[go: up one dir, main page]

WO2009010967A1 - An agent for treatment of inflammation - Google Patents

An agent for treatment of inflammation Download PDF

Info

Publication number
WO2009010967A1
WO2009010967A1 PCT/IL2008/000976 IL2008000976W WO2009010967A1 WO 2009010967 A1 WO2009010967 A1 WO 2009010967A1 IL 2008000976 W IL2008000976 W IL 2008000976W WO 2009010967 A1 WO2009010967 A1 WO 2009010967A1
Authority
WO
WIPO (PCT)
Prior art keywords
agent
disease
use according
glycerol
castor oil
Prior art date
Application number
PCT/IL2008/000976
Other languages
French (fr)
Inventor
Pnina Fishman
Sara Bar-Yehuda
Shira Cohen
Avivit Ochaion
Ilan Cohn
Original Assignee
Can-Fite Biopharma Ltd.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Can-Fite Biopharma Ltd. filed Critical Can-Fite Biopharma Ltd.
Publication of WO2009010967A1 publication Critical patent/WO2009010967A1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
    • A61K9/4841—Filling excipients; Inactive ingredients
    • A61K9/4858—Organic compounds
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A61K31/519—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
    • A61K31/7042—Compounds having saccharide radicals and heterocyclic rings
    • A61K31/7052—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides
    • A61K31/706—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom
    • A61K31/7064—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines
    • A61K31/7076—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines containing purines, e.g. adenosine, adenylic acid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/08—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
    • A61K47/14—Esters of carboxylic acids, e.g. fatty acid monoglycerides, medium-chain triglycerides, parabens or PEG fatty acid esters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/44—Oils, fats or waxes according to two or more groups of A61K47/02-A61K47/42; Natural or modified natural oils, fats or waxes, e.g. castor oil, polyethoxylated castor oil, montan wax, lignite, shellac, rosin, beeswax or lanolin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
    • A61K9/4841—Filling excipients; Inactive ingredients
    • A61K9/4875—Compounds of unknown constitution, e.g. material from plants or animals

