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Abstract
Methods of treating inflammatory skin
diseases such as rosacea, atopic dermatitis, contact dermatitis, drug
eruptions, psoriasis, seborrheic dermatitis, connective tissue diseases,
autoimmune disorders, urticaria or hives, and inflammation associated with
skin infections by topical or systemic administration of a nitroxide
containing compound are provided.
Description of the Invention
BACKGROUND OF THE
INVENTION
Inflammation is a significant component
in a number of skin disorders or diseases including, but not limited to,
acne and rosacea, atopic dermatitis, contact dermatitis, drug eruptions,
psoriasis, seborrheic dermatitis, connective tissue diseases (such as
lupus, scleroderma, and rheumatoid arthritis), other autoimmune disorders
such as the blistering disease bullous pemphigoid or pemphigus, pigmentary
diseases (such as post inflammatory hyperpigmentation, melasma and
vitiligo), urticaria or hives, inflammation associated with skin
infections such as tinea corporis or fungal infection of the finger or
toenails, among others.
Modulating the inflammatory response has been shown to result in dramatic
improvement in the conditions listed above. Standard treatment involves
the use of topical corticosteroids, oral corticosteroids and other agents
that modulate inflammation.
However, topical corticosteroids have undesirable side effects such as
skin atrophy, telangiectasia, and the possibility of adrenal axis
suppression thus limiting their long-term use.
Significant research has been conducted in the field of radiation therapy
to assess the ability of free-radical scavengers in protecting normal
tissue from ionizing radiation.
Sulfhydryl compounds were among the first radioprotectors to be
identified. Their protective mechanism appears to be due to their ability
to scavenge radiation-induced free radicals and/or donate reducing
equivalents to oxidized molecules.
Hematopoietic cytokines have also been investigated as radioprotectors.
They are believed to protect by more quickly restoring hematopoietic
function after radiation exposure.
Recently, a new class of radioprotectors, referred to as nitroxides, has
been described. As a class, nitroxides are stable free radical components
which react with a variety of biologically relevant compounds including
other free radicals (Nilsson et al. J. Biol. Chem., 1989,
264:11131-11135). The observation that several nitroxides themselves
reacted with free radicals, specifically oxy radicals, led to the
investigation of these compounds as radioprotectors (Saminu et al. Free
Radical Biol. Med., 1989, 6:141-148).
Tempol [4-hydroxy-2,2,6,6-tetramethyl-piperidinyloxy, free radical] is one
such example, a piperindinyl-n-oxyl with the n-oxide sterically stabilized
by symmetric pairs of adjacent methyl groups. This compound is
commercially available through Aldrich Chemical Co., Milwaukee, Wis. It is
most commonly used to spin label biological molecules such as NADP.
Tempol has been demonstrated to function as a superoxide dismutase (SOD)
mimic, protecting mammalian cells from superoxide generated from
hypoxanthine/xanthine oxidase and from hydrogen peroxide mediated
cytotoxicity (Mitchell et al. Biochem., 1990, 29:2802-2807; Samuni et al.,
J. Biol. Chem., 1988, 263:17921-17924). Tempol has also been demonstrated
to provide both in vitro and in vivo protection against ionizing radiation
(Mitchell et al. Arch. Biochem. Biophys., 1991, 289:62-70) and to protect
against radiation-induced alopecia by speeding the recovery of hair growth
within a field of heavily irradiated skin (Goffman et al. Int. J. Rad. Onc.
Biol. Phys., 1992, 22:803-806). This protection has been suggested to be
linked to direct protection of hair follicle stem cells and development of
other nitroxides.
U.S. Pat. No. 5,840,734 describes the use of Tempol in prevention of
photoaging, sunburn and skin cancer caused by the UVA and UVB rays of
sunlight. Additionally, U.S. Pat. No. 6,552,040 describes using other
nitroxides in addition to Tempol for photoprotection, and describes using
nitroxides including Tempol to augment wound healing.
Nitroxides are stable free radicals with antioxidant catalytic activities
similar to superoxide dismutase. Nitroxides existing in vivo have been
shown to interact with other substances to also mimic catalase activities.
Nitroxide containing compounds have been described in the art for numerous
uses. For example, U.S. Pat. No. 5,462,946 discloses biologically
compatible compositions containing an effective amount of a metal
independent nitroxide compound for use in protecting the skin against
ionizing radiation, mucositis, the effects of whole body radiation and
radiation induced hair loss. The nitroxide containing compositions
disclosed therein are applied topically as an ointment, lotion or cream,
intravenously or orally by pill or lozenge. This patent also teaches the
nitroxide containing compounds to be useful as protectants against
increased oxygen exposure so as to avoid pulmonary adult respiratory
distress syndrome, oxygen-induced lenticular degeneration and hyaline
membrane disease in infants, oxidative stress-induced cataracts,
reperfusion injury in treating cardiovascular phenomena such as myocardial
infarction and strokes, pancreatitis or intestinal ulceration and organ
transplant, cytotoxicity due to excess oxidation in animal or plant cell
cultures, cytotoxic effects of chemotherapeutic agents, and mutagenic and
carcinogenic agents. Also taught in U.S. Pat. No. 5,462,946 is parenteral,
intra-articular or oral administration of a nitroxide containing
composition in arthritic conditions, parenteral or oral administration of
a nitroxide containing composition as an aging retardant and oral or
intravenous administration of a nitroxide containing compound in weight
reduction.
