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Title: Pain-sensitive
therapeutic wound dressings
United States Patent: 7,361,634
Issued: April 22, 2008
Inventors: Trotter; Patrick
J. (Leeds, GB), Cullen; Breda M. (Skipton, GB)
Assignee: Ethicon, Inc.
(Somerville, NJ)
Appl. No.: 10/554,375
Filed: April 27, 2004
PCT Filed: April 27, 2004
PCT No.: PCT/GB2004/001774
371(c)(1),(2),(4) Date:
October 25, 2005
PCT Pub. No.: WO2004/096302
PCT Pub. Date: November 11,
2004
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Pharm Bus Intell
& Healthcare Studies
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Abstract
The invention provides a wound dressing
comprising a therapeutic agent and a matrix comprising polymers joined by
cross-linkages which cross-linkages comprise oligopeptidic sequences which
are cleavable by a kallikrein associated with wound fluid such that the
rate of release of the therapeutic agent increases in the presence of
elevated kallikrein levels.
Description of the
Invention
SUMMARY
In one aspect, the present invention provides a wound dressing comprising a
therapeutic agent and a matrix comprising polymers joined by cross-linkages
which cross-linkages comprise oligopeptidic sequences which are cleavable by
a kallikrein such that the rate of release of the therapeutic agent
increases in the presence of the protease.
DETAILED DESCRIPTION
A first aspect of the invention provides a wound dressing comprising a
therapeutic agent and a matrix comprising polymers joined by cross-linkages
which cross-linkages comprise, or consist of, oligopeptidic sequences which
are cleavable by a kallikrein such that the rate of release of the
therapeutic agent increases in the presence of the protease.
Preferably, the matrix consists of the cross-linked polymers and optionally
also the therapeutic agent.
By "a kallikrein" we include all serine proteases, whose activation, is
associated with the degradation of kininogen to form kinins, which are
implicated in the onset of pain. Serine proteases are a group of proteins
which cut certain peptide bonds in other proteins. They all contain a serine
at their active site (hence their name).
Examples include: Digestive enzymes such as trypsin and chymotrypsin;
Clotting factors such as Factor X, Factor XI, Thrombin, and Plasmin;
Proteins of the complement cascade such as C1r and C1s.
Proteases that have Kallikrein like activity include tissue kallikrein and
plasma kallikrein. In addition, Kallikreins are also known as kinogenases or
kininases.
They tend to be groups into two types, tissue and plasma kallikreins, each
of which have many different isoforms. Kallikrein also exists as
prekallikrein, which is cleaved by endogenous proteases into an active form.
The half-life of kallikrein itself is very short in vivo (.about.15 s).
Plasma Kallikrein is encoded by 1 of 15 genes and therefore exists as one of
many isoforms. It is manufactured in the liver and circulates as
prekallikrein and binds to the surface of endothelial cells were it cleaves
high molecular weight kininogen to liberate bradykinin. Plasma kallikreins
in normal plasma are typically present in the range of 30-50 .mu.g/ml. The
level of kininogens in healthy plasma is typically 50-100 .mu.g/ml
Tissue Kallikrein differs in its origin (produced in many different
tissues), molecular weight (27-40 kDa), substrate specificity and
susceptibility to various inhibitors. Tissue kallikrein cleaves L and H-kininogens.
There are therefore many types of tissue kallikrein which tend to be tissue
specific but can be detected at low quantities in plasma.
Kallikreins are reviewed by Maeda, H. Wu, J., Okamoto, T., Maruo, K. and
Akaike, T. in Immunopharmacology 43, 115-128 (1999), the entire content of
which is incorporated herein by reference.
The levels of kallikreins and their precursors and reaction products are
elevated in painful wounds and may also be elevated in wounds that are not
painful but which go on to become painful within a few days. It is thought
that the activity of the kallikreins in painful wound fluid is at least
double, and in some cases at least four times that in normal healthy plasma.
