The present invention is an anti-microbial composition of buckminsterfullerene with one or more galloyl functional groups, where these can include a quinic acid ester (catechin) or a benzo-hydropyran of at least one of a tri-hydroxyphenyl group or a di-hydroxyphenyl group and may also include disodium phosphonate groups. One formulation of this composition is in topical beauty products to mitigate the cellular effects of skin aging and chronic infection by skin bacterial and fungal spores. Another formulation of this composition combats periodontal disease, especially in the case of antibiotic resistant esophageal bacteria. The utility of this and other uses simultaneously and synergistically is to prevent or help treat uncontrolled microbial proliferation, and respiratory ailments such as bronchitis and chronic obstructive pulmonary disease (COPD). The provided delivery methods include ingestion, topical application, buccal application, inhalation, or injection. The composition can be formulated as a prophylactic medicament or used as a food supplement.
Green tea is recognized as the most effective cancer prevention drink in the world. Many or most cancers are microbially induced, such as by a chronic virus, or fungal infection. The cancer and antimicrobial protection properties of various tea extracts are widely known and are clearly linked to a group of polyphenols of a type of flavanol derivatives, or flavonoids. These flavonoids have a chemical structure known as a flavan-3-ol that each possess a 2-phenyl-3,4-dihydro-2H-chromen-3-ol skeleton. Of these flavan-3-ols, there are four highly similar, structurally related catechin molecules that have been identified in green tea as being most efficacious. These catechins are EC (epicatechin), epicatechin gallate (ECG), epigallocatechin (EGC), and epigallocatechin gallate (EGCG). The similarity in both structure and nomenclature can sometimes lead to some confusion. In comparison medical studies, however, EGCG has been demonstrated to provide the most effective and prominent antimicrobial properties of each of these catechin variations, perhaps because the related less molecular weight substances are both more reactive and less thermally stable.
A different class of molecules also having benzo hydropyran groups are the tannins, which have at least one central glucose molecule as their distinguishing characteristic feature. Once benzene is derivatized with hydroxyl groups (OH) these groups are also known as phenyl groups. There are many types of tannins, and their structures may vary widely in the number of di-phenyl benzene and tri-phenyl benzene groups. Many of the tannins can become too large to be of effective use because of poor solubility, especially when multiple glucose groups become entrained into their structures. Of the family of tannins, one molecular member, a very simple one, called tannic acid or penta-m-digalloyl-glucose, has been found to be both low enough in molecular weight and sufficiently reproducible in structure to allow medical evaluation for anti-viral, anti-fungal, and anti-bacterial properties. To date, medical studies and reports indicate that tannic acid is reproducibly about equal in efficacy to EGCG, which points to both EGCG and tannic acid as ideal candidates for future development to enhance their anti-microbial properties. It is thought that the anti-microbial properties in both EGCG and tannic acid arises because they express di-hydroxy phenyl or tri-hydroxy phenyl functionality in their outer molecular structures.
EGCG has a maximum solubility at room temperature of 92 grams per liter of water. EGCG from green tea can induce apoptosis in targeted bacterial and fungal cells. There is at most about 1.25 grams per liter of EGCG in brewed green tea. Epidemiological studies indicate that a minimum of from 2.5 to 3 grams of EGCG ingested per day yields a blood serum concentration of 0.1-1 μM EGCG.
Several studies indicate that EGCG polyphenol confers beneficial effects against several (chronic) microbial pathologies associated with oxidative stress damage to cells, including multiple types of cardiovascular disease, and neurodegenerative diseases which have bacterial, fungal, and viral vectors. In addition, EGCG provides significant antibacterial and antiviral properties that find use in Alzheimer's disease. Reference is made to Sneideris et al., “The Environment Is a Key Factor in Determining the Anti-Amyloid Efficacy of EGCG,” Biomolecules, 2019, 9, 855, and to Yang et al., “EGCG-mediated Protection of the Membrane Disruption and Cytotoxicity Caused by the ‘Active Oligomer’ of alpha-Synuclein,” Scientific Reports, 2017, 7, 17945, showing that EGCG inhibits growth of beta amyloid plaques associated with Alzheimer's disease as well as plaques of alpha synuclein associated with Parkinson's disease. Further, Mahler et al. (2020) “Neuroprotective Properties of Green Tea (Camellia sinensis) in Parkinson's Disease: A Review,” Molecules, 2020, 25, 3926 show a similar effect of EGCG against Parkinson's disease by modulating several gene expressions and acting on mitochondrial REDOX signaling pathways.
