Patent Application
20120244124
The present disclosure relates to compositions and methods useful for dietary augmentation, to provide a probiotic supplement useful in a dietary regimen, and/or to provide therapeutic intervention for the treatment, prevention, amelioration and/or regulation of a variety of disease states and/or adverse physiological conditions, including, without limitation, rheumatoid arthritis.
Rheumatoid arthritis currently afflicts approximately 1% of world population, including at least 1.3 million adults in the United States. This disease is an autoimmune disorder involving systemic inflammation of tissues and organs, most typically affecting small joints in the hands and feet. This disorder is associated with pain, swelling, stiffness and impairment of mobility in affected joints, and may be accompanied by reduced energy and appetite, low grade fever, and formation of subcutaneous nodules at the elbow and hands, and appearance of fibrous tissue in the synovium. Progressionary effects of the disease include destruction of articular cartridge and joint ankylosis. The inflammatory effects are frequently manifested in the lungs, pericardium, pleural membranes, and sclera.
While women are afflicted at three times the rate of men, and onset most frequently occurs between age 40 and age 50, the disease can strike persons of any age, with individuals having HLA-DR1 or HLA-DR4 serotypes having increased risk of the disease.
Pharmaceutical and biologic agents for combating rheumatoid arthritis are a relatively recent development. Such agents are used to relieve symptoms, slow the progression of the disease, and maintain function at near-normal levels, but there is presently no cure. The therapeutic agents that have been developed to date for treatment of rheumatoid arthritis have associated side effects that have limited their use.
Accordingly, the art is engaged in a continuing effort to develop new therapeutic agents for combating rheumatoid arthritis.
The present disclosure relates to compositions and methods useful for dietary augmentation, to provide a probiotic regimen, and/or to provide therapeutic intervention for the treatment, prevention, amelioration and/or regulation of disease states and/or other adverse physiological conditions, such as deleterious fungal overgrowth, Candidiasis, autism (including autism per se as well as milder variants such as Aspergers syndrome), delayed development, acid reflux disease, vaginal yeast infections, impaired hearing, chronic ear infections, seasonal allergies, depression, Fibromyalgia syndrome, Crohn's disease, colitis, irritable bowel syndrome, interstitial cystitis, acne, sinusitis, rheumatoid arthritis, chronic fatigue syndrome, asthma, attention deficit disorder, attention deficit/hyperactivity disorder, rosacea, multiple sclerosis, hyperglycemia, Meniere's disease, Addison's disease, Parkinson's disease, Lou Gehrig's disease, ankylosing spondylitis, celiac disease, Graves' disease, Guillain-Barre' syndrome, Hashimoto's disease, lupus erythematosus, myasthenia gravis, Sjogren's syndrome, alopecia universalis, endometriosis, eczema, seborrheic dermatitis, jock itch, hives, athlete's foot, psoriasis, sarcoidosis, schizophrenia, scleroderma, ulcerative colitis and vulvodynia.
The disclosure in one aspect relates to a composition that is useful in such treatment applications, and that constitutes a useful health and nutritional supplement, in which the composition includes bacterial species (i)Bacillus subtilis, (ii) Bacillus coagulans and (iii) Enterococcus faecium.
These bacterial species may be in a dried form, e.g., lyophilized or sporolated form, in a suitable carrier medium, e.g., fructo-oligosaccharide (FOS) medium, or other soluble fiber, sugar, nutrient or base material for the composition, with which the bacterial species can be presented in an orally administrable form.
In one specific aspect, the composition comprises (i) Bacillus subtilis, (ii) Bacillus coagulans and (iii) Enterococcus faecium, in a physiologically compatible carrier medium, wherein the ratio of Bacillus subtilis:Bacillus coagulans:Enterococcus faecium is in a range of from 1:1.5:0.5 to 1:6:2.
In another specific aspect, the composition comprises the following bacterial components (i), (ii) and (iii):
(i) Bacillus subtilis, in an amount of 25 million to 1.5 billion colony forming units (CFUs)/1.5 gm dose
(ii) Bacillus coagulans in an amount of 50 million to 2 billion colony forming units (CFUs)/1.5 gm dose; and
(iii) Enterococcus faecium in an amount of 25 million to 1.5 billion colony forming units (CFUs)/1.5 gm dose,
and a carrier medium, wherein a 1.5 gm dose contains from 5% to 75% of such bacterial components (i), (ii) and (iii), and from 25% to 95% of the carrier medium, wherein the CFU ratio of Bacillus coagulans to Bacillus subtilis is in a range of from 1 to 6, inclusive, and wherein the CFU ratio of Enterococcus faecium to Bacillus subtilis is in a range of from 0.25 to 2, inclusive.
The composition in a further aspect includes a dose form comprising
(i) Bacillus subtilis, in an amount of 25 million to 1.5 billion colony forming units (CFUs);
(ii) Bacillus coagulans in an amount of 50 million to 2 billion colony forming units (CFUs); and
(iii) Enterococcus faecium in an amount of 25 million to 1.5 billion colony forming units (CFUs).
The composition in a still further aspect includes a dose form comprising
(i) Bacillus subtilis, in an amount of 100 million colony forming units (CFUs);
(ii) Bacillus coagulans in an amount of 200 million colony forming units (CFUs);
(iii) Enterococcus faecium in an amount of 100 million colony forming units (CFUs); and
(iv) fructo-oligosaccharides (FOS) in an amount of from 500 to 1000 mg.
Such dose form in a further specific aspect includes the bacterial species in a non-microencapsulated form.
Such dose form in a still further aspect comprises a capsule containing the composition, wherein the capsule is devoid of any enteric coating.
A further aspect of the disclosure relates to a probiotic composition in an oral dose form comprising, as the only bacterial species therein, the bacterial species of Bacillus subtilis, Bacillus coagulans, and Enterococcus faecium.
Another aspect of the disclosure relates to an oral dose form probiotic composition wherein the only bacterial species therein are:
(i) Bacillus subtilis, in an amount of 25 million to 1.5 billion colony forming units (CFUs);
(ii) Bacillus coagulans in an amount of 50 million to 2 billion colony forming units (CFUs); and
(iii) Enterococcus faecium in an amount of 25 million to 1.5 billion colony forming units (CFUs).
Yet another aspect of the disclosure relates to a method of augmenting a diet of a subject with a probiotic supplement, comprising administration to the subject of a composition of the present disclosure.