Definitions

  • the present disclosure relates to agents for treatment of an inflammatory condition or disease as well as to compositions and methods useful in the treatment of inflammatory conditions or diseases.
  • Polyoxyl hydrogenated castor oil (which will be referred to herein, as "PHCO") is a non-ionic solubilizer and emulsifying agent that is obtained by reacting ethylene oxide with hydrogenated castor oil.
  • PHCO polyoxyl hydrogenated castor oil
  • Cremophor RH 40TM polyoxyl 40 hydrogenated castor oil (USP/NF)) obtained through reacting ethylene oxide with hydrogenated castor oil at a respective molar ratio of 40-45 to 1.
  • Cremophor RH 60TM which is obtained through reacting these ingredients at a ratio of 1 to 60.
  • the main constituent of PHCO is glycerol polyethylene glycol oxystearate, which, together with fatty acid glycerol polyglycol esters, forms the hydrophobic part of the product.
  • the hydrophilic part consists of polyethylene glycols and glycerol ethoxylate.
  • Cremophor RH 40TM has been used as an excipient, either by itself, or with other excipients, in pharmaceutical products. For example, use as a carrier within a soft capsule containing the active ingredient N 6 -(3-iodobenzyl)-adenosine-5'-N- methyluronamide (IB-MECA).
  • IB-MECA N 6 -(3-iodobenzyl)-adenosine-5'-N- methyluronamide
  • Cremophor RH 40TM has been used as an excipient together with the medium chain triglyceride, Miglyol 812TM (Condea Chemie GmbH, Germany), which are triglycerides of the fractionated vegetable fatty acids C8 and ClO, comprising caprylic and capric fatty acids.
  • a composition comprising (i) polyoxyl 40 hydrogenated Castor Oil (having the trade name Cremophor RH 40TM) and (ii) the medium chain triglyceride (MCT) product Miglyol 812TM (the composition being referred to herein as the "PHCO composition") had a strong anti-inflammatory effect demonstrated by reduction in disease symptoms in a human clinical study.
  • the PHCO composition was administered to patients in combination with methotrexate (MTX) and was also used as a carrier for IB-MECA. Many of the patients in this study also received folic acid.
  • the PHCO composition had the effect of reducing proliferation of stimulated lymphocytes and of potentiating the anti-inflammatory effect of MTX.
  • the antiinflammatory effect may be embodied in one or more of the components of the PHCO composition.
  • the anti-inflammatory activity may also be a result of interaction of the PHCO composition with MTX, IB-MECA and/or folic acid.
  • the present disclosure provides for the use of an agent for treating an individual afflicted with an inflammatory condition or disease; the agent comprising one or more members of the group consisting of: (i) a polyoxyl hydrogenated castor oil; (ii) a reaction product of ethylene oxide with hydrogenated castor oil; (iii) one or more of a glycerol polyethylene glycol oxystearate and a fatty acid glycerol polyglycol ester, combined with one or more of a polyethylene glycol and glycerol ethoxylate; (iv) one or combination of plant-derived medium chain triglycerides.
  • the agent comprising one or more members of the group consisting of: (i) a polyoxyl hydrogenated castor oil; (ii) a reaction product of ethylene oxide with hydrogenated castor oil; (iii) one or more of a glycerol polyethylene glycol oxystearate and a fatty acid glycerol polyglycol ester,
  • an agent for the preparation of pharmaceutical composition for treating an individual afflicted with an inflammatory condition or disease comprising one or more members of the group consisting of: (i) a polyoxyl hydrogenated castor oil; (ii) a reaction product of ethylene oxide with hydrogenated castor oil; (iii) one or more of a glycerol polyethylene glycol oxystearate and a fatty acid glycerol polyglycol ester, combined with one or more of a polyethylene glycol and glycerol ethoxylate; (iv) one or combination of plant-derived medium chain triglycerides.
  • a method of treatment of an individual afflicted with an inflammatory condition or disease comprising administering to the individual an amount of an agent effective to induce an antiinflammatory effect, the agent comprising one or more members of the group consisting of: (i) a polyoxyl hydrogenated castor oil; (ii) a reaction product of ethylene oxide with hydrogenated castor oil; (iii) one or more of a glycerol polyethylene glycol oxystearate and a fatty acid glycerol polyglycol ester, combined with one or more of a polyethylene glycol and glycerol ethoxylate; (iv) one or combination of plant-derived medium chain triglycerides.
  • a pharmaceutical composition for the treatment of an inflammatory condition or disease comprising as active agent an amount of one or more members of the group consisting of: (i) a polyoxyl hydrogenated castor oil; (ii) a reaction product of ethylene oxide with hydrogenated castor oil; (iii) one or more of a glycerol polyethylene glycol oxystearate and a fatty acid glycerol polyglycol ester, combined with one or more of a polyethylene glycol and glycerol ethoxylate; (iv) one or combination of plant-derived medium chain triglycerides; the amount of the agent being effective to induce an anti-inflammatory effect in an individual afflicted with an inflammatory condition or disease.
  • Fig. 1 shows the effect of a composition comprising polyoxyl 40 hydrogenated castor and Miglyol 812 ("Cremophor" in the figure), MTX or the combination of the composition and MTX, on the proliferation of PHA stimulated peripheral blood mononuclear cells (PBMNC). Results are presented in terms of optical density (OD) as percent of control. Reduction beyond control denotes inhibition of proliferation.
  • OD optical density
  • Fig. 2 shows the A 2A adenosine receptor (A 2A AR) and the A 3 adenosine receptor (A 3 AR) level upon treatment of PHA -stimulated peripheral blood mononuclear cells (PBMNC) with a composition comprising polyoxyl 40 hydrogenated castor and Miglyol 812 (indicated as "Excipients" in the figure).
  • PBMNC peripheral blood mononuclear cells
  • Fig. 3 shows the disease score in rats with an adjuvant-induced arthritis including control animals and animals treated with a PHCO composition (indicated as "Excipients” in the figure). Treatment was induced after onset of disease. The results that are shown are 6 days after onset of treatment.
  • Fig. 4 shows the disease score in rats with an adjuvant-induced arthritis including control animals, animals treated with MTX and animals treated with MTX and a PHCO composition (indicated as "Excipients" in the figure). Treatment was induced after onset of disease. The results that are shown are 10 days after onset of treatment.
  • the present disclosure concerns an agent that has been found to exhibit an antiinflammatory activity.
  • the agent in the context of the present disclosure comprises one or more members of the group consisting of: (i) a polyoxyl hydrogenated castor oil; (ii) a reaction product of ethylene oxide with hydrogenated castor oil; (iii) one or more of a glycerol polyethylene glycol oxystearate and a fatty acid glycerol polyglycol ester, combined with one or more of a polyethylene glycol and glycerol ethoxylate; (iv) one or combination of plant-derived medium chain triglycerides.
  • agent is used to encompass a single component or a combination of any one of the components defined above.
  • a method for the treatment of an inflammatory condition or disease comprising administering to an individual afflicted with an inflammatory condition or disease an amount of the agent, the amount being effective to induce an anti-inflammatory response in said individual.
  • a pharmaceutical composition for the treatment of an inflammatory condition or disease comprising as active ingredient the agent as defined herein, in an amount effective to induce an anti-inflammatory response.
  • the agent comprises a combination of a hydrophobic part and a hydrophilic part
  • the hydrophobic part comprises a glycerol polyethylene glycol oxystearate and a fatty acid glycerol polyglycol ester
  • the hydrophilic part comprises a polyethylene glycol and a glycerol ethoxylate
  • the agent may be obtained by reacting ethylene oxide with hydrogenated castor oil at a molar ration of ethylene oxide to hydrogenated castor oil of about 30-60 to 1. hi accordance with one embodiment, the reaction is carried out at an ethylene oxide:hydrogenated castor oil molar ratio of about 45:1.
  • the agent is a non-ionic agent characterized by one or more of a saponification value of between 40 to 60 and a hydroxyl value of between 50 to 75. More specifically, the agent is characterized by a saponification value of 50 to 60 and a hydroxyl value of 60 to 75.
  • Cremophor preferably Cremophor RH grades.
  • Some specific Cremophor RH grades include Cremophor RH40, Cremophor RH 455 and Cremophor RH 60 as provided by BASF, the details of which are included in BASF technical leaflet of May 1992 (MEl 25e, Register 14).
  • a preferred Cremophor in accordance with the present teaching is Cremophor RH40.
  • the agent comprises one or a combination of plant-derived medium chain triglycerides, the medium chain triglyceride being defined by a C6 to C14 fatty acid, preferably a neutral fatty acid.
  • the plant-derived medium chain triglyceride comprises one or more members of the group consisting of caproic acid (C6:0); caprylic acid (C8:0); capric acid (C10:0); lauric acid (C12:0) and myristic acid (C14:0).
  • a preferred combination of medium chain triglyceride comprises a combination of caprylic and capric triglyceride.
  • the said one or combination of plant-derived medium chain triglycerides is a fractionated Coconut oil.
  • Miglyol neutral oils Some preferred medium chain triglyceride agents in accordance with the present teaching are known in the art by the generic trade name Miglyol neutral oils.
  • Specific Miglyol neutral oils in the context of the present disclosure include the 810, 812, 818, 829 and 840 neutral oils.
  • a preferred Miglyol is the 812 neutral oil (as detailed in SaSoI Germany GmbH leaflet 09.04).
  • compositions comprising such other substances, method of treatment employing such other substances as well as the use of such other substance for the preparation of antiinflammatory pharmaceutical preparations, are also encompassed by teaching herein.
  • the agent may be administered to the individual in need of an anti-inflammatory treatment concomitant with one or more of an A 3 adenosine receptor agonist, an antiinflammatory agent and/or folic acid.
  • a 3 adenosine receptor agonist in the context of the present disclosure refers to any molecule capable of specifically binding to the A 3 Adenosine Receptor (A 3 AR), thereby fully or partially activating said receptor.
  • the agonist is thus a molecule that exerts its prime effect through the binding and activation of the A 3 AR. This means that at the doses it is being administered it essentially binds to and activates only the A 3 AR.
  • the agonist is N 6 -(3-iodobenzyl)- adenosine-5'-N- methyluronamide (IB-MECA).
  • the anti-inflammatory agent may be any anti-inflammatory drug known in the art, particularly those exhibiting an effect similar to that induced by methotrexate (MTX).
  • the anti-inflammatory agent is an anti- folate compound.
  • anti-folate compound refers to a compound having structural similarity to folate and activity as a folate antagonist against one or more folate- dependent enzymes.
  • anti-folate compounds include, e.g., aminopterin, raltitrexed, lometrexol, multitargeted anti-folate (MTA), AQA, MTX, and analogs thereof.
  • Aminopterin for example, possesses a hydrogen instead of a methyl group at position N-IO compared to the structure of MTX.
  • Raltitrexed (ZD 1694) is a selective inhibitor of thymidylate synthase.
  • Lometrexol selectively inhibits glycinamide ribonucleotide formyltransferase, the first enzyme involved in the pathway of de novo purine synthesis.
  • Other anti-folate compounds include, for example, trimetrexate, edetrexate, and the like (see, e.g., Takimoto, Oncologist 1 :68-81, 1996, for a listing of exemplary anti-folate compounds).
