CN101005858A - 用于反差成像的充气微泡组合物 - Google Patents
用于反差成像的充气微泡组合物 Download PDFInfo
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- CN101005858A CN101005858A CNA2005800280529A CN200580028052A CN101005858A CN 101005858 A CN101005858 A CN 101005858A CN A2005800280529 A CNA2005800280529 A CN A2005800280529A CN 200580028052 A CN200580028052 A CN 200580028052A CN 101005858 A CN101005858 A CN 101005858A
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Abstract
本发明涉及新型组合物,其包含用于反差成像的充气微泡,它特别适合对具有不同频率的至少两种特定的超声波提供有效的回声反应。所述组合物优选包括至少两种充气微泡的不同的制剂,它们的非线性回声探测反应的各自的峰彼此相差至少2MHz,并且优选具有不同中值粒径的各自的尺寸分布。具体地讲,所述制剂优选具有这样的尺寸分布:使各自的DV50值彼此相差至少0.5μm,更优选至少1.0μm。或者,所述组合物的体积尺寸分布表现出Bowley偏度值为0.16或以上。根据一种优选实施方案,根据直径至多10μm的微泡群体计算,包含在所述微泡中的气体总体积的至少95%包含在直径为8微米或以下的微泡中。
Description
发明领域
本发明涉及充气微泡组合物,适合用作诊断和/或治疗成像的造影剂,涉及诊断/治疗成像方法,包括所述组合物的使用,并且涉及所述组合物的制备方法。
发明背景
近年来,超声波造影剂的快速发展,业已产生了大量不同的配方,可将它们用于人类或动物肌体器官和组织的超声波反差成像。这些制剂被设计成主要用作静脉内或动脉内可注射的形式,与医学回声探测设备组合使用,该设备例如采用B-模式图像生成(根据反向散射组织特性的空间分布)或多普勒信号处理(根据超声回声的等幅波或脉冲式多普勒处理确定血液或液体流动参数)。
一组可用作超声波造影剂的可注射制剂包括直径为几个微米的气泡分散在含水介质中的悬浮液。
特别感兴趣的是通过合适的添加剂稳定化的气泡,例如乳化剂,油,增稠剂或糖类,或通过将气体或它的前体夹带或包埋在多种系统中。在本领域中所述稳定化的气泡一般被称作″微泡″,并且可以划分成两个主要类型。
第一种类型的稳定化的气泡或微泡在本领域中一般被称作″微泡″,并且包括含水悬浮液,其中,气泡通过非常薄的外被(薄膜)约束在气体/液体界面处,所述外被包括位于气体与液体界面上的稳定化的两亲性材料。微泡悬浮液通常是通过如下方式制备:让粉末状两亲性材料,例如,冷冻干燥的预先成型的脂质体或冷冻干燥的或喷雾干燥的磷脂溶液与空气或其他气体接触,然后与含水载体接触,同时搅拌,以便产生微泡悬浮液,然后就可以服用,优选在制备之后不久服用。
气体微泡的含水悬浮液及其制备的例子可以参见,例如US 5,271,92,US 5,445,813,US 5,413,774,US 5,556,610,5,597,549,US 5,827,504,WO 97/29783和待批的国际专利申请PCT/IB04/00243,以它们的全文形式收作本文参考。
第二种类型的微泡在本领域中一般被称作″微气泡″或″微囊″,并且包括悬浮液,其中,气泡是由类脂或天然或合成聚合物的固体材料外被包围的。微囊及其制备的例子可以参见,例如,US 5,711,933和US 6,333,021,以它们的全文形式收作本文参考。
除了其他特征之外,微泡制剂还以它们各自的平均尺寸和尺寸分布为特征(它们提供了有关微泡群体如何分散在平均尺寸周围的线索)。微泡制剂的尺寸分布一般与高斯型分布类似,集中在它们的平均尺寸值附近。
反差成像基于充气微泡在受到由超声波探头以某种频率发射的超声波的冲击时产生共振,因此反射相应的回声信号,该信号通过超声波探头检测并随后成像的能力。由于造影剂的回声反应相对组织或器官本身的回声反应而言是相当特殊的,因此容纳在血管中的造影剂可以相对周围的组织或器官方便地成像。充气微泡的共振能力取决于多种因素,其中包括它的尺寸与穿透辐射的频率的兼容性。作为一般指示,较小的微泡在较高的频率下共振,而较大的微泡在较低的频率下共振。另外,反射的回波强度一般与具有所述预定兼容尺寸的微泡的浓度成正比,例如,所述浓度是以所述微泡所携带的气体总体积的形式表达的。
本申请人现在业已发现,对于特定造影剂来说,可以确定优选的尺寸范围和相应的尺寸分布,它适合对确定的传输频率作出反应。正如本申请人所发现的,在低频率(例如,大约1.5-大约3.5MHz)下,所述尺寸分布通常具有较大的中位数直径(例如,DV50为大约4μm),并且一般是较宽的;这一发现与以下事实吻合:常规的宽范围分布的充气微泡一般可用于在这种低频率下进行反差成像,因为有足够多数量的微泡可用于在受到特定低频率超声波的轰击时共振。另一方面,在较高频率(例如,5MHz或以上)时,合适反应性的微泡的尺寸分布实质上是较窄的。另外,所述窄的分布一般与相应的较小的DV50值(例如,大约1-2.5μm)相关,符合以下事实,即小的微泡在较高的频率下共振。这一发现还与以下事实吻合:常规较宽范围分布的微泡制剂一般在高频率反差成像时反应性较低,因为其中所包含的小尺寸微泡的比例较低。因此,在将高传输频率用于超声成像时,具有较窄的尺寸分布并具有较小的中值尺度(特别是DV50)的适当校准的充气微泡制剂可用于有效的反差成像,不过所述制剂在低传输频率下使用时不够有效。
一般,将较低的传输频率(例如,0.5-2MHz)用于身体深处部位的回声探测分析,如心脏用途,而较高的传输频率(例如,5-7,并且可高达10-15MHz)一般被用于腹部(例如,肾脏,肝脏等)或浅表分析(例如,眼科学,乳腺分析等)。较高的传输频率(例如,15-20MHz,并且可高达80MHz)还可用于特殊用途。例如,用于血管内超声成像。
本申请人业已发现了适合对至少两种具有不同频率的特定的超声波提供有效的回声反应的新型组合物。正如本申请人所发现的,所述有效的回声反应可以通过适当地改变充气微泡制剂的尺寸分布获得。有利的是,所述制剂包括有效量的具有较小尺寸的微泡,因此能对相应的较高的特定传输频率作出反应,以及有效量的具有较大尺寸的微泡,能对相应地较低的特定传输频率作出反应,不过,所述有效量的大尺寸的微泡足够少,以便不会过分减弱小尺寸微泡在特定高传输频率下的反应。
国际专利申请WO 98/32468披露了包括两种或两种以上类型的含有气体的微粒的组合物,它们对超声波压力具有不同的敏感性。优选的组合物是这样的,它所包含的第一种类型的微粒具有较柔软的封装外壳(如具有磷脂外壳的微泡)和第二种类型的具有较硬封装材料的微粒(如聚合物或蛋白外壳微囊)。具体地讲,所述专利的例1披露了包括氢化卵磷脂酰丝氨酸的微泡与含有聚合物的微囊的混合物,该聚合物包括以下结构式的重复单元:
-O-(CH2)a-CO-O-CH(CH3)-O-CO-(CH2)a-CO-O(CH2)b-CO-,
其中,a是9-19的整数,b是1-8的整数。
WO 01/68150披露了具有稳定化外被的微囊,它包括聚烷基氰基丙烯酸酯聚合物。
发明概述
本发明一方面涉及用于诊断和/或治疗成像的组合物,它包括充气微泡的至少两种不同的制剂,其中,所述至少两种不同的制剂的非线性回声探测反应的相应的峰彼此相差至少2MHz,优选相差至少3MHz。
根据一种优选实施方案,所述非线性回声探测反应的相应峰大约为1.5-大约10MHz。优选的是,所述组合物包括非线性回声探测反应峰为3MHz或以下,更优选1.5-3MHz的微泡的第一种制剂,和非线性回声探测反应峰为5MHz或以上,更优选5-10MHz的微泡的第二种制剂。
根据另一种优选实施方案,所述微泡的不同制剂具有不同中位数直径的各自的尺寸分布。优选的是,所述尺寸分布是由各自的至少第一和至少第二体积中位数直径(DV50)确定的,所述第一和第二DV50彼此相差的值为至少0.5μm,更优选至少1.0μm,更优选至少1.5μm。优选的是,根据直径至多10μm的微泡群体计算的包含在所述微泡中的气体总体积的至少95%,包含在直径为8微米或以下的微泡中。根据另一种优选实施方案,所述至少两种类型的微泡中的至少一种的尺寸分布是由所述体积平均直径和相应的数量平均直径(DV/DN)之间的各自的比例确定的,所述类型的充气微泡的至少一种的DV/DN比例为1.2-3,优选为1.2-2。
本发明的另一方面涉及包括用于诊断成像的充气微泡的组合物,其中,所述充气微泡的尺寸分布的Bowley偏度为0.16或以上。优选的是,包含在所述微泡中的气体总体积的至少95%包含在直径为8微米或以下的微泡中。在本说明书和权利要求书中,Bowley偏度是根据充气微泡制剂或组合物的体积尺寸分布的实验曲线计算的,该计算是在直径高达8μm的微泡群体中计算的。
本发明的另一方面涉及使包括充气微泡的组合物对第一传输频率具有非线性回声探测反应峰,对第二传输频率具有增强的回声探测反应的方法,该方法包括将所述组合物与对所述第二频率具有非线性回声探测反应的各自的峰的充气微泡的第二组合物混合。优选的是,所述第一和第二频率彼此相差至少2MHz,更优选相差至少3MHz。
本发明的另一方面涉及生产对至少两种不同的传输频率具有有效的回声探测反应的超声波造影剂的方法,该方法包括混合充气微泡的至少两种不同的制剂,所述充气微泡的非线性回声探测反应的各自的峰彼此相差至少2MHz,优选相差至少3MHz。优选的是,所述充气微泡的至少两种不同的制剂具有适应对所述至少两种不同的传输频率的有效反应的各自不同的尺寸分布。
本发明的另一方面涉及诊断和/或治疗成像方法,它包括给患者服用有效量的上述组合物。
附图
图1表示比较的微泡尺寸分布的示意图。
图2表示本发明组合物的尺寸分布与常规制剂的示意性宽的尺寸分布比较的示意图。
图3表示用于计算为特定传输频率的最佳尺寸分布的示意性方法。
图4表示计算的最佳尺寸分布。
图5-9表示根据本发明实施例的实验制剂的尺寸分布。
图10表示确定Bowley偏度的参数的示意图。
图11表示用于测量微泡制剂的回波功率反应的实验装置的示意图。
图12表示实验微泡制剂在不同传输频率下的比较性回波功率反应。
图13表示本发明组合物与商业超声波造影剂的尺寸分布的比较。
详细说明
充气微泡的尺度和尺寸分布可以通过许多参数表征,最常用的参数是数量平均直径DN和体积平均直径DV。数量直径提供了对微泡的平均数量尺寸的指示,体积直径提供了有关微泡中夹带的气体总体积在它的群体中是如何分布的信息。用于表征充气微泡群体的其他有用的参数是DV50,DV90或DV95直径。这些参数表示微泡中夹带的气体的百分比(分别为50,90或95%),所述微泡的直径等于或小于所述值。因此,例如,DV90=10μm表示所述微泡制剂的气体总体积的90%被包含在直径为10μm或以下的微泡中。所述DV50值确定了尺寸分布的体积中位数直径。而理论上单一尺寸的微泡将表现出相同的DN和Dv或DV50值,实验制剂中窄的或宽的尺寸分布将分别确定DN和Dv值之间的相应的小的和大的差异,及由此而来的DV/DN比例的相应变化。因此,DV/DN比例的值可用于估算充气微泡的特定群体的尺寸分布有多少是分散在它的平均值周围;一般,尺寸分布越宽,DV/DN比例的值越大。因此,例如,主要包括小微泡(例如,直径为2μm左右的微泡)实质上没有大气泡(例如,直径超过8μm的气泡)的群体,它所表现出的DV值接近于DN值,具有相应较低的DV/DN比例。相反,主要包含小微泡但仍然具有小比例的大气泡的群体,能表现出较高的DV值,及相应较高的DV/DN比例。一般,微泡群体表现出的DV/DN比例小于大约2,可以被认为是窄范围分布的;这些微泡还可以被称作″校正的″微泡。另一方面,DV/DN比例大约为3或以上的微泡群体一般可以被认为具有宽的分布。
