CN1638734A - 微粒结膜下给药的药物释放*** - Google Patents

微粒结膜下给药的药物释放*** Download PDF

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CN1638734A
CN1638734A CNA038044064A CN03804406A CN1638734A CN 1638734 A CN1638734 A CN 1638734A CN A038044064 A CNA038044064 A CN A038044064A CN 03804406 A CN03804406 A CN 03804406A CN 1638734 A CN1638734 A CN 1638734A
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桑野光明
山田和人
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Abstract

本发明提供了一种良好的眼球后部药物释放***。本发明的注射剂含有含药物的微粒,是药物能向眼球后部转移的结膜下注射剂。将含药的微粒结膜下给药时,对眼组织的伤害少且能使药物高效率地输送到眼球后部(视网膜、脉络膜、视神经等)。微粒优选由合成生物可降解性高分子制成,平均粒径为50nm~150μm,药物在微粒中均匀分散。优选的药物为抗炎剂、免疫抑制剂、抗病毒剂、抗癌剂、血管新生抑制剂、视神经保护剂、抗菌剂或抗真菌剂。

Description

微粒结膜下给药的药物释放***
技术领域
本发明涉及用于视网膜、脉络膜、视神经等眼球后部的药物释放***。
背景技术
在视网膜、脉络膜、视神经等眼球后部的疾病中,难治性疾病很多,目前迫切希望开发出有效的治疗方法。对于眼部疾病,最常见的是点眼给药治疗,但药物基本上不向视网膜、脉络膜、视神经等眼球后部转移,而且,就算转移也非常难于使药物浓度得以维持。
所以,对于眼球后部疾病的给药方法,已经尝试了静脉注射、口服给药、玻璃体注射。静脉注射或口服给药时,药物向靶部位的转移量极其微小,而且显著地表现出了所不希望的药物全身作用(副作用)。
玻璃体注射是将药物直接注入眼内,因此其向眼球后部的药物转移量比静脉注射或口服给药多。关于玻璃体注射的眼球后部释放,眼科药学与治疗学杂志  (Journal of Ocular Pharmacology andtherapeutics),(2001)17/4,393-401中已有综述。但是玻璃体注射是需要高度技术的给药方法,由于伴随有相当的痛苦,患者的负担也很大,多次给药非常困难。
相对于这些给药方法,结膜下注射的手法较简单,比玻璃体给药对眼部的伤害小且患者的负担小。结膜下注射后的药物向眼球后部的转移性已有报告(Invest.Ophthalmol.Visual Sci.18(3)250-255,1979)、其半衰期很短,很难长时间维持药物在组织中的浓度。因此,为了维持药物在组织中的浓度必须频繁多次给药,但频繁多次给药使患者的负担加大。
为了避免频繁多次给药,作为维持眼内药物浓度的方法,已知的有静脉注射药物-高分子结合体的方法(Invest.Ophthalmol.VisualSci.40(1),2690-2696,1999)或在玻璃体中注射含有药物的微球的方法(特开2000-247871)等。
如上所述,现有的技术很难维持结膜下注射的药物在组织中的浓度,期待开发出结膜下注射的用于眼球后部的药物持续释放***。
发明内容
本发明者们经深入研究,结果发现,若将含药物的缓释性微粒结膜下给药,作为眼球后部的药物持续释放***非常有用。
本发明涉及将含药的微粒结膜下给药眼球后部药物释放***。本发明还涉及结膜下注射剂,其含有含药的微粒,且其中药物能向眼球后部转移。含药的微粒结膜下给药时,比静脉注射或口服给药的向眼球后部转移性好,对全身的副作用也小。而且比玻璃体注射手法简单,对患者的负担小。另外,由于使药物包含在微粒中,能长时间维持靶组织中的药物浓度。
在本发明中,形成微粒的材料优选生物可降解性高分子或生物可溶性高分子、作为具体例子可举出:聚乳酸、乳酸-乙醇酸共聚物、乳酸-己内酯共聚物、聚酐、聚原酸酯、聚ε-己内酯、聚丙烯氰基丙烯酸酯、多羟基链烷酸酯、聚磷酸酯、聚氨基酸、聚α羟基酸等生物可降解性高分子;明胶、骨胶原、透明质酸、葡聚糖、淀粉、藻酸钠、琼脂、支链淀粉、白蛋白、鹿角菜胶、果胶、黄原胶、茱萸烷胶(gellan gum)、酪蛋白、脱乙酰壳多糖、血纤维蛋白原等天然高分子;甲基丙烯酸共聚物、聚乙烯醇、羟丙基甲基纤维素、羟丙基甲基纤维素醋酸酯、羟乙基纤维素、羧甲基纤维素、甲基纤维素、聚乙烯吡咯烷酮、聚乙二醇、聚N-烷基丙烯酰胺等合成高分子。
