JP7267204B2 - Anti-adhesion composition - Google Patents

Description

TECHNICAL FIELD The present invention relates to an anti-adhesion material, a method for producing the same, a sponge-like laminate, and a pharmaceutical composition.

Adhesion refers to a state in which the surfaces of tissues that should be separated from each other are connected or fused with a fibrous tissue. Adhesions are caused by the formation of fibrin-containing exudate on the surface of tissues due to injury or inflammation, and the organization of this exudate to connect or fuse the tissue surfaces. Trauma formed on the surface of tissue during surgery, inflammation caused by the trauma, and inflammation due to drying of the tissue surface during surgery cause adhesions.

Adhesions can sometimes cause infertility, intestinal obstruction, and chronic pelvic pain. In addition, a second surgical operation may be required to detach adhesions that have occurred after the surgical operation. For example, multiple surgeries are effective for recurrent cases of liver cancer, but the decision to apply reoperation, the risk of treatment, the amount of bleeding at the time of surgery, the operation time, etc. It depends greatly on the prevention of subsequent adhesions. For these reasons, it is necessary to prevent adhesions, and various measures have been taken so far to prevent adhesions.

Some such means for adhesion prevention are to provide a physical barrier placed between the site of trauma or inflammation and the adjacent tissue to prevent the joining or fusion of the tissue. As such a physical barrier, a sheet-shaped one is known.

Specifically, the sheet-like one contains polytetrafluoroethylene (PTFE) film (Preclude (trade name) (WL Gore and Associates, Inc.)), hyaluronic acid (HA) and carboxymethyl cellulose (CMC). sheets (Seprafilm (trade name) (Genzyme GmbH)), regenerated oxidized cellulose sheets (INTERCEED (trade name) (Johnson & Johnson)), and the like. Of these, the PTFE film is not biodegradable, so there is a problem that it remains in the body. Sheets containing HA and CMC and regenerated oxidized cellulose sheets are biodegradable, but cannot completely prevent serious adhesions such as adhesions that occur after hepatectomy, and there is room for improvement in terms of the effect of preventing adhesions. was there.

Here, biocompatible materials selected from proteins such as collagen and polysaccharides such as carboxymethylcellulose, hyaluronic acid and alginic acid are formed into sheets or particles to form medical absorbable materials, medical patches, and anti-adhesion materials. , as a biological tissue reinforcing material, etc. (Patent Documents 1 to 8). It is also known to incorporate drugs into such biocompatible materials (Patent Documents 7 and 8).

JP-A-48-79870 JP-A-2003-126235 WO 2005/26214 JP 2011-25013 A JP 2013-165884 A Japanese Patent Application Publication No. 2016-502874 Japanese translation of PCT publication No. 2013-544549 Japanese translation of PCT publication No. 2009-529926

Under these circumstances, it has a high anti-adhesion effect, can suppress both wound adhesion and de novo adhesion, does not adversely affect the body to which it is applied, does not interfere with wound healing, and is suitable for intestinal anastomosis. There has been a demand for an anti-adhesion material that has at least one of the properties of being able to be used in endoscopic surgery, being easy to apply via a trocar, and being able to be reapplied after adjusting the adhering position.

The present inventors have found an anti-adhesion material that combines the advantages of a film (sheet)-like anti-adhesion material and a spray (liquid/gel)-like anti-adhesion material in animal adhesion models assuming various clinical surgeries. As a result of intensive studies, we found that the first layer and the second layer have different dissolution rates, a sponge-like anti-adhesion material that can be applied to a living body, specifically one of alginic acid with a relatively high weight average molecular weight A sponge-like first layer comprising a valent metal salt (e.g., a monovalent metal salt of low endotoxin alginic acid) and a monovalent metal salt of alginic acid having a relatively low weight average molecular weight (e.g., a monovalent metal salt of low endotoxin alginic acid) ) and a sponge-like laminate that is applicable to a living body and that has an anti-adhesion effect not only in the surgical site but also in a wide range of application areas. and so on. Further, the inventors have found that at least one layer selected from the first and second layers of the sponge-like laminate is selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof. It has been found that an anti-adhesion material containing at least one medicinal ingredient has an even better anti-adhesion effect. Based on these findings, the present inventors have completed the present invention.

The present invention is as follows.
[1-1] A sponge-like first layer and a second layer of a monovalent metal salt of alginic acid, at least a portion of which is crosslinked with a curing agent, and the weight of the monovalent metal salt of alginic acid in the first layer The average molecular weight is 10,000 to 2,000,000, the weight average molecular weight of the monovalent metal salt of alginic acid in the second layer is 1,000 to 1,000,000, and the weight average molecular weight is decrosslinked It was measured by the GPC-MALS method after the treatment, and the weight average molecular weight of the monovalent metal salt of alginic acid in the first layer was higher than that of the monovalent metal salt of alginic acid in the second layer. at least one layer selected from the first layer and the second layer comprises at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof, and is sterilized; An anti-adhesion material comprising a biocompatible sponge-like laminate.
[1-1a] The anti-adhesion material according to [1-1] above, wherein the monovalent metal salt of alginic acid is a low-endotoxin monovalent metal salt of alginic acid.
[1-1b] a sponge-like first layer and a second layer of a low endotoxin monovalent metal salt of alginic acid at least partially crosslinked with a curing agent, wherein the monovalent metal salt of alginic acid of the first layer has a weight average molecular weight of 10,000 to 2,000,000, the weight average molecular weight of the monovalent metal salt of alginic acid in the second layer is 1,000 to 1,000,000, and the weight average molecular weight of Measured by the GPC-MALS method after decrosslinking treatment, the weight average molecular weight of the monovalent metal salt of alginic acid in the first layer is higher than the weight average molecular weight of the monovalent metal salt of alginic acid in the second layer. , at least one layer selected from the first layer and the second layer comprises at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof, and is sterilized Also, an anti-adhesion material containing a sponge-like laminate that is applicable to a living body.

[1-2] The anti-adhesion material according to any one of [1-1] to [1-1b] above, wherein one of the first layer and the second layer contains a curing agent.
[1-3] The anti-adhesion material according to any one of [1-1] to [1-1b] above, wherein both the first layer and the second layer contain a curing agent.
[1-4] The total amount of the monovalent metal salt of alginic acid (for example, the monovalent metal salt of low endotoxin alginic acid) used in the first layer and the second layer is 0.1 mg/cm ² to 3 mg/cm2. The anti-adhesion material according to any one of [1-1] to [1-3] above, which is in the range of cm ² .
[1-5] Any one of the above [1-1] to [1-4], wherein the monovalent metal salt of alginic acid in the first layer and the second layer has an endotoxin content of 500 EU/g or less. The anti-adhesion material according to the item.
[1-6] Any one of [1-1] to [1-5] above, wherein the monovalent metal salt of alginic acid in the first layer and the second layer is sodium alginate or potassium alginate. anti-adhesion material.
[1-7] The adhesion according to any one of [1-2] to [1-6] above, wherein the curing agent for the first layer and the second layer is a divalent or higher metal ion compound. prevention material.
[1-7a] wherein the curing agent for the first layer and the second layer is at least one metal ion compound selected from the group consisting of CaCl ₂ , CaSO ₄ , ZnCl ₂ , SrCl ₂ , FeCl ₃ and BaCl ₂ The anti-adhesion material according to any one of [1-2] to [1-6] above.
[1-8] The anti-adhesion material according to any one of [1-1] to [1-7a] above, for applying the first layer to the wound side surface.
[1-9] Any one of the above [1-1] to [1-8], wherein the sponge-like laminate is sterilized by electron beam and/or γ-ray irradiation with an absorbed dose of 10 kGy to 150 kGy. The anti-adhesion material according to the item.
[1-10] A bio-applicable sponge-like laminate comprising a first layer and a second layer each comprising a monovalent metal salt of alginic acid, at least a portion of which is crosslinked with a curing agent; the rate of dissolution of the layer is slower than that of the second layer,
At least one layer selected from the first layer and the second layer contains at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins, and combinations thereof. .
[1-10a] The anti-adhesion material according to [1-10] above, wherein the monovalent metal salt of alginic acid is a low-endotoxin monovalent metal salt of alginic acid.
[1-10b] A bio-applicable sponge-like laminate comprising a first layer and a second layer each comprising a monovalent metal salt of low endotoxin alginic acid, at least a portion of which is crosslinked with a curing agent; the dissolution rate of one layer is slower than that of the second layer,
At least one layer selected from the first layer and the second layer contains at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins, and combinations thereof. .
[1-11] In a dissolution test using the elution of a monovalent metal salt of alginic acid in a pH 7.5 phosphate buffer as an index, when the elution amount of the monovalent metal salt of alginic acid in the second layer is taken as 100%. The ratio of the elution amount of the monovalent metal salt of alginic acid in the first layer is less than 50% at 1 hour from the start of measurement and less than 70% at 2 hours from the start of measurement [1-10] to The anti-adhesion material according to any one of [1-10b].
[1-12] In a dissolution test using the elution of a monovalent metal salt of alginic acid in a pH 7.5 phosphate buffer as an indicator, the first layer contained 25 ± 10% by weight of the monovalent metal salt of alginic acid. 80±10% by weight within 4 hours. The anti-adhesion material according to any one of [1-10] to [1-10b] above, wherein 10% by weight of the anti-adhesion material dissolves within 4 hours.
[1-13] In a dissolution test using elution of the pharmaceutical ingredient in a phosphate buffer solution at pH 7.5 and 37°C as an index, 40 ± 20% by weight of the pharmaceutical ingredient contained in the first layer was dissolved within 1 hour. The anti-adhesion material according to any one of [1-10] to [1-10b] above, which dissolves and 80±20% by weight dissolves within 4 hours.
[1-14] In a dissolution test using elution of the pharmaceutical ingredient in a phosphate buffer at pH 7.5 and 37°C as an index, 80 ± 20% by weight of the pharmaceutical ingredient contained in the second layer was dissolved within 1 hour. The anti-adhesion material according to any one of [1-10] to [1-10b] above, which dissolves and 90±10% by weight dissolves within 4 hours.
[1-15] In a dissolution test in which the dissolution of a pharmaceutical ingredient in a phosphate buffer solution at pH 7.5 and 37°C is used as an index, 40 ± 20% by weight of the pharmaceutical ingredient contained in the first layer dissolves within 1 hour. 80±20% by weight dissolves within 4 hours; The anti-adhesion material according to any one of [1-10] to [1-10b] above, which dissolves within hours.
[1-16] The anti-adhesion material according to any one of [1-1] to [1-15] above, wherein the sponge-like laminate is pressed.

[2-1] A sponge-like first layer and a second layer of a monovalent metal salt of alginic acid at least partially crosslinked with a curing agent, and the weight of the monovalent metal salt of alginic acid in the first layer The average molecular weight is 10,000 to 2,000,000, the weight average molecular weight of the monovalent metal salt of alginic acid in the second layer is 1,000 to 1,000,000, and the weight average molecular weight is decrosslinked It was measured by the GPC-MALS method after the treatment, and the weight average molecular weight of the monovalent metal salt of alginic acid in the first layer was higher than that of the monovalent metal salt of alginic acid in the second layer. at least one layer selected from the first layer and the second layer comprises at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof, and is sterilized; A method for preventing adhesion, which comprises applying a biocompatible sponge-like laminate to a subject requiring adhesion prevention, with the first layer facing the surface on the wound side.
[2-1a] The method for preventing adhesion according to [2-1] above, wherein the monovalent metal salt of alginic acid is a low-endotoxin monovalent metal salt of alginic acid.
[2-1b] A sponge-like first layer and a second layer of a low endotoxin monovalent metal salt of alginic acid at least partially crosslinked with a curing agent, wherein the monovalent metal salt of alginic acid of the first layer has a weight average molecular weight of 10,000 to 2,000,000, the weight average molecular weight of the monovalent metal salt of alginic acid in the second layer is 1,000 to 1,000,000, and the weight average molecular weight of Measured by the GPC-MALS method after decrosslinking treatment, the weight average molecular weight of the monovalent metal salt of alginic acid in the first layer is higher than the weight average molecular weight of the monovalent metal salt of alginic acid in the second layer. , at least one layer selected from the first layer and the second layer comprises at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof, and is sterilized A method for preventing adhesion, which comprises applying a sponge-like laminate applicable to a living body to a subject requiring adhesion prevention, with the first layer facing the surface on the wound side.
[2-2] The method for preventing adhesion according to any one of the above [2-1] to [2-1b], wherein one of the first layer and the second layer contains a curing agent.
[2-3] The method for preventing adhesion according to any one of [2-1] to [2-1b] above, wherein both the first layer and the second layer contain a curing agent.
[2-4] The total amount of the monovalent metal salt of alginic acid (for example, the monovalent metal salt of low-endotoxin alginic acid) used in the first layer and the second layer is 0.1 mg/cm ² to 3 mg/cm 2 . The method for preventing adhesions according to any one of [2-1] to [2-3] above, which is in the range of cm ² .
[2-5] Any one of [2-1] to [2-4] above, wherein the monovalent metal salt of alginic acid in the first layer and the second layer has an endotoxin content of 500 EU/g or less. The method for preventing adhesions according to the item.
[2-6] Any one of [2-1] to [2-5] above, wherein the monovalent metal salt of alginic acid in the first layer and the second layer is sodium alginate or potassium alginate. adhesion prevention method.
[2-7] The adhesion according to any one of [2-2] to [2-6] above, wherein the curing agent for the first layer and the second layer is a divalent or higher metal ion compound. Prevention method.

