IT201800005367A1 - Composition for the prevention and / or treatment of gastrointestinal diseases - Google Patents
Composition for the prevention and / or treatment of gastrointestinal diseases Download PDFInfo
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- IT201800005367A1 IT201800005367A1 IT102018000005367A IT201800005367A IT201800005367A1 IT 201800005367 A1 IT201800005367 A1 IT 201800005367A1 IT 102018000005367 A IT102018000005367 A IT 102018000005367A IT 201800005367 A IT201800005367 A IT 201800005367A IT 201800005367 A1 IT201800005367 A1 IT 201800005367A1
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- Italy
- Prior art keywords
- diarrhea
- composition according
- composition
- butyric acid
- treatment
- Prior art date
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
- A61K31/19—Carboxylic acids, e.g. valproic acid
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/695—Silicon compounds
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- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0053—Mouth and digestive tract, i.e. intraoral and peroral administration
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/14—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles
- A61K9/141—Intimate drug-carrier mixtures characterised by the carrier, e.g. ordered mixtures, adsorbates, solid solutions, eutectica, co-dried, co-solubilised, co-kneaded, co-milled, co-ground products, co-precipitates, co-evaporates, co-extrudates, co-melts; Drug nanoparticles with adsorbed surface modifiers
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Description
DESCRIZIONE dell’invenzione avente per titolo: "Composizione per la prevenzione e/o il trattamento di patologie gastrointestinali" DESCRIPTION of the invention entitled: "Composition for the prevention and / or treatment of gastrointestinal diseases"
La presente invenzione si riferisce ad una composizione per somministrazione orale comprendente Acido Butirrico o un suo derivato e Polisilossani per uso nella prevenzione e/o il trattamento di patologie gastrointestinali. Tale invenzione si basa sull’azione sinergica dei suddetti principi attivi. The present invention relates to a composition for oral administration comprising Butyric Acid or a derivative thereof and Polysiloxanes for use in the prevention and / or treatment of gastrointestinal pathologies. This invention is based on the synergistic action of the aforementioned active ingredients.
La diarrea è un disturbo della defecazione caratterizzato dall'emissione rapida di feci abbondanti e poco formate. Affinché si possa parlare di diarrea devono essere contemporaneamente presenti entrambe queste condizioni: Diarrhea is a defecation disorder characterized by the rapid emission of abundant and poorly formed stools. In order to be able to speak of diarrhea, both of these conditions must be present at the same time:
● almeno tre evacuazioni al giorno; ● at least three evacuations per day;
● alterazioni della quantità o qualità delle deiezioni (presenza di feci poco formate: liquide o semiliquide) ● alterations in the quantity or quality of manure (presence of poorly formed stools: liquid or semi-liquid)
La diarrea non è una vera e propria malattia ma un sintomo aspecifico, comune a numerose patologie (per lo più gastrointestinali) o a condizioni non patologiche (intolleranze alimentari, stress, ecc.). Spesso la diarrea si accompagna al continuo stimolo di evacuare, anche in assenza di materiale fecale (tenesmo rettale). Si parla invece di dissenteria quando la diarrea si complica sino a causare una importante evacuazione di liquidi con caratteristiche non più fecali (presenza di acqua, muco, pus, proteine, elettroliti, grassi e sangue). Diarrhea is not a real disease but a non-specific symptom, common to numerous pathologies (mostly gastrointestinal) or to non-pathological conditions (food intolerances, stress, etc.). Often diarrhea is accompanied by the constant urge to evacuate, even in the absence of fecal material (rectal tenesmus). We speak instead of dysentery when diarrhea becomes complicated to the point of causing an important evacuation of liquids with characteristics that are no longer fecal (presence of water, mucus, pus, proteins, electrolytes, fats and blood).
In base alla frequenza della sintomatologia la diarrea si classifica in: Based on the frequency of symptoms, diarrhea is classified into:
● diarrea ricorrente (con andamento ciclico ed episodi diarroici ravvicinati tra loro) ● recurrent diarrhea (with a cyclical course and close diarrheal episodes)
● diarrea acuta (durata inferiore alle tre settimane) ● diarrea cronica (durata superiore alle tre-quattro settimane) ● acute diarrhea (lasting less than three weeks) ● chronic diarrhea (lasting more than three to four weeks)
Esistono almeno quattro diversi meccanismi capaci di provocare diarrea: There are at least four different mechanisms capable of causing diarrhea:
● DIARREA DA ALTERATO ASSORBIMENTO: causata da un deficit delle pompe attive, speciali meccanismi che provvedono al riassorbimento intestinale degli elettroliti (sali minerali). Anche una riduzione della superficie intestinale può diminuire la capacità di assorbimento di acqua, elettroliti e sostanze nutritive causando diarrea (resezioni o by-pass chirurgici; malattie che alterano i villi e la mucosa intestinale: celiachia, diverticolite ecc.). ● DIARREA FROM ALTERED ABSORPTION: caused by a deficit of active pumps, special mechanisms that provide for intestinal reabsorption of electrolytes (mineral salts). Even a reduction of the intestinal surface can decrease the absorption capacity of water, electrolytes and nutrients causing diarrhea (resections or surgical bypasses; diseases that alter the villi and intestinal mucosa: celiac disease, diverticulitis, etc.).
● DIARREA OSMOTICA: causata dall'assunzione di sostanze non assorbibili ed osmoticamente attive (richiamano acqua). In questi casi la diarrea può essere causata da lassativi osmotici (sali di magnesio ecc., alimenti dietetici (presenza di polialcoli o di grossi quantitativi di fruttosio) malassorbimenti, intolleranze alimentari (al lattosio, al glutine, alle proteine della soia ecc. ● OSMOTIC DIARREA: caused by the intake of non-absorbable and osmotically active substances (they recall water). In these cases, diarrhea can be caused by osmotic laxatives (magnesium salts, etc., dietary foods (presence of sugar alcohols or large quantities of fructose), malabsorption, food intolerances (to lactose, gluten, soy proteins, etc.)
