CN1323219A - 用于肺送递的稳定的浓缩胰岛素制剂 - Google Patents
用于肺送递的稳定的浓缩胰岛素制剂 Download PDFInfo
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- CN1323219A CN1323219A CN99812208A CN99812208A CN1323219A CN 1323219 A CN1323219 A CN 1323219A CN 99812208 A CN99812208 A CN 99812208A CN 99812208 A CN99812208 A CN 99812208A CN 1323219 A CN1323219 A CN 1323219A
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- insulin
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- human insulin
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Abstract
本发明公开了物理和化学稳定性高的浓缩含水胰岛素制剂。该制剂适于肺送递。通过提供其中的氯化物浓度保持在50mM以下并且其中的其它阴离子例如磷酸根的浓度减到最少的胰岛素制剂实现了该目的。该含水胰岛素制剂含有3至20mM人胰岛素或其类似物或衍生物,低于50mM的氯化物,低于10mM的除氯离子和乙酸根之外的其它阴离子,每6分子胰岛素2至5个Zn2+离子和每6分子胰岛素至少3个酚类分子。
Description
发明领域
本发明涉及物理和化学稳定性高并且适于肺送递的浓缩含水胰岛素制剂。
发明背景
糖尿病是具有过度排尿症状的人类疾病的总称,例如糖尿病和尿崩症。糖尿病是一种利用葡萄糖的能力或多或少地完全丧失了的代谢疾病。约有2%的人患有糖尿病。
自从20世纪20年代胰岛素问世以来,人们一直在进行研究以改善糖尿病的治疗。为了帮助避免极端的血糖水平,糖尿病患者通常接受多次注射疗法,在每次用餐时给药胰岛素。
在溶液中,胰岛素的自缔合方式受蛋白质浓度、金属离子、pH值、离子强度和溶剂组成的影响。对于常用的含有U100胰岛素、锌离子、等渗剂和苯酚防腐剂的可溶性制剂,必需考虑如下平衡:
已知的胰岛素降解方式包括a)原纤维形成;b)在A18、A21和B3脱酰氨基;c)通过转酰氨基作用或形成Schiff-碱而形成二聚体;d)二硫化物交换反应。
根据Brange的描述(《胰岛素的稳定性》(Stability of Insulin),Kluwer Academic Press,1994),所有这些降解反应在单体的情况下要比六聚体时快得多。因此,稳定胰岛素制剂最有效的方法是使上述平衡尽可能地偏向右侧。除了该质量作用的总的影响外,选定残基的反应性还受其直接参与T→R构象转变的影响。因此,B3Asn在R-状态时(当残基在α-螺旋中时)的反应性要比T状态时低得多。二锌胰岛素六聚体的T6、T3R3和R6构象之间的相互转变受与T3R3和R6形式结合的配体的调节。阴离子如氯离子对T3R3和R6的金属离子中的第四配位位置具有亲和性,而防腐剂例如苯酚则可以与位于T3R3和R6形式表面附近的疏水性袋结合(Derewenda,《自然》(Nature)338,594,1989和Brzovic,《生物化学》(Biochemistry)33,130557,1994)。通过使用Co2+胰岛素,已经证实阴离子和苯酚结合的组合效果在稳定R6状态时是特别有效的(Brader,Trends Biochem.Sci.30,6636,1991和Bloom,《分子生物学杂志》(J.Mol.Biol.)245,324,1995)。