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Title: Treatment of skin damage using
polyenylphosphatidylcholine
United States Patent: 6,191,121
Inventors: Perricone; Nicholas V. (27 Coginchaug Ct.,
Guilford, CT 06437)
Appl. No.: 543947
Filed: April 6, 2000
Abstract
Polyenylphosphatidylcholine is topically applied to treat skin damage,
such as contact dermatitis (particularly diaper area dermatitis), atopic
dermatitis, xerosis, eczema (including severe hand and foot eczema),
rosacea, seborrhea, psoriasis, thermal and radiation burns, other types of
skin inflammation, and aging. Typical compositions contain from about
0.25% to about 10% of a polyenylphosphatidylcholine preparation obtained
from natural sources such as soybean oil which contains at least about 25%
by weight, preferably about 40% or more, dilinoeoylphosphatidylcholine.
DETAILED DESCRIPTION OF THE INVENTION
In the practice of the invention, polyenylphosphatidylcholine is used to
treat skin damage when topically applied in effective amounts.
Any synthetic or natural polyenylphosphatidylcholine preparation may be
employed in compositions of the invention. Natural preparations are
preferred because they exhibit desirable physical characteristics and are
both economical and nontoxic. By "polyenylphosphatidylcholine"
is meant any phosphatidylcholine bearing two fatty acid substituents,
wherein at least one is an unsaturated fatty acid with at least two double
bonds. Preferred PPCs contain a mixture of substitutents such as those
found in natural products. The fatty acids can be saturated or unsaturated
and of any length, from C, (acetic) to C28 (montanic), but
typically range between C12 and C18 because most
commercial products are vegetable oil extracts containing common fatty
acids. Preferred polyenylphosphatidylcholines contain at least one
linoleic (18:2) group, most preferably two, in a cis geometrical
configuration typical of natural products, but some preparations contain
linolenic (18:3) or eleostearic (20:3) groups in the doubly unsaturated
component. As mentioned, preferred PPC compositions have
dilinoleoylphosphatidylcholine (18:2--18:2 PC) as the most abundant PC
species, present in the preparation at levels of at least about 25%,
preferably at least about 40% by weight. A typical PPC preparation
available from Rhone-Poulenc is a soybean extract containing about 42%
dilinoleoylphosphatidylcholine and about 24%
palmitoyllinoleylphosphatidylcholine (16:0-18:2 PC) as the major PC
components.
Polyenylphosphatidylcholines are fat-soluble. Therefore, PPC preparations
can be applied neat to skin tissue. It is an advantage of the invention
that the active compound is fatty so that it physically contributes to the
lubrication of affected skin areas to which it is applied.
However, only effective amounts of PPC are needed to treat skin damage
(including either inflammation or aging or both), so generally topical
application to exposed or affected skin sites is accomplished in
association with a carrier, and particularly one in which the PPC active
ingredient is soluble per se or is effectively solubilized (e.g., as an
emulsion or microemulsion). Where employed, the carrier is inert in the
sense of not bringing about a deactivation or oxidation of the PPC, and in
the sense of not bringing about any adverse effect on the skin areas to
which it is applied. In one preferred practice of the invention, PPC is
applied in admixture with a dermatologically acceptable carrier or vehicle
(e.g., as a lotion, cream, ointment, soap, stick, or the like) so as to
facilitate topical application and, in some cases, provide additional
therapeutic effects as might be brought about, e.g., by moisturizing of
the affected skin or mucosal areas. While the PPC carrier for
dermatological compositions can consist of a relatively simple solvent or
dispersant such as water, it is generally preferred that the carrier
comprise a composition more conducive to topical application, and
particularly one which will form a film or layer on the skin to which it
is applied so as to localize the application and provide some resistance
to washing off by immersion in water or by perspiration and/or aid in the
percutaneous delivery of the active agent. Many preparations are known in
the art, and include lotions containing oils and/or alcohols and
emollients such as hydrocarbon oils and waxes, silicone oils, vegetable,
animal or marine fats or oils, glyceride derivatives, fatty acids or fatty
acid esters or alcohols or alcohol ethers, lecithin, lanolin and
derivatives, polyhydric alcohols or esters, wax esters, sterols,
phospholipids and the like, and generally also emulsifiers (nonionic,
cationic or anionic), although some of the emollients inherently possess
emulsifying properties. These same general ingredients can be formulated
into a cream rather than a lotion, or into gels, or into solid sticks by
utilization of different proportions of the ingredients and/or by
inclusion of thickening agents such as gums or other forms of hydrophilic
colloids. One preferred embodiment is an oil-in-water cream. Such
compositions are referred to herein as dermally or dermatologically
acceptable carriers.
