TR202013434A2 - Hyaluronic acid-collagen encapsulated mesenchymal stem cell-platelet-rich plasma and chondrocyte-containing product-method in the treatment of osteoarthritis - Google Patents

Hyaluronic acid-collagen encapsulated mesenchymal stem cell-platelet-rich plasma and chondrocyte-containing product-method in the treatment of osteoarthritis Download PDF

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TR202013434A2
TR202013434A2 TR2020/13434A TR202013434A TR202013434A2 TR 202013434 A2 TR202013434 A2 TR 202013434A2 TR 2020/13434 A TR2020/13434 A TR 2020/13434A TR 202013434 A TR202013434 A TR 202013434A TR 202013434 A2 TR202013434 A2 TR 202013434A2
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collagen
treatment
hyaluronic acid
joint
osteoarthritis
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Atsü Sağlam Saadet (%60)
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Saadet Atsü
Saadet Atsue Saglam %60
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Priority to PCT/TR2020/050782 priority patent/WO2022045996A1/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/36Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
    • A61L27/3604Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix characterised by the human or animal origin of the biological material, e.g. hair, fascia, fish scales, silk, shellac, pericardium, pleura, renal tissue, amniotic membrane, parenchymal tissue, fetal tissue, muscle tissue, fat tissue, enamel
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/70Carbohydrates; Sugars; Derivatives thereof
    • A61K31/715Polysaccharides, i.e. having more than five saccharide radicals attached to each other by glycosidic linkages; Derivatives thereof, e.g. ethers, esters
    • A61K31/726Glycosaminoglycans, i.e. mucopolysaccharides
    • A61K31/728Hyaluronic acid
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/12Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
    • A61K35/14Blood; Artificial blood
    • A61K35/16Blood plasma; Blood serum
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/12Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
    • A61K35/28Bone marrow; Haematopoietic stem cells; Mesenchymal stem cells of any origin, e.g. adipose-derived stem cells
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/12Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
    • A61K35/32Bones; Osteocytes; Osteoblasts; Tendons; Tenocytes; Teeth; Odontoblasts; Cartilage; Chondrocytes; Synovial membrane
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/14Macromolecular materials
    • A61L27/26Mixtures of macromolecular compounds
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/36Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
    • A61L27/38Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells
    • A61L27/3804Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells characterised by specific cells or progenitors thereof, e.g. fibroblasts, connective tissue cells, kidney cells
    • A61L27/3834Cells able to produce different cell types, e.g. hematopoietic stem cells, mesenchymal stem cells, marrow stromal cells, embryonic stem cells
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/50Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/50Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
    • A61L27/54Biologically active materials, e.g. therapeutic substances
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00Drugs for skeletal disorders
    • A61P19/02Drugs for skeletal disorders for joint disorders, e.g. arthritis, arthrosis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2400/00Materials characterised by their function or physical properties
    • A61L2400/06Flowable or injectable implant compositions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2430/00Materials or treatment for tissue regeneration
    • A61L2430/24Materials or treatment for tissue regeneration for joint reconstruction

Abstract

Buluş, tıp ve ilaç sanayisinde, eklem osteoartrit tedavisinde kullanılabilen, yapısında hyaluronik asit - kollagen ile enkapsüle edilmiş mezenkimal kök hücreleri, trombositten zengin plazma, kondrosit ve kombinasyonunu içeren, mezenkimal kök hücrenin, trombositten zengin plazmanın, kondrositin enkapsülasyonu yolu ile ortamda daha uzun canlı kalma ve biyoaktif moleküllerin daha uzun süre ortama verilmelerini sağlayarak kondrojenik, kondroprotektif – rejeneratif ürün ve ürün üretim yöntemi ile ilgilidir.The invention, which can be used in the treatment of joint osteoarthritis in the medical and pharmaceutical industry, contains mesenchymal stem cells encapsulated with hyaluronic acid - collagen, thrombocyte rich plasma, chondrocyte and its combination, which can be used for longer survival in the environment by encapsulation of mesenchymal stem cell, platelet rich plasma, chondrocyte. and it is about chondrogenic, chondroprotective - regenerative product and product production method by providing the release of bioactive molecules to the environment for a longer time.

