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  Pharmaceutical Patents  

 

Title:  Treatment of diseases involving defective gap junctional communication
United States Patent: 
7,514,107
Issued: 
April 7, 2009

Inventors:
 Sies; Helmut (Meerbusch, DE)
Assignee:
  Mars, Incorporated (McClean, VA)
Appl. No.:
 10/392,641
Filed:
 March 20, 2003


 

George Washington University's Healthcare MBA


Abstract

This invention relates to compositions containing polyphenols, for example, cocoa polyphenols such as flavanols and their related oligomers, and methods for treating abnormalities in gap junctional communication of cells, such as cancer, heart arrhythmia, neuro-degenerative diseases and cognitive dysfunction.

Description of the Invention

SUMMARY OF THE INVENTION

The invention relates to compositions, products and methods for treating, preventing, reducing the occurrences of, or reducing the risk of heart arrhythmia in a mammal suffering from, or at risk of suffering from, heart arrhythmia, a human or a veterinary animal such as a horse, a cat or a dog. Moreover, the invention relates to methods and products for treating, preventing, reducing the risk of, or slowing the progression of any condition associated with abnormalities in the gap junctional communication between cells such as cancer, heart arrhythmia, neuro-degenerative diseases and cognitive dysfunction involving defective gap-junctional communication between cells.

In one aspect, the invention relates to a composition, such as a food, a food additive, a dietary supplement, or a pharmaceutical comprising a cocoa polyphenol. The composition may optionally contain L-arginine and/or a cholesterol reducing agent.

Packaged products containing the above-mentioned compositions and a label and/or instructions for use to treat, prevent, reduce the risk of, or slow the progression of heart arrhythmia, a neuro-degenerative disease or any condition associated with abnormalities in the gap junctional communication of cells are also within the scope of the invention.

In another aspect, the invention relates to a method for treating, preventing, reducing the risk of, or reducing the occurrences of heart arrhythmia in a mammal, such as a human or a veterinary animal, by administering a composition containing a cocoa polyphenol such as cocoa flavanols and/or its related oligomers to the mammal in need thereof.

In yet another aspect, the invention relates to a method of treating, preventing, reducing the progression of, or reducing the risk of a condition associated with the abnormalities in the cellular gap junction communication in a mammal, such as a human or a veterinary animal, by administering a composition containing a cocoa polyphenol such as cocoa flavanols and/or its related oligomers to the mammal in need thereof. For example, such condition is a neuro-degenerative disease or cognitive dysfunction and the mammal suffers or is at risk of suffering of the neuro-degenerative disease or cognitive dysfunction.

DETAILED DESCRIPTION

All patents, patent applications and references cited in this application are hereby incorporated herein by reference. In case of any inconsistency, the present disclosure governs.

The present invention relates to a composition containing a flavanol and/or its related oligomers, such as at least one cocoa flavanol and/or its related procyanidin oligomer, to a mammal in need thereof. The composition may optionally contain a cholesterol lowering agent, for example, a sterol and/or stanol based cholesterol lowering agent, L-arginine, calcium, potassium, magnesium, an antioxidant, for example vitamin E and vitamin C, any of the vitamins of the B complex, a carotenoid, guar gum, or a mono or polyunsaturated fatty acid (e.g. omega-3 fatty acid), vitamin D3, retinal, retinoids, soy protein and selenium. Compositions may contain polyphenols from sources other than cocoa, e.g. peanut skins, which have properties similar to those of cocoa polyphenols in addition to, or in place of, the cocoa polyphenols.

As used herein, the term "cocoa polyphenol" (CP) refers to a polyphenolic substance such as flavanols and their related oligomers present in cocoa beans or extracted from cocoa beans or cocoa ingredients. The term "flavanol" includes the monomers catechin and epicatechin. Oligomers of catechin and epicatechin are referred to as procyanidins. Any reference to cocoa polyphenol herein should be understood to also apply to cocoa flavanols and procyanidin, in combination and individually.

The term "cocoa ingredient" refers to a cocoa solids-containing material derived from shell-free cocoa nibs such as chocolate liquor and partially or fully-defatted cocoa solids (e.g. cake or powder).

The phrase "cholesterol lowering agent" means any compound, combination of compounds, an extract or a plant component, naturally found or processed, that has the property of lowering cholesterol levels in a mammal when administered in an effective amount. When such cholesterol lowering agent is a compound or a combination of compounds that is of a sterol or stanol type, i.e., including derivatives and isomeric forms, the cholesterol lowering agent is referred to as a "sterol and/or stanol based cholesterol lowering agent." When the phrase is used in reference to a composition, for example, "a cholesterol reducing dark chocolate," it means that the composition has the property of lowering cholesterol.

The cocoa polyphenols may be of natural origin, i.e., derived from a cocoa bean, or prepared synthetically. A person of skill in the art may select natural or synthetic cocoa polyphenol based on availability or cost. Cocoa polyphenols may be included in the composition in the form of a cocoa ingredient containing cocoa polyphenols, for example, chocolate liquor included in chocolate, or may be added independently of cocoa ingredients, for example, as an extract, extract fraction, isolated and purified individual compound, pooled extract fractions or a synthetically prepared compound.

