EP1809245A2 - Therapeutic liposomes - Google Patents
Therapeutic liposomesInfo
- Publication number
- EP1809245A2 EP1809245A2 EP04817762A EP04817762A EP1809245A2 EP 1809245 A2 EP1809245 A2 EP 1809245A2 EP 04817762 A EP04817762 A EP 04817762A EP 04817762 A EP04817762 A EP 04817762A EP 1809245 A2 EP1809245 A2 EP 1809245A2
- Authority
- EP
- European Patent Office
- Prior art keywords
- liposome
- entity
- animal
- calcium
- ion
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
- 239000002502 liposome Substances 0.000 title claims abstract description 172
- 230000001225 therapeutic effect Effects 0.000 title abstract description 5
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- 238000000034 method Methods 0.000 claims abstract description 108
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- 229910052791 calcium Inorganic materials 0.000 claims description 98
- 239000011575 calcium Substances 0.000 claims description 98
- OYPRJOBELJOOCE-UHFFFAOYSA-N Calcium Chemical group [Ca] OYPRJOBELJOOCE-UHFFFAOYSA-N 0.000 claims description 96
- 241001465754 Metazoa Species 0.000 claims description 87
- HVYWMOMLDIMFJA-DPAQBDIFSA-N cholesterol Chemical compound C1C=C2C[C@@H](O)CC[C@]2(C)[C@@H]2[C@@H]1[C@@H]1CC[C@H]([C@H](C)CCCC(C)C)[C@@]1(C)CC2 HVYWMOMLDIMFJA-DPAQBDIFSA-N 0.000 claims description 79
- KCXVZYZYPLLWCC-UHFFFAOYSA-N EDTA Chemical group OC(=O)CN(CC(O)=O)CCN(CC(O)=O)CC(O)=O KCXVZYZYPLLWCC-UHFFFAOYSA-N 0.000 claims description 50
- 210000002966 serum Anatomy 0.000 claims description 48
- 235000012000 cholesterol Nutrition 0.000 claims description 39
- WTJKGGKOPKCXLL-RRHRGVEJSA-N phosphatidylcholine Chemical compound CCCCCCCCCCCCCCCC(=O)OC[C@H](COP([O-])(=O)OCC[N+](C)(C)C)OC(=O)CCCCCCCC=CCCCCCCCC WTJKGGKOPKCXLL-RRHRGVEJSA-N 0.000 claims description 38
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- KILNVBDSWZSGLL-KXQOOQHDSA-N 1,2-dihexadecanoyl-sn-glycero-3-phosphocholine Chemical compound CCCCCCCCCCCCCCCC(=O)OC[C@H](COP([O-])(=O)OCC[N+](C)(C)C)OC(=O)CCCCCCCCCCCCCCC KILNVBDSWZSGLL-KXQOOQHDSA-N 0.000 claims description 21
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- SNKAWJBJQDLSFF-NVKMUCNASA-N 1,2-dioleoyl-sn-glycero-3-phosphocholine Chemical compound CCCCCCCC\C=C/CCCCCCCC(=O)OC[C@H](COP([O-])(=O)OCC[N+](C)(C)C)OC(=O)CCCCCCC\C=C/CCCCCCCC SNKAWJBJQDLSFF-NVKMUCNASA-N 0.000 claims description 18
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Classifications
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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
- A61K9/10—Dispersions; Emulsions
- A61K9/127—Liposomes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
- A61K31/19—Carboxylic acids, e.g. valproic acid
- A61K31/195—Carboxylic acids, e.g. valproic acid having an amino group
- A61K31/197—Carboxylic acids, e.g. valproic acid having an amino group the amino and the carboxyl groups being attached to the same acyclic carbon chain, e.g. gamma-aminobutyric acid [GABA], beta-alanine, epsilon-aminocaproic acid or pantothenic acid
- A61K31/198—Alpha-amino acids, e.g. alanine or edetic acid [EDTA]
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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
Definitions
- the present invention relates to liposomes that are capable of correcting an imbalance of one or more entities in an animal.
- hypercalcemia is a common clinical metabolic problem. It can occur as a manifestation of many disorders including: hyperparathyroidism, pagets disease, vitamin A and vitamin D toxicity, tuberculosis, sarcoidosis, malignancies e.g. breast cancer, small cell lung cancer, squamous cell carcinoma, multiple myeloma, and others. Hypercalcemia occurs in 1O%-20% of people with cancer, making it one of the most common medical management problems facing physicians. Moreover, hypercalcemia is the most common life-threatening metabolic disorder associated with malignancy.
- the most effective therapy for treating acute hypercalcemia associated with malignancy is to remove or treat the underlying cancer. Until this is achieved, or if this cannot be achieved, the use of antihypercalcemic agents may be necessary. Therapy to treat acute hypercalcemia should be selected carefully with specific patient goals of preventing the consequences of acute hypercalcemia by decreasing serum calcium concentrations and preventing adverse experiences from antihypercalcemic medications. Bisphoshonates, calcitonin, furosemide, gallium nitrate, glucocorticoids, normal saline and plicamycin have been used with some degree of success in the management of malignancy and offer clinicians a range of therapeutic options in the treatment of acute hypercalcemia. These options all, however, suffer from limitations.
