The present invention relates to methods for preventing and/or treating multiple organ failure.
Onset or exacerbation of multiple organ failure can be classified into the following three categories with respect to mechanism: (1) parallel induction of several organ disorders due to the same factor, (2) induction of a specific organ dysfunction due to disorder of an organ; and (3) participation of an iatrogenic factor. Excessive insults due to severe trauma, major surgeries, infectious diseases, or shock, either directly or through various kinds of mediator, participate in the onset or deterioration of multiple organ failure by mechanism (1). In the case of multiple organ failure accompanied with organ disorder due to trauma or primary hepatic insufficiency, participation of mechanism (2) through organ correlation mechanism will largely contribute to the onset or deterioration thereof. By mechanism (3), medical care carried out during intensive care or care to correspond with an organ disorder may result in the other organ disorder. In patients, these three mechanisms participate to the development or deterioration of multiple organ failure in a complex manner. The prognosis of patients of multiple organ failure is generally very poor and, in fact, the survival rate is low as 20–30% in spite of a wide variety of corresponding treatments.
The present inventors searched for an agent for preventing and/or treating multiple organ failure and found that multiple organ failure caused by burn, disseminated intravascular coagulation (DIC), circulatory failure, hemorrhagic shock, infectious disease, acute pancreatitis, ischemic disorder, hepatorenal syndrome, gastrointestinal hemorrhage, nutritional metabolic failure, terminal cancer, acquired immunodeficiency syndrome (AIDS), deterioration of systemic conditions due to radiation affection and cachexia can be prevented or treated with tumor cytotoxic factor-II (TCF-II) which is a glycoprotein derived from human fibroblast or hepatocyte growth factor (HGF) which is a proteineous substance derived from blood of a patient with fulminating hepatitis. Accordingly, an object of the present invention is to provide an agent for preventing and/or treating multiple organ failure comprising TCF-II or HGF as an effective ingredient.
In
The agent of the present invention for preventing and/or treating multiple organ failure can be useful for preventing and/or treating the development from burn, disseminated intravascular coagulation (DIC), circulatory failure, hemorrhagic shock, infectious disease, acute pancreatitis, ischemic disorder, hepatorenal syndrome, gastrointestinal hemorrhage, nutritional metabolic failure, terminal cancer, acquired immunodeficiency syndrome (AIDS), deterioration of systemic conditions due to radiation affection and cachexia etc. These kinds of multiple organ failure may result from burn, surgical operation, administration of chemical substances (including medicine), radiation, or other disorder.
TCF-II, which is an effective ingredient of the present invention, is a glycoprotein derived from human fibroblast having the following characteristics:
TCF-II can be obtained by adsorbing culture medium of human fibroblast on an ion exchange column then purifying the elute by affinity chromatography (as described in WO 90/10651) or by genetic engineering manipulation (as described in WO 92/01053). TCF-II which is an effective ingredient of the present invention can be derived from fibroblast or produced by genetic engineering manipulation using microbial cells or other cells based on the genetic sequence described in patent application WO 90/10651. Further, TCF-II obtained by genetic engineering manipulation described in WO 92/01053 can be also used.
TCF-II with different carbohydrate chain or without carbohydrate chain due to difference of host cell or microbial organism can be also used. However, since carbohydrate chain correlate to metabolic rate in a biological body, a TCF-II protein with carbohydrate chain can be preferably used.
TCF-II obtained by the methods described above can be concentrated and purified by isolation and purification methods known in the art. For example, TCF-II may be purified by precipitation with organic solvent, salting-out, gel permeation, affinity chromatography using monoclonal antibody, or electrophoresis. Purification by affinity chromatography using monoclonal antibody can be carried out using monoclonal antibody described in Japanese unexamined laid open patent application No. 97(1993). TCF-II thus obtained can be lyophilized or frozen.
Substances having the same activity as TCF-II can be used as the agent of the present invention. For example, hepatocyte growth factor (HGF) (described in Japanese unexamined laid open patent application No. 22526 (1988)) can be used as the agent of the present invention. HGF is formed by insertion of 5 amino acids into TCF-II protein or Scattered Factor (SF); Gherardi and Stocker, Nature, 346, 228 (1990).