The cocoa polyphenols include cocoa flavanols and their oligomers. Flavanols include (+)-catechin, (-)-epicatechin and their respective epimers (e.g. (-)-catechin and (+)-epicatechin) and have the structure -- see Original Patent.

The procyanidin oligomers may have from 2 to about 18, preferably from 2 to about 12, and most preferably from 2 to about 10 monomeric units. For example, oligomers may be dimers, trimers, tetramers, pentamers, hexamers, heptamers, octamers, nonamers and decamers. In the oligomer, monomers are connected via interflavan linkages of (4.fwdarw.6) and/or (4.fwdarw.8). Oligomers with exclusively (4.fwdarw.8) linkages are linear; while the presence of at least one (4.fwdarw.6) bond results in a branched oligomer. In the case of peanut skins polyphenols, linkages, such as C2.fwdarw.O.fwdarw.C7, are also present.

Thus, a polymeric compound of the formula A.sub.n, or a pharmaceutically acceptable salt thereof, may be used in the compositions and methods of the present invention -- see Original Patent.

The cocoa polyphenol may be prepared by extraction from cocoa beans, cocoa nibs, or cocoa ingredients such as chocolate liquor, partially defatted cocoa solids, and/or fully defatted cocoa solids. Preferably, the extract is prepared from a fully or partially defatted cocoa powder. Beans from any species of Theobroma, Herrania or inter- and intra-species crosses thereof may be used. The extract may be prepared from fermented, underfermented or unfermented beans, the fermented beans having the least amount of cocoa polyphenols and the unfermented the most. The selection of beans may be made based on the fermentation factor of the beans, for example, the extract may be made from the beans having a fermentation factor of about 275 or less. Optimizing the level of polyphenols in the cocoa ingredient and extract thereof by manipulating the degree of fermentation may be done as described in the International Appl. No. PCT/US97/15893 published as WO98/09533, the relevant portions of which are hereby incorporated herein by reference.

Cocoa polyphenols may be extracted from cocoa ingredients that have been processed using traditional methods of cocoa processing (described, for example, in Industrial Chocolate Manufacture and Use, ed. Beckett, S. T., Blackie Acad. & Professional, New York, 1997, such as in Chapters 1, 5 and 6) or using an improved processing method described in U.S. Pat. No. 6,015,913 to Kealey et al. that preserves polyphenols (by preventing their destruction) in cocoa ingredients in contrast to the traditional methods. The improved cocoa processing method omits the traditional roasting step. Thus, cocoa ingredients obtainable by (a) heating the cocoa bean for a time and a temperature sufficient to loosen the cocoa shell without roasting the cocoa nib; (b) winnowing the cocoa nib from the cocoa shell; (c) screw pressing the cocoa nib and (d) recovering the cocoa butter and partially defatted cocoa solids which contain preserved levels of cocoa polyphenols, may be used. The method retains a much higher level of higher procyanidin oligomers than traditional processing methods. Cocoa solids produced by this method may contain greater than 20,000 .mu.g of total flavanol and/or procyanidins per gram nonfat solids; preferably greater than 25,000 .mu.g/g, more preferably greater than 28,000 .mu.g/g, and most preferably greater than 30,000 .mu.g/g. For purposes of this invention, the total flavanol and/or procyanidin amounts are determined as described in Example 2.

Cocoa polyphenols may be extracted from the sources indicated above using solvents in which the polyphenols dissolve. Suitable solvents include water or organic solvent such as methanol, ethanol, acetone, isopropyl alcohol and ethyl acetate. Solvent mixtures may also be used. When water is used as the solvent, it may be slightly acidified, for example with acetic acid. Examples of some solvents are mixtures of water and organic solvent, for example aqueous methanol, ethanol or acetone. Aqueous organic solvents may contain, for example, from about 50% to about 95% of organic solvent. Thus, about 50%, about 60%, about 70%, about 80% and about 90% organic solvent in water may be used. The solvent may also contain a small amount of acid such as acetic acid, for example, in the amount of about 0.5% to about 1.0%. The composition of the extracts, i.e., the representation (i.e., oligomeric profile) and the amount of procyanidin oligomers, will depend on the choice of solvents. For example, the water extract contains primarily monomers, the ethyl acetate extract contains monomers and lower oligomers, mainly dimers and trimers, and the aqueous methanol, ethanol or acetone extract contains monomers and a range of higher oligomers. One of the solvents for extraction of monomer as well as higher procyanidin oligomers is about 70% acetone. However, any extract containing polyphenols is useful in the invention. The methods of cocoa polyphenol extraction are known in the art and are described, for example, in the U.S. Pat. No. 5,554,645 to Romanczyk et al. and the International Appl. No. PCT/US97/05693, published as WO97/36497. Thus, in one embodiment, the cocoa extract is prepared by reducing cocoa beans to cocoa powder, defatting the powder, extracting the cocoa polyphenols, and purifying the extract. The cocoa powder can be prepared by freeze-drying the cocoa beans and pulp, depulping and dehulling the freeze-dried cocoa beans, and grinding the dehulled beans.