Description

TARIFNAME OSTEOARTRIT TEDAVISINDE HYALURONIKASIT- KOLLAGENLE ENKAPSÜLENEN MEZENKIMAL KÖK HÜCRE-TROMBOSITI'EN ZENGIN PLAZMA VE KONDROSIT IÇEREN ÜRÜN- YÖNTEM TEKNIK ALAN Bulus, tip ve ilaç sanayisinde, eklem osteoartrit tedavisinde kullanilabilen, yapisinda hyaluronik asit - kollagen ile enkapsüle edilmis mezenkimal kök hücreleri, trombositten zengin plazma, kondrosit gibi eklem kondroprotektif - rejeneratif ajanlar ve kombinasyonunu içeren ürün ve üretim yöntemi ile ilgilidir. BULUSLA ILGILI TEKNIGIN BILINEN DURUMU Osteoartrit (0A) esas olarak eklem kikirdagini etkileyen bir eklem hastaligidir. Eklem kikirdagindaki bozulma zamanla agri ve eklem hareketlerinin sinirlanmasina sebep olmaktadir. Dejeneratif bir eklem hastaligi olan osteoartrit (0A) artiküler kartilajin progresif erezyonu, fibrilasyonu ve subkondral kemigin dejenerasyonu ile karakterize inflamatuar bir durumdur. Kikirdak yapilarin tedavisi kartilaj dokularin düsük iyilesme potansiyeli ve vaskülerizasyonu olmadigi Için oldukça güçtür. Bu nedenle hücre bazli tedaviler rejeneratif tip ve dis hekimliginde son yillarda ilgi çekmekte ve popülarite kazanmaktadir. BU LUSUN AMACI Bulus; saglik sektöründe kullanilan, yapisinda hyaluronik asit - kollagen ile enkapsüle edilmis mezenkimal kök hücreleri, trombositten zengin plazma, kondrosit gibi eklem yapisi için kondroprotektif - rejeneratif ajanlar ve kombinasyonunu içeren, rejeneratif tedavide kullanilacak mezenkimal kök hücrenin, trombositten zengin plazmanin, kondrosit gibi eklem kondroprotektif - rejeneratif ajanlarinin enkapsülasyon yolu ile ortamda canli kalma ve biyoaktif moleküllerin daha uzun süre ortama verilmelerini saglayan ürün ve üretim yöntemi ile ilgilidir. Bulusun bir amaci, kartilaj ve eklem koruyucu etkilerinin olmasi sebebiyle içeriginde enkapsülasyon malzemesi olarak hyaluronik asit (HA)-kollagen karisiminin kullanilmasidir. Bu sayede ekstrasellüler matriksin ana komponentlerinden biri olan sinoviyositler, fibroblastlar ve kondrositler tarafindan sentezlenen HA' nin hücre proliferasyonunda, doku tamirinde, hücre migrasyonundaki etkilerinden yararlanilacaktir. Buna ilaveten Hyaluronik asidin ana fonksiyonlari; yara iyilesmesinde inflamasyonun etkilerini yavaslatma, hücre proliferasyonunu ve reepitelizasyonu desteklemektir. Eklem yapisinda kayganlastirici olarak önemli rolü vardir, kartilaji korur, kartilaj ve diskin avasküler kisimlarinin beslenmesinde yardimcidir. Normalde eklem içinde viskoziteyi artirarak eklem tedavisinde kullanilmakta olan hyaluronik asidin, kollagenle kombinasyonuyla hazirlanmis olan enkapsülasyon malzemeleri hazirlayarak bunlarin ekleme saglayacagi faydali etkilerinden yararlanilmaktadir. Bulusun bir diger amaci, kartilaj dejenerasyona rejeneratif etki olusturmasi için trombositten zengin plazmanin (PRP - Platelet Rich Plasma) ve bunun hyaluronik asit (HA)-k0llagen karisimi ile enkapsüalsyonunun kullanimina imkan sunmasidir. Bu sayede PRP (Platelet Rich Plasma) hücre proliferasyonuna, kondrosit farklilasmasina ve dokunun yeniden organizasyonuna (remodeling) katki saglamaktadir. Potansiyel iyilestirme etkisi vardir. Bulusun bir diger amaci, kartilaj dejenerasyona kondrojenik etki olusturmasi için kondrositin ve bunun hyaluronik asit (HA)-k0llagen karisimi ile enkapsüalsyonunun kullanimina imkan sunmasidir. Bu sayede kondrojenik aktivite ve hasarli doku rejenerasyonu artacaktir. Bulusun bir diger amaci, Mezankimal kök hücre, PRP, kondrosit ve bunlarin hyaluronik asit- kollagen enkapsülasyon malzemesi ile enkapsüle edilerek birlikte kullaniminin tek tek rejenertif ve kondroprotektif özellikleri bilinen bu maddelerin sinerjistik etkilerinin osteoartrit tedavisinde rejeneratif ve kondroprotektif tedavi yöntemi olarak kullanilabilen bir ürün olmasidir. Bulusun bir diger amaci, TME (temporamandubular eklem) dejeneratif rahatsizliklarinda ve tüm eklem osteoartritlerinde kondroprotektif özelligi olan HA-kollagen ile kapsüle edilmis kök hücre, PRP, ve sinerjik etkilerinden ayri ayri ve kombinasyonarinin enjeksiyonu ile osteoartrit tedavisinde bilinen tedavi yöntemlerine alternatif, daha kisa zaman alan ve daha kesin çözüm yolu olabilecegini gösteren bir ürün olmasidir. Bulusun bir diger amaci, kök hücre disinda primer kondrositlerinde HA-kollagen ile tek basina ya da PRP enkapsülasyonu ile osteoartrit tedavisinde alternatif bir rejeneratif tedavi yöntemi ortaya çikaran bir ürün olmasidir. Söz konusu bulus, mevcut haliyle sektörde tercih edilen bir ürün haline gelecektir. Böylelikle hem ticari basari saglanacak, hem de saglik sektörüne osteoartriti tedavisi yönünden zengin bir tedavi yöntemi sunmaktadir. Bulusta enkapsülasyon malzemesine hapsedilmis gerek kök hücre, gerek kondrosit gerekse PRP kaynakli biyoaktif moleküllerin daha uzun süre eklem bosluguna salinarak, daha uzun süreli etki saglamasi mümkün kilinmaktadir. Enkapsülayon malzemesi eklem sivisindaki maddelerin kök hücrelere ulasmasina izin vereceginden kök hücrelerin daha uzun süre ortamda kalmalari