  • a preferred anti-folate compound in accordance with the present disclosure is MTX.
  • the present teaching provides a solution for the treatment of an inflammatory condition or disease.
  • treating refers to treating an individual suffering from an inflammatory disease or condition, in order to reduce inflammatory disease symptoms in the individual.
  • the inflammatory condition or disease is an autoimmune disease.
  • treatment is further intended to include both prophylactic treatment to prevent or delay the onset of an autoimmune disease (or to prevent the manifestation of clinical or subclinical, e.g., histological, symptoms thereof), as well as therapeutic suppression or alleviation of symptoms after the manifestation of autoimmune disease, by abating autoimmune attack and preventing or slowing down autoimmune tissue destruction, "abatement", “suppression” or “reduction” of autoimmune attack or reaction encompasses partial reduction or amelioration of one or more symptoms of the attack or reaction.
  • a “substantially” increased suppressive effect (or abatement or reduction) of autoimmune reaction means a significant decrease in one or more markers or histological or clinical indicators of autoimmune reaction or disease.
  • the inflammatory disease or condition may be, without being limited thereto, an autoimmune disease such as rheumatoid arthritis (RA), psoriasis, psoriatic arthritis, Crohn's disease, multiple sclerosis (MS), the autoimmune stage of diabetes mellitus (juvenile-onset or type I diabetes), autoimmune uveoretinitis (AUR) and others where MTX has been used.
  • the treatment may intended to reduce disease manifestation such as the number of swollen or tender joints in rheumatoid arthritis, the amount or extent of skin lesions is psoriasis patients, etc., or symptoms associated with the disease, such reduction of pain, morning stiffness, patient disability and others.
  • the agent may be used in conjugation with another agent or drug.
  • the other agent or drug may be one or a combination of an adenosine A 3 receptor agonist, folic acid or an anti-inflammatory agent.
  • Administration "in conjunction” encompasses simultaneous and sequential administration, as well as administration in combined form or separately.
  • the agent may be used in conjugation with two or more of the adenosine A 3 receptor agonist, the folic acid and/or the anti-inflammatory agent.
  • the agent may be used in combination with MTX and folic acid.
  • the adenosine A 3 receptor agonist, folic acid or an anti-inflammatory agent may be administered to the individual in accordance with acceptable treatment protocols.
  • acceptable treatment protocols include weekly administration either orally or by injection, at such weekly doses of 3-30 mg.
  • the agent as defined herein may be formulated together with the one or combination of the adenosine A 3 receptor agonist, folic acid and/or the antiinflammatory agent, or it may be administered in a separate delivery vehicle. As indicated above, the agent is preferably administered systemically, in a formulation suitable for oral administration.
  • the agent is used for systemic treatment of an individual afflicted with an inflammatory condition or disease.
  • the systemic treatment comprises oral administration of the agent to said individual.
  • systemic administration means to denote administration through a route in which said agent inflicts a systemic effect.
  • Systemic administration my typically be orally (including enteral or intragastric administration).
  • other systemic administration routes are also possible, including, but not limited to, parenteral (e.g. intravenous, intraperitoneal, sub-dermal or intramuscular), nasal (e.g. via a nasal spray), in the form of an inhaled spray, transdermal delivery.
  • parenteral e.g. intravenous, intraperitoneal, sub-dermal or intramuscular
  • nasal e.g. via a nasal spray
  • inhaled spray e.g. via a nasal spray
  • the treatment may be once, twice or several times daily, once every other day, etc.
  • the treatment schedule may be determined through appropriately designed clinical studies by scientific or pharmacologic considerations.
  • the effective amount of said agent may be determined, for example, be dose- finding clinical studies or through extrapolation from laboratory animals through a number of dose conversion formulas or by other considerations.
  • the agent to be used for treatment may be selected through clinical studies, of the kind exemplified herein, through in vitro studies of the kind also exemplified or through experiments in appropriate animal models of inflammatory diseases.
  • the PHCO composition may for example, be polyoxyl 40 hydrogenated castor oil or polyoxyl 60 hydrogenated castor oil.
  • the active agent may be administered within a soft shell capsule, typically enteric coated, may be administered as a drink, and in general in any suitable delivery form.
  • the clinical study was A Phase 2, multicenter, randomized, double-blind, placebo-controlled, parallel-group, dose-finding study to test the safety and efficacy of CFlOl (a cGMP grade manufacture of the A3 adenosine receptor agonist IB-MECA synthesized for Can-Fite BioPharma, under good clinical practice (GMP) by Albany Molecular Research Inc, Albany, NY, USA), administered orally, added to weekly MTX administration, in patients with active RA.
  • CFlOl a cGMP grade manufacture of the A3 adenosine receptor agonist IB-MECA synthesized for Can-Fite BioPharma, under good clinical practice (GMP) by Albany Molecular Research Inc, Albany, NY, USA
  • CFlOl Three doses of CFlOl that were tested in the study were 0.1, 1 and 4 mg in a soft-shell capsule that included, other than CFlOl also polyoxyl 45 hydrogenated castor oil (Cremophor RH 40TM) and Miglyol 812. Capsules not containing CFlOl were used as control. These control capsules included 326.5 mg of polyoxyl 45 hydrogenated castor oil and 173.5 mg Miglyol 812. In the CFl 01 -containing capsules a small amount of the polyoxyl 45 hydrogenated castor oil and Miglyol 812 was substituted by this drug.
  • Patients were administered orally with the CFl 01 -containing or the control capsules twice daily to patients that were concomitantly treated also with MTX.
  • the study was a 12 weeks study. Many of the patients received also folic acid.
  • Disease activity was measured by standard measures at baseline and throughout the study. The disease activity was evaluated by ACR standard criteria laid down by the American College of Rheumatology.
  • the percentage of patients in the control group (who received the control tablets) that had an ACR20 response was 50% as compared to 53.8%, 47.6% and 44.4% of the patients receiving 0.1, 1 and 4 mg of CFlOl, respectively.
  • Historical placebo response rates in patients with active disease, despite receiving MTX are at a range of 15-30%, indicating that the control capsules had an anti-inflammatory activity by themselves or upon interaction within the body with one of the other administered agents, e.g. MTX or folic acid.
  • the ACR20 response in the patients receiving the control capsules continuously accrued through the 12 weeks of the study with the response being 0, 11.3%, 22.6%, 38.7% and 46.8% on weeks 2, 4, 8, 12, respectively.
  • Such a response accrual patterns is not expected to happen in a placebo group, also indicating an anti-inflammatory activity in the anti-in control capsules.
  • RPMI fetal bovine serum
  • FBS fetal bovine serum
  • antibiotics for cell cultures were obtained from Beit Haemek, Haifa, Israel.
  • Methotrexate (MTX) and phytohemagglutinin (PHA) were purchased from ABIC, Israel.
  • Rabbit polyclonal antibodies against rat and human A 3 AR as well as rat A 2A AR was purchased from Santa Cruz Biotechnology Inc., Ca, USA. 3-[4,5-Dimethylthiazol-2-yl]-2,5-dephenyltetrazolium bromide for the MTT assay was purchased from Sigma.
  • the POHC composition that was used was derived from control capsules used in the clinical study reported in Example 1.
  • Blood samples were collected from healthy subjects who signed an informed consent prior to blood withdrawal.
  • PBMNC heparanized blood (20ml) was subjected to Ficoll hypaque gradient.
  • PBMNC (2xlO6/ml) from healthy subjects were incubated with 5 ⁇ g/ml PHA in RPMI 1640 supplemented with 10% FBS.
  • the POHC composition which included 326.5 mg of Cremophor RH 40TM and 173.5mg of Miglyol 812TM were diluted 1:5000 and added to the PHA treated cultures for the whole culture period. After 24h MTX (l ⁇ M) was added for additional 48 hours. To test the effect of excipients and MTX on cell growth MTT assay was used and performed as follows.
  • MTT assay was used. MTT stock solution (5mg/ml) was added (1 :10) to the culture system and incubated for 4 hours. Then the culture medium was removed and MTT solvent (HCL 0.05N in isopropanol) was added to the culture in an amount equal to the original volume. Absorbance of the converted dye was measured at 570nm.
  • the above mentioned cells and additives were cultured in 10 cm tissue culture plates (5xlO4/ml) for 72 hours.
  • the trypsinized cells were washed again with ice-cold PBS, harvested by centrifugation and subjected to lysis in TNN buffer. Cell debris was removed by centrifugation for 10 min at 7500xg.
  • the supernatant was utilized for WB analysis. Protein concentrations were determined using the Bio-Rad protein assay dye reagent. Equal amounts of the sample (50 ⁇ g) were separated by SDS-PAGE, using 12% polyacrylamide gels. The resolved proteins were then electroblotted onto nitrocellulose membranes (Schleicher & Schuell, Keene, NH, USA). Membranes were blocked with 1% bovine serum albumin and incubated with the relevant primary antibody (dilution 1 : 1000) for 24h at 4 0 C. Blots were then washed and incubated with the secondary antibody for Ih at room temperature. Bands were recorded using color development kit (Promega, Madison, Wl, USA).
  • the incubation with the diluted POHC composition inhibited PBMNC proliferation in three different cultures each one of them derived from different healthy subject. Furthermore, a combined exposure of the cells to MTX and the diluted POHC composition caused a larger inhibitory effect as compared to MTX alone.
  • Fig.2. depicts the effect of the excipients on the expression level of the A2A and the A3 protein expression level in PHA-stimulated PBMNC. It can be noted that the excipients induced up-regulation of the A2A adenosine receptor protein expression level.
  • MTX is known to mediate its anti-inflammatory effect via the A3 and the A2A adenosine receptors.
  • the excipients-mediated increase in the level of these two receptors may explain some of the excipient-induced anti-inflammatory effect.
  • Example 3 In vivo studies
  • Adjuvant induced arthritis (AIA) model was established in rats by immunizing the animals with an emulsion contacting Mycobacterium tuberculosis in Freund's adjuvant.
  • a PHCO composition comprising
  • PHOC composition Treatment with the PHOC composition, at a dilution of 1:500 (in PBS) was initiated upon onset of disease.
  • the PHOC composition was administered orally, three- times daily. Each administration was of 0.5 ml.
  • MTX was administered IP at a dose of 0.75 mg/kg, once weekly.
  • the severity of the disease was measured by the observed clinical score according to acceptable measures.
  • the clinical score results depicted in Fig. 3, show that the PHOC composition induces a marked improvement of the clinical score.
  • the results depicted in Fig. 4 show that the combined treatment of MTX and the excipients is beneficial over MTX treatment alone.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Medicinal Chemistry (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Epidemiology (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Oil, Petroleum & Natural Gas (AREA)
  • Zoology (AREA)
  • Botany (AREA)
  • Molecular Biology (AREA)
  • Engineering & Computer Science (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • General Chemical & Material Sciences (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)