- One method of treating hyercalcemia includes hydration with intravenous normal saline (NaCl 0.9%) as the first step in the acute management of hypercalcemia. Since most patients suffering from acute hypercalcemia are volume contracted, the administration of NaCl 0.9% is important because it expands intracellular volume in addition to increasing renal calcium clearance. The optimal administration rate of NaCl 0.9% is determined by the severity of hypercalcemia, the degree of volume contraction, the ability of the patient to tolerate fluid, and the overall clinical status of the patient. The usual rate of infusion for NaCl 0.9% to facilitate hydration and diuresis is 200 to 300 mL/hr. Furosemide, a high-ceiling diuretic, may be used in the treatment of hypercalcemia to increase calcium excretion.
- Furosemide is important in the treatment of acute hypercalcemia because it inhibits calcium reabsorption by the kidneys and protects against volume overload from the administration of saline.
- the furosemide therapy however has limitations, the absence of adequate volume expansion, furosemide treatment may cause a reduction in glomerular filtration rate as well as calcium clearance. Therefore, the treatment should be administered only after adequate hydration. Intravenous doses up to 100 mg every 1-4 hours maybe administered. Regimens of NaCl 0.9% and furosemide result in a modest decrease in serum calcium concentrations. Clinical trials suggest that the combination of saline and furosemide typically decreases calcium levels by only 0.20-0.30 mmol within the first 48 hours.
- calcitonin has a brief duration of action that lasts for only 24 hours.
- the recommended subcutaneous or intramuscular starting dose of calcitonin for treating acute hypercalcemia is 4 IU/kg administered every 12 hours.
- Important side effects of calcitonin are flushing, gastrointestinal upset and rash which make calcitonin unpleasant for animals and causes poor patient compliance.
- Bisphosphonates are toxic to osteoclasts and inhibit osteoclast precursors, thereby decreasing osteoclast function.
- etidronate is commercially available in both an oral and intravenous dosage forms, and pamidronate is available in the intravenous dosage form.
- Etidronate is administered intravenously (IV) in cases of acute hypercalcemia.
- IV intravenously
- the recommended dose is 7.5 mg/kg IV daily for three to seven days; each dose should be infused over two to four hours.
- serum calcium concentrations begin to decline within two days. Maximal efficacy occurs within seven days after initiation of treatment.
- Clinical trials have documented a return to normal serum calcium concentrations in approximately 40%-92% of patients after they have received etidronate.
- Adverse effects associated with etidronate include elevated serum phosphorus concentrations and renal insufficiency.
- pamidronate Some adverse events associated with pamidronate include transient pyrexia, nausea, rash, nephrotoxicity, hypocalcemia and thrombophlebitis. Similar to etidronate, the use of pamidronate is not recommended in patients with renal dysfunction or patients who have elevated serum creatinine levels greater than 2.5 mg/dL. Zolendranate is more potent and requires less IV infusion time. The typical treatment time for metastatic bone disease is one 15 minute IV infusion every 3-4 weeks. However, zolendranate is not an adequate substitute as it is contraindicated in renal insufficiency. Although there are claims that biphosphonates reduce bone pain in metastatic disease, there is no evidence for this in acute therapy.
- Glucocorticoids have been used in combination with other antihypercalcemic agents such as calcitonin to lower serum calcium concentrations. Glucocorticoids combat hypercalcemia by increasing urinary calcium excretion and decreasing intestinal calcium absorption when doses equivalent to hydrocortisone 200-300 mg IV are administered daily for three to five days. Typically, hypercalcemia due to lymphomas, multiple myeloma and granulomatous tumors responds most favorably to glucocorticoid therapy.
- glucocorticosteroids include hyperglycemia and electrolyte disturbances such as hypokalemia. Less frequent affects include GI bleeding, diabetes and altered mentation.
- Gallium nitrate inhibits bone resorption by inhibiting PTH-rp induced calcium resorption from the bone. The recommended dosage of gallium nitrate is 100-200 mg/m 2 daily for five consecutive days or until the desired calcium concentration is obtained.
- Gallium nitrate should be infused as a 24-hour continuous infusion. Serum calcium concentration declines within 48 hours. Maximal effects are achieved within 10 days after the first gallium nitrate dose. Nephrotoxicity has been documented in 8%-15% of patients using gallium nitrate.
- gallium nitrate should be avoided in patients with renal dysfunction or patients with a serum creatinine measurement greater than 2.5 mg/dL.
- nephrotoxic agents should be avoided in patients receiving this agent.
- Other adverse effects associated with gallium nitrate include hypophosphatemia, gastrointestinal upset, visual and hearing impairment, and tachycardia.
- Plicamycin decreases serum calcium concentrations by inhibiting RNA synthesis in osteoclasts. Plicamycin is administered intravenously, either as a bolus injection or slowly as an in fusion. The occurrence of local irritation and other adverse effects may be reduced when plicamycin is administered by slow infusion.
- the recommended dose is 25 mcg/kg over a period of four to six hours.
- the serum calcium concentration declines within 12 hours after initiation of plicamycin. Maximal efficacy usually occurs within 96 hours. Clinical trials have demonstrated a median decrease in serum calcium concentration by 1.4 mg/dL within 48 hours after administration. When necessary, subsequent doses of plicamycin may be given after waiting at least 24 hours.
- Major side effects of plicamycin include hepatic toxicity, nephrotoxicity, thrombocytopenia, myelosuppression, nausea, vomiting, hypocalcemia and reduced levels of clotting factors.