这些高分子物质的分子量没有特别的限制,可根据微粒中所含药物的种类、药物的有效治疗浓度、药物释放时间等进行适当选择。
本发明的微粒的粒径优选50nm~150μm。粒径小于或等于50nm的微粒难以制造,粒径大于或等于150μm的微粒则粒径太大,不适于用于注射剂中。最优选的粒径为200nm~75μm。
本发明的药物释放***用于视网膜、脉络膜以及视神经疾病的治疗或者预防。作为具体疾病的例子可举出,各种原因引起的炎症、病毒或细菌的感染症、视网膜脉络膜的血管新生引发的疾病、视网膜缺血引发的疾病、白内障引发的视神经障碍。具体而言,可举出葡萄膜炎、巨细胞病毒视网膜炎、老年性黄斑变性、糖尿病性视网膜病变、增殖性玻璃体视网膜病变、视网膜剥离、视网膜色素变性、视网膜中央静脉阻塞、视网膜中央动脉阻塞等。
对于微粒中含有的药物没有特别的限制,可选择适合于对象疾病的药物。具体可举出,倍他米松、***、去炎松、强的松龙、氟甲龙、氢化可的松、***等类固醇药或其衍生物;溴芬那酸、双氯酚酸钠等抗炎剂;TNF-α抑制剂、PDE-IV抑制剂、ICE抑制剂等细胞因子抑制剂;环孢菌素、藤霉素等免疫抑制剂;甘环核苷、阿昔洛韦、β干扰素等抗病毒剂;氧氟沙星、克拉霉素、红霉素等的抗菌剂;氟苷、甲胺嘌呤、MPP抑制剂等的抗癌剂;血管内皮抑素、VEGF抑制剂、反义寡核苷酸、PKC抑制剂、粘合因子抑制剂、血管静止性类固醇等血管新生抑制剂;MK-801、噻马洛儿、肌酸、牛璜酸、BDNF等的神经保护剂/神经营养因子、乙酰唑胺等的碳酸脱水酶抑制剂;尿激酶等的血栓溶解剂。作为含药微粒,优选使药物在微粒中均匀分散的基质型或以药物为芯、以微粒囊化后得到的囊型。
微粒所含的药物量,可以根据药物的种类、有效治疗浓度、药物的释放时间、症状等进行适当增减。药物的含量为微粒的0.01~95重量%、优选为0.1~20重量%。
本发明的微粒可用以下的方法制造,但不限于这些方法。这些方法是使用公知研磨机的粉碎法、相分离法(凝聚法)、喷雾干燥法、超临界流体法、界面沉淀法、界面反应法。具体可以举出作为界面沉淀法的浸渍干燥法(J.Control.Release,2,343-352,(1985))、作为界面反应法的界面聚合法(Int.J.Pharm.,28,125-132(1986))、自乳化溶剂扩散法(J.Control.Release,25,89-98,(1993))等。根据微粒的粒径或所含药物的种类、性质或含量等,从这些制造方法中,适当地选择出合适的制造方法即可。
作为微粒的具体制造例,后述的实施例例示了以抗炎剂倍他米松作为药物,用聚乳酸作为微粒材料的含药微粒的制造例。
本发明的效果在后述的视网膜脉络膜药物浓度测定试验项中给予详细说明,用倍他米松作药物的例子,将含有倍他米松的微粒结膜下给药,测定脉络膜视网膜中的药物浓度时,发现脉络膜视网膜中的药物浓度得以持续保持。
本发明的药物释放***的微粒是结膜下给药。结膜下给药的方法可以是通常进行的结膜下注射。如背景技术部分所述,结膜下注射手法较简单且对患者的负担也小。
另外,运用本发明的***时,由于能高效率地将药物输送到靶部位的视网膜、脉络膜或视神经等眼球后部,因此能减少给药量,可望有减轻副作用的效果。
本发明的药物释放***使用的微粒是结膜下给药,所以优选注射剂作为给药剂型。注射剂运用常用的注射剂制剂化技术配制即可。例如,将通常用的添加剂,如氯化钠等渗透压调节剂、磷酸钠等缓冲剂、吐温80等表面活性剂、甲基纤维素等增粘剂等和微粒一起加入注射用蒸馏水中配制成制剂即可。另外,若用无针高压注射器时,则可以不用作成注射剂而直接以微粒的形式给药。
下文所示是微粒的制造例、制剂的配制例、药物浓度测定试验以及脉络膜血管新生抑制试验的结果。
具体实施方式
1、药微粒的制造方法
以下是能在本发明的药物释放***中使用的微粒的制造例。
将倍他米松(0.025g)和重均分子量为20000的聚乳酸(0.25g)溶解于苯甲醇(1.5ml)中,所得溶液作为药物/聚合物溶液。将2.0%(W/V)聚乙烯醇水溶液(30ml)在均化器中均化(5000rpm),向其中滴加药物/聚合物溶液。此混合物滴完后持续均化5分钟,配制成O/W型乳浊液。用搅拌器搅拌(300rpm)超纯水(300ml),向其中滴加配制好的O/W型乳浊液、滴完后持续搅拌1小时。搅拌完之后将所得到的悬浊液离心分离,除去上清液。为了洗净沉淀物,加入超纯水(30ml)使沉淀分散,再次离心分离除去上清液。此操作再重复一次。洗净的沉淀物过筛,得到粒径为50nm~75μm的粒子。将所得粒子冷冻干燥,即得到含有倍他米松的微球。
2、制剂的调制方法
