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Title: Drug delivery system for
hydrophobic drugs
United States Patent: 6,984,395
Issued: January 10, 2006
Inventors: Boch; Ronald Erwin (Vancouver,
CA); Singh; Dev Mitra Ranji (Surrey, CA); Karmadi; Iman (Vancouver, CA)
Assignee: QLT, Inc. (Vancouver, CA)
Appl. No.: 833406
Filed: April 11, 2001
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Pharm Bus Intell
& Healthcare Studies
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Abstract
Compositions comprising microaggregates
containing hydrophobic drugs, as well as methods for their production, are
described. Such microaggregates may include micelle structures or
combinations thereof with liposomes, and constitute an effective delivery
vehicle for a hydrophobic agent. Methods for microaggregate production
include the use of preferred lipid compounds and processing conditions
favoring the production of small aggregates for improved filter
sterilization.
DETAILED DESCRIPTION
OF THE INVENTION
The invention relates to water soluble
microaggregates (MA) of hydrophobic agents and phospholipids or lipids.
Water soluble microaggregates are those which are miscible in water or
other aqueous solutions. Microaggregates refer to submicron size
aggregates of regular or irregular, and spherical or non-spherical shape.
For aggregates of roughly spherical shape, the approximate diameters are
less than one micrometer. For significantly non-spherical aggregates, the
approximate diameter of the aggregate when rotating is less than one
micrometer. Aggregates refer to compositions comprising any aggregated
complex of constituent molecules. Hydrophobic agents refer to those which
are poorly soluble (less than 5 mg/ml water) or insoluble in water or
other aqueous solutions.
Hydrophobic agents for formulation into the MA of the invention include
any that may be used pharmaceutically, agriculturally or industrially.
These include biologically active, or otherwise useful, molecules,
pharmaceuticals, imaging agents, and manufacturing reagents as well as
precursors and prodrugs of such substances. Preferred hydrophobic agents
are those with biological activity or other utility in humans and other
living organisms. These include agents that are therapeutics in medicine,
ingredients in cosmetics, and pesticides and herbicides in agriculture.
Examples of such agents include agonists and antagonists, analgesic and
anti-inflammatory agents, anesthetics, antiadrenergic and antarrhythmics,
antibiotics, anticholinergic and cholinomimetic agents, anticonvulsant
agents, antidepressants, anti-epileptics, antifungal and antiviral agents,
antihypertensive agents, antimuscarinic and muscarinic agents,
antineoplastic agents, antipsychotic agents, anxiolytics, hormones,
hypnotics and sedatives, immunosuppressive and immunoactive agents,
neuroleptic agents, neuron blocking agents, and nutrients. Particularly
preferred agents include porphyrin photosensitizers such as "green
porphyrins" such as BPD-MA, EA6 and B3. Generally, any polypyrrolic
macrocyclic photosensitive compound that is hydrophobic can be used in the
invention.
Microaggregates
The MA of the invention results in the production of phospholipid
containing micelles, liposomes, and mixtures thereof. Phospholipids
suitable for use in the invention may be any naturally occurring or
synthetic phospholipid, whether saturated or unsaturated. They include,
but not limited to, the following: phosphatidylcholine,
phosphatidylethanolamine, phosphatidylserine, phosphatidylinositol,
phosphatidylglycerol, phosphatidic acid, lysophospholipids, egg or soybean
phospholipid or combinations thereof The phospholipids may be in any form,
including salted or desalted, hydrogenated or partially hydrogenated, or
natural, semisynthetic (modified) or synthetic. In preferred embodiments
of the invention, the phospholipids used are those capable of forming
liposomes, but also able to result in the production of micelles if a high
energy processing step is used for size reduction of multilammelar
liposomes.
Even more preferred are unsaturated phosphatidylglycerols or
phosphatidylcholines with charged head groups. Such preferred embodiments
include the use of negatively charged mono- or polyunsaturated
phosphatidylglycerols and phosphatidylcholines such as egg
phosphatidylglycerol (EPG), palmitoyloleoylphosphatidylglycerol (POPG),
dioleoylphosphatidylglycerol (DOPG), dipalmitoylphosphatidylcholine (DPPC),
or combinations thereof. The unsaturated fatty acid chain is preferably on
the same phospholipid molecule as the charged headgroup, but
alternatively, the desired combination of unsaturation and charge could be
attained by using a charged saturated molecule such as DMPG together with
an unsaturated phospholipid molecule. It will generally be preferable to
limit the amount of the unsaturated phospholipid (in other words, not to
make the whole composition from unsaturated phospholipids) because of the
greater stability of saturated phospholipids. Preferably, the ratio of
unsaturated charged phospholipid to the saturated phospholipid is at least
about 1:99, and more preferably the ratio is at least about 3:97, and even
more preferably in the range of about 10:90 or more. Most preferably, the
ratio is in the range of about 40:60 to about 50:50, but may exceed 50:50.
The number of unsaturations (double bonds) in the fatty acid chain can
range from about 1-6, but is more preferably about 1 to 3, and most
preferably about 1 or about 2.
Without being bound by theory, and with respect to the preferential use of
unsaturated lipids in the MA of the invention, it is believed that
saturated acyl chains may not be sufficiently flexible during
lyophilization of (removing water from) the MA. Thus in the case of
liposomes, where water is removed from the core entrapped volume (for
which an analogy of making raisins from grapes is applicable), unsaturated
acyl chains permit more curvature in the lipid membrane and may introduce
the necessary flexibility to allow shrinkage during drying. As such, the
micelle containing MA of the invention are less susceptible to these
effects since they likely lack an inner water core (or alternatively have
a significantly smaller one). This may explain the robustness of micelle
containing MA during lyophilization. The flexibility of unsaturated lipids
may be a likely cause of small stable micelle structure formation during
microfluidization. The presence of unsaturated lipids also lowers the
phase transition temperature (liquid to gel transition) of the formulation
to below room temperature, and induces a less pronounced transition. The
amount of unsaturated lipid determines the degree to which the phase
transition temperature is decreased. It is also believed that the presence
of a charged head group on a phospholipid (for example, on
phosphotidylglycerol) stabilizes small liposomes and micelles because the
repulsive charge prevents fusion into larger liposomal structures.