- Plicamycin should be avoided in patients with severe hepatic or renal dysfunction, thrombocytopenia or any cagulopathy, patients concurrently receiving myelotoxic chemotherapy, and patients who are dehydrated. Plicamycin is usually reserved for patients who are unresponsive to other therapy. As discussed above, current methods of treating hypercalcemia produce many undesired side effects which make treatment difficult and unpleasant for the patient. Additionally, many of the methods also require a significant period of time (24-48 hours or longer) to produce a beneficial effect. Additionally, the methods must be selectively chosen for treatment as many methods are incompatible with other medications, diseases, or the condition of the animal. Thus, there is currently a need for methods that can be used to remove calcium from living systems.
- Diabetes is a condition that is characterized by an absolute or relative deficiency of insulin, which leads in more severe cases, to chronic hyperglycemia.
- the long term complications of diabetes include development of neuropathy, retinopathy, nephropathy, and an increased susceptibility to infection (Stedman's Medical Dictionary, 26 ed., Williamw & Wilkins, Baltimore, Md., 1995).
- hyperglycemia including hyperglycemia that results from diabetes. This is especially the case for hyperglycemia that does not respond to insulin containing regimens.
- An excess amount of metal ions is also associated with a variety of diseases and conditions.
- Parkinson's disease involves the deterioration of specific nerve centers in the brain. It is believed that these excess minerals increase free radical pathology and accelerate cell death. This deterioration changes the chemical balance of two neurotransmitters essential for transmission of nerve signals. The ultimate result is lack of control of physical movements.
- Another disease related to high levels of metals in the blood is
- Alzheimer's disease is a progressive condition that destroys brain cells and structures. researchers believe the disease is associated with excess zinc, copper, aluminum, and/or iron in the blood and/or brain. People with Alzheimer's disease slowly lose their ability to learn, remember and function. Another disease associated with excess metal ions in the body is Wilson's disease. Wilson's disease is caused by a build up of excess copper in the liver, brain, and kidneys. The disease is characterized by inflammation and cirrhosis of the liver and brain damage. If untreated, Wilson's disease is fatal. The accumulation of copper in the brain has also been associated with various forms of Transmissable Spongiform Encephalopathy (TSE) including Creutzfeldt- Jakob Disease (CJD).
- TSE Transmissable Spongiform Encephalopathy
- CJD Creutzfeldt- Jakob Disease
- the present invention provides liposomes that are capable of correcting an imbalance of one or more entities in an animal. Accordingly, the invention provides a method for incorporating an entity from an animal into a liposome comprising administering to an animal in need of such treatment liposomes capable of incorporating the entity. The invention also provides a method for incorporating an entity from a biological sample into a liposome comprising contacting the biological sample with one or more liposomes capable of incorporating the entity. The invention also provides a method for removing an entity from animal serum comprising contacting the serum with one or more liposomes capable of removing the entity from the serum.
- the invention also provides a method for removing an entity from the cerebral spinal fluid of an animal in need of such treatment comprising administering (e.g. interthecally) to the animal liposomes capable of incorporating the entity.
- the invention also provides a method for treating Alzheimer's disease in an animal comprising administering an amount of a liposome to the animal that is effective to lower the level of Zn, Al, Fe or Cu, or an ion thereof in the animal.
- the invention also provides a method for treating Parkinson's disease in an animal comprising administering an amount of a liposome to the animal that is effective to lower the level of Mn, Fe, Hg, Al, or Cu, or an ion thereof in the animal.
- the invention also provides a method for treating diabetes (e.g.
- the invention also provides a method for reducing serum calcium load in an animal in need of such treatment comprising administering an effective calcium reducing amount of one or more liposomes.
- the present invention also provides methods for removing calcium from living systems and methods of treating diseases associated with high calcium ion concentrations.
- the invention provides a method for removing calcium from animal serum comprising contacting (in vitro or in vivo) the serum with a liposome that removes the calcium from the serum
- the present invention also provides liposomes capable of sequestering calcium ions as well as methods of treating diseases caused by high calcium ion concentration comprising administering to an animal in need of such therapy a therapeutically effective amount of liposomes containing calcium ion receivers or sequesters.
- the invention also provides a liposome as described herein for use in medical therapy.
- the invention also provides the use of a liposome as described herein to prepare a medicament useful for treating Alzheimer's disease in an animal.
- the invention also provides the use of a liposome as described herein to prepare a medicament useful for treating Parkinson's disease in an animal.
- the invention also provides the use of a liposome as described herein to prepare a medicament useful for treating diabetes (e.g. hyperglycemia) in an animal.
- the invention also provides the use of a liposome as described herein to prepare a medicament useful for reducing serum calcium load in an animal.
- the invention also provides a pharmaceutical composition comprising a liposome as described herein and a pharmaceutically acceptable vehicle or carrier.
- the invention also provides novel liposomes described herein as well as synthetic processes described herein for preparing liposomes of the invention.
- Figure 1 illustrates the lipid transition temperature dependence of calcium loading for various preparations.
- Figure 2 illustrates calcium loading for three formulations prepared using different methods.
- Figure 3 illustrates the influence of pH and NaCl on calcium loading efficiency.
- Figure 4 illustrates calcium loading for HSPC: cholesterol formulations.
- Figure 5 illustrates loading efficiencies for HSPC:cholesterol formulations.
- Figure 6 illustrates calcium loading for DOPC holesterol formulations.