此外,对于Zn2+-和Co2+胰岛素均已证实,苯酚比间甲酚在诱导胰岛素六聚体的R-状态时更为有效(Wollmer,《生物化学》(Biol.Chem.)Hoppe-Seyler 368,903,1987和Choi,《生物化学》(Biochemistry)32,11638,1993)。诱导R-状态的高亲和性苯酚衍生物是7-羟基-吲哚((Dodson,Phil.Trans.R.Soc.Lond.A 345,153,1993)、间苯二酚和2,6-及2,7-二羟基-萘((Bloom,《分子生物学杂志》(J.Mol.Biol.)245,324,1995)。胰岛素的物理变性称为原纤维形成。在原纤维状态,延伸的肽链平行或反平行地伸展并在彼此之间形成氢键,称为β-结构或β-折叠片。原纤维通常代表蛋白质的最低能量状态,只有苛刻的条件例如强碱才可以从该状态重新生成正确折叠的蛋白质的天然状态。可以增加原纤维形成速率的因素是升高温度、增加液相和气相之间的表面积,对于不含锌的胰岛素,还可以增加浓度。对于六聚的锌胰岛素,原纤维的形成速率随着浓度的增加而降低。据信可以通过胰岛素的单体化促进原纤维的形成。胰岛素的原纤维具有凝胶或沉淀状的外观。
在B-链的C末端截短的胰岛素衍生物例如去五肽(B26-B30)胰岛素和去八肽(B23-B30)胰岛素比人胰岛素更倾向于形成原纤维。易于从六聚体单位解离成单体形式的胰岛素类似物例如AspB28人胰岛素和LysB28-ProB29人胰岛素,同样比人胰岛素更倾向于形成原纤维。可以通过形成稳定六聚体单位的条件来稳定胰岛素的天然状态,即存在锌离子(2-4锌/六聚体)、苯酚(0.1-0.5%w/v)和氯化钠(5-150mM)。
加入可以降低气-液界面表面张力的物质可以进一步降低原纤维形成的倾向。因此,平均分子量为约1800的聚乙二醇、聚丙二醇及其共聚物可在用于输注泵的浓缩胰岛素溶液中用作稳定剂(Grau,1982:Neue Insuline(编者Petersen,SchlLiter&Kerp),FreiburgerGraphische Betriebe,411-419页和Thurow,1981:专利DE2952119A1)。关于胰岛素物理稳定性的综合评论参见Brange 1994,《胰岛素的稳定性》(Stability of Insulin),Kluwer Academic Publisher,18-23页。制剂中胰岛素的化学降解大部分是由于涉及天冬酰胺残基,特别是残基B3和A21的甲酰胺功能基的反应。酰胺基团的水解生成脱酰胺基的衍生物,涉及另一个分子的氨基的转酰氨基作用导致共价连接的二聚体的形成,并在类似的连续反应后,生成三聚体或更高级的聚合物。
在酸性溶液中,AsnA21是最活泼的,导致AspA21胰岛素的生成(Sundby,《生物化学杂志》(J.Biol.Chem.)237,3406,1962)。在通过酸醇萃取得到的来自牛和猪的粗品胰岛素中,分离出的含量最多的二聚体是AspA21-GlyA1和AspA21-PheB1连接的(Helbig 1976,Insulindimere aus der B-Komponente von Insulinpraparationen,Rheinisch-Westfalischen Technischen Hochschule的论文,Aachen)。在中性溶液(该溶液是用于注射治疗的胰岛素制剂的优选方式)中,AsnB3是最易受影响的残基。降解产物包括AspB3胰岛素、AspB3-GlnB4-异肽胰岛素和其中AspB3提供羰基部分与另一个分子的氨基之间形成肽键的二聚体和更高级的聚合物。关于胰岛素化学稳定性的综合评论参见Brange 1994,《胰岛素的稳定性》(Stability ofInsulin),Kluwer Academic Publisher,23-26页。至于稳定六聚体单位的物理稳定性条件,即存在锌离子(2-4锌/六聚体)、苯酚(0.1-0.5%w/v)和氯化钠(5-150mM),可以降低在中性pH下存放过程中降解产物的形成速率。