● DIARREA SECRETORIA O INFIAMMATORIA: causata da una ipersecrezione intestinale di acqua ed elettroliti. Molte infezioni o intossicazioni alimentari sono responsabili di questo tipo di diarrea che può essere causata anche da tumori intestinali ormonosecernenti o da alcuni tipi di lassativi. A causa di questa flogosi (infiammazione) le feci contengono notevoli quantità di acqua e spesso si arricchiscono di proteine, pus e sangue (dissenteria). ● SECRETARY OR INFLAMMATORY DIARREA: caused by intestinal hypersecretion of water and electrolytes. Many infections or food poisoning are responsible for this type of diarrhea which can also be caused by hormone-secreting intestinal tumors or some types of laxatives. Due to this inflammation (inflammation), the stools contain large quantities of water and are often enriched with proteins, pus and blood (dysentery).
● DIARREA MOTORIA: causata da un'alterazione della motilità e della velocità del transito intestinale (iperperistaltismo). L'aumento della peristalsi riduce la digestione e l'assorbimento dell'acqua e delle varie sostanze nutritive causando diarrea. Questo tipo di diarrea è comune nei pazienti che soffrono di colon irritabile o carcinoide con iperproduzione di 5-idrossi-triptamina. ● MOTOR DIARREA: caused by an alteration of the motility and speed of intestinal transit (hyperperistalticism). Increased peristalsis reduces digestion and absorption of water and various nutrients causing diarrhea. This type of diarrhea is common in patients suffering from irritable bowel or carcinoid with overproduction of 5-hydroxy-tryptamine.
La sindrome del colon irritabile (IBS) è la condizione gastrointestinale diagnosticata più di frequente. È una condizione definita dalla presenza di dolore addominale o disagio, con alterate abitudini intestinali, in assenza di qualunque altra patologia che possa causare questi sintomi. La prevalenza dell’IBS è molto variabile a livello globale, correlata in parte alle differenze nella popolazione, nei criteri diagnostici e nella metodologia degli studi. In America settentrionale, la prevalenza di IBS nella popolazione è approssimativamente del 12%. La IBS è molto prevalente nel sud America, dove la prevalenza sale al 21% e meno prevalente nel sud-est asiatico, dove è inferiore al 7%. Negli Stati Uniti, in Canada e in Israele, i sintomi dell’IBS sono 1,52 volte più frequenti nelle donne rispetto agli uomini, mentre sembrerebbe esserci una maggiore parità di genere in Asia. Le donne riportano più comunemente dolore addominale e costipazione, mentre gli uomini riportano più comunemente diarrea. Sembrerebbe che la prevalenza di questa sindrome si riduca con l’età. Irritable bowel syndrome (IBS) is the most frequently diagnosed gastrointestinal condition. It is a condition defined by the presence of abdominal pain or discomfort, with altered bowel habits, in the absence of any other pathology that may cause these symptoms. The prevalence of IBS is highly variable globally, partly related to differences in the population, diagnostic criteria and study methodology. In North America, the prevalence of IBS in the population is approximately 12%. IBS is very prevalent in South America, where the prevalence rises to 21% and less prevalent in Southeast Asia, where it is less than 7%. In the United States, Canada and Israel, IBS symptoms are 1.52 times more frequent in women than in men, while there appears to be greater gender equality in Asia. Women most commonly report abdominal pain and constipation, while men most commonly report diarrhea. It would seem that the prevalence of this syndrome decreases with age.
Differenti co-morbilità sono associate alla sindrome del colon irritabile, includendo sindromi del dolore somatico (fibromialgia, sindrome della fatica cronica e dolore pelvico cronico), altri disordini gastrointestinali (sindrome del reflusso gastroesofageo, dispepsia) e disordini psichiatrici (depressione maggiore, ansietà e somatizzazione). Different co-morbidities are associated with irritable bowel syndrome, including somatic pain syndromes (fibromyalgia, chronic fatigue syndrome, and chronic pelvic pain), other gastrointestinal disorders (gastroesophageal reflux syndrome, dyspepsia) and psychiatric disorders (major depression, anxiety and somatization).
Nella maggior parte dei pazienti, l’IBS è una patologia cronica i cui sintomi possono variare nel corso del tempo. Inoltre, i pazienti possono passare spesso da un sottotipo all’altro di IBS, più comunemente da IBS-C o IBS-D a IBS-M. La sindrome del colon irritabile riduce significativamente la qualità della vita e la produttività del lavoro. Negli Stati Uniti, l’IBS è responsabile di 31 milioni di visite agli ambulatori e 5,9 milioni di prescrizioni l’anno è, con una spesa diretta e indiretta che supera i 20 miliardi di dollari. In most patients, IBS is a chronic disease whose symptoms can vary over time. In addition, patients can often switch from one subtype of IBS to another, most commonly from IBS-C or IBS-D to IBS-M. Irritable bowel syndrome significantly reduces quality of life and work productivity. In the United States, IBS is responsible for 31 million clinic visits and 5.9 million prescriptions a year, with direct and indirect spending exceeding $ 20 billion.
Di seguito sono riportati alcuni dei principali trattamenti farmacologici delle diverse forme di diarrea e della sindrome del colon irritabile associata a diarrea (IBS-D). Below are some of the main drug treatments for the different forms of diarrhea and irritable bowel syndrome associated with diarrhea (IBS-D).
