The field relates to nanoparticles comprising vasoactive intestinal peptides (VIP), and to their use in treatment of pulmonary hypertension, and vascular and neurological disorders.
Pulmonary hypertension (PH or PHT) is an increase in blood pressure in the pulmonary artery, pulmonary vein, and/or pulmonary capillaries. It is a very serious condition, potentially leading to shortness of breath, dizziness, fainting, decreased exercise tolerance, heart failure, pulmonary edema, and death. It can be one of five different groups, classified by the World Health Organization as follows:
Treatment of pulmonary hypertension has proven very difficult. Antihypertensive drugs that work by dilating the peripheral arteries are frequently ineffective on the pulmonary vasculature. For example, calcium channel blockers are effective in only about 5% of patients with IPAH. Left ventricular function can often be improved by the use of diuretics, beta blockers, ACE inhibitors, etc., or by repair/replacement of the mitral valve or aortic valve. Where there is pulmonary arterial hypertension, treatment is more challenging, and may include lifestyle changes, digoxin, diuretics, oral anticoagulants, and oxygen therapy are conventional, but not highly effective. Newer drugs targeting the pulmonary arteries, include endothelin receptor antagonists (e.g., bosentan, sitaxentan, ambrisentan), phosphodiesterase type 5 inhibitors (e.g., sildenafil, tadalafil), prostacyclin derivatives (e.g., epoprostenol, treprostenil, iloprost, beroprost), and soluble guanylate cyclase (sGC) activators (e.g., cinaciguat and riociguat). Surgical approaches to PAH include atrial septostomy to create a communication between the right and left atria, thereby relieving pressure on the right side of the heart, but at the cost of lower oxygen levels in blood (hypoxia); lung transplantation; and pulmonary thromboendarterectomy (PTE) to remove large clots along with the lining of the pulmonary artery.
Heart failure and acute myocardial infarction are common and serious conditions frequently associated with thrombosis and/or plaque build-up in the coronary arteries.
Vasoactive intestinal peptide (VIP) is a peptide hormone containing 28 amino acid residues, produced in many areas of the human body including the gut, pancreas and suprachiasmatic nuclei of the hypothalamus in the brain. In humans, the vasoactive intestinal peptide is encoded by the VIP gene. Various synthetic forms of VIP or VIP from other mammalian sources are known. VIP causes vasodilatation, lowers arterial blood pressure, stimulates myocardial contractility, increases glycogenolysis and relaxes the smooth muscle of trachea, stomach and gall bladder. VIP is a potent dilator of the pulmonary and coronary arteries, and has great potential to reduce pulmonary arterial hypertension and at the same time enhance cardiac function. VIP is also known to dilate the cardiac arteries and to enhance cardiac function. VIP is therefore useful to treat acute myocardial infarction and to treat heart failure resulting from myocardial infarction. It thus has potential to help patients having conditions such as pulmonary hypertension, cardiac insufficiency, heart failure, and acute myocardial infarction. To date, however, it has not been used as a therapeutic because it has a half-life (T1/2) in the blood of less than two minutes.
There is thus an unmet need for improved treatments for pulmonary hypertension, particularly pulmonary arterial hypertension, for cardiac insufficiency due to partial or complete blockage of coronary arteries and/or damage due to myocardial infarction, for example acute or congestive heart failure and acute myocardial infarction. There is moreover a need for a means of sustaining levels of VIP for longer periods of time, e.g. to treat such conditions.
The invention provides VIP nanoparticles, wherein the VIP is encapsulated or immobilized by a bioabsorbable polymer, for example, having any of the following characteristics
In one example, the VIP nanoparticles are made from VIP and the following components:
In one example, the nanoparticles have these components in approximately the following amounts:
The contents of the nanoparticles are confirmed using, e.g. HPLC and LC/MS. The nanoparticle formulations may be sterilized using conventional means, e.g., filtration, gamma radiation. The nanoparticles are optionally coated with bile salt, lipid, PEG for improved delivery.