The principle underlying the present invention is that the cross-linked
polymers would behave as both an enzyme sensor and as an pain-dependent
delivery system. In the absence of elevated levels of kallikreins the
oligopeptidic sequences remain intact, keeping the pore size small and
preventing (or at least keeping to low levels) the release of the
therapeutic agent. Elevated pain protease levels (e.g. in wound infection or
wound chronicity) hydrolyse the oligopeptidic sequences which results in
increased pore size and permeability. The therapeutic agent is then released
from the dressing so that it is free to migrate into the wound. In this way,
delivery of the therapeutic agent increases in the presence of the protease
so that if the wound is infected (including as indicated above when a
protease associated with infection is elevated in a wound that is apparently
not clinically infected but which goes on to become infected within a few
days) or is a chronic wound delivery of the therapeutic agent increases.
By an "increase" in the rate of release of the therapeutic agent we include
the situation where the rate of release of the therapeutic agent increases
by at least 1.5, 2-, 3-, 4-, 5-, 6-, 7-, 8-, 9-, 10- or 15-fold in a painful
wound relative to a non-painful wound. Typically, the rate of release of the
therapeutic agent increases by at least 1.5, 2-, 3-, 4-, 5-, 6-, 7-, 8-, 9-,
10- or 15-fold in the presence of wound fluid containing kallikrein activity
twice that of normal healthy serum. Preferably, there is no release of the
therapeutic agent in the absence of the protease.
The term "polymer" as used herein includes homopolymers and copolymers (e.g.
random copolymers, alternating copolymers and block copolymers).
Although polymers which are degraded by wound proteases could be used, it is
preferred that the polymers are not degraded by the various proteases that
may be present in the wound environment.
In theory, any polymer containing groups to which the reactive groups can be
attached may be used, although of course the skilled person will appreciate
that considerations such as toxicity should be taken into account.
Similarly, the polymers used should not be immunogenic.
In selecting a polymer, charge and size may also be important as an increase
in crystallinity will increase order and therefore reduce permeability of
barrier. The longer the polymers the more likely they are to become
physically intertwined, and consequently the less likely they are to fall
apart. In view of this it is preferred that short polymers (i.e. 5 to 50
monomers) are used.
Preferably, a polyfunctional polymer is used as the pore size will be
smaller and the ability to retain the therapeutic agent in the absence of
protease will be higher.
Preferably, the polymers are non-ionic surfactants, polyalkoylated alcohols,
alkyl or dialkyl polyglycerol compounds, polyethyloxylated alcohols,
polymers (including homopolymers and copolymers) of acrylamide (e.g.
N-(2-hydroxypropyl)methacrylamide (HPMA)), polynucleotides, polypeptides or
carbohydrates.
Preferably, the polymers are synthetic polymers. Examples of synthetic
polymers include polyvinyl alcohol, polyethylene glycerol, PVP, polyolefins,
fluoropolymers, hydropolymers from vinyl esters, vinyl ethers, carboxy vinyl
monomers, meth(acrylic) acid, acrylamide, N-vinyl pyrrolidone,
acylamidopropanem acylamidopropane, PLURONIC (Maleic acid,
NN-dimethylacrylamide diacetone acrylamide acryloyl, morpholine and mixtures
thereof. Biodegradable polymers such as oxidized regenerated cellulose or
polylactide/polyglycolide copolymers may also be used.
Alternatively, natural polymers such as carbohydrates (e.g. dextran, chitin
or chitosan) natural peptides or proteins (collagens, gelatins, elastin,
fibronectins, or even soluble proteins such as albumin), or semi synthetic
peptides (made by using a peptide synthesizer or by recombinant techniques)
may be used.
In a preferred embodiment, polymers of N-(2-hydroxypropyl) methylacrylamide
(HPMA) are used. In this regard, reference is made to Ulbrich et al. (1980)
Biomaterials 1, 199-204, which details the crosslinking of HPMA polymers by
peptides.
As mentioned above, the polymers are joined by cross-linkages which comprise
cleavable oligopeptidic sequences. Oligopeptides are generally defined as
polypeptides of short length, typically twenty amino acids or fewer.
Preferably, the oligopeptidic sequences employed in the present invention
consist of 3 to 15 amino acids, preferably 3 to 10 amino acids, more
preferably, 3 to 8 amino acids and yet more preferably 4 to 8 amino acids.