The cocoa polyphenol extract may be purified, for example, by removal of the caffeine and/or theobromine, and further purified by gel permeation chromatography and/or High Pressure Liquid Chromatography (HPLC). Gel permeation chromatography (e.g. on Sephadex LH-20) may be used to enrich the extract for higher procyanidin oligomers. For example, the eluate containing monomers and lower oligomers may not be collected until the oligomer(s) of choice begins eluting from the column. An example of such an extract is known in the art and is described in Example 5 of the International Appl. No. PCT/US97/05693, published as WO97/36497, the relevant portions of which are hereby incorporated by reference herein. By using preparative HPLC, for example, normal phase HPLC, the extract may be fractionated, for example, into monomeric and oligomeric fractions containing at least 50% by weight of the monomer or specific oligomer(s). When a particular fraction contains the monomers or any of the lower oligomers (e.g. dimers, trimers or tetramers fraction), the fraction contain about 90 to 95% by weight of the particular oligomeric fraction. The desired fractions may be pooled after separation to obtain a combination of oligomers of choice for example to contain oligomers 3-10 or 5-10. A person of skill in the art can manipulate the chromatographic conditions to achieve the desired procyanidin profile in view of the guidance in this specification, general knowledge in the art and, for example, the teachings of U.S. Pat. No. 5,554,645 to Romanczyk et al. and the International Appl. No. PCT/US97/05693, published as WO97/36497.

The monomeric fraction typically contains a mixture of monomers epicatechin and catechin; and the oligomeric fraction typically contains a mixture of dimers (in a dimer fraction), trimers (in a trimer fraction), tetramers (in a tetramer fraction), etc. Mixtures of monomers and oligomers occur in isolated fractions because cocoa contains more than one type of each of monomer, dimer, etc. The oligomeric variability occurs as a result of two monomers, epicatechin and catechin, that are building blocks of procyanidins, as well as the chemical bond connecting monomers in the oligomer. Thus, cocoa dimers are primarily B2 and B5, each of which contains two monomers of epicatechin. Individual monomers and oligomers may be obtained using reversed-phase HPLC, e.g. using a C18 column.

Cocoa polyphenol may be used in the compositions of the invention as a cocoa extract, e.g. solvent-derived extract, cocoa fraction, isolated compounds or in the form of a cocoa ingredient or a chocolate containing an effective amount of cocoa flavanols and/or procyanidins. The cocoa ingredients may be prepared using traditional cocoa processing procedures but is preferably prepared using the method described in U.S. Pat. No. 6,015,913 to Kealey et al. Alternatively, to enhance the level of cocoa polyphenols, chocolate liquor and cocoa solids prepared from cocoa beans having a fermentation factor of about 275 or less may be used. These ingredients have cocoa polyphenol content that is higher than can be obtained using traditional cocoa processing methods (e.g. with roasting) and fully fermented beans. The chocolate may be prepared using conventional techniques from the ingredients described above or using an improved process for preserving cocoa polyphenols during chocolate manufacturing as described in the International Appl. No. PCT/US99/05414 published as WO99/45788, the relevant portions of which are hereby incorporated herein by reference. A chocolate prepared by at least one of the following non-traditional processes is referred to herein as a "chocolate having a conserved amount of cocoa polyphenols": (i) preparing cocoa ingredients from underfermented or unfermented cocoa beans; (ii) preserving cocoa polyphenol during cocoa ingredient manufacturing process; and (iii) preserving cocoa polyphenol during chocolate manufacturing process.

In some embodiments, the compositions contain at least one oligomer, such as for example a dimer. Such compositions may additionally contain at least one monomer or a combination of monomers, e.g. catechin and epicatechin. In another embodiment, compositions containing a combination of monomers, catechin and epicatechin, e.g. in a form of a monomer fraction isolated from cocoa, are also prepared and used.

Synthetic procyanidins may also be used and are prepared by methods known in the art and as described for example in the International Appl. No. PCT/US98/21392 published as WO99/19319, the relevant portions of which are hereby incorporated herein by reference. Cocoa polyphenol derivatives may also be useful. These include gallated monomers and oligomers, glycosylated monomers and oligomers, and mixtures thereof; metabolites of the procyanidin monomers and oligomers, such as the sulphated, glucoronidated, and methylated forms; and enzyme cleavage products of procyanidins generated by colonic microflora metabolism or internal mammalian metabolism. The derivatives may be from natural sources or prepared synthetically.

The composition may optionally comprise a cholesterol lowering agent. Any cholesterol lowering agent irrespective of its mode of action may be used. Suitable agents may act by reducing cholesterol absorption in the bile of a mammal or by reducing cholesterol synthesis. Examples of suitable agents are phytosterols, phytostanols and their derivatives and isomers; soy protein; soluble fibers, e.g. beta-glucan from, for example, oat and psyllium, nuts, rice bran oil, each of which is particularly suitable for use in food, dietary supplements and food additive compositions. Known cholesterol reducing drugs may also be used but are less preferred for use in the food and food additive compositions, but may be used in a pharmaceutical. It will be obvious to a person of skill in the art that the choice of the cholesterol lowering agent depends on the intended delivery vehicle (e.g. food, supplement, pharmaceutical) and the mode of administration. Thus, an agent that reduces absorption of cholesterol in the bile will not be preferred for intravenous administration. Similarly, if the delivery vehicle is food, a cholesterol lowering agent having a strong medicinal taste or smell may not be desirable.