Abstract

The present disclosure relates to the use of an agent for treating an individual afflicted with an inflammatory condition or disease; the agent comprising one or more members of a group consisting of: (i) a polyoxyl hydrogenated castor oil; (ii) a reaction product of ethylene oxide with hydrogenated castor oil; (iii) one or more of a glycerol polyethylene glycol oxystearate and a fatty acid glycerol polyglycol ester, combined with one or more of a polyethylene glycol and glycerol ethoxylate; (iv) one or combination of plant-derived medium chain triglycerides. The agent may be used in conjugation with an anti-inflammatory drug, such as methotrexate, with an A3 adenosine receptor agonist and/or with folic acid. The inflammatory condition or disease is preferably an autoimmune disease. The present disclosure also concerns pharmaceutical compositions comprising the agent as well as methods for treatment of an inflammatory condition or disease. One agent in the context of the present disclosure may be Cremophor, e.g. Cremophor RH40, which may be used in combination with the anti-inflammatory agent, methotrexate (MTX).

Description

AN AGENT FOR TREATMENT OF INFLAMMATION
FIELD OF THE INVENTION
The present disclosure relates to agents for treatment of an inflammatory condition or disease as well as to compositions and methods useful in the treatment of inflammatory conditions or diseases.
BACKGROUND OF THE INVENTION
Polyoxyl hydrogenated castor oil (which will be referred to herein, as "PHCO") is a non-ionic solubilizer and emulsifying agent that is obtained by reacting ethylene oxide with hydrogenated castor oil. Such products are sold commercially under the trade name Cremophor by BASF, Germany. One such product is Cremophor RH 40™ (polyoxyl 40 hydrogenated castor oil (USP/NF)) obtained through reacting ethylene oxide with hydrogenated castor oil at a respective molar ratio of 40-45 to 1. Another such product is Cremophor RH 60™ which is obtained through reacting these ingredients at a ratio of 1 to 60. The main constituent of PHCO is glycerol polyethylene glycol oxystearate, which, together with fatty acid glycerol polyglycol esters, forms the hydrophobic part of the product. The hydrophilic part consists of polyethylene glycols and glycerol ethoxylate.
Cremophor RH 40™ has been used as an excipient, either by itself, or with other excipients, in pharmaceutical products. For example, use as a carrier within a soft capsule containing the active ingredient N6-(3-iodobenzyl)-adenosine-5'-N- methyluronamide (IB-MECA). In the case of the IB-MECA-containing formulation, Cremophor RH 40™ has been used as an excipient together with the medium chain triglyceride, Miglyol 812™ (Condea Chemie GmbH, Germany), which are triglycerides of the fractionated vegetable fatty acids C8 and ClO, comprising caprylic and capric fatty acids. SUMMARY OF THE INVENTION
In accordance with the present disclosure it has been discovered that a composition comprising (i) polyoxyl 40 hydrogenated Castor Oil (having the trade name Cremophor RH 40™) and (ii) the medium chain triglyceride (MCT) product Miglyol 812™ (the composition being referred to herein as the "PHCO composition") had a strong anti-inflammatory effect demonstrated by reduction in disease symptoms in a human clinical study. In that clinical study the PHCO composition was administered to patients in combination with methotrexate (MTX) and was also used as a carrier for IB-MECA. Many of the patients in this study also received folic acid.
Also, it was found that the PHCO composition had the effect of reducing proliferation of stimulated lymphocytes and of potentiating the anti-inflammatory effect of MTX.
It was further found that administration of the PHCO composition to animals, ameliorated inflammatory disease symptoms in these animals, both alone or when administered in combination with another agent.
Thus, without being bound by theory, it has been suggested that the antiinflammatory effect may be embodied in one or more of the components of the PHCO composition. The anti-inflammatory activity may also be a result of interaction of the PHCO composition with MTX, IB-MECA and/or folic acid.
In accordance with a first of its aspects, the present disclosure provides for the use of an agent for treating an individual afflicted with an inflammatory condition or disease; the agent comprising one or more members of the group consisting of: (i) a polyoxyl hydrogenated castor oil; (ii) a reaction product of ethylene oxide with hydrogenated castor oil; (iii) one or more of a glycerol polyethylene glycol oxystearate and a fatty acid glycerol polyglycol ester, combined with one or more of a polyethylene glycol and glycerol ethoxylate; (iv) one or combination of plant-derived medium chain triglycerides.
Further, there is provided the use of an agent for the preparation of pharmaceutical composition for treating an individual afflicted with an inflammatory condition or disease; the agent comprising one or more members of the group consisting of: (i) a polyoxyl hydrogenated castor oil; (ii) a reaction product of ethylene oxide with hydrogenated castor oil; (iii) one or more of a glycerol polyethylene glycol oxystearate and a fatty acid glycerol polyglycol ester, combined with one or more of a polyethylene glycol and glycerol ethoxylate; (iv) one or combination of plant-derived medium chain triglycerides.
In accordance with a further aspect, there is provided a method of treatment of an individual afflicted with an inflammatory condition or disease, comprising administering to the individual an amount of an agent effective to induce an antiinflammatory effect, the agent comprising one or more members of the group consisting of: (i) a polyoxyl hydrogenated castor oil; (ii) a reaction product of ethylene oxide with hydrogenated castor oil; (iii) one or more of a glycerol polyethylene glycol oxystearate and a fatty acid glycerol polyglycol ester, combined with one or more of a polyethylene glycol and glycerol ethoxylate; (iv) one or combination of plant-derived medium chain triglycerides.
In accordance with yet a further aspect, there is provided a pharmaceutical composition for the treatment of an inflammatory condition or disease comprising as active agent an amount of one or more members of the group consisting of: (i) a polyoxyl hydrogenated castor oil; (ii) a reaction product of ethylene oxide with hydrogenated castor oil; (iii) one or more of a glycerol polyethylene glycol oxystearate and a fatty acid glycerol polyglycol ester, combined with one or more of a polyethylene glycol and glycerol ethoxylate; (iv) one or combination of plant-derived medium chain triglycerides; the amount of the agent being effective to induce an anti-inflammatory effect in an individual afflicted with an inflammatory condition or disease.
- A -
BRIEF DESCRIPTION OF THE DRAWINGS
Fig. 1 shows the effect of a composition comprising polyoxyl 40 hydrogenated castor and Miglyol 812 ("Cremophor" in the figure), MTX or the combination of the composition and MTX, on the proliferation of PHA stimulated peripheral blood mononuclear cells (PBMNC). Results are presented in terms of optical density (OD) as percent of control. Reduction beyond control denotes inhibition of proliferation.
• Fig. 2 shows the A2A adenosine receptor (A2AAR) and the A3 adenosine receptor (A3AR) level upon treatment of PHA -stimulated peripheral blood mononuclear cells (PBMNC) with a composition comprising polyoxyl 40 hydrogenated castor and Miglyol 812 (indicated as "Excipients" in the figure). Western blot analysis assay was utilized to determine protein expression level.
Fig. 3 shows the disease score in rats with an adjuvant-induced arthritis including control animals and animals treated with a PHCO composition (indicated as "Excipients" in the figure). Treatment was induced after onset of disease. The results that are shown are 6 days after onset of treatment.
Fig. 4 shows the disease score in rats with an adjuvant-induced arthritis including control animals, animals treated with MTX and animals treated with MTX and a PHCO composition (indicated as "Excipients" in the figure). Treatment was induced after onset of disease. The results that are shown are 10 days after onset of treatment.
DESCRIPTION OF NON-LIMITING EXEMPLARY EMBODIMENTS
The present disclosure concerns an agent that has been found to exhibit an antiinflammatory activity. The agent in the context of the present disclosure comprises one or more members of the group consisting of: (i) a polyoxyl hydrogenated castor oil; (ii) a reaction product of ethylene oxide with hydrogenated castor oil; (iii) one or more of a glycerol polyethylene glycol oxystearate and a fatty acid glycerol polyglycol ester, combined with one or more of a polyethylene glycol and glycerol ethoxylate; (iv) one or combination of plant-derived medium chain triglycerides. Thus, in accordance with a first of its aspect, there is provided the use of the agent for treating an inflammatory condition or disease. The term "agent" is used to encompass a single component or a combination of any one of the components defined above.
In accordance with a second aspect, there is provided the use of the agent for the preparation of a pharmaceutical composition for the treatment of an inflammatory condition or disease.
