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Title: Compounds with improved
cartilage-inducing and/or bone-inducing activity
United States Patent: 7,365,051
Issued: April 29, 2008
Inventors: Paulista;
Michael (Leimen, DE), Pohl; Jens (Hambruecken, DE), Pabst; Joachim (Reinheim,
DE), Heide; Helmut (Kelkheim, DE)
Assignee: Biopharm
Gesellschaft zur Biotechnologischen Entwicklung von Pharmaka mbH
(Heidelberg, DE)
Appl. No.: 11/080,494
Filed: March 16, 2005
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Executive MBA in Pharmaceutical Management, U. Colorado
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Abstract
The present invention concerns a
bioactive implant material having a cartilage-inducing and/or
bone-inducing activity composed of two components A and B, of which A is a
bone-inducing and/or cartilage-inducing protein or protein mixture and
preferably one or several proteins from the TGF-.beta. superfamily,
preferably MP52 or a DNA sequence coding therefor and B is a carrier
matrix composed of calcium phosphate ceramics with an interconnecting
microporosity which already alone has bone-inducing properties. The
invention additionally concerns the production of these compounds and
their use for the treatment of diseases which affect cartilage and/or
bones as well as to treat damage to cartilage and/or bone tissue.
Description of the
Invention
The present invention concerns new
improved compounds with cartilage-inducing and/or bone-inducing activity
composed of one or several members of the TGF-.beta. family, preferably
MP52, or a DNA sequence coding therefor and a special carrier matrix
composed of crystallographically phase-pure tricalcium phosphate. The
invention additionally concerns the production of these compounds and
their use for the treatment of diseases which affect cartilage and/or
bones and to treat damage to cartilage and/or bone tissue.
Many growth factors from the TGF-.beta. superfamily are relevant for a
wide range of medical treatment methods and applications which in
particular concern wound healing and tissue reconstruction. For a review
of members of the TGF-.beta. superfamily cf. e.g.: Roberts, A. B. & Sporn,
M. B. Handbook of Experimental Pharmacology 95 (1990) 419-472; Kingsley,
D. M., Genes & Development 8 (1994) 133-146 and the literature cited
therein. The members include the TGF-.beta. proteins such as TGF-.beta.1,
TGF-.beta.2, TGF-.beta.3, TGF-.beta.4 and TGF-.beta.5, cf. e.g.: U.S. Pat.
No. 5,284,763; EP 0376785; U.S. Pat. No. 4,886,747; Madisen, L. et al.,
DNA 7 (1988) 1-8; Derynck, R. et al., EMBO J. 7 (1988) 3737-3743; Jakowlew,
S. B. et al., Mol. Endo. 2 (1988) 1186-1195; Kondaiah, P. et al., J. Biol.
Chem. 265 (1990) 1089-1093. The activins/inhibins which have the
previously known activin chains .beta.A, .beta.B, .beta.C and .beta.D form
a further subfamily cf. e.g. Mason, A. J. et al., Biochem. Biophys. Res.
Commun. 135 (1986) 957-964; Hotten, G. et al., Biochem. Biophys. Res.
Commun. 206 (1995) 608-613; Oda, S. et al., Biochem. Biophys. Res. Comm.
210 (1995) 581-588. GDF-12 can also be classed with this subfamily due to
its amino acid homology (cf. WO 96/02559). It is known that .beta.A and .beta.B
can also form a heterodimer .beta.A.beta.B in addition to the homodimer.
Combination with an .alpha. subunit forms the inhibins which essentially
have the opposite activities compared to activins, cf: Vale, W. et al.,
Handbook of Experimental Pharmacology 95 (1990) 211-248; Vale, W. et al.,
The Physiology of Reproduction, Raven Press, New York (1994) 1861-1878.