当不采用稳定六聚体单位的条件时,可以观察到不同类型的聚合反应。因此,在不含锌、苯酚和氯化钠并采用50℃的温度时,二硫键连接的二聚体和高分子量的聚合物是主要的形成产物。形成机制是二硫化物互变反应,这是由二硫化物的β-消除引起的(Brems,《蛋白质工程》(Protein Engineering)5,519,1992)。
胰岛素的稳定性受pH、金属离子浓度、离子强度、苯酚类物质、溶剂组成(多元醇、乙醇和其它溶剂)、纯度和品种(牛、猪、人、其它类似物)的影响。综述参见Brange:《胰岛素的盖伦制剂》(Galenics ofInsulin),Springer-Verlag 1987,18和46页。
胰岛素在接近其等电位pH的pH值下、即4.0-7.0的pH范围内溶解性很低。高浓度的猪胰岛素溶液(5000U/ml~30mM)被调至酸性pH(Galloway,《糖尿病护理》(Diabetes Care)4,366,1981),但制剂中的胰岛素由于在AsnA21脱酰氨基化而是高度不稳定的。在中性pH下可以制备高浓度的不含锌的胰岛素溶液,但这些溶液由于高的聚合速率以及在AsnB3的脱酰氨基化而是不稳定的。据报道,含有苯酚的中性pH的猪锌胰岛素溶液在浓度为1000U/ml时在升高的温度下是稳定的,但当温度低达4℃时会出现过度饱和(Brange和Havelund,《胰岛素送递的人工系统》(Artificial Systems for Insulin Delivery),Brunetti等编,Raven Press 1983)。
为了减少胰岛素注射液的不便之处,人们开始广泛关注其它给药途径(概述参见Brange和Langkjaer,《蛋白质送递:物理学系统》(Protein Delivery:Physical Systems),Sanders和Hendren编,PlenumPress 1997)。肺送递系统似乎是这些系统中最有前途的(Service,《科学》(Science)277,1199,1997)。胰岛素可以以雾化成干粉的形式给药,或以雾化小滴的形式从胰岛素溶液给药。其效果可以通过训练呼吸(Gonda,美国专利5,743,250)和加入吸收促进剂(Baekstroem,美国专利5,747,445)或蛋白酶抑制剂(Okumura,《国际药学杂志》(Int.J.Pharm.)88,63,1992)增强。
与皮下注射相比,雾化的浓缩胰岛素溶液(500U/ml)的生物利用度为20-25%(Elliot,《澳大利亚儿科杂志》(Aust.Paediatr.J.)23,293,1987)。使用每次喷雾30-50μl胰岛素溶液时,胰岛素溶液的浓度必需比常用的0.6mM的浓度高5-20倍。通过使用单剂量容器例如凸泡包装(Gonda,美国专利5,743,250),可以不使用防腐剂。大部分胰岛素制剂通过有毒性的、粘膜刺激性和有令人不愉快气味的苯酚和间甲酚来防腐。但是,不用苯酚类物质将会产生稳定性的问题。除了抑制细菌的作用外,苯酚类物质与锌离子组合还起物理-化学稳定剂的作用。因此,优选用于吸入的胰岛素制剂用最低浓度的苯酚制备或将苯酚用更易接受的物质代替。
本发明的描述定义
文中所用的“人胰岛素类似物”(以及类似的表达方式)是指其中有一个或多个氨基酸缺失和/或被其它氨基酸、包括非编码氨基酸取代了的人胰岛素,或含有额外的氨基酸、即超过了51个氨基酸的人胰岛素。
文中所用的“人胰岛素衍生物”(以及类似的表达方式)是指其中至少有一个有机取代基与一个或多个氨基酸结合的人胰岛素或其类似物。
文中所用的“酚类分子”是指苯酚或其衍生物,例如间甲酚或氯甲酚。
发明概述