Inibitori della motilità intestinale (antidiarroici): da utilizzarsi anche in caso di diarrea acuta, complicata o meno. L'assunzione degli antidiarroici non è utile per la cura della patologia sottostante alla diarrea, ma ne cura semplicemente i sintomi: Intestinal motility inhibitors (antidiarrheals): to be used also in case of acute diarrhea, complicated or not. The intake of antidiarrheals is not useful for the treatment of the pathology underlying diarrhea, but simply treats its symptoms:
● Bismuto salicilato: la posologia di questo antidiarroico (utilizzato anche per la cura della gastrite) varia dagli 87 ai 262 mg, da assumere ogni 30-60 minuti, al bisogno; ● Bismuth salicylate: the dosage of this antidiarrheal (also used for the treatment of gastritis) varies from 87 to 262 mg, to be taken every 30-60 minutes, as needed;
● Loperamide; ● Loperamide;
● Difenoxilato; ● Diphenoxylate;
● Codeina: oltre che per la cura della tosse, la codeina viene talvolta impiegata in terapia per il trattamento della diarrea acuta non complicata degli adulti. La dose indicativa è 30 mg, 3-4 volte al dì. Il farmaco non è indicato per i bambini. ● Codeine: In addition to the treatment of cough, codeine is sometimes used in therapy for the treatment of acute uncomplicated diarrhea in adults. The indicative dose is 30 mg, 3-4 times a day. The drug is not indicated for children.
Antibiotici a largo spettro: indicati in caso di diarrea dipendente da infezioni batteriche. Ad ogni modo, gli antibiotici non sono generalmente utilizzati per il trattamento della diarrea associata a gastroenteriti semplici, anche in caso di presunta infezione batterica, dato che la condizione tende a risolversi da sé in pochi giorni. Solo in caso di diarrea nel contesto di accertata coinfezione batterica, il medico può prescrivere farmaci antibiotici. Broad spectrum antibiotics: indicated in case of diarrhea dependent on bacterial infections. However, antibiotics are generally not used to treat diarrhea associated with simple gastroenteritis, even in the case of presumed bacterial infection, as the condition tends to resolve on its own within a few days. Only in case of diarrhea in the context of proven bacterial co-infection, the doctor can prescribe antibiotic drugs.
Antispastici e anticolinergici: non sono i farmaci utilizzati come prima linea per la cura della diarrea. Sono indicati per ridurre i sintomi che accompagnano il disturbo, come crampi e dolori addominali. Tra questi, i più indicati sono: Antispasmodics and anticholinergics: these are not the drugs used as the first line for the treatment of diarrhea. They are indicated to reduce symptoms accompanying the disorder, such as cramps and abdominal pain. Among these, the most suitable are:
● Scopolamina: particolarmente indicata per dare sollievo sintomatico a disturbi gastrointestinali (spasmo della muscolatura liscia). ● Scopolamine: particularly suitable for giving symptomatic relief to gastrointestinal disorders (spasm of smooth muscles).
● Alverina citrato: si consiglia la somministrazione orale di 60-120 mg 1-3 volte al giorno. È sconsigliata la somministrazione ai bambini sotto i 12 anni. ● Alverine citrate: oral administration of 60-120 mg 1-3 times a day is recommended. It is not recommended for children under 12 years of age.
● Atropina solfato (es. Atropina Lux): utile in caso di spasmo della muscolatura liscia nel contesto della diarrea. Generalmente, si somministra il farmaco per iniezione sottocutanea o intramuscolare alla posologia di 20 μg per chilo di peso corporeo (dose massima 600 μg). ● Atropine sulphate (eg Atropine Lux): useful in case of spasm of smooth muscles in the context of diarrhea. Generally, the drug is administered by subcutaneous or intramuscular injection at a dosage of 20 μg per kilo of body weight (maximum dose 600 μg).
I trattamenti sopra elencati sono solo moderatamente efficaci e sono dotati di numerosi e, talvolta, gravi effetti collaterali, come stitichezza e meteorismo e/o distensione addominale, reazioni di ipersensibilità, reazioni cutanee, orticaria, prurito, tachicardia, secchezza delle fauci, ritenzione urinaria, midriasi, turbe dell’accomodazione, aumento del tono oculare, sonnolenza. Pertanto, è tuttora sentita la necessità di poter disporre di composizioni, o farmaci, per il trattamento delle patologie gastrointestinali, che siano ben tollerate, efficaci e possibilmente con ridotti effetti collaterali, soprattutto nei confronti dei soggetti che devono assumere farmaci per prolungati periodi di tempo. The treatments listed above are only moderately effective and come with numerous and sometimes serious side effects, such as constipation and bloating and / or abdominal distension, hypersensitivity reactions, skin reactions, hives, itching, tachycardia, dry mouth, urinary retention , mydriasis, accommodation disturbances, increased eye tone, somnolence. Therefore, the need is still felt to have available compositions, or drugs, for the treatment of gastrointestinal pathologies, which are well tolerated, effective and possibly with reduced side effects, especially towards subjects who have to take drugs for prolonged periods of time. .
Un obiettivo della presente invenzione è quello di fornire una composizione che superi gli svantaggi sopra elencati delle composizioni note per uso nel trattamento delle patologie gastrointestinali. An object of the present invention is to provide a composition which overcomes the disadvantages listed above of the compositions known for use in the treatment of gastrointestinal pathologies.
Come soluzione a detta necessità, la presente invenzione fornisce una composizione per uso secondo le unite rivendicazioni. As a solution to said need, the present invention provides a composition for use according to the appended claims.
Forma oggetto della presente invenzione una composizione comprendente una quantità efficace di una miscela che comprende: The subject of the present invention is a composition comprising an effective amount of a mixture which comprises:
(a) Acido Butirrico o un suo derivato, (a) Butyric acid or a derivative thereof,
(b) Polisilossani (b) Polysiloxanes
per uso nel trattamento, terapeutico e/o preventivo, delle patologie gastrointestinali e di patologie o disturbi ad esse collegati, in cui detto trattamento comprende la somministrazione di detta composizione a un soggetto per via orale. for use in the therapeutic and / or preventive treatment of gastrointestinal pathologies and related pathologies or disorders, in which said treatment comprises administering said composition to a subject orally.