The disclosure in another aspect relates to a method of treatment, prevention, amelioration and/or regulation of a physiological condition susceptible to therapeutic intervention by probiotic administration, comprising administering to a subject afflicted with or susceptible to such physiological condition and effective amount of the composition of the present disclosure.
The physiological condition related to such method in one aspect disclosure includes one or more of fungal overgrowth, Candida, autism, delayed development, acid reflux disease, vaginal yeast infections, impaired hearing, chronic ear infections, seasonal allergies, Fibromyalgia syndrome, Crohn's disease, colitis, small intestinal bacterial overgrowth, gluten and/or casein intolerance, irritable bowel syndrome, hyperacidity/acid reflux, insomnia, migraines, chronic sinus problems, anxiety, chills and night sweats, recurrent yeast and fungal infections, interstitial cystitis, acne, sinusitis, rheumatoid arthritis, chronic fatigue syndrome, asthma, attention deficit disorder, attention deficit/hyperactivity disorder, rosacea, multiple sclerosis, hyperglycemia, Meniere's disease, Addison's disease, Parkinson's disease, Lou Gehrig's disease, ankylosing spondylitis, celiac disease, Graves' disease, Guillain-Barre' syndrome, Hashimoto's disease, lupus erythematosus, myasthenia gravis, Sjogren's syndrome, alopecia universalis, endometriosis, eczema, skin rashes and dry, flaking skin, dandruff, seborrheic dermatitis, jock itch, rectal itching, tinnitus, muscle twitching and muscle weakness, low sexual drive, chronic allergies, sensitivities to noise, sounds, food, odors and chemicals, hives, athlete's foot, psoriasis, sarcoidosis, schizophrenia, scleroderma, ulcerative colitis and vulvodynia.
In another aspect, the disclosure relates to a method of combating rheumatoid arthritis, comprising administering to a subject, e.g., a human subject, in need thereof, an effective oral dose of a probiotic composition including as the only bacterial species therein Bacillus subtilis, Bacillus coagulans, and Enterococcus faecium.
Such effective dose of the probiotic composition may contain the foregoing bacterial species in the following amounts:
(i) Bacillus subtilis, in an amount of 25 million to 1.5 billion colony forming units (CFUs);
(ii) Bacillus coagulans in an amount of 50 million to 2 billion colony forming units (CFUs); and
(iii) Enterococcus faecium in an amount of 25 million to 1.5 billion colony forming units (CFUs).
The disclosure in other aspects relates to a method of combating a disorder, e.g., autism or irritable bowel syndrome, in a subject, by administering to the subject an effective amount of a composition of the disclosure.
Other aspects, features and embodiments of the disclosure will be more fully apparent from the ensuing description and appended claims.
The present disclosure relates to probiotic compositions and methods useful for dietary augmentation, to provide a probiotic supplement useful in a dietary regimen, and/or to provide therapeutic intervention for the treatment, prevention, amelioration and/or regulation of a variety of disease states and/or adverse physiological conditions.
Applicants have discovered that the compositions of the present disclosure are unexpectedly efficacious as a dietary augmentation and a therapeutic intervention for combating a variety of disease states and adverse physiological conditions, including, but not limited to, fungal overgrowth, Candida, autism, delayed development, acid reflux disease, vaginal yeast infections, impaired hearing, chronic ear infections, seasonal allergies, Fibromyalgia syndrome, Crohn's disease, colitis, small intestinal bacterial overgrowth, gluten and/or casein intolerance, irritable bowel syndrome, hyperacidity/acid reflux, insomnia, migraines, chronic sinus problems, anxiety, chills and night sweats, recurrent yeast and fungal infections, interstitial cystitis, acne, sinusitis, rheumatoid arthritis, chronic fatigue syndrome, asthma, attention deficit disorder, attention deficit/hyperactivity disorder, rosacea, multiple sclerosis, hyperglycemia, Meniere's disease, Addison's disease, Parkinson's disease, Lou Gehrig's disease, ankylosing spondylitis, celiac disease, Graves' disease, Guillain-Barre' syndrome, Hashimoto's disease, lupus erythematosus, myasthenia gravis, Sjogren's syndrome, alopecia universalis, endometriosis, eczema, skin rashes and dry, flaking skin, dandruff, seborrheic dermatitis, jock itch, rectal itching, tinnitus, muscle twitching and muscle weakness, low sexual drive, chronic allergies, sensitivities to noise, sounds, food, odors and chemicals, hives, athlete's foot, psoriasis, sarcoidosis, schizophrenia, scleroderma, ulcerative colitis and vulvodynia.
For example, applicants have surprisingly discovered that compositions of the present disclosure are able to effectively ameliorate the symptoms of fibromyalgia. Additionally, applicants have discovered that when autistic patients were administered the composition of the present disclosure, their manifested symptoms (i.e., minimal eye contact, verbal skills, etc.) were lessened in severity. In many cases, the symptoms of autism were no longer present and the diagnosis was removed. The term “effectively ameliorate” refers to substantial improvement in the symptoms associated with the subject disease state or physiological condition, e.g., at least 50% improvement in such symptoms.
The gastrointestinal microflora has been shown to play a number of vital roles in maintaining gastrointestinal tract function and overall physiological health. For example, the growth and metabolism of the many individual bacterial species inhabiting the gastrointestinal tract depend primarily upon the substrates available to them, most of which are derived from the diet. See e.g., Gibson G. R. et al., 1995. Gastroenterology 106: 975-982; Christi, S. U. et al., 1992. Gut 33: 1234-1238. These findings have led to attempts to modify the structure and metabolic activities of the community through diet, primarily with probiotics, which are live microbial food supplements. Probiotic microorganisms are live microorganisms that confer a benefit when administered in adequate amounts to confer a health benefit on the host, often by inhibiting the growth of other biological organisms in the same corporeal environment. The best known probiotics are the lactic acid-producing bacteria (i.e., Lactobacilli) and Bifidobacteria, which are widely utilized in yogurts and other dairy products. These probiotic organisms are non-pathogenic and non-toxigenic, retain viability during storage, and survive passage through the stomach and small intestine. Since probiotics do not permanently colonize the host, they need to be ingested regularly for any health promoting properties to persist. Commercial probiotic preparations are generally comprised of mixtures of Lactobacilli and Bifidobacteria, although yeast such as Saccharomyces has also been utilized.
Probiotic microorganisms can be employed to protect the body against pathogens, maintain vital chemical and micro-flora balance in the gastrointestinal tract, produce essential vitamins and hormones, and assist in stimulating immune response.