使含有倍他米松的微球粉末(442mg)分散在4ml溶剂(0.4%(w/v)吐温80/2.6%(w/v)甘油水溶液)中,所得的分散液作为含倍他米松的微球注射剂。
3、脉络膜视网膜中药物浓度的测定试验
用含有倍他米松的微球注射剂,按下述方法测定脉络膜视网膜内的浓度。用倍他米松悬浊剂作为对照并按下述方法进行浓度测定。比较微球给药组和悬浊剂给药组的倍他米松在脉络膜视网膜内的浓度。倍他米松悬浊剂是将倍他米松悬浮分散在溶剂(0.4%(w/v)吐温80/2.6%(w/v)甘油水溶液)中所得的悬浊液。
1)将日本白色家兔两眼中点入盐酸奥布卡因(0.5%(W/V))点眼液进行眼表面麻醉。
2)用27G针的注射器,将含有倍他米松的微球注射剂在上部结膜下按每只眼睛100μL给药。微球中倍他米松的含量为4.6%(W/V),因此倍他米松的给药量约为500μg。对照组中,用27G针的注射器,将1%(W/V)的倍他米松悬浊剂在上部结膜下按每只眼睛50μL给药。
3)家兔给药后,分别在2、7、14、21、28天杀死,摘除眼球后,回收脉络膜视网膜、用高效液相色谱法测定脉络膜视网膜内倍他米松的浓度。
表1给出了药物的经时浓度变化结果。从表1可以明确看出,倍他米松悬浊剂的脉络膜视网膜内倍他米松浓度在7天后约为0.96μg/g组织,而14天后在检出限以下。与其相对,含有倍他米松微球注射剂的脉络膜视网膜内倍他米松浓度在28天后仍为0.09μg/g组织,脉络膜视网膜中药物浓度得以维持。
表1脉络膜视网膜内倍他米松浓度(μg/g组织)
    对照组(悬浊剂)     微球注射剂
    给药2天后     0.54±0.35     0.70±0.26
    7天后     0.96±0.54     0.18
    14天后     检出限以下     0.17±0.06
    21天后     检出限以下     0.10±0.02
    28天后     检出限以下     0.09±0.02
(表中脉络膜视网膜内倍他米松浓度表示的是3或4只眼的平均值±标准误差。微球注射剂的7天后的值由于4只眼中2只眼在检出限以下,所以表示的是2只眼的平均值。)
4、脉络膜血管新生的抑制试验
关于含有倍他米松的微球注射剂对脉络膜血管新生的抑制效果,用激光诱发的大鼠脉络膜血管新生模型,按如下方法进行探讨。用只含有溶剂(0.4%(w/v)吐温80/2.6%(w/v)甘油水溶液)的微球注射剂作为对照,进行如下的操作。
1)用5%(W/V)的盐酸***注射液和2%(W/V)盐酸赛拉嗪注射液的混合液(7∶1)按1ml/Kg对家兔肌肉注射,进行全身麻醉,在两眼点入0.5%(W/V)托品酰胺/0.5%(W/V)盐酸苯福林点眼液使其散瞳后,用氪激光凝固器进行光凝固。光凝固是在视网膜深层聚焦,避开大的血管,在各眼8处不同部位呈散在状进行,(凝固条件:光斑大小100μm、输出100mW、凝固时间0.1秒)。光凝固后,进行眼底照相,确认激光照射部位。
2)光凝固后接着用装有30G针的微量注射器,将含有倍他米松的微球注射剂在大鼠上部结膜下按每眼50μl给药,对照组中,将只含溶剂(0.4%(w/v)吐温80/2.6%(w/v)甘油水溶液的微球注射剂在上部结膜下按每眼50μl给药。
3)光凝固14天和28天后,尾静脉注射10%(w/v)的荧光素水溶液0.1ml,进行荧光眼底照相。通过荧光眼底照相确认没有漏出荧光的点被判定为阴性,确认有漏出荧光的点被判定为阳性。按照以下的计算公式,从对应于激光照射的8点阳性点数的比例,算出血管新生发生率。应予说明,显示出轻度漏荧光的点中每发生两个点计数为1个阳性。
血管新生发生率(%)=
(漏出荧光的点数/激光照射的点数)×100
所得结果用平均值±标准误差表示。用Studentt检验进行统计分析。两侧显著性水平为5%。
含有倍他米松微球的脉络膜血管新生的抑制效果由表2表示。相对于光凝固14天后对照组的血管新生发生率60.9±4.4%,含有倍他米松微球组的血管新生发生率为12.5±2.4%,表现出有统计学意义的脉络膜血管新生抑制作用。另外,相对于光凝固28天后对照组血管新生发生率73.4±6.0%,含有倍他米松的微球组的血管新生发生率为12.5±2.4%,表现出有统计学意义的脉络膜血管新生抑制作用。根据以上结果,能明确断定含有倍他米松的微球经结膜下给药,14天和28天后仍能表现出对脉络膜血管新生的抑制作用。
表2含有倍他米松微球的血管新生发生率(%)
    对照组     微球组
    14天后     60.9±4.4     12.5±2.4
    28天后     73.4±6.0     12.5±2.4
(表中,各组的血管新生发生率表示8只眼的平均值±标准偏差。)
产业上的可利用性
通过本发明能提供经结膜下给药的良好的眼球后部药物释放***。