HGF, which is an effective ingredient has an activity of inducing proliferation of hepatic cells, was isolated from the blood of a patient with fulminating hepatitis and is a known protein with the following characteristics (as described in Japanese Patent No. 2564486):
1) Molecular weight (SDS-PAGE); under non-reducing conditions is 76,000–92,000;
2) The ability of HGF to induce hepatic cell proliferation was not deactivated by heating the HGF protein at 56° C. for 15 minutes, but heating the HGF protein at 80° C. for 10 minutes did deactivated the ability of HGF to induce hepatic cell proliferation;
3) Digestion with trypsin or chymotrypsin deactivated the ability of HGF to induce hepatic cell proliferation; and
4) HGF demonstrates an affinity with heparin.
HGF can be obtained by heating plasma at 56° C. for about 15 minutes, taking precipitated fraction at the ammonium sulfate concentration of 1.1–1.2 M, followed by purification using gel permeation and ion exchange chromatography such as DEAE anion exchange chromatography. Alternatively, HGF can be obtained by genetic engineering manipulation using HGF cDNA (BRRC 163, 967–973, 1989, or Japanese unexamined laid open Patent Application No. 97 (1993)).
The agent of the present invention for preventing and/or treating multiple organ failure can be administered intravenously, intramuscularly or subcutaneously. These pharmaceutical preparations can be prepared according to a known pharmaceutical preparation methods and, if necessary, pH conditioner, buffer and/or stabilizer can be added thereto. Dosage of the present agent can be different depending on the severity of symptom, health conditions, age, body weight of a patient. Though the dose will not be restricted, pharmaceutical preparation comprising 0.6 mg-600 mg-TCF-11/day is preferred, and pharmaceutical preparations comprising 6 mg-60 mg-TCF-II/day are most preferred. The preparation can be administered to an adult person in a single dose or in multiple doses. The dose of HGF can be nearly the same as that of TCF-II.
Administration as described above can prevent multiple organ failure caused by various kinds of mechanism described before or alleviate symptom thereof.
The present invention will be described below in detail by the following examples. However, these are only examples and the present invention will not limited thereby.
According to a method described in WO 90/10651 and the method of Higashio et. al. (Higashio, K et. al, B.B.R.C., Vol. 170, pp 397–404 (1990)), human fibroblast cells were cultured to obtain purified TCF-II. 3×106 human fibroblast IMR-90 (ATCC CCL 186) cells were placed in a roller bottle containing 100 ml DMEM medium including 5% calf fetal serum and cultured by rotating it at the rate of 0.5–2 rpm for 7 days. When the total number of cells reached 1×107 the cells were detached from the walls of the roller bottle by trypsin digestion and collected at the bottom of bottle. 100 g of ceramic with the size of 5–9 mesh (Toshiba Ceramic) was sterilized and place in the roller bottle, Culture was continued for 24 hours. After then, 500 ml of the above culture medium was added to the roller bottle and the culture was again continued. The total volume of culture medium was recovered every 7–10 days and fresh medium was supplemented. Production continued in this manner for 2 months and 4 liters of culture medium was recovered per roller bottle. The specific activity of TCF-II in culture medium obtained by the method described above was 32 μg/ml. Culture medium (750 L) was concentrated by ultrafiltration using membrane filter (MW 6,000 cut; Amicon) and purified by 4-step chromatography, that is, CM-Sephadex C-50 (Pharmacia), Con-A Sepharose (Pharmacia), Mono S column (Pharmacia), Heparin-Sepharose (Pharmacia) to yield purified TCF-II. This TCF-II had the same weight and isoelectric, point as described above.
According to the method described in WO 92/01053, cells transformed with TCF-II gene were cultured and purified TCF-II was obtained. That is, transformed Namalwa cell was cultured and 20 L of culture medium was obtained. This culture medium was treated by CM-Sephadex C-50 chromatography, Con-A Sepharose CL-6B chromatography, and finally HPLC equipped with a Mono S column to yield about 11 mg of recombinant TCF-II. This TCF-II had the same molecular weight and isoelectric, point as described above.
Expression vector of HGF cDNA was constructed by inserting 2.4 kb fragment of transcription unit of mouse dihydrofolate reductase (DBFR) into Nhe I site of plasmid pcDNA1 and, further, inserting 2.3 kb of HGF cDNA cloned by Miyazawa (BBRC 163, 967–973, 1999) into the downstream of cytomegalovirus (CMV) promoter. The constructed HGF cDNA expression vector (μg and pSV2 neo 1 μg) were co-transfected into Namalwa cell by liposome intervened transfection method using LIPOFECTIN® (N-[1-(2,3-dioleyloxy)propyl]-n,n,n-trimethlammonium chloride (DOTMA) and dioleoyl phosphotidylethanolamine (DOPE)), Life Technologies, Inc., Gaithersburg, Md. After transformed cells were screened by G418 resistance, gene amplification was carried out using methotrexate (MTX). HGF highly producing cell line was cultured in 2 L roller bottles containing 1 L DMEM medium including 5% bovine serum for 7 days. Culture was carried out using 20 roller bottles (2 rpm) and 21 L of culture medium was obtained. The culture medium obtained contained 4 mg/L HGF.