saglanmaktadir. Enkapsülasyon malzemesi ayrica eklemin viskozitesine yardimci olmakta ve ilave bir etki saglamaktadir. BU LUSUN DETAYLI AÇIKLANMASI Bulus, eklem osteoartrit tedavisinde kullanilabilen, yapisinda hyaluronik asit - kollagen ile enkapsüle edilmis eklem kondroprotektif - rejeneratif ajanlar ve kombinasyonunu içeren ürün ve üretim yöntemidir. Bulusta eklem yapisi için kondroprotektif - rejeneratif ajan; mezenkimal kök hücre, trombositten zengin plazma, kondrosit ve bunlarin kombinasyonlarida olabilmekteclir. Eklem osteoartriti tedavisinde kök hücre kullanimi ile ilgili yapilmis az sayida çalismanin sonuçlari, kök hücre enjeksiyonunun kartilaj rejenerasyonunu stimüle edebilecegini ve TIVIE' deki progresif yikimi yavaslatabilecegine isaret etmektedir. Bu bilgi kapsaminda yapilan arastirmalar sonucu bulusta örnekleme amaciyla kök hücre enkapsülasyonun da hyaluronik asit (HA)-kollagen karisimi kullanilmistir. Ayni zamanda bu bulusta birçok büyüme faktörü içeren PRP gibi sivilarin da enkapsülasyonu yapilabilmektedir. Bu bulusta kullanilan enkapsülasyon malzemesi olan hyaluronik asit (HA)-kollagen karisiminin enkapsülasyon malzemelerinden beklenen bu özelliklere ilaveten kartilaj ve eklem koruyucu etkileri gözlemlenmistir. Tüm bu faktörler birlikte degerlendirildiginde bulusta kondroprotektif hyaluronik asit-kollagen karisimi ile enkapsüle edilmis mezenkimal kök hücre, PRP ve bunlarin sinerjistik etkilerini in vitro ve in vivio tavsan örneklerinde TME osteoartrit modeli özel bir teknikle olusturulmus ve ortaya çikan ürünle rejeneratif ve bir tedavi yöntemi gelistirilmistir. Bu teknikte TME osteoartrit modeli olusturulmus olsa da vücuttaki tüm eklem yapilarinda rejeneratif ve kondroprotektif bir tedavi yöntemi olarak uygulanabilmektedir. Bulusta trombositten zengin plazma (PRP)'nin potansiyel iyilestirme etkisi nedeniyle kartilaj dejenerasyonunda da kullanimi saglanmistir. PRP hücre proliferasyonuna, kondrosit farklilasmasina ve dokunun yeniden organizasyonuna (remodeling) katki saglamaktadir. Bulusta kök hücre enkapsülasyonunun yapilmasi hücrelerin korunmasi ve hücrelerin bir arada kalarak sinerjistik etki göstermelerini, daha uzun süre ortamda kalmalarini ve hücre kaynakli biyoaktif moleküllerin daha uzun süre ortama verilmelerini saglamak amaciyla yapilmaktadir. Bulusta kullanilan enkapsülasyon malzemesi biyouyumlu olmalidir. Besin maddelerinin hücrelere ulasmasini saglamali ve istenilen sürede ortamda kalmalidir. Bulus olusturulurken HA-kollagen enkapsülasyon malzemelerin kök hücrelere olan etkisi ve primer kondrositler üzerindeki kondrojenik kapasiteleri degerlendirilmistir. Bununla birlikte. kök hücre, PRP, kondrosit tek tek veya beraber HA-kollagen ile enkapsüle edilerek bu kombinasyon kondrojenik kapasite açisindan degerlendirilmistir. Bu analizlerde; hücre morfolojisi, glikozaminoglikan sentezi, kollagen tip I ve tip II sentezi, apoptoz, nekroz, proliferasyon, sitotoksisite ve kondrosit canliligi gibi birçok parametre histolojik, histokimyasal, immünohistokimyasal, PCR, Western Blot, spekrofotometrik, Alamar Blue, Annexin V, gerçek zamanli hücre analiz sistemleri gibi güncel yöntemlerle degerlendirilmistir. Kök hücre tedavisinde ortamda etkinligin artmasi ve iylesmenin hizlandirilmasi için kök hücre ile birlikte trombositten zengin plazma PRP (Platelet Rich Plasma) kullanilmasi saglanmistir. Bulusta kök hücre yerine sadece PRP kullanilarak ta enkapsülasyon islemi gerçeklestirilebilmektedir. Bulusta kök hücre yerine kondrosit kullanilarak ta enkapsülasyon islemi gerçeklestirilebilmektedir. Böylece kök hücre disinda primer kondrositlerinde HA-kollagen ile tek basina ya da PRP enkapsülasyonu ile osteoartrit tedavisinde alternatif bir rejeneratif tedavi yöntemi olarak ortaya konmaktadir. HYALURONIK ASIT-KOLLAGEN ENKASPÜLASYON MALZEMESININ HAZIRLANMASI, KARAKTERIZASYONU HA/Kollagen enkapsülasyon malzemesi hücrelerin korunmasi ve hücrelerin bir arada kalarak sinerjistik etki göstermelerini, daha uzun süre ortamda kalmalarini ve hücre kaynakli biyoaktif moleküllerin daha uzun süre ortama verilmelerini saglamak amaciyla yapildi. HA/Kollagen enkapsülasyon malzemesi biyouyumlu olmasi, besin maddelerinin hücrelere ulasmasini saglamasi, istenilen sürede ortamda kalmasi, toksik olmamasi ve bu özelliklerine ilave olarak kartilaj ve eklem koruyucu özelliklerinden dolayi çogunlukla tercih edilen malzemeler arasinda yer almaktadir. Enkapsülasyon malzemesinin hazirlanmasinda Kollagen Tip II (Nutragen), hyaluronik asit ve çapraz baglayici ajan olarak 4 arm Polietilen Glikol Succinimidyl Glutaramide (4sPEG) (Jenkem Technology) kullanildi. Öncelikle HA ve 4sPEG 30 dakika UV isigina maruz birakildi. 15 ml falkon içeriside,2 ml (Smg/ml) hazirlanan HA, 2ml kollagen üzerine mikropipet ile pipetaj yaparak ilave edildi. Son olarak 500 pl 4sPEG karisim içerisine mikropipet ile ilave edildi ve iyice karistirildi. 