All MA of the invention may comprise, consist of or consist essentially of
any one or more phospholipids in combination with a hydrophobic agent.
Preferably, the phospholipids used in the MA of the invention are either
synthetic or derived from non-animal sources. More preferably, the
phospholipids used in the MA of the invention include DOPG (1,2
dioleoylphosphatidylglycerol), which is a doubly unsaturated lipid of
plant origin.
Phosphatidyl glycerols (PGs) may also be present in the MA of the
invention. Examples of such PGs include dimyristoyl phosphatidyl glycerol
(DMPG), DLPG and the like. The incorporation of such PGs may be used to
contribute to the stabilization of micelles. Other types of suitable
lipids that may be included are phosphatidyl ethanolamines (PEs),
phosphatidic acids (PAs), phosphatidyl serines, and phosphatidyl inositols.
A range of total lipid to hydrophobic agent ratios may be use in the
practice of the invention. The ratio depends on the hydrophobic agent
being used, but will assure the presence of a sufficient number of lipid
molecules to form stable MA. Appropriate total lipid:hydrophobic agent
ratios may be from about 7:1 and higher, although lower ratios also do not
exhibit adverse effects. A preferred range is from about 7:1 to 10:1. Of
course all intermediate ratios within this range, such as about 8:1 and
about 9:1, are within the scope of the invention. Additionally within the
scope of the invention are the sub-intermediate ratios within the range,
such as from about 7.1:1 to 7.9:1, about 8.1:1 to 8.9:1, and about 9.1:1
to 9.9:1, are within the scope of the invention. When the number of lipid
molecules is not sufficient to form a stable complex, the lipophilic phase
of the MA may become saturated with hydrophobic agent molecules. Then, any
slight change in the process conditions can force some of the previously
encapsulated hydrophobic agent to leak out onto the surface of the MA, or
even out into the aqueous phase.
If the concentration of hydrophobic agent is high enough, it can actually
precipitate out from the aqueous layer and promote aggregation of the MA.
The more unencapsulated hydrophobic agent present, the higher the degree
of aggregation. The more aggregation, the larger the mean aggregate size
will be, and the MA will no longer be of a sufficiently small size for
efficient use in steps such as filter sterilization. Thus slight increases
in the lipid content can increase significantly the filterability of the
liposome composition by increasing the ability to form and maintain small
aggregates. This is particularly advantageous when working with
significant volumes of 500 ml, a liter, five liters, 40 liters, or more,
as opposed to smaller batches of about 100-500 ml or less.
When larger volumes of MA are being made, a higher molar ratio of
phospholipid provides more assurance of reliable aseptic filterability by
providing smaller aggregates. Moreover, the substantial potency losses
that are common in scale-up batches, due at least in part to filterability
problems, can thus be avoided. Another means of increasing filterability
is by preparation of micelle containing MA since micelles are smaller than
liposomes in general. Such micelle containing MA are more readily filter
sterilized with a 0.22 micron filter and a preferred embodiment of the
invention. Additional advantages in MA containing the smaller micelles is
reduced loss of the active hydrophobic agent via large aggregates lost
during filtering or other processes; and the stability of smaller
aggregates after reconstitution. Thus a preferred embodiment of the
invention is where the hydrophobic agent is present in amounts, or in
ratios, that favor micelle formation.
When a combination of phospholipids is used in the MA of the invention, a
range of relative lipid ratios may be used in combination with the total
lipid:hydrophobic agent ratios described above. Appropriate lipid ratios
for combinations of two phospholipids range from about 50:50 to about
97:1. Of course all intermediate ratios within this range, such as about
70:30, about 80:20 and about 90:10, are within the scope of the invention.
As indicated by the use of the 99:1 ratio, sub-intermediate ratios within
the range, such as from about 71:29 to 79:21, about 81:19 to 89:11, and
about 91:9 to 97:3, are within the scope of the invention. Examples of
combinations of two phospholipids where such ratios may be used include
DMPC:DMPG, DMPC:EPG, DMPC:POPG and DMPC:DOPG. An additional example is
DMPC: EPG, preferably at a ratio of about 5:3 respectively. With this
combination, even higher hydrophobic agent:lipid ratios, such as 1:10,
1:15, or 1:20, respectively, may be used.
A particularly preferred embodiment of the MA of the invention comprises
hydrophobic agents in an 8:1 total phospholipid:hydrophobic agent ratio
with a 60:40 lipid ratio of a DMPC:DOPC combination containing
antioxidants BHT and AP. In particular, hydrophobic agents such as EA6
and/or BPD-MA may be used in such MA. Also preferred are MA compositions
comprising EA6 in small liposomes comprising lipids and other components
as described herein.
Antioxidants
In preferred embodiments comprising the use of unsaturated phospholipids,
the invention encompasses the use of antioxidants to prevent oxidation of
the phospholipids. Auto-oxidation of unsaturated acyl chains has been
known to be a problem for long-term storage of liposome formulations.
Failure to prevent oxidative breakdown of unsaturated phospholipids
results in subcomponents such as lyso lipids and fatty acids, which may be
undesirable in some MA compositions. As such, antioxidants suitable for
inclusion in phospholipid containing microaggregates to improve long-term
storage are known in the art. Examples of such antioxidants include
butylated hydroxytoluene (BHT), alpha-tocopherol, and ascorbyl palmitate
(AP) as well as pH buffering agents such as phosphates and glycine.
Preferably, BHT is present at about 0.01-0.02% by weight and AP at about
0.1-0.2% by weight.
BHT is hydrophobic and would be expected to remain in the lipophilic
environments of the MA of the invention. BHT has the ability to prevent
chain propagation during auto-oxidation by accepting radicals formed
during the oxidative breakdown of lipids. Ascorbic acid has the capacity
to act as an antioxidant and to act with other antioxidants such as alpha-tocopherol.