In accordance with a third aspect, there is provided a method for the treatment of an inflammatory condition or disease comprising administering to an individual afflicted with an inflammatory condition or disease an amount of the agent, the amount being effective to induce an anti-inflammatory response in said individual. hi accordance with a fourth aspect, there is provided a pharmaceutical composition for the treatment of an inflammatory condition or disease, the composition comprising as active ingredient the agent as defined herein, in an amount effective to induce an anti-inflammatory response.
In accordance with one embodiment, the agent comprises a combination of a hydrophobic part and a hydrophilic part, the hydrophobic part comprises a glycerol polyethylene glycol oxystearate and a fatty acid glycerol polyglycol ester, and the hydrophilic part comprises a polyethylene glycol and a glycerol ethoxylate.
The agent may be obtained by reacting ethylene oxide with hydrogenated castor oil at a molar ration of ethylene oxide to hydrogenated castor oil of about 30-60 to 1. hi accordance with one embodiment, the reaction is carried out at an ethylene oxide:hydrogenated castor oil molar ratio of about 45:1.
In accordance with some other embodiments, the agent is a non-ionic agent characterized by one or more of a saponification value of between 40 to 60 and a hydroxyl value of between 50 to 75. More specifically, the agent is characterized by a saponification value of 50 to 60 and a hydroxyl value of 60 to 75.
Some preferred agents in accordance with the present teaching are known in the art by the generic trade-name Cremophor, preferably Cremophor RH grades. Some specific Cremophor RH grades include Cremophor RH40, Cremophor RH 455 and Cremophor RH 60 as provided by BASF, the details of which are included in BASF technical leaflet of May 1992 (MEl 25e, Register 14). A preferred Cremophor in accordance with the present teaching is Cremophor RH40.
In accordance with another embodiment, the agent comprises one or a combination of plant-derived medium chain triglycerides, the medium chain triglyceride being defined by a C6 to C14 fatty acid, preferably a neutral fatty acid.
In accordance with some other embodiments, the plant-derived medium chain triglyceride comprises one or more members of the group consisting of caproic acid (C6:0); caprylic acid (C8:0); capric acid (C10:0); lauric acid (C12:0) and myristic acid (C14:0).
A preferred combination of medium chain triglyceride comprises a combination of caprylic and capric triglyceride.
In accordance with some alternative embodiments, the said one or combination of plant-derived medium chain triglycerides is a fractionated Coconut oil.
Some preferred medium chain triglyceride agents in accordance with the present teaching are known in the art by the generic trade name Miglyol neutral oils. Specific Miglyol neutral oils in the context of the present disclosure include the 810, 812, 818, 829 and 840 neutral oils. A preferred Miglyol is the 812 neutral oil (as detailed in SaSoI Germany GmbH leaflet 09.04).
Based on the teaching herein, a person versed in the art may find one or more derivatives for the agents. For example, since Cremophor RH grades and Miglyol are typically used as excipients, The Handbook of Pharmaceutical Excipients (Edited by RC Rowe, PJ Sheskey, and SC Owen, Royal Pharmaceutical Society of Great Britain, London, UK) can be used to identify alternatives for the agent as defined herein and their combinations which have similar pharmacological properties to said PHCO composition, permitting to use said substance(s) for treating inflammation in an individual with or without another anti-inflammatory agent as disclosed herein. Compositions comprising such other substances, method of treatment employing such other substances as well as the use of such other substance for the preparation of antiinflammatory pharmaceutical preparations, are also encompassed by teaching herein. The agent may be administered to the individual in need of an anti-inflammatory treatment concomitant with one or more of an A3 adenosine receptor agonist, an antiinflammatory agent and/or folic acid.
The term "A3 adenosine receptor agonist" in the context of the present disclosure refers to any molecule capable of specifically binding to the A3 Adenosine Receptor (A3AR), thereby fully or partially activating said receptor. The agonist is thus a molecule that exerts its prime effect through the binding and activation of the A3AR. This means that at the doses it is being administered it essentially binds to and activates only the A3AR.
The characteristic of some adenosine A3 adenosine receptor agonists and methods of their preparation are described in detail in, inter alia, US 5,688,774; US 5,773,423, US 5,573,772, US 5,443,836, US 6,048,865, WO 95/02604, WO 99/20284, WO 99/06053, WO 97/27173, US7,064,751, all of which are incorporated herein by reference.
In accordance with one preferred embodiment, the agonist is N6-(3-iodobenzyl)- adenosine-5'-N- methyluronamide (IB-MECA).
The anti-inflammatory agent may be any anti-inflammatory drug known in the art, particularly those exhibiting an effect similar to that induced by methotrexate (MTX). In accordance with one embodiment, the anti-inflammatory agent is an anti- folate compound.
As used herein, the term "anti-folate compound" refers to a compound having structural similarity to folate and activity as a folate antagonist against one or more folate- dependent enzymes. Examples of anti-folate compounds include, e.g., aminopterin, raltitrexed, lometrexol, multitargeted anti-folate (MTA), AQA, MTX, and analogs thereof. Aminopterin, for example, possesses a hydrogen instead of a methyl group at position N-IO compared to the structure of MTX. Raltitrexed (ZD 1694) is a selective inhibitor of thymidylate synthase. Lometrexol selectively inhibits glycinamide ribonucleotide formyltransferase, the first enzyme involved in the pathway of de novo purine synthesis. Other anti-folate compounds include, for example, trimetrexate, edetrexate, and the like (see, e.g., Takimoto, Oncologist 1 :68-81, 1996, for a listing of exemplary anti-folate compounds). A preferred anti-folate compound in accordance with the present disclosure is MTX.
The present teaching provides a solution for the treatment of an inflammatory condition or disease.
The term "treating" or "treatment" used herein refers to treating an individual suffering from an inflammatory disease or condition, in order to reduce inflammatory disease symptoms in the individual.
In accordance with one embodiment, the inflammatory condition or disease is an autoimmune disease. Thus, the term "treatment" is further intended to include both prophylactic treatment to prevent or delay the onset of an autoimmune disease (or to prevent the manifestation of clinical or subclinical, e.g., histological, symptoms thereof), as well as therapeutic suppression or alleviation of symptoms after the manifestation of autoimmune disease, by abating autoimmune attack and preventing or slowing down autoimmune tissue destruction, "abatement", "suppression" or "reduction" of autoimmune attack or reaction encompasses partial reduction or amelioration of one or more symptoms of the attack or reaction. A "substantially" increased suppressive effect (or abatement or reduction) of autoimmune reaction means a significant decrease in one or more markers or histological or clinical indicators of autoimmune reaction or disease.
The inflammatory disease or condition may be, without being limited thereto, an autoimmune disease such as rheumatoid arthritis (RA), psoriasis, psoriatic arthritis, Crohn's disease, multiple sclerosis (MS), the autoimmune stage of diabetes mellitus (juvenile-onset or type I diabetes), autoimmune uveoretinitis (AUR) and others where MTX has been used. The treatment may intended to reduce disease manifestation such as the number of swollen or tender joints in rheumatoid arthritis, the amount or extent of skin lesions is psoriasis patients, etc., or symptoms associated with the disease, such reduction of pain, morning stiffness, patient disability and others.
The agent may be used in conjugation with another agent or drug. The other agent or drug may be one or a combination of an adenosine A3 receptor agonist, folic acid or an anti-inflammatory agent. Administration "in conjunction" encompasses simultaneous and sequential administration, as well as administration in combined form or separately.
Further, the agent may be used in conjugation with two or more of the adenosine A3 receptor agonist, the folic acid and/or the anti-inflammatory agent. For example, the agent may be used in combination with MTX and folic acid. The adenosine A3 receptor agonist, folic acid or an anti-inflammatory agent may be administered to the individual in accordance with acceptable treatment protocols. In the case of MTX, for example, acceptable treatment protocols include weekly administration either orally or by injection, at such weekly doses of 3-30 mg.
The agent as defined herein may be formulated together with the one or combination of the adenosine A3 receptor agonist, folic acid and/or the antiinflammatory agent, or it may be administered in a separate delivery vehicle. As indicated above, the agent is preferably administered systemically, in a formulation suitable for oral administration.
In accordance with one preferred embodiment, the agent is used for systemic treatment of an individual afflicted with an inflammatory condition or disease. According to one embodiment, the systemic treatment comprises oral administration of the agent to said individual.