The members of the BMP (bone morphogenetic protein) family form a further
subfamily which include the proteins BMP-2 (BMP-2a), BMP-3, BMP-3b, BMP-4
(BMP-2b), BMP-5, BMP-6, BMP-7 (OP-1), BMP-8 (OP-2), BMP-9, BMP-10, BMP-11,
BMP-12 and BMP-13 cf. e.g.: Wozney, J. M. et al. Science 242 (1988)
1528-1534; Celeste, A. J. et al., Proc. Natl. Acad. Sci. USA 87 (1990)
9843-9847; Ozkaynak, E. et al., J. Biol. Chem. 267 (1992) 25220-25227;
Takao et al. Biochem. Biophys. Res. Com. 219 (1996) 656-662; WO 93/00432;
WO 94/26893; WO 94/26892, WO 95/16035. A further subgroup is the GDF
(growth differentiation factor) family which include GDF-1, GDF-3, GDF-9,
GDF-10, GDF-11 as well as GDF-5, GDF-6 and GDF-7 which are particularly
interesting for cartilage-induction and/or bone-induction c.f. McPherron,
A. C. & Lee, S.-J., J. Biol. Chem. 268 (1993) 3444-3449; Storm, E. E. et
al., Nature 368 (1994) 639-643; Lee, S.-J.; Proc. Natl. Acad. Sci. USA 88
(1991) 4250-4254; Cunningham et al. Growth Factors 12 (1995), 99-109;
Hotten, G. et al., Growth Factors 13 (1996) 65-74; Chang, S. C. et al., J.
Biol. Chem. 269 (1994) 28227-28234. There are some overlaps between the
subgroups of the GDF and BMP family due to amino acid homologies. It was
also possible to detect a cartilage-inducing potential and bone-inducing
potential for the TGF-.beta. superfamily members dpp and 60A from
Drosophila cf.: Sampath, T. K. et al., Proc. Natl. Acad. Sci. USA 90
(1993) 6004-6008. The proteins dorsalin and the bone formation-inducing
protein are also of interest cf.: Basler, K. et al., Cell 73 (1993)
687-702; WO 94/01557. Heterodimers of various members have also been
described cf.: Aono, A. et al., Biochem. Biophys. Res. Commun. 210 (1995)
670-677; WO 93/09229; EP 0 626 451. It is known that many members
especially from the subfamilies of the TGF-.beta., BMP and GDF families
have a cartilage-inducing and/or bone-inducing potential and members of
the activin family can also influence bone formation at least in
combination with other TGF-.beta. superfamily members cf. for example
Hock, J. M. et al., Endocrinol. 126 (1990) 421-426; Wang et al., Proc.
Natl. Acad. Sci. USA 87 (1990) 2220-2224; Wozney et al., Mol. Reprod. Dev.
32 (1992) 160-167; Sampath et al., J. Biol. Chem. 267 (1992) 20352-20362;
Ogawa, Y. et al., J. Biol. Chem. 267 (1992) 14233-14237; WO 88/00205; U.S.
Pat. No. 5,013,649; WO 89/10409; WO 90/11366; WO 91/05802; WO 92/15323; WO
91/18098; WO 93/00432; WO 93/09229; WO 94/01557; WO 94/26893; WO 94/26892;
WO 94/15949; WO 95/01801; WO 95/01802 and EP 0 626 451. Since some of the
individual proteins act at different sites during the course of cartilage
and bone induction, it can be assumed that a combination of various such
proteins would be advantageous for the efficiency of cartilage and bone
induction. Such protein mixtures are also encompassed by this invention.
The DNA and protein sequences of proteins of the TGF-.beta. family i.e.
MP52 and MP121 are described in WO 93/16099, WO 95/104819 and WO 96/01316.
MP121 is the activin .beta.C which has already been mentioned above. MP52
(sometimes also named GDF5 in publications) for which a cartilage-inducing
and bone-inducing potential has already been proven is of particular
interest (WO 95/04819 and Hotten et al. Growth Factors 13 (1996) 65-74).
The members of the TGF-.beta. superfamily which have a cartilage-inducing
and/or bone-inducing potential are characterized in the mature part by
high amino acid homologies and have the seven conserved cysteines which
are typical for members of the TGF-.beta. superfamily. The active form of
members of this superfamily is usually always a homodimeric and/or
heterodimeric protein. The cartilage-inducing and/or bone-inducing
potential of these proteins is usually tested on inert carrier matrices
which themselves have no cartilage-inducing and/or bone-inducing effect at
all.