[2-7a] wherein the curing agent for the first layer and the second layer is at least one metal ion compound selected from the group consisting of CaCl ₂ , CaSO ₄ , ZnCl ₂ , SrCl ₂ , FeCl ₃ and BaCl ₂ ; The method for preventing adhesions according to any one of [2-2] to [2-6] above.
[2-8] Any one of [2-1] to [2-7a] above, wherein the sponge-like laminate is sterilized by electron beam and/or gamma irradiation with an absorption dose of 10 kGy to 150 kGy. The adhesion prevention method described in .
[2-9] A first layer and a second layer each containing a monovalent metal salt of alginic acid at least partially crosslinked with a curing agent, wherein the dissolution rate of the first layer is higher than that of the second layer late,
At least one layer selected from the first layer and the second layer contains at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins, and combinations thereof, and is applied to a living body. A method of adhesion prevention, comprising applying a possible sponge-like laminate to a subject in need of adhesion prevention.
[2-9a] The method for preventing adhesion according to [2-1] above, wherein the monovalent metal salt of alginic acid is a low-endotoxin monovalent metal salt of alginic acid.
[2-9b] comprising a first layer and a second layer each containing a monovalent metal salt of low endotoxin alginic acid at least partially crosslinked with a curing agent, wherein the dissolution rate of the first layer is lower than that of the second layer; slower than
At least one layer selected from the first layer and the second layer contains at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins, and combinations thereof, and is applied to a living body. A method of adhesion prevention, comprising applying a possible sponge-like laminate to a subject in need of adhesion prevention.
[2-10] When the elution amount of the monovalent metal salt of alginic acid in the second layer is taken as 100% in a dissolution test using the elution of the monovalent metal salt of alginic acid in a pH 7.5 phosphate buffer as an index, The ratio of the elution amount of the monovalent metal salt of alginic acid in the first layer is less than 50% at 1 hour from the start of measurement and less than 70% at 2 hours from the start of measurement [2-9] to The adhesion prevention method according to any one of [2-9b].
[2-11] In a dissolution test using the elution of a monovalent metal salt of alginic acid in a pH 7.5 phosphate buffer as an index, the first layer contained 25 ± 10% by weight of the monovalent metal salt of alginic acid. 80±10% by weight within 4 hours. The method for preventing adhesion according to any one of [2-9] to [2-9b] above, wherein 10% by weight elutes within 4 hours.
[2-12] In a dissolution test in which the dissolution of the pharmaceutical ingredient in a phosphate buffer solution at pH 7.5 and 37°C is used as an index, 40 ± 20% by weight of the pharmaceutical ingredient contained in the first layer dissolves within 1 hour. The method for preventing adhesions according to any one of [2-9] to [2-9b] above, wherein 80±20% by weight is eluted within 4 hours.
[2-13] In a dissolution test in which the dissolution of the pharmaceutical ingredient in a phosphate buffer solution at pH 7.5 and 37°C is used as an index, 80 ± 20% by weight of the pharmaceutical ingredient contained in the second layer dissolves within 1 hour. The adhesion-preventing method according to any one of [2-9] to [2-9b] above, wherein 90±10% by weight is eluted within 4 hours.
[2-14] In a dissolution test in which elution of a pharmaceutical ingredient in a phosphate buffer solution at pH 7.5 and 37°C is used as an index, 40 ± 20% by weight of the pharmaceutical ingredient contained in the first layer dissolves within 1 hour. 80±20% by weight dissolves within 4 hours; The method for preventing adhesions according to any one of [2-9] to [2-9b] above, which dissolves within hours.
[2-15] The adhesion preventing method according to any one of [2-1] to [2-14] above, wherein the sponge-like laminate is pressed.

[3-1] A method for producing an adhesion-preventing material containing a sponge-like laminate applicable to a living body, comprising the following steps.
(1) a step of curing a monovalent metal salt of alginic acid having a weight average molecular weight of 10,000 to 2,000,000 with a curing agent;
(2) freezing the hardened monovalent metal salt of alginic acid;
(3) On the monovalent metal salt of alginic acid obtained in (2), a monovalent metal salt of alginic acid having a weight average molecular weight of 1,000 to 1,000,000 is cured with a curing agent to obtain a laminate. process,
(4) freeze-drying the obtained laminate to obtain a sponge-like laminate;
Here, the molecular weight is measured by the GPC-MALS method,
The sponge-like laminate comprises a sponge-like first layer containing a monovalent metal salt of alginic acid having a weight average molecular weight of 10,000 to 2,000,000, and a sponge-like first layer having a weight average molecular weight of 1,000 to 1,000,000. and a sponge-like second layer containing a monovalent metal salt of alginic acid, wherein the weight average molecular weight of the monovalent metal salt of alginic acid in the first layer is higher than that in the second layer, and the first layer and the second layer comprises at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof;
The at least one pharmaceutical ingredient is contained in the monovalent metal salt of alginic acid before curing in step (1) and/or step (3), or the sponge-like laminate after freeze-drying in step (4). is included for the first layer and/or the second layer of
[3-1a] The method for producing an adhesion-preventing material according to [3-1] above, wherein the monovalent metal salt of alginic acid is a low-endotoxin monovalent metal salt of alginic acid.
[3-1b] A method for producing an adhesion-preventing material containing a sponge-like laminate applicable to a living body, comprising the following steps.
(1) a step of curing a monovalent metal salt of low endotoxin alginic acid having a weight average molecular weight of 10,000 to 2,000,000 with a curing agent;
(2) freezing the hardened monovalent metal salt of alginic acid;
(3) On the monovalent metal salt of alginic acid obtained in (2), a monovalent metal salt of low endotoxin alginic acid having a weight average molecular weight of 1,000 to 1,000,000 is cured with a curing agent to form a laminate. a step of obtaining
(4) freeze-drying the obtained laminate to obtain a sponge-like laminate;
Here, the molecular weight is measured by the GPC-MALS method,
The sponge-like laminate comprises a sponge-like first layer containing a monovalent metal salt of low endotoxin alginic acid having a weight average molecular weight of 10,000 to 2,000,000; a sponge-like second layer comprising a monovalent metal salt of alginic acid with low endotoxin of 000, wherein the weight average molecular weight of the monovalent metal salt of alginic acid in the first layer is higher than that in the second layer; at least one layer selected from the layer and the second layer comprises at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof;
The at least one pharmaceutical ingredient is contained in the monovalent metal salt of alginic acid before curing in step (1) and/or step (3), or the sponge-like laminate after freeze-drying in step (4). is included for the first layer and/or the second layer of
[3-2] Any one of [3-1] to [3-1b] above, wherein the sponge-like laminate is sterilized by electron beam and/or gamma irradiation with an absorption dose of 10 kGy to 150 kGy. 3. The method for producing the anti-adhesion material according to 1.
[3-3] The method for producing an adhesion-preventing material according to any one of [3-1] to [3-2] above, further comprising a step of pressing the laminate obtained in (4).

[4-1] A bio-applicable sponge-like laminate obtained by the following steps (1) to (4).
(1) a step of curing a monovalent metal salt of alginic acid having a weight average molecular weight of 10,000 to 2,000,000 with a curing agent;
(2) freezing the hardened monovalent metal salt of alginic acid;
(3) On the monovalent metal salt of alginic acid obtained in (2), a monovalent metal salt of alginic acid having a weight average molecular weight of 1,000 to 1,000,000 is cured with a curing agent to obtain a laminate. process,
(4) freeze-drying the obtained laminate to obtain a sponge-like laminate;
Here, the molecular weight is measured by the GPC-MALS method,
The sponge-like laminate comprises a sponge-like first layer containing a monovalent metal salt of alginic acid having a weight average molecular weight of 10,000 to 2,000,000, and a sponge-like first layer having a weight average molecular weight of 1,000 to 1,000,000. and a sponge-like second layer containing a monovalent metal salt of alginic acid, wherein the weight average molecular weight of the monovalent metal salt of alginic acid in the first layer is higher than that in the second layer, and the first layer and the second layer comprises at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof;
The at least one pharmaceutical ingredient is contained in the monovalent metal salt of alginic acid before curing in step (1) and/or step (3), or the sponge-like laminate after freeze-drying in step (4). is included for the first layer and/or the second layer of
[4-1a] The sponge-like laminate according to [4-1] above, wherein the monovalent metal salt of alginic acid is a low-endotoxin monovalent metal salt of alginic acid.
[4-1b] A sponge-like laminate applicable to a living body obtained by the following steps (1) to (4).
(1) a step of curing a monovalent metal salt of low endotoxin alginic acid having a weight average molecular weight of 10,000 to 2,000,000 with a curing agent;
(2) freezing the hardened monovalent metal salt of alginic acid;
(3) On the monovalent metal salt of alginic acid obtained in (2), a monovalent metal salt of low endotoxin alginic acid having a weight average molecular weight of 1,000 to 1,000,000 is cured with a curing agent to form a laminate. a step of obtaining
(4) freeze-drying the obtained laminate to obtain a sponge-like laminate;
Here, the molecular weight is measured by the GPC-MALS method,
The sponge-like laminate comprises a sponge-like first layer containing a monovalent metal salt of low endotoxin alginic acid having a weight average molecular weight of 10,000 to 2,000,000; a sponge-like second layer comprising a monovalent metal salt of alginic acid with low endotoxin of 000, wherein the weight average molecular weight of the monovalent metal salt of alginic acid in the first layer is higher than that in the second layer; at least one layer selected from the layer and the second layer comprises at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof;
The at least one pharmaceutical ingredient is contained in the monovalent metal salt of alginic acid before curing in step (1) and/or step (3), or the sponge-like laminate after freeze-drying in step (4). is included for the first layer and/or the second layer of
[4-2] The sponge-like laminate according to any one of [4-1] to [4-1b] above, which is used as an anti-adhesion material.
[4-3] Any one of [4-1] to [4-2] above, wherein the sponge-like laminate is sterilized by electron beam and/or gamma irradiation with an absorption dose of 10 kGy to 150 kGy. The sponge-like laminate according to 1.
[4-4] The sponge-like laminate according to any one of [4-1] to [4-3] above, further comprising a step of pressing the laminate obtained in (4).

[5-1] A first raw material containing a monovalent metal salt of alginic acid having a weight average molecular weight of 10,000 to 2,000,000 and a monovalent metal alginic acid having a weight average molecular weight of 1,000 to 1,000,000 and a second raw material containing a salt, wherein the weight average molecular weight of the first raw material is higher than that of the second raw material, and at least one layer selected from the first layer and the second layer contains a drug, a growth A combination of raw materials for manufacturing an anti-adhesion material, comprising at least one pharmaceutical ingredient selected from the group consisting of factors, hormones, proteins and combinations thereof.
[5-1a] The combination of raw materials according to [5-1] above, wherein the monovalent metal salt of alginic acid is a low-endotoxin monovalent metal salt of alginic acid.
[5-1b] A first raw material containing a monovalent metal salt of low endotoxin alginic acid having a weight average molecular weight of 10,000 to 2,000,000 and a low endotoxin alginic acid having a weight average molecular weight of 1,000 to 1,000,000 and a second raw material containing a monovalent metal salt of, wherein the weight average molecular weight of the first raw material is higher than that of the second raw material, and at least one layer selected from the first layer and the second layer is , drugs, growth factors, hormones, proteins and combinations thereof.
[5-2] The combination of raw materials according to any one of [5-1] to [5-1b] above, which is used for producing a sponge-like laminate.

[6-1] comprising a sponge-like first layer and a second layer of a monovalent metal salt of alginic acid, at least a portion of which is crosslinked with a curing agent; The weight average molecular weight is 10,000 to 2,000,000, the weight average molecular weight of the monovalent metal salt of alginic acid in the second layer is 1,000 to 1,000,000, and the weight average molecular weight is zero. Measured by the GPC-MALS method after the cross-linking treatment, the weight average molecular weight of the monovalent metal salt of alginic acid in the first layer is higher than the weight average molecular weight of the monovalent metal salt of alginic acid in the second layer, at least one layer selected from the first layer and the second layer contains at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof, and is sterilized , a pharmaceutical composition having an anti-adhesion effect, comprising a sponge-like laminate that is applicable to a living organism.
[6-1a] The pharmaceutical composition of [6-1] above, wherein the monovalent metal salt of alginic acid is a low-endotoxin monovalent metal salt of alginic acid.
[6-1b] comprising sponge-like first and second layers of a monovalent metal salt of low endotoxin alginic acid at least partially crosslinked with a curing agent, wherein the monovalent metal alginate of the first layer The weight average molecular weight of the salt is 10,000 to 2,000,000, the weight average molecular weight of the monovalent metal salt of alginic acid in the second layer is 1,000 to 1,000,000, and the weight average molecular weight is is measured by the GPC-MALS method after decrosslinking treatment, and the weight average molecular weight of the monovalent metal salt of alginic acid in the first layer is higher than the weight average molecular weight of the monovalent metal salt of alginic acid in the second layer. at least one layer selected from the first layer and the second layer comprises at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof; A pharmaceutical composition having an anti-adhesion effect, comprising a bio-applicable sponge-like laminate.
[6-2] The pharmaceutical composition according to any one of [6-1] to [6-1b] above, wherein one of the first layer and the second layer contains a curing agent.
[6-3] The pharmaceutical composition according to any one of [6-1] to [6-1b] above, wherein both the first layer and the second layer contain a curing agent.
[6-4] The total amount of the monovalent metal salt of alginic acid (for example, the monovalent metal salt of low-endotoxin alginic acid) used in the first layer and the second layer is 0.1 mg/cm ² to 3 mg/cm2. The pharmaceutical composition according to any one of [6-1] to [6-3] above, which is in the range of cm ² .
[6-5] Any one of [6-1] to [6-4] above, wherein the monovalent metal salt of alginic acid in the first layer and the second layer has an endotoxin content of 500 EU/g or less. The pharmaceutical composition according to the paragraph.
[6-6] Any one of [6-1] to [6-5] above, wherein the monovalent metal salt of alginic acid in the first layer and the second layer is sodium alginate or potassium alginate. pharmaceutical composition of
[6-7] The medicament according to any one of [6-1] to [6-6] above, wherein the curing agents for the first layer and the second layer are divalent or higher metal ion compounds. Composition.
[6-7a] wherein the curing agent for the first layer and the second layer is at least one metal ion compound selected from the group consisting of CaCl ₂ , CaSO ₄ , ZnCl ₂ , SrCl ₂ , FeCl ₃ and BaCl ₂ ; The pharmaceutical composition according to any one of [6-1] to [6-6] above.
[6-8] The pharmaceutical composition according to any one of [6-1] to [6-7a] above, for applying the first layer to the wound side surface.
[6-9] The pharmaceutical composition according to any one of [6-1] to [6-8] above, wherein the sponge-like laminate is pressed.

According to the present invention, it has a high anti-adhesion effect, can suppress both wound adhesion and de novo adhesion, does not adversely affect the living body to which it is applied, does not interfere with wound healing, and can also be used for intestinal anastomosis. It is possible to provide an anti-adhesion material that has at least one of the properties of being usable, being easy to apply via a trocar in endoscopic surgery, being able to be reapplied after adjusting the adhering position, and the like.

FIG. 10 is a diagram showing an example of an anti-adhesion material; FIG. 4 is a diagram showing the evaluation of the dissolution rate of each layer of the anti-adhesion material. FIG. 4 shows evaluation of adhesion formation in a partial liver resection model. (A) Number of individuals forming adhesions at the dissection surface, (B) Dissection surface grade, (C) Dissection surface Extent (mm). **p<0.01, *p<0.05. FIG. 4 shows evaluation of adhesion formation in a partial liver resection model. (A) Number of individuals forming adhesions on the non-dissecting plane, (B) non-dissecting section grade, (C) non-dissecting section Extent (mm). **p<0.01, *p<0.05. FIG. 10 shows the evaluation of body weight change and spleen weight in a partial liver resection model. (A) body weight change, (B) spleen weight. FIG. 4 shows evaluation of adhesion formation in the Pean liver resection model. (A) Number of individuals forming adhesions at the dissection surface, (B) Dissection surface grade, (C) Dissection surface Extent (mm). **p<0.01, *p<0.05. FIG. 4 shows evaluation of adhesion formation in the Pean liver resection model. (A) Number of individuals forming adhesions on the non-dissecting plane, (B) non-dissecting section grade, (C) non-dissecting section Extent (mm). **p<0.01, *p<0.05. FIG. 10 shows the evaluation of body weight change and spleen weight in the Pean hepatectomy model. (A) body weight change, (B) spleen weight. FIG. 4 is a diagram showing swelling test results of sponges before and after pressing. It is a figure which shows the time-dependent change of the height (A) of each test piece front-end|tip after spraying, and the angle (B) from a test stand. FIG. 10 shows the evaluation of adhesion formation in a dissected plane in a rat 70% hepatectomy model. (A) Number of individuals forming adhesions on the dissection plane, (B) Extent (mm) on the dissection plane. **p<0.01, *p<0.05. FIG. 10 shows evaluation of adhesion formation on non-dissected planes in a rat 70% hepatectomy model. (A) Number of individuals forming adhesions on the non-dissecting plane, (B) Extent (mm) on the non-dissecting plane. **p<0.01, *p<0.05. FIG. 3 is a diagram showing the elution behavior of a medicinal ingredient from an anti-adhesion material. (A) Dexamethasone (Dex), (B) Dexamethasone sodium phosphate (DSP).