The composition of the present disclosure includes the bacilli Bacillus subtilis, Bacillus coagulans and Enterococcus faecium, in combination with one another. The bacterial composition of the present disclosure, in various embodiments thereof, may comprise, consist of, or consist essentially of the combination of these three types of bacteria, and a physiologically compatible carrier medium for such bacteria.
Bacillus coagulans is a non-pathogenic, Gram positive, spore-forming bacterium that produces L(+) lactic acid (dextrorotatory) under homo-fermentation conditions. It has been isolated from natural sources, such as heat-treated soil samples inoculated into nutrient medium (see e.g., Bergey's Manual of Systemic Bacteriology, Vol. 2, Sneath, P. H. A. et al., eds., Williams & Wilkins, Baltimore, Md., 1986). Bacillus coagulans has also been utilized to produce lactic acid (U.S. Pat. No. 5,079,164). Though not naturally found in the gut, Bacillus coagulans strains have been used as general nutritional supplements and agents to control constipation and diarrhea in humans and other animals.
Bacillus coagulans strains and their growth requirements have been described previously (see e.g., Baker, D. et al, Can. J. Microbiol., 6: 557-563, 1960; Nakamura, H. et al, Int. J. Syst. Bacteriol. 38: 63-73, 1988). In addition, various strains of Bacillus coagulans can be isolated from natural sources (e.g., heat-treated soil samples) using well-known procedures (see e.g., Bergey's Manual of Systemic Bacteriology, Vol. 2, p. 1117, Sneath, P. H. A. et al., eds., Williams & Wilkins, Baltimore, Md., 1986).
Bacillus subtilis is a Gram-positive, endospore-forming soil bacterium comprising aerobic and a few facultatively anaerobic rod-shaped bacteria. Bacillus subtilis was historically used to treat dysentery. It has been reported that ingested Bacillus subtilis are able to activate the human immune defense, including the IgM, IgG and IgA antibodies. Bacillus subtilis strains and their growth requirements are well known in the art.
Enterococcus faecium is a facultative anaerobic, Gram positive, cocci that produces L(+) lactic acid. The Enterococcus faecium strain is a natural inhabitant of the mammalian G.I. tract and causes many of the same problems as other members of the intestinal flora, including opportunistic urinary tract infections and wound infections.
The compositions of the disclosure, comprising the bacilli (A) Bacillus subtilis, (B) Enterococcus faecium, and (C) Bacillus coagulans, are suitably administered for dietary augmentation, to provide a probiotic supplement useful in a dietary regimen, and/or to provide therapeutic intervention for combating a variety of disease states and/or adverse physiological conditions, to effectively ameliorate symptoms thereof.
As described in our prior U.S. patent application Ser. No. 10/928,951 and U.S. Provisional Patent Application No. 60/499,255, the disclosures of which have been incorporated by reference herein for all purposes, the probiotic composition of the disclosure in another aspect relates to a probiotic composition comprising (i) Bacillus subtilis, (ii) Bacillus coagulans, and (iii) Enterococcus faecalis, which is useful for treatment of autism.
The respective bacterial species may be in a dried form, e.g., lyophilized or sporolated form, in a suitable carrier medium, e.g., fructo-oligosaccharide (FOS) medium, or other soluble fiber, sugar, nutrient or base material for the composition, with which the bacterial species can be presented in an orally administrable form.
The compositions of the disclosure are usefully employed as probiotic supplements, food additives, food supplements, and compositions for combating a variety of disorders, such as fungal overgrowth, Candida, autism, delayed development, acid reflux disease, vaginal yeast infections, impaired hearing, chronic ear infections, seasonal allergies, Fibromyalgia syndrome, Crohn's disease, colitis, small intestinal bacterial overgrowth, gluten and/or casein intolerance, irritable bowel syndrome, hyperacidity/acid reflux, insomnia, migraines, chronic sinus problems, anxiety, chills and night sweats, recurrent yeast and fungal infections, interstitial cystitis, acne, sinusitis, rheumatoid arthritis, chronic fatigue syndrome, asthma, attention deficit disorder, attention deficit/hyperactivity disorder, rosacea, multiple sclerosis, hyperglycemia, Meniere's disease, Addison's disease, Parkinson's disease, Lou Gehrig's disease, ankylosing spondylitis, celiac disease, Graves' disease, Guillain-Barre' syndrome, Hashimoto's disease, lupus erythematosus, myasthenia gravis, Sjogren's syndrome, alopecia universalis, endometriosis, eczema, skin rashes and dry, flaking skin, dandruff, seborrheic dermatitis, jock itch, rectal itching, tinnitus, muscle twitching and muscle weakness, low sexual drive, chronic allergies, sensitivities to noise, sounds, food, odors and chemicals, hives, athlete's foot, psoriasis, sarcoidosis, schizophrenia, scleroderma, ulcerative colitis and vulvodynia, as well as other disorders that can be treated or prevented by probiotics, e.g., gastrointestinal disorders.
In the compositions of the disclosure, the bacilli Bacillus subtilis, Bacillus coagulans and Enterococcus faecium can be varied in relative therapeutic amounts with respect to one another. For example, in various specific embodiments, the ratio of Bacillus subtilis:Bacillus coagulans:Enterococcus faecium can be in a range of from 1:0.5:0.5 to 1:8:4. In other embodiments, each of the bacterial species is present in an amount of at least 25 million colony forming units (CFUs), e.g., a composition containing 25 million CFUs Bacillus subtilis, 200 million CFUs Bacillus coagulans and 25 million CFUs Enterococcus faecium.
In one specific aspect, the composition comprises (i) Bacillus subtilis, (ii) Bacillus coagulans and (iii) Enterococcus faecium, in a physiologically compatible carrier medium, wherein the ratio of Bacillus subtilis:Bacillus coagulans:Enterococcus faecium is in a range of from 1:1.5:0.5 to 1:6:2.
The physiologically compatible carrier medium with which the bacterial species are employed, can be of any simple type, e.g., a pharmaceutically acceptable carrier such as fructo-oligo-saccharide (FOS) medium, or other soluble fiber, sugar, nutrient or base material for the composition, with which the bacterial species can be formulated, e.g., in an orally administrable form. Other carrier media include mannitol, inulin (a polysaccharide), polydextrose, arabinogalactan, polyolslactulose, lactitol, etc. A wide variety of materials can be used as carrier material in the practice of the present disclosure, as will be apparent to those of ordinary skill in the art, based on the description herein.