According to a modified method of Higashio (Higashio et. al., vol. 170, 397–404, 1990), 20 L of culture medium containing HGF was purified by 3 step chromatography, that is, CM-Sephadex C-50 (Pharmacia), Mono S column (Pharmacia) and Heparin 5-PW (Toso) and purified HGF with homogeneous mobility of SDS-electrophoresis was obtained in about 60% yield.
TCF-II (100 μg/mouse) obtained in Example 2 was administered intravenously to 7 week old male ICR mice (25 mice/group) twice daily for 5 days (only at the final day, once a day). The control group was treated with the vehicle, citric acid buffer solution with pH 6.03, hereinafter the same solution was used as control group). At 6 hours after the final administration, lethal dose of endotoxin (E coli lipopolysaccharide (LPS); 20 mg/kg, Difco Laboratories, Detroit, Mich.) was administered intravenously. The survival rates thereof was shown in
From these results, TCF-II was confirmed to show an excellent protective effect on endotoxin-induced multiple organ failure.
HGF (100 μg/mouse) obtained in by the method described in Example 3 was administered intravenously to 7 weekold male ICR mice (15 mice/group) twice daily for 5 days (only at the final day, once a day). The control group was treated with the vehicle (citric acid buffer solution with pH 6.03). At 6 hours after the final administration, lethal dose of endotoxin (E coli lipopolysaccharide (LPS); 20 mg/kg, Difco Laboratories, Detroit, Mich.) was administered intravenously. The survival rates for the two groups is shown in
Animal model of multiple organ failure was made by continuously injecting endotoxin (E coli lipopolysaccharide (LPS); 10 mg.kg/day, Difco Laboratories, Detroit, Mich.) to 6 week old male Wister rats using osmotic pump (Model 7 I2001, Alzet). After then, animals were divided into two groups (9 rats/group) and Vehicle or TCF-II (1 mg/kg) was administered intravenously once a day for 7 days. The results of clinical examination at the day after the final administration are shown in Table 1. In the vehicle group, the serum levels of total protein, albumin, total cholesterol and the plasma levels of plasminogen were decreased the day after the final administration, indicating that these rats were developing cachexia, but those in TCF-II treated group were significantly improved (Table 1). From these results, TCF-II was confirmed to show an excellent protective effect on multiple organ failure caused by endotoxin-induced cachexia.
TCF-II (100 μg/mouse) was administered intravenously to 7 weeks old male ICR mice (25 mice/group) twice daily for 5 days (only at the final day, once a day). The control group was treated with the vehicle. At 6 hours after the final administration, a lethal dose of 0.15% dimethynitrosoamine (DMN) (vehicle: physiological saline solution, 0.1 ml/10 g body weight, Tokyo-kasei-kogyo) was administered intravenously. The results of clinical examination of mice at 24 hours after the onset is shown in Table 2 and the survival rates of both groups of mice are shown in
TCF-II (100 μg/mouse) was administered intravenously to 7 week old male ICR mice (25 mice/group) twice daily for 5 days (only at the final day, once a day). The control group was treated with the vehicle. At 6 hours after the final administration, a lethal dose of thioacetamide (600 mg/kg Wako-junyaku) or acetaminophen (800 mg/kg, Sigma) was administered. The survival rates for both groups are shown in
TCF-II (1 μg/mouse) was administered intravenously to 7 week old male ICR mice (25 mice/group) twice daily for 5 days (only at the final day, once a day). The control group was treated with the vehicle. At 6 hours after, the final administration, lethal dose of mercuric chloride (Wako-junyaku) was administered intravenously. The survival rates of both groups are shown in
From these results, TCF-II was confirmed to show an excellent protective effect on multiple organ failure caused by mercuric chloride-induced.