It has been shown that the BHT/ascorbic acid system allows for BHT
regeneration, following its conversion to a phenoxyl radical after free
radical scavenging from oxidized lipids, thereby resulting in the
appearance of ascorbyl radicals. This latter factor justifies the relative
weight ration of AP to BHT described above. AP was used in place of
ascorbic acid because the hydrophobic nature of the former would be
expected to concentrate the antioxidant within lipophilic environments.
Another anti-oxidation considerations is the filling of container
headspaces with nitrogen gas and the sealing of such containers.
Additionally, and because metal ions can catalyze oxidative processes, the
use of high quality drug, excipients, and containers, the judicious
cleaning of manufacturing equipment, and the appropriate use of metal ion
chelators are preferred.
Cryoprotective Agents and Isotonic Agents
In a preferred embodiment of the invention, the MA are stabilized by
lyophilization. An advantage to the micelle containing MA of the invention
is the fact that micelles may be more readily lyophilized in comparison to
liposomes due to the absence of a water core. Lyophilization of liposomes
require the passage of water across at least one lipid bilayer, resulting
in increased processing times and expense. The absence of a water core
also permits micelles to have a greater concentration of phospholipid per
unit volume. Thus a larger amount of hydrophobic agent can be solubilized
by the phospholipid per unit volume of micelle. This permits the final
micelle MA delivery vehicle to have a higher drug density per unit volume
than other delivery vehicles, such as liposomes alone.
MA of the invention may contain a cryoprotectant for stabilizing the MA
during lyophilization. Alternatively, the physical structures of the MA
can be preserved by the presence of sufficient water after lyophilization.
This is may be accomplished by appropriate control of the degree of
lyophilization. Since there is no entrapped volume in micelles, the
micelle containing MA of the invention facilitates greater control over
water soluble components, like solvent or salt, to be removed in the
preparation of delivery vehicles requiring such removal.
Any cryoprotective agent known to be useful in the art of preparing
freeze-dried formulations, such as di- or polysaccharides or other bulking
agents such as lysine, may be used in the claimed invention. Further,
isotonic agents typically added to maintain isomolarity with body fluids
may be used. In preferred embodiments, a di-saccharide or polysaccharide
is used and functions both as a cryoprotective agent and as an isotonic
agent. In an especially preferred embodiment, the disaccharide or
polysaccharide is selected from among the group consisting of lactose,
trehalose, maltose, maltotriose, palatinose, lactulose or sucrose, with
lactose or trehalose being preferred. Effective sugars such as trehalose
and lactose are capable of hydrogen bonding to the phospholipidhead group
in place of water. It has also been hypothesized that effective sugars
also act a as a spacing matrix to decrease the opposition of phospholipids
on the exterior of adjacent MA such as liposomes.
When the process of hydrating a lipid film is prolonged, larger liposomes
tend to be formed, and hydrophobic agents may even precipitate. The
addition of a disaccharide or polysaccharide provides the largest surface
area for depositing a thin film of MA and virtually instantaneous
subsequent hydration. This thin film provides for faster hydration so
that, when the MA are initially formed by adding the aqueous phase
(hydrated), the MA are of a smaller and more uniform particle size. This
provides significant advantages in terms of manufacturing ease.
However, it is also possible that, when a saccharide is present in the
composition of the invention, it is added after dry lipid film formation,
as a part of the aqueous solution used in hydration. In a particularly
preferred embodiment, a saccharide is added to the dry lipid film of the
invention during hydration.
Disaccharides or polysaccharides are preferred to monosaccharides for this
purpose. To keep the osmotic pressure of the MA compositions of the
invention similar to that of blood, no more than 4-5% monosaccharides
should be added. In contrast, about 9-10% of a disaccharide can be used
without generating an unacceptable osmotic pressure. The higher amount of
disaccharide provides for a larger surface area, which results in smaller
particle sizes being formed during hydration of the lipid film.
Also, when present, the disaccharide or polysaccharide is formulated in a
preferred ratio of about 10-20 saccharide to 0.5-6.0 total phospholipids,
respectively, even more preferably at a ratio from about 10 to 1.5-4.0. In
one embodiment, a preferred but not limiting formulation is lactose or
trehalose and total phospholipids in a ratio of about 10 to 0.94-1.88 to
about 0.65-1.30, respectively.
The presence of the disaccharide or polysaccharide in the composition not
only tends to yield MA having extremely small and narrow aggregate size
ranges, but also provides MA compositions in which the hydrophobic agents,
such as a hydro-monobenzoporphyrin photosensitizer, may be stably
incorporated in an efficient manner, i.e., with an encapsulation
efficiency approaching 80-100%. Moreover, MA made with a saccharide
typically exhibit improved physical and chemical stability, such that they
can retain an incorporated hydrophobic agent, such as hydro-monobenzoporphyrin
photosensitizer, without leakage upon prolonged storage, either as a
reconstituted aqueous suspension or as a cryodesiccated powder.
Freeze-Drying
Once formulated, the MA of the invention may be freeze-dried for long-term
storage if desired. For example, BPD-MA, a preferred hydro-monobenzoporphyrin
photosensitizer, has maintained its potency in a cryodesiccated MA
composition for a period of at least nine months at room temperature, and
a shelf life of at least two years has been projected. If the composition
is freeze-dried, it may be packed in vials for subsequent reconstitution
with a suitable aqueous solution, such as sterile water or sterile water
containing a saccharide and/or other suitable excipients, just prior to
use. For example, reconstitution may be by simply adding water for
injection just prior to administration.
Various lyophilization techniques are known in the art. For example, MA
containing vials of the invention may be first frozen to -45° C. and then
held there for a period of up to about 90 minutes. This may be followed by
a high vacuum primary drying cycle wherein the temperature is increased
slowly to up to about 10° C. for a period usually on the order of about 50
hours. This may be followed by a 20° C. secondary drying cycle of up to
about 24 hours. Once the lyophilizer pressure stabilizes at about 55-65
mTorr (73-87 microbar), the cycle is terminated. Thereafter, the vials may
be sealed after overlaying with nitrogen gas. A general rule for
freeze-drying is that a solid, brittle, non-collapsed, and homogenous cake
is preferred for successful re-hydration.