The carrier medium, when present, can be blended with the bacterial species Bacillus subtilis, Bacillus coagulans and Enterococcus faecium in any suitable amounts, such as an amount of from 5% to 95% by weight of carrier medium, based on the total weight of the three bacterial species and the carrier medium, in various embodiments.
In other embodiments, the amount of carrier medium may be in a range having a lower limit of any of 5%, 10%, 12%, 15%, 20%, 25%, 28%, 30%, 40%, 50%, 60%, 70% or 75%, and an upper limit, higher than the lower limit, of any of 20%, 22%, 25%, 28%, 30%, 40%, 50%, 60%, 70%, 75%, 80%, 85%, 90%, and 95%.
The amount of carrier medium in a specific embodiment may be determined based on considerations of the specific dose form, relative amounts of the three bacterial species, the total weight of the composition including the carrier medium and the bacterial species, and the physical and chemical properties of the carrier medium, and other factors, as known to those of ordinary skill in the probiotic formulation art.
In various specific embodiments, the composition comprises:
(i) Bacillus subtilis, in an amount of 25 million to 1.5 billion colony forming units (CFUs)/1.5 gm dose
(ii) Bacillus coagulans in an amount of 50 million to 2 billion colony forming units (CFUs)/1.5 gm dose; and
(iii) Enterococcus faecium in an amount of 25 million to 1.5 billion colony forming units (CFUs)/1.5 gm dose,
and a carrier medium.
Such 1.5 gm dose can for example contain from 5% to 75% of such bacterial components (i), (ii) and (iii), and from 25% to 95% of the carrier medium. It will be recognized that such 1.5 gm dose has been set forth above as one illustrative dosage of the composition of the disclosure, with respect to which the amounts of the various components of the composition have been specified.
In other embodiments of the disclosure, compositions are provided wherein the CFU ratio of Bacillus coagulans to Bacillus subtilis is in a range of from 1 to 6, inclusive, and wherein the CFU ratio of Enterococcus faecium to Bacillus subtilis is in a range of from 0.25 to 2, inclusive. The probiotic compositions of the disclosure can be formulated in any suitable manner, and are desirably formulated to contain only the bacterial species identified herein in the various embodiments of the disclosure.
The composition in a further embodiment includes a dose form comprising
(i) Bacillus subtilis, in an amount of 25 million to 1.5 billion colony forming units (CFUs);
(ii) Bacillus coagulans in an amount of 50 million to 2 billion colony forming units (CFUs); and
(iii) Enterococcus faecium in an amount of 25 million to 1.5 billion colony forming units (CFUs).
The composition in another embodiment constitutes a dose form comprising
(i) Bacillus subtilis, in an amount of 100 million colony forming units (CFUs);
(ii) Bacillus coagulans in an amount of 200 million colony forming units (CFUs);
(iii) Enterococcus faecium in an amount of 100 million colony forming units (CFUs); and
(iv) fructo-oligosaccharides (FOS) in an amount of from 500 to 1000 mg.
The compositions of the disclosure, including the bacterial species and optionally a suitable carrier medium, can be provided in any suitable dose form for administration. The dose form is preferably a pill, powder, capsule, sachet, or the like, formulated for oral administration.
One preferred embodiment of the dose form is a capsule containing the composition of the disclosure including the three bacterial species in a dried form, blended with FOS. The composition may for example be constituted by 100 million CFUs of Bacillus subtilis, 200 million CFUs of Bacillus coagulans, and 100 million CFUs of Enterococcus faecium, with 660 mg of FOS in a 750 mg capsule.
The capsule for such dose form can be of any suitable type, e.g., a gelatin capsule of a conventional variety. Preferably, such capsule is devoid of any enteric coating. Preferably the bacterial species are non-microencapsulated in the dose form.
The disclosure in a further embodiment relates to a method of augmenting a diet of a subject with a probiotic supplement, comprising administration to a subject of a composition of the present disclosure.
The disclosure in another aspect relates to a method of treatment, prevention, amelioration and/or regulation of a physiological condition susceptible to therapeutic intervention by probiotic administration, in which the method includes administering to a subject afflicted with or susceptible to such physiological condition, an effective amount of the composition of the present disclosure.
The physiological condition related to such method in one aspect includes one or more of deleterious fungal overgrowth, Candidiasis, autism, delayed development, acid reflux disease, vaginal yeast infections, impaired hearing, chronic ear infections, seasonal allergies, Fibromyalgia syndrome, Crohn's disease, colitis, irritable bowel syndrome, interstitial cystitis, acne, sinusitis, rheumatoid arthritis, chronic fatigue syndrome, asthma, attention deficit disorder, attention deficit/hyperactivity disorder, rosacea, multiple sclerosis, hyperglycemia, Meniere's disease, Addison's disease, Parkinson's disease, Lou Gehrig's disease, ankylosing spondylitis, celiac disease, Graves' disease, Guillain-Barre' syndrome, Hashimoto's disease, lupus erythematosus, myasthenia gravis, Sjogren's syndrome, alopecia universalis, endometriosis, eczema, seborrheic dermatitis, jock itch, hives, athlete's foot, psoriasis, sarcoidosis, schizophrenia, scleroderma, ulcerative colitis and vulvodynia.
The composition of the disclosure has proven dramatically effective in ameliorating symptoms of autism, as shown by the empirical results of the examples set out hereinafter. Such composition has advantage in treating a pregnant mother and/or her subsequently delivered child, as a therapeutic intervention for preventing autism from developing in the child. The use of the composition of the disclosure for the treatment or prophylaxis of autism also includes such usage for lesser related disease states such as Asperger's syndrome.
An additional disease state for which the composition of the disclosure has demonstrated particular efficacy in ameliorating symptoms, as also shown by the ensuing data and examples, is irritable bowel syndrome.
It will be appreciated that the composition of the disclosure can be usefully employed for combating a variety of adverse physiological conditions for which probiotic treatment is advantageous. It will be further appreciated that the probiotic composition of the disclosure can be usefully employed as a food additive in foodstuffs of widely varied types, to realize the health, dietary and nutritional benefits of such composition.