本发明的目的是提供具有可接受的物理和化学稳定性的用于肺送递的浓缩胰岛素制剂。
通过提供其中的氯化物浓度保持在50mM以下并且其中的其它阴离子例如磷酸根的浓度减到最少的胰岛素制剂,出人意料地实现了该目的。
因此,本发明涉及含水胰岛素制剂,所述制剂含有:3至20mM人胰岛素或其类似物或衍生物,低于50mM的氯化物,低于10mM的除氯离子和乙酸根之外的其它阴离子,每6分子胰岛素2至5个Zn2+离子和每6分子胰岛素至少3个酚类分子。优选的实施方案
本发明的胰岛素制剂优选含有3至15,更优选4至15mM,仍更优选5至15mM,特别优选6至15mM的人胰岛素或其类似物或衍生物。
在某些优选的实施方案中,本发明的制剂含有约3mM、约6mM、约9mM、约12mM或约15mM的人胰岛素或其类似物或衍生物。
当本发明的胰岛素制剂准备用多剂量容器给药时,需要进行防腐,因此最好含有最多50mM的酚类分子。但令人惊奇的是,通过使用相对低浓度的酚类分子,例如每6分子胰岛素3至12个酚类分子、优选每6分子胰岛素3至9个酚类分子,可以获得足够的稳定性。当不需要或需要很少的防腐作用时(例如在单剂量的容器中),可以使用低浓度的酚类分子。使用低用量酚类分子的另一个优点是增加了患者的舒适性。
本发明的胰岛素制剂优选含有低于40mM,更优选低于30mM氯化物,仍更优选5至20mM氯化物,以保证最佳的稳定性。
在具体的实施方案中,胰岛素可以含有少量磷酸盐缓冲液,优选最多5mM磷酸盐。
每6分子胰岛素含有2至4个Zn2+离子,优选2.2至3.2个Zn2+离子的本发明的胰岛素制剂是非常稳定的。
每6分子胰岛素含有3至5个Zn2+离子,优选3.5至5个Zn2+离子的本发明的胰岛素制剂也是适宜的。
令人惊奇的是,可以向本发明的胰岛素制剂中加入相对高浓度的两性离子例如N-甘氨酰甘氨酸和甘氨酸而不会降低胰岛素的溶解度。N-甘氨酰甘氨酸在中性pH值下起缓冲剂的作用,并且由于其中度的锌螯合作用,可以增加锌胰岛素在中性至碱性pH下的溶解速率。此外,N-甘氨酰甘氨酸还可以在存放过程中起到胺反应清除剂的作用。因此,在优选的实施方案中,本发明的胰岛素制剂还含有5至150mM的两性离子胺,优选N-甘氨酰甘氨酸或甘氨酸。
在优选的实施方案中,本发明的胰岛素制剂还含有5至50mM的三羟基甲基氨基甲烷,该化合物在中性pH值下起缓冲剂的作用,并且可以起到胺活泼化合物的清除剂的作用。
在另一个优选的实施方案中,本发明的胰岛素制剂含有钠离子作为阳离子。钠离子具有低的盐析作用。
在另一个优选的实施方案中,本发明的胰岛素制剂含有钾或钾和钠离子的混合物作为阳离子。浓度高于4-5mM的血浆浓度的钾离子可以增加胰岛素通过肺的转运。
在另一个优选的实施方案中,浓度高于4-5mM的钾离子与中度的支气管扩张剂如薄荷醇合用。
在另一个优选的实施方案中,本发明的胰岛素制剂含有0.001%(重量)至1%(重量)的非离子表面活性剂,优选吐温20或Polox 188。可以加入非离子型去污剂以稳定胰岛素,防止其在存放和雾化过程中形成原纤维。
在另一个优选的实施方案中,本发明的胰岛素制剂含有1mM至10mM的阴离子表面活性剂,优选牛磺胆酸钠,以进一步增加胰岛素的生物利用度。
在一个优选的实施方案中,使用的胰岛素是人胰岛素。
在另一个优选的实施方案中,使用的胰岛素是人胰岛素的类似物,其中位置B28是Asp、Lys、Leu、Val或Ala,位置B29是Lys或Pro;或是去(B28-B30)、去(B27)或去(B30)人胰岛素。
优选的人胰岛素类似物是其中的位置B28是Asp或Lys,位置B29是Lys或Pro的人胰岛素,优选AspB28人胰岛素或LysB28ProB29人胰岛素。
在另一个优选的实施方案中,胰岛素选自可溶性长效胰岛素衍生物,例如带有一个或多个亲脂性取代基的人胰岛素衍生物,优选乙酰化的胰岛素。