- Figure 7 illustrates loading efficiencies for DOPC:cholesterol formulations.
- Figure 8 illustrates calcium loading for DEPC: cholesterol formulations.
- Figure 9 illustrates loading efficiencies for DEPC:cholesterol formulations.
- Figure 10 illustrates calcium loading for DPPC:cholesterol formulations.
- Figure 11 illustrates loading efficiencies for DPPC holesterol formulations.
- the term “animal” refers to mammals, birds, reptiles, and fishes.
- biological sample includes a tissue, serum, blood, plasma, cerebral spinal fluid, saliva, urine, etc. sample taken from an animal.
- the term “calcium” includes calcium and calcium ions.
- channel/transporter includes any moleule or set of molecules that allow an entity (e.g. calcium) to enter the liposome (e.g. that can effectively tranport the entity to the interior of the liposome).
- the term “insoluble” or “slightly soluble” refers to inorganic salts (e.g.
- the term "primarily bind” refers to a sequestering agent which either covalently or ionically binds to an entity (e.g. calcium) preferably over one or more other ions within the surroundings.
- the term “sequestering agent” or “receiver” refers to compounds complexes, molecules, or atoms capable of binding to an entity thereby removing the entity from the immediate surroundings.
- the invention provides methods for removing unwanted entities from animals or from biological samples. Liposomes can be formulated to incorporate a wide variety of entities. Accordingly, the methods of the invention are generally useful for removing a wide variety of materials from an animal or from a biological sample.
- the methods of the invention can be used to remove metal or a metal ions e.g. an alkali metal, an alkaline earth metal, Fe, Os, Co, Ni, Pd, Cu, Ag, Au, Zn, Al, Cd, Hg, Sn, or Pb, or an ion thereof).
- the methods of the invention are useful for removing Zn, Al, Fe or Cu, or an ion thereof from an animal.
- the methods are useful for removing calcium from an animal.
- the methods are also useful for removing unwanted molecules (e.g. peptides, organic molecules, therapeutic agents, nitrous oxide, or glucose) from an animal.
- the methods are useful for therapy (i.e. removing peptides or compounds that are associated with a pathological condition).
- the methods are also useful for treating over exposure to therapeutic agents (i.e. overdoses) or toxic substances (i.e. poisonings).
- the term organic compound includes any compound that comprises one or more carbon atoms. Typically an organic compound has a molecular weight of less than about 450 atomic mass unit (amu). In one preferred embodiment, the organic compound has a molecular weight of less than about 300 amu.
- the methods of the invention can be carried out in vitro or in vivo.
- the methods can typically be carried out by administering liposomes to an animal.
- a biological sample e.g. serum, cerebral spinal fluid, or tissue
- the sample can be returned into the animal.
- the methods of the invention are useful for therapeutic applications as well as for diagnostic applications.
- the liposomes used in the methods of the invention typically include an ion channel or shuttle to facilitate entry of the metal or the ion into the liposome.
- an ion channel or shuttle to facilitate entry of the metal or the ion into the liposome.
- A23187 available from CalBiochem (La Jolla, CA) or from Fermentek Ltd (Jerusalem, Israel ) can be used to transport Ca +2 or other divalent cations.
- a channel or shuttle is not always required.
- amphiphilic entities can load in response to a chemical potential gradient (e.g. against a pH gradient).
- a chamiel that facilitates entry of the hydrophobic entity may or may not be necessary.
- the liposome may be permeable to some hydrophobic entities, but the entity may be trapped or modified inside the liposome after entry, so that it does not immediately pass back out of the liposome.
- the entity Once incorporated into the liposome, the entity may simply reside in the hydrophilic environment of the liposome interior, in the hydrophobic bilayer, or the liposome may include a sequestering agent that associates with (e.g. through hydrogen bonding or ionic interactions) the entity and reduces its ability to pass out of the liposome.
- the liposome may include sequestering agents such as a polyamine, polydentate carboxylic acid (e.g.
- the liposomes may also include a reagent or enzyme capable of reacting with the entity so as to reduce its ability to pass out of the liposome.
- a reagent or enzyme capable of reacting with the entity so as to reduce its ability to pass out of the liposome.
- glucose could undergo conversion within the liposome to glucose-6-phosphate using hexokinase.
- an energy source e.g. ATP
- a co-factor e.g. a specific pH, or a specific ion balance to take place
- the liposomes can be prepared so that they include these features.
- such features may also be provided from an external source.
- the liposomes can reduce the available concentration of an entity in an animal in a number of ways. For example, 1) the liposome can incorporate the entity in a reversible manner and then release the entity over time so that the maximum amount or concentration of entity available in the animal over that time is reduced; 2) the liposome can incorporate the entity and then be cleared from the animal thereby eliminating the entity from the animal's serum; 3) the liposome can incorporate the entity and the entity can be sequestered or modified within the liposome so that it does not pass out of the liposome; or 4) following incorporation of the entity, the liposome can be redirected to other locations in the body (e.g. loaded into a macrophage) where the entity can be released or where the liposome containing the entity can be eliminated from the body. A combination of one or more of 1- 4 above may also occur.
- the present invention includes methods of treating an animal having hypercalcemia.
- the methods comprise administering to an animal in need of such treatment a therapeutically effective amount of at least one calcium sequestering liposome thereby reducing calcium ion concentration within the animal.