The dosing regimen involving compositions in accordance with the present disclosure can be varied to achieve a desired result, such as may be determined empirically for a given individual subject, or by extrapolation from data obtained from administering the composition to a clinical or other test population. For example, the dosage regimen may be carried out to administer each of the three bacilli Bacillus subtilis, Bacillus coagulans and Enterococcus faecium, in an amount that is within a range of from 40 million CFUs up to 2 billion CFUs per day for each of such bacilli, and wherein the relative amounts of each may be the same as or different from the others, each being independently selected from such range. The dose forms may be constituted as necessary for a specific dosing regimen, and such regimen may maintained or varied as appropriate to the desired result.
In general, the composition of the disclosure may be administered in any suitable dose amount that is effective as a health supplement, food supplement, food additive, and/or therapeutic agent to prevent, ameliorate, regulate, cure or otherwise treat a disease state or physiological condition in a subject in need of such intervention. As used herein, the phrase “effective amount” means an amount including at least 10 million CFUs of Bacillus subtilis, at least 100 million CFUs of Bacillus coagulans and at least 10 million CFUs of Enterococcus faecium.
In various specific embodiments, an effective dose of a composition of the present disclosure can be in a range of from 1.0 gm to 15.0 gm for an adult patient, more preferably between about 2.0 gm and about 10.0 gm of the composition. Effective doses can be administered to a subject at any suitable frequency, e.g., at least once a week, preferably once a day. Pediatric dosages may be in the range of 15% to 90% of adult dosages.
In therapeutic applications for combating an adverse physiological condition, a constant dosage of the composition can be administered over time, for example about 2 gm to about 4 gm per day, up to about 6 g to about 10 g per day, depending on the severity of the physiological condition. Once the physiological condition has been effectively ameliorated, the subject can in many instances decrease the dosage to about 2 gm to about 4 gm per day for maintenance purposes.
The desired dose may be presented in multiple (e.g., two, three, four, five, six, or more) sub-doses administered at appropriate intervals throughout the day.
The compositions of the disclosure may additionally and optionally include any suitable adjuvants, excipients, additives, carriers, additional therapeutic agents, bioavailability enhancers, side-effect suppressing components, diluents, buffers, flavoring agents, binders, preservatives or other ingredients that do not preclude the efficacy of the composition. In various preferred embodiments, the bacilli (Bacillus subtilis, Enterococcus faecium, and Bacillus coagulans) comprise from about 50% to about 90% by weight of the composition, based on the total weight of the composition including a carrier medium, most preferably from about 60% to about 80% by weight of the composition. It is generally preferred that the composition contain only the bacilli and a carrier medium, in a gelatin capsule that is devoid of any enteric coating, with the bacteria being in a dried form such as powder or granules, and the carrier medium likewise being in a dry powder or particulate form.
The compositions of the present disclosure are preferably formulated for oral administration. Other routes of administration can be employed, however, including, but not limited to, subcutaneous, intramuscular, intradermal, transdermal, intraocular, intraperitoneal, mucosal, vaginal, rectal, and intravenous. For example, a dose of the composition of the present disclosure can be presented in a gelatin capsule and inserted vaginally to treat vaginal yeast infections.
In one embodiment, the therapeutic composition of the disclosure may comprise at least 40 million CFUs of each of Bacillus subtilis, Bacillus coagulans and Enterococcus faecium, as contained in capsules containing from 25 to 200 milligrams of the mixture Bacillus subtilis, Bacillus coagulans and Enterococcus faecium with one or more excipients, such as 500-1,000 milligrams of fructo-oligosaccharides, in a unitary dose form tablet or capsule.
In one advantageous form, the probiotic composition contains Bacillus coagulans (200 million CFU), Bacillus subtilis (100 million CFU), Enterococcus faecium (100 million CFU) as the only microbial species in the composition, in combination with fructo-oligosaccharides (FOS) and no other ingredients, as packaged in a gelatin capsule dose form. Such composition is referred to hereinafter as the “Symbion formulation.”
The Symbion formulation may be administered and taken orally according to any effective dosing regimen. In one embodiment, the beginning dose is one capsule taken after a meal. After one week, the dose is increased to one capsule twice daily. At four weeks, the dose is increased to two capsules, twice daily. Up to six capsules a day may be taken, but the recommended long term dose is four capsules per day.
The compositions of the disclosure are readily manufactured. The respective bacterial species Bacillus subtilis, Bacillus coagulans and Enterococcus faecium are seeded from standard stock into a reactor and grown in standardized media until a predetermined CFU/gm concentration is reached. The bulk material then is drained from the reactor and dried by spray drying, lyophilization, or flatbed oven drying. The dried bacterial raw material then is blended with the carrier medium and the resulting mixture can be pressed into tablets, filled into foil pouches as a granular solid, or introduced into gelatin capsules as a particulate material.
The bacterial species therefore are present in the dose form as live bacteria, whether in dried, lyophilized, or sporolated form. Bacillus coagulans may for example be in a sporolated form, while Enterococcus faecium may not be in a sporolated form.
Although the preceding discussion has been directed primarily to probiotic compositions containing the bacterial species Bacillus subtilis, Bacillus coagulans and Enterococcus faecium as the only microbial species in such compositions, the disclosure alternatively contemplates a probiotic composition comprising (i) Bacillus subtilis (ii) Bacillus coagulans and (iii) Enterococcus faecalis as the only microbial components of the composition. Such alternative probiotic composition may be formulated with fructo-oligosaccharides (FOS), and may be formulated, provided in specific proportions as regards the microbial species in the composition, packaged, and dosed and administered, as otherwise described herein for the primary compositions containing Bacillus subtilis, Bacillus coagulans and Enterococcus faecium as the only microbial species in such compositions.
For example, the alternative compositions comprising (i) Bacillus subtilis (ii) Bacillus coagulans and (iii) Enterococcus faecalis as the only microbial components of the composition may be likewise provided in capsule or powder formulations and dosage forms, as having efficacy for treatment and prophylaxis of disease states and conditions, including, but not limited to, fungal overgrowth, Candida, autism, delayed development, acid reflux disease, vaginal yeast infections, impaired hearing, chronic ear infections, seasonal allergies, Fibromyalgia syndrome, Crohn's disease, colitis, small intestinal bacterial overgrowth, gluten and/or casein intolerance, irritable bowel syndrome, hyperacidity/acid reflux, insomnia, migraines, chronic sinus problems, anxiety, chills and night sweats, recurrent yeast and fungal infections, interstitial cystitis, acne, sinusitis, rheumatoid arthritis, chronic fatigue syndrome, asthma, attention deficit disorder, attention deficit/hyperactivity disorder, rosacea, multiple sclerosis, hyperglycemia, Meniere's disease, Addison's disease, Parkinson's disease, Lou Gehrig's disease, ankylosing spondylitis, celiac disease, Graves' disease, Guillain-Barre' syndrome, Hashimoto's disease, lupus erythematosus, myasthenia gravis, Sjogren's syndrome, alopecia universalis, endometriosis, eczema, skin rashes and dry, flaking skin, dandruff, seborrheic dermatitis, jock itch, rectal itching, tinnitus, muscle twitching and muscle weakness, low sexual drive, chronic allergies, sensitivities to noise, sounds, food, odors and chemicals, hives, athlete's foot, psoriasis, sarcoidosis, schizophrenia, scleroderma, ulcerative colitis and vulvodynia.
