Drug – bio-affecting and body treating compositions – Designated organic active ingredient containing – Ester doai
Reexamination Certificate
1999-12-16
2003-07-22
Pryor, Alton N. (Department: 1616)
Drug, bio-affecting and body treating compositions
Designated organic active ingredient containing
Ester doai
C514S513000, C514S558000, C514S560000, C514S724000, C514S739000
Reexamination Certificate
active
06596763
ABSTRACT:
FIELD OF THE INVENTION
This application is a 371 of PCT/PK97/00524 filed Nov. 14, 1997.
This invention relates to novel valuable uses of microbicidal lipids, in particular to a method for counteracting infection of the genital mucosa of a mammal by virus, pathogenic bacteria or fungi. The invention also relates to novel pharmaceutical formulations which may be used in the method as well as for other valuable uses such as for application to skin or non-genital mucosa.
BACKGROUND OF THE INVENTION
Use of microbicidal compounds in prevention of HIV infection and other sexually transmitted diseases (STD)
The World Health Organization (WHO) has estimated that as of late 1993 15 million adults and children world-wide were infected with HIV and that, in that year, heterosexual transmission accounted for up to 90% of new infections. It is projected that by the year 2000 the cumulative number of HIV infected individuals will reach 30 to 40 million people (Report of a meeting on the development of vaginal microbicides for the prevention of heterosexual transmission of HIV, WHO/GPA/RID/CRD/94.1, Geneva, Switzerland, 1993). Infections are on the rise in the developing countries, particularly in South and Southeast Asia, where the epidemic is to an increasing extent affecting young women of childbearing age. Also in the U.S. and other western societies, heterosexual transmission is causing an increasing proportion of AIDS cases (A. R. Lifson, Preventing HIV: have we lost our way? The Lancet 343, 1306-1307, 1994). These facts emphasise the need for effective means of protection against heterosexual transmission of HIV.
Three types of preventive methods can be used: i) a physical barrier provided by e.g. a condom, ii) a chemical barrier provided by an intravaginal microbicide, and iii) an immunological barrier provided by mucosal immunity resulting from a prophylactic vaccine (C. J. Elias and L. L. Heise, Challenges for the development of female-controlled vaginal microbicides. AIDS 8,1-9,1994).
Since HIV vaccines giving mucosal protection are probably many years away and condoms, although highly effective in preventing HIV infection, have failed to become generally accepted by males in many parts of the world, protective means are required which are under the control of the woman and can, if necessary, be used without the knowledge or consent of the male partner. Vaginal microbicides would meet this requirement and could not only protect the female's reproductive tract against infectious agents in the semen, but could vice versa protect the male's genital mucosa against possible infectious agents in the female's vaginal secretions.
Three types of vaginal microbicides have been considered: i) the microbicides which kill free viruses and virus-infected cells on contact before they can infect the mucosal epithelial cells or lymphocytes and monocytes/macrophages in the mucosa, ii) compounds which prevent infection of mucosal cells by free or cell-associated virus. These include polyanionic polysaccharides and related compounds which are inhibitors of virus adsorption but do not kill virus or virus-infected cells at inhibitory concentrations, and iii) compounds which inhibit replication of virus in infected cells and thus stop the infection locally. Such compounds include, for example, reverse transcriptase inhibitors. The two latter types of compounds are non-contraceptive, i.e. they do not kill sperm cells and are therefore advantageous for women who desire conception but require protection against HIV infection. They are generally water-soluble and supposedly have low toxicity for mucosal membranes. On the other hand, they do not have the broad antimicrobial activity of the membrane-disruptive microbicides, many of which kill a variety of agents causing STD in addition to being spermicidal. A number of products which have been licensed and used as vaginal spermicides have been shown in vitro to have a broad activity against sexually transmitted pathogens including HIV. They include for example nonoxynol-9, octoxynol-9, benzalkonium chloride and menfegol which are used in the form of foams, jellies, creams, sponges, foaming tablets, suppositories, and as coating for condoms. (M. J. Rosenberg, K. K. Holmes et al. Virucides in prevention of HIV infection, Sex. Trans. Dis. 20, 41-44, 1993). In addition to their in vitro activities there is some evidence of in vivo efficacy against gonococcal and clamydial infections (W. C. Louv, et al. A clinical trial of nonoxynol-9 for preventing gonococcal and clamydial infections. J. Infect. Dis. 158, 518-523, 1988). The microbicidal activity of nonoxynol-9 has been studied both in vitro and in vivo. However, the results of clinical trials have been controversial (L. Zekeng et al. Barrier contraceptive use and HIV infection among high-risk women in Cameroon. AIDS 7, 725-731, 1993), but when used frequently or at a high dose nonoxynol-9 may cause vaginal and cervical lesions which could increase the risk of HIV transmission.