La presente invenzione è basata sulla ricerca e sulla identificazione di una nuova combinazione di principi attivi che miscelati tra loro esercitano un effetto sinergico nella prevenzione e/o nel trattamento delle patologie gastrointestinali, in particolare nelle patologie del colon, e ancora più in particolare di una delle seguenti patologie: diarrea acuta, diarrea cronica, diarrea ricorrente, diarrea infettiva, diarrea da alterato assorbimento, diarrea osmotica, diarrea secretoria o infiammatoria, diarrea motoria, sindrome del colon irritabile associata a diarrea, costipazione e/o ad alvo alterno, malattie infiammatorie croniche intestinali, morbo di Crohn e/o rettocolite ulcerosa. La presente invenzione si riferisce a composizioni comprendenti o consistenti in una miscela idonea alla somministrazione per via orale, comprendente Acido Butirrico o un suo derivato e Polisilossani. The present invention is based on the research and identification of a new combination of active ingredients which, when mixed together, exert a synergistic effect in the prevention and / or treatment of gastrointestinal pathologies, in particular in the pathologies of the colon, and even more in particular of a of the following diseases: acute diarrhea, chronic diarrhea, recurrent diarrhea, infectious diarrhea, diarrhea due to impaired absorption, osmotic diarrhea, secretory or inflammatory diarrhea, motor diarrhea, irritable bowel syndrome associated with diarrhea, constipation and / or alternate hibernation, inflammatory diseases intestinal chronic diseases, Crohn's disease and / or ulcerative colitis. The present invention relates to compositions comprising or consisting of a mixture suitable for oral administration, comprising Butyric Acid or a derivative thereof and Polysiloxanes.
Forme preferite della presente invenzione appariranno chiare dalla descrizione dettagliata che segue e sono indicate nelle unite rivendicazioni. Preferred forms of the present invention will become clear from the following detailed description and are indicated in the appended claims.
Nell’ambito della presente invenzione, per “trattamento” di una patologia o disturbo si intende la terapia finalizzata al ripristino delle condizioni di salute di un soggetto, al mantenimento delle condizioni in essere e/o a impedire il peggioramento di dette condizioni di salute. In the context of the present invention, the term "treatment" of a pathology or disorder means therapy aimed at restoring a person's health conditions, maintaining existing conditions and / or preventing the worsening of said health conditions.
Nell’ambito della presente invenzione, per “prevenzione” di una patologia o disturbo si intende la terapia finalizzata ad evitare l’insorgenza di una tale patologia o disturbo in un soggetto, anche, ma non solo, come complicanza o effetto di una condizione patologica o disturbo pre-esistente. In the context of the present invention, "prevention" of a pathology or disorder means the therapy aimed at avoiding the onset of such a pathology or disorder in a subject, also, but not limited to, as a complication or effect of a pathological condition or pre-existing disorder.
Se non diversamente indicato, nell’ambito della presente invenzione le percentuali e le quantità di un componente in una miscela sono da riferirsi al peso di tale componente rispetto al peso totale della miscela delle sostanze attive. Unless otherwise indicated, in the context of the present invention the percentages and quantities of a component in a mixture are to be referred to the weight of this component with respect to the total weight of the mixture of active substances.
Se non diversamente specificato, nell’ambito della presente invenzione, relativamente ad intervalli di valori numerici per una certa caratteristica, l’indicazione “da X a Y” comprende gli estremi, cioè X e Y, oltre a tutti i possibili valori numerici intermedi. Unless otherwise specified, in the context of the present invention, in relation to ranges of numerical values for a certain characteristic, the indication "from X to Y" includes the extremes, that is X and Y, in addition to all possible intermediate numerical values.
Nel contesto della presente invenzione con il termine “composizione/i” si intende ricomprendere una composizione farmaceutica, un dispositivo medico, un medicamento, una composizione nutraceutica o integratore alimentare, un alimento, un alimento a fini medici speciali. In the context of the present invention, the term "composition (s)" is intended to include a pharmaceutical composition, a medical device, a medicament, a nutraceutical composition or food supplement, a food, a food for special medical purposes.
Il termine “dispositivo medico” nel contesto della presente invenzione è usato nel significato secondo il Decreto Legislativo italiano 24 febbraio 1997, n. 46, e della direttiva 93/42/CEE del 14 giugno 1993, cioè indica una sostanza o un altro prodotto, utilizzato da solo o in combinazione, destinato dal fabbricante ad essere impiegato nell'uomo a scopo di diagnosi, prevenzione, controllo, terapia o attenuazione di una malattia, il quale prodotto non eserciti l'azione principale, nel o sul corpo umano, cui è destinato, con mezzi farmacologici o immunologici né mediante processo metabolico, ma la cui funzione possa essere coadiuvata da tali mezzi. The term "medical device" in the context of the present invention is used in the meaning according to the Italian Legislative Decree 24 February 1997, n. 46, and of Directive 93/42 / EEC of 14 June 1993, i.e. it indicates a substance or other product, used alone or in combination, intended by the manufacturer to be used in humans for the purpose of diagnosis, prevention, control, therapy or attenuation of a disease, which product does not exert the main action, in or on the human body, for which it is intended, by pharmacological or immunological means or by metabolic process, but whose function can be assisted by such means.
Nell’ambito della presente invenzione, con l’espressione composizione per somministrazione orale s’intende qualsiasi formulazione idonea per somministrare gli ingredienti attivi a livello dell’apparato gastrointestinale, in modo da ottenere un effetto sistemico o locale. Ad esempio le formulazioni potranno essere in forma solida, liquida, o semisolida, in particolare in forma di polvere, granulato, compressa, capsula, capsula molle, bustina, pillola, soluzione, sospensione, emulsione, spray e in ogni altra forma nota al tecnico del ramo. In the context of the present invention, the expression composition for oral administration means any formulation suitable for administering the active ingredients at the level of the gastrointestinal system, in order to obtain a systemic or local effect. For example, the formulations may be in solid, liquid, or semi-solid form, in particular in the form of powder, granulate, tablet, capsule, soft capsule, sachet, pill, solution, suspension, emulsion, spray and in any other form known to the technician. of the branch.