1 saat etüvde 37°C'de %5 COz, kültüre edildikten sonra hazir hale geldi. PRP nin tavsandan elde edilmesinde tavsandan toplamda 18 ml kari kulagin marjinal veninden alinarak ve 2 ml citrate dextroz ile erken dönemde pihtilasmayi önlemek için karistirildi. Antikoagüle olan kan karisimi platelet ayirici kite yerlestirildi (Harvest SmartPrep, Plymouth, MA) sistemin gerektirdigi sekilde 14 dakika santrifuje edildi. Santrifujdan sonra PRP disposible tüp içerisinde elde edilip ve 1 ml PRP dilue edilip, platelet sayimi için Bulustaki ürün olusturulurken üretim yöntemi olarak su islem adimlari izlenmektedir; ilk olarak hyaluronik asit-kollagen enkapsülasyon malzemesinin hazirlanmasi esnasinda; kross linker olarak 4SPEG 37 °C'de yaklasik 8 dakika süreyle inkübe edilerek kullanilmaktadir. Çapraz baglama baslamadan önce ortama HA ve kollagen karistirilmakta ve HA kollagen içerisine penetre edilmektedir. 0.05 M asetik asit içerisinde 1000 pl kollagen ve PES içesinde 350 ul HA hazirlanmasi ve llVI sodyum hidroksit ile pH si 7.4 e ayarlanmasi saglanmakta ve PES de hazirlanmis 100 pl 4SPEG ilave edilmektedir. Karisimin 37 °C'de 1 saat jellesmenin beklenmektedir. Jel degredasyon testine göre farkli konsantrasyonlarda kollagen, HA ve 4SPEG kullanilabilmektedir. Mikroskopla gün asiri parçalanan kapsüller parçalanmayanlara göre orantilanmaktadir. Hücrenin kapsüllenmesi mikropipet yardimiyla veya peristaltik pompa araciligi ile yapilmaktadir ve ürün ortaya çikmaktadir. Kök hücre izolasyonunda ise; yag dokusundan kök hücrelerin primer kültürü asamasinda tavsandan temin edilen yag dokusu örnekleri kullanilmaktadir. Yag dokusu örnekler enzimatik parçalanma asamasi için küçük parçalara ayrilarak ve kollajenaz (%99,8 DMEM, %2 Kollajenaz) enziminde 1 saat bekletilmektedir. Enzimatik parçalama asamasindan sonra örnek 12000 RPM'de 2 dakika santrifüje edildikten sonra santrifüj tüpünün dip kismindan alinan hücreler 5mL DMEM ile (%88 DMEM, %10 FetalCalf Serum, %2 L-Glutamin, Streptomisin-Ampisilin) 12,5 cm2'lik hücre kültürü flasklarina aktarilarak etüve alinmaktadir( olmus fusiform morfolojiye sahip olmalari beklenmektedir. Hücreler belirlenen pasaja kadar, her pasajda flowsitometri uygulamasi yapilarak kök hücreler CD12, CD90, CD105 hücre yüzey reseptörlerinin varligina göre karakterize edilmektedir. Ayrica kök hücre negatif markerleri C034 ve CD45 kullanilmaktadir. Gerekli olursa diger CD19, CDll-B gibi markerlar da kullanilabilmektedir. Primer kondrosit izolasyonunda ise; tavsandan steril sartlarda alinan kikirdak dokulari laboratuvar ortaminda steril bistüriler yardimiyla küçük parçalara ayrilip 25cm2'lik flasklara ekilmektedir. Üzerine %89 DMEM (DuIbecco'sModifiedEaglesMedium), %10FBS( FetalBovine Serum), %1 penicillinstreptomycine içeren besiyeri eklenerek 1 hafta 37C° de %5 COZlik etüvde inkübe edilmektedir. Yeterli sayida hücre izole olduktan sonra flasklara tutunmus olan hücrelerin vasatlari atilip 0,5 ml tripsin EDTA ile muamele edilerek 4 dk inkübe edilmektedir. Inkübasyon sonunda hücreler kontrol edilip kalkmayan hücreler mekanik güç uygulanarak kaldirilacaktir. Steril falkon tüpe aktarilan hücrelerin üzerine tripsin aktivasyonunu inhibe etmek için 1 ml serum içeren besiyeri eklenmekte ve daha sonra 2500 rpm'de 2 dk santrifüj edilip elde edilen pellet üzerine her flask için 3 ml besiyeri eklenerek yeni flasklara pasajlanmaktadir. Hücre kültüründeki primer kondrositler, kültür ortamindan kaynaklanan farklilasmaya veya baska hücrelerce kontaminasyona karsi CD44, CD49c ve CD151 markerlariyla flow sitometride teyit edilmektedir. Kök hücrelerin, kondrositlerin, PRP' nin ayri ayri ve birlikte enkapsüllenmesi ve kök hücre/ kondrositler üzerindeki etkisi o Nekroz o Proliferasyon o Sitotoksisite o Kondrosit morfolojisi o GAG ölçümü o RT-PCR iler Kollagen tip II, Kollagen tip I, Agrecan, SOK-9 ve COIVIP sentezi o Western blot ile kollagen I ve kollagen II tayini ile belirlenmektedir. Son olarak uygulama eklem bölgesine enjeksiyon seklinde olmaktadir. Enkapsüle edilmis meznkimal kök hücre gerekli degerde eklem bölgesine enjekte edilmektedir. PRP uygulamasi için enkapsüle edilmis PRP veya PRP ve mezanimal kök hücrenin birlikte enkapsüle edilmesi ile enjeksiyon yapilmaktadirkol. Kondrosit uygulamasi için HA- Kollogen ile enkapsüle edilen kondrosit tek basina ya da PRP' ninde birlikte enkapsüle edilmesi ile enjekte edilmektedir. TR DESCRIPTION PRODUCT- METHOD CONTAINING MESENCYMAL STEM CELL-PLASM AND CHONDROCYTE RICH PLASMA AND CHONDROCYTE ENCAPSULATED WITH HYALURONIC ACID- COLLAGEN IN THE TREATMENT OF OSTEOARTHRITIS advanced mesenchymal stem cells, rich in platelets It is related to the product and production method containing joint chondroprotective - regenerative agents such as plasma and chondrocytes and their combination. BACKGROUND OF THE ART RELATED TO THE INVENTION Osteoarthritis (0A) is a joint disease that mainly affects the joint cartilage. Deterioration in joint cartilage causes pain and limitation of joint movements over time. Osteoarthritis (0A), a degenerative joint disease, is an inflammatory condition characterized by progressive