Suitable carriers include water, alcohols, oils and the like, chosen for
their ability to dissolve or disperse PPC and any other ingredients used
in the treatment. Generally, even low concentrations of active ingredients
in a carrier are suitable, depending upon the application regimen and
adjunct ingredients employed. Many embodiments contain from about 0.1% to
about 10% by weight, more narrowly from about 0.25% to about 5% to 7% by
weight, PPC. Chronic conditions typically require a lower concentration of
active PPC ingredient than to acute conditions. As a practical matter,
however, to avoid the need for repeated application, it is desirable that
the topically applied composition (i.e., PPC plus carrier) be formulated
to contain at least about 1% by weight PPC, and many embodiments contain
more than 1 weight % PPC. One efficacious embodiment contains from about
2% to about 5% by weight PPC; a 5% composition was employed in examples
described below.
Generally in the practice of methods of the invention, the composition is
topically applied to the affected skin areas in a predetermined or
as-needed regimen either at intervals by application of a lotion or the
like, it generally being the case that gradual improvement is noted with
each successive application. Insofar as has been determined based upon
clinical studies to date, no adverse side effects are encountered.
Some embodiments of this invention contain at least one other adjunct
ingredient in addition to PPC. Adjunct ingredients include, but are not
limited to, .alpha.-hydroxy acids and fatty acid esters of ascorbic acid.
Many embodiments employ more than one adjunct ingredient.
As used herein, the term ".alpha.-hydroxy acid" has reference to
and encompasses the general class of organic compounds containing at least
one hydroxy group and at least one carboxyl group, and wherein at least
one hydroxyl group is located on the .alpha.-carbon atom. Typically, the
compounds are organic acids having at least one carboxylic acid group and
at least one hydroxyl group on the .alpha.-carbon atom, and may contain
other functional groups including additional hydroxyl and carboxylic acid
moieties. Preferred .alpha.-hydroxy acids and/or .alpha.-hydroxy acid
derivatives are less bulky structurally so that they penetrate the skin
well, and thus have a backbone of from one to three carbon atoms such as
those set out in U.S. Pat. No. 5,965,618 at column 6 lines 4 to 29. Where
employed, glycolic and/or lactic acid or their derivatives are preferred;
glycolic acid is especially efficacious.
Fat-soluble fatty acid esters of ascorbic acid (vitamin C) is employed as
an adjunct ingredient in other embodiments, alone or in combination with
.alpha.-hydroxy acids. The more oxidation-resistant saturated fatty acid
esters of ascorbic acid are preferred, including, but not limited to,
ascorbyl laurate, ascorbyl myristate, ascorbyl palmitate, ascorbyl
stearate, and ascorbyl behenate. Ascorbyl palmitate is used in one
embodiment. As denoted herein, where fatty acid esters are described,
e.g., ascorbyl stearate, compositions having predominantly that ester,
e.g., predominantly stearate, are included. The esters may be prepared
using hydrogenated oils or fats, or fractions thereof, and contain small
amounts of another ester. Ascorbyl stearate prepared using canola, for
example, commonly contain about 4% ascorbyl palmitate. It is an advantage
of the invention that where fatty acid esters of ascorbic acid are
employed as an adjunct ingredient, they help stabilize the PPC in the
composition.