Phytosterols are plant sterols that do not dissolve in water and have the molecular weight and the structure similar to cholesterol. Phytosterol reduce cholesterol absorption in the bile (of both endogenic and dietary cholesterol) as well as serum cholesterol levels (total and LDL) without being absorbed themselves. Over forty plant sterols have been identified but beta-sitosterol, campesterol and stigmasterol are most abundant. Other examples of useful sterols are brassicasterol, desmosterol, chalinosterol, poriferasterol, an clionasterol. Individual sterols or a mixture of sterols, isolated from natural sources or synthetic, and isomers and derivatives thereof may be used. Particularly useful are saturated derivatives of sterols, known as stanols, in which all carbon-carbon bonds in the rings are saturated. Suitable stanols have 28 or 29 carbon atoms and include beta-sitostanol, clionastanol, 22,23-dyhydrobrassicastanol and campestenol. Phytosterols may be solid (e.g. powder, granules) or liquid (e.g. oil) form.

The sterols and stanols are found in several plant materials as described for example in the International Appl. No. PCT/EP96/02344. Exemplary sources of sterols/stanols are pine bark, soy oil, tall oil, bamboo shoot extract (described in the International Appl. No. PCT/US98/12556, published as WO98/57545), cocoa hulls and oil, and rice bran oil. Tall oil, a byproduct of the pulp and paper industry, is a good source of stanol, i.e., beta-stanol.

Plant sterol may be obtained from natural sources such as vegetative oils, vegetative oil sludge, vegetative oil distillates, and other plant oil sources such as tall oil by relatively simple and inexpensive means. For example, a preparation of sterols from vegetable oil sludge by using solvents such as methanol is described in U.S. Pat. No. 4,420,427 to Hamunen. Stanols are found in small amounts in nature but may be easily prepared from sterols by hydrogenating sterols by any of the several methods known to those of skill in the art. When a sterol starting material is prepared from a plant material it will contain a mixture of several different sterols thus, after hydrogenation, the resulting stanol will also be a mixture of different stanols. The mixtures are suitable for use in the present invention. However, pure specific sterol preparations may be hydrogenated as well to produce pure stanols that can also be utilized.

Cocoa oil extracted from cocoa hulls is a good source of phytosterol. Cocoa phytosterols are a mixture of free and bound sterols, with the free sterols being up to about 90% of the phytosterols present. The phytosterols include campesterol, .beta.-sitosterol, stigmasterol, cycloartenoyl, 24-methylene cycloartenoyl, as well as minor amounts of other phytosterols. The bound phytosterols include the fatty acid esters or ferulate derivatives of the phytosterols. The cocoa oil also contains tocols, which include tocopherols (which have antioxidant properties) and tocotrienols (which may have cholesterol lowering activity. The cocoa oil is prepared by the process comprising the steps of: (i) grinding the cocoa hulls; (ii) extracting the ground cocoa hulls with a solvent for the phytosterols; (iii) removing the solvent; and (iv) recovering the cocoa oil. The cocoa hulls, a byproduct of the cocoa bean roasting, can be from dried fermented cocoa beans, micronized cocoa beans, roasted cocoa beans, and preferably from dried unfermented beans, which contain the highest total sterol content. The preferred cocoa beans are from Theobroma cacao. The preferred solvents are petroleum ether, hexane, pentane, and ethyl ether. The solvent may be recovered by vacuum distillation. In one embodiment, freeze dried hulls are ground to a fine powder with a Tekmar Mill (Cincinnati, Ohio) and the ground mass is subjected to an overnight extraction with redistilled petroleum ether (b. p. 38-39.6.degree. C.) in a Soxtec apparatus (Fisher Scientific, Springfield, N.J.). The following morning, the solvent is carefully removed by slow evaporation under a stream of nitrogen, and the resultant extract is stored at -40.degree. C. The phytosterols may then be purified by preparative HPLC or column chromatography.

Esterified forms of both sterols and stanols may also be used. Esterification renders the sterols/stanols more soluble in fats and oils, which may, in some instances, help their incorporation into food products or other delivery vehicles. For example, sterols may be esterified with fatty acid esters. Examples of such esterified sterols include sitosterol acetate, sitosterol oleate and stigmasterol oleate. Stanol esters may be prepared as is known in the art and for example as described in U.S. Pat. No. 6,031,118 to van Amerongen et al., U.S. Pat. No. 5,892,068 to Higgins, U.S. Pat. No. 5,502,045 to Miettenen et al, and the International Appl. No. PCT/CA99/00655 (published as WO00/04887). In one embodiment, useful stanol esters are prepared by esterifying at least one sterol with a C.sub.2 to C.sub.22 fatty acid ester as described in U.S. Pat. No. 5,958,913 to Miettenen et al. Other methods known in the art may be used to increase the solubility of sterols/stanols upon administration to a mammal. One such method is described in U.S. Pat. No. 5,932,562 to Ostlund, wherein the sterol/stanol is mixed with lecithin to obtain a water soluble powder.

