Wang, Wound Repair Regen. Jul-Aug 2015;23(4):591-600; Park et al., Acta Biomater. May 2019;90:179- 191; Chu et al., J Control Release. Mar 102011;150(2):157-163; Johnson and Wang, J Control Release. Mar 102013;166(2):124-129).
- PEAD synthetic biodegradable poly(ethylene arginyl aspartate diglyceride)
- HB-EGF heparin-binding EGF-like growth factor
- mice Male and female mice (6 to 8 months of age and weighing approximately 25 g) were anesthetized with an intraperitoneal injection containing ketamine (75 mg/kg) and xylazine (5 mg/kg). The backs were cleaned, shaved, and sterilized with betadine solution. Full-thickness wounds were performed using an 8 mm diameter punch biopsy through the epidermal and dermal layers along one side of the dorsal midline of the mouse. The contralateral uninjured skin served as unwounded control skin. Coacervate Preparation PEAD was synthesized as previously described (Chu et al., J Control Release. Mar 10 2011;150(2):157-163).
- a mouse received a total of 200 ⁇ L of either treatment coacervate or control coacervate through a series of 4 injections of 50 ⁇ L around the wound bed to avoid tissue trauma (FIG.10A).
- Mice 8123-107870-02 treated with HB-EGF coacervate received a dose of 200 ⁇ L containing a total of 1.45 ⁇ g HB-EGF
- mice treated with DCN received a dose of 200 ⁇ L containing a total of 10 ⁇ g DCN.
- Coacervate Release Coacervate was prepared as stated above to create three independent samples for both HB-EGF and DCN.
- Skin thickness measurements – H&E and MT sample images were analyzed using ImageJ line measurement tool to measure the thickness of the epidermal layer and dermal layer for each mouse specimen.
- the epidermal layers were measured from the stratum basale to the stratum granulosum (excluding the stratum corneum); and the dermal layer was measured form the top of the papillary layers to the bottom of the reticular layer. A total of 6 measurements per biological sample were scored for each layer. 8123-107870-02 Collagen quantification – Polarized PSR images were quantified using ImageJ version 1.53K. Each image was split into red, green, and blue channels, from which the red and green channels were selected. The isolated red and green channels then underwent thresholding and follow-up measurements to determine the total staining area for each collagen type.
- PSR birefringence under polarized light reveals tightly packed thick and long fibrils of type 1 collagen as either bright red-orange intense birefringence in tissue and thin short loose fibrils as yellow-green (Coelho et al., An Bras Dermatol. Jun 2018;93(3):415-418).
- the overall ratio of type 1 collagen to type III collagen was analyzed by comparing the representative staining results for either collagen type back to the original image for total collagen content.
- Collagen orientation and alignment – Polarized PSR images were quantified using ImageJ plug-in: OrientationJ version 2.0.5.
- Example 8 Modifying the matrix increased vascularization during tissue replacement Continuing onto the findings of delayed dermal maturation of CXCR -/- mice, it was observed whether any coacervate treatment group helped to improve outcomes during the tissue replacement phase of repair by examining outcomes at 30 days. At this point in the wound healing process, histological stains using H&E and MT reveal complete migration and stratification of the epidermal layer, including eliminating the eschar in all three treatment groups (FIGS.12A, 12B). Additional staining with involucrin showed a complete protective barrier signifying the completion of the stratified corneum in the epidermis in all three treatment groups (FIG.12F).
- Example 9 Coacervate with Decorin improves wound healing outcomes in the resolution phase CXCR3 knockout mice exhibit hypertrophic scarring by day 90 after the initial wound (Yates et al., Am J Pathol. Apr 2010;176(4):1743-1755); this was predicted to be the time point during wound resolution that 'stop' signals would exert their most significant effects. To this point, significantly improved wound healing scores were observed in mice treated with CO + DCN as compared to CO only mice (FIGS.13A- 13C). CO + DCN treated mice exhibited less overall cellularity within the dermal layer of tissue in addition to more organized collagen fibrils.
- CO + DCN treated mice presented a significantly thinner epidermal and dermal wound thickness compared to CO only mice as these resolved back towards unwounded thicknesses (FIG.13D).
- CO + HB-EGF also exhibited a significantly higher dermal wound score over CO only mice but did not significantly change the overall thickness measurement for either the epidermal or dermal layers, suggesting that this treatment did not drive resolution.
- the collagen content and alignment of PSR staining was further assessed (FIG.13E).
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