图1和2表示本发明有利方面的例子,其中,组合至少两种不同的充气微泡制剂,以便获得对至少两种不同传输频率的有效的回声探测反应。在图1中,实线11表示在典型的具有宽尺寸分布(BM)的微泡群体中,气体体积相对于微泡尺寸的正规化分布的示意图。虚线12表示在分布狭窄的微泡的第一群体中的气体体积的正规化分布的示意图(NM1),所述微泡的DV50值为1.9μm,所述尺寸分布适合对第一传输频率f1作出有效反应。虚线13表示在相对较少的分布狭窄的微泡的第二群体中气体体积的正规化分布的示意图(NM2),所述微泡的DV50值为4.1μm,所述尺寸分布适合对第二传输频率f2作出有效反应。为了清楚起见,业已将对称性高斯型分布用于BM,NM1和NM2的尺寸分布的示意性表示,同时正如在说明书的以下部分所表明的,实验性尺寸分布形式一般会相对所述对称分布或多或少地扭曲。
当特定的传输频率f1轰击BM或NM1的微泡时,具有与所述频率兼容的尺度(即主要是包含在由与传输频率兼容的尺寸周围限定的限幅(slice)S1中的那些)的所述微泡的各个部分会共振,并且反射具有特定强度的回声信号。所述反射的回声信号的强度大体上与包含在由12(NM1)或11(BM)以下的S1确定的各个部位所包含的气体的体积成比例。从图1中可以看出,在12下面所限定的S1的部位所包含的气体的体积远远大于在11下面所限定的相同限幅中所包含的相应的气体体积,因此,导致了更强的反射回声,并最终导致了更好的图像增强。当第二个较低的传输频率f2轰击BM或NM2的限幅S2中的兼容性微泡时,会产生类似的结果。
在图2中,实线21表示通过以1∶1的体积比混合NM1和NM2获得的组合的组合物(CC)的气体体积的正规化分布的示意图。虚线22表示以前的制剂BM的微泡中的气体体积的正规化尺寸分布。从该附图中可以看出,本发明这一方面的组合的组合物使得可以将有效体积的气体用于尺寸与两种传输频率f1和f2兼容的微泡中。相反,使用常规BM制剂将会限制单一传输频率f2的组合。在所述具体例子中,相对于BM,与CC中的频率f1兼容的较大数量的微泡会产生相应的较强的回声反应。这种较强的回声反应会导致有效的回声反差成像,即使是在存在较大数量的较大的微泡的情况下,而大微泡除了不会对特定的频率作出反应外,主要有助于信号的减弱,包括发射信号和反射信号的减弱。值得指出的是,尽管BM在限幅S1各个部位的反应理论上讲可以通过它的气体总体积增加(即,使用较大数量的BM制剂)而增强,不过,这种增强在实践中可能是不希望的。一个原因是,一般优选将造影剂的浓度保持尽可能得低(与可接受的成像增强一致),以便避免它所产生的任何可能的副作用。另一个原因是,BM中气体总体积的增加能决定较大微泡部分的相应的增加,它会决定超声波信号的无法接受的减弱。
正如本申请人所发现的,本发明组合物的尺寸分布形式(在用曲线作图时以微泡尺寸为横坐标,以正规化体积百分比为纵坐标)相对于由单一微泡制剂限定的典型的尺寸分布形式而言是相当特殊的。一般,后者实际上可能类似于大体上的高斯型分布,又被称作高斯型分布,在它的右半部分具有大体上略微分散的分布。对称的高斯型分布的分布偏差,即分散,可以通过常规参数形式,如“偏度”来表示。正如本领域所公知的,偏度是对称性指标,或更确切地讲,缺少分布或数据集的对称性。在文献中可以查阅到对偏度的可靠的测量标准。有用的偏度系数是″偏度的Bowley系数″(Elements of statistics,New York:Charles Scribner′s Sons,1920),又被称作″四分位数偏度系数″,它是通过以下公式定义的:
其中,Q1是所述分布的第一个四分位数。因此,正如图10中所示出的,对于微泡制剂的气体体积分布来说,Q1相当于夹带了高达夹带气体总体积的25%的微泡的较大的直径,Q2相当于夹带了高达夹带气体总体积的50%的微泡的较大的直径,而Q3相当于夹带了高达夹带气体总体积的75%的微泡的较大的直径。从公式(1)和图10中可以看出,对于任何对称分布来说BS=0。分母Q3-Q1重新设定了所述系数,从而BS的最大值(即1)表示极端的右侧偏度,而BS的最小值(即-1)表示极端的左侧偏度。
本申请人业已发现,适用于至少两种不同的传输频率的组合物一般在它们的各自的右半部分具有相当明显的分布。因此,根据本发明的另一方面,本发明的组合物的BS值大于0.16,优选至少0.18或以上,更优选至少0.20或以上,例如,高达0.40。为了表征本发明的组合物,本发明计算的Bowley偏度值在0μm-8μm的尺寸范围内,以便避免由于少数不受控制的大尺寸微泡的不希望的分布造成的任何可能的错误计算。因此,在本说明书和权利要求书中所提到的所有BS值表示仅包括直径至多8μm的微泡的计算。优选的是,具有所述BS值的所述组合物的微泡的稳定化的外被不包括聚烷基氰基丙烯酸酯聚合物。
相当特别的是,在某些场合下,组合的组合物的分布形式的中央部分大体上是扁平的,而在其他特殊场合下,在所述中央部分可以观察到局部最小(如在图2中所示出的示意性分布)。
根据本发明的一种优选实施方案,具有上述BS值的组合物可有利地通过组合两种或两种以上不同的充气微泡制剂获得。在本发明的优选实施方案中,为了最小化大尺寸微泡的不希望的减弱作用,特别是在相当高的传输频率下工作时,包含在本发明的充气微泡组合物中的气体总体积(DV95)的至少95%包含在直径为8微米或以下的微泡中。对于本发明来说,为了确定所述DV95值,在计算时只考虑直径至多10μm的微泡。具体地讲,所述组合的组合物的DV95值在7μm或以下,优选6.5μm或以下,更优选6μm或以下,例如,低到大约4μm。
适用于制备本发明的组合的组合物的充气微泡可以是本领域已知的任何类型的微泡,如充气微泡或充气的微囊,通常是以悬浮液形式包含在生理学上可接受的液体载体中。优选的是,所述微泡是微气泡。
术语″生理学上可接受的″的含义包括能够以特定数量给患者服用而又不会对患者的肌体健康或正常的功能产生负面影响或发生明显改变(例如,不会产生任何不可接受的毒性状态,导致任何极端或无法控制的变态反应或产生任何异常病理学状态或疾病状态)的任何化合物,材料或制剂。
微泡
本文所定义的充气微泡包括分散在含水悬浮液中的气泡,它们是通过薄的外被稳定化的,所述外被包含位于气体和液体界面上的两性分子化合物。所述稳定化外被,在本领域中有时被称作″易消散的外被″,一般它的厚度小于5nm,通常为大约2-3nm,因此,通常总计达到大体的单分子层。
包含在微泡外被中的两性分子化合物可以是合成的或天然存在的生物相容的化合物,并且可以包括,例如,成膜类脂,特别是磷脂。两性分子化合物的例子包括,例如,磷脂;溶血磷脂;脂肪酸,如棕榈酸,硬脂酸,花生四烯酸或油酸;具有类脂的聚合物,如几丁质,透明质酸,聚乙烯吡咯烷酮或聚乙二醇(PEG),又被称作″聚乙二醇化的类脂″;具有类脂的磺化单糖、二糖、寡糖或多醣;胆甾醇,硫酸胆甾醇或半琥珀酸胆甾醇;半琥珀酸生育酚;类脂与醚或酯连接的脂肪酸;聚合的类脂;二乙酰磷酸酯;联十六烷基磷酸酯;神经酰胺;聚氧化乙烯脂肪酸酯(如聚氧化乙烯脂肪酸硬脂酸酯),聚氧化乙烯脂肪醇,聚氧化乙烯脂肪醇醚,聚氧乙烯化的山梨聚糖脂肪酸酯,甘油聚乙二醇蓖麻醇酸酯,乙氧基化的大豆甾醇,乙氧基化的蓖麻油或环氧乙烷(EO)和环氧丙烷(PO)嵌段共聚物;甾醇脂族酸酯,包括胆甾醇丁酸酯,胆甾醇异丁酸酯,胆甾醇棕榈酸酯,胆甾醇硬脂酸酯,羊毛甾醇乙酸酯,麦角甾醇棕榈酸酯,或植物甾醇n-丁酸酯;糖酸的甾醇酯,包括胆甾醇葡糖苷酸酯,羊毛甾醇葡糖苷酸酯,7-脱氢胆甾醇葡糖苷酸酯,麦角甾醇葡糖苷酸酯,胆甾醇葡糖酸酯,羊毛甾醇葡糖酸酯,或麦角甾醇葡糖酸酯;糖酸和醇的酯,包括月桂基葡糖苷酸酯,硬脂酰葡糖苷酸酯,肉豆蔻酰葡糖苷酸酯,月桂基葡糖酸酯,肉豆蔻酰葡糖酸酯,或硬脂酰葡糖酸酯;糖与脂族酸的酯,包括蔗糖月桂酸酯,果糖月桂酸酯,蔗糖棕榈酸酯,蔗糖硬脂酸酯,葡萄醛酸,葡萄糖酸或多糖醛酸;皂苷类包括萨洒皂草配基,菝葜配基,常春藤苷配基,齐墩果醇酸,或毛地黄毒苷配基;甘油或甘油酯包括甘油三棕榈酸酯,甘油二硬脂酸酯,甘油三硬酯酸酯,甘油二肉豆蔻酸酯,甘油三肉豆蔻酸酯,甘油二月桂酸酯,甘油三月桂酸酯,甘油二棕榈酸酯;长链醇包括n-癸醇,月桂醇,肉豆寇醇,鲸蜡醇,或n-十八烷醇;6-(5-胆甾烯氧-3 β-)-1-硫代-β-D-半乳糖吡喃糖苷;二半乳糖基甘油二酯;6-(5-胆甾烯-3β-氧)己基-6-氨基-6-脱氧-1-硫代-β-D-半乳糖吡喃糖苷;6-(5-胆甾烯-3β-氧)己基-6-氨基-6-脱氧-1-硫代-β-D-甘露糖吡喃糖苷;12-(((7′-二乙基氨基香豆素-3-基)羰基)甲氨基)十八烷酸;N-[12-(((7′-二乙基氨基香豆素-3-基)羰基)甲氨基)十八烷酰基]-2-氨基棕榈酸;N-琥珀酰-二油酰基磷脂酰乙醇胺;1,2-二油酰基-sn-甘油;1,2-二棕榈酰-sn-3-琥珀酰甘油;1,3-二棕榈酰-2-琥珀酰甘油;1-十六烷基-2-棕榈酰甘油磷酸乙醇胺或棕榈酰高半胱氨酸;烷基胺或烷基铵盐,包括至少一个(C10-C20),优选(C14-C18),烷基链,例如,N-硬脂酰胺,N,N′二硬脂酰胺,N-十六烷基胺,N,N′-双十六烷基胺,N-硬脂酰氯化铵,N,N′-二硬脂酰氯化铵,N-十六烷基氯化铵,N,N′-双十六烷基氯化铵,二甲基双十八烷基溴化铵(DDAB),十六烷基三甲基溴化铵(CTAB);叔铵或季铵盐,包括一个或优选两个(C10-C20),优选(C14-C18),通过(C3-C6)亚烃基桥与N-原子连接的酰基链,例如,1,2-二硬脂酰-3-三甲基铵-丙烷(DSTAP),1,2-二棕榈酰-3-三甲基铵-丙烷(DPTAP),1,2-油酰-3-三甲基铵-丙烷(DOTAP),1,2-二硬脂酰-3-二甲基铵-丙烷(DSDAP);以及它们的混合物或组合物。
根据成分的组合以及根据微泡的生产方法,上面所列举的典型的化合物可以用作形成微泡外被的主要化合物,或作为简单的添加剂,并因此以微量存在。
根据一种优选实施方案,形成微泡外被的至少一种化合物是磷脂,任选它与上述任何其他成膜材料混合。根据本发明,术语磷脂包括任何两亲性的磷脂化合物,它的分子能够在最终的微泡悬浮液的气水界面上形成稳定化的材料薄膜(通常是单分子层形式的)。因此,在本文中,所述材料又被称作″成膜磷脂″。
两亲性的磷脂化合物通常包括至少一个磷酸基团,以及至少一个,优选两个亲脂的长链烃基。
合适的磷脂的例子包括甘油与一个或优选两个(相同或不同的)脂肪酸残基或与磷酸形成的酯,其中,所述磷酸残基又与亲水性的基团,例如,胆碱(磷脂酰胆碱-PC),丝氨酸(磷脂酰丝氨酸-PS),甘油(磷脂酰甘油-PG),乙醇胺(磷脂酰乙醇胺-PE),肌醇(磷脂酰肌醇)结合。磷脂只与一个脂肪酸残基形成的酯在本领域中一般被称作″溶血″形式的磷脂或″溶血磷脂″。磷脂中所存在的脂肪酸残基一般是长链脂族酸,通常包括12-24个碳原子,优选14-22;所述脂族链可以包括一个或多个不饱和的或优选完全饱和的脂肪酸。磷脂上所包含的合适脂肪酸的例子有,例如,月桂酸,肉豆蔻酸,棕榈酸,硬脂酸,花生酸,山嵛酸,油酸,亚油酸,和亚麻酸。优选的是,使用饱和的脂肪酸,如肉豆蔻酸,棕榈酸,硬脂酸和花生酸。
磷脂的其他例子有磷脂酸,即甘油-磷酸与脂肪酸的二酯;鞘脂类,如鞘磷脂,即,磷脂酰胆碱的类似物,其中,甘油二酯与脂肪酸的残基被神经酰胺链所取代;心磷脂,即,1,3-二磷脂酰甘油与脂肪酸的酯;醣脂,如神经节苷脂GM1(或GM2)或脑苷脂;糖脂;硫苷脂和鞘糖脂。
在本文中,术语磷脂包括天然存在的,半合成的或合成制备的产品,它们可以单独使用或者作为混合物使用。
天然存在的磷脂的例子有天然卵磷脂(磷脂酰胆碱(PC)衍生物),如一般为大豆或卵黄卵磷脂。
半合成的磷脂的例子有部分或完全氢化的天然存在的卵磷脂的衍生物。优选的磷脂是磷脂酰胆碱,乙基磷脂酰胆碱,磷脂酰甘油,磷脂酸,磷脂酰乙醇胺,磷脂酰丝氨酸,磷脂酰肌醇的脂肪酸二酯或鞘磷脂。
优选的磷脂的例子有,例如,二月桂酰-磷脂酰胆碱(DLPC),二肉豆蔻酰-磷脂酰胆碱(DMPC),二棕榈酰-磷脂酰胆碱(DPPC),双花生四烯酰-磷脂酰胆碱(DAPC),二硬脂酰-磷脂酰胆碱(DSPC),二油酰-磷脂酰胆碱(DOPC),1,2二硬脂酰-s n-甘油-3-乙基磷酸胆碱(乙基-DSPC),双十五烷酰-磷脂酰胆碱(DPDPC),1-肉豆蔻酰-2-棕榈酰-磷脂酰胆碱(MPPC),1-棕榈酰-2-肉豆蔻酰-磷脂酰胆碱(PMPC),1-棕榈酰-2-硬脂酰-磷脂酰胆碱(PSPC),1-硬脂酰-2-棕榈酰-磷脂酰胆碱(SPPC),1-棕榈酰-2-油酰基磷脂酰胆碱(POPC),1-油酰基-2-棕榈酰-磷脂酰胆碱(OPPC),二月桂酰-磷脂酰甘油(DLPG)以及它的碱金属盐,双花生四烯酰磷脂酰甘油(DAPG)以及它的碱金属盐,二肉豆蔻酰磷脂酰甘油(DMPG)以及它的碱金属盐,二棕榈酰磷脂酰甘油(DPPG)以及它的碱金属盐,二硬脂酰磷脂酰甘油(DSPG)以及它的碱金属盐,二油酰-磷脂酰甘油(DOPG)以及它的碱金属盐,二肉豆蔻酰磷脂酸(DMPA)以及它的碱金属盐,二棕榈酰磷脂酸(DPPA)以及它的碱金属盐,二硬脂酰磷脂酸(DSPA),双花生四烯酰磷脂酸(DAPA)以及它的碱金属盐,二肉豆蔻酰-磷脂酰乙醇胺(DMPE),二棕榈酰磷脂酰乙醇胺(DPPE),二硬脂酰磷脂酰乙醇胺(DSPE),二油酰基磷脂酰乙醇胺(DOPE),双花生四烯酰磷脂酰乙醇胺(DAPE),二亚油酰基磷脂酰乙醇胺(DLPE),二肉豆蔻酰磷脂酰丝氨酸(DMPS),双花生四烯酰磷脂酰丝氨酸(DAPS),二棕榈酰磷脂酰丝氨酸(DPPS),二硬脂酰磷脂酰丝氨酸(DSPS),二油酰磷脂酰丝氨酸(DOPS),二棕榈酰鞘磷脂(DPSP),和二硬脂酰鞘磷脂(DSSP),二月桂酰-磷脂酰肌醇(DLPI),双花生四烯酰磷脂酰肌醇(DAPI),二肉豆蔻酰磷脂酰肌醇(DMPI),二棕榈酰磷脂酰肌醇(DPPI),二硬脂酰磷脂酰肌醇(DSPI),二油酰-磷脂酰肌醇(DOPI)。