Sterols/stanols may be added to the composition in powder form by mixing with other ingredients. In case of a food composition, stanol/sterols as well as other cholesterol lowering agents are conveniently added at the step of mixing. During the preparation of cholesterol lowering chocolate, for example, sterols/stanols may be added to the dry mix containing sugar, the melting butter; the nibs before milling; or the melted chocolate, which may be less preferred. To facilitate mixing, sterols/stanols may be first dissolved in a solubilizing agent such as fat, vegetable oil, monoglycerides, diglycerides, triglycerides, tocopherols and mixtures thereof. Effective carriers for making suspensions and emulsions of sterols/stanols are water, alcohol, polyol, other edible compounds, for example chocolate liquor, in which sterols/stanols are at least partially soluble and mixtures thereof.

Soy protein may be added to the composition in any known form, for example, it may be soy protein isolate, soy protein concentrate, textured soy protein or soy flour, flakes and grits. Whole grain or fragment thereof may also be used as described, for example, in Example 5. Various forms of soy protein are well known in the art and are commercially available. Its properties and methods of obtaining are described, for example, in Soy Protein and Human Nutrition, Wilcke et al., eds., Acad. Press, NY, 1979. Soy protein may be used in combination with any sterol and/or stanol based cholesterol lowering agent.

Soluble plant fibers, e.g. beta-glucan, are capable of reducing plasma cholesterol. The fibers for use in the present invention may be obtained from any source of beta-glucan, preferably oat grain and oat bran. The fibers may be prepared and added to compositions according to methods known in the art. They are particularly suitable for orally delivered compositions such as foods and dietary supplements. Beta-glucan and other soluble plant fibers may be used in combination with any sterol and/or stanol based cholesterol lowering agent.

The composition of the invention may also contain L-arginine, which may be provided in the composition of the invention in various forms, for example as a purified compound, an extract from an L-arginine containing plant, or in the form of a seed/nut ingredient, e.g. nut flour, or as an entire seed/nut. Any L-arginine source may be used, synthetic or natural. Preferred L-arginine sources are soy beans and nut meats such as peanuts, walnuts, almonds, and hazelnuts. Defatted and partially defatted nut meats may be used. These may be ground and are referred to as nut flour.

The composition may also contain calcium, potassium, magnesium, antioxidant such as vitamin E and vitamin C, any of the vitamins of the B complex, a carotenoid, guar gum, or a mono or polyunsaturated fatty acid (e.g. omega-3 fatty acid), which can be obtained according to the methods known in the art. The mono or polyunsaturated fatty acids may be used in the form of an olive oil, fish oil or a nut. Examples of nuts suitable for this use are: peanuts, almonds and walnuts.

The composition of the invention is useful as a food, a food additive, a dietary supplement, or a pharmaceutical. The compositions may contain a carrier, a diluent, or an excipient. Depending on the intended use, the carrier, diluent, or excipient may be chosen to be suitable for human or veterinary use, food, additive, supplement or pharmaceutical use.

As used herein a "food" is a material consisting essentially of protein, carbohydrate and/or fat, which is used in the body of an organism to sustain growth, repair and vital processes and to furnish energy. Foods may also contain supplementary substances such as minerals, vitamins and condiments. See Merriam-Webster's Collegiate Dictionary, 10th Edition, 1993. The term food includes a beverage adapted for human or animal consumption. As used herein a "food additive" is as defined by the FDA in 21 C.F.R. 170.3(e)(1) and includes direct and indirect additives. As used herein, a "pharmaceutical" is a medicinal drug. See Merriam-Webster's Collegiate Dictionary, 10th Edition, 1993. A pharmaceutical may also be referred to as a medicament. As used herein, a "dietary supplement" is a product (other than tobacco) that is intended to supplement the diet that bears or contains the one or more of the following dietary ingredients: a vitamin, a mineral, an herb or other botanical, an amino acid, a dietary substance for use by man to supplement the diet by increasing the total daily intake, or a concentrate, metabolite, constituent, extract or combination of these ingredients.

Any conventional food including any beverage which has been improved by the presence of a cocoa polyphenol or a derivative thereof, e.g. methylated compounds or metabolic breakdown products, and optionally in combination with a cholesterol lowering agent, L-arginine, calcium, potassium, magnesium, an oxidant such as vitamin E and vitamin C, any of the vitamins of the B complex, a carotenoid, guar gum, and/or a mono or polyunsaturated fatty acid (e.g. omega-3), is within the scope of the invention.