Although the present invention will be described in detail below, the following embodiments are examples for explaining the present invention, and the present invention can be implemented in various forms without departing from the gist thereof.

1. Anti-adhesion "Adhesion" refers to a state in which surfaces of tissues that should be separated from each other are joined or fused together by fibrous tissue. Causes of adhesions include trauma caused on the tissue surface during surgery, inflammation caused by the trauma, and inflammation caused by drying of the tissue surface during surgery. Exudate containing fibrin is produced on the surface of tissues due to these traumas and inflammations, and this exudate is organized to connect or fuse the tissue surfaces to form adhesions.

"Anti-adhesion" refers to reducing the formation of adhesions. The prevention of adhesions does not necessarily require complete prevention of adhesion formation, as long as the formation of adhesions is prevented as compared to the state in which the anti-adhesion material is not applied. That is, "adhesion prevention" may be rephrased as reduction of adhesions, and for example, at least one selected from the frequency, range and degree of adhesions may be reduced. "Anti-adhesion" means that, for example, when the adhesion grade evaluation described in the Examples is performed, the average adhesion grade is lower than the average adhesion grade when the anti-adhesion material is not applied. It is good if there is Alternatively, "adhesion prevention" is, for example, when the adhesion extent evaluation described in the Examples is performed, the average adhesion extent is higher than the average adhesion extent when the adhesion preventing material is not applied. It should be low. "Adhesion prevention" is preferably the prevention of adhesions resulting from surgery, more preferably prevention of peritoneal adhesions resulting from surgery. That is, "adhesion prevention" is preferably postoperative adhesion prevention.
In addition, as shown in the Examples, target adhesions include adhesions at the excised site of the target organ during surgery and de novo adhesions (adhesions with a wide range of sites around the site other than the surgical site, the abdominal cavity, and the body). There is

2. Anti-Adhesion Materials The present invention includes sponge-like first and second layers of a monovalent metal salt of alginic acid (e.g., a monovalent metal salt of low endotoxin alginic acid) at least partially crosslinked with a curing agent. , a sponge-like first layer comprising a monovalent metal salt of alginic acid having a relatively high weight-average molecular weight (e.g., a monovalent metal salt of low-endotoxin alginic acid); and a monovalent metal salt of alginic acid having a relatively low weight-average molecular weight. (e.g., a low endotoxin monovalent metal salt of alginic acid), including a biocompatible sponge-like laminate including a sponge-like second layer, at least one selected from the first layer and the second layer One layer contains an anti-adhesion material (hereinafter sometimes referred to as "anti-adhesion material A") containing at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof. offer. The weight average molecular weight of the monovalent metal salt of alginic acid (e.g., monovalent metal salt of low-endotoxin alginic acid) used in the first layer and the second layer is, for example, 10,000 to 2,000,000, respectively. 1,000 to 1,000,000. Such a weight average molecular weight is measured by GPC-MALS method after decrosslinking treatment, for example, dissolving in a chelating agent solution.
In this specification, when the symbol "-" is used in a numerical range, it means "more than the lower limit value and less than the upper limit value", and the numerical values at both ends of the symbol are included in the range.

The adhesion-preventing material A contains monovalent metal salts of alginic acid with different molecular weights (for example, monovalent metal salts of low endotoxin alginic acid) in the first layer and the second layer of the sponge-like laminate. Specifically, the weight average molecular weight of the monovalent metal salt of alginic acid in the first layer is higher than that in the second layer. The dissolution rate of the layer containing the monovalent metal salt of alginic acid is slow when the weight average molecular weight of the monovalent metal salt of alginic acid is large, whereas the dissolution rate is fast when the weight average molecular weight is small. Therefore, by applying the anti-adhesion material A with the first layer facing the wound and the second layer facing the abdominal cavity, the first layer remains on the wound and the second layer It can be expected to dissolve relatively quickly and suppress adhesions throughout the abdominal cavity.

In addition, the present invention provides a living body comprising a first layer and a second layer each comprising a monovalent metal salt of alginic acid (for example, a monovalent metal salt of low-endotoxin alginic acid) at least partially crosslinked with a curing agent. Applicable sponge-like laminates, wherein the first layer and the second layer have different dissolution rates, and at least one layer selected from the first layer and the second layer contains a drug, a growth factor, a hormone , proteins and combinations thereof (“Anti-adhesion material B”). Specifically, the dissolution rate of the first layer is slower than that of the second layer. In order to make the dissolution rate of the first layer slower than the dissolution rate of the second layer, for example, the weight average molecular weight of the monovalent metal salt of alginic acid in the first layer as in the anti-adhesion material A is The degree of cross-linking of the monovalent metal salt of alginic acid in the first layer is changed to that of the second layer by making it higher than that in the second layer, changing the type of cross-linking agent, or changing the concentration of the cross-linking agent. and the like.

Preferably, the adhesion-preventing material B has a dissolution test in which the elution of the monovalent metal salt of alginic acid is used as an indicator. The ratio of the monovalent metal salt of alginic acid eluted from the layer is less than 50% at 1 hour and less than 70% at 2 hours from the start of measurement.
As another preferred example, in a dissolution test using the dissolution of a monovalent metal salt of alginic acid as an index, the adhesion-preventing material B was found to contain 25±10% by weight of the monovalent metal salt of alginic acid within 1 hour. 80 ± 10% by weight is eluted within 4 hours, and in the second layer, 70 ± 10% by weight of the monovalent metal salt of alginic acid is eluted within 1 hour, and 90 ± 10% by weight % eluted within 4 hours. Specifically, the dissolution test is as described in Examples below.

In another preferred embodiment, the anti-adhesion material B is 10 to 70% of the medicinal ingredient contained in the first layer in a dissolution test with the elution of the medicinal ingredient in a phosphate buffer at pH 7.5 and 37°C as an index. % by weight dissolves within 1 hour, 20 to 100% by weight dissolves within 4 hours, more preferably 40±20% by weight of the pharmaceutical ingredient contained in the first layer in the same test is eluted within 1 hour, and 80±20% by weight is eluted within 4 hours.
In another preferred embodiment, the anti-adhesion material B is 40 to 100% of the medicinal ingredient contained in the second layer in a dissolution test using elution of the medicinal ingredient in a phosphate buffer at pH 7.5 and 37°C as an index. % by weight dissolves within 1 hour, 60 to 100% by weight dissolves within 4 hours, more preferably 80±20% by weight of the pharmaceutical ingredient contained in the second layer in the same test is eluted within 1 hour, and 90±10% by weight is eluted within 4 hours.
In another preferred embodiment, the anti-adhesion material B is 10 to 70% of the medicinal ingredient contained in the first layer in a dissolution test with the elution of the medicinal ingredient in a phosphate buffer at pH 7.5 and 37°C as an index. % by weight dissolves within 1 hour, 20 to 100% by weight dissolves within 4 hours, and 40 to 100% by weight of the pharmaceutical ingredient contained in the second layer dissolves within 1 hour, 60 to 100% by weight dissolves within 4 hours. 20% by weight dissolves within 4 hours, 80±20% by weight of the pharmaceutical ingredient contained in the second layer dissolves within 1 hour, and 90±10% by weight dissolves within 4 hours. It is a thing.

Here, in this specification, "anti-adhesion material A" and "anti-adhesion material B" may be collectively referred to as "anti-adhesion material". Further, the "first layer" is the layer that becomes the lower layer when the sponge-like laminate is applied to the object, that is, the layer that comes into contact with the surface of the tissue to which the sponge-like laminate is applied. The "second layer" is the layer that becomes the upper layer when the sponge-like laminate is applied to the object, that is, the layer that does not come into contact with the surface of the tissue to which the object is to be applied. "Bioapplicable" means capable of being placed on the surface of tissue to be applied as a medical material.
The bio-applicable sponge-like laminate used for the anti-adhesion material may have a third layer containing an optional component in addition to the above-described first and second layers. , may have a multilayer structure. It also includes a sponge-like laminate having a structure in which each layer does not have a distinct boundary surface and the molecular weight continuously increases or decreases.

An example of an anti-adhesion material is shown in FIG. The anti-adhesion material 1 comprises a sponge-like laminate 4 comprising a first layer 2 and a second layer 3 . The first layer 2 and the second layer 3 are each spongy. "Sponge-like" means a state having porosity. At least one layer selected from the first layer 2 and the second layer 3 contains at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof. .

The shape of the sponge-like laminate that can be applied to the living body is not particularly limited, and can be appropriately selected in consideration of the range, shape, unevenness, etc. of the surface to be applied. The shape of the sponge-like laminate may be, for example, a flat plate shape as shown in FIG. 1, or may have a disk shape, a cylindrical shape, a rectangular parallelepiped shape, or the like. It is preferably flat plate-like or disk-like. When it is in the form of a flat plate or disc, the size of the flat plate or disc is not particularly limited because the anti-adhesion material can be further cut according to the range, shape, unevenness, etc. of the surface to be applied and applied to the surface. For example, when the shape of a flat plate is represented by length x width x height (thickness), the lengths of the length and width are not particularly limited, and the height (thickness) is preferably 0.2 mm to 30 mm. Yes, more preferably 0.3 mm to 15 mm, still more preferably 0.5 mm to 10 mm. More preferably, in addition to such height (thickness), the vertical and horizontal lengths are respectively 1 mm to 300 mm x 1 mm to 300 mm, particularly preferably 3 mm to 200 mm x 3 mm to 200 mm, More preferably, it is 5 mm to 150 mm x 5 mm to 150 mm. It should be noted that the thickness may not be uniform, and a sloped structure in which one side is thick and the other side is thin may be used.

The sponge-like laminate of the adhesion-preventing material of the preferred embodiment has high flexibility and is less likely to crack than Seprafilm (trade name).

In some embodiments, the sponge laminate is pressed. "Press" is as described below. When the sponge-like laminate is pressed, its height (thickness) is preferably 0.02 mm to 3 mm, more preferably 0.03 mm to 1.5 mm, and still more preferably 0.05 mm to 1 mm. More preferably, in addition to such height (thickness), the vertical and horizontal lengths are respectively 1 mm to 300 mm x 1 mm to 300 mm, particularly preferably 3 mm to 200 mm x 3 mm to 200 mm, More preferably, it is 5 mm to 150 mm x 5 mm to 150 mm. Note that in some embodiments the thickness after pressing is uniform.

In some aspects, at least one pharmaceutical ingredient is included in the first layer but not in the second layer. In some other aspects, at least one pharmaceutical ingredient is included in the second layer but not in the first layer. In some further aspects, at least one pharmaceutical ingredient is independently included in both the first layer and the second layer.
The at least one pharmaceutical ingredient is, for example, three or more, two or one pharmaceutical ingredient.

Among medicinal ingredients, drugs include drugs having an antibiotic action, drugs having an anti-inflammatory action, drugs having an anti-adhesion action, drugs having a wound healing promoting action, and drugs having a hemostatic action. Such drugs include, but are not limited to:
Penicillin antibiotics such as penicillin, ampicillin and amoxicillin; cephem antibiotics such as cefazolin, cefotiam, ceftazidime and cefpirom; carbapenem antibiotics such as meropenem; monobactam antibiotics such as tazobactam; penem antibiotics such as faropenem; Aminoglycoside antibiotics such as streptomycin, tobramycin, amikacin, gentamicin, and neomycin; lincomycin antibiotics such as lincomycin; fosfomycin antibiotics such as fosfomycin; tetracycline antibiotics such as tetracycline and minocycline; chloramphenicol antibiotics, macrolide antibiotics such as erythromycin, clarithromycin, azithromycin and josamycin, ketolide antibiotics such as telithromycin, polypeptide antibiotics such as polymyxin, glycopeptide antibiotics such as vancomycin Antibiotics, streptogramin antibiotics such as quinupristin and dalfopristin, quinolone antibiotics such as nalidixic acid, enoxacin, levofloxacin, gatifloxacin, oxazolidinone antibiotics such as linezolid, and antibacterial and antifungal actions such as amphotericin B having antibiotics,
Non-steroidal anti-inflammatory drugs (NSAIDs, e.g. aspirin, loxoprofen, diclofenac sodium, indomethacin, piroxicam, mefenamic acid, sulpyrine, acetaminophen, ibuprofen, meloxicam, chlorpheniramine maleate, etc.), steroidal anti-inflammatory drugs (e.g. , dexamethasone, dexamethasone sodium phosphate, hydrocortisone, hydrocortisone succinate, prednisolone, methylprednisolone, methylprednisolone succinate, triamcinolone, triamcinolone acetonide and betamethasone, etc.),
These include anti-adhesion drugs (same as anti-inflammatory drugs above), drugs that promote wound healing, and drugs that have hemostatic action such as tranexamic acid and carbazochrome. Preferably, the drug is a non-steroidal anti-inflammatory drug or a steroidal anti-inflammatory drug, more preferably a steroidal anti-inflammatory drug (eg, dexamethasone, dexamethasone sodium phosphate, triamcinolone acetonide, etc.). These drugs may be commercially available or may be produced by known methods.

Among pharmaceutical ingredients, growth factors are used to promote wound healing. Such growth factors include, for example, bone morphogenetic protein (BMP), fibroblast growth factor (FGF), vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), transforming growth factor (TGF). , insulin-like growth factor (IGF), platelet-derived growth factor (PDGF), CDMP (cartilage-derived-morphogenic protein), colony-stimulating factor (CSF), erythropoietin (EPO), thrombopoietin (TPO), interleukin (IL), platelet-rich plasma (PRP (Platelet Rich Plasma)), SOX, IF, epidermal growth factor (EGF), nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF) and NT3, preferably FGF, VEGF, NGF, IGF, PDGF and HGF, more preferably FGF and VEGF. These growth factors may be produced by recombinant methods, purified from protein compositions, or obtained commercially.

Among medicinal ingredients, hormones are used for alleviating inflammation, preventing adhesions, promoting wound healing, and the like. Such hormones are, for example, anabolic hormones such as stanozolol, growth hormone and leptin, etc., preferably growth hormone and leptin. These hormones may be commercially available or may be produced by known methods.