术语磷脂还包括改性的磷脂,例如,其中亲水的基团又与另一个亲水的基团结合的磷脂。改性的磷脂的例子有用聚乙二醇(PEG)改性的磷脂酰乙醇胺,即,磷脂酰乙醇胺,其中亲水的乙醇胺部分与各种分子量的PEG分子连接(例如,分子量为300-5000道尔顿),如DPPE-PEG(或DSPE-,DMPE-或DAPE-PEG),即具有结合在它上面的PEG聚合物的DPPE(或DSPE,DMPE,或DAPE)。例如,DPPE-PEG2000表示在它上面结合了PEG聚合物(平均分子量大约为2000)的DPPE。
特别优选的磷脂是DAPC,DSPC,DPPA,DSPA,DMPS,DPPS,DSPS和乙基-DSPC。最优选的是DPPS或DSPC。
还可以使用磷脂的混合物,例如,DPPE,DPPC,DSPC和/或DAPC与DSPS,DPPS,DSPA,DPPA,DSPG,DPPG,乙基-DSPC和/或乙基-DPPC的混合物。
在优选实施方案中,磷脂是微泡的稳定化外被的主要成分,占形成充气微泡外被的成分总量的至少50%(w/w)。在某些优选实施方案中,所述外被的几乎全部(即至少占重量的90%,至高达100%)可以由磷脂组成。
所述磷脂通常可与上面所列举的任何两性分子化合物混合使用。例如,类脂如胆甾醇,麦角甾醇,植物甾醇,谷甾醇,羊毛甾醇,生育酚,没食子酸丙酯或抗坏血酸棕榈酸酯,脂肪酸如肉豆蔻酸,棕榈酸,硬脂酸,花生酸及其衍生物或丁基化羟基甲苯和/或其他非-磷脂化合物可任选地添加到上述一种或多种磷脂中,其比例为占重量的0-50%,优选高达25%。特别优选的是棕榈酸。
根据一种优选实施方案,形成本发明组合物微泡的外被包括总体上带净电荷(正或负)的化合物。所述化合物可以是带电荷的两亲性材料,优选类脂或磷脂。
总体上带负电荷的磷脂的例子是衍生物,特别是磷脂酰丝氨酸的脂肪酸二酯衍生物,如DMPS,DPPS,DSPS;磷脂酸的脂肪酸二酯衍生物,如DMPA,DPPA,DSPA;磷脂酰甘油的脂肪酸二酯衍生物,如DMPG,DPPG和DSPG或磷脂酰肌醇的脂肪酸二脂衍生物,如DMPI,DPPI或DPPI。还包括改性的磷脂,特别是PEG-改性的磷脂酰乙醇胺,如DMPE-PEG1000,DMPE-PEG2000,DMPE-PEG3000,DMPE-PEG4000,DMPE-PEG5000,DPPE-PEG1000,DPPE-PEG2000,DPPE-PEG3000,DPPE-PEG4000,DPPE-PEG5000,DSPE-PEG1000,DSPE-PEG2000,DSPE-PEG3000,DSPE-PEG4000,DSPE-PEG5000,DAPE-PEG1000,DAPE-PEG2000,DAPE-PEG3000,DAPE-PEG4000或DAPE-PEG5000可以用作带负电荷的分子。另外,上述磷脂的溶血形式,如溶血磷脂酰丝氨酸衍生物(例如,溶血-DMPS,-DPPS或-DSPS),溶血磷脂酸衍生物(例如,溶血-DMPA,-DPPA或-DSPA)和溶血磷脂酰甘油衍生物(例如,溶血-DMPG,-DPPG或-DSPG),可有利地用作带负电荷的化合物。带负电荷的类脂的例子有胆汁酸盐如胆酸盐,脱氧胆酸盐或甘氨胆酸盐;和(C12--C24),优选(C14-C22)脂肪酸盐,例如,棕榈酸盐,硬脂酸盐,1,2-二棕榈酰-sn-3-琥珀酰甘油盐或1,3-二棕榈酰-2-琥珀酰甘油盐。
优选的是,所述带负电荷的化合物选自DPPA,DPPS,DSPG,DSPE-PEG2000,DSPE-PEG5000或它们的混合物。
所述带负电荷的成分通常与相应的正的抗衡离子结合,它可以是一价-(例如,碱金属或铵盐),二价-(例如,碱土金属)或三价(例如铝)。优选的是,所述抗衡离子选自碱金属阳离子,如Li+,Na+,或K+,更优选Na+。
总体上带正电荷的磷脂的例子是乙基磷脂酰胆碱的衍生物,特别是乙基磷脂酰胆碱与脂肪酸的二酯,如1,2-二硬脂酰-sn-甘油-3-乙基磷酸胆碱(乙基-DSPC或DSEPC),1,2-二棕榈酰-sn-甘油-3-乙基磷酸胆碱(乙基-DPPC或DPEPC)。负抗衡离子优选为卤素离子,特别是氯或溴。带正电荷的类脂的例子有烷基铵盐与卤素抗衡离子(例如,氯或溴),包括至少一个(C10-C20),优选(C14-C18),烷基链,例如,一或二硬脂酰氯化铵,一或二十六烷基氯化铵,二甲基双十八烷基溴化铵(DDAB),十六烷基三甲基溴化铵(CTAB)。带正电荷的类脂的其他例子有叔铵或季铵盐与卤素抗衡离子(例如,氯或溴),包括一个或优选两个(C10-C20),优选(C14-C18),通过(C3-C6)亚烃基桥与N-原子连接的酰基链,例如,1,2-二硬脂酰-3-三甲基铵-丙烷(DSTAP),1,2-二棕榈酰-3-三甲基铵-丙烷(DPTAP),1,2-油酰-3-三甲基铵-丙烷(DOTAP),1,2-二硬脂酰-3-二甲基铵-丙烷(DSDAP)。
DSEPC,DPEPC和/或DSTAP优选被用作微泡外被中的带正电荷的化合物。
所述带正电荷的成分通常与相应的负的抗衡离子结合,它们可以是一价-(例如,卤素),二价-(例如,硫酸盐)或三价(例如,磷酸盐)。优选的抗衡离子选自卤素离子,如F-(氟),Cl-(氯)或Br-(溴)。
中性和带电荷的化合物的混合物,特别是磷脂和/或类脂可令人满意地形成微泡外被。带电荷的类脂或磷脂的摩尔数量相对类脂和磷脂的总数量可以在大约95%-大约1%,优选80%-20%内变化。
中性磷脂和带电荷的类脂或磷脂的优选混合物是,例如,DPPG/DSPC,DSTAP/DAPC,DPPS/DSPC,DPPS/DAPC,DPPE/DPPG,DSPA/DAPC,DSPA/DSPC和DSPG/DSPC。
其他赋形剂或添加剂能够以微泡的干燥制剂的形式存在或与含水载体一起添加,用于它们的重构,而又不必涉及(或仅部分涉及)微泡的稳定化外被的形成。其中包括pH调节剂,克分子渗透压重量浓度调节剂,粘度增强剂,乳化剂,填充剂等,并且能够以常规用量使用。例如,可以使用诸如聚丙二醇和聚乙二醇以及它们的共聚物的化合物。粘度增强剂或稳定剂的例子是选自线性和交联的聚糖和寡聚糖,糖类,亲水的聚合物,如聚乙二醇的化合物。
由于充气微泡的制备可能涉及冷冻干燥或喷雾干燥步骤,因此它优选在配方中包含冷冻干燥添加剂,如具有防冷冻和/或低温保护作用的制剂和/或填充剂,例如,氨基酸,如甘氨酸;碳水化合物,例如,糖,如蔗糖,甘露醇,麦芽糖,海藻糖,葡萄糖,乳糖或环糊精,或多醣如葡聚糖;或聚二醇如聚乙二醇。
本发明的组合物的微泡可以按照本领域公知的方法生产。一般,生产方法涉及制备干燥的粉末状材料,包括上述两亲性材料,优选冻干(冷冻干燥)包括所述材料的含水的或有机悬浮液。
例如,正如在WO 91/15244中所披露的,可首先通过任何脂质体形成方法将成膜两性分子化合物转化成层状形式。为此,要对包括成膜类脂以及任选其他添加剂(例如,粘度增强剂,非成膜表面活性剂,电解质等)的水溶液进行高度机械匀浆或在有声或超声频率下进行超声波处理,然后冷冻干燥,以便形成能自由流动的粉末,然后在存在气体的条件下保存。例如,正如在US 5,597,549中所披露的,在进行冷冻干燥之前,可任选进行洗涤步骤。
根据另一种实施方案(例如,参见US 5,597,549中所描述的),可以将成膜化合物和亲水的稳定剂(例如,聚乙二醇,聚乙烯吡咯烷酮,聚乙烯醇,乙醇酸,苹果酸或麦芽醇)溶解在有机溶剂(例如,叔丁醇,2-甲基-2-丁醇或C2Cl4F2)中,并且对该溶液进行冷冻干燥以便形成干燥的粉末。
优选的是,正如在待批的国际专利申请WO 2004/069284中所披露的,可以将磷脂(选自上述所列举的,并且包括至少一个上述带电荷的磷脂)和低温保护剂(如在前面所列举的,特别是碳水化合物,糖醇,聚二醇和它们的混合物)可以在搅拌条件下分散在水和与水不混溶的有机溶剂(例如,分支的或线性链烷烃,烯属烃,环烷,芳香烃,烷基醚,酮,卤代烃,全氟化烃或它们的混合物)的乳液中。所述乳液可以通过用本领域已知的任何合适的乳液产生技术在存在至少一种磷脂的条件下处理所述含水介质和溶剂获得,所述技术例如为,超声波,摇晃,高压匀浆,微量混合,膜片乳化,高速搅拌,和高剪切力混合。例如,可以使用转子-定子匀浆器,如PolytronPT3000。转子-定子匀浆器的搅拌速度可以根据乳液的成分,乳液的体积,有机溶剂的相对体积,容纳乳液的容器的直径,和在乳液中所需要的溶剂微滴的最终直径进行选择。另外,可以利用微量混合技术乳化所述混合物,例如,通过第一入口将有机溶剂导入所述搅拌器(例如,流速为0.05-5ml/分),并且通过第二入口导入水相(例如,流速为2-100ml/分)。然后将微型搅拌器的出口与装有水相的容器连接,以便水相随后从所述容器中抽出,并且进入装有数量逐渐增加的乳化溶剂的微型搅拌器中。在业已添加了所有体积的溶剂之后,来自所述容器的乳液可以通过微型搅拌器保持再循环另一段预定时间,例如,5-120分钟,以便完成所述乳化。根据乳化技术,可以在乳化步骤期间逐渐导入有机溶剂,或者在乳化步骤开始前即刻导入。另外,含水介质可以在乳化步骤期间逐渐添加到与水不混溶的溶剂中,或者在乳化步骤开始前即刻加入。优选的是,将磷脂分散在含水介质中,然后将分散液与有机溶剂混合。另外,可以将磷脂分散在有机溶剂中,或者在乳化步骤之前或期间将它们分别添加到水-有机混合物中。由此获得的微乳液包括溶剂的微滴,它是由磷脂材料(和任选由其他两亲性的成膜化合物和/或添加剂)包围和稳定化的,然后按照常规技术冷冻干燥,以便获得冷冻干燥材料,保存该材料(例如,在存在合适气体的条件下用小瓶保存),该材料可以用含水载体重构,以便最终提供充气微泡悬浮液,其中所述微泡的尺度和尺寸分布大体上与微滴悬浮液的尺度和尺寸分布相当。
用于制备充气微泡的另一种方法包括制备气体微泡分散液,通过对含有磷脂(并且任选含有其他两亲性的成膜化合物和/或添加剂)的含水介质进行受控制的高搅拌能量(例如,通过转子定子搅拌器)在存在需要的气体的条件下搅拌,并且将所获得的分散液冻干,以便得到干燥的可重构的产物。例如,该方法的例子可以参见WO97/29782,被收作本文参考。
喷雾干燥技术(例如,参见US 5,605,673)还可用于获得干燥的粉末,在与生理学含水载体接触时可以重构,以便获得充气微泡。
通过上述任何技术获得的干燥的或冻干的产物一般是粉末或块状形式的,并且能够在与需要的气体接触的条件下保存(例如,保存在小瓶中)。所述产品可方便地用合适的生理学上可接受的含水液体载体重构,它通常是可注射的,以便在柔和搅拌悬浮液时形成充气微泡。合适的生理学上可接受的液体载体是无菌的水,水溶液,如盐水(它优选是平衡过的,以便用于注射的最终产品不是低渗的),或一种或多种渗透压调节物质的溶液,如盐或糖,糖醇,糖醇、二醇或其他非离子型多元醇材料(如葡萄糖,蔗糖,山梨糖醇,甘露醇,甘油,聚乙二醇,和丙二醇等)。
最终重构的微泡的平均尺度和尺寸分布一般是通过对制备方法的参数进行合适的作用确定的。一般,最终制剂的平均尺寸和尺寸分布的不同的值可以通过选择不同的外被-稳定化磷脂和/或(当方法需要时)通过选择不同的有机溶剂和/或它们的不同的体积(相对于水相的体积)获得。另外,对于在WO2004/069284或WO97/29782中所披露的特定制备方法来说,混合速度的改变通常会导致最终的微泡制剂的平均尺寸的改变(一般,混合速度越高,所获得的微泡越小)。
微囊
本文所定义的充气的微囊包括具有材料外被的微囊,它的厚度一般远远超过微泡稳定薄膜外被的厚度。根据构成所述外被的材料(例如,它可以是聚合物,蛋白质,水不溶性类脂或它们的任意组合),所述厚度一般至少为50nm,通常为至少100nm,可以高达几百纳米(例如,300nm)。