The term "systemic administration" or "systemically administering" means to denote administration through a route in which said agent inflicts a systemic effect. Systemic administration my typically be orally (including enteral or intragastric administration). However, other systemic administration routes are also possible, including, but not limited to, parenteral (e.g. intravenous, intraperitoneal, sub-dermal or intramuscular), nasal (e.g. via a nasal spray), in the form of an inhaled spray, transdermal delivery. A person versed in the art of formulating ingredients for system administration will be able to design a formulation on the basis of relevant pharmacokinetic and pharmacological considerations.
The treatment may be once, twice or several times daily, once every other day, etc. As known in the art of clinical development, the treatment schedule may be determined through appropriately designed clinical studies by scientific or pharmacologic considerations. The effective amount of said agent may be determined, for example, be dose- finding clinical studies or through extrapolation from laboratory animals through a number of dose conversion formulas or by other considerations.
The agent to be used for treatment may be selected through clinical studies, of the kind exemplified herein, through in vitro studies of the kind also exemplified or through experiments in appropriate animal models of inflammatory diseases. The PHCO composition, may for example, be polyoxyl 40 hydrogenated castor oil or polyoxyl 60 hydrogenated castor oil.
The active agent may be administered within a soft shell capsule, typically enteric coated, may be administered as a drink, and in general in any suitable delivery form.
NON-LIMITING EXAMPLES Example 1: Clinical study
Methods
The clinical study was A Phase 2, multicenter, randomized, double-blind, placebo-controlled, parallel-group, dose-finding study to test the safety and efficacy of CFlOl (a cGMP grade manufacture of the A3 adenosine receptor agonist IB-MECA synthesized for Can-Fite BioPharma, under good clinical practice (GMP) by Albany Molecular Research Inc, Albany, NY, USA), administered orally, added to weekly MTX administration, in patients with active RA.
Three doses of CFlOl that were tested in the study were 0.1, 1 and 4 mg in a soft-shell capsule that included, other than CFlOl also polyoxyl 45 hydrogenated castor oil (Cremophor RH 40™) and Miglyol 812. Capsules not containing CFlOl were used as control. These control capsules included 326.5 mg of polyoxyl 45 hydrogenated castor oil and 173.5 mg Miglyol 812. In the CFl 01 -containing capsules a small amount of the polyoxyl 45 hydrogenated castor oil and Miglyol 812 was substituted by this drug.
Patients were administered orally with the CFl 01 -containing or the control capsules twice daily to patients that were concomitantly treated also with MTX. The study was a 12 weeks study. Many of the patients received also folic acid. Disease activity was measured by standard measures at baseline and throughout the study. The disease activity was evaluated by ACR standard criteria laid down by the American College of Rheumatology.
Results
The percentage of patients in the control group (who received the control tablets) that had an ACR20 response (an ACR20 response means a 20% improvement in 5 out of 8 diseases parameters) was 50% as compared to 53.8%, 47.6% and 44.4% of the patients receiving 0.1, 1 and 4 mg of CFlOl, respectively. Historical placebo response rates in patients with active disease, despite receiving MTX, are at a range of 15-30%, indicating that the control capsules had an anti-inflammatory activity by themselves or upon interaction within the body with one of the other administered agents, e.g. MTX or folic acid.
The ACR20 response in the patients receiving the control capsules continuously accrued through the 12 weeks of the study with the response being 0, 11.3%, 22.6%, 38.7% and 46.8% on weeks 2, 4, 8, 12, respectively. Such a response accrual patterns is not expected to happen in a placebo group, also indicating an anti-inflammatory activity in the anti-in control capsules.
Patient reported parameters including patient global assessment, pain assessment and health assessment questionnaire disability index, also showed a continuous improvement throughout the study, a pattern not expected in a placebo response. The overall improvement seen in these parameters considerably exceeded levels reached in placebo responses. This finding also indicates that the control is active.
Example 2: In vitro studies
Materials and Methods Reaeents
RPMI, fetal bovine serum (FBS) and antibiotics for cell cultures were obtained from Beit Haemek, Haifa, Israel. Methotrexate (MTX) and phytohemagglutinin (PHA) were purchased from ABIC, Israel. Rabbit polyclonal antibodies against rat and human A3AR as well as rat A2AAR was purchased from Santa Cruz Biotechnology Inc., Ca, USA. 3-[4,5-Dimethylthiazol-2-yl]-2,5-dephenyltetrazolium bromide for the MTT assay was purchased from Sigma.
The POHC composition that was used was derived from control capsules used in the clinical study reported in Example 1.
Blood sample collection and separation
Blood samples were collected from healthy subjects who signed an informed consent prior to blood withdrawal. To separate PBMNC, heparanized blood (20ml) was subjected to Ficoll hypaque gradient.
Cell cultures of mitogen activated PBMNC
PBMNC (2xlO6/ml) from healthy subjects were incubated with 5μg/ml PHA in RPMI 1640 supplemented with 10% FBS. The POHC composition which included 326.5 mg of Cremophor RH 40™ and 173.5mg of Miglyol 812™ were diluted 1:5000 and added to the PHA treated cultures for the whole culture period. After 24h MTX (lμM) was added for additional 48 hours. To test the effect of excipients and MTX on cell growth MTT assay was used and performed as follows.
MTT assay
Cells and additives as described above were cultured in 96-well microtiter plates. At the end of the incubation period (72 hours total), MTT assay was used. MTT stock solution (5mg/ml) was added (1 :10) to the culture system and incubated for 4 hours. Then the culture medium was removed and MTT solvent (HCL 0.05N in isopropanol) was added to the culture in an amount equal to the original volume. Absorbance of the converted dye was measured at 570nm.
At the end of the incubation time the PBMNC 's were collected from the culture plates and protein extracts were prepared.
Western Blot Analysis of 'A?A and A^ adenosine receptors
To assess the effect of the excipients and MTX on the expression level of A2A and A3 adenosine receptors, the above mentioned cells and additives were cultured in 10 cm tissue culture plates (5xlO4/ml) for 72 hours. At the end of the incubation period cell samples were rinsed with ice-cold PBS and transferred to ice-cold lysis buffer (TNN buffer, 5OmM Tris buffer pH=7.5, 15OmM NaCl, NP 40). The trypsinized cells were washed again with ice-cold PBS, harvested by centrifugation and subjected to lysis in TNN buffer. Cell debris was removed by centrifugation for 10 min at 7500xg. The supernatant was utilized for WB analysis. Protein concentrations were determined using the Bio-Rad protein assay dye reagent. Equal amounts of the sample (50μg) were separated by SDS-PAGE, using 12% polyacrylamide gels. The resolved proteins were then electroblotted onto nitrocellulose membranes (Schleicher & Schuell, Keene, NH, USA). Membranes were blocked with 1% bovine serum albumin and incubated with the relevant primary antibody (dilution 1 : 1000) for 24h at 40C. Blots were then washed and incubated with the secondary antibody for Ih at room temperature. Bands were recorded using color development kit (Promega, Madison, Wl, USA).
Results
Excipients potentiate the inhibitory effect of MTX on the proliferation of PHA stimulated PBMC in vitro
As can be seen in Fig. 1, the incubation with the diluted POHC composition inhibited PBMNC proliferation in three different cultures each one of them derived from different healthy subject. Furthermore, a combined exposure of the cells to MTX and the diluted POHC composition caused a larger inhibitory effect as compared to MTX alone.
Fig.2. depicts the effect of the excipients on the expression level of the A2A and the A3 protein expression level in PHA-stimulated PBMNC. It can be noted that the excipients induced up-regulation of the A2A adenosine receptor protein expression level.
Without intending to be bound by theory, it should be noted that MTX is known to mediate its anti-inflammatory effect via the A3 and the A2A adenosine receptors. The excipients-mediated increase in the level of these two receptors may explain some of the excipient-induced anti-inflammatory effect. Example 3: In vivo studies
Methods
Adjuvant induced arthritis (AIA) model was established in rats by immunizing the animals with an emulsion contacting Mycobacterium tuberculosis in Freund's adjuvant. A PHCO composition comprising
Treatment with the PHOC composition, at a dilution of 1:500 (in PBS) was initiated upon onset of disease. The PHOC composition was administered orally, three- times daily. Each administration was of 0.5 ml.
MTX was administered IP at a dose of 0.75 mg/kg, once weekly.
The severity of the disease was measured by the observed clinical score according to acceptable measures.
Results
The clinical score results depicted in Fig. 3, show that the PHOC composition induces a marked improvement of the clinical score. The results depicted in Fig. 4 show that the combined treatment of MTX and the excipients is beneficial over MTX treatment alone.
The results show that the combined treatment of MTX and the excipients is beneficial over MTX treatment alone.