Additionally, the use of lyophilization may prevent hydrolysis of
hydrophobic agents susceptible to such reactions. For example, the
photosensitizer BPD-MA may be hydrolyzed to BPD-DA.
Size
In one aspect of the invention, the MA are of a sufficiently small and
narrow size that the aseptic filtration of the composition through a 0.22
micron hydrophilic filter can be accomplished efficiently and with large
volumes of 500 ml to a liter or more without significant clogging of the
filter. As such micelle and small liposome containing MA are a preferred
embodiment of the invention. Moreover, and given their smaller size, the
MA of the invention may mainly, or predominantly, contain hydrophobic
agent bearing micelles. The MA of the invention may contain greater than
about 50%, greater than about 60%, greater than about 75%, greater than
about 80%, greater than about 90%, and greater than about 95% micelles.
Even more preferably, the MA of the invention may contain greater than
about 97%, about 98%, or about 99% micelles. Most preferably in desired
circumstances, the MA of the invention consist only of micelles.
Alternatively, the MA of the invention may in some circumstances (when an
extrusion process is used for size reduction of multilammelar liposomes,
rather than a high energy process such as microfluidization) contain up to
100% liposomes.
Micelles refer to microaggregates with the hydrophobic (lipophilic) "tail"
portion of the phospholipids generally oriented toward the interior of the
micelle. Preferably, micelles have the "tail" portion generally oriented
toward the center of the micelle. Micelles do not have a bilayer structure
and so are not considered vesicles or liposomes. The micelles of the
invention have average diameters of less than about 30 nm (nanometers).
Preferably, they have average diameters of less than about 20 nm.
Liposomes refer to microaggregates comprising at least one phospholipid
bilayer, composed of two lipid monolayers having a hydrophobic "tail"
region and a hydrophilic "head" region. The structure of the membrane
bilayer is such that the hydrophobic (nonpolar) "tails" of the lipid
monolayers orient themselves towards the center of the bilayer, while the
hydrophilic "heads" orient themselves toward the aqueous phase. They
generally comprise completely closed, lipid bilayer membranes that contain
an entrapped aqueous volume. Given the bilayer structure, a significant
portion (up to about half) of the phospholipids will have their
hydrophobic (lipophilic) portion generally oriented away from the center
of the liposome. Liposomes include unilamellar vesicles having a single
membrane bilayer or multilamellar vesicles having multiple membrane
bilayers, each bilayer being separated from the next by an aqueous layer.
The average diameters of liposomes are larger than that of micelles.
In liposomes, a hydrophobic agent can be entrapped in the aqueous phase of
the liposome or be associated with the "tail" portion of phospholipids in
the lipid bilayer. In micelles, a hydrophobic agent is left to associate
only with the "tail" portion of phospholipids in the core of the micelle.
Additionally, both micelles and liposomes may be used to help "target" a
hydrophobic drug to an active site or to solubilize hydrophobic drugs for
parenteral administration.
One aspect of the present invention uses this ability to form micelles and
liposomes by the same mixture of hydrophobic agent and phospholipids. This
would result in MA that have a bimodal distribution in their diameters,
indicating the presence of both micelles and liposomes. In another aspect
of the invention, the micelles and liposomes are form under conditions
that favor one type of microaggregate over the other in the same mixture.
Conditions that favor micelle formation include the presence of low salt
in the mixture as well as the use of low salt aqueous solution for
hydrating the dried mixture. "Low salt" refers to conditions containing
less than about 0.1 N free cations or anions. Preferably, it refers to
less than about 0.01 N free ions. More preferably it refers to less than
about 0.001 N free ions.
Preferred MA of the invention have an average aggregate size diameter of
well below about 300 nm, more preferably below from about 200 nm. Most
preferably, the MA of the invention have an average aggregate size
diameter below about 100 nm, and sometimes, depending on the conditions
chosen, in the range of 10-50 nm. The size of the microaggregates made
comprising QLT 0074, DOPG and DMPC (see Example 1 below) have been sized
using three different methods (using a NICOMP 370 Submicron Particle Sizer,
by freeze fracture analysis and by size exclusion HPLC). Freeze fracture
analysis showed a mixture of micelles (7-15 nm in diameter), and
relatively few liposomes (between 6- and 270 nm diameter). Size exclusion
HPLC indicated mean particle size of 28 nm when tested in four different
media (PBS, 0.9% sodium chloride, 9.2% lactose and 5% dextrose) with a
range or 25-35 nm.
As discussed herein, the invention controls four major parameters that can
affect the ease of aggregate size reduction to an unexpected degree. As a
result, the filterability, particularly with standard aseptic filtration,
is significantly improved in the MA of the invention. These parameters are
(1) the production of micelles and small liposomes by use of low salt
conditions; (2) suitable molar ratio of hydro-monobenzoporphyrin
photosensitizer to total phospholipids; (3) temperature during the
hydration step; and (4) temperature during the homogenization or size
reduction step. The latter two parameters are discussed below.
Filterability can be tested by passing a MA composition through a
Microfluidizer™ three times and withdrawing a sample with a syringe. The
syringe is connected to a 0.22 micron hydrophilic filter and then placed
in a syringe pump. The constant rate of piston movement is set at 10
ml/min, and filtrate is collected until the filter becomes blocked by
large aggregates. The volume of the filtrate is then measured and recorded
in terms of ml/cm2 or g/cm2, with a square
centimeter being the effective filtration area. Thus, filterability for
the purposes of the invention is defined as the maximum volume or weight
of MA composition that can be filtered through a 0.22 micron filter.