The improvement is achieved either (i) by adding cocoa polyphenol or a derivative thereof to a food that does not contain cocoa polyphenol or (ii) when the food traditionally may contain cocoa polyphenols, such as for example chocolate, by enhancing the polyphenol level over the one found in the traditionally prepared food. The enhancement may be achieved by adding additional cocoa polyphenols, for example, in a form of an extract, fraction or isolated and purified compound there from; by adding cocoa polyphenol in combination with another polyphenol containing ingredient (e.g. nut skins); by manipulating the cocoa ingredients processing and cocoa bean selection, as described above, to preserve cocoa polyphenol in the cocoa ingredient used for the manufacture of the food product; or by manipulating the chocolate manufacturing process as described above. Thus, these foods (including beverages) contain an "elevated level of polyphenols" (including cocoa procyanidins) in comparison to comparative conventional foods (including beverages). An example of a chocolate having an elevated level of polyphenol occurs when a chocolate manufacturer adds a cocoa extract containing cocoa polyphenols to its previously commercially available product. The foods may also be referred to as "high cocoa polyphenol foods," i.e., they contain higher levels of polyphenol than their traditional counterparts.

The foods comprising cocoa polyphenols and optionally at least one cholesterol lowering agent (e.g. a sterol and/or stanol based cholesterol lowering agent), L-arginine, calcium, potassium, magnesium, an antioxidant such as vitamin E and vitamin C, any of the vitamins of the B complex, a carotenoid, guar gum, or a mono or polyunsaturated fatty acid (e.g. omega-3) may be adapted for human or veterinary use, and include pet foods. The food may be other than a confectionery, however, the preferred cholesterol lowering food is a confectionery such as a standard of identity (SOI) and non-SOI chocolate, such as milk, sweet and semi-sweet chocolate including dark chocolate, low fat chocolate and a candy which may be a chocolate covered candy. Other examples include a baked product (e.g. brownie, baked snack, cookie, biscuit) a condiment, a granola bar, a toffee chew, a meal replacement bar, a spread, a syrup, a powder beverage mix, a cocoa or a chocolate flavored beverage, a pudding, a rice cake, a rice mix, a savory sauce and the like. If desired, the foods may be chocolate or cocoa flavored. Food products that contain L-arginine, in addition to the cocoa polyphenol and the cholesterol lowering agent, are preferably chocolates and candy bars, such as granola bars, containing nuts, for example, peanuts, walnuts, almonds, and hazelnuts. It should be noted that the addition of nuts with skins to the food described herein may also increase the total polyphenol content since, for example, peanut skins contain about 17% flavanols and procyanidins and almond skins contain about 30% flavanols and procyanidins. In one embodiment, the nut skins are added to the nougat of a chocolate candy containing a cholesterol lowering agent.

In certain embodiments, the non-chocolate food product contains from about at least 5 micrograms/g to about 10 mg/g, and, for example, at least 5 micrograms/g food product, preferably at least 10 microgram/g, more preferably at least 100 micrograms/g of cocoa flavanols and/or procyanidin oligomers. If desired, the non-chocolate food products can contain much higher levels of cocoa procyanidins than those found in the chocolate food products described below.

In one embodiment, a chocolate confectionery contains an effective amount of cocoa flavanol and/or procyanidin to treat, prevent, reduce the risk of, or reduce the occurrences of heart arrhythmia, or generally any condition associated with abnormalities in gap junctional communication, such as for example, a neuro-degenerative disease. The chocolate confectionery may be milk or dark chocolate. In certain embodiments, the chocolate comprises at least 3,600 micrograms, preferably at least 4,000 micrograms, preferably at least 4,500 micrograms, more preferably at least 5,000 micrograms, and most preferably at least 5,500 micrograms cocoa flavanols and/or procyanidins each per gram of chocolate, based on the total amount of nonfat cocoa solids in the product. In other embodiments, the chocolate contains at least 6,000 micrograms, preferably at least 6,500 micrograms, more preferably at least 7,000 micrograms, and most preferably at least 8,000 micrograms of cocoa procyanidins per gram, and even more preferably 10,000 micrograms/g based on the nonfat cocoa solids in the product.

A milk chocolate confectionery may have at least 1,000 micrograms, preferably at least 1,250 micrograms, more preferably at least 1,500 micrograms, and most preferably at least 2,000 micrograms cocoa flavanols and/or procyanidins each per gram of milk chocolate, based on the total amount of nonfat cocoa solids in the milk chocolate product. In the preferred embodiment, the milk chocolate contains at least 2,500 micrograms, preferably at least 3,000 micrograms, more preferably at least 4,000 micrograms, and most preferably at least 5,000 micrograms cocoa flavanols and/or procyanidins each per gram of milk chocolate, based on the total amount of nonfat cocoa solids in the milk chocolate product.

The amount of L-arginine in the food products can vary. Typically, cocoa contains between 1 to 1.1 grams of L-arginine per 100 grams of partially defatted cocoa solids. It can range from 0.8 to 1.5 per 100 grams of cocoa. The chocolate food products of this invention contain L-arginine in an amount greater than that which naturally occurs in the cocoa ingredients. Knowing the amount of cocoa ingredients and L-arginine used in the food product, one of ordinary skill in the art can readily determine the total amount of L-arginine in the final product. The food product will generally contain at least 5 micrograms/g, preferably at least 30 micrograms/g, or at least 60 micrograms/g, even more preferably at least 200 micrograms/g food product.