该实施方案的胰岛素衍生物优选选自B29-Nε-肉豆蔻酰-去(B30)人胰岛素、B29-Nε-棕榈酰-去(B30)人胰岛素、B29-Nε-肉豆蔻酰人胰岛素、B29-Nε-棕榈酰人胰岛素、B28-Nε-肉豆蔻酰LysB29ProB29人胰岛素、B28-Nε-棕榈酰LysB29ProB29人胰岛素、B30-Nε-肉豆蔻酰-ThrB29LysB30人胰岛素、B30-Nε-棕榈酰-ThrB29LysB30人胰岛素、B29-Nε-(N-棕榈酰-γ-谷氨酰基)-去(B30)人胰岛素、B29-Nε-(N-石胆酰-γ-谷氨酰基)-去(B30)人胰岛素、B29-Nε-(ω-羧基十七烷酰基)-去(B30)人胰岛素和B29-Nε-(ω-羧基十七烷酰基)人胰岛素。
首选的胰岛素衍生物是B29-Nε-肉豆蔻酰-去(B30)人胰岛素或B29-Nε-(N-石胆酰-γ-谷氨酰基)-去(B30)人胰岛素。
上述可溶性长效胰岛素衍生物是与白蛋白结合的,并且设计成可以提供恒定的基础胰岛素供给(Markussen;Diabetologia 39,281,1996)。每天皮下给药一次或两次可以保证所需的基础胰岛素供给,而对于肺给药则推荐每天吸入数次,优选在进餐时给药。
胰岛素衍生物的起效会延迟,因此会抵销通常与肺给药有关的血浆胰岛素非常迅速的增加。通过仔细选择胰岛素的类型,本发明可以对给药时间进行调整,以获得所需的胰岛素作用形式。
在本发明的具体实施方案中,胰岛素制剂含有胰岛素类似物或人胰岛素以及胰岛素衍生物。
胰岛素制剂中的酚类分子优选选自苯酚、间甲酚、氯甲酚、百里酚或其混合物。
本发明的胰岛素制剂的pH值优选在7至8.5之间,更优选7.4至7.9。
通过以下实施例对本发明进行进一步的描述,但不应将这些实施例看作是限定性的。
实施例1
将337mg不含锌的人胰岛素溶于1237μl水并加入263μl 0.1MZnCl2和637μl水,然后用38μl 0.2M NaOH调整pH,最后加水至2.5ml制得2.5ml 21mM的胰岛素储备液,计算出胰岛素的比体积为0.7μl/mg。然后加入350μl 0.16M间甲酚、175μl 0.32M苯酚和盐或去污剂至表1所示的浓度制得15mM的制剂,然后用溶媒稀释至12、9、6、3和0.6mM并于5℃下存放。
实施例2
将锌胰岛素在冰浴上分散在水中(1∶10),加入N-甘氨酰甘氨酸(7/15)当量和氢氧化钠(3.1当量),然后在5℃下缓慢搅拌过夜。然后加入0.1当量的氯化锌和去污剂,用0.8当量的盐酸将pH调至7.5,调整体积,然后加入苯酚和水并在最后将15mM的制剂用含有氯化钠、N-甘氨酰甘氨酸和去污剂的溶媒稀释得到12、9、6和3mM的人胰岛素(表2和3)。
结果如下表1至3所示。
表1的数据表明,即使少量的磷酸盐(例如5mM)也会降低胰岛素的稳定性,并且用三羟基甲基氨基甲烷盐酸盐代替氯化钠也倾向于降低胰岛素的溶解度。与盐相反,两性离子N-甘氨酰甘氨酸和甘氨酸可以增加胰岛素的溶解度,并且可以加入出人意料的高浓度的两性离子N-甘氨酰甘氨酸和甘氨酸而不会破坏对胰岛素的稳定作用。N-甘氨酰甘氨酸在中性pH下起缓冲剂的作用,并且由于其中度的锌螯合作用,可以增加锌胰岛素在中性至碱性pH下的溶解速率。N-甘氨酰甘氨酸还可以在存放过程中起到胺反应清除剂的作用。加入最多1%(重量)的非离子型去污剂吐温20和泊咯沙姆188以及3mM的阴离子型去污剂牛磺胆酸钠不会降低在5℃存放时的稳定性。
表2中显示了加入与胰岛素等摩尔量的酚类物质时的影响。有三种酚类分子可以增加6至15mM或更高浓度的胰岛素在低温下的物理稳定性并使升高温度下的聚合物形成减少2-3倍(在低氯化物浓度下)。在另一组实验(表3)中,增加化学稳定性的苯酚或氯甲酚的相对量从0至2/胰岛素变化。
实施例3