Among pharmaceutical ingredients, proteins include physiologically active peptides, which are used for alleviating inflammation, preventing adhesion, promoting wound healing, hemostasis, alleviating pain, and the like. Such proteins are, for example, thrombin, plasmin, ulinastatin, anti-TNF antibody, anti-NGF antibody, TSG-6 and hemocoagulase, preferably thrombin and ulinastatin. These proteins may be commercially available or may be produced by known methods.

Among pharmaceutical ingredients, combinations of drugs, growth factors, hormones and proteins include, for example, the following combinations. Non-steroidal anti-inflammatory drug and growth factor combination, non-steroidal anti-inflammatory drug and protein combination, steroidal anti-inflammatory drug and growth factor combination, steroidal anti-inflammatory drug and protein combination are listed. Specifically, for example, a combination of diclofenac sodium and FGF, a combination of diclofenac sodium and thrombin, a combination of diclofenac sodium and ulinastatin, a combination of dexamethasone sodium phosphate and FGF, and a combination of dexamethasone sodium phosphate and Examples include, but are not limited to, a combination of thrombin, a combination of dexamethasone sodium phosphate and ulinastatin, and the like.

Preferred pharmaceutical ingredients to be contained in the first layer are as follows. Pharmaceutical ingredients and antibiotics having wound healing promoting action and hemostatic action, specifically any hemostatic agent, any hormone, thrombin, plasmin, urinastatin and the like, more specifically tranexamic acid, FGF, growth hormones, thrombin and ulinastatin;
Another preferred pharmaceutical ingredient to be contained in the first layer is a fat-soluble pharmaceutical ingredient.
Another preferred pharmaceutical ingredient to be contained in the first layer is a pharmaceutical ingredient to be contained for sustained release.

Preferred pharmaceutical ingredients to be contained in the second layer are as follows. Pharmaceutical ingredients and antibiotics having inflammation-relieving action and anti-adhesion action, specifically non-steroidal anti-inflammatory drugs, steroidal anti-inflammatory drugs, anti-TNF antibodies, anti-NGF antibodies, TSG-6, etc., and more Specific examples include diclofenac sodium and dexamethasone sodium phosphate.
Another preferable pharmaceutical ingredient to be contained in the second layer is a water-soluble pharmaceutical ingredient.
In addition, another preferred pharmaceutical ingredient to be contained in the second layer includes a pharmaceutical ingredient to be contained for prompt release after surgery.

In embodiments in which the pharmaceutical ingredient is included in both the first layer and the second layer, the pharmaceutical ingredient of the first layer and the pharmaceutical ingredient of the second layer are each independently selected. That is, the same pharmaceutical ingredient may be contained in the first layer and the second layer, or different pharmaceutical ingredients may be contained in the first layer and the second layer.

When the same pharmaceutical ingredient is contained in the first layer and the second layer, at least one (for example, three or more, two or one) pharmaceutical ingredient contained in the first layer and the second At least one (eg, 3 or more, 2 or 1) pharmaceutical ingredient contained in the layer of the layer is perfectly matched. In some embodiments, the first layer contains one pharmaceutical ingredient and the second layer also contains the same one pharmaceutical ingredient.

A preferred pharmaceutical ingredient when the same pharmaceutical ingredient is contained in the first layer and the second layer is, for example, an antibiotic.

When the first layer and the second layer contain different pharmaceutical ingredients, at least one (for example, three or more, two or one) pharmaceutical ingredients contained in the first layer and the second layer at least one (eg, 3 or more, 2 or 1) of the pharmaceutical ingredients are not exactly matched. That is, the inclusion of different pharmaceutical ingredients in the first layer and the second layer includes no overlap between at least one pharmaceutical ingredient in the first layer and at least one pharmaceutical ingredient in the second layer; and that at least one pharmaceutical ingredient in the first layer and at least one pharmaceutical ingredient in the second layer overlap, but only partially. In some aspects, the first layer includes one pharmaceutical ingredient and the second layer includes another pharmaceutical ingredient.
A preferred combination of pharmaceutical ingredients when the first layer and the second layer contain different pharmaceutical ingredients is the following combination.
(1) First layer: one or more optional pharmaceutical ingredients having wound healing promoting action and hemostatic action, Second layer: one or more optional pharmaceutical ingredients having inflammation reducing action and anti-adhesion action combination.
(2) 1st layer: one or more optional pharmaceutical ingredients having wound healing promoting action and hemostatic action, and 2nd layer: one selected from non-steroidal anti-inflammatory drug and steroidal anti-inflammatory drug A combination of the above.
(3) First layer: a combination of one or more selected from FGF, thrombin and ulinastatin, and a second layer: one or more selected from diclofenac sodium and dexamethasone sodium phosphate.

Some aspects of the anti-adhesion material can be used as a pharmaceutical composition by containing the above-described pharmaceutical ingredients. A preferred embodiment of the adhesion-preventing material contains a medicinal ingredient and is applied to enhance the effect of the medicinal ingredient; At least one of the following effects may be obtained: reduction of adverse events, sustained release of the pharmaceutical ingredient, local retention of the pharmaceutical ingredient, and adjustment of the release rate of the pharmaceutical ingredient. be.

The content of the medicinal ingredient to be contained in the anti-adhesion materials of some embodiments is not particularly limited as long as the medicinal ingredient exhibits its effect and does not cause adverse events. Depending on the situation, for example, 0.0001% to 200% by weight, preferably 0.001% to 100% by weight, of the total weight of the anti-adhesion material (sponge-like laminate) containing no medicinal ingredient can be mentioned.

Since the sponge-like laminate is porous and has a water-absorbing capacity, it is easier to incorporate a medicinal ingredient by preparation just before use than, for example, non-porous Seprafilm (trade name). For example, by impregnating a sponge with a solution containing a medicinal ingredient and administering it, adhesion prevention and local sustained release of the medicinal ingredient can be simultaneously achieved in the abdominal cavity, thoracic cavity, heart cavity, and the like. Furthermore, by containing the pharmaceutical ingredient in layers with different dissolution rates, it is possible to achieve sustained release of the pharmaceutical ingredient at a fast sustained release rate and a slow sustained release rate.
By containing a medicinal component, the sponge-like laminates of some embodiments exhibit an excellent anti-adhesion effect compared to those containing no medicinal component.

The present invention also includes sponge-like first and second layers of a monovalent metal salt of alginic acid (e.g., a monovalent metal salt of low endotoxin alginic acid) at least partially crosslinked with a curing agent, A sponge-like first layer containing a monovalent metal salt of alginic acid with a relatively high weight average molecular weight (e.g., a monovalent metal salt of low endotoxin alginic acid) and a monovalent metal salt of alginic acid with a relatively low weight average molecular weight ( For example, a biocompatible sponge-like laminate including a sponge-like second layer comprising a low endotoxin monovalent metal salt of alginic acid), wherein at least one selected from the first layer and the second layer A pharmaceutical composition is provided wherein the layer comprises at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof. The weight average molecular weight of the monovalent metal salt of alginic acid (e.g., monovalent metal salt of low-endotoxin alginic acid) used in the first layer and the second layer is, for example, 10,000 to 2,000,000, respectively. 1,000 to 1,000,000. Such a weight average molecular weight is measured by GPC-MALS method after decrosslinking treatment, for example, dissolving in a chelating agent solution.
The explanations regarding the sponge-like laminate, the medicinal ingredients, etc. are the same as above.

3. Monovalent metal salt of alginic acid "Monovalent metal salt of alginic acid" is a water-soluble salt made by ion-exchanging the hydrogen atom of the 6-position carboxylic acid of alginic acid with a monovalent metal ion such as Na ⁺ or K ⁺ . is salt. Specific examples of the monovalent metal salt of alginic acid include sodium alginate and potassium alginate, and sodium alginate, which is commercially available, is particularly preferred. Solutions of monovalent metal salts of alginic acid form gels when mixed with curing agents.

"Alginic acid" used here is a biodegradable high-molecular-weight polysaccharide, and is a polymer in which two types of uronic acids, D-mannuronic acid (M) and L-guluronic acid (G), are linearly polymerized. be. More specifically, a homopolymer fraction of D-mannuronic acid (MM fraction), a homopolymer fraction of L-guluronic acid (GG fraction), and randomly arranged D-mannuronic acid and L-guluronic acid The fraction (MG fraction) is an optionally conjugated block copolymer. The composition ratio (M/G ratio) of D-mannuronic acid and L-guluronic acid in alginic acid varies depending on the type of organisms from which it is derived, mainly seaweed, etc., and is affected by the habitat and season of the organisms. It ranges widely from high G type with M/G ratio of about 0.4 to high M type with M/G ratio of about 5.

The monovalent metal salt of alginic acid is a high-molecular-weight polysaccharide, and it is difficult to determine the molecular weight accurately. It is known that the molecular-weight measurement of high-molecular-weight substances derived from natural products may differ depending on the measurement method. ing.

According to the GPC-MALS method, the absolute weight average molecular weight can be measured. The weight-average molecular weight of the monovalent metal salt of alginic acid used as a raw material measured by the GPC-MALS method in the first layer of the sponge-like laminate is, for example, 10,000 to 2,000,000, preferably , 15,000 to 1,500,000, more preferably 20,000 to 1,000,000, and particularly preferably 25,000 to 500,000. In addition to being such a first layer, the second layer has a weight average molecular weight measured by the GPC-MALS method of, for example, 1,000 to 1,000,000, preferably 1 ,000 to 500,000, more preferably 2,000 to 250,000, and particularly preferably 3,000 to 100,000.

In some embodiments, for example, after irradiation by electron beam and/or gamma sterilization, the weight average molecular weight measured by the GPC-MALS method for the first layer of the sponge-like laminate is, for example, from 10,000 to 10,000. 300,000, preferably 10,000 to 200,000, more preferably 10,000 to 100,000, and particularly preferably 10,000 to 80,000. In addition to being such a first layer, the weight average molecular weight of the second layer measured by GPC-MALS is, for example, 1,000 to 100,000, preferably 1,000. 80,000, more preferably 2,000 to 60,000, and particularly preferably 3,000 to 60,000.
For the monovalent metal salt of alginic acid, at least a portion of which is crosslinked with a curing agent, the weight-average molecular weight of the monovalent metal salt of alginic acid that is not crosslinked is measured by the GPC-MALS method after an optional decrosslinking treatment. can be measured. The decrosslinking treatment includes, for example, dissolving in a solution of any chelating agent such as EDTA (ethylenediaminetetraacetic acid), phytic acid, or the like. EDTA is preferred as the chelating agent to be used.

The weight-average molecular weight of the monovalent metal salt of alginic acid in the first layer of the sponge-like laminate is higher than that in the second layer. The weight average molecular weight of the raw material of the sponge-like laminate or the monovalent metal salt of alginic acid in the first layer contained in the sponge-like laminate is higher than that of the second layer, for example, by 1,000 to 1,000,000. , preferably 2,000 to 500,000 higher, more preferably 3,000 to 300,000 higher.

Normally, when the molecular weight of a high-molecular-weight polysaccharide is calculated by the method described above, a measurement error of 10 to 20% by weight can occur. For example, 8,000 to 12,000 for 10,000, 80,000 to 120,000 for 100,000, 160,000 to 240,000 for 200,000, 160,000 to 240,000 for 400,000 If it is 320,000 to 480,000 and 500,000, the value may fluctuate in the range of 400,000 to 600,000.
The molecular weight of alginic acids can be measured according to a conventional method. Typical conditions for using GPC-MALS for molecular weight determination are as described in Example 1 herein. As detectors, for example, RI detectors and light scattering detectors (MALS) can be used.

Alginic acids generally have a high molecular weight when they are first extracted from brown algae, but their molecular weights gradually decrease during processes such as drying with heat and purification. Alginic acids with different molecular weights can be produced by controlling conditions such as temperature in the production process, selecting brown algae as raw materials, and molecular weight fractionation in the production process. Furthermore, it is also possible to obtain alginic acids having the desired molecular weight by mixing with another lot of alginic acids having different molecular weights.

The monovalent metal salt of alginic acid used here is, for example, one treated with low endotoxin. In some aspects, the monovalent metal salt of alginic acid may not have been confirmed to have been subjected to low endotoxin treatment, or may not have been subjected to low endotoxin treatment.
Low endotoxin treatment can be performed by a known method or a method based thereon. For example, the method of Suga et al. for purifying sodium hyaluronate (see, for example, JP-A-9-324001), the method by Yoshida et al. for purifying β1,3-glucan (see, for example, JP-A-8-269102) etc.), the method of William et al. for purifying biopolymer salts such as alginate and gellan gum (see, for example, JP-A-2002-530440), the method for purifying polysaccharides by James et al. 93/13136), Lewis et al. (see e.g. U.S. Pat. No. 5,589,591), Herman Frank et al. -643, etc.) or a similar method. Low endotoxin treatment includes, but is not limited to, washing, filtration with filters (endotoxin removal filters, charged filters, etc.), ultrafiltration, columns (endotoxin adsorption affinity columns, gel filtration columns, columns with ion exchange resins, etc.). purification, adsorption to hydrophobic substances, resins or activated carbon, etc., organic solvent treatment (extraction with organic solvent, precipitation / sedimentation by adding organic solvent, etc.), surfactant treatment (for example, see JP 2005-036036, etc.) ) or a suitable combination thereof. A known method such as centrifugation may be appropriately combined with these treatment steps. It is desirable to appropriately select according to the type of alginic acid.

The endotoxin level can be confirmed by a known method, and can be measured, for example, by a method using Limulus reagent (LAL), a method using Endospecie (registered trademark) ES-24S set (Seikagaku Corporation), or the like. .

The endotoxin treatment method of the monovalent metal salt of alginic acid used here is not particularly limited. , preferably 500 endotoxin units (EU)/g or less, more preferably 100 EU/g or less, particularly preferably 50 EU/g or less, particularly preferably 30 EU/g or less. Low endotoxin-treated sodium alginate is commercially available, for example, Sea Matrix (registered trademark) (Mochida Pharmaceutical Co., Ltd.), PRONOVA ^™ UP LVG (FMC BioPolymer), and the like.

The amount of the monovalent metal salt of alginic acid used in the sponge-like laminate can be appropriately selected in consideration of the anti-adhesion effect. The total amount of the monovalent metal salt of alginic acid used in the first layer and the second layer of the sponge-like laminate is, for example, 0.1 mg/cm ² to 10.0 mg/cm ² , preferably , 0.1 mg/cm ² to 3.0 mg/cm ² , more preferably 0.5 mg/cm ² to 2.5 mg/cm ² , still more preferably 1.8 mg/cm ² to 2.0 mg/cm 2 . 2 mg/cm ² , particularly preferably 2.0 mg/cm ² . The total amount of the monovalent metal salt of alginic acid used in the first layer and the second layer of the sponge-like laminate is 1.0 mg/cm ² to 3.0 mg/cm ² , thereby achieving higher adhesion. A preventive effect can be expected. If the amount used is 10.0 mg/cm ² or less, adverse events such as accumulation in the body and hypertrophy of specific organs are less likely, and if the amount used is 0.1 mg/cm ² or more, sufficient anti-adhesion effect is obtained. can be expected.