erosion and fibrillation of the articular cartilage and degeneration of the subchondral bone. Treatment of cartilage structures is quite difficult due to the low healing potential and lack of vascularization of cartilage tissues. For this reason, cell-based therapies have attracted attention and gained popularity in regenerative medicine and dentistry in recent years. PURPOSE OF THIS INVENTION Invention; Used in the health sector, it contains mesenchymal stem cells encapsulated with hyaluronic acid - collagen in its structure, chondroprotective - regenerative agents for joint structure such as platelet-rich plasma, chondrocytes and its combination. It is related to the product and production method that allows the agents to remain alive in the environment through encapsulation and to deliver bioactive molecules to the environment for a longer period of time. One purpose of the invention is to use hyaluronic acid (HA)-collagen mixture as an encapsulation material due to its cartilage and joint protective effects. In this way, the effects of HA, synthesized by synoviocytes, fibroblasts and chondrocytes, which are one of the main components of the extracellular matrix, on cell proliferation, tissue repair and cell migration will be utilized. In addition, the main functions of Hyaluronic acid are; It slows down the effects of inflammation in wound healing and supports cell proliferation and reepithelialization. It has an important role as a lubricant in the joint structure, protects the cartilage, and helps nourish the avascular parts of the cartilage and the disc. By preparing encapsulation materials prepared by combining hyaluronic acid, which is normally used in joint treatment by increasing the viscosity within the joint, with collagen, the beneficial effects of these on the joint are utilized. Another purpose of the invention is to enable the use of platelet-rich plasma (PRP) and its encapsulation with hyaluronic acid (HA)-collagen mixture to create a regenerative effect on cartilage degeneration. In this way, PRP (Platelet Rich Plasma) contributes to cell proliferation, chondrocyte differentiation and tissue reorganization (remodeling). It has a potential healing effect. Another aim of the invention is to enable the use of chondrocyte and its encapsulation with hyaluronic acid (HA)-collagen mixture to create a chondrogenic effect on cartilage degeneration. In this way, chondrogenic activity and damaged tissue regeneration will increase. Another purpose of the invention is to create a product that can be used as a regenerative and chondroprotective treatment method in the treatment of osteoarthritis due to the synergistic effects of mesenchymal stem cells, PRP, chondrocytes and their encapsulation with hyaluronic acid-collagen encapsulation material and the synergistic effects of these substances, which are known to have regenerative and chondroprotective properties individually. Another aim of the invention is to use the injection of stem cells, PRP, encapsulated with HA-collagen, which has chondroprotective properties, and their synergistic effects, separately and in combination, in TMJ (temporamandubular joint) degenerative disorders and all joint osteoarthritis, as an alternative to known treatment methods, a shorter time-consuming treatment method. and it is a product that shows that there may be a more definitive solution. Another aim of the invention is to be a product that creates an alternative regenerative treatment method in the treatment of osteoarthritis with HA-collagen alone or with PRP encapsulation in primary chondrocytes other than stem cells. The invention in question will become a preferred product in the industry in its current form. In this way, both commercial success will be achieved and it offers a rich treatment method to the health sector in terms of osteoarthritis treatment. In the invention, it is possible to release bioactive molecules originating from stem cells, chondrocytes or PRP, which are trapped in the encapsulation material, into the joint cavity for a longer period of time and provide a longer-lasting effect. Since the encapsulation material will allow substances in the joint fluid to reach the stem cells, the stem cells are allowed to remain in the environment for a longer period of time. The encapsulation material also helps the viscosity of the joint and provides an additional effect. DETAILED DESCRIPTION OF THE INVENTION The invention is a product and production method that can be used in the treatment of joint osteoarthritis and contains joint chondroprotective - regenerative agents encapsulated with hyaluronic acid - collagen in its structure and its combination. In the invention, chondroprotective - regenerative agent for joint structure; Mesenchymal stem cells, platelet-rich plasma, chondrocytes and combinations of these may also be present. The results of the few studies on the use of stem cells in the treatment of joint osteoarthritis indicate that stem cell