In one embodiment, the invention provides a method for treating pulmonary hypertension, e.g., pulmonary arterial hypertension, comprising administering an effective amount of a VIP-nanoparticle formulation to a patient in need thereof, wherein the VIP-nanoparticle comprises a bioabsorbable polymer, for example as described above.
In another embodiment, the invention provides a method for treating cardiac insufficiency, e.g., heart failure, angina, or acute myocardial infarction, comprising administering an effective amount of a VIP-nanoparticle formulation to a patient in need thereof, wherein the VIP-nanoparticle comprises a bioabsorbable polymer, for example as described above.
In a specific example of the foregoing methods, the VIP-nanoparticle administered comprises chitosan-PLGA nanoparticles encapsulating VIP.
In another example, the VIP-nanoparticle administered comprises chitosan nanoparticles encapsulating VIP with glutaraldehyde as a cross linker. Other cross-linkers may be used. In yet another example, the VIP-nanoparticle administered comprises chitosan-PLGA nanoparticles encapsulating VIP alone. Such examples of VIP nanoparticles may utilize a process that includes gelation/conjugation of preformed biodegradable polymers.
In yet another example, the VIP-nanoparticle administered includes chitosan-PLGA nanoparticles immobilizing VIP. Alternatively, the VIP-nanoparticles administered comprises chitosan-PLGA nanoparticles immobilizing VIP as well as chitosan-PLGA nanoparticles encapsulating VIP.
In another example, the VIP-nanoparticle comprises VIP covalently linked to chitosan or chitosan-PLGA nanoparticles.
In another example, the present invention also includes methods for treating pulmonary hypertension, comprising administering an effective amount of a VIP nanoparticle formulation to a patient in need thereof. It is contemplated by the present invention that an effective amount of a VIP nanoparticle formulation may be used to treat pulmonary arterial hypertension. It is further contemplated by the present invention that a VIP nanoparticle formulation may be administered in conjunction with: endothelin receptor antagonists (e.g., bosentan, sitaxentan, ambrisentan), phophodiesterase type 5 inhibitors (e.g., sildenafil, tadalafil), prostacylin derivatives (e.g., epoprostenol, treporostenil, iloprost, beroprost), and soluble guanylate cyclase (sGC) activators (e.g., cinaciguat and riociguat).
In yet another example, the present invention contemplates the use of a VIP nanoparticulate formulation to treat a patient in need thereof. It is contemplated by the present invention that a VIP nanoparticulate formulation may be used to treat cardiac insufficiency, e.g., heart failure, angina, or acute myocardial infarction. It is also contemplated by the present invention that a VIP nanoparticulate formulation may be used to treat pulmonary hypertension, e.g. pulmonary arterial hypertension.
VIP, as used herein includes any peptide or peptide analogue having VIP activity, e.g., capable of binding VPAC1 or VPAC2, esp. VPACI, e.g. selected from
Administration routes include, but are not limited to intravenous, intra-arterial, intracardiac, subcutaneous, intramuscular, orally, intrapulmonary (e.g., by inhalation), intradermal, topically or rectally. The formulation may be for immediate release, e.g., via intravenous, intra-arterial, or intracardiac injection, or may be in the form of a sustained release depot formulation, e.g., a depot comprising a bioerodible polymer comprising the VIP nanoparticles of the invention, for example for subcutaneous or intramuscular injection, resulting in release of VIP over a period of days or weeks.
In one embodiment the VIP nanoparticles can be used in a drug-eluting metal or bioresorbable stent, e.g., for patients having had or at risk of acute myocardial infarction, e.g., for insertion in the coronary artery.
In a further embodiment, the VIP-eluting stents are also useful for patients with a history of stroke or transient ischemic attacks or patients otherwise at risk of stroke, e.g., for placement in the carotid artery, or for patients having pulmonary hypertension, e.g. for placement in the pulmonary artery.
In one embodiment, administration is by a pump activated by a signal, which releases the nanoparticles into the bloodstream. In one embodiment the signal is generated when pulmonary arterial pressure rises above a given level, e.g., greater than 30, for example, greater than 40 mmHg, as measured by an electronic pressure transducer linked to a cannula in the pulmonary artery. In another embodiment, the signal is generated when oxygen levels in the blood drop below a certain level, e.g., % SpO2 below 90, e.g., below 85 as measured by a pulse oximeter.