Vehicle (55 rats/group) or 1 mg/kg TCF-II (35 rats/group) was administered intravenously to 8 week old male Wister rats twice daily for 5 days (10 times). At the day after the final administration, 0.16 ml of mixed solution of lethal dose of trypsin (Sigma; 50000 U/ml) and taurocolic acid (Sanko-junyaku; 100 mg/ml) was injected into pancreas through the common bile duct. The survival rates for both groups are shown in
Vehicle or 1 mg/kg TCF-II was administered intravenously to 7 week old male Wister rats (50 rats/group) twice daily for 6 days (only once a day on the final day). At 6 hours after the final administration, 25% burn (250° C., 30 sec.) was made on shaved back with a heating plate (Iwaki-glass). The survival rates of both groups are shown in
In 9 week old male Wister rats, 40% burn was made using 85° C. hot water. After burn, rats were divided into 2 groups consisting of 27 rats each. Vehicle or 1 mg/kg TCF-II was administered intravenously 3 times/daily for 3 days (9 times). The survival rates of both groups are shown in
In 9 week old male Wister rats, 40% burn was made using 85° C. hot water. After burn, rats were divided into 2 groups consisting of 10 rats each. Vehicle or 1 mg/kg HGF was administered intravenously 3 times/daily for 3 days (9 times). The survival rates for both groups are shown in
An example of manufacturing injections of recombinant TCF-II obtained by the method described in Example 2 was shown.
The above composition was dissolved in citric acid buffer solution with pH 6.03 (consisting of 10 mM sodium citrate, 0.3 M sodium chloride, 0.03% polysolbate) so that the total volume would be 20 ml. The solution was then divided into vials containing 2 ml each after sterilization and sealed after lyophilization.
The above composition was dissolved in physiological saline solution for injections so that the total volume would be 20 ml. The solution was then divided into vials containing 2 ml each after sterilization and sealed after lyophilization.
The above composition was dissolved in citric acid buffer solution with pH 6.03 so that the total volume would be 20 ml. The solution was then was divided into vials containing 2 ml each after sterilization and sealed after lyophilization.
The above composition was dissolved in physiological saline solution for injections so that the total volume would be 20 ml. The solution was then was divided into vials containing 2 ml each after sterilization and sealed after lyophilization.
The above composition was dissolved in physiological saline solution for injections so that the total volume would be 20 ml. The solution was then was divided into vials containing 2 ml each after sterilization and seated after lyophilization.
The above composition was dissolved in citric acid buffer solution with pH 6.03 so that the total volume would be 20 ml. The solution was then divided into vials containing 2 ml each after sterilization and sealed after lyophilization.
The above composition was dissolved in physiological saline solution for injections so that the total volume would be 20 ml. The solution was then divided into vials containing 2 ml each after sterilization and sealed after lyophilization.
The above composition was dissolved in citric acid buffer solution with pH 6.03 so that the total volume would be 20 ml. The solution was then divided into vials containing 2 ml each after sterilization arid sealed after lyophilization.
An example of manufacturing injections of recombinant HGF obtained by the method described in Example 3 was shown.
The above composition was dissolved in citric acid buffer solution with pH 6.03 so that the total volume would be 20 ml. The solution was then divided into vials containing 2 ml each after sterilization and sealed after lyophilization.
The above composition was dissolved in physiological saline solution for injections so that the total volume would be 20 ml. The solution was then divided into vials containing 2 ml each after sterilization and sealed after lyophilization.
The above composition was dissolved in 0.01 M phosphate buffer solution with pH 7.0 so that the total volume would be 20 ml. The solution was then divided into vials containing 2 ml each after sterilization and sealed after lyophilization.
An agent is provided for preventing and/or treating multiple organ failure comprising TCF-II or HGF as an effective ingredient is provided by the present invention. The agent for preventing and/or treating multiple organ failure of the present invention will be useful for preventing and/or treating the development from burn, disseminated intravascular coagulation (DIC), circulatory failure, hemorrhagic shock, infectious disease, acute pancreatitis, ischemic disorder, hepatorenal syndrome, gastrointestinal hemorrhage, nutritional metabolic failure, terminal cancer, acquired immunodeficiency syndrome (AIDS), deterioration of systemic conditions due to radiation affection and cachexia to multiple organ failure.
Number | Date | Country | Kind |
---|---|---|---|
9-074372 | Mar 1997 | JP | national |
9-157645 | May 1997 | JP | national |
This application is a continuation of U.S. patent application Ser. No. 09/180,599 filed on Aug. 27, 1999 now abandoned, which is the U.S. National Phase Application of International Patent Application PCT/JP98/00998, filed on Mar. 11, 1998, which claims priority to Japanese Patent Application No. 74372, filed on Mar. 11, 1997, and Japanese Patent Application No. 157645, filed on May 30, 1997, the disclosures of each of the foregoing are herein incorporated by reference.
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Child | 10317011 | US |