微泡的优选的例子是具有稳定化外被的微泡,所述外被包括聚合物,优选生物可降解的聚合物,或包括生物可降解的水不溶性类脂的稳定化外被,例如,参见US 5,711,933和US 6,333,021中所述的,以它们的全文形式收作本文参考。可以使用具有蛋白质的外被的微囊,即由天然蛋白质(白蛋白,血红蛋白)组成,例如,参见US-A-4,276,885或EP-A-O 324 938。
构成可注射微泡的外被的聚合物优选是亲水的,生物可降解的生理学上相容的聚合物。所述聚合物的例子,它可以是天然的或合成的,大体上是不溶性的多糖(例如,壳聚糖或几丁质),聚氰基丙烯酸酯,聚交酯和聚乙醇酸交酯以及它们的共聚物,丙交酯和内酯如γ-己内酯或δ-戊内酯的共聚物,环氧乙烷和丙交酯的共聚物,聚乙烯亚胺,多肽,和蛋白,如明胶,胶原,球蛋白和白蛋白。在US 5,711,933中所提到的其他合适的聚合物包括聚-(原酸)酯,聚乳酸和聚乙醇酸,以及它们的共聚物(例如,DEXON,Davis & Geek,Montreal,Canada);聚(DL-丙交酯-共-γ-己内酯),聚(DL-丙交酯-共-δ-戊内酯),聚(DL-丙交酯-共-γ-丁内酯),聚烷基氰基丙烯酸酯;聚酰胺,多羟基丁酸酯;聚二氧六环酮;聚-β-氨基酮;聚磷腈;和聚酐。还可以使用聚氨基酸,如聚谷氨酸和聚天冬氨酸,以及它们的衍生物,如与低级醇或甘油的部分酯。也可以使用与其他氨基酸,如甲硫氨酸,亮氨酸,缬氨酸,脯氨酸,甘氨酸,丙氨酸等的共聚物。还可以使用具有受控制的生物降解能力的聚谷氨酸和聚天冬氨酸的衍生物(例如,参见WO 87/03891,US 4,888,398或EP 130935,都被收做本文参考)。这些聚合物(和与其他氨基酸的共聚物)具有以下类型的结构式:-(NH-CHA-CO)w-(NH-CHX-CO)y-,其中,X表示氨基酸残基的侧链(例如,甲基,异丙基,异丁基,或苄基);A是以下结构式的基团-(CH2)nCOOR1R2-OCOR,-(CH2)nCOO-CHR1COOR,-(CH2)nCO(NH-CHX-CO)mNH-CH(COOH)-(CH2)PCOOH,或它们的相应的酸酐,其中,R1和R2表示H或低级烷基类,R表示烷基和芳基;或R和R1是通过取代过的或未取代过的连接成分连接在一起,以便提供5-或6-员环;n,m和p是较小的整数,不超过5;而w和y是选择的整数,以便使分子量不低于5000。
非-生物可降解的聚合物(例如,用于制备微囊,以便用在消化道中),可以从大部分水不溶性、生理学上可接受的,生物耐受性聚合物中选择,包括聚烯烃(聚苯乙烯),丙烯酸树脂(聚丙烯酸酯,聚丙烯腈),聚酯(聚碳酸酯),聚氨基甲酸酯,聚脲以及它们的共聚物。ABS(丙烯-丁二烯-苯乙烯)是优选的共聚物。
可用于形成微胶囊的生物可降解的水不溶性类脂包括,例如,固体水不溶性甘油一酯、甘油二酯或甘油三酯,脂肪酸,脂肪酸酯,甾醇,如胆甾醇,蜡和它们的混合物。甘油一酯、甘油二酯和甘油三酯主要包括月桂酸一酯、月桂酸二酯和月桂酸三酯化合物,以及相应的-肉豆寇精,-棕榈精,-硬脂精,-花生四烯精和-山嵛精衍生物。一-,二-和三-花生四烯精,-棕榈精-硬脂精和混合的甘油三酯,如二棕榈酰一油酰基甘油酯是特别有用的;三棕榈精和三硬脂精是优选的。脂肪酸包括固体(在室温下,大约18-25℃)脂肪酸(优选饱和的)具有12个碳原子或更多,例如,包括月桂酸,花生酸,山嵛酸,棕榈酸,硬脂酸,癸二酸,肉豆蔻酸,巴豆酸(cerotinic),蜂蜜酸和芥酸,以及它们的脂肪酸酯。优选的是,所述脂肪酸和它们的酯是与其他甘油酯混合使用的。
所述甾醇优选与其他甘油酯和或脂肪酸混合使用,并且选自胆甾醇,植物甾醇,羊毛甾醇,麦角甾醇等,以及甾醇与上述脂肪酸的酯;不过,优选胆甾醇。
优选的生物可降解的类脂是甘油三酯,如三棕榈精,三花生四烯精,三硬脂精或上述甘油三酯的混合物。
任选地将重量百分比高达75%的生物可降解的聚合物,如上面所列举的聚合物与形成微胶囊外被的生物可降解的水不溶性类脂混合在一起。有利的是,还可以使用离子型聚合物(即在它们的结构上具有离子部分的聚合物),有利生物可降解的离子型聚合物用于形成微囊的稳定化外被,由此使它具有需要的总体净电荷。离子型聚合物可以被用作稳定化外被的主要成分或它们能够以各种数量(例如,占重量的2-80%)与非离子型聚合物混合。合适的离子型聚合物有,例如,包括季铵化氮原子的聚合物,如季铵化胺或包括羧酸,硫酸,磺酸或磷酸部分的聚合物。合适的离子型聚合物的例子包括,但不局限于聚乙烯亚胺,聚(二烯丙基二甲基氯化铵),聚(双(2-氯乙基)醚-alt-1,3-双[3-(二甲氨基)丙基]脲}季铵化(聚季铵盐-2),聚(4-乙烯基吡啶三溴化物),羟乙基纤维素乙氧基化物季铵化(聚季铵盐-4,聚(p-对二甲苯四氢氯化苯硫酚),聚(L-赖氨酸),几丁质,二亚乙基氨基乙基葡聚糖,聚(丙烯酸),聚(异丁烯酸),聚(苯乙烯-alt-马来酸),聚(氨基酸),藻酸,聚(尿甙酸),透明质酸,即聚(β-葡萄醛酸-alt-β-N-乙酰葡萄糖酰胺),聚(半乳糖醛酸),聚(乙酸乙烯酯-共-巴豆酸),DNA,聚(3,3′,4,4′-二苯甲酮四羧酸二酐-4,4′-氧二苯胺),聚(异戊二烯-接枝-马来酸一甲基醚),谷氨酸与烷基谷氨酸酯的共聚物,肝素,聚(苯乙烯磺酸盐),磺化聚(异酞酸),聚(乙烯基磺酸盐,钾盐),聚(乙烯硫酸,钾盐),硫酸软骨素A,硫酸葡聚糖,岩藻依聚糖,多磷酸,多磷酸钠,聚乙烯磷酸钠,聚-L-赖氨酸氢溴化物,壳聚糖,硫酸壳聚糖,藻酸钠,藻酸和木质素磺酸盐。还可以将常规添加剂添加到微囊的外被中,以便改变它的物理特性,如可分散性,弹性和渗水性。具体地讲,可以将有效数量的两亲性材料添加到为了生产所述微囊所制备的乳液中,以便提高它的稳定性。所述材料可有利地选自两性分子化合物,如类脂,磷脂和改性的磷脂,正如在本说明书的前面所列举的。
所添加的两亲性材料可优选为总体上带有净电荷的化合物。优选的带电荷的类脂,磷脂和改性的磷脂是如上文所提到的。优选的是,当存在时,带电荷的化合物的量为形成稳定化外被的材料总重量的大约2%-40%。
其他赋形剂或添加剂,特别是用于微囊制备的添加剂,如再分散剂或粘度增强剂可以添加到所述外被中。
可以制备含有生物可降解的聚合物的微囊,例如,按照在US 5,711,933中所披露的方法制备,该文被收做本文参考,该方法包括(a)将疏水性有机相乳化至水相,以便获得所述疏水相的液滴,作为所述水相中的水包油乳液;(b)向所述乳液中添加至少一种在不溶于水相的挥发性溶剂中的聚合物溶液,以便所述聚合物在所述液滴周围形成层;(c)蒸发所述挥发性溶剂,以便所述聚合物通过界面沉淀沉积在液滴周围,然后形成具有通过所述聚合物的薄膜包围的所述疏水相的核心的珠,所述珠悬浮在所述水相中;(d)通过在负压条件下对所述悬浮液进行蒸发除去所述包封的疏水相;和(e)用合适的气体代替蒸发的疏水相。
可以制备含有生物可降解的类脂的微囊,例如,按照在US 6,333,021中披露的方法制备(被收做本文参考),包括将溶解在有机溶剂中的微胶囊外被的一种或多种固体成分的混合物分散在水载体相中,以便产生水包油乳液。该乳液水相可以包括有效量的两亲性材料,它被用于稳定所述乳液。
然后将一定数量的再分散剂和/或防冻剂或低温保护剂,如上文所提到的制剂添加到所述有机溶液在水相中的微滴乳液中,然后在低于-30℃的温度下冷冻。可以使用任何常见再分散剂;优选选自糖,白蛋白,明胶,聚乙烯基吡咯烷酮(PVP),聚乙烯醇(PVA),聚乙二醇(PEG)和环氧乙烷-环氧丙烷嵌段共聚物(例如,Pluronic,或Synperonic)或它们的混合物的再分散剂。为了避免颗粒聚合而添加的再分散剂当所述微囊是非合并的、干燥的和可快速分散的粉末形式时特别实用。然后对冷冻的乳液进行减压处理,以便实现冻干,即通过有机溶剂从液滴中和载体相中的水的升华作用除去,并且然后让冷冻干燥的产品与需要的气体接触。
然后可以通过让干燥的粉末与合适的含水载体在轻微搅拌下接触重构微囊。
生物相容性气体
可以用任何生物相容性气体,气体前体或它们的混合物填充上述微泡。
所述气体可以包括,例如,空气;氮;氧;二氧化碳;氢;一氧化氮;稀有气体或惰性气体,如氦,氩,氙或氪;放射性气体,如Xe133或Kr81;超极化稀有气体,如超极化氦,超极化氙或超极化氖;低分子量烃(例如,含有多达7个碳原子),例如,链烷,如甲烷,乙烷,丙烷,丁烷,异丁烷,戊烷或异戊烷,环链烷,如环丁烷或环戊烷,链烯,如丙烯,丁烯或异丁烯,或炔,如乙炔;醚;酮;酯;卤代气体,优选氟化气体,,如卤化的,氟化的或全氟化的低分子量烃(例如,含有高达7个碳原子);或上述任何成分的混合物。当使用卤代烃时,所述化合物中的优选至少某些,更优选全部的卤素原子是氟原子。
优选氟化气体,特别是全氟化的气体,特别是用于超声成像领域。氟化气体包括这样的材料,它包括至少一个氟原子,例如,氟化烃(含有一个或多个碳原子和氟的有机化合物);六氟化硫;氟化的,优选全氟化的,酮,如全氟化丙酮;和氟化的,优选全氟化的,醚,如全氟化二乙醚。优选的化合物是全氟化的气体,如SF6或全氟化碳(全氟化烃),即这样的烃,其中所有的氢原子被氟原子所取代,已知它构成了特别稳定的微泡悬浮液,例如,参见EP 0554213,其被收做本文参考。
术语全氟化碳包括饱和的,不饱和的,和环全氟化碳。生物相容性的,生理学上可接受的全氟化碳的例子有:全氟化链烷烃,如全氟化甲烷,全氟化乙烷,全氟化丙烷,全氟化异丁烷(例如,全氟化-n-丁烷),任选地与其他异构体(如全氟化-异丁烷)混合,全氟化戊烷,全氟化己烷或全氟化庚烷;全氟化烯属烃,如全氟化丙烯,全氟化丁烯(例如,全氟化丁-2烯)或全氟化丁二烯;全氟化炔(例如,全氟化丁-2炔);和全氟化环烷(例如,全氟化环丁烷,全氟化甲基环丁烷,全氟化二甲基环丁烷,全氟化三甲基环丁烷,全氟化环戊烷,全氟化甲基环戊烷,全氟化二甲基环戊烷,全氟化环己烷,全氟化甲基环己烷和全氟化环庚烷)。优选的饱和的全氟化碳具有结构式CnFn+2,其中n是1-12,优选2-10,最优选3-8,更优选3-6。合适的全氟化碳包括,例如,CF4,C2F6,C3F8,C4F8,C4F10,C5F12,C6F12,C6F14,C7F14,C7F16,C8F18,和C9F20。
特别有利的气体是SF6或选自下列一组的全氟化碳:CF4,C2F6,C3F8,C4F8,C4F10或它们的混合物;特别优选的是SF6,C3F8或C4F10。
同样优选的是使用任何比例的上述气体的混合物。例如,所述混合物可以包括常规气体,如氮,空气或二氧化碳,以及形成稳定的微泡悬浮液的气体,如上文所述的六氟化硫或全氟化碳。合适气体混合物的例子可以参见,例如,WO 94/09829,它被收做本文参考。以下组合是特别优选的:气体(A)和(B)的混合物,其中气体(B)是氟化气体,优选选自SF6,CF4,C2F6,C3F6,C3F8,C4F6,C4F8,C4F10,C5F10,C5F12或它们的混合物,而(A)选自空气,氧,氮,二氧化碳或它们的混合物。气体(B)的数量占总混合物的大约0.5%-大约95%v/v,优选大约5%-80%。
在某些场合下,可能需要包括气体物质的前体(即能够在体内转化成气体的材料)。优选的是,所述气体前体和由它所产生的气体是生理学上可接受的。所述气体前体可以是pH-激活的,光-激活的,温度激活的等,例如,可以将某些全氟化碳用作温度激活的气体前体。这些全氟化碳,如全氟化戊烷或全氟化己烷,具有超过室温(或生产和/或保存所述制剂的温度),不过,低于体温的液相/气相转变温度;因此,它们能在人体内发生液相/气相转变,并且转化成气体。
对于超声波回波描记术来说,所述生物相容性气体或气体混合物优选选自空气,氮,二氧化碳,氦,氪,氙,氩,甲烷,卤代烃(包括氟化气体如全氟化碳和六氟化硫)或它们的混合物。有利的是,可以使用全氟化碳(特别是C4F10或C3F8)或SF6,任选地与空气或氮混合。
为了用于MRI,所述微泡优选含有超极化稀有气体如超极化氖,超极化氦,超极化氙,或它们的混合物,任选地与空气,CO2,氧,氮,氦,氙,或上述任何卤代烃混合。
为了用于闪烁照相术,所述微泡优选包括放射性气体,如Xe133或Kr81或它们的混合物,任选地与空气,CO2,氧,氮,氦,氪或上述任何卤代烃混合。
改性的微泡
用于本发明的组合物中的微泡可任选地包括(例如,含有或与之结合)靶向制剂,诊断剂和/或生物活性剂。