Preferably, the oligopeptidic sequences consist of 3, 4, 5, 6, 7 or 8 amino
acids.
The degree of crosslinking of the polymers should be sufficient such that
the rate of release of the therapeutic agent increases in the presence of
the protease. Preferably, the degree of crosslinking of the polymers should
be sufficient to render the matrix sufficiently impermeable to the molecule
to be delivered so that the therapeutic agent is only released in the
presence of the target protease. This will be dependent on the molecular
weight of the therapeutic agent.
The rate of degradation of the matrix will depend on a number of factors,
including the length of the oligopeptidic sequences. Ulbrich et al. noted
that extension of the peptidic linkers by one amino acid residue to give a
peptidic linker of four amino acids caused a pronounced rise in the rate of
cleavage of the polymeric substrates. Ulbrich et al. reported that extension
of the oligopeptidic sequence led to a decrease in the steric hindrance by
polymer chain and thus to an increase in degradability.
Steric hindrance may also be reduced by coupling the oligopeptidic sequence
to the polymer by means of an appropriate spacer. Thus, the oligopeptidic
sequences may couple the polymers directly (in which case the cross-linkage
consists of the oligopeptidic sequence) or by means of an appropriate
spacer.
The following paper gives a useful review of bioconjugation techniques for
use in pharmaceutical chemistry: Veronese, F. M. and Morpurgo, M (1999)
Bioconjugation in Pharmaceutical chemistry 11 Farmaco, 54, 497-516. This
paper describes in detail the chemistry of each amino acid and which ones
are most suitable for use in bioconjugation techniques. For example, it
demonstrates that conjugation would occur by nucleophile to electrophile
attacks. The amino acid side chains R--S--, R--NH.sub.2, R--COO-- and .dbd.R--O--
are well suited to bioconjugation (to natural or synthetic molecules).
In addition this paper indicates and gives examples of a wide range of
structures and chemical groups that the peptides (containing amino (e.g.
lysine), carboxyl (COO--) or cystyl groups (R--SH) can bind to.
With regard to conjugation techniques, see also Ulbrich, K., et al (2000)
Polymeric drugs based on conjugates of synthetic and natural marcomolecules
I. Synthesis and physico-chemical characterisation. Journal of controlled
release 64, 63-79. This reference describes how antibodies, peptides or
proteins can be conjugated to synthetic polymers (e.g. poly HPMA).
The rate of degradation will not only depend on the number of amino acids
but also on the nature of the amino acids comprising the cross-links. This
dependency arises from the substrate specific nature of proteases. The
region of the enzyme where interaction with the substrate takes place is
known as the "active site" of the enzyme. The active site performs the dual
role of binding the substrate while catalysing the reaction, for example
cleavage. Studies of the structures of the complexes of proteolytic enzymes
with peptides indicate that the active site of these enzymes is relatively
large and binds to several amino acid residues in the peptide. Thus, the
degradability of a particular bond in a peptide chain depends not only on
the nature of the structure near the cleaved bond, but also on the nature of
the amino acid residues which are relatively remote from the cleaved bond,
but play an important part in holding the enzyme in position during
hydrolysis.
The structure of the oligopeptidic sequences must be chosen so as to
correspond to that of the active site of the kaliikrein. Suitable peptide
sequences include -Phe-Arg-Ser-Ser-Arg-GIn- (SEQ ID NO: 1) or -Met-Ile-Ser-Leu-Met-Lys-Arg-Pro-Gln-
(SEQ ID NO: 2) that can be degraded by kallikrein at Lys-Arg or Arg-Ser
bonds.
Preferably, the oligopeptidic sequences are cleavable only by a kallikrein.
Alternatively, the oligopeptidic sequences may be cleavable by two, three or
more proteases associated with wound fluid.
The design of the linking oligopeptidic sequence is important as it must not
only contain a hydrolysable sequence that would be cleaved in the presence
of the protease but also a terminal amino acid that can be readily
conjugated to the polymers employed or to a spacer. Examples of reactive
amino acids that could be used to link the oligopeptidic sequences to the
polymers or spacers include cysteine and lysine.