The ratio (weight ratio) of the amount of the monovalent metal salt of alginic acid used in the first layer and the second layer is preferably 1:20 to 20:1, more preferably 1:5 to 5: 1, more preferably 1:3 to 3:1, and particularly preferably 1:2 to 2:1.

4. Curing agent (crosslinking agent)
In the anti-adhesion material, either the first layer or the second layer may contain a curing agent (i.e., neither the first layer nor the second layer may contain a curing agent). alternatively, both the first layer and the second layer may contain a curing agent.
Alternatively, neither the first layer nor the second layer of the anti-adhesion material may contain a curing agent.

Here, in some aspects, the first layer and the second layer are at least partially crosslinked with a curing agent.

The curing agent cures by cross-linking a solution of a monovalent metal salt of alginic acid. Curing agents include, for example, divalent or higher metal ion compounds such as Ca ²⁺ , Mg ²⁺ , Ba ²⁺ , Sr ²⁺ , Zn ²⁺ , Fe ³⁺ , cross-linking reagents having 2 to 4 amino groups in the molecule, and the like. mentioned. More specifically, the divalent or higher metal ion compounds include CaCl ₂ , MgCl ₂ , CaSO ₄ , ZnCl ₂ , FeCl ₃ , BaCl ₂ , SrCl ₂ and the like (preferably CaCl ₂ , CaSO ₄ , ZnCl ₂ , SrCl ₂ , FeCl ₃ , BaCl _2, etc.) as a cross-linking reagent having 2 to 4 amino groups in the molecule, and a lysyl group (—COCH(NH ₂ )—(CH ₂ ) _{4 )} on the nitrogen atom. —NH ₂ ), that is, diaminoalkanes and derivatives in which the amino group is substituted with a lysyl group to form a lysylamino group, specifically diaminoethane, diaminopropane, N- (lysyl)-diaminoethane and the like can be mentioned.

The amount of the curing agent used in the first layer and the second layer is desirably adjusted according to the amount of the monovalent metal salt of alginic acid used, the molecular weight, and the like. When a curing agent is used, the amount of curing agent used in the first layer is, for example, 0.1 μmol/cm ² to 100 μmol/cm ² , preferably 0.5 μmol/cm ² to 2.0 μmol/cm 2 . ² . When a curing agent is used, the amount of curing agent used in the second layer is, for example, 0.1 μmol/cm ² to 10 μmol/cm ² , preferably 0.6 μmol/cm ² to 2.4 μmol/cm 2 . ² .

5. Method for Producing Adhesion-Preventing Material An adhesion-preventing material including a bio-applicable sponge-like laminate and a bio-applicable sponge-like laminate can be produced, for example, through the following steps.

(1) A step of curing a monovalent metal salt of alginic acid having a weight average molecular weight of 10,000 to 2,000,000 (for example, a monovalent metal salt of low endotoxin alginic acid) with a curing agent;
(2) freezing the hardened monovalent metal salt of alginic acid;
(3) On the monovalent metal salt of alginic acid obtained in (2), a monovalent metal salt of alginic acid having a weight average molecular weight of 1,000 to 1,000,000 (for example, a monovalent metal salt of low endotoxin alginic acid) ) with a curing agent to obtain a laminate,
(4) A step of freeze-drying the obtained laminate to obtain a sponge-like laminate.

wherein at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof is added to the monovalent metal of alginate before curing in step (1) and/or step (3). It is included in the salt or in the first layer and/or the second layer of the sponge-like laminate after freeze-drying in step (4). Any method may be used, but from the viewpoint of uniformly containing the medicinal component in the entire sponge, the method of containing the monovalent metal salt of alginic acid before curing in step (1) and/or step (3). is more desirable.

In the above step (1), first, a monovalent metal salt of alginic acid having a weight average molecular weight of 10,000 to 2,000,000 (for example, a monovalent metal salt of low endotoxin alginic acid) (hereinafter referred to as "first alginate") ) solution and a hardener solution. The first alginate solution and the curing agent solution can be prepared by a known method or a method analogous thereto. The solvent is not particularly limited as long as it is applicable to living organisms, but is preferably an aqueous solvent. Phosphate-buffered saline, DMSO, etc., and more preferably pure water. They are preferably sterilized and preferably treated with low endotoxin.

The first alginate can then be cured by mixing the solution of the first alginate and the solution of the curing agent.

When the pharmaceutical ingredient is included in the monovalent metal salt of alginic acid before curing in step (1), at least one pharmaceutical ingredient is included in the first alginate solution, and then the curing agent is added. Further mixing of the solution causes the first alginate to harden. The cured first alginate thereby contains at least one pharmaceutical ingredient. In addition, the pharmaceutical ingredient to be contained may be subjected in advance to microencapsulation, liposome formation, or the like.

In step (2) above, the first alginate hardened in step (1) is frozen by a conventional method. Freezing once before step (3) can reduce the mixing ratio of the first layer and the second layer. The freezing temperature and time are, for example, −20° C. for 4 hours.

In the above step (3), first, a monovalent metal salt of alginic acid having a weight average molecular weight of 1,000 to 1,000,000 (for example, a monovalent metal salt of low endotoxin alginic acid) (hereinafter referred to as "second alginate") ) solution and a hardener solution. The second alginate solution and curing agent solution can be prepared by a known method or a method analogous thereto. The solvent is the same as described in step (1) above.

When the pharmaceutical ingredient is included in the monovalent metal salt of alginic acid before curing in step (3), at least one pharmaceutical ingredient is included in the second alginate solution, and then the curing agent is added. Further mixing of the solution causes the second alginate to harden. The hardened second alginate thereby contains at least one pharmaceutical ingredient. In addition, the pharmaceutical ingredient to be contained may be subjected in advance to microencapsulation, liposome formation, or the like.

The second alginate can then be cured by mixing the solution of the second alginate and the solution of the curing agent.

The further hardened second alginate may be frozen prior to step (4). The freezing temperature and time are, for example, −20° C. for 4 hours.

In the step (4), the laminate obtained in the step (3) is freeze-dried to obtain a sponge-like laminate. Freeze-drying can be performed by a known method. The freeze-drying conditions can be appropriately adjusted, and a primary drying step, a secondary drying step, and the like may be provided.

When the pharmaceutical ingredient is contained in the first layer and/or the second layer of the sponge-like laminate after freeze-drying in step (4), for example, a solution containing the pharmaceutical ingredient is added to the first layer and/or the second layer. / Or dropping the second layer to remove the solvent in the solution, spraying the solution containing the pharmaceutical ingredient onto the first layer and / or the second layer, applying the first By soaking the layer and/or the second layer, sprinkling a powder containing a pharmaceutical ingredient on the first layer and/or the second layer of the sponge-like laminate swollen with physiological saline or the like, etc. conduct. These allow the medicinal ingredient to be contained in the first layer and/or the second layer of the sponge-like laminate.

These steps yield a sponge-like first layer comprising a first alginate and a curing agent, a sponge-like second layer comprising a second alginate and a curing agent, and the alginate of the first layer. The weight average molecular weight of the monovalent metal salt of is higher than that of the second layer, and at least one layer selected from the first layer and the second layer contains drugs, growth factors, hormones, proteins and combinations thereof A biocompatible sponge-like laminate comprising at least one pharmaceutical ingredient selected from the group consisting of, and an anti-adhesion material comprising the sponge-like laminate can be obtained.

In the above method, first, a sponge-like first layer containing a first alginate and a curing agent is prepared, and a sponge-like second layer containing a second alginate and a curing agent is formed thereon. However, the second layer may be produced first, and the first layer may be produced thereon. In this case, the sponge-like laminate can be produced, for example, through the following steps.
(1′) curing the second alginate with a curing agent;
(2') freezing the hardened second alginate;
(3') on the second alginate obtained in (2'), a step of curing the first alginate with a curing agent to obtain a laminate;
(4′) A step of freeze-drying the obtained laminate to obtain a sponge-like laminate.

wherein at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof is added to the second alginate before curing of step (1′) and/or step (3) ') before curing, or included in the first and/or second layer of the sponge-like laminate after freeze-drying in step (4') .
The specific description of each step is the same as in the method described above. The method for incorporating the medicinal component into the sponge-like laminate is also the same as the method described above.

Alternatively, the first alginate is cured and freeze-dried to form a sponge-like first layer, and the second alginate is cured and freeze-dried separately to form a sponge-like second layer. It is also possible to obtain a sponge-like laminate by laminating the resulting sponge-like layers.
wherein at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof is added to the pre-hardening first alginate and/or the pre-hardening second alginate. or the first layer and/or the second layer of the spongy laminate after lamination.
The specific description of each step is the same as in the method described above. The method for incorporating the medicinal component into the sponge-like laminate is also the same as the method described above.

When curing the first alginate and the second alginate, by using containers, molds, substrates, porous membranes, non-woven fabrics, woven fabrics, etc. of the desired size, height and shape, the desired size , height and shape of the sponge-like laminate can be obtained.

It is preferable that the sponge-like layered body of the adhesion-preventing material is further sterilized. Sterilization includes, but is not limited to, γ-ray sterilization, electron beam sterilization, ethylene oxide gas sterilization, ethanol sterilization, and the like. More preferably, the anti-adhesion material is sterilized by electron beam and/or gamma irradiation. By irradiating a polymer material with γ-rays, electron beams, etc., it is preferable to obtain a highly biocompatible medical material with controlled in vivo retention (see, for example, JP-A-2000-237294). .
Irradiation conditions for electron beam and/or gamma ray sterilization include, for example, an absorbed dose of 10 kGy to 150 kGy, more preferably 20 kGy to 100 kGy, and still more preferably 40 kGy to 80 kGy. Another preferred aspect of irradiation conditions for electron beam and/or gamma ray sterilization includes, for example, an absorbed dose of 20 kGy to 80 kGy, 20 kGy to 60 kGy, and 40 kGy to 60 kGy. Electron beam sterilization is preferred over gamma sterilization.

In some aspects, the step of pressing the laminate obtained in step (4) above or the like is further included. Pressing is performed manually or by sandwiching and pressurizing the laminate with a press machine. In addition, generally used processes such as compression and thinning are also included in the press here. The pressing pressure is, for example, 1 kPa to 100 MPa, more preferably 10 kPa to 80 MPa, still more preferably 100 kPa to 60 MPa. Manual pressing is carried out using a tool that can be pressed by hand so as to uniformly apply pressure to the laminate, such as an acrylic ruler, an acrylic plate, a glass plate, a metal plate, or the like. Further, the press used is, for example, a hot press (AH-1T manufactured by AS ONE Corporation).

6. Method of Use The anti-adhesion material or pharmaceutical composition (hereinafter referred to as "anti-adhesion material") is used by applying it to a subject in need of anti-adhesion. Preferably, the anti-adhesion material is absorbed and decomposed after staying in the applied area for about one week, which is usually necessary for exhibiting the anti-adhesion effect, and is finally metabolized and excreted in about one to two months. , safe.

The anti-adhesion material may be applied to the surface of a wound, such as tissue surfaces associated with surgery.

"Surgery-related tissue" is tissue that has been surface-traumatized during surgery or tissue that has become or is likely to become inflamed due to surface desiccation during surgery. Tissues relevant for surgery are preferably peritoneal-enclosed organs such as the stomach, jejunum, ileum, appendix, colon, liver, spleen, duodenum, and pancreas. A preferred embodiment of the anti-adhesion material can effectively prevent serious adhesions such as adhesions that occur after hepatectomy.

Also, "applying" refers to placing the anti-adhesion material on the surface of a wound (eg, the surface of tissue associated with a surgical procedure). Specifically, the surface of the first layer of the sponge-like laminate is in contact with the surface of the wound site (eg, the surface of the tissue), and the surface of the second layer is the surface of the wound site (eg, the surface of the tissue). The anti-adhesion material should be placed on the wound side surface (eg, tissue surface associated with the surgical procedure) so that it faces away from the wound side (eg, the abdominal surface). Due to the relatively high weight average molecular weight of the first layer of sponge-like laminate, it remains undegraded on the surface of the tissue for sufficient time to prevent adhesions, acting as a physical barrier to the wound surface. On the other hand, since the second layer of the sponge-like laminate has a relatively low weight-average molecular weight, it quickly melts and spreads, and plays a role in preventing adhesion on the non-wounded surface.

Preferably, the sponge-like laminate of the adhesion barrier is more flexible and less likely to crack than Seprafilm (trade name). Therefore, in a preferred embodiment, the anti-adhesion material is not defined on the surface of the tissue to which it is applied, and can be used, for example, by wrapping it around the intestinal tract during intestinal anastomosis. Also, in another preferred embodiment, surgical instruments can be easily inserted through a passage through which a surgical instrument can be inserted into and removed from an object during surgical operations using an endoscope. In yet another preferred embodiment, the anti-adhesion material can be reapplied.
Further, preferably, the sponge laminate of the adhesion-preventing material has a wider range of adhesion-preventing targets than INTERCEED (trade name).

Preferably, the anti-adhesion material is prepared in an appropriate size according to the range, shape, unevenness, etc. of the surface to be applied, and is applied to the surface of the tissue involved in the surgical operation to prevent adhesion. A "subject" is a human or non-human organism, such as avian and non-human mammals (e.g., cows, monkeys, cats, mice, rats, guinea pigs, hamsters, pigs, dogs, rabbits, sheep, and horses). be.

A sponge layered body of an adhesion-preventing material, especially when the sponge layered body is a pressed one, can be compactly assembled. Easy to apply. The anti-adhesion material applied to the affected area preferably absorbs moisture present in the affected area or moisture applied to the affected area to recover its thickness.

Preferably, the anti-adhesion material is safe to use on the subject, similar to Seprafilm (trade name) and INTERCEED (trade name).

After application to the surface of the tissue associated with the surgical procedure, suturing the adhesion preventive material to the tissue surface associated with the surgical procedure is not usually necessary, but if necessary, the adhesion preventive material and the tissue associated with the surgical procedure may be sutured. The surface may be sutured.

Also provided is a method of adhesion prevention, comprising applying the sponge-like laminate to a subject in need of adhesion prevention. A specific method is as described above.

Also provided is the use of the sponge-like laminate for manufacturing an anti-adhesion material. Specific uses are as described above.

Further provided is a sponge-like laminate for adhesion prevention. A specific sponge-like laminate is as described above.
Also, a kit containing a sponge-like laminate and a medicinal ingredient for preparing an adhesion-preventing material or a pharmaceutical composition containing a medicinal ingredient at the time of use, and an adhesion-preventing material or a medicinal composition containing a medicinal ingredient at the time of use. To do so, a method is provided for using the sponge-like laminate in combination with a pharmaceutical ingredient. Specific sponge-like laminates and medicinal ingredients are as described above.

7. Concomitant Medications Antibiotics, non-steroidal anti-inflammatory drugs (such as Concomitant drugs such as NSAIDs) and steroidal anti-inflammatory drugs may be administered separately from the anti-adhesion material.

It should be noted that all publications, such as prior art documents and publications, patent publications and other patent documents, cited herein are hereby incorporated by reference in their entirety. In addition, this specification refers to the disclosure of the claims, specification, and drawings of the Japanese application (Japanese Patent Application No. 2017-218433, filed on November 13, 2017), which is the basis for claiming priority of this application. shall be incorporated.