In one embodiment, the particles provide a sustained release which allows the VIP to affect gene expression.
The VIP nanoparticles of the invention may be administered in conjunction with, or adjunctive to, the normal standard of care for pulmonary hypertension or cardiac insufficiency or other cardiovascular or neurological disorders, for example in conjunction with one or more of:
Various methods of synthesizing VIP-nanoparticles are provided. For example, a single emulsion process may produce chitosan-PLGA nanoparticles encapsulating VIP. In yet another example, a process involving gelation/conjugation of preformed biodegradable polymers produces 1) chitosan nanoparticles encapsulating VIP with and without glutaraldehyde as a cross-linker; or 2) chitosan-PLGA nanoparticles encapsulating VIP. Other cross-linkers may be used.
In yet another example, a process involving chemical bonding of VIP on the surface of chitosan-PLGA nanoparticles produces 1) chitosan-PLGA nanoparticles immobilizing VIP or 2) chitosan-PLGA nanoparticles immobilizing VIP and additionally including chitosan-PLGA nanoparticles encapsulating VIP.
For example, in one embodiment, PLGA and VIP are first immersed in a 1% PVA solution and chitosan. They are then stirred and sonicated. Then a dialysis step is performed. After a dialysis step occurs, PLGA-chitosan nanoparticles encapsulating VIP are produced. Then in the final step, the nanoparticles may then have a chitosan layer cross-linked with glutaraldehyde. Other cross-linkers may be used.
An entrapment efficiency may also be measured. The entrapment efficiency may be calculated to be the total amount of VIP in the nanoparticles/initial concentration of VIP added to make the formulation×100.
Chitosan nanoparticles encapsulating VIP are produced using a reverse micellar method as shown in
In
VIP encapsulated in nanoparticles with different degrees of cross-linking is tested for optimal pharmacokinetics. The formulation is optimized for loading efficiency. The ratios of different constituents are manipulated for optimum delayed release. To achieve that goal, the following parameters are evaluated: Particle size analysis by DLS spectroscopy, zeta potential measurement, in vitro release kinetics, Transmission Electron Microscopy for size confirmation, measurement of VIP inside the nanoparticles (by HPLC or LC/MS).
Hydrophobic chitosan polymer is synthesized according to the following scheme: To Chitosan (0.200 g) (75-85% deacetylated) solution in HCl (0.2 N, 20 mL), MeOH (20 mL), NHS, lithocholic acid (106.4 mg, 0.283 mmol) and pyridine (647.0 μL) are added. After overnight stirring at room temperature, another portion of MeOH (40 mL) is added to obtain a clearer reaction mixture. EDAC (81.2 mg, 0.424 mmol) is added and magnetically stirred at room temperature for 24 hrs. Chitosan product is precipitated out by ammonium hydroxide (3 mL) and collected by centrifugation. The precipitates are washed three times with deionized water. The precipitates are then redissolved in 1% AcOH (20 mL), washed with DCM:MeOH (1:4) (3×20 mL), precipitated again with ammonium hydroxide (3 mL), washed with deionized water (3×20 mL) and lyophilized for 48 hours.
Different ratios of chitosan: lithocholic acid are synthesized.
The examples and drawings provided in the detailed description are merely examples, which should not be used to limit the scope of the claim construction or interpretation.
Alternative combinations and variations of the examples provided will become apparent based on this disclosure. It is not possible to provide specific examples for all of the many possible combinations and variations of the embodiments described, but such combinations and variations may be claims that eventually issue.
This application claims priority from U.S. Provisional Application No. 61/355,283, filed Jun. 16, 2010, the contents of which are herein incorporated by reference in their entirety.
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/US11/40704 | 6/16/2011 | WO | 00 | 11/13/2013 |
Number | Date | Country | |
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61355283 | Jun 2010 | US |