Already in the sixties intensive research work began on the applications
of calcium phosphate ceramics as an implantable bone substitute (Bhaskar
et al., Oral Surg. 32 (1971) 47) which was based on the chemical
similarity of this group of compounds to the mineral component of bone.
One of the first systematic investigations on the connections between the
chemical and material parameters and the biological properties was carried
out at the beginning of the seventies at the Battelle Institute (Heide,
Koster et al., Z. Orthop. 118 (1979) 398 and Biotechn. Umschau 2 (1978)
226). In these investigations calcium phosphates with various CaO/P.sub.2O.sub.5
ratios were produced by sintering processes as granular and pelleted
ceramic implant materials and tested in animal experiments. The major
results of these studies can be summarized as follows: (a) Calcium
phosphate ceramics of particular compositions are characterized by an
excellent bone tissue tolerance. (b) The optimum tissue tolerance is
mainly achieved with ceramics with a CaO/P.sub.2O.sub.5 ratio of 3/1 i.e.
with tricalcium phosphate TCP, Ca.sub.3(PO.sub.4).sub.2 (or written
3CaO.P.sub.2O.sub.5 as a ceramic formula) and hydroxylapatite (HA) itself
i.e. [Ca.sub.5(PO.sub.4).sub.3OH] which can also be prepared
synthetically. This result is logical since it is also known that the
composition of the mineral bone component with its most important mineral
component hydroxylapatite approximately corresponds to this ratio.
Although TCP and HA have a similar chemical composition there are
considerable differences in their solubility properties and other physical
properties such as density and strength. The potential areas of
application also of course depend on this. (c) The two optimal
biocompatible modifications of tricalcium phosphate TCP (i.e. the
metastable high temperature modification .alpha.-TCP and especially the
stable low temperature modification .beta.-TCP) and hydroxylapatite HA are
more or less biodegradable i.e. in biological storage they are degraded or
absorbed more or less rapidly. .alpha.-TCP and .beta.-TCP have a
pronounced biodegradability according to Ramselaar et al., J. Materials
Sci. 2 (1991) 63. The resorption of HA is very much less in a biological
environment. TCP in a bone store tends to be degraded chemically according
to experiments with radioactively labelled implant materials by Schuster,
Heide et al., (unpublished report of the Battelle Institute Frankfurt)
i.e. the dissolution and metabolism of the dissolved products occurs
without involvement of bone-degrading cells whereas the very much slower
resorption of hydroxylapatite is based more on a specific action of
bone-degrading cells (osteoclasts). (d) The biocompatible calcium
phosphate ceramics based on TCP and HA are integrated in the bone store
largely without encapsulation by connective tissue as was impressively
demonstrated in animal experiments in the seventies by the said Battelle
working group among others. At that time the term "bioactivity" was
introduced for this outstanding property.
During further development of the promising calcium phosphate ceramics it
turned out that detailed knowledge of the complex crystal-chemical
relationships of the system CaO--P.sub.2O.sub.5 (+H.sub.2O) is an absolute
prerequisite for a systematic optimization. Unfortunately in the past and
still today many users ignore these requirements especially when materials
based on the poorly biodegradable HA are used for typical temporary
applications such as e.g. the sanitation of periodontal pockets. Important
papers on this subject have been published by De Groot et al.,
Biomaterials 1 (1980) 47, and Bauer and Hohenberger, "Berichte der DKG" 66
(1989) 23.
Numerous implant materials that are nowadays still commonly available on
the market which are composed of undefined mixtures of TCP and HA and
other calcium phosphate phases such as dicalcium or tetracalcium
phosphates and calcium phosphate glasses have adverse biomedical
properties such as provocation of connective tissue infiltration and
activation of macrophages which may be accompanied by inflammatory
reactions. The connective tissue encapsulation of materials with such a
defective composition is then a manifestation of the rejection of the
implant (Bauer and Hohenberger, "Berichte der DKG" 66 (1989) 23). The
stoichiometric composition alone is not a criterium for the existence of
unphysiological foreign phases. These results lead to the requirement for
a crystallographic phase purity of the implant materials that are used.