When the cholesterol lowering agent is used in the food, its amount will depend on the type of the agent used and can be determined by a person of skill in the art based on the guidance in the specification, particularly daily dosages provided below, and the knowledge in the art. A food composition, for example, may contain from about 0.5 to about 10 g per 45 g serving size, preferably about 1.5 to about 5 g per 45 g serving size, most preferably about 2 to about 4.5 g per 45 g serving size of sterols/stanols. With respect to soy protein and soluble fiber from oats, FDA has provided minimum amounts per food serving to be able to make a health claim. According to the FDA, a food serving containing beta-glucan must contain at least 0.75 g, and the food serving containing soy protein must contain at least 6.25 g soy protein. These values may also be used as a guide for determining the amount of these cholesterol lowering agents in the food.

A daily effective amount of cocoa flavanols and/or procyanidins may be provided in a single serving. Thus, a confectionery (e.g. chocolate) may contain at least about 100 mg/serving (e.g. 150-200, 200-400 mg/serving) cocoa procyanidins. When the cholesterol lowering agent is included in the composition, at least 1.5 (e.g. 1.5-4.5 g) per serving sterol/stanol may be added.

Pharmaceuticals containing cocoa flavanols and/or procyanidins, optionally in combination with a cholesterol lowering agent and/or L-arginine, may be administered in a variety of ways such as orally, sublingually, bucally, nasally, rectally, intravenously, parenterally and topically. A person of skill in the art will be able to determine a suitable cholesterol lowering agent depending on the mode of administration. Thus, dosage forms adapted for each type of administration are within the scope of the invention and include solid, liquid and semi-solid dosage forms, such as tablets, capsules, gelatin capsules (gelcaps), bulk or unit dose powders or granules, emulsions, suspensions, pastes, creams, gels, foams or jellies. Sustained-release dosage forms are also within the scope of the invention and may be prepared as described in U.S. Pat. Nos. 5,024,843; 5,091,190; 5,082,668; 4,612,008 and 4,327,725, relevant portions of which are hereby incorporated herein by reference. Suitable pharmaceutically acceptable carriers, diluents, or excipients are generally known in the art and can be determined readily by a person skilled in the art. The tablet, for example, may comprise an effective amount of the cocoa polyphenol-containing composition and optionally a carrier, such as sorbitol, lactose, cellulose, or dicalcium phosphate.

The dietary supplement containing cocoa flavanol and/or procyanidin, and optionally at least one cholesterol lowering agent and/or L-arginine, may be prepared using methods known in the art and may comprise, for example, nutrient such as dicalcium phosphate, magnesium stearate, calcium nitrate, vitamins, and minerals.

Further within the scope of the invention is a package comprising the composition of the invention (e.g. a food, a dietary supplement, a pharmaceutical) and a label indicating the presence of, or an enhanced content of cocoa flavanol and/or procyanidin and/or a derivative thereof, or directing use of the composition to treat, prevent, reduce the occurrences of, or reduce the risk of heart arrhythmia or any condition associated with the abnormality in the cellular gap junction communication, such as a neuro-degenerative disease. Optionally, the label may indicate the cholesterol lowering agent and/or L-arginine content, the beneficial properties of the combined polyphenol(s), cholesterol lowering agent(s) and optionally L-arginine. The package may contain the composition and the instructions for use to treat, prevent, reduce the risk of, slow progression or reduce the occurrences of heart arrhythmia or any condition associated with the abnormality/defect in the cellular gap junction communication, such as a neuro-degenerative disease or cancer.

As used herein, "treatment" means improving an existing medical condition, for example, heart arrhythmia, or the symptoms associated therewith. The term "preventing" means reducing the risks associated with developing a disease, including reducing the onset of the disease. The prevention or prophylaxis may be used in an individual known to be at high risk of developing a disease or in a population at large for maintaining good health, for example, reducing the risk of arrhythmia. The methods may be used in a human or a veterinary animal, such as a dog, a cat, and a horse.

The methods comprise administering to a mammal, preferably a human or a veterinary animal, for an effective period of time (for example, to induce de novo connexin synthesis), an amount of the composition comprising a flavanol and/or its related oligomer, such as a cocoa flavanol and/or its related oligomer, optionally in combination with a cholesterol lowering agent, L-arginine, an antioxidant (e.g. vitamin E, vitamin C), the flavanol and/or its related oligomer being in the amount effective to treat, prevent or reduce the occurrences of heart arrhythmia or any condition associated with the gap junctional abnormalities/defects, e.g. neuro-degenerative diseases (such as Parkinson's and Alzheimer's). Moreover, treatment of cognitive dysfunctions which are connexin, for example, connexin 40 and/or 43, related is also within the scope of the invention. Thus, connexin related functions may be treated or improved. Examples of cognitive dysfunctions that may be treated according to the invention are short term memory and depression. Other polyphenols such as those isolated from peanut skins may also be used.

Thus, the following use is within the scope of the invention. Use of a cocoa flavanol and/or its oligomer in the manufacture of a medicament, food, nutraceutical or dietary supplement for use in treating, preventing, reducing the risk of, or reducing the progression of a disease involving defective gap junctional communication in a human or a veterinary animal.