- the method typically reduces serum calcium concentration by administering an effective calcium reducing amount of at least one liposome that comprises a calcium sequestering agent to an animal.
- the method comprises administering to an animal in a hypercalcemic state at least one calcium sequestering liposome in an amount effective to lower serum cholesterol levels in the animal.
- the animal's calcium ion serum concentration can be monitored about every 4 to about 6 hours for several days. Treatment can be terminated once the desired calcium ion serum concentration is reach, i.e. normocalcemia.
- the levels of magnesium ion, PTH, and phosphate may be monitored either simultaneously or sequentially with calcium ion concentration.
- the liposomes can also be combined with other therapies to treat a given condition (e.g. hyperglycemia, Alzheimer's disease, Wilson's disease, heavy metal poisoning, or hypercalcemia).
- a given condition e.g. hyperglycemia, Alzheimer's disease, Wilson's disease, heavy metal poisoning, or hypercalcemia
- the administration of liposomes can be combined with the administration of one or more therapeutic agents useful for reducing calcium load in an animal.
- the additional therapeutic agents maybe administered, either prior, during, or after administration of the liposomes of the invention.
- the liposomes can contain one or more additional therapeutic agents within the liposome to treat a given condition (e.g. hyperglycemia, Alzheimer's disease, Wilson's disease, heavy metal poisoning, or hypercalcemia).
- Therapeutic agents contemplated for use in treating hypercalcemia include, but are not limited to, furosemide, calcitonin, bisphosphonates, etidronate, pamidronate, zolendranate, glucocorticoids, gallium nitrate, plicamycin, mithromycin.
- the liposomes include some liposome forming lipids (e.g. a phosphatidyl choline or sphingomyelin).
- the lipids include at least one phosphatidyl choline, which provides the primary packing/entrapment/structural element of the liposome.
- the phosphatidyl choline comprises mainly C 16 or longer fatty-acid chains. Chain length provides for both liposomal structure, integrity, and stability.
- one of the fatty- acid chains have at least one double bond.
- phosphatidyl choline includes Soy PC, Egg PC dielaidoyl phosphatidyl choline (DEPC), dioleoyl phosphatidyl choline (DOPC), distearoyl phosphatidyl choline (DSPC), hydrogenated soybean phosphatidyl choline (HSPC), dipalmitoyl phosphatidyl choline (DPPC), 1- palmitoyl-2-oleo phosphatidyl choline (POPC), dibehenoyl phosphatidyl choline (DBPC), and dimyristoyl phosphatidyl choline (DMPC).
- Soy PC Egg PC dielaidoyl phosphatidyl choline
- DOPC dioleoyl phosphatidyl choline
- DSPC distearoyl phosphatidyl choline
- HSPC hydrogenated soybean phosphatidyl choline
- DPPC dipalmit
- Soy-PC refers to phosphatidyl choline compositions including a variety of mono-, di-, tri-unsaturated, and saturated fatty acids.
- Soy-PC includes palmitic acid present in an amount of about 12% to about 33% by weight; stearic acid present in an amount of about 3% to about 8% by weight; oleic acid present in an amount of about 4% to about 22% by weight; linoleic acid present in an amount of about 60% to about 66% by weight; and linolenic acid present in an amount of about 5% to about 8% by weight.
- Egg-PC refers to a phosphatidyl choline composition including, but not limited to, a variety of saturated and unsaturated fatty acids.
- Egg-PC comprises palmitic acid present in an amount of about 34% by weight; stearic acid present in an amount of about 10% by weight; oleic acid present in an amount of about 31 % by weight; and linoleic acid present in an amount of about 18% by weight.
- Cholesterol Cholesterol typically provides stability to the liposome.
- the ratio of phosphatidyl choline to cholesterol is typically from about 0.5:1 to about 4:1 by mole ratio.
- the ratio of phosphatidyl choline to cholesterol is from about 1 : 1 to about 2: 1 by mole ratio. More preferably, the ratio of phosphatidyl choline to cholesterol is about 2:1 by mole ratio.
- Calcium sequestering agents suitable for use with the liposome of the invention include, but are not limited to, compounds, complexes, ions, molecules, reagents, or combinations thereof capable of binding to calcium ions sufficiently to remove the calcium ions from the immediate surroundings. Calcium removal includes, but is not limited to, forming calcium complexes or insoluble or slightly soluble inorganic compounds within the liposome and thereafter removing the liposome from the serum.
- the calcium sequestering agent preferably binds to calcium ions, however, the calcium sequester may bind to other ions.
- the calcium sequestering agent may primarily bind to calcium ions and/or remove other ions such as magnesium ions, among others.
- Typical calcium sequestering agents include polyamines, polycarbonates, polydendate carboxylic acids, crown ethers, lactams, inorganic compounds, polyanions, protein fragments and peptides.
- Particular, calcium sequesters include, but are not limited to, ethylenediaminetetraacetic acid (EDTA), ethylenebis(oxyethylenenitrilo)-tetraacetic acid (EGTA), and calcitonin.
- EDTA ethylenediaminetetraacetic acid
- EGTA ethylenebis(oxyethylenenitrilo)-tetraacetic acid
- calcitonin calcitonin.
- the amount of calcium sequester in the liposome may vary according to the type of calcium sequester desired, the desired time for reduction of hypercalcemia, and the condition of the animal. Typically, the amount of calcium sequester should be sufficient to cause a reduction in calcium ion concentration within minutes or hours from liposome administration.