The therapeutic agent may, for example, be an antimicrobial agent and/or a
pain relieving agent. The antimicrobial agent may, for example, comprise an
antiseptic, an antibiotic, or mixtures thereof. The pain relieving agent may
comprise an anaesthetic, an analgesic, or a kallikrein inhibitor. Suitable
anaesthetics include lidocaine or novocaine. Suitable analgesics include
non-steroidal anti-inflammatory drugs (NSAIDs). Suitable kallikrein
inhibitors include aprotonin, kallistatin, nafamostat mesilate, protease
inhibitor-6 (as described in U.S. Pat. No. 6,472,143), and mixtures thereof.
A particular advantage of including the kallikrein inhibitor as one of the
active agents is that it can also be used to regulate the rate of breakdown
of the polymer matrix by kallikrein. For example, the kallikrein inhibitor
may be dispersed in the matrix at a level just sufficient to prevent
breakdown of the matrix when the level of kallikreins in the ambient wound
fluid is at non-painful levels, but not so high as to prevent breakdown of
the matrix when the concentration of kallikreins exceeds a threshold
characteristic of pain sensation. In other embodiments, the kallikrein
inhibitors are encapsulated by the matrix material but not dispersed in the
matrix material, so they do not interfere with the breakdown of the matrix
material by the kallikreins.
In selecting one or more therapeutic agents for use with the wound dressings
of the present invention, it is preferred that larger molecules are employed
(e.g. molecules having a molecular weight of at least 500, 1,000, 5,000,
10,000, or 20,000). Small molecules may penetrate the matrix, whereas larger
molecules such as chlorohexidine may be better suited to this type of
application. Further, if a polyfunctional polymer is used the pore size of
the matrix will be smaller and thus the ability of the matrix to retain the
therapeutic agent in the absence of protease will be higher. Moreover, as
noted above, the degree of cross-linking will influence the permeability of
the matrix.
Preferred antibiotics include peptide antimicrobials (e.g. defensins,
Magainin, synthetic derivatives of them) tetracycline, penicillins,
terramycins, erythromycin, bacitracin, neomycin, polymycin B, mupirocin,
clindamycin and mixtures thereof. Preferred antiseptics include silver
sulfadiazine, chlorhexidine, povidone iodine, triclosan, other silver salts,
sucralfate, quaternary ammonium salts and mixtures thereof.
The therapeutic agent may be incorporated within the matrix of the invention
or may alternatively be located behind the matrix in a "donor layer". Thus,
in one embodiment of the first aspect invention, the therapeutic agent is
incorporated within the matrix. For ready release of the therapeutic agent
upon elevation of the wound kallikrein level, the therapeutic agent should
not be covalently bound to the matrix. For example, if the molecule to be
delivered is relatively inert it could be mixed into the formulation during
manufacture. Silver is one example of a molecule that could be delivered in
this way. The wound contacting layer of the dressing may comprise or consist
of the matrix into which the therapeutic agent has been incorporated.
Alternatively, the dressing may comprise a liquid permeable wound contacting
layer, an intermediate layer (which may be an absorbent layer) comprising or
consisting of the matrix within which the therapeutic agent has been
incorporated, and preferably also an outer, liquid-impervious backing layer.
Upon degradation of the matrix by kallikrein present in wound fluid, the
therapeutic agent present in the intermediate layer may diffuse into the
wound.
Another embodiment of the first aspect of the invention provides a wound
dressing which comprises a barrier layer which comprises the cross-linked
matrix of the invention, the barrier layer being for initially separating
the therapeutic agent in the wound dressing from wound fluid when in use.
Suitably, the barrier layer consists of the matrix.
The barrier layer is separate from the therapeutic agent, and the
therapeutic agent is initially prevented from contacting the wound fluid by
the barrier layer. That is to say, the bioavailability of the therapeutic
agent to the wound surface is low until the peptide cross-linkages in the
barrier material have been broken down by the kallikrein enzyme, at which
point the bioavailability of the therapeutic agent increases. Since
kallikrein protease levels are elevated in painful wounds, such as some
chronic and infected wounds, this provides for accelerated and/or selective
release of the therapeutic agent into such wounds. The barrier layer is
normally substantially impervious to wound fluid and insoluble therein
unless the wound fluid contains a sufficient level of kallikrein to break
down the substrate material.