The two main types of calcium phosphate, tricalcium phosphate (TCP) and
hydroxylapatite (HA) have different areas of application corresponding to
the differences in their resorption: TCP is particularly advantageous as a
temporary bone substitute where in the course of time the biomaterial is
resorbed concurrently with bone regeneration (filling of cysts in the jaw
area, filling in of bone defects caused by disease or operations or
degenerative bone defects etc.). In contrast HA is preferably indicated
for long-term bone replacement such as e.g. in connection with the coating
of joint endoprostheses where one wants to avoid direct contact of the
stressed bone store with metal or other inert materials.
The object of the present invention is to provide new compounds which have
particularly high cartilage-inducing and/or bone-inducing activities in
mammals and especially in primates such as humans but do not have the
disadvantages of the previously used materials or only to the smallest
possible extent. Such compounds should greatly accelerate the healing
process of diseases which affect cartilage and/or bones and which are in
particular associated with a loss of bone substance and/or damage to
cartilage and/or bone tissue.
This object is achieved according to the invention by a bioactive implant
material for bone replacement with cartilage-forming and/or bone-forming
activity composed of two components A and B which comprises a
cartilage-inducing and/or bone-inducing protein or protein mixture or DNA
coding for such a protein or protein mixture as component A, and a matrix
material composed of calcium phosphate which has no intrinsic osteogenic
activity as component B, and A is applied to B. Preferred embodiments of
the invention are described in the subclaims. In particular a material is
provided which is composed of the two components A and B in which A
denotes a protein or protein mixture composed of one or several
homodimeric or heterodimeric proteins from the TGF-.beta. superfamily with
cartilage-inducing and/or bone-inducing activity and B denotes an
oesteoinductive carrier matrix preferably composed of a biodegradable bone
ceramic particularly preferably of .alpha.- or .beta.-tricalcium phosphate
ceramics. A is associated with B without being covalently bound and can
for example be slowly released from B during the bone formation process to
the same extent that B is subject to chemical degradation in the bone
store. Hence A is subject to a so-called controlled release.
Alternatively A can also denote a DNA coding for the said proteins or
protein mixtures. The DNA can optionally be protected from degeneration by
methods known to a person skilled in the art. After release into the
surrounding tissue, such a DNA can be taken up by the cells that are
present there or by cells that migrate into the carrier matrix and be
expressed so that the expressed proteins or protein mixtures act in turn
as the active substance.
Hence the DNA is preferably associated with sequences which cause or
promote expression. Expression can be promoted especially by specific
recombination into the cell genome and namely at a site which leads to the
generation of protein under the control of cellular sequences.
On the other hand DNA can also be used on a suitable expression vector.
The term "protein of the TGF-.beta. superfamily with a cartilage-inducing
and/or bone-inducing activity" denotes a protein which in its mature part
contains the characteristic 7 conserved cysteines. This includes members
of the TGF-.beta., activin, BMP and GDF family and in particular MP52 and
fragments thereof with basically the same activity. The corresponding
nucleotide and protein sequences are given in the aforementioned citations
to the disclosure of which reference is herewith made. These preferably
include homodimers of the said proteins and also heterodimers of various
family members. Proteins are preferably included which have the same
receptor mechanism and/or the same signal transmission as the members of
the BMP and/or GDF family, in particular MP52. It also includes a
combination of various proteins from the TGF-.beta. superfamily with
cartilage-inducing and/or bone-inducing activity. The cartilage-inducing
and/or bone-inducing potential can be tested in known experiments such as
e.g. in vivo by induction of cartilage and/or bones after implantation of
the protein with a suitable carrier matrix into rat musculature; cf. e.g.
Sampath, T. K. et al., J. Biol. Chem. 267 (1992) 20352-20362 and/or in
vitro by induction of alkaline phosphase activity in ROB-C26 cells; cf.