将441mg B29-Nε-(N-石胆酰-γ-谷氨酰基)-去(B30)人胰岛素(143nmol/mg)于0℃下悬浮在5ml水中并加入220μl 1N NaOH。当胰岛素类似物溶解后,加入295μl 0.1 M ZnCl2并将溶液搅拌至暂时出现的沉淀溶解。依次加入315μl 0.32mM苯酚和98μl 0.5MN-甘氨酰甘氨酸和70μl 1%吐温20,测得pH为7.60。最后加入693μl水并将溶液通过无菌的0.22μm Millex-GV滤器得到7ml 9mM的B29-Nε-(N-石胆酰-γ-谷氨酰基)-去(B30)人胰岛素。该溶液在5℃下3个月后仍然保持稳定。
表1人胰岛素溶液在常规的苯酚/甲酚浓度(用于多剂量容器)下的稳定性与盐浓度、离子电荷和去污剂浓度的关系。
赋形剂 溶液在5℃下的物理稳定性0.5Zn2+/胰岛素 4个月没有沉淀的最大浓度。苯酚和甲酚16mM 实验溶液分别为0.6、3、6、9、12和pH7.5并加入(mM): 15mM胰岛素 |
参照(正常溶解*)) 3-6参照(低离子强度) 12NaCl 10 15NaCl 20 12NaCl 40 6NaCl 60 <3NaH2PO45+NaCl 20 6+NaCl 25 6+NaCl 37.5 6+NaCl 50 6N-甘氨酰甘氨酸7 15N-甘氨酰甘氨酸12 15N-甘氨酰甘氨酸24 15N-甘氨酰甘氨酸48 15N-甘氨酰甘氨酸72 15N-甘氨酰甘氨酸96 15N-甘氨酰甘氨酸120 15 |
甘氨酸10 15甘氨酸20 15甘氨酸40 15甘氨酸60 15甘氨酸80 15甘氨酸100 15三羟基甲基氨基甲烷**)7 12tris 12 9tris 24 9tris 48 3吐温20 0.05% 15吐温20 0.2% 15吐温20 1% 15吐温20 5% <3Polox 188 0.2% 12Polox 188 1% 12牛磺胆酸钠3 12牛磺胆酸钠15 9 |
表2人胰岛素在等摩尔浓度的酚类防腐剂存在下的稳定性
赋形剂 | 溶液在5℃下的物理稳定性 | 在37℃下的化学稳定性 |
0.5Zn2+/胰岛素,NaCl15mM,N-甘氨酰甘氨酸7mM,吐温200.01%,pH7.5和等摩尔的: | 在3、6、9、12和15mM胰岛素下3个月没有沉淀的最大稳定浓度 | %聚合物/周3和15mM胰岛素 |
甲酚 | 15 | 0.55 0.56 |
苯酚 | 15 | 0.37 0.39 |
氯甲酚 | 15 | 0.51 0.40 |
百里酚 | 9 | 0.85 1.25 |
参照(无酚类物质) | 6 | 0.94 1.49 |
表3人胰岛素在各种酚类防腐剂浓度下的稳定性
赋形剂 | 在37℃下的化学稳定性 | |
0.5Zn2+/胰岛素,NaCl15mM,N-甘氨酰甘氨酸7mM,吐温200.01%,pH7.5和 | 每分子胰岛素的酚类化合物的当量数 | %聚合物/周3和9mM胰岛素 |
参照 | 0 | 0.99 1.43 |
苯酚 | 0.33 | 0.69 0.96 |
苯酚 | 0.67 | 0.52 0.55 |
苯酚 | 1 | 0.46 0.38 |
苯酚 | 2和1.33 | 0.27 0.26 |
氯甲酚 | 0.33 | 0.66 0.93 |
氯甲酚 | 0.67 | 0.48 0.58 |
氯甲酚 | 1 | 0.30 0.30 |
氯甲酚 | 2和1.33 | 0.13 0.18 |
Claims (23)
1.一种含水胰岛素制剂,含有:3至20mM人胰岛素或其类似物或衍生物,低于50mM的氯化物,低于10mM的除氯离子和乙酸根之外的其它阴离子,每6分子胰岛素2至5个Zn2+离子和每6分子胰岛素至少3个酚类分子。
2.权利要求1的胰岛素制剂,含有3至15mM人胰岛素或其类似物或衍生物,优选约3mM、约6mM、约9mM、约12mM或约15mM人胰岛素或其类似物或衍生物。