The following uses are representative of some embodiments. Use of a cocoa flavanol and/or its oligomer in the manufacture of a medicament, food, nutraceutical or dietary supplement for use in treating, preventing, reducing the risk of, or reducing the occurrence of heart arrhythmias in a human or a veterinary animal. Use of a cocoa flavanol and/or its oligomer in the manufacture of a medicament, food, nutraceutical or dietary supplement for use in treating, preventing, reducing the risk of, or reducing the progression of a cognitive dysfunction in a human or a veterinary animal.

A polymeric compound of the formula A.sub.n, or a pharmaceutically acceptable salt thereof, may be used in the compositions and uses of the present invention -- see Original Patent.

The effective amount may be determined by a person of skill in the art using the guidance provided herein. For example, the effective amount may be such as to achieve a physiologically relevant concentration in the body of a mammal. Such a physiologically relevant concentration may be at least 20 nanomolar (nM), preferably at least about 100 nM, and more preferably at least about 500 nM. In one embodiment, at least about one micromole in the blood of the mammal is achieved.

The methods may further comprise determining the effectiveness of the treatment by, for example, determining the heart beat, such as using electrocardiogram (ECG), ambulatory monitors, holter monitors, transtelephonic monitors (optionally with memory loop), stress test, echocardiogram, cardiac catheterization, electophysiology study and head upright tilt test.

The composition may be administered to a healthy mammal for prophylactic purposes or to a mammal in need of a treatment or having at least one of the risk factors associated with heart arrhythmia. Any individual having at least one of the risk factors associated with heart arrhythmia is a subject for administration of the compositions described herein. The individuals with a familial history of heart arrhythmia, hypertension, coronary artery disease, heart attack, abnormal thyroid function as well as those smoking, and having alcohol, caffeine, or illegal substance intake (e.g. cocaine), or those recovering from heart surgery, are susceptible individuals in need of the treatment described herein. Other populations of mammals that are susceptible to developing vascular health problems will be apparent to a person of skill in the art.

Veterinary animal, for example dogs, cats and horses, may be administered the above described compositions to treat, prevent or reduce the occurrences of heart arrhythmia.

The effective amount to treat, prevent, reduce the risk of and/or reduce the occurrences of heart arrhythmia may be determined by a person skilled in the art using the guidance provided herein and the general knowledge in the art. Cocoa flavanols and/or related oligomers may be administered at from about 50 mg/day to about 1000 mg/day, preferably from about 100-150 mg/day to about 900 mg/day, and most preferably from about 300 mg/day to about 500 mg/day. However, given that cocoa polyphenols are non-toxic, amounts higher than stated above may be used.

To additionally obtain a cholesterol lowering effect, using sterols/stanols, more than what is normally found in the average diet of a non-vegetarian should be administered. A person on a typical North American diet consumes about 200-400 mg/day. Thus, when phytosterol, such as sitosterol, is used to reduce cholesterol levels, about at least 1 g/day, preferably at least about 3 g/day should be administered. Preferably, from at least about 1 g/day, preferably at least about 4.5 g/d, to about 20 g/day is used. However, the amount will vary depending on the cholesterol lowering potency of the phytosterol so that, for example, if a more potent sitostanol is used, the effective amount may be as low as about one to about three g/day. The amounts may be determined using the analytical procedure described in Roger et al., J. Amer. Oil Chem. Soc. 70(30) 1993 and Carpenter, et al., J. Amer. Oil Chem. Soc. 71(8) 1994. Soy protein may be administered, for example, at least about 25 g/day. Further guidance can be found in Recommended Daily Allowances, 9.sup.th ed., National Res. Council/National Acad. Sci., Washington, D.C. Soluble fiber may be administered, for example, in the amount of at least 3 g/day.

L-arginine, when used in the compositions and the treatment, may be administered from about 2 g/day to about 50 g/day, preferably from about 3 g/day to about 10 g/day, and most preferably from about 6 g/day to about 8 g/day. Here as well, given that L-arginine naturally occurs in foods, amounts higher than stated above may be used. Polyphenols generally may be administered in the amounts known in the art. The enhanced absorption in the presence of sterols/stanols may also be taken into consideration when determining the effective amount.

The treatments/preventive administration may be continued as a regimen, i.e., for an effective period of time, e.g., daily, monthly, bimonthly, biannually, annually, or in some other regimen, as determined by the skilled medical practitioner for such time as is necessary. The administration may be continued for at least a period of time required to induce connexin synthesis. Preferably, the composition is administered daily, most preferably two or three times a day, for example, morning and evening to maintain the levels of the effective compounds in the body of the mammal. To obtain the most beneficial results, the composition may be administered for at least about 30 to about 60 days. These regiments may be repeated periodically.
 

Claim 1 of 33 Claims

1. A method of treating a subject suffering from cognitive dysfunction comprising administrating to the subject a composition comprising an effective amount of a cocoa extract, chocolate liquor, cocoa cake, cocoa powder, and/or cocoa nib, each comprising at least the following cocoa polyphenol compounds: (a) a flavanol having the formula -- see Original Patent, and (b) a dimer composed of two units of the above flavanol connected via interflavan linkages 4.fwdarw.6 and/or 4.fwdarw.8; wherein the subject is a human or a veterinary animal, and wherein the composition comprises at least 100 mg of the cocoa polyphenol compounds per unit of the composition.

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