The MA of the invention may be used as a delivery vehicle for the
constituent hydrophobic agent to target any cell or tissue for which
contact with the agent is desired. In preferred embodiments of the
invention, the agent is a photosensitizer to be delivered prior to light
irradiation as part of photodynamic therapy (PDT). Particularly preferred
MA of the invention comprise a hydro-monobenzoporphyrin photosensitizer,
including BPD-MA and EA6, for use in photodynamic therapy (PDT) or
diagnosis.
The MA of the invention also preferably comprises micelles which are
readily, and significantly, destabilized in the presence of proteins,
salts, charged elements, and/or polymers. Such MA are well suited as a
pharmaceutical formulation to deliver hydrophobic drugs to fluids such as
blood, which contains proteins, salts, charged elements and polymers.
Given the ability to destabilize after delivery to target conditions, the
MA of the invention can rapidly deliver hydrophobic agents to targets such
as the bloodstream, where the drugs may be picked up or transferred to
blood components for farther transport and/or targeting based on the
components' specificities. As such, the MA can be considered "fast
breaking" in that the MA is stable in vitro but, when administered in
vivo, the hydrophobic drug (such as a photosensitizer) is rapidly released
into the bloodstream where it associates with blood components such as
serum lipoproteins. Another beneficial effect of this transfer is reduced
depositing of hydrophobic agents in various organs, especially the liver.
As such, the pharmokinetics of delivering the hydrophobic agent with such
micelles are altered compared to the use of other delivery vehicles or
systems, such as those that do not release the agent rapidly or those that
do not transfer the agent to blood components.
Preparation
Methods for the production of the MA of the invention comprise, consist
of, and/or consisting essentially of the combination of hydrophobic agents
and phospholipids and subjecting them to conditions capable of forming
micelles, small liposomes or combinations thereof. Preferably, the methods
comprise the use of phospholipids capable of forming lipid bilayers and
result in the production of stable micelles and/or small liposomes. The
resultant MA, especially those comprising or consisting of micelles of the
invention, do not contain detergents normally used for micelle production.
The absence of detergents can markedly reduce toxicity known to result in
hemolysis and kidney damage. To favor micelle formation, the MA of the
invention are formulated under low salt conditions because, as noted
above, the micelles of the invention are destabilized by salt.
Generally, the MA of the invention are produced by dissolving the desired
MA constituent component molecules (such as desired phospholipids,
hydrophobic agent, and optionally antioxidants and cryoprotectants) into a
solvent to form an "intermediate complex". Preferred solvents are organic
or otherwise non-aqueous. Suitable organic solvents include any volatile
organic solvent, such as diethyl ether, acetone, methylene chloride,
chloroform, piperidine, piperidine-water mixtures, methanol, tert-butanol,
dimethyl sulfoxide, N-methyl-2-pyrrolidone, and mixtures thereof.
Preferably, the organic solvent is water-immiscible, such as methylene
chloride, but water immiscibility is not required. In any event, the
solvent chosen should not only be able to dissolve all of the components
of the lipid film, but should also not react with, or otherwise
deleteriously affect, these components to any significant degree.
The organic solvent is then removed from the resulting solution to form a
dry lipid film by any known laboratory technique that is not significantly
deleterious to the dry lipid film and the hydrophobic agent. Such
techniques include any that remove the solvent via its gaseous phase,
including evaporation or vacuum. In one embodiment, the solvent is removed
by placing the solution under a vacuum until the organic solvent is
evaporated. The solid residue is the dry lipid film of the invention,
which contains aggregates of the MA components, considered the "presome".
The thickness of the lipid film is not critical, but usually varies from
about 30 to about 45 mg/cm2, depending upon the amount of solid
residual and the surface area of the vessel which contains it. In another
embodiment of the invention, the solvent is removed as part the "presome"
process of Nanba et al. (U.S. Pat. No.5,096,629, which is hereby
incorporated by reference as if fully set forth), which heats the
"intermediate complex" and subjects it to dryness via an instantaneous
vacuum drying system such as the CRUX 8B™ (Orient Chemical Ind., Ltd.,
Japan) to produce a lipid powder containing aggregates of the MA
components.
Once formed, the film or powder may be stored for an extended period of
time, preferably not more than 4 to 21 days, prior to hydration. Storage
may be under an appropriate gas, such as argon. While the temperature
during a lipid film or powder storage period is also not an important
factor, it is preferably below room temperature, most preferably in the
range from about -20 to about 4° C. One advantage to the Nanba et al. "presome"
process is the reduction of batch to batch variability seen with thin
film, which arises due to the use of multiple batches in evaporation
vessels.
The dry lipid film or powder may be hydrated with an aqueous solution,
preferably containing a disaccharide or polysaccharide if not previously
present. This will result in the formation of large multilammelar
liposomes that can be further processed by extrusion or a high energy
process, such as microfluidization to form the desired particle size.
Examples of useful aqueous solutions used during the hydration step
include sterile water, or a dilute solution of lactose. In one embodiment
of the invention, the solution is physiologically isotonic, such as 9.2%
lactose, which permits bolus injections. Preferably the aqueous solution
is sterile. Most preferably for the production of micelles and the
stabilization of small liposomes, the solution is low salt. It is believed
that the presence of salts neutralizes the negative repulsive charges that
prevent the aggregation or fusion of these small particles into larger
liposomes.
The volume of aqueous solution used during hydration can vary greatly, but
should not be so great as about 98% nor so small as about 30-40%. A
typical range of useful volumes would be from about 50 or 60% to about
95%, preferably about 75% to about 95%, more preferably about 80% to about
90%, and most preferably about 85% to 90%. Of course all subranges from
about 30% to about 98% are included as part of the invention.
The physical manipulation of material during hydration may be conducted by
a variety of means, including mixing and rotating on a rotary evaporator,
manual swirling of vessels, and the use of standard laboratory stirrer or
shaker means (including stir bars with stir plates, high shear mixers,
paddles and combinations thereof). Preferred in the practice of the
invention are high agitation methods, such as the use of high-shear mixing
or egg-shaped stir bars.