injection may stimulate cartilage regeneration and slow the progressive destruction in TIVIE. As a result of the research conducted within the scope of this information, hyaluronic acid (HA)-collagen mixture was used in stem cell encapsulation for exemplary purposes in the invention. At the same time, in this invention, encapsulation of liquids such as PRP containing many growth factors can be made. In addition to these properties expected from encapsulation materials, the cartilage and joint protective effects of the hyaluronic acid (HA)-collagen mixture, which is the encapsulation material used in this invention, were observed. When all these factors are evaluated together, in the invention, mesenchymal stem cells encapsulated with chondroprotective hyaluronic acid-collagen mixture, PRP and their synergistic effects in in vitro and in vivo rabbit samples, a TMJ osteoarthritis model was created with a special technique and a regenerative and treatment method was developed with the resulting product. Although this technique has created a TMJ osteoarthritis model, it can be applied as a regenerative and chondroprotective treatment method in all joint structures in the body. In the invention, platelet-rich plasma (PRP) was also used in cartilage degeneration due to its potential healing effect. PRP contributes to cell proliferation, chondrocyte differentiation and tissue reorganization (remodeling). In the invention, stem cell encapsulation is performed in order to protect the cells and to ensure that the cells remain together and show a synergistic effect, remain in the environment for a longer period of time, and provide cell-derived bioactive molecules to the environment for a longer period of time. The encapsulation material used in the invention must be biocompatible. It must ensure that nutrients reach the cells and remain in the environment for the desired period of time. While creating the invention, the effect of HA-collagen encapsulation materials on stem cells and their chondrogenic capacity on primary chondrocytes were evaluated. With this. Stem cells, PRP, and chondrocytes were encapsulated with HA-collagen individually or together, and this combination was evaluated in terms of chondrogenic capacity. In these analyses; Many parameters such as cell morphology, glycosaminoglycan synthesis, collagen type I and type II synthesis, apoptosis, necrosis, proliferation, cytotoxicity and chondrocyte viability are histological, histochemical, immunohistochemical, PCR, Western Blot, spectrophotometric, Alamar Blue, Annexin V, real-time cell analysis. It was evaluated with current methods such as systems. In order to increase the effectiveness of stem cell treatment and accelerate healing, platelet-rich plasma PRP (Platelet Rich Plasma) has been used together with stem cells. In the invention, the encapsulation process can be carried out by using only PRP instead of stem cells. In the invention, the encapsulation process can also be performed by using chondrocytes instead of stem cells. Thus, it is presented as an alternative regenerative treatment method in the treatment of osteoarthritis with HA-collagen alone or with PRP encapsulation in primary chondrocytes other than stem cells. PREPARATION AND CHARACTERIZATION OF HYALURONIC ACID-COLLAGEN ENCASPULATION MATERIAL HA/Collagen encapsulation material was made in order to protect the cells and to ensure that the cells stay together and show a synergistic effect, stay in the environment for a longer time and provide cell-derived bioactive molecules to the environment for a longer time. HA/Collagen encapsulation material is among the most preferred materials because it is biocompatible, allows nutrients to reach the cells, remains in the environment for the desired period of time, is non-toxic, and in addition to these features, it has cartilage and joint protective properties. In the preparation of the encapsulation material, Collagen Type II (Nutragen), hyaluronic acid and 4 arm Polyethylene Glycol Succinimidyl Glutaramide (4sPEG) (Jenkem Technology) were used as a cross-linking agent. First, HA and 4sPEG were exposed to UV light for 30 minutes. 2 ml (Smg/ml) HA prepared in 15 ml falcon was added onto 2 ml collagen by pipetting with a micropipette. Finally, 500 pl 4sPEG was added into the mixture with a micropipette and mixed thoroughly. It was ready after being cultured in an oven at 37°C, 5% CO2 for 1 hour. To obtain PRP from the rabbit, a total of 18 ml was taken from the marginal vein of the rabbit ear and mixed with 2 ml of citrate dextrose to prevent early clotting. The anticoagulated blood mixture was placed in a platelet separation kit (Harvest SmartPrep, Plymouth, MA) and centrifuged for 14 minutes as required by the system. After centrifugation, PRP is obtained in a disposable tube and 1 ml of PRP is diluted, and water processing steps are followed as the production method while creating the product in the invention for platelet counting; Firstly, during the preparation of hyaluronic acid-collagen encapsulation material; 4SPEG is used as a cross linker by incubating at 37 °C for approximately 8 minutes. Before cross-linking begins, HA and collagen are mixed into the medium and HA is penetrated into the collagen. 