The present invention will be described in more detail with reference to the following examples, but the present invention should not be understood as being limited to these examples.

Example 1: Preparation of Alginate Laminated Sponge An alginate laminated sponge was prepared as follows.

[reagent]
Reagents used for preparation of the alginic acid laminated sponge are as follows.
Low endotoxin sodium alginate was obtained from Mochida Pharmaceutical Co., Ltd.
- AL10: (Lot No. 5K12202), endotoxin amount 4 EU/g.
- AL500: (Lot No. BL150713-500), endotoxin amount 19 EU/g.
Calcium chloride was obtained from Wako Pure Chemical Industries, Ltd. (product code: 036-00485).

[Used equipment]
35mm untreated dish (IWAKI product code 1000-035)
Micropipette (Gilson Pipetman (trade name))
Pure water production device (Merck Millipore Elix Essential UV5 (trade name))
Freezer (SHARP SJ-56S (trade name))
Freeze dryer (TAITEC VD-550R (trade name))

[Preparation procedure]
(1) Preparation of solution AL500 was dissolved in pure water at a concentration of 1.0 wt% to prepare an AL500 solution. Similarly, AL10 was dissolved in pure water at a concentration of 1.0 wt % to prepare an AL10 solution. Furthermore, calcium chloride was dissolved in pure water to prepare 10 mM and 15 mM calcium chloride aqueous solutions, respectively.

(2) Preparation of AL500 Layer (Lower Layer) 1.0 mL of AL500 solution and 1.0 mL of 10 mM calcium chloride aqueous solution were added to a 35 mm untreated dish using a micropipette and mixed uniformly by pipetting. This was allowed to stand overnight to gel. The dish was transferred to a freezer and frozen at -20°C for 4 hours.

(3) Lamination of AL10 layer (upper layer) The dish was removed from the freezer, and 1.0 mL of AL10 solution and 1.0 mL of 15 mM calcium chloride aqueous solution were added onto the frozen AL500 layer with a micropipette, and pipetted until uniform. mixed into The dish was transferred to the freezer again and frozen at -20°C for 4 hours.

(4) Production of Sponge The dish after freezing was set in a freeze dryer and freeze-dried for two nights to obtain the desired alginic acid-layered sponge.

A contemplated alginate laminated sponge comprises a lower sponge layer (ie, first layer) comprising AL500 and calcium chloride and an upper sponge layer (ie, second layer) comprising AL10 and calcium chloride. The alginate-laminated sponge had a substantially circular shape with a diameter of 35 mm and a thickness of 1.83±0.13 cm (n=4). The total amount of sodium alginate used in the upper and lower layers was approximately 2.0 mg/cm ² . The ratio (weight ratio) of the amount of sodium alginate used in the upper layer and the lower layer was 1:1. Furthermore, the amount of calcium chloride used was approximately 1.0 μmol/cm ² in the upper layer and approximately 1.5 μmol/cm ² in the lower layer.

(5) Measurement of Weight Average Molecular Weight Alginic acid used as a raw material for production was measured for weight average molecular weight by the following GPC-MALS method.

[Pretreatment method]
After adding the eluent to the sample and dissolving it, the sample was filtered through a 0.45 μm membrane filter to obtain a measurement solution.

[Measurement conditions (refractive index increment (dn/dc) measurement)]
Differential refractometer: Optilab T-rEX
Measurement wavelength: 658 nm
Measurement temperature: 40°C
Solvent: 200 mM sodium nitrate aqueous solution Sample concentration: 0.5 to 2.5 mg/mL (5 concentrations)

[Measurement conditions (absolute molecular weight distribution measurement)]
Column: TSKgel GMPW-XL × 2 + G2500PW-XL (7.8 mm ID × 300 mm × 3)
Eluent: 200 mM sodium nitrate aqueous solution Flow rate: 1.0 mL/min.
Concentration: 0.05%
Detector: RI detector, light scattering detector (MALS)
Column temperature: 40°C
Injection volume: 200 μL

[result]
AL10: 55,000
AL500: 280,000

Further, after electron beam sterilization of the AL10-containing single-layer sponge and the AL500-containing single-layer sponge produced according to the above steps (1), (2) and (4), EDTA (ethylenediaminetetraacetic acid) Each was dissolved in a solution and the molecular weight was measured by the GPC-MALS method. The results are shown below.

[result]
(When the irradiation dose for electron beam sterilization is 20 kGy)
AL10: 36,000
AL500: 75,000
(When the irradiation dose for electron beam sterilization is 40 kGy)
AL10: 27,000
AL500: 45,000

In Examples 3, 3-2, and 4, which will be described later, electron beam sterilization (20 kGy) of the obtained laminated sponge was used as the laminated sponge.
In Examples 6 and 7 described later, a non-sterilized sponge was used as the laminated sponge.

Example 1-2: Preparation of Alginate Laminated Sponge (1) Preparation of Sponge Using alginic acid described in [Reagent] below, using AL100 or AL500 as a raw material for the lower layer, and using AL10 or AL20 as a raw material for the upper layer. According to the method described in Example 1, each alginate laminated sponge was produced by a combination of AL10 (upper layer)-AL100 (lower layer), AL20 (upper layer)-AL100 (lower layer), and AL20 (upper layer)-AL500 (lower layer). .

[reagent]
· AL10: Same as Example 1 · AL20: (Lot No. BL150713-20), endotoxin amount 13 EU/g.
- AL100: (Lot No. 5G17201), endotoxin amount 6 EU/g.
・ AL500: Same as in Example 1

(2) Measurement of Weight-Average Molecular Weight In addition, the weight-average molecular weight of AL20 and AL100 among the alginic acids used for sponge production was measured by the GPC-MALS method using the method described in Example 1.
[result]
AL20: 82,000
AL100: 170,000

Further, the single-layer sponge containing AL20 produced according to the method described in Example 1 and the single-layer sponge containing AL100 were subjected to electron beam sterilization using the method described in Example 1. It was measured. The results are shown below.

[result]
(When the irradiation dose for electron beam sterilization is 20 kGy)
AL20: 46,000
AL100: 63,000
(When the irradiation dose for electron beam sterilization is 40 kGy)
AL20: 33,000
AL100: 40,000

Example 2 Measurement of Dissolution Rate of Each Layer of Alginic Acid Laminated Sponge Laminated sponges each having a fluorescence-modified upper layer or lower layer were prepared, and the dissolution rate was measured. A specific method is shown below. FTSC (Fluorescein-5-Thiosemicarbazide) was used as a fluorescent labeling reagent, and alginic acid was labeled by a conventional method.
A laminated sponge was produced according to the method described in Example 1 using fluorescently labeled alginic acid.

[material]
Low endotoxin sodium alginate is as described in Example 1. Phosphate buffers include sodium dihydrogen phosphate (Wako Pure Chemical Industries, Ltd., 197-09705 (trade name)), potassium dihydrogen phosphate (Wako Pure Chemical Industries, Ltd., 166-04255 (trade name)), sodium chloride (trade name) Ko Junyaku Co., Ltd., 191-01665 (trade name)) and potassium chloride (Wako Junyaku Co., Ltd., 166-17945 (trade name)) were used for adjustment. Sodium ethylenediaminetetraacetate (N001) was purchased from Dojindo.

[Used equipment]
8 mm diameter biopsy trepan (Kai medical BP-80F (trade name))
96-well black microplate (Nunc 137101 (trade name))
Fluorescent plate reader (Perkin Elmer ARVO X3 (trade name))

[procedure]
First, the fluorescence-modified laminated sponge was punched out with a biopsy trepan (BP-60F (trade name) manufactured by Kai medical) with a diameter of 8 mm. This was immersed in 10 mL of 150 mM phosphate buffer (pH 7.5), and 200 μL of the immersion liquid was collected at regular intervals. The recovered solution was transferred to a 96-well plate, and the fluorescence intensity was measured using a fluorescence plate reader to quantify the amount of dissolved alginic acid.

[result]
FIG. 2 shows the measurement results of the dissolution behavior of each layer of the laminated sponge. As shown in FIG. 2, in the lower layer, 25±10% by weight of the monovalent metal salt of alginic acid was eluted within 1 hour, and 80±10% by weight was eluted within 4 hours. On the other hand, in the upper layer, 70±10% by weight of the monovalent metal salt of alginic acid was eluted within 1 hour, and 90±10% by weight was eluted within 4 hours. In addition, when the elution amount of the monovalent metal salt of alginic acid in the upper layer is 100%, the ratio of the elution amount of the monovalent metal salt of alginic acid in the lower layer is 36% (less than 50%) at one hour after the start of measurement. ), 55% (less than 70%) at 2 hours.
Thus, it was confirmed that the dissolution rate of the upper layer was higher than that of the lower layer. By applying the alginate sponge with the lower layer facing the wound and the upper layer facing the abdominal cavity, the lower layer can remain on the wound to prevent adhesion of the wound, and the upper layer dissolves relatively quickly. It is thought that many de novo adhesions that are formed even at locations far from the wound site, such as adhesions throughout the abdominal cavity, can be suppressed.

Each laminated sponge (AL10 (upper layer) - AL100 (lower layer); AL20 (upper layer) - AL100 (lower layer); AL20 (upper layer) - AL500 (lower layer)) prepared in Example 1-2 is dissolved in the same manner. As a result of speed measurement, the same dissolution behavior as the laminated sponge (AL10 (upper layer)-AL500 (lower layer)) produced in Example 1 was exhibited.

Example 3: Rat Partial Hepatectomy Model A rat partial hepatectomy model was used to evaluate the formation of adhesions. The rat partial hepatectomy model is a model in which the formation of adhesions that cause severe inflammation and have high strength can be observed with high reproducibility (Shimizu A et al., (2014) Surg Today. (44): 314- 323). Specifically, adhesion formation was evaluated as follows.

[material]
Low endotoxin sodium alginate is as described in Example 1.
Seprafilm (trade name) is a sheet material of a blend of carboxymethylcellulose (CMC) and hyaluronic acid, obtained from Genzyme GmbH.
Interceed™ is a regenerated oxidized cellulose sheet and was obtained from Johnson & Johnson.

[Experimental group]
Control group (n=8): 3 cm of the margin of the left lateral lobe was measured, cut, and coagulated to stop bleeding (untreated control group).
500-10 layered sponge group (n=8): The alginate sponge prepared in Example 1 was applied as an anti-adhesion material.
Seprafilm group (n=8): 2 x 3 cm Seprafilm was applied as adhesion barrier.
Interceed group (n=8): 2×3 cm Interceeds were applied as anti-adhesion material.

[procedure]
Rats were anesthetized by intraperitoneal administration of pentobarbital equivalent to 35 mg/kg and their body weights were measured with an electronic balance. Rats were then laparotomyed through a midline incision. The abdominal wall was then picked up with forceps and lifted to cut the abdominal wall. As a preparatory preparation for hepatectomy, the left lateral lobe was pulled out from the deep part of the abdominal cavity and gauze was spread under it. Next, we moved on to the actual liver resection. Specifically, a ruler was applied to the liver to find a position where the dissection plane was 3 cm, and both ends were cauterized with a bipolar and marked. A straight cut was made between the two marked points. In the control group, the abdomen was closed immediately after this to terminate the treatment. In the group to which the adhesion preventing material was applied, the adhesion preventing material was applied after removing the gauze. Next, the abdominal wall and the skin were sutured in two parts to close the abdomen. A biodegradable thread was used when suturing the abdominal wall, and a non-absorbable thread was used when suturing the skin. One week after laparotomy, rats were euthanized by an overdose of approximately 2 mL of pentobarbital as over-anesthesia and body weights were measured on an electronic balance. After that, the abdomen was opened again, and the adhesion was evaluated as follows. Spleen weight was measured with an electronic balance after removing the spleen from the abdominal cavity.

[Evaluation of adhesion]
Adhesion was evaluated as follows.

(1) Dissected section The following (a) and (b) evaluations were performed on the dissected section of the liver described in the above [Procedure].
(a) Adhesion grade Adhesion was evaluated visually. Adhesion scores were assigned to liver-separated cross-sections based on the following scoring method.
Adhesion score:
Grade 0: No adhesion is observed.
Grade 1: Adhesion to the extent that it peels off due to its own weight (physiological adhesion)
Grade 2: Adhesion that can be peeled off with tweezers (blunt adhesion)
Grade 3: Adhesions that cannot be removed without using scissors or a scalpel (sharp adhesions)

(b) adhesion extent
The width of the 3-cm liver-resecting section was measured with a ruler, and expressed in length (unit: mm) (therefore, the maximum extent of the dissecting section was 30 mm).

(2) Non-dissected section The following (a) and (b) evaluations were performed on the surface of the liver, omentum, peritoneum, small intestine, just below the median wound, and the like, other than the dissected section of the liver.
(a) Adhesion grade Adhesion was evaluated visually. Adhesion scores were given to the sites other than the section of liver separation based on the following scoring method. The site was not specified and the maximum observed adhesion score was recorded as the adhesion score for that test animal.
Adhesion score:
Grade 0: No adhesion is observed.
Grade 1: Adhesion to the extent that it peels off due to its own weight (physiological adhesion)
Grade 2: Adhesion that can be peeled off with tweezers (blunt adhesion)
Grade 3: Adhesions that cannot be removed without using scissors or a scalpel (sharp adhesions)

(b) adhesion extent
For sites other than the cutaway section of the liver, the width of the adhered tissue was measured with a ruler and expressed in length (unit: mm). As in (2)(a) above, the site was not specified, and the maximum width at which the observed adhesions were formed was recorded as the adhesion extent of the test animal.

[result]
The results of adhesion evaluation are shown in FIG. 3 (dissecting section) and FIG. 4 (non-dissecting section). Also, the results of body weight measurement and spleen weight measurement are shown in FIG.
In the dissected plane, each group tended to suppress adhesions compared to the control group (FIGS. 3(A) to 3(C)).
A significant anti-adhesion effect was confirmed in the 500-10 laminated sponge group in the non-separated section (FIGS. 4(A) to 4(C)). Seprafilm (trade name) and Interceed (trade name), which were used as positive controls, showed no anti-adhesion effect and tended to exacerbate adhesions compared to the control group. On the other hand, a remarkable anti-adhesion effect was confirmed in the 500-10 laminated sponge group.
There was no significant difference in body weight and spleen weight among the Control group, Seprafilm group, Interceed group, and 500-10 layered sponge group, confirming that the application of 500-10 layered sponge does not adversely affect the living body. (FIGS. 5(A) and (B)).
Here, significant difference tests in Examples were performed by Student's t-test unless otherwise specified, and only Grade evaluation was performed by Mann-Whitney U test.

Example 3-2: Rat Partial Hepatectomy Model Using Pean Forceps The same materials, experimental groups, procedures, and adhesion evaluation method as in Example 3 were used, except that Pean forceps were used to transect the liver. were used to evaluate the adhesion grade and adhesion extent of the liver-dissecting and non-dissecting sections.