EGCG is stable during transit through the intestines when it is taken orally. After it is absorbed by the intestines, EGCG becomes metabolized by intestinal cells. Digested catechins such as EC and EGCG tend to produce glucuronic acids and then may also become partially methylated, forming 3-O-methyl groups. What this means is that oxidized catechins are an attractor for methylating processes and will remove and chemically incorporate the methyl groups from methylating agents. DNA methylation arising from the somatic response to microbial infection is strongly implicated in one of the causes leading to the development of cancers. The oxidative methylation metabolites of the polyphenolic catechins mitigate microbially induced methylation dysfunctions that are often associated with the randomization of the epigenome and therefore the aging process. Incompletely destroyed infective agents are only one of the many possible cumulative errors that can lead to somatic as well as neurological disease states. It is important to note that methylation antagonists are one area of scientific medical research. Therefore, it is widely appreciated that the medical usefulness of the catechins and of EGCG requires more focus and innovation, and that infectious disease prevention is likely not the only medical purpose to which this material or its derivatives will find new application in the future, as the association of EGCG in combination with other molecules has been found synergistic with combating cognitive diseases and is now gaining considerable attention.
The excellent water solubility of EGCG at 92 grams per liter however limits the ability of this polyphenolic molecule to penetrate across lipid cellular membranes and into hydrophobic cellular compartments. This substantially explains the consistently high serving size or dosages of EGCG required to obtain significant health benefits.
An acidic binding substance must be able to penetrate cell lipid membranes to render protection against oxidative and nitrative stress. Some of the current therapeutic strategies have put emphasis on the design of multiple functional properties into molecules or particles that enable them to target enzymes or receptors to help correct the dysfunctions leading to disease states.
While there is great promise in the beneficial effects of EGCG, there are no known strategies to enhance its poor stability against rapid metabolic breakdown to deliver this substance. Attempts to perform encapsulation within microspheres or nanoparticles or attempts to perform a molecular dispersion in polymer matrices to be used as carriers, have proven effective at delivery but remain insufficiently stable.
In all cases, no present state of the art has considered to allow for the possibility of oxidative and reductive cycling of epigallocatechin gallate by tethering it to a specially designed reduction-oxidation (REDOX) center that is capable of both storing and releasing electrons and hydrogen protons for the purpose of recycling the active carboxyl groups of epigallocatechin gallate as an aid to the long-term maintenance of cellular redox homeostasis. Also, there are no present formulations that are clearly designed to ensure that the delivered, released, or free epigallocatechin gallate will be able to penetrate to and then remain at the active molecular signaling and biochemical redox site of the membranes of cell organelles. Part of the reason for this may be those current formulations use targeting that does not adequately provide simultaneous electrostatic and hydrophobic anchoring of epigallocatechin gallate to cellular membranes. Another reason for this may be the lack of a clearly defined function or mechanism to penetrate hydrophobic proteins, especially those containing sulfur-sulfur bridges that confer significant parasitic bacterial resistance.
A significant limitation to the use of dietary EGCG is in the lack of maturity of cell signaling designs. Such design failures are attributed to an incomplete understanding of cell signaling functions and protein messaging effects to defend the cell. Cell signal interactions begin with surface charges at membranes. Surface charges are in contact with the cell cytosol, proteins, DNA, and the lipid membranes of the cell. Some signaling regions, such as at the site of endoplasmic and sarcoplasmic reticula of mitochondria, may become insufficiently engaged in oxidation that is associated with the development of waxy, hydrophobic proteins networked with excess glutathione and other sulfur containing molecules. This REDOX deficit is thought to contribute to dysfunction of the electron transfer cycle that allows proper cellular respiration to take place, and the result can be programmed cell death by apoptosis.
What is therefore needed is a novel therapeutic strategy or unique material used to confer cellular protection and prevent, mitigate, or reverse toxic pathology arising from bacterial and viral induced dysfunction before irreversible damage progresses. Desirably, such a treatment should include a means to remove sources of free radicals even under reducing conditions, to include a very localized and very targeted acidic functionality while also retaining lipid membrane permeation ability. It is believed the present invention provides the first broadly effective discovery of such a composition, having a biological and electrochemical design to confer multiple therapeutic and prophylactic functions to highly targeted protein structures. This composition will change our perspective on applications to boost resistance to the effects of invasive disease pathologies. The use of different carrier formulations enables appropriate methods of administration for this novel composition.