The barrier layer is preferably about 0.1 to about 3 mm thick. Preferably
about 0.5 to 1.5 mm thick. The cross-linked polymers may be combined in a
film-forming composition with polymeric materials, plasticisers, and
humectants. Suitable polymers include alginates, guar gum, carboxymethyl
cellulose, methyl cellulose, hydroxypropyl methyl cellulose, locust bean
gum, carrageenan, chitosan, heparan sulfate, dermatan sulfate,
glycosaminoglycans such as hyaluronic acid, proteoglycans, and mixtures
thereof. Suitable plasticisers include C2-C8 polyhydric alcohols such as
glycerol. Preferably the cross-linked polymers make up at least about 10% by
weight, more preferably at least about 20%, 30%, 40%, 50%, 60%, 70%, 80% or
90% by weight of the film-forming composition.
In certain embodiments the barrier layer comprises a substantially
continuous film comprising the film forming composition of the cross-linked
polymers as described above.
In other embodiments the barrier layer comprises an apertured sheet having a
composition comprising the cross-linked polymers applied thereto in
occlusive fashion. The occlusive composition may be similar to the
film-forming composition described above. In these embodiments, the
apertures typically make up from about 0.1% to about 50% of the area of the
wound facing surface of the sheet before swelling, more typically from about
1% to about 30% of the area of the apertured sheet, and preferably from
about 10% to about 25% of the area of the apertured sheet. Typically, the
apertured sheet has from about 1 to about 30 apertures per square cm, for
example from about 4 to about 15 apertures per square cm or from about 5 to
about 10 apertures per square cm. In certain embodiments the apertures are
uniformly distributed over the surface of the sheet, preferably in a regular
pattern. The mean area of each aperture may for example be from about 0.01
to about 10 mm.sup.2, preferably from about 0.1 to about 4 mm.sup.2, and
more preferably from about 1 mm.sup.2 to about 2 mm.sup.2. It will be
appreciated that the sheet may include more than one size and shape of
aperture in order to provide apertures that open more or less quickly on
exposure to painful wound fluid. This enables still more control over the
dynamics of therapeutic agent delivery to the wound. Typically,
substantially the whole area of the apertures in the apertured sheet is
blocked by the barrier material before exposure to wound exudate.
Preferably, the thickness of the barrier film or the apertured sheet (by
ASTM D374-79) is from about 0.2 to about 5 mm, more preferably from about
0.4 to about 3 mm.
In one embodiment the barrier layer material may comprise, in addition to
the cross-linked matrix of the invention, a polymer selected from the group
consisting of water soluble macromolecular materials (hydrogels) such as
sodium alginate, sodium hyaluronate, alginate derivatives such as the
propylene glycol alginate described in EP-A-0613692, and soluble
hydropolymers formed from vinyl alcohols, vinyl esters, vinyl ethers and
carboxy vinyl monomers, meth(acrylic) acid, acrylamide, N-vinyl pyrrolidone,
acylamidopropane sulphonic acid, PLURONIC (Registered Trade Mark) (block
polyethylene glycol, block polypropylene glycol) polystyrene-, maleic acid,
NN-dimethylacrylamide diacetone acrylamide, acryloyl morpholine, and
mixtures thereof. Suitable hydrogels are also described in U.S. Pat. No.
5,352,508.
In one embodiment the barrier layer material may comprise, in addition to
the cross-linked matrix of the invention, a polymer selected from the group
consisting of bioerodible polymers such as polylactidelpolyglycolide,
collagen, gelatin, polyacrylate gels such as those described in
EP-A-0676457, calcium alginate gels, cross-linked hyaluronate gels, gels of
alginate derivatives such as propylene glycol alginate, and gels wherein the
hydropolymer is formed from vinyl alcohols, vinyl esters, vinyl ethers and
carboxy vinyl monomers, meth(acrylic) acid, acrylamide, N-vinyl pyrrolidone,
acylamidopropane sulphonic acid, PLURONIC (Registered Trade Mark) (block
polyethylene glycol, block polypropylene glycol) polystyrene-, maleic acid,
NN-dimethylacrylamide diacetone acrylamide, acryloyl morpholine, and
mixtures thereof. Suitable hydrogels are also described in U.S. Pat. No.