- the calcium sequester may be selected to provide a steady and prolonged reduction of calcium ion over time, e.g. a day or several days.
- the calcium sequester is present in a concentration of about at least 50 mM prior to contact with the animal serum.
- the calcium sequester is present in a concentration of about at least 100 mM, and more preferably, in a concentration of about at least 200 mM prior to contact with the animal serum.
- the calcium sequester is capable of removing from about 10% to about 30% of the calcium ion concentration within the animal's serum which may also cause normalization of the animals EKG.
- the liposomes typically comprise a lipid layer of phospholipids and cholesterol. Typically, the ratio of phospholipid to cholesterol is sufficient to form a liposome that will not dissolve or disintegrate once administered to the animal.
- the lipid and cholesterol are dissolved in a suitable solvent or solvent mixture with an appropriate amount of ionophore. After a suitable amount of time, the solvent is removed via vacuum drying or spray drying. The resulting solid material can be stored or used immediately. Subsequently, the resulting solid material is hydrated in aqueous solution optionally containing a sequestering agent (e.g.
- a calcium sequestering agent such as EDTA
- MLV multilameller vesicles
- the solutions containing MLV are size-reduced via homogenization to form Small Unilameller Vesicles (SUV).
- a portion of the calcium sequestering agent is encapsulated in the aqueous compartment of SUV during the process.
- the unencapsulated sequestering agent is removed via suitable methods, such as dialysis, desalting column, or cross filtration.
- the resulting liposome solution is filtered and ready for use.
- Calcium sequestering agent loading in buffer is formulation dependent. Among the relevant factors is the effective phase transition temperature of the lipid components (Tm).
- Figure 1 illustrates the lipid transition temperature dependence of calcium loading for various preparations.
- the loading in buffer may or may not directly relate to loading in vitro (serum, plasma or blood) or in vivo. Serum proteins or other elements may influence (positively or negatively) the function of the transporter channel.
- the overall liposome performance will result in part from loading in vivo and the biodistribution, pharmacokinetics, and/or pharmacodynamics of the liposome.
- the lipid-based dispersions of the invention can also be formulated to be administered parenterally. Moreover, the lipid-based dispersions can be formulated for subcutaneous, intramuscular, intravenous, or intraperitoneal administration by infusion or injection. These preparations may also contain a preservative to prevent the growth of microorganisms, buffers, or anti-oxidants in suitable amounts. Compositions and preparations will typically contain at least 0.1% of the sequestering agent. The percentage of the compositions and preparations may, of course, be varied and may conveniently be between about 2% to about 60% of the weight of a given unit dosage form. The amount of sequestering agent active in such therapeutically useful compositions is such that an effective dosage level will be obtained.
- the liposome may also comprise physiologically acceptable salts to maintain isotonicity with animal serum. Any pharmaceutically acceptable salt that achieves isotonicity with animal serum is acceptable, such as NaCl.
- the amount of formulation required for use in treatment will vary not only with particular agent but also with the route of administration, the nature of the condition being treated and the age and condition of the animal; the amount required will be ultimately at the discretion of the attendant physician or clinician.
- the desired amount of a formulation may conveniently be presented in a single dose or as divided doses administered at appropriate intervals, for example, as two, three, four or more sub-doses per day.
- the sub-dose itself may be further divided, e.g., into a number of discrete loosely spaced administrations.
- the liposomes and/or the formulations may comprise at least one anti-oxidant, buffer, stabilizer, or pharmaceutically acceptable excipient.
- the contacting occurs in vivo. In another specific embodiment of the invention the contacting occurs in vitro
- the entity is a metal or a metal ion. In another specific embodiment of the invention the entity is an alkali metal, an alkaline earth metal, Fe, Os, Co, Ni, Pd, Cu, Ag, Au, Zn, Al, Cd, Hg, Sn, or Pb, or an ion thereof. In another specific embodiment of the invention the entity is Zn, Al, Fe or Cu, or an ion thereof.
- the entity is calcium or an ion thereof. In another specific embodiment of the invention the entity is a peptide. In another specific embodiment of the invention the entity is an organic molecule. In another specific embodiment of the invention the entity is a therapeutic agent. hi another specific embodiment of the invention the entity is glucose. In another specific embodiment of the invention the animal is a mammal. h another specific embodiment of the invention the animal is a human. In another specific embodiment of the invention the liposome comprises one or more liposome forming lipids and cholesterol, wherein the mole ratio of the lipids to cholesterol is from about 0.5 to 1 to about 4:1. In another specific embodiment of the invention the liposome comprises phosphatidyl choline and cholesterol.
- the mole ratio of phosphatidyl choline to cholesterol in the liposome is from about 0.5 to 1 to about 4:1. h another specific embodiment of the invention the mole ratio of phosphatidyl choline to cholesterol in the liposome is from about 1 to 1 to about 2:1 In another specific embodiment of the invention the mole ratio of phosphatidyl choline to cholesterol in the liposome is about 2:1. In another specific embodiment of the invention the phosphatidyl choline is selected from Soy-PC, Egg-PC, DEPC, DOPC, DSPC, HSPC, DMPC, and DPPC, and mixtures thereof.
- the phosphatidyl choline is selected from DEPC, DOPC, DSPC, HSPC, DMPC, POPC, DBPC, and DPPC, and mixtures thereof.