术语″靶向制剂″的含义包括具有或能够促进本发明组合物的微泡针对活体内的任何生物学或病理学部位的定向活性(例如,包括选择性结合)的任何化合物,部分或残基。靶向制剂可以结合的目标包括组织,例如,心肌组织(包括心肌细胞和心脏肌细胞),膜组织(包括内皮和上皮),板层,结缔组织(包括间质组织)或肿瘤,血液凝块,和受体,例如,用于肽激素的细胞表面受体,神经递质,抗原,补体片段,和免疫球蛋白,和甾醇激素的细胞质受体。
所述靶向制剂可以是合成的,半合成的,或天然存在的。例如,可用作靶向制剂的材料或物质包括,但不局限于蛋白质,包括抗体,抗体片段,受体分子,受体结合分子,糖蛋白和外源凝集素;肽,包括寡肽和多肽;肽模拟物;糖类,包括单糖和多醣;维生素;甾醇,甾醇类似物,激素,辅因子,生物活性剂和遗传学材料,包括核酸,核苷酸和多核苷酸。
合适的目标和靶向制剂的例子可以参见,例如美国专利号6,139,819,它被收做本文参考。
所述靶向制剂本身可以是化合物,它与所述微泡的其他成分混合,或者可以是与用于形成所述微泡的两亲性分子结合的化合物。
在-种优选实施方案中,所述靶向制剂可以通过共价键与所述微泡的两亲性分子结合。在这种情况下,需要出现在两亲性分子上的所述特殊的活性部分取决于要与它结合的具体的靶向制剂。作为例子,如果所述靶向制剂可以通过氨基基团与两亲性分子连接,所述两亲性分子的合适的活性部分可以是异硫氰酸盐基团(它可以形成硫脲键),活性酯(以便形成酰胺键),醛基(用于形成亚胺键,以便还原成烷基胺键)等;如果所述靶向制剂可以通过硫醇基与所述两亲性分子连接,所述两亲性分子的合适的互补性活性部分包括卤代乙酰衍生物或马来酰亚胺(以便形成硫醚键);并且,如果所述靶向制剂可以通过羧基与两亲性分子连接,两亲性分子的合适的活性部分可以是胺和酰肼(以便形成酰胺或烷基酰胺键)。为了共价结合需要的靶向制剂,构成微泡的两性分子化合物的至少一部分应当包括合适的活性部分并且包括互补性官能度的所述靶向制剂按照已知技术与它连接,例如,将它添加到包括微泡的两亲性成分的悬浮液中。所述两性分子化合物可以在制备微泡之前与所述需要的靶向制剂混合,并且由此获得的组合物可用于微泡的制备过程。另外,所述靶向制剂可以在微泡的制备过程中与相应的两性分子化合物连接。
根据另一种实施方案,所述靶向制剂还可以通过物理和/或静电地相互作用适当地与微泡结合。作为例子,可以将对互补部分具有高亲和力和选择性的功能性部分导入所述两亲性分子,同时所述互补部分与所述靶向制剂连接。例如,抗生物素蛋白(或抗生蛋白链菌素)部分(对生物素具有高亲和力)可以与磷脂共价连接,同时将互补性生物素部分结合到合适的靶向制剂,例如,肽或抗体上。因此,通过抗生物素蛋白-生物素偶联系统,生物素-标记的靶向制剂将与微泡的抗生物素蛋白-标记的磷脂结合。或者,磷脂和靶向制剂可以具有生物素部分并且随后通过抗生物素蛋白(它是双功能成分,可以桥接两个生物素部分)彼此结合。结合磷脂和肽的生物素/抗生物素蛋白的例子还披露于上文所披露的US 6,139,819中。另外,范德华相互作用,静电相互作用和其他结合过程可以使靶向制剂与两亲性分子结合或连接。
根据另一种实施方案,所述靶向制剂可以是与形成微泡的成分混合的化合物,以便最终结合在微泡结构上,例如,脂肽,例如,参见国际专利申请WO 98/18501或99/55383,都被收做本文参考。
或者,可以首先生产微泡,它包括具有能够与靶向制剂的相应互补部分相互作用的合适部分的化合物;然后,将需要的靶向制剂添加到微泡悬浮液中,以便使相应的互补部分结合在微泡上。微泡可以导向的合适的具体目标的例子有,例如,纤维蛋白和激活的血小板上的GPIIbIIIa结合受体。纤维蛋白和血小板实际上一般出现在″血栓症″,即凝结块中,它可以在血流中形成,并且导致血管堵塞。合适的结合肽可以参见,例如上面所引用的US 6,139,819。对纤维蛋白-靶向特异的结合肽可以参见,例如,国际专利申请WO 02/055544,它被收做本文参考。
重要目标的其他例子包括脆弱的噬斑中的受体和肿瘤特异性受体,如激酶结构域(KDR)和VEGF(血管内皮生长因子)/KDR复合物。适合KDR或VEGF/KDR复合物的结合肽可以参见,例如,国际专利申请WO03/74005和WO 03/084574,都被收做本文参考。
术语″诊断剂″包括可以用于对患者的体内部位进行成像的方法中,和/或诊断患者体内疾病的存在与否的任何化合物,组合物或颗粒。具体地讲,被整合或结合在本发明组合物的微泡中的诊断剂是可以与诊断技术,包括,磁共振成像,X-光,特别是计算断层照相法,光学成像,核成像或分子成像结合起到成像增强作用的任何化合物,组合物或颗粒。合适的诊断剂的例子有,例如,磁纳米颗粒,碘化化合物,如Iomeprol,或顺磁性离子配合物,如疏水性钆配合物。
术语″治疗制剂″包括可用于任何治疗用途中,如用于治疗患者疾病的方法的任何物质,组合物或颗粒,以及能够在体外和/或体内发挥或负责发挥生物学作用的任何物质。因此,治疗制剂包括可用于治疗(包括诊断,预防,缓和,疼痛缓解或治愈)患者的任何病理学状态(包括疾病,痛苦,病变或损伤)的任何化合物或材料。治疗制剂的例子有药物,医药品,生物活性剂,细胞毒性剂,化疗制剂,放射治疗制剂,蛋白,天然或合成肽,包括寡肽和多肽,维生素,甾醇和遗传学材料,包括核苷,核苷酸,寡核苷酸,多核苷酸和质粒。其中,优选药物和医药品。
合适的治疗制剂的例子包括抗溃汤药,如甲氰咪胍,法莫替丁,雷尼替丁,乙酸蜂王胶,潘托拉唑,奥美拉唑,羊毛二烯或硫酸铝;肠道松弛剂或促动力药,如溴化丙胺太林,卡米罗芬(胺苯戊酯),双环胺,东莨菪碱丁基溴,美贝维林,西沙必利,奥西布宁,溴化哌苯偶酯甲基溴,屈他维林,灭吐灵,克利溴铵,异丙胺或安胃灵;酶或驱风止痛剂,如胰酶,木瓜蛋白酶,胃蛋白酶,或蛋白酶;肝胆管制剂,如鹅脱氧胆酸,熊果脱氧胆酸,L-鸟氨酸或水飞蓟素;抗高血压药,如可乐定,甲基多巴,硝普钠,特拉唑嗪,多沙唑嗪,(DI)肼苯哒嗪或哌唑唪;β阻断剂如艾思洛尔,高脂肪肝,氨酰心安,labetolol,心得安,美托洛尔,卡维地洛,心得怡,oxyprenolol或比索洛尔;钙通道阻断剂,如费乐地,尼群地平,硝苯吡啶,苄尼地平,戊脉安,阿姆罗赫或乐息平;血管紧张素转化酶(ace)抑制剂,如依拉普利,利生普利,雷米普利,培哚普利拉,贝那普利或卡托普利;血管紧缩素II抑制剂,如洛沙坦;钾通道激活剂,如尼可地尔;利尿剂和抗利尿剂,如氢氯噻嗪,氯磺水杨胺,丁苯氧酸,氨氯吡脒,螺旋内酯,茚磺苯酰胺,氨苯蝶啶,多巴酰胺,利尿磺胺或氯噻酮;防心绞痛药,如异山梨醇二硝酸盐,丙烯氧心得安,异山梨醇5-一硝酸盐,地尔硫卓,丁四硝酯,三甲氧苄嗪,利多氟嗪,季戊四醇四硝酸酯,三硝酸甘油酯或克冠二氮卓;凝血剂,如缀合的雌激素,香叶木甙,甲萘醌,维生素K3,蝮蛇血凝酶,止血敏(cydanamine),芸香苷黄酮类化合物或肾上腺素红单半卡巴腙;抗凝血剂,抗血栓药或抗血小板药,如噻氯匹定,华法林,链激酶,苯茚满二酮,重组组织型纤溶酶原激活剂(rtpa),尿激酶,血管加压素,新抗凝,肝素,低分子量肝素,粘多醣多硫酸盐或潘生丁;抗心律失常剂,如奎纳定,达舒平,普鲁卡因胺,利诺卡因(利多卡因),脉律定,乙胺碘呋酮,腺苷,丙胺苯丙酮;用于心力衰竭和中风的药物,如美芬丁胺,地高辛,多巴胺,多巴酚丁安或去甲肾上腺素,血管舒张药,如异舒普林,烟胺羟丙茶碱,苄丙酚胺HCl,己酮可可碱(己酮柯柯豆碱)或环扁桃酯;强心苷,如去乙酰毛花甙丙(Deslaneside),洋地黄毒苷,地高辛或洋地黄苷;青霉素如苄青霉素,普鲁卡因青霉素(G),长效青霉素(G),青霉素V,青霉素G/V,巴卡西林,羧苄青霉素,氧哌嗪青霉素,氨比西林(任选地与舒巴克坦或丙磺舒组合),氯洒西林,或羟氨苄青霉素(任选地与必消痰,氯洒西林,羧甲半胱氨酸或棒酸组合);喹诺酮或喹诺酮如萘啶酸,果皮油,氧氟沙星,司巴沙星,氟哌酸,卷须霉素,洛美沙星,头孢菌素如头孢噻肟,头孢呋新,头孢克肟,氨噻肟头孢菌素,氯氨苄青霉素,头孢三嗪钠,头孢羟氨苄,头孢氨苄,(任选地与组合必消痰HCI或丙磺舒)头孢菌素V,头孢利定,头孢噻甲羧或ceforperazone;磺酰胺如磺酰胺,sulphamoxole,sulphadimehtoxine,cotrifamole,复方新诺明,甲氧苄氨嘧啶,氨基糖苷类,如庆大霉素,托普霉素,新霉素,丁胺卡那霉素,紫苏霉素,卡那徽素,乙基西梭霉素,多粘菌素如多粘菌素-b,硫酸粘菌素;氯霉素;四环素如四环素,强力霉素,二甲胺四环素,demedocycline,羟基四环素;大环内酯,如红霉素,(任选地与溴已新组合),克红霉素,万古霉素,林肯霉素,阿齐霉素,螺旋霉素,罗红霉素,氯林可霉素,头孢吡若,泰科霉素(泰科霉素a2),抗病毒素,如阿巴卡维,拉米夫定,无环鸟苷,金刚胺,干扰素,病毒唑,stavurdine,拉米夫定或齐多夫定(azt);抗疟药,如奎宁,氯胍,氯喹,首喹,氨酚喹,蒿甲醚,甲蒿琥酯,甲氟奎,乙嘧啶,蒿乙醚,麦帕克林;抗结核药,如环丝氨酸,卷曲霉素,乙硫异烟胺,丙硫异烟胺,异烟肼(inh),利福平,利福平任选地与组合异烟肼,异烟肼,吡嗪酰胺和/或乙胺丁醇;乙胺丁醇(任选地与组合异烟肼),链霉素或吡嗪酰胺;驱肠虫剂和抗感染剂,如哌嗪,贝螺杀,双羟萘酸喹嘧啶,左旋咪唑,乙胺嗪,四咪唑,丙硫咪唑,吡喹酮,钠锑葡糖酸盐或地巴唑;抗麻风药如氨苯砜或氯苯吩嗪;抗厌氧菌药,抗原虫药或抗阿米巴药,如硝砜咪唑,灭滴灵(任选地与组合呋喃唑酮或氟哌酸),二氯散糠酸盐,塞克硝唑,羟基喹诺酮,脱氢吐根碱,奥硝唑或呋喃唑酮;抗真菌剂如氟康唑,酮康唑,哈霉素,特比奈芬,益康唑,两性霉素-b,制霉菌素,克霉唑,灰黄霉素,咪康唑或伊曲康唑;维生素;呼吸兴奋剂,如一水合多沙普仑盐酸盐;平喘药如喘息定,舒喘宁(albuterol),奥西那林,麻黄素,硫酸特布他林,沙美特罗,氨茶碱,therophylline,bedomethasone dipropionate或丙酸氟替卡松;抗过敏药如特非那定,阿司咪唑,氯雷他定,克立马丁,dimethindene maletate,fexofenadine hydrochloride,羟嗪,氯屈米,马来酸阿扎他定,甲地拉嗪,马来酸抗感明,苯海拉明或西替立嗪;骨骼肌松弛药如替扎尼定美索巴莫,异丙基甲丁双脲,戊乙酯,巴氯芬,氯美乍酮或氯唑沙宗;平滑肌弛缓药如奥芬溴铵,溴化普洛盘舍啉,diclomine,东莨菪碱丁基溴化物,美贝维林,氢喹维林,克利溴铵,异丙胺或卡米罗芬二氢氯化物;非类固醇抗炎药物,如甲氧萘丙酸,甲灭酸,尼美舒利,双氯芬酸,替诺昔康,异丁苯丙酸(任选地与扑热息痛组合),美罗西康,阿司匹林,氟联苯丙酸,酮丙酸,ketoprolac,苯基丁氮酮,羟保松,消炎痛或吡罗昔康;抗肿瘤药,如氮芥化合物(例如,环磷酰胺,氯乙环磷酰胺,iofosfamide,美法仑或苯丁酸氮芥),氮丙啶(例如,thioepa),N-甲环亚硝脲衍生物(例如,卡氮芥,环己亚硝脲或嘧啶亚硝脲),铂化合物(例如,螺铂,顺氯氨铂,和卡波铂),甲基苄肼,氮烯唑胺,甲氨蝶呤,阿霉素,丝裂霉素,安丝菌素,阿糖胞苷,arabinosyl腺嘌呤,巯基聚赖氨酸,长春新碱,白消安,苯丁酸氮芥,美法仑(例如,PAM,L-PAM或苯丙氨酸氮芥),巯基嘌呤,米托坦,盐酸甲基苄肼,放线菌素(放线菌素D),盐酸道诺霉素,盐酸吗乙苯吡酮,表柔比星,普卡霉素(光神霉素),米托蒽醌,博来霉素,硫酸博来霉素,氨基苯乙哌啶酮,雌氮芥磷酸钠,氟他米特,乙酸亮丙瑞林,乙酸基孕甾酮,苯氧胺枸橼酸,睾内酯,曲洛司坦,安吖啶(m-AMSA),天门冬酰胺酶(L-天门冬酰胺酶)Erwina天门冬酰胺酶,足叶乙甙(VP-16),干扰素α-2a,干扰素α-2b,替尼泊甙(VM-26),硫酸长春碱(VLB),硫酸长春新碱,去乙酰长春酰胺,多西他赛(紫杉酚),甲氨蝶呤,阿霉素,arabinosyl,羟基脲;叶酸拮抗剂(例如,氨基蝶呤,甲氨蝶呤),嘌呤和嘧啶碱基的拮抗剂(例如,巯基嘌呤,硫鸟嘌呤,氟尿嘧啶或阿糖胞苷);麻醉药,鸦片剂或镇静剂如止痛剂,可待因,吗啡,鸦片,异戊巴比妥,异戊巴比妥钠,阿普比妥,正丁巴比妥钠,水合氯醛,氯乙基戊烯炔醇,凡眠特,盐酸氟胺安定,苯乙哌啶酮,盐酸甲基三甲泼拉嗪,甲乙哌酮,盐酸咪达唑仑,三聚乙醛,戊巴比妥,丙烯戊巴比妥钠,甲丙巴比妥,双香豆素或三唑苯二氮;局部或全身麻醉剂如丁呱卡因,氯普鲁卡因,依替卡因,利多卡因,马比佛卡因,普鲁卡因或丁卡因,氟哌利多,依托咪酯,枸橼酸芬太尼与氟哌利多,盐酸氯胺酮,美索比妥钠或戊硫代巴比妥;神经肌肉阻断剂如甲磺酸阿曲库铵,三乙碘蚕胺酚,溴化乙芴胺,碘甲筒箭毒,溴化双哌雄双酯,氯化琥珀酰胆碱,氯化筒箭毒碱或维库溴铵;或内分泌系统的治疗剂,如生长激素,黑素细胞刺激激素,雌二酮,二丙酸氯地米松,倍他米松,醋酸可的松,地塞米松,氟尼缩松,氢化可的松,甲基强的松龙,醋酸泼拉米松,波尼松龙,强的松,醋酸去炎松或醋酸氟氢可的松。