Yamaguchi, A. et al., J. Cell Biol. 113 (1991) 681-687 and/or W-20-17
cells; cf.: Thies, R. S. et al. Endocrinol. 130 (1992) 1318-1324 and/or
stimulation of the expression of proteins of the extracellular matrix,
cf.: Hock, J. M. et al. Endocrinol. 126 (1990) 421-426 and/or in
experiments as described by Chen, P. et al., Exp. Cell Res. 195 (1991)
509-515 and/or Vukicevic, S., et al. Proc. Natl. Acad. Sci. USA 86 (1989)
8793-8797. The protein can be present as a mature protein and also as a
precursor protein or a protein in which the propeptide part has been
processed in different ways and/or a protein with additional or modified
N-terminal and/or C-terminal amino acid sequences which essentially do not
influence the biological activity.
On the other hand fusion proteins are also possible which, in addition to
the part coding for the mature protein or fragments thereof, additionally
still contain functional signal or/and propeptide parts of other proteins
in particular of the TGF-.beta. superfamily and especially also of activin,
BMP and GDF proteins. The corresponding nucleotide and protein sequences
are also found in the above-mentioned citations to the disclosure of which
reference is herewith made. It is important that the correct reading frame
for the mature protein is retained. Thus for example the exchange of
propeptide parts by corresponding parts of other proteins is described in
Mol. Endocrinol. 5 (1991), 149-155 and Proc. Natl. Acad. Sci. USA 90
(1993), 2905-2909.
The protein in the compound according to the invention or the protein
coded thereby can contain substituted or inserted amino acids or contain
deletions, also provided that the activity is not significantly influenced
and can be isolated from various species such as e.g. humans, mouse, rat,
cow or pig. Furthermore the protein can be modified by methods known in
the prior art such as glycosylations, phosphatizations, sulfations and
esterification with fats also provided that this does not result in a
significant change in the activity.
In a preferred embodiment of the present invention A is a protein from the
GDF or BMP family or a fragment thereof.
In a particularly preferred embodiment of the present invention the
component A is characterized by a protein which (a) contains the mature
part and optionally additional functional parts of the protein sequence
shown in SEQ ID NO. 1, (b) contains parts of the mature part of (a) which
have essentially the same activity, in particular mature proteins with a
modified N-terminus, (c) contains parts corresponding to (a) or (b) which
differ from SEQ ID NO:1 due to the origin of the protein from other
vertebrates but have essentially the same activity, (d) in addition to
containing parts of the mature protein according to (a), (b) or (c), also
contains parts of another protein from the TGF-.beta. superfamily in the
form of a fusion protein, (e) in addition to containing monomeric mature
proteins according to (a) to (d), also contains a monomer of another
protein from the TGF-.beta. superfamily with formation of heterodimers,
(f) in addition to containing dimeric mature proteins according to (a) to
(e), also contains at least one dimer of another protein from the TGF-.beta.
superfamily.
This embodiment in particular comprises the mature protein MP52 or
functional parts or fragments thereof in which the active form is
preferably present as a dimer. Functional regions or sections or fragments
are particularly preferred which contain at least the region of the seven
conserved cysteines.
A "biocompatible" and "bioactive" carrier matrix denotes in the
osteological sense a calcium phosphate ceramic which, on the one hand, can
be integrated into bones without damaging tissue reactions such as
connective tissue encapsulations, inflammations and tissue degenerations
and, on the other hand, stimulates a direct growth of bones onto or into
the surface structure of the implant. However, "bioactivity" of a carrier
matrix is not present until a histologically and clinically detectable
stimulation of bone growth occurs. There is clinical experience with the
highly porous bioactive carrier matrix (such as e.g. Cerasorb.RTM.)