U.S. Pat. No. 5,824,781, U.S. Pat. No. 5,840,701 and U.S. Pat. No.
5,817,632 teach compositions and processes to alleviate free radical
toxicity based on use of nitroxides in association with physiologically
compatible macromolecules. These compositions are suggested to be useful
as blood substitutes, radioprotective agents, imaging agents, agents to
protect against ischemia and reperfusion injury, particularly cerebral
stroke, and in vivo enzyme mimics.
SUMMARY OF THE
INVENTION
The present invention provides a new use
for nitroxide containing compounds. In the present invention nitroxide
containing compounds or combinations of nitroxides with other agents are
applied topically or administered systemically to alleviate the symptoms
and/or treat inflammatory skin disorders. Examples of inflammatory skin
diseases or disorders which can be treated or symptoms of which can be
alleviated in accordance with the present invention include, but are in no
way limited to, rosacea, atopic dermatitis, contact dermatitis, drug
eruptions, psoriasis, seborrheic dermatitis, connective tissue diseases
such as lupus, scleroderma, and rheumatoid arthritis, other autoimmune
disorders such as the blistering disease bullous pemphigoid, pemphigus,
pigmentary diseases such as post inflammatory hyperpigmentation, melasma
and vitiligo, urticaria or hives, and inflammation associated with skin
infections such as tinea corporis or fungal infection of the finger or
toenails, among others.
DETAILED DESCRIPTION
OF THE INVENTION
Numerous skin diseases or disorders
result from inflammation with the associated release of mediators from a
variety of inflammatory and resident cells. Neutrophils, mast cells and
lymphocytes orchestrate an inflammatory response that results in
significant release of inflammatory mediators, and the creation of
numerous free radicals. Skin diseases in which inflammation is a
significant component include, but are not limited to acne and rosacea,
atopic dermatitis, contact dermatitis, drug eruptions, psoriasis,
seborrheic dermatitis, connective tissue diseases (such as lupus,
scleroderma, and rheumatoid arthritis), other autoimmune disorders such as
the blistering disease bullous pemphigoid or pemphigus, pigmentary
diseases (such as post inflammatory hyperpigmentation, melasma and
vitiligo), urticaria or hives, inflammation associated with skin
infections such as tinea corporis or fungal infection of the finger or
toenails, among others. Inflammation is the key step to most of these
diseases, and the production of free radicals enhances or maintains the
inflammatory response in many cases. In addition, free radicals cause the
majority of damage and maintain changes in skin architecture to a large
degree.
It is now believed that topical application or systemic administrations of
a composition comprising a nitroxide containing compound is useful in
treating and/or alleviating the symptoms of inflammatory skin diseases. By
systemic administration it is meant to include, but is not limited to,
oral, intravenous, or sublingual administration or intra-muscular or
subcutaneous injection.
For purposes of the present invention, by "nitroxides" or "nitroxide
containing compound" it is meant stable nitroxide free radicals. Examples
of nitroxide containing compounds are well known in the art and taught in
prior art references such as U.S. Pat. No. 5,462,946, the teachings of
which are herein incorporated by reference in their entirety.
Examples of inflammatory skin diseases which can be treated and/or the
symptoms alleviated include, but are not limited to, rosacea, atopic
dermatitis, contact dermatitis, drug eruptions, psoriasis, seborrheic
dermatitis, connective tissue diseases such as lupus, scleroderma, and
rheumatoid arthritis, other autoimmune disorders such as the blistering
disease bullous pemphigoid and pemphigus, pigmentary diseases such as post
inflammatory hyperpigmentation, melasma and vitiligo, urticaria or hives,
and inflammation associated with skin infections such as tinea corporis or
fungal infection of the finger or toenails, among others.
In the present invention, a nitroxide containing compound or a combination
of nitroxides with a second agent is applied topically or administered
systemically to a subject to alleviate the symptoms and/or treat the
inflammatory skin disorder or disease.
By subject it is meant to include any mammal, and in particular humans.
Examples of topically applied compositions comprising a nitroxide
containing compound for use in the present invention include, but are not
limited to creams, lotions gel, sprays and solutions. Methods of
formulating nitroxide containing compounds into creams, lotions, gels,
sprays, or solutions, as well as pharmaceutical additives for such
formulations, are well known to those skilled in the art. The topically
applied nitroxide containing formulations may further comprise a second
agent useful in treatment of the inflammatory skin disorder such as a
topical antibiotic or topical corticosteroids in the same preparation.
Methods for preparation of formulations for systemic administration of a
nitroxide containing compound are also well known.
Examples of second agents which can be co-administered in the same
formulation or at the same time as the nitroxide containing compound
include, but are not limited to, alpha-hydroxy acids, poly-hydroxy acids,
antibiotics, benzoyl peroxide, hydroquinone, kojic acid, corticosteroids,
and tacrolimus.
Claim 1 of 5 Claims
1. A method for treating or
alleviating symptoms of an inflammatory skin disease or disorder consisting
of administering to a subject suffering from an inflammatory skin disease or
disorder a nitroxide containing compound wherein the inflammatory skin
disease is rosacea, atopic dermatitis, contact dermatitis, a drug eruption,
psoriasis, seborrheic dermatitis, urticaria or hives, so that the
inflammatory skin disease or disorder is treated or its symptoms alleviated.
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