This invention is a composition of unique fullerene nanoparticles made from commercially available buckminsterfullerene, optionally including groups of disodium phosphonate (FDSP), on reaction with epicatechin or a galloyl such as penta-m-digalloyl-glucose (tannic acid) or a catechin such as epigallocatechin gallate (EGCG) which may also have a galloyl group.
It is an object to provide a compound that increases the bioavailability, in particular the solubility in aqueous solutions, via the penetrability of hydrophobic regions, and the biological redox functionality of catechin polyphenols such as epigallocatechin gallate having the formula C22H18O11.
The present invention provides the first broadly effective discovery of a compound, having a biological and electrochemical design to confer multiple therapeutic and prophylactic functions. The described carrier formulations, derivatives and compositions enable appropriate methods of administration and their use as a medicament, for example.
Some embodiments of this invention provide a cluster of nanoparticles composed with carbon fullerenes, optionally covalently derivatized with phosphonates having oxidation state of three, and a galloyl such as a catechin moiety, being preferably EGCG, in which this substance is pi-carbonyl bonded from at least one carbonyl group (C═O) to the aromatic regions of the fullerene phosphonate. This enables particularly high solubility of the EGCG in aqueous solutions, thereby increasing the bioavailability of the EGCG and its therapeutic effect.
The pendant acid phosphonates are neutralized with cations being preferably sodium to form disodium phosphonate groups being of a surfactant nature and having a viral or fungal protease inhibiting function via the phosphonate sulfurization reaction. The fullerene disodium phosphonate group has the general formula (C60((OP(ONa)2)5)x—Ry, with R is a selected catechin polyphenol or penta-m-digalloyl-glucose, for example. Preferably, R is EGCG.
In a preferred embodiment, y is 1 or 2, such that the derivate of buckminsterfullerene has the formula C60((OP(ONa)2)5—C22H18O11 or C60((OP(ONa)2)5—(C22H18O11)2, respectively.
This fullerene derivative possesses properties which reflect the singular free radical scavenging chemical function of fullerenes, the anti-proliferative function of acidic catechin polyphenols, and the protease control function of cationic disodium phosphonates.
These properties allow the composition ingress to penetrate waxy sulfurized proteins, to confer localized chemical quenching of excessive methylation, and to reduce the ubiquitination of p53 anti-tumor proteins critical to reducing and correcting DNA damage.
In particular, the catechin polyphenol group such as EGCG has antimicrobial properties. By increasing the bioavailability of the galloyl group through targeting redox reactions at cell membranes, the buckminsterfullerene derivative enhances or increases the pharmaceutical properties of the catechin polyphenol group. By provision of stored electrons or protons, in some embodiments, the buckminster-fullerene group allows the regenerative oxidation and reduction of EGCG hydroxyl and carboxyl groups to moderate as an intermediary in the multiplicity of biological redox reactions. It is well known that redox reactions tend to take place at cellular membranes and especially at the internal membrane structures of cellular organelles. This latter ability is highly promoted by the presence of the hydrophobic and lipophilic carbon facets of the buckminsterfullerene adduct, which is attracted to and then anchors in cell membrane lipids, as has been well documented in over 30 years of fullerene biochemical studies. The provision of, for instance, EGCG adducts to buckminsterfullerene thereby effectively targets the catechin polyphenol portion of this moiety to those biologically active sites at membrane surfaces where its activity will find the greatest cellular utility in moderating and regulating redox homeostasis where free radicals are most likely to collect and damage the integrity of the cell membrane.
In one aspect, multiple hydroxyl regions of the catechin functional group of FDSP becomes sacrificially methylated. Suitable FDSP catechins for use as a sacrificial methylation molecule and methylation antagonist include epicatechin (EC), epicatechin gallate (ECG), epigallocatechin (EGC), and epigallocatechin gallate (EGCG).