构成本发明组合物的微泡还可以与其他成分结合,例如,脂质体或胶束,所述成分可以与微泡简单地混合在一起,或者可以与微泡的稳定化外被通过物理和/或化学相互作用,例如,通过共价结合,静电或离子相互作用,范德华相互作用,疏水性或亲水相互作用形成组合。所述结合的微泡组合物和它的制备的例子可以参见,例如,美国专利号6,258,378和国际专利申请WO 2005/063305和WO2005/063306,都被收做本文参考。可以结合或者与微泡结合的成分反过来又具有上述任何靶向制剂,诊断剂或生物活性剂,因此,它们通过所述结合的成分与所述微泡结合。例如,磁铁纳米颗粒可以与带电荷的两亲性材料混合,如上文所提到的,以便稳定所述颗粒,并且保持它们分布在水溶液中(例如,参见US 5,545,395,被收做本文参考),以便使它与微泡结合。另外,钆络合物可以与合适的成胶束化合物结合,例如,参见欧洲专利EP 804 251(被收做本文参考),并且所形成的胶束与微泡结合。类似地,治疗制剂可以制备成胶束或脂质体悬浮液,并且以这种形式与微泡结合。
微泡组合物的制备
本发明的组合物可有利地通过混合按照本领域公知方法(例如,上述任何制备方法)制备的充气微泡的两种或两种以上不同的制剂,以及所述微泡制剂的两种或两种以上前体获得(例如,作为乳液或作为干燥的化合物)。
在本说明书和权利要求书的文本中,术语″不同的″在用于表示充气微泡的至少两种制剂时,它的含义包括微泡制剂,它是通过使用至少一种不同的工艺参数(如搅拌速度,温度,压力,稳定化外被和/或工艺溶剂的化学成分)进行它的生产而获得的。因此,要组合的微泡制剂的化学组成不同(例如,稳定化外被的组合物不同)和/或它们的物理参数(例如,稳定化外被的厚度,微泡的平均尺寸和/或它们的尺寸分布)不同,以便获得需要的最终组合的组合物,它能对至少两种不同的传输频率作出有效反应。优选的是,所述至少两种不同类型的微泡具有不同的DV50值。
这些制剂可以以需要的不同的相对体积比例混合,例如,取决于它们的相对组成,平均尺度和/或尺寸分布,以便适当地改变最终的组合配方,以便满足特殊的需要。
优选的是,混合的微囊制剂的各个DV50值彼此相差至少0.5μm,更优选相差至少1.0μm,更优选相差至少1.5μm,例如,差异高达5.0μm,这取决于具体的诊断要求。在优选实施方案中,所述至少两种微泡制剂的至少一种具有较窄的尺寸分布,以便能够更好地控制组合配方的最终尺寸分布。具体地讲,所述分布优选是由大约1.2-3,优选1.2-2的DV/DN比例确定的。具有较窄的尺寸分布的唯一的微泡制剂的使用,当造影剂的相关传输频率预期以彼此相对接近(例如,3MHz或以下)的场合使用时是特别优选的。实际上,这可能有助于减少具有中等尺寸(即介于两种制剂的各自特定平均值之间)的微泡的数量,它不会造成(或以低的多的程度造成)回声信号的反射。
正如上文所提到的,本发明的组合的组合物的DV95值(在0-10μm范围内计算)优选低于大约8μm,更优选7μm或以下,更优选6μm或以下。
制备组合的微泡组合物的合适方法是将微泡的各自的重构悬浮液混合,包括混合各自体积的悬浮液,所述悬浮液包含夹带在微泡中的所需体积的气体。
另外,可以混合所述微泡制剂的各自的前体,所述混合比例是通过每一种制剂提供各诊断有效体积的充气微泡的能力决定的。例如,能够以干燥粉末形式混合至少两种分别获得的冻干的制剂(例如,按照上述任何制备方法获得的),然后混合的冻干制剂的重构物能够提供最终所需组合的组合物。另外,根据一种优选实施方案,可以将通过在WO 2004/069284中所披露的方法获得的两种或两种以上微乳剂(或两种或两种以上悬浮液,例如,可以通过上文所引用的WO 97/29782中所披露的方法获得,包括在存在气体的条件下高速混合含有磷脂的悬浮液)以需要的相对体积混合,然后冻干,并最终用生理学上可接受的液体载体重构,以便提供所需组合的组合物。
作为独立制备且随后将其混合的微泡组合物(或它的前体)的替代,所述组合的组合物可有利地是通过使用″一体化″方法获得的,通过对相同的制备混合物采用不同的工艺参数形成组合物的组合物。该方法特别适用于某些组合的微泡组合物的制备方法。
例如,可以按照在上述WO 2004/069284中披露的方法制备第一种乳液,包括在存在磷脂的条件下以特定速度(例如,速度为12000rpm,使用转子定子搅拌器)对水和有机溶剂进行匀化,以便获得具有各自的DV50值的微滴的第一群体。然后,将额外等分的溶剂(相同或不同的溶剂)以及任选地将磷脂(相同或不同的)添加到所形成的乳液中,然后在较低的速度下(例如,8000rpm)匀化,由此获得具有各自DV50值的第二微滴群体,所述DV50一般高于第一群体的值,使它与第一种制剂充分混合。
类似地,在使用微量混合方法时,第一种乳液(具有各自的DV50值)可以通过使乳液以预定的循环速度与预定的相对体积的溶剂一起循环制备;然后降低再循环速度,添加额外(相等或不同)体积的相同或不同的溶剂,由此获得了具有更高的DV50值的第二种″一体化的″乳液。该方法可以不连续地进行(即通过停止第一次匀化,重新设定工艺参数,和进行第二次匀化)或以连续方式进行,即通过改变匀化参数,而不停止工艺过程,同时添加额外的溶剂。
另外,特别是对于微量混合方法来说,可以对工艺参数进行逐渐调整(例如,可以用2 0分钟时间将循环速度从20逐渐降低到10ml/分,每分钟的改变量为0.5ml/分),由此获得了通过组合较大数量的具有不同平均尺寸的微泡制剂形成的最终组合物。取代这种逐步改变方法,还可以使用连续改变再循环速度的方法;在这种情况下,将会获得具有不同平均尺寸的大体上无限数量的充分混合的微泡制剂。
与上述乳化方法类似,其他制备方法也可适当改进,以便得到本发明的组合的组合物的一体化制备方法。因此,例如,第一种类型的充气微泡可以通过给含有磷脂的含水介质(并且任选地其他两亲性的成膜化合物和/或添加剂)提供第一种受控制的搅拌能量(例如,通过使用转子定子搅拌器),在存在需要的气体的条件下搅拌制备;然后,给相同的悬浮液(具有任选添加的相同的或其他的磷脂)提供第二种搅拌能量,该能量低于第一种能量,以便获得第二种类型的较大的微泡。
按照上述″一体化″方法获得的组合的组合物前体,随后可以按照常规技术冻干,以便获得如上文所述的干燥的粉末;然后通过重构冻干的残余物获得最终的组合的组合物。
在任何情况下,即无论所述组合的组合物是通过混合两种分别制备的微泡制剂获得的还是按照上述任何一体化方法获得的,最终的组合的组合物都表现出特殊的尺寸分布形式,这种分布形式来自构成组合的组合物的不同微泡制剂的组合,而无论这些制剂是怎样混合的。
因此,由如此获得的组合的组合物的微泡的尺寸分布将适合使造影剂在不同的特定工作频率下具有有效的反应。
本发明的组合的组合物特别适合在相差很大的不同的传输频率下使用,同时在所述特定频率下表现出显著良好的图像增强。有利的是,本发明可以制备″多用途″超声波造影剂,它能够有效地用于较宽范围的频率。例如,可以对所述组合物的尺寸分布进行修饰,以便在由目前所使用的超声波探头所发出的两种或两种以上不同的超声波频率下有效工作,频率通常为1.5-15MHz,优选1.5-10MHz。另外,可以使用较低的频率,如低到0.5MHz(例如,用于特殊的心脏用途),以及较高的频率,例如高达约80MHz,用于其他特殊用途(如血管超声成像)。
最近的超声波强反差成像方法利用充气微泡的非线性散射特性作为超声波造影剂(UCA)。从文献(例如,Eatock等,Journal of theAcoustical Society of America,vol.77(5),pp1692-1701,1985)中得知,非线性散射只有对于小于或接近共振尺寸的微泡群体明显,并且主要针对为共振尺寸一半的微泡。″共振尺寸的一半″是微泡的尺寸,它的共振频率等于发出的超声波中心频率的两倍。
在对基于充气微泡的含有超声波造影剂的空间进行成像时,针对组织回声的微泡回声的可检测性由于微泡的非线性散射水平而增强,并且因为位于探头和感兴趣的部位之间的微泡导致的减弱而降低。沿传递途径的减弱降低了可用于产生充气微泡的非线性反应的超声波能量;沿接收通道的减弱排除了可以到达超声波探头的回声能量。
对于包括宽范围微泡尺寸的悬浮液来说,在特定发送频率下,大于共振尺寸的微泡主要造成了传递-接收减弱,没有以有效的方式产生所述非线性(例如,2nd谐波)回声信号。相反,在所述发送频率下,非线性成像的整体声音反应可以通过使用微泡尺寸的窄的分布而获益,用接近于或小于共振尺寸的平均尺寸进行校正,优选用介于共振尺寸和1/2共振尺寸之间的平均尺寸进行校正。因此,对于特定的发送频率来说,可以确定对所述频率具有最佳总体声音反应的微泡尺寸分布(即在所述特定传输频率下的非线性回声探测反应峰),特别是具有高的第二谐波散射和低的减弱。
确定具有最佳总体声音反应的尺寸分布的合适的参数的例子是″第二谐波散射与减弱比″或″STARH″。例如,STARH,以及随后的相应的尺寸分布可以按照大体上在图3中示出的方法计算。根据所述方法,微泡组合物对特定基频f1的超声波的反应(Resp.f1)首先是使用本领域已知的模型作为微泡尺寸的函数模拟的,例如,在以下文献中所披露的模型:Morgan等,IEEE Trans.Ultrason.Ferr.Freq.Control,vol.47(6),pp.1494,2000,除了其他参数之外要考虑该参数,还要考虑粘弹性参数和微泡的稳定化外被的厚度(一般,它是由它的化学组成决定的)。然后将上述第一种模拟用于计算微泡在各自的第二谐波频率f2下的相应的非线性反应(non-L resp.f2)。然后计算由于超声波从变频器通过一定体积的微泡向感兴趣的部位的传播(正向传播)造成的基频f1的减弱(Atten.f1)作为微泡尺寸的函数。最后,计算由于超声波从感兴趣的部位通过一定体积的微泡向变频器传播(反向传播)造成的第二谐波频率f2的减弱(Atten.f2)作为微泡尺寸的函数。在基频f1下的减弱可以用与上述相同的模型计算或使用其他模型计算,例如,参见Gorce等,Inyest.Radiol.,vol.35(11),pp 661,2000。例如,在第二谐波频率f2下的减弱可以用Gorce等所披露的相同的模型计算。
无论采用什么样的计算方法,将Atten.f1和Atten.f2的非-Lresp f2的计算的值合并在-起(例如,使用图3所示的操作模式),以便计算STARH,作为微泡尺寸的函数。根据所述STARH,可以通过最佳拟合方法构建微泡的尺寸分布,所述最佳拟合方法在特定的频率下具有最佳声音反应(STARH)。例如,图4表示图3所示方法的结果,它是对磷脂稳定化的微泡计算的,表明了模拟的体积尺寸分布,分别在大约2MHz(实线)和大约6MHz(虚线)的频率下具有最佳声音反应(即非线性回声探测反应峰)。
因此,上述或其他模拟可以估算最佳尺寸分布的足够好的近似,所述最佳尺寸分布在特定的传输频率下具有非线性回声探测反应峰;然后可以将这些结果用于专门修饰本发明组合的组合物,以对特定类型的传输频率作出有效反应。不过,同样在缺少可用于特殊诊断用途的最终传输频率的信息的情况下,根据本发明的说明,一般性的″多反应″组合的组合物可以方便地通过混合至少两种不同类型的微泡制备,所述微泡具有相对不同的中值粒径(DV50)的值。
以下是实验磷脂-型充气微泡制剂的某些例子,以它们的各自的DV50值,DV/DN和相应的非线性回声探测反应峰(峰)为特征:
Prep.1:DV50=1.7,DV/DN=1.4,峰≈6MHz;
Prep.2:DV50=1-8,DV/DN=1.5,峰≈6MHz;
Prep.3:DV50=2.5,DV/DN=1.8,峰≈3.5MHz;
Prep.4:DV50=2.9,DV/DN=1.85,峰≈3MHz;
Prep.5:DV50=3.6,DV/DN=2.1,峰≈2MHz;
Prep.6:DV50=4.1,DV/DN=2.2,峰≈1.5MHz。
因此,上述制剂可以混合,以便获得能对不同的传输频率有反应的组合的组合物。以下是可以通过混合各自的相对体积的所述微泡制剂的气体(RVG)获得的组合的组合物的说明性例子:
Comp.1:Prep.4/Prep.2,RVG=27/73;
Comp.2:Prep.4/Prep.2,RVG=43/57;