- the phosphatidyl choline is selected from DEPC, DOPC, DSPC, HSPC, DMPC, and DPPC, and mixtures thereof.
- the phosphatidyl choline is selected from DOPC, DSPC, HSPC, DMPC, and DPPC, and mixtures thereof.
- the phosphatidyl choline is selected from DOPC, DSPC, HSPC, and DPPC, and mixtures thereof.
- the phosphatidyl choline is DPPC.
- the liposome comprises a channel or shuttle to facilitate incorporation of the entity into the liposome.
- the channel is an ion channel.
- the pH of the interior of the liposome is less than about 8 prior to administration or contact with the biological sample or the serum.
- the liposome is an SUV or an MLV.
- the entity binds with a sequestering agent inside the liposome to form a complex that is incapable of passing out of the liposome.
- calcium binds with a sequestering agent inside the liposome to form a calcium complex that is incapable of passing out of the liposome.
- the liposome comprises one or more calcium sequestering agents.
- the liposome comprises liposome forming lipids and a transporter/channel that allows calcium to pass into the liposome.
- the sequestering agent is a polyamine, polydentate carboxylic acid, crown ether, lactam, or an inorganic compound.
- the sequestering agent is EDTA.
- the concentration of EDTA in the liposome is at least about 10 mM prior to administration or contact. In another specific embodiment of the invention the concentration of EDTA in the liposome is at least about 20 mM prior to administration or contact. In another specific embodiment of the invention the concentration of
- EDTA in the liposome is at least about 25 mM prior to administration or contact. In another specific embodiment of the invention the concentration of EDTA in the liposome is at least about 50 mM prior to administration or contact. In another specific embodiment of the invention the concentration of EDTA in the liposome is at least about 80 mM prior to administration or contact. In another specific embodiment of the invention the concentration of EDTA in the liposome is at least about 100 mM prior to administration or contact. In another specific embodiment of the invention the concentration of EDTA in the liposome is at least about 200 mM prior to administration or contact. In another specific embodiment of the invention the sequestering agent is at least 2-fold selective for calcium binding compared to zinc, selenium, or copper.
- the entity reacts with a reagent inside the liposome to form a reacted entity.
- the reacted entity is incapable of passing out of the liposome.
- the entity reacts with an enzyme inside the liposome.
- the reaction between the entity and the enzyme requires ATP.
- the liposome comprises the ion channel A23187.
- the liposome comprises an ion channel that is at least 2-fold selective for calcium entry into the liposome compared to zinc, selenium, or copper.
- the methods of the invention utilize liposomes that are capable of removing calcium from an animal's circulation.
- the liposomes contain calcium sequestering agents or receivers capable of associating with calcium ions.
- the liposomes comprise a lipid layer comprising liposome forming lipids, cholesterol, and a channel/transporter, as well as a calcium sequestering agent or receiver capable of binding to one or more calcium ions.
- Figures Figure 1 illustrates the lipid transition temperature dependence of calcium loading in buffer solution for various liposome preparations. Five different formulations of 2:1 phospholipid-cholesterol preparations are shown. The five phospholipids were HSPC (55°C), DPPC (41 °C), DMPC (23°C), DEPC (12°C) and DOPC (-20°C).
- FIG. 2 illustrates calcium loading for three formulations prepared in four different manners.
- the formulations were prepared using 2:1 HSPC holesterol (Formulation 2A); 1:1.25:1.5 HSPC:cholesterol:DOPC (Formulation 2B); and 2:1 DPPC:cholesterol (Formulation 2C), at pH 4.5 with and without 140 mM NaCl or at a pH of 7.5 with and without 140 mM NaCl.
- Each phospholipid: cholesterol preparation in the 4 different preparations were averaged to obtain the loading curves presented.
- Figure 3 illustrates the in vitro pH and NaCl dependency of calcium loading efficiency.
- a 2:1 DPPC:cholesterol formulation was prepared using 140 mM NaCl and 200 EDTA at a pH of 4.5 (Formulation 3 A) and a second at a pH of 7.5 (Formulation 3B).
- a 2: 1 DPPC:cholesterol formulation was prepared using 200 EDTA at a pH of 4.5 (Formulation 3C) and a second at a pH of 7.5 (Formulation 3D). Measurements were taken at 0 min, 30 min, 60 min, 120 min, and 240 min. The graph indicates that the formulations prepared at pH of 4.5 contained the highest EDTA % saturation.
- Figure 4 illustrates the calcium loading for four HSPC:cholesterol formulations, h particular, a 2:1 HSPCxholesterol formulation was prepared using 140 mM NaCl and 200 mM EDTA at a pH of 4.5 (Formulation 4A) and a second at apH of 7.5 (Formulation 4B). Then a 2:1 HSPCxholesterol formulation was prepared using 200mM EDTA at a pH of 4.5 (Formulation 4D) and a second at a pH of 7.5 (Formulation 4D). Measurements were taken at 0 min, 30 min, 60 min, 120 min, and 240 min.
- FIG. 5 illustrates the loading efficiency for four HSPCxholesterol formulations.
- a 2:1 HSPC: cholesterol formulation was prepared using 140 mM NaCl and 200 mM EDTA at a pH of 4.5 (Formulation 5 A) and a second at a pH of 7.5 (Formulation 5B).