While not wishing to be bound to any theory, it is possible that PPC is
efficacious in the treatment of skin damage because it is fat-soluble and
readily disperses in cell membranes and other cellular components. PPC
readily penetrates skin. It also is an active antioxidant that has been
shown to protect against lipid peroxidation and liver damage, including
fibrosis and cirrhosis (Aleynik, S. I., et al., J. Investig. Med. 47:
507-512 (1999)). PPC acts as a free radical scavenger and neutralizer, and
prevents the cross-linking of cell membranes that is often seen in its
postinflammatory phases. By the same token, PPC modulation of free
radicals and other oxidative species appears to affect gene expression,
including expression of nuclear factor .kappa.-B (NF-.kappa.B), nitric
oxide synthetase and other mediators at all stages of proinflammation and
inflammation. PPC's alteration of lipid peroxidation, protein
cross-linking, growth factor stimulation, and membrane permeability may
explain its negative effect on the symptoms of damaged skin.
When skin is inflamed from ultraviolet radiation, irritants, trauma, and
other reasons, phospholipase-A-2 produces arachidonic acid from the
phospholipidrich membranes of the cell, resulting in the production of
metabolites. We now know that stabilization of the cell membrane can
inhibit the inflammatory cascade, therefore preventing the inflammatory
response. It is also now known that arachidonic acid has a direct toxic
effect on the mitochondria, resulting in the uncoupling of oxidative
phosphorylation, resulting in free radical damage to the mitochondrial
membrane, Polyenylphosphatidylcholine appears to intersperse in the cell
membrane, stabilizing the membrane, and, at the same time, providing
antioxidant capability. In addition, the incorporation of
polyenylphosphatidylcholine into the cell membrane appears to enhance
membrane activity, such as exchange of nutrients and wastes of the
cellular environment. This also enhances cellular function and repair.
Methods and compositions of the present invention are particularly useful
for treating damaged skin tissue, particularly various types of
dermatitis, skin conditions such as rosacea, seborrhea, eczema (including
severe hand and foot eczema presenting with skin fissures), xerosis (dry
skin), psoriasis, thermal and radiation burns, and other types of
inflammation. PPC compositions of the invention are useful in treating
both contact dermatitis, particularly diaper area dermatitis, and atopic
dermatitis. Topical application of PPC according to the invention can also
be effective to prevent symptoms in aging persons for the inhibition of
microscarring of the dermis and to promote collagen production. It is an
advantage of the invention that treatment or preventive measures employ,
as an active ingredient, a natural compound found in edible vegetable
oils. It is another advantage of the invention that topical application of
PPC provides a simple, non-invasive, nontoxic, over-the-counter topical
method for treating all kinds of skin damage. It is a further advantage of
the invention that PPC is particularly efficacious in the treatment of
certain skin conditions that do not respond to topical corticosteroids.
PPC can also be employed over primary irritants such as Retin-A.TM. (tretinoin)
application to counteract inflammation, and simultaneously enhance the
effect of the other irritant (e.g., Retin-A.TM.).
On one study, patients having severe hand eczema that was recalcitrant to
potent topical corticosteroids, were treated with twice daily application
of a composition containing 5% PPC by weight (primarily
dilinoleoylphosphatidylcholine). The eczema improved dramatically in five
to seven days. In another study, the same composition applied twice daily
to diaper area dermatitis resolved the severe erythema and irritation in
two to three days.
All references cited herein are hereby incorporated by reference, as are
additional ingredients and methods set out in U.S. Pat. Nos. 4,775,530,
5,376,361, 5,409,693, 5,545,398, 5,574,063, 5,643,586, 5,709,868,
5,879,690, 5,965,618, and 5,968,618. Generally, these compositions contain
other active ingredients summarized above that enhance the effect of
active ingredients of the invention.
The above description is for the purpose of teaching the person of
ordinary skill in the art how to practice the present invention, and it is
not intended to detail all those obvious modifications and variations of
it which will become apparent to the skilled worker upon reading the
descrip In one embodiment, the composition contains fromtion. It is
intended, however, that all such obvious modifications and variations be
included within the scope of the invention in any sequence which is
effective to meet the objectives there intended, unless the context
specifically indicates the contrary. Claim 1 of 20
Claims What is claimed is:
1. A topical composition comprising from about 0.1% to about 10% by weight
polyenylphosphatidylcholine in a dermatologically acceptable carrier.
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