Comp.3:Prep.5/Prep.1,RVG=53/47;
Comp.4:Prep.5/Prep.1,RVG=37/63;
Comp.5:Prep.6/Prep.3/Prep.1,RVG=30/35/35;
Comp.6:Prep.6/Prep.3/Prep.1,RVG=25/35/40。
除了各自平均尺寸的差异之外,其他参数,例如,稳定化外被的厚度以及粘弹性质(以及所固有的化学组成)也可以改变,以便提供对至少两种不同的频率作出有效反应的组合的组合物。例如,微气泡(对第一传输频率有反应)的制剂可以与微囊(对第二传输频率有反应)的制剂混合。根据一种优选实施方案,混合所述微泡,以便形成本发明组合的组合物,不过大体上是相同类型的,即它们是微气泡或微囊。更优选的是,形成所述组合的组合物的微泡是充气的磷脂稳定化的微气泡。
一般,构成本发明的组合的组合物的单一的制剂可能在其他化学,生物学和/或物理参数方面不同,例如,它们对声压的耐受性,它们在静脉内施用之后在血液中的半衰期,它们靶定或作用于特定组织,器官或细胞的能力和/或可能的诊断和/或生物活性剂包含物。
本发明的组合的组合物优选以干粉形式保存,并因此可有利地包装在两个部分的诊断和/或治疗试剂盒中。所述试剂盒优选包括第一个容器,装有冻干的组合物,它与特定的成微泡气体接触,以及第二个容器,装有生理学上可接受的含水载体。合适的载体的例子是水,通常是无菌的,无热源的水(以便尽可能地避免对中间冻干产物的污染),水溶液,如盐水(它有利地是平衡过的,以便用于注射的最终产品不是低渗的)或一种或多种渗透压调节物质,如盐或糖,糖醇,二醇类或其他非离子型多元醇材料(例如,葡萄糖,蔗糖,山梨糖醇,甘露醇,甘油,聚乙二醇,和丙二醇等)的水溶液。所述两个部分的试剂盒可以包括两个独立的容器或复式腔室容器。对前一种情况来说,所述容器优选是常见的隔膜密封的小瓶,其中,装有冻干的残余物的小瓶是用隔膜密封的,可以使用任选的预先填充的注射器通过所述隔膜注射载体液体。在这种情况下,被用作第二部分的容器的注射器还被用于注射造影剂。在后一种情况下,复式腔室优选为复式腔室注射器,并且一旦重构了冷冻干燥物,则就进行适当地混合或轻柔地摇晃,可以将所述容器直接用于注射造影剂。
本发明的造影剂可以在多种诊断和/或治疗成像技术中使用,特别包括超声波和磁共振技术。术语治疗成像的含义包括用于治疗患者疾病的任何方法,该方法包括使用反差成像制剂(例如,用于将生物活性化合物输送到特定的目标部位或组织),并且,它能够在体外和/或体内发挥或负责发挥生物学作用。可能的其他诊断成像的用途包括闪烁照相术,光学成像,和X-光成像,包括X-光相位反差成像。如果需要使用三-二维成像技术的话,可以将多种成像技术用于超声波用途,例如包括基础和谐波B-模式成像,脉冲或相反转成像,及基础和谐波多普勒成像。本发明的微泡通常能够以患者每kg体重大约0.01-大约1.0μl气体的浓度施用,例如,取决于它们各自的组合物,要成像的组织或器官和/或所选择的成像技术。这种一般的浓度范围可以根据特殊的成像用途改变,例如,当能够以非常低的剂量观察信号时,如彩色多普勒或功率脉冲反转。
下面的实施例将对本发明作更详细地说明。
实施例
在以下例子中,尺寸分布,体积浓度和微泡的数量(在冻干并且用水相重构之后)是通过使用装配有30μm孔径,测定范围为0.7-20μm的Coulter Counter Mark II装置测定的。
计算的所述实施例的微泡组合物的DV95值仅仅是考虑直径至多10μm的微泡群体。
Bowley偏度值(BS)是按照以前披露的公式计算的,仅仅考虑了直径至多8μm的微泡群体。
例1
第一种乳液(Ela)是按照以下方法获得的:
将20mg的二棕榈酰磷脂酰丝氨酸(DPPS)添加到20ml的10%(w/w)甘露醇水溶液中。悬浮液在65℃下加热15分钟,然后冷却到室温(22℃)。将全氟化庚烷(8%v/v)添加到该水相中,并且在直径大约4cm的烧杯中,通过使用高速匀浆器(Polytron T3000,探头直径3cm)以8500rpm的速度匀浆1分钟来乳化。
第二种乳液(E1b)是通过使用上述方法获得的,所不同的是,高速匀浆是以12000rpm的速度离心1分钟进行的。将这两种乳液在75℃下加热1.5小时,冷却到室温,并且离心(10分钟,800-1200rpm,Sigmacentrifuge 3K1010)以便除去多余的磷脂。回收分离的微滴并且重新悬浮在相同原始体积的10%的甘露醇中。
然后以不同的体积比混合这两种乳液,以便获得三种组合的乳液CE1A,CElB和CE1C(参见表1)。
-表1-
组合的乳液 | 乳液1a(ml) | 乳液1b(ml) |
CElA | 1 | 4 |
CE1B | 2 | 4 |
CE1C | 3 | 4 |
然后在-45℃下分别在各自100ml圆底容器中冷冻每一种乳液(两种单一的和三种组合的)5分钟,并且在室温下在0.2mbar的压力下在Christ-Alpha 2-4冷冻干燥机中冻干。
使每一个获得的块暴露在包含全氟化-n-丁烷和氮(35/65v/v)的混合物的气氛下,然后通过在二倍原始体积的水中通过用手轻柔地摇晃而分散,以便获得各个微气泡悬浮液M1a,M1b,CMlA,CMlB和CMlC。在用蒸馏水重构之后获得的微气泡悬浮液用Coulter计数器进行分析。从相应的乳液获得的微气泡悬浮液的尺寸分布在图5a-5c中示出(在各自的附图中细实线表示M1a,虚线表示M1b,并且用粗实线表示每一种组合的组合物,即图5a中的CMlA,图5b中的CMlB和图5c中的CMlC)。参见这些曲线图,微气泡制剂M1a和M1b(从乳液E1a和E1b获得),表示各自的DV50值分别为2.77μm和1.64μm(具有大约3MHz和大约6MHz的非线性回声探测反应的各自峰),而合并的制剂CMlA-CMlC表现出相应的中等尺寸分布。从这些附图中可以看出,观察到所述组合制剂的异常的尺寸分布形式,特别是对于组合的制剂CMlC来说平台期从大约1.5μm延伸到大约3.5μm。
计算的组合的组合物的各自的BS和DV95值如下:
CM1A:BS=0.20;DV95=4.2
CMlB:BS=0.19;DV95=4.6
CMlC:BS=0.19;DV95=4.8
例2
第一种悬浮液(S2a)是通过将200mg的DPPS添加到100ml的含有5.4%(w/w)的丙二醇和甘油(3:10w/w)混合物的水中制备的。摇晃所得到的混合物,在80℃下加热5分钟,让它冷却到室温,然后导入与水浴连接的双壁反应器中,以便保持所述温度。所述反应器与直列式转子定子混合系统(Megatron MT40-Kinematica)连接。通过Y-形连接,将全氟化-n-丁烷气体(F2 Chemicals,Preston LancashireUK)导入反应器和搅拌系统之间的液流中。在室温下以25000rpm的速度对所述溶液进行匀化三分钟。将所得到的微气泡悬浮液转入100ml注射器,并且在倾析过夜之后,去掉下部的相,并且换成10%的麦芽糖水溶液。
第二种悬浮液S2b是按照上述方法获得的,唯一的差别是所述溶液是在0-5℃下以17000rpm的速度匀化3分钟。
将两种悬浮液的等份样品以不同的相对比例混合,以便获得如表2所示的三种组合的微气泡制剂CS2A,CS2B和CS2C。
-表2-
组合的悬浮液 | 悬浮液S2a(ml) | 悬浮液S2b(ml) |
CS2A | 20 | 20 |
CS2B | 24 | 15 |
CS2C | 30 | 10 |
将1 ml每一种制剂导入各自的10ml平底小瓶。所述小瓶在-45℃下冷却1小时,进行冷冻干燥(冷冻干燥机Christ Epsilon2-12DS--主要干燥:-5℃/0.1mBar/5小时--最终干燥:25℃/0.1mBar/10小时),在全氟化-n-丁烷气氛中封堵并且密封。
为了获得各自的最终微气泡制剂M2a(来自S2a),M2b(来自S2b),CM2A(来自CS2A),CM2B(来自CS2B)和CM2C(来自CS2C),通过隔膜将水(5ml)添加到每一个小瓶中,并且对小瓶进行柔和搅拌。用例1所述的Coulter计数器测量微气泡的尺寸分布。
制剂M2a和M2b显示各自的DV50值为大约1.64和2.81μm,非线性回声探测反应的各自峰为大约6MHz和大约3MHz。
图6a-6c显示每一种各自组合的组合物CM2A(图6a),CM2B(图6b)和CM2C(图6c)的尺寸分布(粗实线),与两种单一制剂M2a和M2b的尺寸分布(分别为细实线和虚线)进行比较。同样在这种情况下,可以发现图6a-6c的组合的制剂具有特别异常的(梯形状的)尺寸分布形式,特别是对于制剂6a来说表现出大体上扁平的部分。计算的组合的组合物的各自的BS和DV95值如下:
CM2A:BS=0.22;DV95=5.7
CM2B:BS=0.32;DV95=5.3
CM2C:BS=0.31;DV95=4.8
例3
将20mg的DPPS添加到20ml的10%(w/w)甘露醇水溶液中。该悬浮液在65℃下加热15分钟,然后冷却到室温(22℃)。将全氟化庚烷(0.6ml-2.9%v/v)添加到所述含水悬浮液中,并且在直径为大约4cm的烧杯中用高速匀浆器(PolytronT3000,探头直径为3cm),在1分钟时间以8500rpm的速度乳化,以便获得第一种乳液(E3a)。
第二种乳液(E3b)是通过相同的方法获得的,所不同的是,将全氟化庚烷(1ml-4.8%)添加到所述水相中,并且用1分钟时间以12000rpm的速度乳化。
第三种乳液(CE3A)是通过相同的方法获得的,所不同的是,首先将1ml的全氟化庚烷添加到所述含水悬浮液中,并且用1分钟时间以12000rpm的速度在水相中乳化;然后停止搅拌,将另外0.6ml的全氟化庚烷添加到所述乳液中,并且以8500rpm的速度搅拌另外1分钟来乳化混合物。
第四种乳液(CE3B)是通过相同的方法获得的,所不同的是,首先将0.8ml的全氟化庚烷添加到所述含水悬浮液中,并且以12000rpm速度乳化1分钟;然后停止搅拌,将另外0.8ml的全氟化庚烷添加到所述乳液中,并且以8500rpm的速度搅拌1分钟使所这混合物乳化。
将所获得的每一种乳液在75℃加热1.5小时,冷却到室温,然后离心(10分钟,1200rpm,Sigma centrifuge 3K1010),以便去掉多余的磷脂。回收分离的微滴,并且重新悬浮在相同原始体积的10%甘露醇中。
然后分别在-45℃下用5分钟时间在各自的100ml圆底容器中冷冻四种乳液的各10ml,然后在室温下在0.2mbar的压力下,在Christ-Alpha 2-4冷冻干燥机中冻干。
将每个块暴露在含有全氟化-n-丁烷/氮(35/65 v/v)气体混合物的气氛中,然后通过用手在原始体积两倍的水中轻柔地摇晃进行分散。将获得的微气泡悬浮液用蒸馏水重构之后,使用Coulter计数器进行分析。
图7分别用虚线和细线表示微气泡制剂M3a(来自E3a)和M3b(来自E3b)的尺寸分布,并且分别用粗实线和细线表示组合的组合物CM3A(来自CE3A)和CM3B(来自CE3B)的尺寸分布。
制剂M3a和M3b表现出的各自的DV50值为大约2.53和1.58μm,非线性回声探测反应的各自峰为大约3.5MHz和大约6MHz。
计算的组合的组合物的各自的BS和DV95值如下:
CM3A:BS=0.24;DV95=3.7
CM3B:BS=0.24;DV95=4.6
例4
第一种乳液(E4a)是按以下方法获得的:
将二硬脂酰磷脂酰胆碱(DSPC)和二棕榈酰磷脂酰丝氨酸(DPPS)在70℃下导入40ml的10%甘露醇水溶液中,浓度分别为0.5mg/ml。在冷却到室温之后,将该悬浮液放在微型搅拌器(InterdigitalMicro-miXer,Institutfǔr Microtechnik Mainz GmbH,Germany)中再循环,流速为20ml/分。然后通过第二个通道以0.2ml/分的流速注入环辛烷(3.2ml)。所得到的乳液在微型搅拌器中再循环20分钟。
第二种乳液(E4b)是使用上述方法获得的,所不同的是,再循环速度是10ml/分。
将所得到的两种乳液分别加热(120℃,30分钟),然后冷却到室温。
然后以4/1或4/3的体积比混合两种乳液的等份样品,以便获得各自的组合的乳液CE4A和CE4B。
单一的和组合的乳液最终以1ml的等份量分配到DIN 8R小瓶中,并且冻干(Telstar Lyobeta-35冷冻干燥机)。在冻干法的最后,将全氟化丁烷/氮混合物(35/65v/v)导入冷冻干燥机,并且封堵所述小瓶。在用蒸馏水重构时,获得了各自的微气泡制剂M4a(来自E4a),M4b(来自E4b),CM4A(来自CE4A)和CM4B(来自CE4B)。