Upon hydration, coarse aggregates are formed that incorporate a
therapeutically effective amount of the hydrophobic agent. The
"therapeutically effective amount" can vary widely, depending on the
tissue to be treated and whether the hydrophobic agent is coupled to a
target-specific ligand, such as an antibody or an immunologically active
fragment. Typically, the therapeutically effective amount is such to
produce a dose of hydrophobic agent within a range of from about 0.1 to
about 20 mg/kg, preferably from about 0.15-2.0 mg/kg and, even more
preferably, from about 0.25 to about 0.75 mg/kg. Preferably, the w/v
concentration of the hydrophobic agent in the "intermediate complex"
ranges from about 0.1 to about 8.0-10.0 g/L, when the mixture becomes such
a thick gel that it is not possible to handle or administer to a subject
by the usual means. Most preferably, the concentration is about 2.0 to 2.5
g/L.
It should be noted that if the agent is a photosensitizer, the various
parameters used for selective photodynamic therapy are interrelated.
Therefore, the therapeutically effective amount should also be adjusted
with respect to other parameters, for example, fluence, irradiance,
duration of the light used in photodynamic therapy, and the time interval
between administration of the photosensitizing agent and the therapeutic
irradiation. Generally, all of these parameters are adjusted to produce
significant damage to tissue deemed undesirable, such as neovascular or
tumor tissue, without significant damage to the surrounding tissue, or to
enable the observation of such undesirable tissue without significant
damage to the surrounding tissue.
The hydration step should take place at a temperature that does not exceed
the glass transition temperature of the phospholipid and hydrophobic agent
aggregates formed. For photosensitizers of the invention, this temperature
is about 30° C. Preferably the temperature is at room temperature or
lower, such as from 10-25, or even more preferred from 15-20° C. or 17-22°
C. An especially preferred temperature is about 21° C. The glass
transition temperature of the phospholipid and hydrophobic agent
aggregates can be measured by using a differential scanning
microcalorimeter. Madden et al. ("Spontaneous vesiculation of large
multilamellar vesicles composed of saturated phosphatidylcholine and
phosphatidylglycerol mixtures." Biochemistry, Vol. 27, pp. 8724-8730,
(1988)) describe the effects of temperature and ionic strength on vesicle
formation.
The use of unsaturated charged lipids as encompassed by the invention may
effectively lower the phase transition temperature Tc (liquid to gel
transition) of the formulation to below room temperature and induce a less
pronounced transition. The amount of unsaturated lipid determines the
degree of Tc lowering.
The particle sizes of the coarse aggregates first formed during hydration
are then homogenized to a more uniform size and/or reduced to a smaller
size range of about less than about 50 to about 300 nm, depending on the
method of size reduction used. Preferably, this homogenization and/or
reduction is also conducted at a temperature below the glass transition
temperature of the hydrophobic agent-phospholipid complex formed in the
hydration step. For photosensitizers of the invention, such temperature
does not exceed about 30° C., and is preferably below room temperature of
about 25° C. It has been found that the homogenization temperature with
photosensitizers is preferably at room temperature or lower, e.g., 15-20°
C. At higher homogenization temperatures, such as about 32-42° C., the
relative filterability of the MA composition may improve initially due to
increased fluidity as expected, but then, unexpectedly, tends to decrease
with continuing agitation due to increasing particle size.
Various high-speed agitation or high energy system manipulation processes
may be used during the homogenization step. Examples of such processes
include microfluidization (liquid jet milling), high shear mixing, and
sonication. While effective, sonication is not ideal for use in large
scale production of MA. Processing through the aforementioned high energy
system results in the production of small particles, usually a mixture of
small liposomes and micelles. Extrusion, is another method of size
reduction. Extrusion results in the production of small liposomes (as
small as 50 to 100 nm), but micelles have not been observed by the
inventors in production by this procedure. Extrusion involves the forcing
of hydrated material, under pressure and at temperatures known to make
liposome formulations fluid, through membrane filters of defined pore
sizes. While adequate for laboratory scale batches of material, extrusion
may not be ideal for large scale processes since 1) the pores become
clogged even at high pressures of greater than 1000 psi, 2) the surface
area of the filter membrane and extruder volume are limitations, and 3)
multiple discontinuous passes through the extruder increases the
likelihood of differences between batches.
Devices for the above described processes include a Microfluidizer™ (such
as a Microfluidics™ Model 110F); a sonicator; a high-shear mixer; a
homogenizer; a standard laboratory shaker or stirrer, or any other
agitation device. Of course modifications in such processes to suit the
particular hydrophobic agent of interest and formation of the desired MA
are within the scope of the invention. In one preferred embodiment of the
invention, these processes are used for the production of MA containing
mainly micelles.
Such processes may be used to produce MA various ratios of micelles,
liposomes and combinations thereof. In embodiments where both micelles and
liposomes are produced, they may be separated by the bimodal size
distribution seen in combinations of the two. This arises from the
significantly smaller size of micelles in comparison to liposomes. The
analysis of MA size may be performed by methods including electron
microscopy, to exclude large aggregates as liposomes, and use of a
particle sizer, which may be used in combination with fitting routines for
uni- and bimodal distributions. Another method is by use of manganese
chloride (Mn2+) mediated nuclear magnetic resonance (31P-NMR),
where 31Phosphorus labeled headgroups of lipids on the inner
layer of a liposome lipid bilayer are not quenched by Mn2+
because Mn2+ cannot readily cross the bilayer to enter the
entrapped volume. Thus liposomes will produce a residual NMR signal of
about 30-40% for large and small liposomes after adding Mn2+.
All 31P-labeled headgroups of lipids of a micelle, however, are
on the surface and thus fully exposed to Mn2+ quenching. Thus
micelles produce no remaining NMR signal due to quenching after adding Mn2+
(see FIG. 1).