Gli enterociti sono cellule epiteliali che rivestono la superficie dell’intestino e del colon. La loro principale funzione è quella di ampliare la superficie di contatto con il contenuto del lume intestinale e massimizzare l’assorbimento dei nutrienti. A livello del colon, la fonte di energia per questo tipo di cellule sono alcuni amminoacidi, acidi grassi a corta catena e altre piccole molecole non digerite a livello dell’intestino tenue. La carenza di nutrienti è una delle possibili cause dell’aumento della permeabilità intestinale. La maggiore permeabilità favorisce il passaggio di patogeni nella mucosa intestinale. I patogeni possono scatenare processi infettivi e/o infiammatori a livello intestinale e si ritiene che questa sia una delle principali cause di patologie come la diarrea e la sindrome del colon irritabile. Fornire nutrienti agli enterociti del colon potrebbe portare alla riduzione della permeabilità intestinale, con conseguente prevenzione di queste patologie. Enterocytes are epithelial cells that line the surface of the intestine and colon. Their main function is to widen the contact surface with the contents of the intestinal lumen and maximize the absorption of nutrients. In the colon, the source of energy for this type of cell are certain amino acids, short-chain fatty acids and other small undigested molecules in the small intestine. Lack of nutrients is one of the possible causes of the increase in intestinal permeability. The greater permeability favors the passage of pathogens into the intestinal mucosa. Pathogens can trigger infectious and / or inflammatory processes in the intestine and it is believed that this is one of the main causes of diseases such as diarrhea and irritable bowel syndrome. Supplying nutrients to the enterocytes of the colon could lead to the reduction of intestinal permeability, with consequent prevention of these diseases.
L'acido butirrico è caratterizzato dall'odore poco gradevole se presente in elevata concentrazione e dal sapore acre, con un retrogusto dolciastro (simile all'etere dietilico). In basse concentrazioni costituisce, insieme ai suoi esteri, l’aroma caratteristico di alcuni formaggi fermentati. L'acido butirrico è riconosciuto dai mammiferi dalle buone capacità olfattive (come i cani) in 10 ppb, e gli umani ne riconoscono concentrazioni in 10 ppm. Butyric acid is characterized by an unpleasant odor if present in high concentration and by an acrid taste, with a sweetish aftertaste (similar to diethyl ether). In low concentrations it constitutes, together with its esters, the characteristic aroma of some fermented cheeses. Butyric acid is recognized by mammals with good olfactory abilities (such as dogs) in 10 ppb, and humans recognize concentrations in 10 ppm.
L'acido è un liquido oleoso e incolore, che solidifica a -8 °C, e bolle a 164 °C. È facilmente solubile in acqua, etanolo ed etere, ed emerge dalla sua soluzione acquosa con l'aggiunta di cloruro di calcio. Il dicromato di potassio e l'acido solforico lo ossidano in diossido di carbonio e acido acetico, mentre il permanganato di potassio lo ossida in diossido di carbonio. Il sale a base di calcio Ca(C4H7O2)2·H2O, è meno solubile in acqua calda che in quella fredda. The acid is an oily, colorless liquid, which solidifies at -8 ° C, and boils at 164 ° C. It is easily soluble in water, ethanol and ether, and emerges from its aqueous solution with the addition of calcium chloride. Potassium dichromate and sulfuric acid oxidize it to carbon dioxide and acetic acid, while potassium permanganate oxidizes it to carbon dioxide. The calcium-based salt Ca (C4H7O2) 2 H2O is less soluble in hot water than in cold water.
Il Sodio Ialuronato Butirrato (Numero CAS 942471-70-7) è un derivato dell’Acido Butirrico, derivante dalla esterificazione di alcuni gruppi ossidrilici del sodio ialuronato con acido butirrico. Il grado di sostituzione dei residui ossidrilici del sodio ialuronato con acido butirrico va da 0,10 a 2,24, corrispondente a una percentuale in peso compresa tra 1,8 e 28,4% p/p. La molecola che ne deriva presenta una maggiore lipofilia e un’alta solubilità in acqua. Sodium Hyaluronate Butyrate (CAS number 942471-70-7) is a derivative of Butyric Acid, resulting from the esterification of some hydroxyl groups of sodium hyaluronate with butyric acid. The degree of substitution of the hydroxyl residues of sodium hyaluronate with butyric acid ranges from 0.10 to 2.24, corresponding to a percentage by weight between 1.8 and 28.4% w / w. The resulting molecule has a higher lipophilicity and a high solubility in water.
Si tratta di un polimero biocompatibile grazie alla presenza di acido ialuronico, una molecola biologicamente attiva, che ne consente una rapida metabolizzazione in vivo. Il Sodio Ialuronato Butirrato si presenta come un solido bianco. La soluzione acquosa all’1% di Sodio Ialuronato Butirrato si presenta come una soluzione chiara, inodore, con un pH compreso tra 5,0 e 7,5. It is a biocompatible polymer thanks to the presence of hyaluronic acid, a biologically active molecule, which allows its rapid metabolization in vivo. Sodium Hyaluronate Butyrate appears as a white solid. The 1% aqueous solution of Sodium Hyaluronate Butyrate is presented as a clear, odorless solution, with a pH between 5.0 and 7.5.