1000 pl collagen in 0.05 M acetic acid and 350 ul HA in PES are prepared and the pH is adjusted to 7.4 with 1VI sodium hydroxide and 100 pl 4SPEG prepared in PES is added. The mixture is expected to gel for 1 hour at 37 °C. Different concentrations of collagen, HA and 4SPEG can be used according to the gel degradation test. Capsules that disintegrate over time under the microscope are compared to those that do not disintegrate. The encapsulation of the cell is done with the help of a micropipette or a peristaltic pump and the product is formed. In stem cell isolation; Adipose tissue samples obtained from rabbits are used in the primary culture of stem cells from adipose tissue. Fat tissue samples are cut into small pieces for the enzymatic degradation stage and kept in collagenase (99.8% DMEM, 2% Collagenase) enzyme for 1 hour. After the enzymatic digestion phase, the sample was centrifuged at 12000 RPM for 2 minutes, and then the cells were taken from the bottom of the centrifuge tube with 5mL DMEM (88% DMEM, 10% FetalCalf Serum, 2% L-Glutamine, Streptomycin-Ampicillin) to form 12.5 cm2 cells. They are transferred to culture flasks and placed in the oven (they are expected to have a mature fusiform morphology. Flow cytometry is performed at each passage until the cells are determined, and the stem cells are characterized according to the presence of CD12, CD90, CD105 cell surface receptors. Additionally, stem cell negative markers C034 and CD45 are used. If necessary, Other markers such as CD19 and CDll-B can also be used. In primary chondrocyte isolation, cartilage tissues taken from rabbits under sterile conditions are cut into small pieces with the help of sterile scalpels and planted in 25cm2 flasks with 89% DMEM (DuIbecco's ModifiedEaglesMedium) and 10% FBS (FetalBovine). Serum), medium containing 1% penicillinstreptomycin is added and incubated for 1 week at 37°C in an oven with 5% CO2. After a sufficient number of cells are isolated, the media of the cells attached to the flasks are discarded, treated with 0.5 ml trypsin EDTA and incubated for 4 minutes. At the end of the incubation, the cells will be checked and the cells that do not lift will be removed by applying mechanical force. 1 ml of medium containing serum is added to the cells transferred to a sterile falcon tube to inhibit trypsin activation, and then it is centrifuged at 2500 rpm for 2 minutes and the resulting pellet is passaged into new flasks by adding 3 ml of medium for each flask. Primary chondrocytes in cell culture are confirmed by flow cytometry with CD44, CD49c and CD151 markers against differentiation caused by the culture medium or contamination by other cells. Encapsulation of stem cells, chondrocytes, PRP separately and together and its effect on stem cells/chondrocytes o Necrosis o Proliferation o Cytotoxicity o Chondrocyte morphology o GAG measurement o RT-PCRs Collagen type II, Collagen type I, Aggrecan, SOK-9 and COIVIP synthesis is determined by the determination of collagen I and collagen II by Western blot. Finally, the application is by injection into the joint area. The required amount of encapsulated mesnchymal stem cells is injected into the joint area. For PRP application, injection is made by encapsulating encapsulated PRP or PRP and mesenimal stem cells together. For chondrocyte application, chondrocytes encapsulated with HA-Collagen are injected alone or together with PRP. TR

Claims (1)

1.ISTEMLER2.Bulus, saglik sektöründe ve ilaç sanayisinde, eklem osteoartrit tedavisinde kullanilan ürün olup, özelligi; eklem kondroprotektif - rejeneratif ajanlarin; korunmasi ve bir arada kalarak sinerjistik etki göstermelerini, daha uzun süre ortamda kalmalarini ve hücre kaynakli biyoaktif moleküllerin daha uzun süre ortama verilmelerini saglamak amaciyla HA (hyaluronik asit) ve kollagen birlesiminden olusan enkapsülasyon malzemesi ile enkapsüle edilmesiyle karakterize edilmesidir.3.Istem-l' e uygun ürün olup, özelligi; osteoartrit tedavisinde kullanilan HA (hyaluronik asit) ve kollagen birlesiminden olusan enkapsülasyon malzemesi ile enkapsüle edilen eklem kondroprotektif - rejeneratif ajanin mezenkimal kök hücre olmasiyla karakterize edilmesidir. istem-1' e uygun ürün olup, özelligi; osteoartrit tedavisinde kullanilan HA (hyaluronik asit) ve kollagen birlesiminden olusan enkapsülasyon malzemesi ile enkapsüle edilen eklem kondroprotektif - rejeneratif ajanin trombositten zengin plazma (PRP -4.Platelet Rich Plasma) olmasiyla karakterize edilmesidir.5.Istem-l' e uygun ürün olup, özelligi; osteoartrit tedavisinde kullanilan HA (hyaluronik asit) ve kollagen birlesiminden olusan enkapsülasyon malzemesi ile enkapsüle edilen eklem kondroprotektif - rejeneratif ajanin kondrosit olmasiyla karakterize edilmesidir. istem-1 veya istem-2' ye uygun ürün olup, özelligi; kök hücre tedavisinde ortamda etkinligin artmasi ve iylesmenin hizlandirilmasi için mezenkimal kök hücre ile birlikte trombositten zengin plazma (PRP - Platelet Rich Plasma) kullanilmasiyla karakterize edilmesidir. istem-1 veya istem-2' ye uygun ürün olup, özelligi; hücre bazli tedavide ortamda etkinligin artmasi ve iyilesmenin hizlandirilmasi için trombositten zengin plazma6.