Accordingly, there is a need for new products which can be used frequently without adverse effects.
A microbicidal compound should fulfil a number of criteria to qualify as a safe and effective measure for prevention of sexually transmitted HIV infection. Since evidence suggests that HIV-infected lymphocytes and macrophages are the primary infectious elements in semen (D. J. Anderson, Mechanisms of HIV-1 transmission via semen. J. NIH Res. 4, 104, 1992; D. M. Philips and A. S. Bourinbaiar, Mechanism of HIV spread from lymphocytes to epithelia. Virology 186, 261-273, 1992), the compound should efficiently kill these cells in addition to killing free virus in the semen. Preferably, it should also kill other agents transmitting STD, since lesions in the genital mucosa caused by these agents may promote HIV transmission. It should not cause ulcers or other lesions in the genital mucosa and it should not adversely affect the vaginal environment, such as the vaginal flora and pH. Preferably, it should be stable and inexpensive.
Microbicidal Lipids
There are several published reports on antiviral and antibacterial activities of milk lipids (J. K. Welsh et al. Use of Semliki Forest virus to identify lipid-mediated antiviral activity and anti-alphavirus immunoglobulin A in human milk, Infect. Immun. 19, 395-401, 1978; J. K. Welsh et al. Effect of antiviral lipids, heat and freezing on the activity of viruses in human milk, J. Infect. Dis. 140,322-328,1979; J. J. Kabara, Fatty acids and derivatives as antimicrobial agents. In: The pharmacological effect of lipids. Edited by J. J. Kabara. The American Oil Chemists Society, St.Louis, Mo., 1978, pp. 1-13; C. E. Isaacs, H. Thormar et al., Membrane disruptive effect of human milk: Inactivation of enveloped viruses, J. Infect. Dis. 154, 966-971, 1986; C. E. Isaacs and H. Thormar, Human milk lipids inactivate enveloped viruses. In: Breast feeding, Nutrition, Infection and Infant Growth in Developed and Emerging Countries. Edited by S. A. Atkinson, L. A Hanson, R. K. Chandra. ARTS Biomedical Publ. St. Johns, Newfoundland, Canada. 1990, pp. 161-174; C. E. Isaacs et al., Antiviral and antibacterial lipids in human milk and infant formula feeds, Arch. Dis. Childhood 65, 861-864, 1990; C. E. Isaacs and H. Thormar, The role of milk-derived antimicrobial lipids as antiviral and antibacterial agents. In: Immunology of Milk and the Neonate. Edited by J. Mestecky et al. Plenum Press, 1991, pp. 159-165; C. E. Isaacs et al., Addition of lipases to infant formulas produces antiviral and antibacterial activity, J. Nutr. Biochem. 3, 304-308, 1992; C. E. Isaacs et al. Antimicrobial activity of lipids added to human milk, infant formula, and bovine milk, Nutr. Biochem. 6, 362-366, 1995) where the active lipids are free fatty acids and monoglycerides which are released from triglycerides in the milk by milk lipases or lipases of the gastrointestinal tract.
The virucidal effect of purified lipids has been studied in cell culture media (H. Thormar, C. E. Isaacs et al., Inactivation of enveloped viruses an
Kristmundsdottir Thordis
Thormar Halldor
Lipomedica ehf.
Pryor Alton N.
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