Claims

CLAIMS:
1. Use of an agent for treating an individual afflicted with an inflammatory condition or disease; the agent comprising one or more members of a group consisting of: (i) a polyoxyl hydrogenated castor oil; (ii) a reaction product of ethylene oxide with hydrogenated castor oil; (iii) one or more of a glycerol polyethylene glycol oxystearate and a fatty acid glycerol polyglycol ester, combined with one or more of a polyethylene glycol and glycerol ethoxylate; (iv) one or combination of plant-derived medium chain triglycerides.
2. Use according to Claim 1, for treating an individual in combination with one or more of an A3 adenosine receptor agonist, an anti-inflammatory agent or folic acid.
3. Use according to Claim 2, wherein the anti-inflammatory agent is methotrexate (MTX).
4. Use according to any one of Claims 1 to 3, wherein the treatment is systemic.
5. Use according to Claim 4, wherein the treatment is oral.
6. Use of an agent for the preparation of pharmaceutical composition for treating an individual afflicted with an inflammatory condition or disease; the agent comprising one or more members of the group consisting of: (i) a polyoxyl hydrogenated castor oil; (ii) a reaction product of ethylene oxide with hydrogenated castor oil; (iii) one or more of a glycerol polyethylene glycol oxystearate and a fatty acid glycerol polyglycol ester, combined with one or more of a polyethylene glycol and glycerol ethoxylate; (iv) one or combination of plant-derived medium chain triglycerides.
7. Use according to Claim 6, wherein said pharmaceutical composition is intended for treatment of an individual in combination with one or more of an A3 adenosine receptor agonist, an anti-inflammatory agent or folic acid.
8. Use according to Claim 7, wherein said anti-inflammatory agent is MTX.
9. Use according to any one of Claims 6 to 8, for the preparation of a composition for systemic administration.
10. Use according to Claim 9, for the preparation of a composition for oral administration.
11. Use according to any one of Claims 1 to 10, wherein said agent comprises a combination of a hydrophobic part and a hydrophilic part, said hydrophobic part comprises said glycerol polyethylene glycol oxystearate and said fatty acid glycerol polyglycol ester, and said hydrophilic part comprises said polyethylene glycol and said glycerol ethoxylate.
12. Use according to any one of Claims 1 to 11, wherein said agent is obtained by reacting ethylene oxide with hydrogenated castor oil at a molar ration of ethylene oxide to hydrogenated castor oil of about 30-60 to 1.
13. Use according to Claim 12, wherein said ethylene oxide :hydrogenated castor oil ration is about 45:1.
14. Use according to any one of Claims 1 to 13, wherein said agent is a non-ionic agent characterized by one or more of a saponification value of between 40 to 60 and a hydroxyl value of between 50 to 75.
15. Use according to Claim 14, wherein said agent is characterized by a saponification value of 50 to 60 and a hydroxyl value of 60 to 75.
16. Use according to any one of Claims 1 to 10, wherein said one or combination of plant-derived medium chain triglycerides comprises a C6 to Ci4 neutral fatty acid.
17. Use according to Claim 16, wherein said one or combination of plant-derived medium chain triglycerides comprises one or more members of the group consisting of caproic acid (C6:0); caprylic acid (C8:0); capric acid (C10:0); lauric acid (C12:0) and myristic acid (C14:0).
18. Use according to any one of Claims 1 to 10, wherein said one or combination of plant-derived medium chain triglycerides comprises fractionated Coconut oil.
19. Use according to any one of Claims 1 to 18, wherein said inflammatory condition or disease is an autoimmune disease.
20. Use according to Claim 19, wherein said autoimmune disease is selected from rheumatoid arthritis (RA), psoriasis, psoriatic arthritis, Crohn's disease, multiple sclerosis (MS), the autoimmune stage of diabetes mellitus (juvenile-onset or type I diabetes), autoimmune uveoretinitis (AUR).
21. A method of treatment of an individual afflicted with an inflammatory condition or disease, comprising administering to the individual an amount of an agent effective to induce an anti-inflammatory effect, the agent comprising one or more members of the group consisting of: (i) a polyoxyl hydrogenated castor oil; (ii) a reaction product of ethylene oxide with hydrogenated castor oil; (iii) one or more of a glycerol polyethylene glycol oxystearate and a fatty acid glycerol polyglycol ester, combined with one or more of a polyethylene glycol and glycerol ethoxylate; (iv) one or combination of plant-derived medium chain triglycerides.
22. The method of Claim 21, being for systemic treatment.
23. The method of claim 21 or 22, being for oral treatment.
24. The method of any one of Claims 21 to 23, wherein said agent is as defined in any one of Claims 11 to 18.
25. The method of any one of Claims 21 to 24, for the treatment of an autoimmune disease.
26. The method of Claim 25, wherein said autoimmune disease is selected from rheumatoid arthritis (RA), psoriasis, psoriatic arthritis, Crohn's disease, multiple sclerosis (MS), the autoimmune stage of diabetes mellitus (juvenile-onset or type I diabetes), autoimmune uveoretinitis (AUR).
27. The method of any one of Claims 21 to 26, comprising treatment with one or more of an adenosine A3 receptor agonist, folic acid or an anti-inflammatory agent.
28. The method of Claim 27, wherein said anti-inflammatory agent comprises MTX.
29. A pharmaceutical composition for the treatment of an inflammatory condition or disease comprising as active agent an amount of one or more members of the group consisting of: (i) a polyoxyl hydrogenated castor oil; (ii) a reaction product of ethylene oxide with hydrogenated castor oil; (iii) one or more of a glycerol polyethylene glycol oxystearate and a fatty acid glycerol polyglycol ester, combined with one or more of a polyethylene glycol and glycerol ethoxylate; (iv) one or combination of plant-derived medium chain triglycerides; the amount of the agent being effective to induce an antiinflammatory effect in an individual afflicted with an inflammatory condition or disease.
30. The pharmaceutical composition of Claim 29, comprising a physiologically acceptable carrier for systemic delivery of said active agent.
31. The pharmaceutical composition of Claim 30, wherein said carrier is for oral delivery of said active agent.
32. The pharmaceutical composition of any one of Claims 29 to 31 , wherein said agent is as defined in any one of Claims 11 to 18.
33. The pharmaceutical composition of any one of Claims 29 to 32, wherein said inflammatory condition or disease is an autoimmune disease.
34. The pharmaceutical composition of Claim 33, wherein said autoimmune disease is selected from rheumatoid arthritis (RA), psoriasis, psoriatic arthritis, Crohn's disease, multiple sclerosis (MS), the autoimmune stage of diabetes mellitus (juvenile- onset or type I diabetes), autoimmune uveoretinitis (AUR).
PCT/IL2008/000976 2007-07-15 2008-07-15 An agent for treatment of inflammation WO2009010967A1 (en)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
IL184620 2007-07-15
IL184620A IL184620A0 (en) 2007-07-15 2007-07-15 Composition for the treatment of inflammation
US92994107P 2007-07-18 2007-07-18
US60/929,941 2007-07-18