(PRP)ile birlikte kondrosit kullanilmasiyla karakterize edilmesidir.7. Bulus, saglik sektöründe ve ilaç sanayisinde, eklem osteoartrit tedavisinde kullanilan ürün üretim yöntemi olup, özelligi; Hyaluronik asit-kollagen enkapsülasyon malzemesinin hazirlanmasinda; Kross Iinker olarak 4SPEG inkübe edilerek kullanilmasi Çapraz baglama baslamadan önce ortama HA ve kollagen karistirilmasi, HA 'nin kollagen içerisine penetre edilmesi, asetik asit içerisinde kollagen ve PES içerisinde HA hazirlanmasi ve sodyum hidroksit ile pH sinin ayarlanmasi, PBS de hazirlanmis 4SPEG ilave edilmesi, jellesmenin beklenmesi, mikroskopla gün asiri parçalanan kapsüller parçalanmayanlara orantilanmasi hücre kapsülleme isleminin tamamlanmasi, islem adimlarini içermesidir.8. istem-7' e uygun ürün üretim yöntemi olup, özelligi; bahsedilen hücre kapsülleme isleminin mikropipet kullanilarak gerçeklestirilmesiyle karakterize edilmesidir.9. Istem-7' e uygun ürün üretim yöntemi olup, özelligi; bahsedilen hücre kapsülleme isleminin peristaltik pompa kullanilarak gerçeklestirilmesiyle karakterize edilmesidir. TR1.CLAIMES 2.The invention is a product used in the treatment of joint osteoarthritis in the health sector and pharmaceutical industry, and its feature is; joint chondroprotective - regenerative agents; It is characterized by encapsulation with an encapsulation material consisting of a combination of HA (hyaluronic acid) and collagen in order to protect them and to show a synergistic effect by remaining together, to remain in the environment for a longer period of time and to ensure that cell-derived bioactive molecules are released into the environment for a longer period of time. It is a suitable product and its features are; It is characterized by the fact that the joint chondroprotective - regenerative agent is mesenchymal stem cell, encapsulated with the encapsulation material consisting of a combination of HA (hyaluronic acid) and collagen used in the treatment of osteoarthritis. It is a product in accordance with claim-1 and its feature is; It is characterized in that the joint chondroprotective - regenerative agent encapsulated with the encapsulation material consisting of a combination of HA (hyaluronic acid) and collagen used in the treatment of osteoarthritis is platelet rich plasma (PRP -4.Platelet Rich Plasma). 5. It is a product in accordance with claim 1 and its feature is ; It is characterized by the chondrocyte being the joint chondroprotective - regenerative agent encapsulated with the encapsulation material consisting of a combination of HA (hyaluronic acid) and collagen used in the treatment of osteoarthritis. It is a product in accordance with claim-1 or claim-2, and its feature is; It is characterized by the use of platelet-rich plasma (PRP) along with mesenchymal stem cells to increase the effectiveness of stem cell treatment and accelerate healing. It is a product in accordance with claim-1 or claim-2, and its feature is; It is characterized by the use of chondrocytes together with platelet-rich plasma6. (PRP) to increase the effectiveness of the cell-based treatment and accelerate healing.7. The invention is a product production method used in the treatment of joint osteoarthritis in the health sector and pharmaceutical industry, and its feature is; In the preparation of hyaluronic acid-collagen encapsulation material; Using 4SPEG as a Kross Iinker by incubating it. Mixing HA and collagen into the medium before starting cross-linking, penetrating HA into collagen, preparing collagen in acetic acid and HA in PES and adjusting the pH with sodium hydroxide, adding 4SPEG prepared in PBS, ensuring gelation. It includes the following steps: waiting, proportioning the capsules that are broken down to those that are not broken down by the microscope every other day, and completing the cell encapsulation process.8. It is a product production method in accordance with claim-7 and its feature is; It is characterized by the said cell encapsulation process being carried out using a micropipette.9. It is a product production method in accordance with Claim-7 and its feature is; It is characterized by the fact that the said cell encapsulation process is carried out using a peristaltic pump. TR
TR2020/13434A 2020-08-26 2020-08-26 Hyaluronic acid-collagen encapsulated mesenchymal stem cell-platelet-rich plasma and chondrocyte-containing product-method in the treatment of osteoarthritis TR202013434A2 (en)

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