La composizione secondo la presente invenzione potrà comprendere Acido Butirrico o un suo derivato in una quantità compresa tra 1 mg e 15000 mg, preferibilmente tra 10 mg e 5000 mg, ovvero in una concentrazione in peso compresa tra l’1% e il 90% p/p, preferibilmente tra il 5% e l’80% p/p. Nell’ambito della presente invenzione, con la dicitura “Acido Butirrico o un suo derivato” si può intendere indifferentemente la forma acida e qualunque sale, estere o ammide dell’acido butirrico, preferibilmente la forma di Sodio Ialuronato Butirrato. The composition according to the present invention may comprise Butyric Acid or a derivative thereof in an amount of between 1 mg and 15000 mg, preferably between 10 mg and 5000 mg, or in a concentration by weight of between 1% and 90% by weight. / w, preferably between 5% and 80% w / w. In the context of the present invention, the term "Butyric Acid or a derivative thereof" can mean indifferently the acid form and any salt, ester or amide of butyric acid, preferably the form of Sodium Hyaluronate Butyrate.
I siliconi (o polisilossani) sono polimeri inorganici basati su una catena silicio-ossigeno e gruppi funzionali organici (R) legati agli atomi di silicio. Silicones (or polysiloxanes) are inorganic polymers based on a silicon-oxygen chain and organic functional groups (R) bonded to silicon atoms.
A seconda della lunghezza della catena silossanica, della sua ramificazione e dei gruppi funzionali, si possono ottenere numerosi materiali dalle più varie caratteristiche. Depending on the length of the siloxane chain, its branching and functional groups, it is possible to obtain numerous materials with the most varied characteristics.
In commercio si trovano siliconi della più varia consistenza (dall'oleoso al gommoso) che possono essere divisi in varie classi di applicazione, come: On the market there are silicones of the most varied consistency (from oily to rubbery) which can be divided into various application classes, such as:
● liquidi ● liquids
● emulsioni ● emulsions
● composti ● compounds
● lubrificanti ● lubricants
● resine ● resins
● elastomeri ● elastomers
● plastiche ● plastics
Il polidimetilsilossano (PDMS) è tra i più comuni polisilossani. Si ottiene a partire dal dimetilclorosilano, che è a sua volta un composto chimico prodotto per reazione diretta tra silicio e cloruro di metile. Per successiva idrolisi del dimetilclorosilano si ottengono silossani ciclici e lineari che successivamente polimerizzati danno luogo ai polimeri siliconici. Polydimethylsiloxane (PDMS) is among the most common polysiloxanes. It is obtained starting from dimethylchlorosilane, which in turn is a chemical compound produced by direct reaction between silicon and methyl chloride. By subsequent hydrolysis of dimethylchlorosilane cyclic and linear siloxanes are obtained which subsequently polymerized give rise to silicone polymers.
I dimeticoni (conosciuti anche come polidimetilsilossani) sono fluidi idrorepellenti con una bassa tensione superficiale. Strutturalmente, si caratterizzano per essere polimeri la cui struttura chimica di base è costituita da una successione di atomi di silicio e di ossigeno. Dimethicones (also known as polydimethylsiloxanes) are water-repellent fluids with a low surface tension. Structurally, they are characterized by being polymers whose basic chemical structure consists of a succession of silicon and oxygen atoms.
I dimeticoni sono liquidi incolori ed inodori. Non risultano miscibili con acqua, alcool, acetone e metanolo. Sono invece miscibili con idrocarburi clorurati, etere, xilene, amile acetato, cicloesano, kerosene, toluene ed etile acetato. Sono molto poco solubili in alcool assoluto e in alcool isopropilico. Dimethicones are colorless and odorless liquids. They are not miscible with water, alcohol, acetone and methanol. On the other hand, they are miscible with chlorinated hydrocarbons, ether, xylene, amyl acetate, cyclohexane, kerosene, toluene and ethyl acetate. They are very slightly soluble in absolute alcohol and in isopropyl alcohol.
Il dimeticone attivato (simeticone secondo USP) che è utilizzato in terapia è costituito da una miscela di dimeticoni contenenti il 4-7% di silicio biossido finemente suddiviso. Appare come un fluido grigio, translucido e viscoso. La fase liquida è insolubile in acqua e in alcool e solubile in cloroformio, in etere e in benzene. La parte costituita da silicio biossido rimane sempre non disciolta. Il dimeticone si conserva in recipienti ermeticamente chiusi. The activated dimethicone (simethicone according to USP) which is used in therapy consists of a mixture of dimethicones containing 4-7% of finely divided silicon dioxide. It appears as a gray, translucent and viscous fluid. The liquid phase is insoluble in water and alcohol and soluble in chloroform, ether and benzene. The part made up of silicon dioxide always remains undissolved. Dimethicone is kept in hermetically sealed containers.
L'attività farmacologica del dimeticone è dovuta alle sue proprietà antischiuma. Gli agenti antischiuma a base di silicio si disperdono sulla superficie dei liquidi acquosi formando un film di bassa tensione superficiale che fa sì che le bolle di gas presenti nel tratto gastrointestinale si uniscano per formare delle entità di maggiori dimensioni (coalescenza) formando gas libero che viene facilmente eliminato. The pharmacological activity of dimethicone is due to its antifoam properties. Silicon-based defoamers disperse on the surface of aqueous liquids forming a low surface tension film that causes the gas bubbles present in the gastrointestinal tract to join together to form larger entities (coalescence) forming free gas which is easily eliminated.
Il dimeticone non viene assorbito dal tratto gastrointestinale e non interferisce con l'assorbimento di altre sostanze. Viene eliminato immodificato nelle feci. Il dimeticone trova impiego nel trattamento sintomatico della flatulenza e del meteorismo gastroenterico, sia dell'adulto che del bambino. Viene talvolta utilizzato come antiacido. Dimethicone is not absorbed from the gastrointestinal tract and does not interfere with the absorption of other substances. It is eliminated unchanged in the faeces. Dimethicone is used in the symptomatic treatment of flatulence and gastrointestinal bloating, both in adults and children. It is sometimes used as an antacid.