Publications (1)

Publication Number Publication Date
WO2009010967A1 true WO2009010967A1 (en) 2009-01-22

Family

ID=39941836

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IL2008/000976 WO2009010967A1 (en) 2007-07-15 2008-07-15 An agent for treatment of inflammation

Country Status (2)

Country Link
IL (1) IL184620A0 (en)
WO (1) WO2009010967A1 (en)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20120165284A1 (en) * 2009-09-06 2012-06-28 Can-Fite Biopharma Ltd. Pharmaceutical composition comprising a3 adenosine receptor agonist (ib-meca/cf-101) for treatment of psoriasis

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3620674A1 (en) * 1986-06-20 1987-12-23 Nattermann A & Cie Ointment for the treatment of skin diseases
EP0274870A2 (en) * 1986-12-18 1988-07-20 Cortecs Limited Micelles containing a non-steroidal antiinflammatory compound
US5583153A (en) * 1994-10-06 1996-12-10 Regents Of The University Of California Use of taxol in the treatment of rheumatoid arthritis
US20020032171A1 (en) * 1999-06-30 2002-03-14 Feng-Jing Chen Clear oil-containing pharmaceutical compositions containing a therapeutic agent
WO2004110380A2 (en) * 2003-06-11 2004-12-23 Novacea, Inc. Treatment of immune-mediated disorders with active vitamin d compounds alone or in combination with other therapeutic agents
WO2007063538A1 (en) * 2005-11-30 2007-06-07 Can-Fite Biopharma Ltd. Use of a3 adenosine receptor agonist in osteoarthritis treatment
WO2007086044A1 (en) * 2006-01-27 2007-08-02 Can-Fite Biopharma Ltd. Adenosine a3 receptor agonists for the treatment of dry eye disorders

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3620674A1 (en) * 1986-06-20 1987-12-23 Nattermann A & Cie Ointment for the treatment of skin diseases
EP0274870A2 (en) * 1986-12-18 1988-07-20 Cortecs Limited Micelles containing a non-steroidal antiinflammatory compound
US5583153A (en) * 1994-10-06 1996-12-10 Regents Of The University Of California Use of taxol in the treatment of rheumatoid arthritis
US20020032171A1 (en) * 1999-06-30 2002-03-14 Feng-Jing Chen Clear oil-containing pharmaceutical compositions containing a therapeutic agent
WO2004110380A2 (en) * 2003-06-11 2004-12-23 Novacea, Inc. Treatment of immune-mediated disorders with active vitamin d compounds alone or in combination with other therapeutic agents
WO2007063538A1 (en) * 2005-11-30 2007-06-07 Can-Fite Biopharma Ltd. Use of a3 adenosine receptor agonist in osteoarthritis treatment
WO2007086044A1 (en) * 2006-01-27 2007-08-02 Can-Fite Biopharma Ltd. Adenosine a3 receptor agonists for the treatment of dry eye disorders

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20120165284A1 (en) * 2009-09-06 2012-06-28 Can-Fite Biopharma Ltd. Pharmaceutical composition comprising a3 adenosine receptor agonist (ib-meca/cf-101) for treatment of psoriasis
US8987228B2 (en) * 2009-09-06 2015-03-24 Can-Fite Biopharma Ltd. Pharmaceutical composition including an A3 adenosine receptor agonist 1-deooxy-1-[N6-(3-idobenzyl)-adenin-9-yl]-N-methyl-β-D-ribofuronamide(IB-MECA/CF-101) for treatment of psoriasis

Also Published As

Publication number Publication date
IL184620A0 (en) 2008-01-20

Similar Documents

Publication Publication Date Title
AU2012221704B2 (en) Flumazenil complexes, compositions comprising same and uses thereof
Kovarik et al. Effect of food on everolimus absorption: quantification in healthy subjects and a confirmatory screening in patients with renal transplants
HK1226940A1 (en) Treatment of multiple sclerosis with combination of laquinimod and glatiramer acetate
KR20130014523A (en) Treatment of rheumatoid arthritis with a combination of laquinimod and methotrexate
EP4570314A2 (en) Sacubitril-valsartan dosage regimen for treating chronic systolic heart failure
AU2018334467A1 (en) Method and improved neuroprotective composition for treating neurological conditions
JP7293129B2 (en) Pharmaceutical compositions containing PDE9 inhibitors
US20080188497A1 (en) Dipyridamole, Acetylsalicylic Acid, and Angiotensin II Antagonist Pharmaceutical Compositions
US11744829B2 (en) Methods for treating neurological conditions and exposure to nerve agents
JP2020523334A (en) Vibegron dosing for the treatment of overactive bladder
AU5198301A (en) The use of growth hormone secretagogues to treat systemic lupus erythematosus and inflammatory bowel disease
Cranswick et al. Levocetirizine in 1-2 year old children: pharmacokinetic and pharmacodynamic profile
JP5956868B2 (en) Composition for treating frequent urination containing loxoprofen and peppermint extract
WO2009010967A1 (en) An agent for treatment of inflammation
Sanford et al. Enteric-coated mycophenolate sodium: a review of its use in the prevention of renal transplant rejection
KR20250040645A (en) Therapeutic tyrosine kinase inhibitors for multiple sclerosis and myasthenia gravis
KR20090024248A (en) Pharmaceutical formulations and compositions of selective antagonists of CBCR2 or selective antagonists of both CBCR1 and CBCR2, and methods of use thereof for treating inflammatory diseases
Ponticelli et al. The pharmacology of old and new agents for specific therapy of primary glomerular diseases
JPH06500129A (en) nucleoside derivatives
US20140194428A1 (en) Combination treatments for bipolar disorders
WO2023150336A1 (en) Methods of treating complex regional pain syndrome
Peck et al. Multiple dose netivudine, a potent anti-varicella zoster virus agent, in healthy elderly volunteers and patients with shingles
WO2008143491A1 (en) Pharmaceutical compositions combining a hydrogenated lipstatin derived agent and a hmg-coa reductase inhibiting agent
O’Connell et al. New drugs for pulmonary hypertension
Brampton PrRAN™-MYCOPHENOLATE

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 08776609

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 08776609

Country of ref document: EP

Kind code of ref document: A1