By way of specific illustration, the alternative composition containing (i) Bacillus subtilis (ii) Bacillus coagulans and (iii) Enterococcus faecalis as the only microbial components of the composition can be formulated with 25 million CFUs of Bacillus subtilis, 200 million CFUs of Bacillus coagulans and 25 million CFUs of Enterococcus faecalis, and 90 wt. % of fructo-oligosaccharides (FOS).
In a specific aspect of the present disclosure, treatment of rheumatoid arthritis is contemplated, using a probiotic composition of the present disclosure.
The probiotic composition for such purpose advantageously is in an oral dose form comprising, as the only bacterial species therein, the bacterial species of Bacillus subtilis, Bacillus coagulans, and Enterococcus faecium. Such bacterial species may be present in the probiotic composition in such oral dose form in the following amounts: (i) Bacillus subtilis, in an amount of 25 million to 1.5 billion colony forming units (CFUs); (ii) Bacillus coagulans in an amount of 50 million to 2 billion colony forming units (CFUs); and (iii) Enterococcus faecium in an amount of 25 million to 1.5 billion colony forming units (CFUs). The probiotic composition may comprise fructo-oligosaccharide in the dose form, e.g., in an amount of from 500 to 1000 milligrams. The oral dose form may comprise a capsule containing the probiotic composition.
In various specific embodiments, the above-describe probiotic composition may contain the bacterial species in a ratio of Bacillus subtilis:Bacillus coagulans:Enterococcus faecium that is in a range of from 1:0.5:0.5 to 1:8:4, or in other particular embodiments, in a ratio of Bacillus subtilis:Bacillus coagulans:Enterococcus faecium that is in a range of from 1:1.5:0.5 to 1:6:2.
The disclosure therefore contemplates a method of combating rheumatoid arthritis, comprising administering to a human subject in need thereof, an effective oral dose of a probiotic composition as variously described above. When in an oral dose form comprising a capsule containing (i) Bacillus subtilis, in an amount of 25 million to 1.5 billion colony forming units (CFUs); (ii) Bacillus coagulans in an amount of 50 million to 2 billion colony forming units (CFUs); and (iii) Enterococcus faecium in an amount of 25 million to 1.5 billion colony forming units (CFUs), and fructo-oligosaccharide in an amount of from 500 to 1000 milligrams, the oral dose form may be administered in a daily amount of from 1 capsule to 6 capsules. In specific embodiments, the oral dose form may be administered in any other suitable daily amounts, e.g., a daily amount of from 3 to 5 capsules.
In a specific implementation, the oral dose form can be administered daily in an amount, and for sufficient duration, to cause the elimination of initially present rheumatoid factor and/or anti-CCP antibodies present in a blood sample of the human subject. The duration of such treatment may for example be on the order of from 8 to 12 months.
The foregoing blood marker methodology is based on the fact that rheumatoid arthritis can be diagnostically established in a human patient by assaying a biological sample from the patient, such as a blood sample, to determine presence of rheumatoid factor (RF) and/or presence of antibodies that bind citrulline modified proteins (anti-CCP antibodies). Such biological markers can be utilized as indicia for monitoring the rheumatoid arthritis condition in the patient, and the reduction and/or elimination of such biological marker(s) can be determined as a correlate for adjusted dosage of the probiotic composition to the patient, with progressive increase in the dosage, e.g., beginning with one capsule/day and increasing to a maximum of five capsules/day over a period of 8-12 months, until the biological marker(s) is/are absent in the RF and/or anti-CCP antibody tests, whereupon the dosage can be downwardly adjusted to a maintenance dose, such as a maintenance dose of three capsules/day.
The features and advantages of the disclosure are more fully shown by the following illustrative and non-limiting examples.
In each of the following Examples 1-27, the human test subject received a composition (referred to in the examples as “Composition A”), containing 10 wt. % of a bacterial mixture consisting of 25 million CFUs of Bacillus subtilis, 200 million CFUs of Bacillus coagulans and 25 million CFUs of Enterococcus faecalis, and 90 wt. % of fructo-oligosaccharides (FOS). The composition in each of the examples was orally administered in the weight amount as specified in each such example.
A seven-and-a-half year-old male patient with autism for at least four years had substantial difficulties learning to speak, read, write and process language. The patient was orally administered approximately 4 g of Composition A per day with water. Within three weeks with such daily treatment, the patient learned to ride a two-wheel bicycle for the first time. After six weeks of such daily treatment, the patient's speech and his ability to read, write and process language improved substantially and his self-stimulating behaviors decreased.
A six year-old female patient with autism who had ceased verbalizing with her family, was orally administered approximately 2 g of Composition A per day with water. Within a few days, with daily administration, she started speaking again. Following four months of such daily administration, her verbal improvement leveled off, at which point the dosage was increased to approximately 4 g of Composition A per day with water.
A six year-old female patient with autism was orally administered approximately 0.5 g of Composition A per day with water. Following daily administration of the composition for four days, the patient experienced some constipation, which was treated. The patient displayed a large improvement in eye contact and verbal skills Four weeks later, with daily administration of Composition A continued, the patient continued to show improvement.
A five year-old male patient with autism and a leaky gut was orally administered approximately 2 g of Composition A per day with water. The patient's gut began to heal immediately with a concomitant jump in verbal articulation. In addition, the patient's gluten infractions did not manifest themselves as they previously typically had done.
A three year-old male patient with autism was orally administered approximately 2 g of Composition A per day with water. The dosage was increased up to approximately 4 g of Composition A per day and is presently maintained at approximately 2 g of Composition A per day. Immediately, the patient began making better eye contact with others and responded to verbal requests from his mother. At the age of four, the diagnosis of autism was completely removed and the patient has entered traditional schools.