In a related aspect, FDSP-EGCG is utilized as a methylating antagonist, where FDSP-EGCG becomes sacrificially methylated at hydroxyl regions of the catechin functional group to control dysfunctional methylation because of the systemic aging process. This process is enabled by polygalloyl quinic acid ester functional groups, where more functional groups provide a greater number of methylation sinks at the cost of less local reactivity but improved long term stability for the FDSP-catechins. Specifically, the FDSP-EGCG composition protects the epigenome from methylation induced aging by sacrificial methylation of FDSP-EGCG acting as a demethylating agent otherwise known as a methylation antagonist. This action protects the excessive chemical accretion of methyl (—CH3) functional groups on the epigenome to maintain proper gene expression critical for organism function.
In yet another related aspect, FDSP-EGCG helps regulate epigenetic methylation mechanisms including crosstalk between DNA methylation, histone modifications and non-coding RNAs, and the methylation effects on gene expression. Specifically, FDSP-EGCG controls dysregulated methylation responsible for invasive microbial disease progression. The extraction of methyl groups by sacrificial methylation of FDSP-EGCG therefore provides a pathway to avoid microbially induced tumor and cancer cell generation associated with chronic infections, especially for those microbes that have developed resistance against antibiotic, antiviral, or antifungal drugs.
In yet another related aspect, FDSP-EGCG limits cognitive decline in neurological diseases. In Lewy body dementia and Parkinson's disease, levodopa can become methylated, resulting in the loss of function of the neurotransmitter dopamine that is metabolized from levodopa in the glutamate cycle, leading alpha synuclein plaque formation in the substantia nigra portion of the brain. In Alzheimer's disease, excessive methylation is quenched to limit the formation and agglomeration of beta amyloid plaques. The FDSP-EGCG composition provides a demethylation property by sacrificial methylation of a pendant hydroxyphenyl group that is chemically activated by the presence of the C60 fullerene adduct. The extraction of methyl groups by sacrificial methylation by FDSP-EGCG provides protection of neurotransmitters such as dopamine and its precursor levodopa from functional deactivation by methylation.
In yet another aspect, the sacrificial demethylation function of FDSP-EGCG acts to protect functional regions of cellular proteins from methylation.
In another aspect, the FDSP-EGCG composition provides a desulfurization property by sacrificial oxidation of a pendant phosphonate group. Regions of excess sulfur arise from a local excess of hydrophobic sulfur-protein bonds associated with the bacterial cells or the capsids of some viruses that shields them from the native immune system. The extraction of sulfur from cross-linked and waxy protein agglomerates by FDSP-EGCG leads to a unique mode of protection against invasive cell penetration to better allow the natural immune response access to them.
In another aspect, the nanoparticle ensemble amplifies the well-known bacteriostatic effect of EGCG by the bond to C60, especially for those bacteria that are known as “super bugs” because they have evolved a resistance to prescribed antibiotics.
In a related aspect, certain bacteria commonly live on the skin of many people without causing harm. However, these bacteria can cause skin infections or buccal infections if they enter the body through cuts, open wounds, or other breaks in the skin. A clear alternative to prescribed antibiotics for mouth, skin, or gastric infections by pathological strains of antibiotic resistant bacteria is provided. Non-limiting examples of the types of bacteria that can be treated include methicillin-resistant Staphylococcus aureus (MRSA), group ‘A’ Streptococcus (GAS) or “strep” leading to ‘strep throat’, and Impetigo especially as it is most commonly found on the face as ruptured blisters that form a flat, thick, honey-colored (yellowish-brown) crust.
In another aspect, delivery methods are provided. In one aspect of delivery, a nano-aerosolized composition carries the FDSP-EGCG in a carrier fluid dispenser, and the composition in gasified and delivered to the nose, mouth, trachea, and airways of a patient or user.
In another aspect of delivery, the FDSP-EGCG is adsorbed onto the pore structure of a mineral such as zeolite for oral administration and timed release into the intestinal tract wherein a variation of the silicon to aluminum ratio of this mineral, or a variation in the porosity of diatomaceous earth mineral, or like negative charged mineral, provides both a charged surface and different pore sizes and therefore a timed-release function.
In yet another aspect of delivery, the FDSP-EGCG is formulated into a topical cream carrier for application to the skin and the buccal cavity regions.
In yet another aspect of delivery, the FDSP-EGCG is formulated into an oral solution with sweeteners, flavors, and preservatives suitable to formulate a beverage or to be used as an additive to existing beverages such as traditional tea or coffee.