Viene inoltre utilizzato per eliminare gas, aria e schiuma dal tratto gastrointestinale prima di eseguire esami radiografici, ecografici e gastroscopici. Viene spesso somministrato in associazione con antiacidi come l'idrossido di alluminio. It is also used to clear gas, air, and foam from the gastrointestinal tract prior to X-ray, ultrasound and gastroscopic examinations. It is often given in combination with antacids such as aluminum hydroxide.
La composizione secondo la presente invenzione potrà comprendere Polisilossani in una quantità compresa tra 1 mg e 5000 mg, preferibilmente tra 10 mg e 1000 mg, ovvero in una concentrazione in peso compresa tra lo 0,1% e il 50% p/p, preferibilmente tra l’1% e il 30% p/p. Nell’ambito della presente invenzione, con il termine “Polisilossani” si intende polimeri basati su una catena silicio-ossigeno con gruppi funzionali alchilici, preferibilmente polialchilsilossani, più preferibilmente polidimetilsilossani, ancor più preferibilmente dimeticone attivato, o simeticone, o loro miscele. The composition according to the present invention may comprise Polysiloxanes in an amount of between 1 mg and 5000 mg, preferably between 10 mg and 1000 mg, or in a concentration by weight of between 0.1% and 50% w / w, preferably between 1% and 30% w / w. In the context of the present invention, the term "Polysiloxanes" means polymers based on a silicon-oxygen chain with alkyl functional groups, preferably polyalkylsiloxanes, more preferably polydimethylsiloxanes, even more preferably activated dimethicone, or simethicone, or their mixtures.
La composizione secondo la presente invenzione può essere per uso in soggetti umani o per uso veterinario, ad esempio, ma senza limitazione, negli animali da compagnia come cani o gatti, in animali da allevamento o in altri mammiferi. Preferibilmente, la composizione secondo la presente invenzione è per uso nell’uomo. The composition according to the present invention can be for use in human subjects or for veterinary use, for example, but without limitation, in companion animals such as dogs or cats, in farm animals or in other mammals. Preferably, the composition according to the present invention is for use in humans.
Resta inteso che, nel trattamento secondo l’invenzione la somministrazione degli ingredienti attivi può avvenire in contemporanea, ad esempio in un’unica formulazione, o in rapida sequenza, ad esempio tramite due o più formulazioni assunte dal soggetto in qualsiasi ordine, in sequenza ravvicinata nel tempo (es. entro da 1 a 10 minuti) in due composizioni distinte. It is understood that, in the treatment according to the invention, the administration of the active ingredients can take place simultaneously, for example in a single formulation, or in rapid sequence, for example by means of two or more formulations taken by the subject in any order, in a close sequence. over time (eg within 1 to 10 minutes) in two distinct compositions.
La composizione per uso secondo la presente invenzione può comprendere, oltre a Saccharomyces boulardii, un estratto di almeno una pianta appartenente al genere Mentha e, opzionalmente, almeno una sostanza dotata di azione trofica sugli enterociti, almeno un ingrediente inerte, come almeno un eccipiente tra quelli comunemente utilizzati e noti alla persona esperta del ramo. The composition for use according to the present invention can comprise, in addition to Saccharomyces boulardii, an extract of at least one plant belonging to the genus Mentha and, optionally, at least one substance endowed with trophic action on enterocytes, at least one inert ingredient, such as at least one excipient among those commonly used and known to the person skilled in the art.
Per “ingrediente inerte” si intende qualsiasi sostanza, o combinazione di sostanze, ausiliaria della produzione di una forma farmaceutica, cosmetica, alimentare o nutraceutica si trovi nel prodotto finito che non sia il principio attivo, anche se ne può modificare la stabilità, il rilascio o altre caratteristiche. By "inert ingredient" we mean any substance, or combination of substances, auxiliary to the production of a pharmaceutical, cosmetic, food or nutraceutical form found in the finished product that is not the active ingredient, even if its stability, release or other features.
Esempi non limitativi di tali ingredienti, come noto al tecnico del ramo delle formulazioni in ambito farmaceutico, nutraceutico o alimentare, sono gli eccipienti come i diluenti, gli assorbenti, gli adsorbenti, i lubrificanti, i glidanti, i coloranti, i tensioattivi, gli antiossidanti, gli edulcoranti, gli aromatizzanti, i leganti, i disaggreganti, i plasticizzanti, i viscosizzanti, gli emulsionanti, gli umettanti, i bagnanti, i conservanti, i chelanti e simili. Non-limiting examples of these ingredients, as known to those skilled in the art of pharmaceutical, nutraceutical or food formulations, are excipients such as diluents, absorbents, adsorbents, lubricants, glidants, dyes, surfactants, antioxidants. , sweeteners, flavorings, binders, disaggregators, plasticizers, viscosifiers, emulsifiers, humectants, wetting agents, preservatives, chelators and the like.
La composizione secondo la presente invenzione può essere solida, liquida o semisolida e può essere in qualsiasi forma nota all’esperto del ramo delle formulazioni farmaceutiche, cosmetiche, alimentari o nutraceutiche, ad esempio, non limitativo, sotto forma di compressa, capsula, capsula molle, bustina, pillola, soluzione, sospensione, emulsione, spray, flacone, polvere almeno parzialmente idrosolubile, granuli, pellets, microparticelle, opzionalmente contenute in una bustina o in una capsula o in una compressa (mini-tablet), preparato liquido o semisolido, sospensione, soluzione sistema liquido bifasico e forme equivalenti. The composition according to the present invention can be solid, liquid or semi-solid and can be in any form known to those skilled in the art of pharmaceutical, cosmetic, food or nutraceutical formulations, for example, not limiting, in the form of tablet, capsule, soft capsule , sachet, pill, solution, suspension, emulsion, spray, bottle, at least partially water-soluble powder, granules, pellets, microparticles, optionally contained in a sachet or capsule or tablet (mini-tablet), liquid or semi-solid preparation, suspension, solution biphasic liquid system and equivalent forms.