3.权利要求2的胰岛素制剂,含有4至15mM,优选5至15mM,更优选6至15mM人胰岛素或其类似物或衍生物。
4.前述权利要求任意一项所述的胰岛素制剂,含有至多50mM酚类分子,优选每6分子胰岛素3至12个酚类分子,更优选每6分子胰岛素3至9个酚类分子。
5.前述权利要求任意一项所述的胰岛素制剂,含有低于40mM,优选低于30mM的氯化物,更优选含有5至20mM氯化物。
6.前述权利要求任意一项所述的胰岛素制剂,含有至多5mM磷酸盐。
7.前述权利要求任意一项所述的胰岛素制剂,含有每6分子胰岛素2至4个Zn2+离子,优选2.2至3.2个Zn2+离子。
8.前述权利要求任意一项所述的胰岛素制剂,还含有5至150mM两性离子胺,优选N-甘氨酰甘氨酸或甘氨酸。
9.前述权利要求任意一项所述的胰岛素制剂,还含有5至50mM三羟基甲基氨基甲烷。
10.前述权利要求任意一项所述的胰岛素制剂,含有钠离子、钾离子或其混合物作为阳离子。
11.前述权利要求任意一项所述的胰岛素制剂,还含有0.001%(重量)至1%(重量)的非离子表面活性剂,优选吐温20或Polox 188。
12.前述权利要求任意一项所述的胰岛素制剂,还含有1mM至10mM的阴离子表面活性剂,优选牛磺胆酸钠。
13.前述权利要求任意一项所述的胰岛素制剂,含有人胰岛素。
14.前述权利要求任意一项所述的胰岛素制剂,含有人胰岛素类似物,其中位置B28是Asp、Lys、Leu、Val或Ala,位置B29是Lys或Pro;或是去(B28-B30)、去(B27)或去(B30)人胰岛素。
15.权利要求14的胰岛素制剂,含有人胰岛素类似物,其中的位置B28是Asp或Lys,位置B29是Lys或Pro,优选AspB28人胰岛素或LysB28ProB29人胰岛素。
16.权利要求1-12中任意一项所述的胰岛素制剂,含有带有一个或多个亲脂性取代基的人胰岛素衍生物,优选酰化的胰岛素。
17.权利要求16的胰岛素制剂,其中的胰岛素衍生物选自B29-Nε-肉豆蔻酰-去(B30)人胰岛素、B29-Nε-棕榈酰-去(B30)人胰岛素、B29-Nε-肉豆蔻酰人胰岛素、B29-Nε-棕榈酰人胰岛素、B28-Nε-肉豆蔻酰LysB28ProB29人胰岛素、B28-Nε-棕榈酰LysB28ProB29人胰岛素、B30-Nε-肉豆蔻酰-ThrB29LysB30人胰岛素、B30-Nε-棕榈酰-ThrB29LysB30人胰岛素、B29-Nε-(N-棕榈酰-γ-谷氨酰基)-去(B30)人胰岛素、B29-Nε-(N-石胆酰-γ-谷氨酰基)-去(B30)人胰岛素、B29-Nε-(ω-羧基十七烷酰基)-去(B30)人胰岛素和B29-Nε-(ω-羧基十七烷酰基)人胰岛素。
18.权利要求17的胰岛素制剂,其中的胰岛素衍生物是B29-Nε-肉豆蔻酰-去(B30)人胰岛素或B29-Nε-(N-石胆酰-γ-谷氨酰基)-去(B30)人胰岛素。
19.前述权利要求中任意一项所述的胰岛素制剂,含有胰岛素类似物或人胰岛素以及胰岛素衍生物。
20.前述权利要求中任意一项所述的胰岛素制剂,其中的酚类分子选自苯酚、间甲酚、氯甲酚、百里酚或其混合物。
21.前述权利要求中任意一项所述的胰岛素制剂,其pH值在7至8.5、优选7.4至7.9的范围内。
22.治疗Ⅰ型或Ⅱ型糖尿病的方法,该方法包括,向需要所述治疗的患者施用前述权利要求中任意一项所述的胰岛素制剂。
23.权利要求22所述的方法,其中的胰岛素在用餐时给药。
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CN104870469A (zh) * | 2012-12-26 | 2015-08-26 | 沃克哈特有限公司 | 药物组合物 |
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