5,352,508.
The barrier layer material may further comprise from about 5 to about 50% by
weight, preferably from 15 to 40% by weight, on the same basis of one or
more humectants such as glycerol. The barrier layer material may further
contain up to about 30% w/w, more preferably up to about 15% w/w on the same
basis of water.
The matrix of the invention comprising the therapeutic agent may contact the
barrier layer directly, or may be separated therefrom for example by an
absorbent layer.
Preferably, the wound dressing of the invention comprises an absorbent layer
and/or a backing layer. As will be evident from the above, the absorbent
layer may, for example, separate the barrier layer from the therapeutic
agent containing cross-linked matrix or alternatively the absorbent layer
may comprise the therapeutic agent containing cross-linked matrix.
The area of the optional absorbent layer is typically in the range of from 1
cm.sup.2 to 200 cm.sup.2, more preferably from 4 cm.sup.2 to 100 cm.sup.2.
The optional absorbent layer may comprise any of the materials
conventionally used for absorbing wound fluids, serum or blood in the wound
healing art, including gauzes, nonwoven fabrics, superabsorbents, hydrogels
and mixtures thereof. Preferably, the absorbent layer comprises a layer of
absorbent foam, such as an open celled hydrophilic polyurethane foam
prepared in accordance with EP-A-0541391, the entire content of which is
expressly incorporated herein by reference. In other embodiments, the
absorbent layer may be a nonwoven fibrous web, for example a carded web of
viscose staple fibers. The basis weight of the absorbent layer may be in the
range of 50-500 g/m.sup.2, such as 100-400 g/m.sup.2. The uncompressed
thickness of the absorbent layer may be in the range of from 0.5 mm to 10
mm, such as 1 mm to 4 mm. The free (uncompressed) liquid absorbency measured
for physiological saline may be in the range of 5 to 30 g/g at 25.degree..
Preferably, the wound dressing further comprises a backing layer covering
the barrier sheet and the optional absorbent layer on the side opposite the
wound-facing side of the dressing. The backing layer preferably provides a
barrier to passage of microorganisms through the dressing and further
preferably blocks the escape of wound fluid from the dressing. The backing
layer may extend beyond at least one edge of the barrier sheet (if present)
and optional absorbent layer to provide an adhesive-coated margin adjacent
to the said edge for adhering the dressing to a surface, such as to the skin
of a patient adjacent to the wound being treated. An adhesive-coated margin
may extend around all sides of the barrier sheet (if present) and optional
absorbent layer, so that the dressing is a so-called island dressing.
However, it is not necessary for there to be any adhesive-coated margin.
Preferably, the backing layer is substantially liquid-impermeable. The
backing sheet is preferably semipermeable. That is to say, the backing sheet
is preferably permeable to water vapour, but not permeable to liquid water
or wound exudate. Preferably, the backing sheet is also
microorganism-impermeable. Suitable continuous conformable backing sheets
will preferably have a moisture vapor transmission rate (MVTR) of the
backing sheet alone of 300 to 5000 g/m.sup.2/24 hrs, preferably 500 to 2000
g/m.sup.2/24 hrs at 37.5.degree. C. at 100% to 10% relative humidity
difference. The backing sheet thickness is preferably in the range of 10 to
1000 micrometers, more preferably 100 to 500 micrometers.
Suitable polymers for forming the backing sheet include polyurethanes and
poly alkoxyalkyl acrylates and methacrylates such as those disclosed in
GB-A-1280631. Preferably, the backing sheet comprises a continuous layer of
a high density blocked polyurethane foam that is predominantly closed-cell.
A suitable backing sheet material is the polyurethane film available under
the Registered Trade Mark ESTANE 5714F.