A three-and-a-half year-old female patient with autism and redness and itching associated with the autism was orally administered approximately 2 g of Composition A per day with water. The patient began repeating sounds and words, and responded to verbal requests from her parents. In addition, the redness and itching subsided and the patient was successfully potty trained for the first time without complaint.
A six-and-a-half year-old male patient with autism for at least four years was orally administered approximately 2 g of Composition A per day with water at age 5.5 years. Following thirty days of approximately 2 g/day of Composition A, the dosage was increased to approximately 4-6 g/day of the composition for the next thirty days. Thereafter, the dosage was reduced back to approximately 2 g/day of the composition for maintenance. The patient is no longer diagnosed as learning disabled and he is able to attend traditional schools.
A four year-old male patient with autism was orally administered approximately 2 g of Composition A per day with water. The dosage was increased up to approximately 4 g of the composition per day. At the age of five, the diagnosis of autism was completely removed and the patient has entered traditional schools.
A 48 year-old female patient with fibromyalgia who did massage therapy, yoga and Pilates, but failed to be relieved of the pain, was orally administered approximately 2 g of Composition A per day with water for two months. The patient's energy level increased substantially and she was able to play eighteen holes of golf on four consecutive days, was able to ride a bicycle sixteen miles and take several 5-6 mile hikes all within the same week, without exhaustion or extreme pain.
A 26 year-old female patient with fibromyalgia was orally administered approximately 2 g of Composition A per day with water. Within just four days, the patient noticed a substantial improvement, whereby the pain associated with the condition decreased and her night sweats disappeared.
A 55 year-old female patient with fibromyalgia and allergies was orally administered approximately 6 g of Composition A per day with water for about five months. She noticed a significant improvement of her fibromyalgia symptoms and a decrease in the severity of her allergies.
A 34 year-old female patient who had suffered fibromyalgia for at least five years was orally administered approximately 4 g of Composition A per day with water. Within three weeks of taking the composition, the patient experienced enough relief of her symptoms to stop taking sleeping pills and pain medications.
A 49 year-old female patient with fibromyalgia was orally administered approximately 6 g of Composition A per day with water. Her fibromyalgia is now in a reversed state, whereby her tender points are non-existent and she was able to exercise twenty five to forty five minutes per day.
An approximately twenty-five year-old female patient with a severe sinus infection and acid reflux was orally administered approximately 2 g of Composition A per day with water. Both the sinus infection and the acid reflux were completely stopped.
A 47 year-old female patient with acid reflux was orally administered approximately 2 g of Composition A per day with water for five days and then the dosage was increased to approximately 4 g of Composition A per day for the next ten days. The heartburn caused by the acid reflux improved and other indications, such as hot flashes and sores on her head, ceased.
A 58 year-old female patient with hearing problems and some tinnitus was orally administered approximately 2 g of Composition A per day with water. After experiencing some bowel pains, she increased the dosage of Composition A to approximately 4 g per day and started feeling much better. She regained almost all of the hearing in her right ear and the ringing in her ears subsided.
A 51 year-old female patient with hearing problems, irritable bowel syndrome, and high blood sugar was orally administered approximately 2 g of Composition A per day with water. She noticed an improvement in her irritable bowel symptoms and her blood sugar problems became more regulated, whereby she didn't become faint and panicky if she was unable to eat at the same time every day. In addition, although she still needed to wear two digital hearing aids, she noticed an improvement in her hearing whereby she began to hear noises, e.g., alarm clocks that were previously unheard.
A 36 year-old female patient with irritable bowel syndrome, tinnitus and depression was orally administered approximately 2 g of Composition A per day with water for three months. She noticed a significant improvement in her irritable bowel symptoms and discontinued her anti-depression medications. In addition, the noise in her ears ceased.
A 50 year-old female patient with adult onset asthma and allergies was orally administered approximately 2 g of Composition A per day with water for several weeks. Her asthma went away completely and she experienced considerable relief from her allergies.
A 37 year-old female patient with candidiasis and seasonal hayfever was orally administered approximately 2 g of Composition A per day with water for six months. For the first time in twenty years, the patient did not suffer from seasonal hayfever.
A 38 year-old female patient with chronic ear infections and hearing fluctuations over more than twenty years was orally administered approximately 2 g of Composition A per day with water. She experienced relief from her recurrent ear infections and her hearing improved.
A 33 year-old female patient with a persistent vaginal yeast infection vaginally administered a gelatin capsule containing approximately 2 g of Composition A. After several administrations, the yeast infection went away.
A 24 year-old female patient with a persistent vaginal itch vaginally administered two gelatin capsules containing approximately 4 g of Composition A. Immediately, the itching subsided.
A 52 year-old female patient with Type I diabetes was orally administered approximately 6 g of Composition A per day with water. She noticed that she was feeling more energetic and that her blood sugars had stabilized.
A 55 year-old female patient with Multiple Sclerosis was orally administered approximately 4 g of Composition A per day with water for sixteen days. Prior to taking the composition, the patient could not walk properly and she experienced tingling and numbness on her right side and pressure in her head. After just one day, the pressure in her head eased and the leg muscles spasms became less painful. She began to use her right hand to carry objects without dropping them. She could also walk around the house without help and did not tire as easily.
A questionnaire was provided to 500 individual users of Composition A. The questionnaire inquired about the disease state or physiological condition afflicting the individual, their gender, how much of the composition they took, how long they had been taking the composition, and their self-determined percent improvement. A total of 319 individuals responded. The results are tabulated in Table 1.
It is noted that the administration schedule and dosage varied from patient to patient depending on the severity of the disease state or physiological condition and as such, it was not possible to correlate the percent improvement to the amount of composition taken or the length of time the composition was taken. The data show that the effective amelioration of the disease state or physiological condition is completely unrelated to the age or gender of the patient (with the exception of patients less than six years of age).
Referring to Table 1, it can be seen that the composition of the present disclosure effectively treated various disease states and physiological conditions, including, but not limited to, autism, delayed development, acid reflux disease, impaired hearing, chronic ear infections, seasonal allergies, Fibromyalgia syndrome, Crohn's disease, colitis, irritable bowel syndrome, interstitial cystitis, acne, sinusitis, rheumatoid arthritis, chronic fatigue syndrome, asthma, attention deficit disorder, and rosacea.