These and other advantages of the present invention will be further understood and appreciated by those skilled in the art by reference to the following written specification, claims, and appended drawings.
Some embodiments are described in detail with reference to the related drawings. Additional embodiments, features, and/or advantages will become apparent from the ensuing description or may be learned by practicing the invention. In the illustrations, which are not drawn to scale, like numerals refer to like features throughout the description. The following description is not to be taken in a limiting sense but is made merely for describing the general principles of the invention.
Preferred embodiments of the invention will now be described, by way of example, with reference to the accompanying drawings, in which:
Some embodiments are described in detail with reference to the related drawings. Additional embodiments, features, and/or advantages will become apparent from the ensuing description or may be learned by practicing the invention. In the illustrations, which are not drawn to scale, like numerals refer to like features throughout the description. The following description is not to be taken in a limiting sense but is made merely for describing the general principles of the invention.
The following detailed description, taken in conjunction with the accompanying drawings, is merely exemplary in nature and is not intended to limit the described embodiments or the application and uses of the described embodiments. Any implementation described herein as “exemplary” or “illustrative” is not necessarily to be construed as preferred or advantageous over other implementations.
Furthermore, there is no intention to be bound by any expressed or implied theory presented in the preceding technical field, background, brief summary or the following detailed description. It is also understood that the specific devices, systems, methods, and processes illustrated in the attached drawings, and described in the following specification, are simply exemplary embodiments of the inventive concepts defined in the appended claims that there may be variations to the drawings, steps, methods, or processes, depicted therein without departing from the spirit of the invention. All these variations are within the scope of the present invention. Hence, specific structural and functional details disclosed in relation to the exemplary embodiments described herein are not to be interpreted as limiting, but merely as a representative basis for teaching one skilled in the art to variously employ the present embodiments in virtually any appropriate form, and it will be apparent to those skilled in the art that the present invention may be practiced without these specific details.
Various terms used in the following detailed description are provided and included for giving a perspective understanding of the function, operation, and use of the present invention, and such terms are not intended to limit the embodiments, scope, claims, or use of the present invention.
An acceptable replacement for EGCG 110 is the polygalloyl quinic acid esters with the number of galloyl moieties per molecule ranging from 2 up to 12, is represented by the tannin molecular structure 130 for tannic acid, also known as penta-m-digalloyl-glucose. Tannic acid is reproducibly about equal in anti-proliferative and anti-bacterial function to the efficacy of EGCG, which points to both EGCG 110 and tannic acid 130 as ideal candidates for development as functional groups to enhance their anti-microbial properties because of each expresses di-hydroxy phenyl or tri-hydroxy phenyl (more generally, polygalloyl) functionality in their outer molecular structures. Substances 110, 130 are used to help create, process, or deliver parts of the composition or their metabolites according to these teachings.
The presence of phosphonate groups of oxidation state three is provided in the molecular structure of FDSP-EGCG to penetrate the sulfur-rich hydrophobic region of a bacterium or virion, as well as to desulfurize fungal proteases associated with respiratory pathology such as valley fever, or to desulfurize viral proteases. The phosphonate sulfurization reaction proceeds by extraction of sulfur (S) as indicated by the black arrow 750, where the source of extracted sulfur can be a local excess of glutathione and sulfur-protein bonds associated with the waxy region that separates tumor cells from the native immune system carried by aqueous phase physiological plasma such as blood in the circulatory system. One of the phosphonate groups of FDSP-EGCG is sulfurized by the acquisition of a sulfur atom 760. The sulfurization results in a sulfurized phosphonate having phosphorus of oxidation state 5. Sulfurization demonstrates the superiority of FDSP-EGCG over C60-EGCG in penetrating the regions masked by sulfur bonded protein regions.
The remaining four disodium phosphonate groups 790 may continue to act as desulfurization agents, as these can provide additional subsequent desulfurization reactions, thereby enabling proteins complexed with FDSP-EGCG to penetrate even more deeply into the waxy sulfurized coatings around invasive virions, fungal spores, and pathogenic bacteria cells, according to the teachings of the present invention.