ESEMPI EXAMPLES
Di seguito sono riportati alcuni esempi non limitativi di dosaggi giornalieri della combinazione d’ingredienti attivi usati nelle composizioni della presente invenzione. Below are some non-limiting examples of daily dosages of the combination of active ingredients used in the compositions of the present invention.
ESEMPIO 1 EXAMPLE 1
Ingrediente Dose Ingredient Dose
Acido Butirrico 200 mg Butyric Acid 200 mg
Simeticone 80 mg Simethicone 80 mg
ESEMPIO 2 EXAMPLE 2
Ingrediente Dose Acido Butirrico 600 mg Simeticone 80 mg Ingredient Dose Butyric Acid 600 mg Simethicone 80 mg
ESEMPIO 3 EXAMPLE 3
Ingrediente Dose Sodio Ialuronato Butirrato 1000 mg Simeticone 80 mg Ingredient Dose Sodium Hyaluronate Butyrate 1000 mg Simethicone 80 mg
ESEMPIO 4 EXAMPLE 4
Ingrediente Dose Sodio Ialuronato Butirrato 1333 mg Simeticone 80 mg Ingredient Dose Sodium Hyaluronate Butyrate 1333 mg Simethicone 80 mg
ESEMPIO 5 EXAMPLE 5
Ingrediente Dose Sodio Ialuronato Butirrato 4000 mg Simeticone 80 mg Ingredient Dose Sodium Hyaluronate Butyrate 4000 mg Simethicone 80 mg
ESEMPIO 6 EXAMPLE 6
Ingrediente Dose Sodio Ialuronato Butirrato 8000 mg Simeticone 80 mg Ingredient Dose Sodium Hyaluronate Butyrate 8000 mg Simethicone 80 mg
ESEMPIO 7 EXAMPLE 7
Ingrediente Dose Sodio Ialuronato Butirrato 4000 mg Simeticone 160 mg Ingredient Dose Sodium Hyaluronate Butyrate 4000 mg Simethicone 160 mg
ESEMPIO 8 EXAMPLE 8
Ingrediente Dose Sodio Ialuronato Butirrato 4000 mg Dimeticone 80 mg Ingredient Dose Sodium Hyaluronate Butyrate 4000 mg Dimethicone 80 mg
ESEMPIO 9 EXAMPLE 9
Ingrediente Dose Sodio Ialuronato Butirrato 4000 mg Dimeticone 160 mg PARTE SPERIMENTALE Ingredient Dose Sodium Hyaluronate Butyrate 4000 mg Dimethicone 160 mg EXPERIMENTAL PART
In questo studio è stata valutata l’azione antidiarroica delle singole sostanze e dell’associazione tra Acido Butirrico o un suo derivato e Polisilossani. In this study, the antidiarrheal action of the individual substances and the association between Butyric Acid or its derivative and Polysiloxanes was evaluated.
L’induzione della diarrea con olio di ricino deriva dall’azione dell’acido ricinoleico derivante dall’idrolisi dell’olio. L’acido ricinoleico produce dei cambiamenti nel trasporto di acqua ed elettroliti, che portano ad una risposta ipersecretoria. In aggiunta alla ipersecrezione, l’acido ricinoleico sensibilizza i neuroni intramurali dell’intestino. The induction of diarrhea with castor oil derives from the action of ricinoleic acid resulting from the hydrolysis of the oil. Ricinoleic acid produces changes in the transport of water and electrolytes, which lead to a hypersecretory response. In addition to hypersecretion, ricinoleic acid sensitizes the intramural neurons of the intestine.
Per la procedura sono utilizzati topi tenuti a digiuno durante la notte. Per l’esperimento, i topi sono stati posti in gabbie individuali e privati dell’accesso a cibo e acqua. Le sostanze della presente invenzione (Acido Butirrico o un suo derivato e Polisilossani), da sole e in combinazione, sono state somministrate agli animali mediante sondino gastrico. Il gruppo di controllo ha ricevuto solo il veicolo. Mice fasted overnight are used for the procedure. For the experiment, the mice were placed in individual cages and deprived of access to food and water. The substances of the present invention (Butyric Acid or a derivative thereof and Polysiloxanes), alone and in combination, were administered to the animals by means of a gastric tube. The control group only received the vehicle.
Un’ora dopo la somministrazione, viene somministrato 1 mL di olio di ricino per via orale. Le feci sono raccolte su fogli di carta di peso uniforme per 24 ore dopo la somministrazione dell’olio di ricino. L’effetto antidiarroico è valutato mediante peso delle feci escrete dai topi. One hour after administration, 1 mL of castor oil is administered orally. The feces are collected on sheets of uniform weight paper for 24 hours after the administration of the castor oil. The antidiarrheal effect is assessed by the weight of the feces excreted by the mice.
RISULTATI RESULTS
Sono stati analizzati i dati ottenuti trattando i modelli in vivo sopra descritti con una composizione comprendente Acido Butirrico o un suo derivato e Polisilossani e quelli ottenuti trattando gli stessi in vivo con una composizione comprendente solo uno dei due principi attivi con dosaggio e modalità di somministrazione comparabili. Il confronto dei dati ottenuti con la combinazione dei due ingredienti attivi rispetto al trattamento con uno qualsiasi dei due indica un netto miglioramento nel trattamento della patologia nel modello di diarrea usato per la sperimentazione. The data obtained by treating the in vivo models described above with a composition comprising Butyric Acid or its derivative and Polysiloxanes and those obtained by treating the same in vivo with a composition comprising only one of the two active ingredients with comparable dosage and administration methods were analyzed. . Comparison of the data obtained with the combination of the two active ingredients versus treatment with either of the two indicates a marked improvement in the treatment of the pathology in the model of diarrhea used for the trial.
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