In a preferred embodiment, a high pressure device such as a Microfluidizer™
is used for agitation. Some models of microfluidization systems are
continuous and batch size scalable processors. Microfluidization uses high
pressure streams of hydrated material that collide at ultra-high
velocities in precisely defined microchannels. In the interaction chamber,
two streams of fluid at a high speed collide with each other at a 90°
angle. The combined forces of shear, impact and cavitation result in the
production of liposomes and micelles. In microfluidization, a large amount
of heat is generated during the short period of time during which the
fluid passes through a high pressure interaction chamber. As the
microfluidization temperature increases, the fluidity of the membrane also
increases, which initially makes particle size reduction easier, as
expected. For example, filterability can increase by as much as four times
with the initial few passes through a Microfluidizer™ device. The increase
in the fluidity of the bilayer membrane promotes particle size reduction,
which makes filtration of the final composition easier. In the initial
several passes, this increased fluidity mechanism advantageously dominates
the process.
However, as the number of passes and the temperature both increase, more
of the hydrophobic agent molecules are apparently squeezed out in cases
involving liposomes, increasing the tendency of the liposomes to aggregate
into larger particles. At the point at which the aggregation of vesicles
begins to dominate the process, the sizes cannot be reduced any further.
For this reason, in the methods of the invention, the homogenization
temperature is cooled down to and maintained at a temperature no greater
than room temperature after the composition passes through the zone of
maximum agitation, e.g., the interaction chamber of a Microfluidizer™
device. An appropriate cooling system can easily be provided for any
standard agitation device in which homogenization is to take place, e.g.,
a Microfluidizer™, such as by circulating cold water into an appropriate
cooling jacket around the mixing chamber or other zone of maximum
turbulence. While the pressure used in such high pressure devices is not
critical, pressures from about 10,000 to about 16,000 psi are not
uncommon.
Maintaining the hydration temperature and the homogenizing/reducing step
at a temperature below 30° C. would not have been expected to produce
smaller particle sizes. In fact, the invention is contrary to the
conventional wisdom that small particle sizes are achieved by increasing
rather than decreasing these temperatures. See, e.g., M. Lee et al., "Size
Distribution of Liposomes by Flow Field-Flow Fractionation", J. Pharm.
& Biomed. Analysis, 11:10, 911-20 (1993), equation (6) showing
particle diameter "d" as inversely related to temperature "T", and FIG. 6b
therein showing liposome preparation I (prepared at about 70° C.)
having smaller particle sizes than preparation II (prepared at about 23°
C.).
As a last step, the MA compositions of the inventions are preferably
aseptically filtered through a filter having an extremely small pore size,
i.e., 0.22 micron. While other sterilization methods, such as heating and
X-ray irradiation are known, in the art, the use of such methods may
result in irreversible structural changes in lipids and hydrophobic agents
such as many photosensitizers. A wide variety of filtration systems are
known in the art, including Durapore TP cartridges, Millipak 100,
Millidisk 40S, and millidisk MCGL. Filter pressures used during sterile
filtration can vary widely, depending on the volume of the composition,
the density, the temperature, the type of filter, the filter pore size,
and the size of the MA. However, as a guide, a typical set of filtration
conditions would be as follows: filtration pressure of 15-25 psi;
filtration load of 0.8 to 1.5 ml/cm2; and filtration
temperature of about 25° C. Preferably, the hydrophilic Millidisk 40S is
used at a load of approximately 1 ml/cm2.
A typical general procedure for producing hydro-monobenzoporphyrin
photosensitizer containing MA of the invention is described below with
additional exemplary detail:
(1) Sterile filtration of methylene chloride as organic solvent through a
hydrophobic, 0.22 micron filter.
(2) Addition of DMPC:EPG:BPD-MA at a ratio of 4.7:3.25:1 and excipients to
the filtered organic solvent, dissolving both the excipients and the
photosensitizer to form the "intermediate complex".
(3) Filtration of the resulting solution through a 0.22 micron hydrophobic
filter.
(4) Transfer of the filtrate to a rotary evaporator apparatus, such as
that commercially available under the name Rotoevaporator.
(5) Removal of the organic solvent to form a dry lipid film.
(6) Analysis of the lipid film to determine the level of organic solvent
concentration; optionally continuing removal until the level of organic
solvent is below 0.01%,
(7) Preparation of a 10% lactose solution. If the MA formulation is to be
injected, this solution should be injectable.
(8) Filtration of the lactose solution through a 0.22 micron hydrophilic
filter.
(9) Hydration of the lipid film with the filtered 10% lactose solution to
form coarse aggregates.
(10) Reduction of the particle sizes of the coarse aggregates by passing
them through a Microfluidizer™, optionally at 9000 psi (pounds per square
inch) for about 5 discrete passes to produce micelles.
(11) Determination of the reduced aggregated size distribution of MA.
(12) Aseptic filtration of the MA composition through a 0.22 micron
hydrophilic filter. (Optionally, the solution may first be pre-filtered
with a 5.0 micron or smaller pre-filter.)
(13) Analysis of photosensitizer potency.
(14) Filling of vials with the MA composition.
(15) Freeze-drying.
The above may be adapted for the selective production of micelles by
conducting all appropriate steps under low salt conditions to favor
subsequent micelle production after hydration. As such, salt based bulking
agents must not be used. In such applications, the resulting micelles are
on the order of about 15 nm in diameter, which is at the lower limit for
feasible liposome sizes. The micelle structure was confirmed by use of
31P-NMR.
An alternative general procedure for producing hydro-monobenzoporphyrin
photosensitizer containing MA of the invention by use of a "presome"
process of Nanba et al. (see U.S. Pat. No. 5,096,629) is described below
with additional exemplary detail:
(1) Sterile filtration of methylene chloride as organic solvent through a
hydrophobic, 0.22 micron filter.
(2) Addition of DMPC:DOPG at a ratio of 60:40 with a total lipid:EA6 at a
ratio of 8:1 and antioxidants BHT and AP to the filtered organic solvent,
dissolving both the excipients and the photosensitizer to form the
"intermediate complex".
(3) Filtration of the resulting solution through a 0.22 micron hydrophobic
filter.