according to the invention which is based on tricalcium phosphate, in
particular on .beta.-TCP and also .alpha.-TCP. The phase-pure and open
microporous .beta.-TCP has an outstanding position with regard to
bioactivity or osteoinductivity and alone produces an ion environment as a
result of the predictable chemical dissolution in the bone store which
contributes to the stimulation of osteoblast activity and in situ serves
as a substrate for osteoblast activity. If the chemical dissolution or
resorption of the carrier matrix occurs simultaneously with the primary
phase of bone formation (woven bone phase) there is an excellent chance of
regaining the strength and structure of the surrounding bone store. A
prerequisite for this is the absence of unstoichiometric secondary phases
which often react unphysiologically. This can be demonstrated for
phase-pure .beta.-TCP and it therefore already alone has an osteoinductive
action. Crystallographically phase-pure .alpha.- or .beta.-tricalcium
phosphate ceramics with an interconnecting microporosity in the range of
20-60% of their volume are particularly preferred. In a particularly
preferred embodiment the primary particle size of the crystallographically
phase-pure .alpha.- or .beta.-tricalcium phosphate ceramics is in the
range of 10-40 .mu.m. In a further preferred embodiment of the invention
this implant material is present in the form of an injectable suspension.
This for example enables the material to be applied with a minimum of
invasiveness. Hence a suspension of this matrix in suitable liquids for
medical applications such as water, serum, plasma and blood does not cause
any infiltration of giant cells or connective tissue into the implant.
Hence an important subject matter of the invention is an implant material
composed of two components A and B in which the osteopoetic effect of
component A is synergistically amplified by an osteoinductive effect of
component B. Hence the compound is based on an advantageous combination of
mechanisms of action of two components i.e. a cartilage-inducing and/or
bone-inducing protein or protein mixture and an osteoinductive carrier
matrix. Such an implant material according to the invention avoids
counter-productive effects with regard to the osteopoetic effect of the
proteins A which some biocompatible but not bioactive implant materials
exhibit. Thus carrier materials such as HA are often unsuitable for an
application in protein-stimulating oestosynthesis due to their slow
biodegradability. Rapidly biodegradable carrier ceramics such as phosphate
glasses and metastable phases or phase mixtures of CaP and also of
chemically modified matrices which are for example obtained from corals
have already alone a counter-productive effect on protein-stimulating
osteosynthesis due to the activation of macrophages or/and osteoclasts.
Furthermore it has turned out that coating the matrix surface of suitable
carrier materials with physiologically inert protein fillers such as
collagen has an inhibitory effect on resorption and thus on bioactivity.
Surprisingly mixtures of carrier materials based on microporous phase-pure
TCP, preferably .beta.-TCP, with homogenates of red bone marrow or blood
have been shown to promote osteosynthesis despite the considerable
coverage of the matrix surface with proteins. Hence the implant materials
according to the invention represent an optimization of these results. The
minimal matrix coverage with the protein or DNA component A ensures the
maintenance of the bioactive, i.e. intrinsic, osteoinductive properties of
the carrier matrix B from which component A is inevitably released through
its interconnecting micropore structure and is thus biologically active to
an extent corresponding to the chemical degradation of the matrix at the
site of implantation. If it were not combined with a suitable matrix, the
osteopoetic protein A alone would rapidly lose its biological activity at
the site of implantation due to metabolism, transport by body fluids or
phagocytosis. The phase purity of the carrier matrix with a defined
micropore structure ensures a predictable resorption and thus also a
controlled release of the protein component A or of a DNA coding therefor.
Such an interaction between matrix B and protein A undoubtedly represents
a synergistic amplification of the effects of the two components A and B.
A further subject matter of the present invention is a process for the
production of the implant materials according to the invention in which a
solution of the protein A or DNA in a physiologically acceptable,
water-miscible solvent or in appropriate solvent mixtures is applied to
the microporous structure of the biocompatible matrix B in such a way that
the component A is distributed homogeneously in and/or on the microporous
structure of the matrix.
Information on the production of proteins of the TGF-.beta. superfamily,
their expression in suitable host cells and purification may be found in
numerous already cited publications and patent documents. In particular
reference is made to WO 95/04819 and DE 19525416.3 as well as to Hotten et
al. (Growth Factors 13 (1996) 65-74) for the preparation of MP52/GDF-5 or
active fragments thereof.
If the proteins are produced in bacteria where the proteins are present in
the form of inclusion bodies as is the case for MPS2, they are renatured
by known methods in order to obtain the protein, for example MP52, in an
active form. MP52-like proteins expressed in E. coli can be refolded into
an active protein cf.: Krieglstein, K. et al., J. Neuroscience Res. 42
(1995) 724-732. Exact procedures are also described in the Japanese Patent
Application Hei 7('95)-93664 as well as in DE 19525416.3. Other
investigations by us as well as by Ruppert, R. et al. (Eur. J. Biochem.