Claims (12)

1、眼球后部药物释放***,其特征在于,含有药物的微粒是经结膜下给药的。
2、结膜下注射剂,所说注射剂含有含药的微粒,能使药物向眼球后部转移。
3、如权利要求1所述的药物释放***或权利要求2所述的结膜下注射剂,其中微粒的平均粒径为50nm~150μm。
4、如权利要求1所述的药物释放***或权利要求2所述的结膜下注射剂,其中微粒是由生物可降解性高分子或生物溶解性高分子制成的。
5、如权利要求1所述的药物释放***或权利要求2所述的结膜下注射剂,其中眼球后部是指视网膜、脉络膜、视神经、玻璃体或晶状体。
6、如权利要求1所述的药物释放***或权利要求2所述的结膜下注射剂,其中所述药物是用于治疗或预防视网膜、脉络膜、视神经、玻璃体或晶状体疾病的药物。
7、如权利要求1所述的药物释放***或权利要求2所述的结膜下注射剂,其中所述药物是抗炎剂、免疫抑制剂、抗病毒剂、抗癌剂、血管新生抑制剂、抗血栓剂、视神经保护剂、抗菌剂或者抗真菌剂。
8、眼球后部疾病的治疗和/或预防方法,所述方法包括在患者结膜下给予治疗有效剂量的含有含药微粒的注射剂。
9、如权利要求8所述的眼球后部疾病的治疗和/或预防方法,其中微粒的平均粒径为50nm~150μm。
10、如权利要求8所述的眼球后部疾病的治疗和/或预防方法,其中微粒是由生物可降解性高分子或生物溶解性高分子制成的。
11、如权利要求8所述的眼球后部疾病的治疗和/或预防方法,其中眼球后部是指视网膜、脉络膜、视神经、玻璃体或晶状体。
12、如权利要求8所述的眼球后部疾病的治疗和/或预防方法,其中所述药物是抗炎剂、免疫抑制剂、抗病毒剂、抗癌剂、血管新生抑制剂、抗血栓剂、视神经保护剂、抗菌剂或抗真菌剂。
CNA038044064A 2002-02-22 2003-02-21 微粒结膜下给药的药物释放*** Pending CN1638734A (zh)

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