A survey was made of persons using Composition A. The survey identified the responses of 111 test subjects who suffered from one of the disease states or adverse physiological conditions listed in Table 2 (irritable bowel syndrome, arthritis, fibromyalgia, hyperglycemia, hearing impairment, chronic fatigue, colitis, vaginal yeast infections, attention deficit disorder, sinusitis, seasonal allergies, acid reflux, multiple sclerosis, asthma, acne, autism, eczema and rosacea).
As set out in Table 2, the respondents are identified as male or female subjects, and the dosage administered to them daily is identified as grams of Composition A.
As shown in Table 2, percent improvements of the disease states or adverse physiological conditions were identified by the respondents, on a scale of 0 to 100%, with the percent improvement being set out in parenthesis following an identification of the number of individuals who reported that percent improvement in the test group.
For example, 11 subjects, including 9 females and 2 males, who were afflicted with irritable bowel syndrome, were administered 1.5 to 6 grams of Composition A daily, with continued daily administration for at least four months.
One subject in the 11-person test group reported 25% improvement, one subject reported 40% improvement, two subjects reported 50% improvement, three subjects reported 75% improvement, one subject reported 80% improvement, two subjects reported 90% improvement and one subject reported 95% improvement, in relation to the severity of the disease state or adverse physiological condition that was originally identified by persons in the test group as afflicting them.
The reported survey data of the test subjects set out in Table 2 evidence the efficacy of Composition A taken by such test subjects, in improving their condition of suffering from a specific disease state or adverse physiological condition (irritable bowel syndrome, arthritis, fibromyalgia, hyperglycermia, hearing impairment, chronic fatigue, colitis, vaginal yeast infections, attention deficit disorder, sinusitis, seasonal allergies, acid reflux, multisclerosis, asthma, acne, autism, eczema or rosacea), as specified in such Table 2.
1 (25%0
In the following Example 28, the human test subjects received the Symbion formulation as a probiotic composition, containing Bacillus coagulans (200 million CFU), Bacillus subtilis (100 million CFU), and Enterococcus faecium (100 million CFU) as the only microbial species in the composition, in combination with fructo-oligosaccharides (FOS) and no other ingredients, packaged in a gelatin capsule dose form.
A field study was conducted involving 29 people afflicted with IBS and 37 people suffering from fibromyalgia. This test group was given capsules of the Symbion formulation for a period of 12 months. The capsules were filled in an FDA-approved cGMP pharmaceutical facility in the United States and DNA tested at a commercial testing laboratory for purity, quality and ingredient conformity of the microbial species of Bacillus coagulans, Bacillus subtilis, and Enterococcus faecium in the formulation.
All the study participants started with a dosage of two capsules of the Symbion formulation per day and slowly worked up to six capsules per day over a period of two months, then slowly came back down to a dosage of four per day. Each month of the study, the participants reported percentage improvement in their symptoms. The results are shown in
The results show the efficacy of the Symbion formulation in ameliorating the symptoms of IBS and fibromyalgia.
A 32-year-old female subject suffering from rheumatoid arthritis had been prescribed methotrexate for her condition, but discontinued such medication due to attendant side effects. She then began probiotic therapy and began using the Symbion probiotic composition described in Example 28, containing Bacillus coagulans (200 million CFU), Bacillus subtilis (100 million CFU), and Enterococcus faecium (100 million CFU) as the only microbial species in the composition, in combination with fructo-oligosaccharides (FOS) and no other ingredients, packaged in a gelatin capsule dose form. She initially took one capsule per day of the Symbion probiotic composition and worked up to a maximum of five capsules per day over a period of one year before slowly working back down to a maintenance dose of three capsules per day.
Two years after being initially diagnosed with rheumatoid arthritis, and with the above-described dosage regimen culminating in a maintenance dose of three capsules per day, the subject underwent a physical exam in which her blood sample was tested for biological markers of rheumatoid arthritis, and was determined to be free of any evidence of the previously diagnosed and determined rheumatoid arthritis condition.
While the disclosure has been set out herein with reference to various specific embodiments, it will be appreciated that the disclosure is not thus limited, and extends to and encompasses various other modifications and embodiments, as will be appreciated by those ordinarily skilled in the art. Accordingly, the disclosure is intended to be broadly construed and interpreted, in accordance with the ensuing claims.
This is a continuation-in-part under 35 U.S.C. §120 of U.S. patent application Ser. No. 12/840,289 filed Jul. 20, 2010 in the names of Mark L. Cobb and Alyson J. Cobb for “PROBIOTIC COMPOSITION USEFUL FOR DIETARY AUGMENTATION AND/OR COMBATING DISEASE STATES AND ADVERSE PHYSIOLOGICAL CONDITIONS,” and issued Jun. 5, 2012 as U.S. Pat. No. 8,192,733, which in turn is a continuation-in-part under 35 U.S.C. §120 of U.S. patent application Ser. No. 11/840,992 filed Aug. 19, 2007 in the names of Mark L. Cobb and Alyson J. Cobb for “TREATMENT OF DISEASE STATES AND ADVERSE PHYSIOLOGICAL CONDITIONS UTILIZING THERAPEUTIC COMPOSITIONS,” and issued Jul. 20, 2010 as U.S. Pat. No. 7,759,105, which in turn is a continuation-in-part under 35 U.S.C. §120 of U.S. patent application Ser. No. 10/928,951 filed Aug. 27, 2004 in the names of Mark L. Cobb and Alyson J. Cobb for “TREATMENT OF DISEASE STATES AND ADVERSE PHYSIOLOGICAL CONDITIONS UTILIZING THERAPEUTIC COMPOSITIONS,” now abandoned, which in turn claims the benefit under 35 U.S.C. §119(e) of U.S. Provisional Patent Application No. 60/499,255 filed on Aug. 29, 2003 in the names of Mark L. Cobb and Alyson J. Cobb for “TREATMENT OF DISEASE STATES AND ADVERSE PHYSIOLOGICAL CONDITIONS UTILIZING THERAPEUTIC COMPOSITIONS.” The disclosures of all of the foregoing applications are incorporated by reference herein in their respective entireties, for all purposes.
| Number | Date | Country | |
|---|---|---|---|
| 60499255 | Aug 2003 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 12840289 | Jul 2010 | US |
| Child | 13489111 | US | |
| Parent | 11840992 | Aug 2007 | US |
| Child | 12840289 | US | |
| Parent | 10928951 | Aug 2004 | US |
| Child | 11840992 | US |