237, 295-302 (1996)) have shown that for example BMP-2 can also be
expressed in E. coli and refolded to form the dimer.
The DNA is prepared by methods known to a person skilled in the art as
described for example in Current Protocols in Molecular Biology (Ausubel
et al., Greene Publishing Associates and Wiley-Interscience, Wiley & Sons,
1987-1996) or in Molecular Cloning (Sambrook et al., second edition, Cold
Spring Harbor Laboratory Press 1989).
The following procedure according to DE 38 10 803 C2 can be used to
prepare the carrier matrix B: homogeneous stoichiometric mixtures of
CaCO.sub.3 and CaHPO.sub.4 are subjected in various steps to sintering
temperatures up to 1350.degree. C. in compacted moulded bodies according
to the constitution diagram (phase diagram) of the system CaO and
P.sub.2O.sub.5 (Tromel, Stahl und Eisen 63 (1943) 21; Welch, J. Chem. Soc.
(1961) 4442) in which water and CO.sub.2 are removed from the sintering
system. Between the sintering processes the intermediate stages of the
sintering synthesis are comminuted, micronized, recompacted for the
production of moulded articles or pelletized for granulate production. The
sintering processes are carried out with respect to time and temperature
such that coexisting neighbouring phases of TCP according to the phase
diagram are avoided i.e. in particular tetra calcium phosphate on the one
hand and dicalcium phosphate on the other hand. Metastable phases of the
thermodynamically stable .beta.-Ca.sub.3(PO.sub.4).sub.2 or .beta.-TCP can
either be specifically avoided by regulating the sintering process
according to the intended application or can be intentionally made to
coexist or can even be prepared alone as the dominant product.
A homogeneous incorporation and distribution of the component A in the
pore structure of the carrier matrix B requires several types of process
which enable such a distribution without the component itself being
changed by the processes.
Thus it is obvious that a combination of A and B cannot be used
simultaneously in the ceramic sintering process due to the high process
temperatures.
In contrast it is possible to penetrate the microporous ceramic structure
of the moulded parts and granulate particles with solutions of the
proteins A or the DNA coding therefor according to the invention in
suitable solvents in which the capillary forces of the open ceramic
structure become effective. When selecting solvents, of course only those
come into consideration which do not alter the characteristics of the
components A and B of the biomaterial. Thus for example acidic solvents
are unsuitable which although being excellent solvents for osteopoetic
proteins, attack and chemically modify the calcium phosphates. On the
other hand water is neutral towards ceramics but is often only able to
incompletely dissolve the protein components A. A penetration by means of
suspensions would not allow a homogeneous distribution in the carrier
matrix due to the microporous structure.
A process for penetrating the carrier matrix by means of the solvent phase
which could obviously be driven out by evaporation, also does not lead to
a completely homogeneous distribution of A in B since when the solvent
evaporates on the surface of the porous ceramics there is a mass transport
of the dissolved phase from the inside to the outside resulting in a
concentration on the surface.
A solution for this complex problem of homogeneously dosing the carrier
matrix with component A can be accomplished according to the invention by
the following types of process: Removing the solvent after cooling a
gently heated solution saturated with the proteins A. As a result the
limit of solubility of the proteins in the solvent is exceeded and the
proteins are deposited in the carrier structure. This reduces the amount
of protein in the remaining solution and correspondingly reduces the
described concentration effect. There is a natural limit to this method
due to the small temperature margin, but it is especially appropriate when
a quantity gradient of the protein in the ceramic structure is desirable
with regard to a certain starter effect on osteopoesis. Removing a
protein-containing or DNA-containing liquid mixture composed of organic
solvent and/or water by sublimation according to critical point drying.