(4) Transfer of the filtrate to liquid tank followed by feeding to a
tubular heater heated externally.
(5) Removal of the organic solvent by sending the heated mixture into a
vacuum chamber of no more than 300 mm Hg at a speed over 0.1 times the
speed of sound to instantaneously dry the mixture to form lipid powder.
(6) Analysis of the lipid powder to determine the level of organic solvent
concentration; optionally continuing removal until the level of organic
solvent is below 0.01%,
(7) Preparation of a 10% lactose solution. If the MA formulation is to be
injected, this solution should be injectable.
(8) Filtration of the lactose solution through a 0.22 micron hydrophilic
filter.
(9) Hydration of the lipid powder with the filtered 10% lactose solution
to form coarse aggregates.
(10) Dispersion of the coarse aggregates by stirring them at high rpm at a
temperature below the glass transition temperature of the photosensitizer
and phospholipid containing aggregates.
(11) Determination of the reduced aggregated size distribution of MA.
(12) Aseptic filtration of the MA composition through a 0.22 micron
hydrophilic filter. (Optionally, the solution may first be pre-filtered
with a 5.0 micron or smaller pre-filter.)
(13) Analysis of photosensitizer potency.
(14) Filling of vials with the MA composition.
(15) Freeze-drying.
One means of conducting the above instantaneous drying is by use of a
vacuum drying system such as the CRUX 8B™ product of Orient Chemical Ind.,
Ltd., Japan. Moreover, the above dispersion step may be at speeds of about
10,000 rpm, or ranging from 8000 to 15,000 rpm. Such a "presome" process
may also be adapted for the selective production of micelles by conducting
all appropriate steps under low salt conditions to favor subsequent
micelle production after hydration. As such, salt based bulking agents
must not be used.
As described above, the practice of the methods of the invention for MA
production may be conducted with a variety of phospholipids and processes.
The invention includes the observation, beyond the use of low salt
conditions, that the use of charged, unsaturated phospholipids, such as
EPG and DOPG, as well as high energy processing (such as microfluidization
and sonication), appears to favor the formation of micelles in otherwise
liposome forming combinations of phospholipids and hydrophobic agents. The
use of unsaturated phospholipids provides a number of desirable
characteristics. These include the ability to conduct MA production steps
at room temperature and to produce smaller MA when used in combination
with saturated lipids.
Administration and Use
The use of the hydrophobic agents incorporated in the MA of the invention
may be for any appropriate pharmaceutical, agricultural or industrial
application. With incorporated photosensitizers, the MA may be used for
any condition or in any method for which the photosensitizers are
appropriate in combination with exposure to light or other electromagnetic
radiation. These include, but are not limited to, the diagnosis or
treatment of cancer, the reduction of activated leukocytes, the treatment
of ocular disorders, the treatment and prevention of neovasculature and
angiogenesis, the destruction of viruses and cells infected thereby, the
treatment of atherosclerotic plaques, the treatment of restenosis, and
others. In addition, many photosensitizers may be photoactivated by
appropriate excitation wavelengths to fluoresce visibly. This fluorescence
can then be used to localize a tumor or other target tissue. By
incorporating hydrophobic agents in the MA of the invention, more
efficient packaging, delivery and hence administration of the agents can
be obtained.
Generally speaking, the MA of the invention may be applied in any manner
identical or analogous to the administration of micelles and liposomes.
The concentration of the hydrophobic agent in the MA of the invention
depends upon the nature of the agent as well as the nature of the
administration desired. This dependency also exists in application of
hydro-monobenzoporphyrin photosensitizers via MA.
The MA compositions and formulations of the invention may be administered
parenterally or by injection. Injection may be intravenous, subcutaneous,
intramuscular, intrathecal, or even intraperitoneal. However, the MA may
also be administered by aerosol intranasally or intrapulmonarally, or
topically. Formulations designed for timed release are also with the scope
of the invention.
The quantity of hydrophobic agent MA formulation to be administered
depends on the choice of active agents, the conditions to be treated, the
mode of administration, the individual subject, as well as the skill,
experience and judgement of the practitioner. Generally speaking, however,
dosages in the range of 0.05-10 mg/kg may be appropriate. The foregoing
range is, of course, merely suggestive, as the number of variables in
regard to an individual treatment regime is large. Therefore, considerable
excursions from these recommended values are expected.
For example, and with the use of photosensitizers as a diagnostic in
localizing tumor tissue or in localizing atherosclerotic plaques, the MA
compositions of the invention are administered systemically in the same
general manner as is known with respect to photodynamic therapy. The
waiting period to allow the drugs to clear from tissues to which they do
not accumulate is approximately the same, for example, from about 30
minutes to about 10 hours. After the compositions of the invention have
been permitted to localize, the location of the target tissue is
determined by detecting the presence of the photosensitizer.
In diagnosis, the photosensitizers incorporated into MA may be used along
with, or may be labeled with, a radioisotope or other detecting means. If
this is the case, the detection means depends on the nature of the label.
Scintigraphic labels such as technetium or indium can be detected using ex
vivo scanners. Specific fluorescent labels can also be used but, like
detection based on fluorescence of the photosensitizers themselves, these
labels may require prior irradiation.
For activation of the photosensitizer applied by the MA of the invention,
any suitable absorption wavelength is used. This can be supplied using the
various methods known to the art for mediating cytotoxicity or
fluorescence emission, such as visible radiation, including incandescent
or fluorescent light sources or photodiodes such as light emitting diodes.
Laser light can also be used for in situ delivery of light to a localized
photosensitizer. In a typical protocol, for example, several hours prior
to irradiation, approximately 0.5-1.5 mg/kg of green porphyrin
photosensitizer containing MA is injected intravenously and then excited
by an appropriate wavelength.
Claim 1 of 15 Claims
1. A composition comprising
micelles, said micelles comprising saturated and unsaturated phospholipids
and one or more hydro-monobenzo-porphyrin photosensitizer
wherein the micelles in the composition have an average diameter below about
100 nm.
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