Specifically, transection of the liver using Pean forceps was performed as follows. That is, in the [procedure] of Example 3, "resecting linearly between the two marked points" was performed by crushing the liver parenchyma with Pean forceps and cauterizing the exposed blood vessels with a bipolar forceps. .

[result]
The results of adhesion evaluation are shown in FIG. 6 (dissecting section) and FIG. 7 (non-dissecting section). Also, the results of body weight measurement and spleen weight measurement are shown in FIG.
In the dissection plane, each group (n = 8) showed a tendency to suppress adhesion compared to the control group (n = 8). A statistically significant difference was observed (FIGS. 6(A) to (C)).
A significant anti-adhesion effect was confirmed in the 500-10 laminated sponge group in the non-separated section (FIGS. 7(A) to (C)). Seprafilm (trade name) used as a positive control showed no adhesion-preventing effect, and Interceed (trade name) tended to exacerbate adhesions compared to the control group. On the other hand, a remarkable anti-adhesion effect was confirmed in the 500-10 laminated sponge group.
There was no significant difference in body weight and spleen weight among the Control group, Seprafilm group, Interceed group, and 500-10 layered sponge group, confirming that the application of 500-10 layered sponge does not adversely affect the living body. (FIGS. 8(A) and (B)).

Example 4 Visualization of Each Layer of Alginate Laminated Sponge by Fluorescent Labeling A test of visualization by fluorescent labeling of each layer of the alginate laminated sponge was performed as follows.

[material]
Low endotoxin sodium alginate is as described in Example 1.

[Used equipment]
Handy UV lamp (UVP UVGL-58 (trade name))

[procedure]
The rat liver resection procedure is as described in Example 3. An alginate sponge having a fluorescence-labeled first layer or second layer was attached to the prepared dissected surface of the liver. For the application, a laminated sponge using 4.0 mg/cm ² of alginic acid, which is more than in Example 1, was prepared according to the method of Example 1 and used so as to facilitate observation of the remaining material. Thereafter, the abdomen was closed according to the procedure described in Example 3, and the abdomen was opened one week later. The exposed intraperitoneal cavity was irradiated with ultraviolet light by a lamp to visualize the intraperitoneal distribution of the fluorescently labeled alginic acid.

As a result, it was confirmed that the AL10 layer was widely distributed on the surface of the peritoneum as well as on the transected surface. This suggests that the second layer of the sponge-like laminate rapidly dissolves and spreads in the abdominal cavity because the monovalent metal salt of alginic acid has a relatively low weight-average molecular weight.
In addition, although the AL500 layer was partially seen in the abdominal wall and the like, the fluorescence from the dissected plane was observed more conspicuously. This suggests that the first layer of the sponge-like laminate has a relatively high weight-average molecular weight of the monovalent metal salt of alginic acid, so that it stays on the separated surface and acts as a physical barrier.

Example 5: Winding test In order to demonstrate the adherence followability of the alginate-laminated sponge to curved surfaces, a wrapping test was conducted as follows.

[material]
Low endotoxin sodium alginate is as described in Example 1. Agar (010-08725) was purchased from Wako Pure Chemical.

[procedure]
After the agar was dissolved in hot water, it was poured into a cylindrical mold and cooled to prepare an agarose gel cylinder with a diameter of 20 mm. This was used as a model tubular organ, and the sponge produced in Example 1 was wrapped around it to verify the followability of the wrapping.

As a result, it was confirmed that the flexibility of the alginate layered sponge allows it to be wrapped around a cylinder that simulates an intestinal tract. From this, it was suggested that the anti-adhesion material containing the spongy laminate can also be used for intestinal anastomosis.

Example 6: Pressing and Swelling Test of Sponge Pressing of the alginate-laminated sponge, measurement of the thickness after pressing and swelling test were carried out as follows.

[material]
The alginate laminated sponge (AL10 (upper layer)-AL500 (lower layer)) is as described in Example 1.

[reagent]
Agarose was obtained from Wako Pure Chemical Industries, Ltd. (product code: 010-08725).

[procedure]
(1) Pressing and Measurement of Thickness After Pressing (1-1) Manual Pressing The alginate-laminated sponge was placed on a flat surface and pressed with the palm of the hand via an acrylic ruler so that the entire sponge was uniformly pressed. The thickness of the sponge before and after pressing was measured with an electronic caliper, and the average value was calculated (n=4).

(1-2) Pressing with a press The alginic acid laminated sponge was set in a press (manufactured by AS ONE Corporation, product name AH-1T). The alginic acid laminated sponge was pressed at room temperature with a pressure of 10 MPa and held for 5 minutes. The thickness of the sponge after pressing was measured with an electronic caliper, and the average value was calculated (n=4).

(2) Swelling test Agarose was dissolved in hot water at 2% by weight and cooled to room temperature to prepare an agarose gel. The agarose gel was cut into 2 cm x 2 cm squares and immersed in pure water on a glass petri dish to moisten it.
The alginic acid-laminated sponge before and after pressing cut into 1 cm×1 cm squares was placed on the agarose gel. Photographs were taken from the lateral direction at regular intervals, and the thickness of the sponge was calculated from the photographed images. In the test, as the pressed alginate laminated sponge, one pressed by a pressing machine was used.

[result]
Table 1 shows the measurement results of the thickness after pressing.

The average sponge thickness was about 1.5 mm before pressing, about 0.33 mm after manual pressing, and about 0.16 mm after pressing with a press. In addition, the thickness of the pressed sponge was maintained without increasing with the lapse of time.

FIG. 9 shows changes in sponge thickness over time in the swelling test. From the results of the swelling test, it was confirmed that the pressed alginate laminated sponge absorbs water and has a thickness approximately equal to that of the unpressed alginate sponge.
From this, it was suggested that the sponge, which is an anti-adhesion material, can be applied relatively easily to the affected area through a trocar or the like in endoscopic surgery, because the sponge can be compacted by pressing.
Furthermore, it was also suggested that the pressed sponge applied to the affected area absorbs the moisture present in or applied to the affected area and regains its thickness. By recovering the thickness, the function as a laminated sponge can be exhibited.

Example 7: Atomization test Alginate laminated sponge and Seprafilm (trade name) were subjected to the following test to evaluate fragility when absorbing water.

[material]
The alginic acid laminated sponge is as described in Example 1, and the Seprafilm (trade name) is as described in Example 3. Also, as the pressed alginate laminated sponge, one pressed by the pressing machine described in Example 6 was used.

[procedure]
1 cm x 2 cm specimens were made from alginate laminated sponge and Seprafilm (trade name). A double-faced tape was applied to one end of the test piece (1 cm x 1 cm), and the test piece was held at the end of the test table. As a result, the test piece was fixed so that the other end of 1 cm×1 cm was in the air.
Each test piece was sprayed with pure water five times using a sprayer. A moving image was taken of the process in which the test piece was bent downward as it got wet.
By image analysis of the obtained moving image, both the height and angle of the tip of the test piece from the test stand were calculated, and the change over time was plotted.

[result]
The results are shown in FIG.
As for the height of the alginate-laminated sponge, the decrease in height was within 2 mm up to 50 seconds after spraying, and was about 3 mm even after 90 seconds (Fig. 10(A)). Also, the height of the pressed alginic acid-laminated sponge was about 9 mm even after 90 seconds from spraying. On the other hand, with Seprafilm (trade name), a significant drop in height was observed immediately after spraying (Fig. 10(A)). The results for the angle were similar to those for the height (FIG. 10(B)).
From this, it was suggested that the alginic acid-laminated sponge maintains its shape and strength for a while even if it is in a water-absorbing state, regardless of whether it is pressed or not. For this reason, when applied to the affected area as an adhesion-preventing material, it is possible to reapply it by adjusting the sticking position. When applied to a trocar, it has the advantage of avoiding situations such as not being able to spread well due to absorption of moisture in the trocar. It has been confirmed in Example 3, Example 5, etc. that the alginic acid laminated sponge has suitable pressure-bonding properties to the affected area or its model system.

Example 8 Preparation of Alginate Sponge Containing Pharmaceutical Ingredients Alginate sponge containing pharmaceutical ingredients was prepared as follows.
[reagent]
Reagents used for the preparation of the medicinal component-containing alginate sponge are as follows.
Low endotoxin sodium alginate was obtained from Mochida Pharmaceutical Co., Ltd.
- AL500: (Lot No. 5F05204), endotoxin amount 19 EU/g.
Calcium chloride, dexamethasone (Dex) and dexamethasone sodium phosphate (DSP) were obtained from Wako Pure Chemical Industries, Ltd.
- Calcium chloride: (product code: 036-00485).
Dex: (product code: 040-30811).
DSP: (product code: 041-18861").

[Used equipment]
10mL syringe Syringe joint Micropipette Petri dish

[Preparation procedure]
(1) Preparation of solutions i) Dex solution: Dex was dissolved in ethanol to prepare a 10 mg/mL Dex solution.
ii) DSP solution: DSP was purely dissolved to prepare a 25 mg/mL DSP solution.

(2) Preparation of pharmaceutical ingredient-containing alginate sponge A method of adding Dex-containing alginate sponge and DSP-containing alginate sponge to an alginate sponge prepared from AL500 by dropping Dex or DSP, and adding Dex or DSP to a gel made of AL500. After mixing, it was produced by two methods of containing by freezing and drying.

A) Method of preparing by dropping Dex or DSP onto alginate sponge A-1) Dex-containing alginate sponge Using 2 ml of 1% AL500 solution and 2 mL of 10 mM calcium chloride aqueous solution, [Preparation procedure] of Example 1 (2 ), AL500 single layer sponge was prepared according to the method of (4). The resulting alginate sponge had a substantially circular shape with the same diameter and thickness as the laminated sponge obtained in Example 1. 500 μL of the Dex solution was dropped onto the prepared alginate sponge and allowed to stand to volatilize the ethanol to obtain an alginate sponge containing 5 mg of Dex.

A-2) DSP-Containing Alginate Sponge An alginate sponge was prepared using AL500 in the same manner as in A-1). 200 μL of the DSP solution was added dropwise to the prepared alginate sponge, which was again frozen and dried at −20° C. for 4 hours to remove moisture, thereby obtaining an alginate sponge containing 5 mg of DSP.

B) Method of mixing Dex or DSP with alginate gel and then freeze-drying B-1) Dex-containing alginate sponge 1) 1 wt% alginate solution is prepared by the method of Example 1 [Preparation procedure] (1) bottom. 3 mL of the Dex solution prepared in (1) i) above was added to 6 mL of 1 wt % alginic acid solution and mixed well.
2) 600 μL of 100 mM calcium chloride solution was added to 2.4 mL of pure water and mixed well.
3) Alginate gel containing Dex was obtained by mixing the two solutions well in a 10 mL syringe.
4) The alginate gel obtained in 3) was dispensed into petri dishes (2 mL each), frozen at −20° C., and dried in a freeze dryer for 4 hours to obtain alginate sponges containing 5 mg of Dex. The resulting alginate sponge had a substantially circular shape with the same diameter and thickness as the laminated sponge obtained in Example 1.
Another Dex-containing alginate sponge was prepared in the same manner as described above, except that the two liquids were mixed on a petri dish using a pipette without using a syringe.

B-2) DSP-Containing Alginic Acid Sponge 1) A 1 wt % alginic acid solution was prepared by the method of Example 1 [Preparation procedure] (1). 1.2 mL of the DSP solution prepared in (1) ii) above was added to 6 mL of 1 wt % alginic acid solution and mixed well.
2) 600 μL of 100 mM calcium chloride solution was added to 4.2 mL of pure water and mixed well.
3) A DSP-containing alginate gel was obtained by mixing the two solutions well in a 10 mL syringe.
4) The alginic acid gel obtained in 3) was dispensed into petri dishes (2 mL each), frozen at -20°C, and dried in a freeze dryer for 4 hours to obtain alginate sponges containing 5 mg of DSP. The resulting alginate sponge had a substantially circular shape with the same diameter and thickness as the laminated sponge obtained in Example 1.
Another DSP-containing alginate sponge was prepared in the same manner as above, except that the two liquids were mixed on a petri dish using a pipette without using a syringe.

[result]
Alginate sponges prepared by dripping Dex or DSP showed no difference in appearance from alginate sponges containing no medicinal ingredient.
On the other hand, the alginate sponge prepared by mixing Dex or DSP with alginate gel gave different results depending on whether it was mixed on a petri dish using a pipette or thoroughly mixed in a syringe. The mixture on the petri dish started to gel immediately after the two liquids were injected on the petri dish, and mixing was difficult, resulting in insufficient mixing. As a result, a sponge with nonuniform crosslink density was obtained. On the other hand, when two syringes were used to thoroughly mix and gel, a uniform gel was obtained, resulting in a sponge with a uniform crosslink density.

Example 9: Rat 70% hepatectomy model In order to evaluate the anti-adhesion effect in vivo, a rat 70% hepatectomy model (Shimizu et al.Surgery Today (2014) 44, pp.314-323) was used. . From the results of using the rat partial hepatectomy model described in Examples 3 and 3-2, the adhesion-preventing effect of the alginate laminated sponge was confirmed. In this example, the anti-adhesion effect was evaluated using a 70% hepatectomy model, which is more invasive than the rat partial hepatectomy model of Examples 3 and 3-2 and causes more severe adhesions.

[material]
Low endotoxin sodium alginate was obtained from Mochida Pharmaceutical Co., Ltd.
- AL10: (Lot No. 5K12202), endotoxin amount 4 EU/g.
AL500: As described in Example 8.
Seprafilm (trade name) and Interceed (trade name) are as described in Example 3.

[Preparation of alginate sponge]
A single layer sponge and a pharmaceutical ingredient-containing alginate laminated sponge were prepared as follows.
AL500 single layer sponge was prepared by the method described in Example 8.
1) Preparation of a laminated sponge containing Dex in the first layer (lower layer) and no pharmaceutical ingredient in the second layer (upper layer):
The Dex-containing alginic acid gels obtained by the methods of Example 8, B-1), 1) to 3) were dispensed into 2 mL petri dishes and frozen at -20°C for 4 hours. A laminated sponge containing Dex in the first layer was obtained according to Example 1 [Preparation procedure] (3) and (4).
2) Preparation of a layered sponge containing no pharmaceutical ingredient in the first layer (lower layer) and Dex in the second layer (upper layer):
Example 1 [Preparation procedure] After creating an AL500 layer (lower layer) according to (1) and (2), a 1% solution of AL10 was prepared according to the methods of Example 8, B-1), 1) to 3). was layered on the AL500 layer and frozen at −20° C. for 4 hours. A laminated sponge containing Dex in the second layer was obtained according to Example 1 [Preparation procedure] (4).
3) Preparation of laminated sponge containing DSP in the first layer (lower layer) and no pharmaceutical ingredient in the second layer (upper layer):
The DSP-containing alginic acid gels obtained by the methods of Example 8, B-2), 1) to 3) were dispensed into 2 mL petri dishes and frozen at -20°C for 4 hours. A laminated sponge containing DSP in the first layer was obtained according to Example 1 [Preparation procedure] (3) and (4).
4) Preparation of laminated sponge containing no pharmaceutical ingredient in the first layer (lower layer) and DSP in the second layer (upper layer):
Example 1 [Preparation procedure] After creating an AL500 layer (lower layer) according to (1) and (2), a 1% solution of AL10 was prepared according to the methods of Example 8, B-2), 1) to 3). A DSP-containing alginate gel prepared using was layered on the AL500 layer and frozen at −20° C. for 4 hours. Then, according to Example 1 [Preparation procedure] (4), a laminated sponge containing DSP in the second layer was obtained.