The direct transition of the solidified solvent mixture into the gaseous
state prevents transport of the protein or the DNA via the liquid phase
and results in a uniform distribution of the precipitated protein or the
DNA in the ceramic structure. Homogeneous precipitation of protein in the
ceramic carrier structure from a protein-containing organic solution by
adding for example water which leads to a rapid precipitation of the
protein and thus to an in situ deposition in the ceramic structure. This
method can be used in various ways and works with substance pairs in which
the protein is soluble in the organic solvent, the pure solvent is
miscible with water but not the protein-containing solution. Acetonitrile/water,
propanediol-1,2/water or propanol/water can, among others, for example be
used for this. Homogeneous precipitation of DNA in a ceramic carrier
structure from a DNA-containing salt solution (for example 0.1 M NaCl or
0.25 M NaAc) by adding an alcoholic solution such as absolute ethanol
which leads to a rapid precipitation of the DNA in the ceramic structure.
The doped carrier matrix can if necessary be washed with 70% ethanol.
The efficacy of the implant materials according to the invention can be
tested in conventional test systems such as e.g. the already mentioned
rat, dog, rabbit or also primate animal models.
Further subject matters of the present invention are therefore a
pharmaceutical composition containing an implant material optionally
together with pharmaceutically as well as physiologically acceptable
auxiliary substances, diluents and/or fillers and the use of the compounds
according to the invention at a pharmaceutically effective concentration
optionally together with pharmaceutically as well as physiologically
acceptable auxiliary substances, diluents and/or fillers for the local
treatment of cartilage and/or bone diseases and/or of damage to cartilage
and/or bone tissue caused by injury, operation, degeneration or strain in
vertebrates and in particular in mammals such as humans.
The compounds according to the invention can be used to specifically treat
diseases which are associated with bone loss caused for example by age,
metabolic diseases or inflammatory processes.
Damage to cartilage or bone tissue can occur after injury such as sport
injuries, accidents, straining the apparatus of locomotion or can occur as
a result of operations for example due to drill holes in the bones after
removing screws for artificial fastening apparatuses or after resections
of tumour tissue. The specific local treatment of bone fractures is
particularly preferred. It is also possible to elongate limbs.
Applications in the dental or jaw region are of particular interest such
as the treatment of perioaontosis, sinus lift or cyst filling in the jaw
area. There are also applications in cosmetic surgery in particular
plastic surgery in the facial region. The compounds according to the
invention also enable two movable bone parts to be immobilized such as
e.g. the connection of two vertebrae by means of a newly formed bone
bridge which can for example be advantageous for intervertebral disk
problems. The said methods of treatment also include veterinary medicine.
The dose is in the range of 10 .mu.g to 100 mg depending on the type of
protein component and on the type of application, the disease and the
state of the patient. The amount of carrier matrix depends on the size of
the bone or cartilage defect which is to be treated.
If large pressed carrier matrices are used they have to be mechanically
fixed by for example steel rods and screws.
The synergistic effect which is the basis of this invention achieved by
combining mechanisms of action of two components in a compound i.e.
cartilage-inducing and/or bone-inducing protein and osteoinductive carrier
matrix enables very good results to be achieved in treatments.
An advantage of the implant materials according to the invention is that
it is possible to substantially improve and accelerate healing processes
that require cartilage-inducing and/or bone-inducing reactions. This
advantageously results in a considerable reduction of the period of
suffering for the patients, shorter periods out of work and a reduction of
the costs for hospital stays. A further economic aspect is the effective
treatment of the wide-spread disease periodontosis which is accompanied by
a premature loss of teeth. Thus economically tooth preservation made
possible by periodontosis treatment contrasts with expensive premature
dentures.
Claim 1 of 14 Claims
1. An implant material suitable for
cartilage, bone, or cartilage and bone growth comprising a matrix material
which is composed of a crystallographically phase-pure calcium phosphate
and applied in and/or on said matrix a cartilage inducing, bone inducing,
or cartilage and bone inducing MP52 protein, wherein the MP52 protein is
selected from the group consisting of (a) a protein comprising amino acid
1 to 501, 28 to 501, 361-400 to 501, 381 to 501, or 382 to 501 of SEQ ID
NO. 1, and (b) a protein according to (a) which is a homodimer. ____________________________________________
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