Diatomaceous earth is a silicate bearing mineral composed of a multiplicity of silicon dioxide skeletons of diatoms having a multitude of shapes 880, 885 and being from 30 to about 200 nanometers in size. The negatively charged diatomaceous silicates can adsorb thiamine (vitamin B1) as a positive counter-ion and hydrogen bonding adduct; these adducts stabilize the impregnation with the composition of FDSP-EGCG in the form of a multiplicity of clusters 890, 895. At pH greater than 7, as well as under saline or physiological ionic salt conditions, diatomaceous earth slowly diffusion releases and expresses FDSP-EGCG and thiamine counterions stored within the pores and the spaces between the silicate structures of the diatoms to achieve a timed-release of the FDSP-EGCG composition into the digestive tract.
The counter ion-exchange property of Transcarpathian zeolite (clinoptilolite) or diatomaceous earth or other solid pharmaceutical grade minerals may be used as adjuvant delivery or timed-release delivery in any combination whatsoever, to perform timed digestive release of the composition of the present invention as one method of oral delivery of the composition of the present invention, according to these teachings.
Some of the nano-aerosolized composition is exhaled and shown as particulate clusters 1230, 1240, 1250 within exhaled smoke puffs 1260 and 1270 emitted on exhalation as indicated by the direction of thin line arrows radiating away from the nose of the subject 1220. Delivery of the C60-FDSP-EGCG nano-aerosol composition from dispenser 1210 provides antioxidant properties to the mucus airway tissues wherein destruction of free radicals and oxidants associated with microbial invasion is provided. Systems that may be used for the method of dispersion of the FDSP-EGCG represented by dispenser 1210, include, without limitation, any of the electronic cigarette devices produced internationally and listed in Appendix 4.1, “Major E-cigarette Manufacturers” of the “2016 Surgeon General's Report: E-Cigarette Use Among Youth and Young Adults” published by the Center for Disease Control and Prevention (CDC), Office of Smoking and Health (OSH) freely available at the CDC.GOV website, or any combination of piezoelectric, resistively heated, or inductively heated vaporized fluid delivery methods that can be utilized to deliver the composition of the present invention, especially when approved as a medical drug delivery device. Each embodied variation of such methods without limit are intended to aspirate aerosols as the method of therapeutic substance delivery of the composition of the present invention directed into the nasal cavities, mouth, tracheal breathing orifice, or intubated trachea of a patient. The supply direction of nebulized feed of FDSP-EGCG on inhalation and exhalation are delivered into the airways and lungs of the intended patient by the flow of supplied air as indicated by the direction of upward and downward facing large white arrows 1280, when used according to these teachings.
The sample of EGCG analyte prepared by KBr pellet obtains a broad characteristic absorbance from 3100 cm−1 to 3600 cm−1 arising from hydroxyl (OH) functional groups bonded to each aromatic ring. Absorbances at 1609 cm−1, and 1646 cm−1 arise from the carbonyl group (C═O) that links between the trihydroxybenzoate group and the chromane (benzo dihydropyran) ring. The absorbance at 1450 cm−1 arises from the C—H group present in the Chromane ring. Absorbances at 1150 cm−1 and 1091 cm−1 are attributed to the hydroxyl (OH) group, and the peak at 817 cm−1 is attributed to carbon-hydrogen (CH) stretch pendant from the aromatic ring. Comparison of the illustrated experimental FTIR data for EGCG 1800 indicates similarity to the FTIR absorbances reported for EGCG that are generally available from the scientific literature for confirmation of this reactant material when used according to the teachings of the present invention.
As variations, combinations and modifications may be made in the construction and methods herein described and illustrated without departing from the scope of the invention, it is intended that all matter contained in the foregoing description or shown in the accompanying drawings shall be interpreted as illustrative rather than limiting. Thus, the breadth and scope of the present invention should not be limited by any of the above-described exemplary embodiments but defined in accordance with the foregoing claims appended hereto and their equivalents.
This application is a continuation-in-part of International Application PCT/US22/14454 filed on Jan. 28, 2022 which claims the benefit of International Application PCT/US22/12369 filed on Jan. 13, 2022 and the benefit of U.S. provisional patent application 63/161,310 filed on Mar. 15, 2021, all three of which are incorporated herein by reference in their entireties.
Number | Date | Country | |
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63161310 | Mar 2021 | US |
Number | Date | Country | |
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Parent | PCT/US22/14454 | Jan 2022 | US |
Child | 17592899 | US | |
Parent | PCT/US2022/012369 | Jan 2022 | US |
Child | PCT/US22/14454 | US |