制剂M4a和M4b表现出的各自的DV50值为大约1.9和2.7μm,非线性回声探测反应的各自峰为大约6MHz和大约3.5MHz。测得的组合的组合物的BS和DV95值如下:
CM4A:BS=0.20;DV95=4.6μm
CM4B:BS=0.17;DV95=6.8μm
图8显示微气泡制剂CM4B(粗实线)的尺寸分布,与上述M4a(细实线)和M4b(虚线)的尺寸分布进行比较。
例5
将二硬脂酰磷脂酰胆碱(DSPC)和二棕榈酰磷脂酰丝氨酸(DPPS)在70℃下导入40ml的10%甘露醇水溶液中,各自的浓度为0.5mg/ml。在冷却到室温之后,让该悬浮液在微型搅拌器(InterdigitalMicro-mixer,Institutfǔr Microtechnik Mainz GmbH,Germany)中再循环,流速为20ml/分。然后通过第二个通道以0.2ml/分的速度注入环辛烷(1.6ml)。让所得到的乳液在微型搅拌器中再循环20分钟。然后将再循环速度降低到10ml/分,并且将第二个数量的环辛烷(1.6ml)导入微型搅拌器的第二通道,流速为0.2ml/分。在20分钟的时间内该乳液以流速为10ml/分再循环。收集所得到的乳液,加热(120℃,30min),分配到DIN 8R小瓶中,大小为1ml的等份,并且冻干(Telstar Lyobeta-35冷冻干燥机)。在冻干法的最后,将全氟化丁烷/氮混合物(35/65v/v)导入冷冻干燥器,并且封堵所述小瓶。
使用Coulter计数器分析用蒸馏水重构之后获得的微气泡悬浮液。
所获得的微气泡制剂的尺寸分布(BS=0.19,DV95=4.9μm)在图9中示出(粗实线),与例4的制剂M4a和M4b(分别为细实线和虚线)进行示意性比较。
例6
本发明的超声波造影剂(UCA)(按照例1制备的组合物CMlB)的回声探测反应与商业化UCA,Sonovue(Bracco International B.V.)的反应在两种不同的传输频率2MHz和10MHz下进行比较。图13显示CMlB的尺寸分布(虚线)与Sonovue的尺寸分布(实线)的比较。表3表示这两种UCA的DV95值和BS。
表3
DV95[μm] | BS | |
Sonovue | 9.63 | -0.05 |
CMlB | 4.58 | 0.19 |
通过将不同体积的UCA添加到800mL的0.9%NaCl中制备两种UCA的不同的悬浮液,以便获得两种UCA的各种浓度,在两种不同的传输频率下进行测试。
对于第一个实验(2MHz传输频率)来说,采用了在图11中示意性地示出的装置。该装置包括烧杯111,在它里面放置组织模拟人体模型112(Model#528,ATS Laboratories Inc.,Bridgeport,CT),浸泡在各自的UCA悬浮液113中。感兴趣的部位(ROI)114被确定为距离变频器115大约7.5cm的距离A,并且被用于测量第二谐波散射,包括通过UCA的长的传播途径(例如,通过左侧脑室模拟成像)。因此,来自该ROI的数据可以被解释为对第二谐波散射与减弱比例的测定值。使用Megas超声波系统(Esaote,Florence,Italy),图中没有示出,具有PA230E相控阵探头,传输频率为2MHz。焦距为6.5cm,深度被设定为25cm,以便最小化含有空腔的UCA内的回响。根据在水中的校准测量计算的机械指数(MI)为0.11。包括大约3.5cm的组织模拟人体模型材料的厚度B的相应值为0.071。所述Megas超声波系统通过光纤链路连接在Femmina平台(Scabia等″Hardware and softwareplatform for processing and visualization of echographicradio-frequency signals″;IEEE Trans.Ultra.Ferr.Freq.Contr.,49(10),1444-1452,2002)上,以便收集射频(RF)数据。将所述RF数据保存在PC上,并且用Matlab(version6.5;TheMathworks Inc.,Natick,MA)进行脱机处理。在ROI中计算的平均功率谱密度在第二谐波频率附近(4MHz),带宽为0.6MHz。在测量期间,通过连续搅拌,通过使用磁力搅拌器106保持对UCA的搅动。在获取数据的间隙,所述变频器与Megas系统断开,以避免过度曝光,并且可能破坏所述气泡。进行了没有UCA的测量,以便对背景噪声进行定量。
对于第二个实验来说,用Sequoia超声波系统(Siemens MedicalSystems)取代Megas超声波系统,它具有15L8-S线性阵列探头,功率为10MHz,使用反差脉冲排序(CPS)模式。使用图11所示相同的装置,唯一的差别是,去掉了所述组织模拟幻象,并且使ROI移动到距变频器大约2cm的距离。焦距为2.5cm,并且将深度设定为8cm,以便最小化在含有空腔的UCA内的回响。计算在水中校准测量的MI为0.13。将视频图象保存在数字视频(DV)带上,并且使用视频密度测量程序进行脱机分析,以便进行灰度级线性化,获得与制剂浓度成正比的信号。在获取数据的间隙,将所述Sequoia系统设置为冷冻模式,以避免过度曝光,并且对气泡造成可能的破坏。进行没有UCA的测量,以便对背景噪声进行定量。
图12a和12b表示回波功率,即第二谐波-散射与减弱比例,分别作为用Megas(2MHz)和Sequoia(10MHz)系统测量的制剂浓度的函数。虚线表示用Sonovue获得的结果,而实线表示用CM1B制剂获得的结果。如这些附图所示,两种制剂在2MHz的频率下表现出非常类似的性能,较高浓度(>0.0001μl/ml)的CM1B表现出略微改善的性能。在10MHz的频率下,CMlB制剂与Sonovue相比在所使用的整个浓度范围内表现出显著改善。特别是在低和中等浓度下(<0.0002μl/ml)下,CMlB制剂的第二谐波散射与基础比例几乎比Sonovue的高出6dB(几乎为4倍)。
Claims (27)
1.用于诊断和/或治疗成像的组合物,它包括充气微泡的至少两种不同的制剂的混合物,其中,所述至少两种不同的制剂具有彼此相差至少2MHz的非线性回声探测反应的各自的峰。
2.如权利要求1的组合物,其中,所述非线性回声探测反应的峰彼此相差至少3MHz。
3.如权利要求1的组合物,其中,所述非线性回声探测反应的各自峰为大约1.5-大约10MHz。
4.如权利要求1的组合物,其中,所述至少两种制剂具有为3MHz或以下和5MHz或以上的非线性回声探测反应的各自峰。
5.如权利要求1的组合物,其中,所述微泡的不同制剂具有有着不同中值粒径的各自的尺寸分布。
6.如权利要求5的组合物,其中,所述中值粒径是由各自的至少第一和至少第二体积中位数直径(DV50)确定的,所述第一和第二DV50的值彼此相差为至少0.5μm。
7.如权利要求5的组合物,其中,所述第一和第二DV50的值彼此相差至少1.0μm。
8.如上述权利要求中任意一项的组合物,其中,所述至少两个组的微泡的尺寸分布是由所述体积平均直径和相应的数量平均直径(DV/DN)之间的各自的比例确定的,所述充气微泡中的至少一组的DV/DN比例为1.2-3。
9.用于诊断和/或治疗成像的包括充气微泡的组合物,其中,所述充气微泡的体积尺寸分布是根据直径至多8μm的微泡群体确定的,Bowley偏度为0.16或以上,前提是所述微泡不是通过聚烷基氰基丙烯酸酯聚合物稳定的微囊。
10.如权利要求9的组合物,其中,所述Bowley偏度为0.18或以上。
11.如上述权利要求中任意一项的组合物,其中,根据直径至多10μm的微泡群体确定的包含在所述微泡中的气体总体积的至少95%被包含在直径为8μm或以下的微泡中。
12.如上述权利要求中任意一项的组合物,其中,所述充气微泡是通过两亲性材料的薄膜层稳定化的微气泡。
13.如上述权利要求中任意一项的组合物,其中,所述充气微泡是具有稳定化外被的微囊,所述外被包括聚合物、蛋白、生物可降解的水不溶性类脂或其混合物。
14.如权利要求12的组合物,其中,所述两亲性材料是磷脂。
15.如上述权利要求中任意一项的组合物,还包括生理学上可接受的含水载体。
16.如权利要求1-14中任意一项的组合物,其中,所述充气微泡是在与生理学上可接受的含水载体接触时可以重构的干粉形式的。
17.如上述权利要求中任意一项的组合物,其中,所述充气微泡包括靶向配体,诊断剂,生物活性剂或它们的任意组合。
18.如权利要求1-8中任意一项的组合物,其中,所述充气微泡的制剂的至少一种包括靶向配体、诊断剂、生物活性剂或它们的任意组合。
19.生产对至少两种不同的传输频率具有诊断有效的回声探测反应的造影剂的方法,该方法包括混合充气微泡或其前体的至少两种不同的制剂,所述两种不同的制剂具有彼此相差至少2MHz的非线性回声探测反应的各自的峰。
20.如权利要求19的方法,其中,所述前体是干粉形式的,在可以药用的液体载体中重构时能形成所述微泡制剂。
21.如权利要求19的方法,其中,所述前体是通过将磷脂分散在由水和与水不混溶的有机溶剂所形成的乳液中而获得的微乳剂,所述乳液在存在低温保护剂的情况下冷冻干燥,并且随后用可以药用的液体载体重构时形成了微泡制剂。
22.如权利要求20的方法,其中,所述充气微泡或其前体的至少两种不同的制剂是以组合制剂形式直接获得的,包括将不同的工艺参数应用在相同的制剂混合物上。
23.诊断和/或治疗成像方法,它包括给患者施用有效量的如权利要求1-18中任意一项的组合物。
24.诊断和/或治疗试剂盒,包括干粉形式的如权利要求1-11中任意一项的组合物,和生理学上可接受的含水载体。
25.使包括对第一传输频率具有非线性回声探测反应峰的充气微泡的组合物对第二传输频率具有增强的回声探测反应的方法,该方法包括将所述组合物与对所述第二频率具有非线性回声探测反应的各自峰的充气微泡的第二组合物混合。
26.如权利要求25的方法,其中,所述第一和第二频率彼此相差至少2MHz。
27.如权利要求25的方法,其中所述第一和第二频率彼此相差至少3MHz。
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Cited By (2)
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CN101745126B (zh) * | 2008-12-10 | 2012-04-25 | 温州医学院 | 一种包载水溶性药物超声造影剂的制备方法 |
US11246945B2 (en) | 2019-06-07 | 2022-02-15 | National Defense Medical Center | Cisplatin-loaded microbubbles, pharmaceutical composition for treatment of cancer, method for preparing pharmaceutical compositions and method for treating cancer |
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CA2575677A1 (en) | 2006-02-23 |
CA2575677C (en) | 2013-01-22 |
JP4837663B2 (ja) | 2011-12-14 |
US9248204B2 (en) | 2016-02-02 |
AU2005273865A1 (en) | 2006-02-23 |
EP1784228A1 (en) | 2007-05-16 |
JP2008509970A (ja) | 2008-04-03 |
WO2006018433A1 (en) | 2006-02-23 |
US20160184464A1 (en) | 2016-06-30 |
EP1784228B1 (en) | 2016-10-05 |
CN103120799A (zh) | 2013-05-29 |
US10076580B2 (en) | 2018-09-18 |
AU2005273865B2 (en) | 2011-02-24 |
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