[Experimental group]
Control group (n=8): After resecting the liver of rats, the intraperitoneal cavity was washed with physiological saline and the abdomen was closed (untreated control group).
Single-layer sponge group AL500 group (n=8): After performing the same treatment as in the control group, a 2 cm × 2 cm sponge made from 1 wt% alginic acid (AL500) solution and 10 mM calcium chloride solution was applied to the liver dissection. I was hungry.
Interceed group (n=8): After performing the same treatment as in the control group, a 2 cm x 2 cm Interceed was applied to the transected surface of the liver and the abdomen was closed.
Seprafilm group (n=8): After performing the same treatment as in the control group, Seprafilm of 2 cm x 2 cm was applied to the transected surface of the liver and the abdomen was closed.
Laminated sponge group Lower layer: Dex group (n=8): After performing the same treatment as in the control group, a 2 cm x 2 cm Dex-containing laminated sponge was applied to the liver's distal section and the abdomen was closed. Dex is contained in AL500 of the lower layer of the laminated sponge.
- Lower layer: DSP group (n = 8): After the same treatment as in the control group, a 2 cm x 2 cm DSP-containing laminated sponge was applied to the liver dissection and the abdomen was closed. DSP is contained in AL500 of the lower layer of the laminated sponge.
Upper layer: Dex group (n=8): After the same treatment as in the control group, a 2 cm x 2 cm Dex-containing laminated sponge was applied to the liver transectal plane and the abdomen was closed. Dex is contained in AL10 of the upper layer of the laminated sponge.
Upper layer: DSP group (n = 8): After the same treatment as in the control group, a 2 cm x 2 cm Dex-containing laminated sponge was applied to the liver transversal plane and the abdomen was closed. DSP is contained in AL10 of the upper layer of the laminated sponge.

[procedure]
Rats were anesthetized by intraperitoneal injection of somnopentyl. The abdominal wall of the rat was then cut through a midline incision. As a preparatory preparation for hepatectomy, a non-absorbable thread was lightly tied in a loop, and the rat liver was lifted and fixed so as to pass the looped thread. While gradually tying the thread, it was moved to the base of the liver, and moved to the base of the liver. The thread was tied tightly to tie the blood vessel at the base of the liver. The liver was then excised near the knot of the thread. Another liver was resected following the same procedure. 10 ml of physiological saline was injected into the peritoneal cavity from a syringe for washing. Moisture was removed with sterile gauze. In the control group, the abdomen was closed immediately after this to terminate the treatment. In the group to which the anti-adhesion material was applied, the adhesion-preventing material was then applied to the dissected surface, and the abdominal wall and skin were sutured to close the abdomen. As for the laminated sponge, the sponge was attached so that the lower layer (first layer, AL500) side was in contact with the wound surface. One week after abdominal closure, the rats were euthanized by administering approximately 2 mL of pentobarbital as an overdose of anesthesia. After that, the abdomen was opened and the adhesion was evaluated as follows.

[Evaluation of adhesion]
The presence or absence of adhesion, and the extent of adhesion on the dissected and non-dissected surfaces were evaluated in the same manner as in Example 3.

[result]
Figures 11(A) and (B) show the evaluation results of the presence or absence of adhesions and the length of adhesions in the liver transectal plane-diaphragm (wound surface (transtectural plane)). 12(A) and 12(B) show the evaluation results of the presence or absence of adhesion and adhesion length in the liver-stomach (non-dissection plane).

As shown in FIGS. 11(A) and (B), in the control group, adhesions of the dissected surfaces were observed. None of the anti-adhesion materials used in the single-layer sponge group, the Interceed group, and the Seprafilm group could prevent adhesion between the liver transectal surface, which is the wound surface, and the diaphragm. The adhesion was also severe, and it was difficult to lift the organ and separate it by its own weight. A laminated sponge containing no medicinal component was also examined in the same manner, but no significant anti-adhesion effect was observed. In addition, it was confirmed that the cut surface of the liver, which is the wound surface, causes severe adhesion with peripheral organs such as the omentum and esophagus in addition to the diaphragm.

As shown in FIGS. 12(A) and (B), even in non-dissected surfaces such as liver and stomach that were not resected, in all experimental groups of the control group, the single-layer sponge group, the interceed group and the Seprafilm group, Severe adhesions were observed. Similarly, no significant anti-adhesion effect was observed for the laminated sponge containing no medicinal ingredient. Thus, similar adhesions were observed in the experimental group to which the anti-adhesion material currently used clinically was attached.

On the other hand, as shown in the right-hand column of FIG. 11(B), the adhesion-preventing effect on the separated plane was confirmed by the laminated sponge containing the medicinal component. The layered sponge containing a medicinal component in the upper layer exhibited a high adhesion-preventing effect, and in particular, the layered sponge containing DSP in the upper layer exhibited a significant adhesion-preventing effect. In some of the groups using layered sponges containing Dex or DSP in the lower layer, an abscess was observed around the application site, which was assumed to be an adverse event caused by dexamethasone. No abscesses were observed in layered sponges containing Dex or DSP in the top layer.

In addition, as shown in the right column of FIG. 12(B), the adhesion-preventing effect was observed even in the non-separated cross section due to the laminated sponge containing the medicinal component. It was confirmed that a layered sponge containing Dex or DSP in the upper layer provides a higher anti-adhesion effect than a layered sponge containing Dex or DSP in the lower layer.

It is assumed that the anti-adhesion effect after surgery is obtained by supplying an anti-inflammatory drug in an amount sufficient to obtain an anti-inflammatory effect in the early stage of inflammation after surgery, but the upper layer contains Dex or DSP. It was assumed that the layered sponge, especially the layered sponge containing DSP, which is a water-soluble steroid, rapidly released the medicinal component, and therefore had a high anti-adhesion effect.

From the above results, the adhesion prevention effect of the alginate-layered sponge can be greatly improved by incorporating a steroid (anti-inflammatory drug) into the upper layer composed of low-molecular-weight alginic acid in the layered sponge consisting of two layers with different molecular weights. In order to improve the anti-adhesion effect of a steroid (anti-inflammatory drug) using a laminated sponge, it is preferable to quickly supply the steroid (anti-inflammatory drug) to the site of invasion and its surroundings, particularly to the site of severe invasion. Therefore, it is considered preferable that the adhesive be rapidly supplied immediately after application.

Example 10: Measurement of elution rate of pharmaceutical ingredient from sponge in phosphate buffer solution (PBS) According to the method of Example 8, B), dexamethasone ( Dex) and dexamethasone sodium phosphate (DSP)-containing sponges (4 types in total) were produced, and the elution rate of the medicinal ingredient from each sponge was measured.

A specific method is shown below.
[material]
Low endotoxin sodium alginate is described in Example 1, phosphate buffer in Example 2, and dexamethasone and dexamethasone sodium phosphate in Example 9, respectively.

[Used equipment]
8 mm diameter biopsy trepan (Kai medical BP-80F (trade name))
Plastic bottle UVvis (used for absorbance measurement)

[procedure]
A Dex-containing AL10 sponge, a DSP-containing AL10 sponge, a Dex-containing AL500 sponge, and a DSP-containing AL500 sponge were prepared according to the method of Example 8, B). Each sponge was punched out with a biopsy trepan (BP-60F (trade name) from Kai medical) with a diameter of 8 mm. This was immersed in 15 mL of 150 mM phosphate buffer (pH 7.5, 37° C.), and 500 μL of the immersion liquid was sampled at 30 minutes, 1 hour, 2 hours, 4 hours and 6 hours before immersion and after immersion. . The absorbance at λ=242 nm of the sampled solution was measured to evaluate the dissolution rate of the drug component.

[result]
The elution behavior of the medicinal ingredients from each sponge is shown in FIGS. 13(A) and (B). As shown in FIG. 13(A), it was confirmed that the fat-soluble steroid Dex was eluted relatively quickly when it was contained in AL10 (second layer, corresponding to the upper layer) (upper layer: Dex). was done. On the other hand, when it was contained in AL500 (first layer, corresponding to the lower layer) (lower layer: Dex), the release rate was slow. As shown in FIG. 13(B), when DSP, a water-soluble steroid, is contained in AL10 (corresponding to the second layer, upper layer) (upper layer: DSP)), AL500 (first layer, lower layer) (corresponding to ) (lower layer: DSP)), rapid elution was confirmed.

From this, it was confirmed that the medicinal ingredient contained in the sponge corresponding to the second layer of the laminated sponge quickly elutes regardless of fat solubility/water solubility. Therefore, it is assumed that the second layer preferably contains a medicinal ingredient that is expected to have a pharmacological effect in the early postoperative period (for example, in the early postoperative period of inflammation). On the other hand, it is assumed that pharmaceutical ingredients expected to have sustained local pharmacological effects for a predetermined period after surgery should preferably be included in the first layer after confirming their dissolution behavior in vitro. rice field.

REFERENCE SIGNS LIST 1 anti-adhesion material 2 first layer 3 second layer 4 sponge laminate

Claims (11)

sponge-like first and second layers of a monovalent metal salt of alginic acid at least partially crosslinked with a curing agent, wherein the monovalent metal salt of alginic acid in the first layer has a weight average molecular weight of 25 ,000 to 500,000 , and the weight average molecular weight of the monovalent metal salt of alginic acid in the second layer is 3,000 to 100,000 , and the weight average molecular weight is measured by GPC-MALS after decrosslinking treatment. wherein the weight-average molecular weight of the monovalent metal salt of alginic acid in the first layer is higher than the weight-average molecular weight of the monovalent metal salt of alginic acid in the second layer, and the monovalent metal salt of alginic acid in the first layer The total amount used in the layer and the second layer is in the range of 0.1 mg/cm ² to 10 mg/cm ² , and at least one layer selected from the first layer and the second layer is An anti-adhesion material comprising at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof, comprising a sterilized, biocompatible sponge-like laminate. The monovalent metal salt of alginic acid is a low endotoxin monovalent metal salt of alginic acid, and the endotoxin content of the monovalent metal salts of alginic acid in the first layer and the second layer is 500 EU/g or less. 1. The anti-adhesion material according to 1. 3. The anti-adhesion material according to claim 1 or 2, wherein both the first layer and the second layer contain a curing agent. 4. The total amount of the monovalent metal salt of alginic acid used in the first layer and the second layer is in the range of 0.1 mg/cm ² to 3 mg/cm ^{2 .} The anti-adhesion material described in . The anti-adhesion material according to any one of claims 1 to 4 , wherein the monovalent metal salt of alginic acid in the first layer and the second layer is sodium alginate or potassium alginate. 5. The anti-adhesion material according to claim 3 , wherein the curing agents for the first layer and the second layer are divalent or higher metal ion compounds. The anti-adhesion material according to any one of claims 1 to 6 , for applying the first layer to the wound side surface. a biocompatible sponge-like laminate comprising a first layer and a second layer each comprising a monovalent metal salt of alginic acid at least partially crosslinked with a curing agent, wherein the dissolution rate of the first layer is , slower than the second layer, and
In a dissolution test using the elution of the monovalent metal salt of alginic acid in a phosphate buffer solution of pH 7.5 as an index, when the elution amount of the monovalent metal salt of alginic acid in the second layer is 100%, the first The ratio of the monovalent metal salt of alginic acid eluted from the layer is less than 50% at 1 hour and less than 70% at 2 hours from the start of measurement, or
In a dissolution test using the elution of the monovalent metal salt of alginic acid in a pH 7.5 phosphate buffer as an indicator, the first layer was such that 25±10% by weight of the monovalent metal salt of alginic acid was eluted within 1 hour. , 80±10% by weight of the monovalent metal salt of alginic acid dissolves within 4 hours, and the second layer contains 70±10% by weight of the monovalent metal salt of alginic acid that dissolves within 1 hour, and 90±10% by weight of the monovalent metal salt dissolves within 4 hours. elute within hours,
At least one layer selected from the first layer and the second layer contains at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins, and combinations thereof. . The anti-adhesion material according to any one of claims 1 to 8 , wherein the sponge-like laminate is pressed. A method for producing an adhesion-preventing material containing a sponge-like laminate applicable to a living body, comprising the following steps.
(1) a step of curing a monovalent metal salt of alginic acid having a weight average molecular weight of 25,000 to 500,000 with a curing agent;
(2) freezing the hardened monovalent metal salt of alginic acid;
(3) a step of curing a monovalent metal salt of alginic acid having a weight average molecular weight of 3,000 to 100,000 with a curing agent on the monovalent metal salt of alginic acid obtained in (2) to obtain a laminate;
(4) freeze-drying the obtained laminate to obtain a sponge-like laminate;
Here, the molecular weight is measured by the GPC-MALS method,
The sponge-like laminate comprises a sponge-like first layer containing a monovalent metal salt of alginic acid having a weight average molecular weight of 25,000 to 500,000 , and a monovalent metal salt of alginic acid having a weight average molecular weight of 3,000 to 100,000. and a sponge-like second layer containing a metal salt, wherein the weight average molecular weight of the monovalent metal salt of alginic acid in the first layer is higher than that of the second layer, and the first layer of the monovalent metal salt of alginic acid. and the second layer is in the range of 0.1 mg/cm ² to 10 mg/cm ² , and at least one layer selected from the first layer and the second layer contains a drug, comprising at least one pharmaceutical ingredient selected from the group consisting of growth factors, hormones, proteins and combinations thereof;
The at least one pharmaceutical ingredient is contained in the monovalent metal salt of alginic acid before curing in step (1) and/or step (3), or the sponge-like laminate after freeze-drying in step (4). It is included for the first layer and/or the second layer. sponge-like first and second layers of a monovalent metal salt of alginic acid at least partially crosslinked with a curing agent, wherein the monovalent metal salt of alginic acid in the first layer has a weight average molecular weight of 25 ,000 to 500,000 , and the weight average molecular weight of the monovalent metal salt of alginic acid in the second layer is 3,000 to 100,000 , and the weight average molecular weight is measured by GPC-MALS after decrosslinking treatment. wherein the weight-average molecular weight of the monovalent metal salt of alginic acid in the first layer is higher than the weight-average molecular weight of the monovalent metal salt of alginic acid in the second layer, and the monovalent metal salt of alginic acid in the first layer The total amount used in the layer and the second layer is in the range of 0.1 mg/cm ² to 10 mg/cm ² , and at least one layer selected from the first layer and the second layer is A medicament having an anti-adhesion effect, comprising a sterilized, bio-applicable sponge-like laminate comprising at least one pharmaceutical ingredient selected from the group consisting of drugs, growth factors, hormones, proteins and combinations thereof. Composition.

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