- a 2:1 DPPC cholesterol formulation was prepared using 200 mM EDTA at a pH of 4.5 (Formulation 5D) and a second at a pH of 7.5 (Formulation 5C). Measurements were taken at 0 min, 30 min, 60 min, 120 min, and 240 min.
- FIG. 6 illustrates the calcium loading for seven HSPC:cholesterol:DOPC formulations.
- Four 1:1.25:1.5 HSPC:cholesterol:DOPC formulations were prepared: one 140 mM NaCl and 200mM EDTA at a pH of 4.5 (Formulation 6B), a second at a pH of 7.5
- HSPCxholesterohDOPC formulation were prepared: one 140 mM NaCl and 200 mM EDTA at a pH of 4.5 (Formulation 7B), a second at a pH of 7.5 (Formulation 7C), a third without NaCl at a pH of 7.5 (Formulation 7 A), and a fourth without NaCl at a pH of 4.5 (Formulation 7D).
- Three HSPCxholesterohDOPC formulations were prepared. One is 1:0.17:0.5
- HSPCxholesterohDOPC using 200mM EDTA at a pH of 7.5 (Formulation 7E) a second is 1 :0.14:0.25 HSPCxholesterohDOPC using 200mM EDTA at a pH of 7.5 (Formulation 7F) a third is 1:0.12:0.05 HSPCxholesterohDOPC using 200mM EDTA at a pH of 7.5 (Formulation 7G). Measurements were taken at 0 min, 30 min, 60 min, 120 min, and 240 min.
- Figure 8 illustrates the calcium loading for three HSPCxholesterohDEPC formulations. Three HSPCxholesterohDEPC formulations were prepared.
- HSPCxholesterohDEPC using 200mM EDTA at a pH of 7.5
- a second is 1:0.14:0.25 HSPCxholesterohDEPC using 200mM EDTA at a pH of 7.5
- a third is 1 :0.12:0.05 HSPCxholesterohDEPC using 200mM EDTA at a pH of 7.5
- Measurements were taken at 0 min, 30 min, 60 min, 120 min, and 240 min.
- Figure 10 illustrates the calcium loading for four DPPCxholesterol formulations, h particular, a 2: 1 DPPCxholesterol formulation was prepared using 140 mM NaCl and 200 EDTA at a pH of 4.5 (Formulation 10D) and a second at apH of 7.5 (Formulation 10C). Then a 2:1 DPPCxholesterol formulation was prepared using 200 EDTA at apH of 4.5 (Formulation 10B) and a second at a pH of 7.5 (Formulation 10A). Measurements were taken at 0 min, 30 min, 60 min, 120 min, and 240 min.
- FIG. 11 illustrates the loading efficiency for four DPPCxholesterol formulations.
- a 2:1 DPPCxholesterol formulation was prepared using 140 mM NaCl and 200mM EDTA at a pH of 4.5 (Formulation 1 ID) and a second at a pH of 7.5 (Formulation 11C).
- a 2:1 DPPCxholesterol formulation was prepared using 200mM EDTA at a pH of 4.5 (Formulation 1 IB) and a second at a pH of 7.5 (Formulation 11 A). Measurements were taken at 0 min, 30 min, 60 min, 120 min, and 240 min.
- the graph indicates that the formulation prepared with 140 mM NaCl and 200mM EDTA at pH of 4.5 contained the highest calcium ion concentration.
- the invention is further defined by reference to the following examples describing the preparation of the liposomes and methods of treating hypercalcemia using the liposomes. It will be apparent to those skilled in the art, that many modifications, both to materials and methods, may be practiced without departing from the purpose and interest of this invention.
- Calcium loading was studied in vitro by diluting liposomes in buffer or biological media (e.g. serum) and incubating (e.g. at 37°C). Over the course of incubation, samples are microfiltered through a small diameter cutoff ( ⁇ lOOkDa) micro filtration device. Filtrates are assayed by high performance liquid chromatography for total calcium concentration. These filtrate concentrations represent the amount of free calcium found in the media. Thus a decrease in filtrate calcium can be attributed to liposome uptake of calcium from the media.
- Example 1 General Liposome Preparation Phospholipids and cholesterol in a ratio of about 2:1, respectively, are dissolved in suitable solvent or solvent mixtures with appropriate amount of ionophore. The solvent is removed subsequently via vacuum drying or spray drying. The resulting solid material can be stored or used immediately. Subsequently, the resulting solid material is hydrated in aqueous solution containing EDTA at appropriate temperatures, resulting in multilameller vesicles (MLV). The solutions containing MLV are size-reduced via homogenization to form Small Unilameller Vesicles (SUV). A portion of the EDTA is encapsulated in the aqueous compartment of SUV during the process.
- MLV multilameller vesicles
- SUV Small Unilameller Vesicles
- the unencapsulated EDTA is removed via suitable methods, such as dialysis, desalting column, or cross filtration.
- suitable methods such as dialysis, desalting column, or cross filtration.
- the resulting liposome solution is filtered and ready for use.
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Abstract
Description
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US5525232A (en) * | 1990-03-02 | 1996-06-11 | The Liposome Company, Inc. | Method for entrapment of cationic species in lemellar vesicles |
EP0780133A1 (en) * | 1995-12-22 | 1997-06-25 | BELLCO S.p.A. | Method for rapid removal of liposoluble molecules from a colloidal solution; in particular for dialysis |
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2004
- 2004-09-09 EP EP04817762A patent/EP1809245A4/en not_active Withdrawn
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