The adhesive layer (where present) should be moisture vapor transmitting
and/or patterned to allow passage of water vapor therethrough. The adhesive
layer is preferably a continuous moisture vapor transmitting,
pressure-sensitive adhesive layer of the type conventionally used for
island-type wound dressings, for example, a pressure sensitive adhesive
based on acrylate ester copolymers, polyvinyl ethyl ether and polyurethane
as described for example in GB-A-1280631. The basis weight of the adhesive
layer is preferably 20 to 250 g/m.sup.2, and more preferably 50 to 150
g/m.sup.2. Polyurethane-based pressure sensitive adhesives are preferred.
Preferably, the adhesive layer extends outwardly from the absorbent layer
and the envelope to form an adhesive-coated margin on the backing sheet
around the absorbent layer as in a conventional island dressing.
Also within the scope of the present invention are embodiments in which the
cross-linked matrix material substantially encapsulates the therapeutic
agent. For example, the dressing may comprise, or consist essentially of,
particles such as microspheres of therapeutic agent (e.g. antimicrobial
material or kallikrein inhibitor) encapsulated in a layer comprising the
cross-linked matrix material. The particles are preferably loaded with from
1 to 90 wt. %, more preferably from 3 to 50 wt. % of the therapeutic agent.
The particles may be made by any suitable technique, including comminution,
coacervation, or two-phase systems for example as described in U.S. Pat. No.
3,886,084. Techniques for the preparation of medicated microspheres for drug
delivery are reviewed, for example, in Polymeric Nanoparticles and
Microspheres, Guiot and Couvreur eds., CRC Press (1986).
A preferred method for preparation of the microparticles is coacervation,
which is especially suited to the formation of particles in the preferred
size range of 100 to 500 micrometers having a high loading of therapeutic
agents. Coacervation is the term applied to the ability of a number of
aqueous solutions of colloids, to separate into two liquid layers, one rich
in colloid solute and the other poor in colloid solute. Factors which
influence this liquid-liquid phase separation are: (a) the colloid
concentration, (b) the solvent of the system, (c) the temperature, (d) the
addition of another polyelectrolyte, and (e) the addition of a simple
electrolyte to the solution. Coacervation can be of two general types. The
first is called "simple" or "salt" coacervation where liquid phase
separation occurs by the addition of a simple electrolyte to a colloidal
solution. The second is termed "complex" coacervation where phase separation
occurs by the addition of a second colloidal species to a first colloidal
solution, the particles of the two dispersed colloids being oppositely
charged. Generally, materials capable of exhibiting an electric charge in
solution (i.e. materials which possess an ionizable group) are coacervable.
Such materials include natural and synthetic macromolecular species such as
gelatin, acacia, tragacanth, styrene-maleic anhydride copolymers, methyl
vinyl ether-maleic anhydride copolymers, polymethacrylic acid, and the like.
If, prior to the initiation of coacervation, a water-immiscible material,
such as an oil, is dispersed as minute droplets in an aqueous solution or
sol or an encapsulating colloidal material, and then, a simple electrolyte,
such as sodium sulfate, or another, oppositely charged colloidal species is
added to induce coacervation, the encapsulating colloidal material forms
around each oil droplet, thus investing each of said droplets in a liquid
coating of the coacervated colloid. The liquid coatings which surround the
oil droplets must thereafter be hardened by cross-linking to produce
solid-walled microcapsules
Preferably, the wound dressing according to any aspect of the present
invention is sterile and packaged in a microorganism-impermeable container.
Claim 1 of 10 Claims
1. A wound dressing comprising a
therapeutic agent and a matrix comprising polymers joined by
cross-linkages which cross-linkages comprise oligopeptidic sequences which
are cleavable by a kallikrein such that the rate of release of the
therapeutic agent increases in the presence of the kallikrein, wherein the
oligopeptide sequence comprises -Phe-Arg-Ser-Ser-Arg-Gln- (SEQ ID NO: 1)
or -Met-Ile-Ser-Leu-Met-Lys-Arg-Pro-Gln- (SEQ ID NO: 2), wherein the
polymer is a polymer of N-(2-hydroxypropyl) methyacrylamide (HPMA) and
wherein the therapeutic agent is an antimicrobial agent, a pain relieving
agent, an antiseptic, an analgesic, a local anaesthetic, or a kallikrein
inhibitor. ____________________________________________
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