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Title:
Penetrating carrier, anti-fungal composition using the same and method for
treatment of dermatophytes
United States Patent: 7,601,371
Issued: October 13, 2009
Inventors: Selner; Marc
(Studio City, CA)
Appl. No.: 11/684,869
Filed: March 12, 2007
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Abstract
A liquid carrier for topical
administration is provided that contains a mineral oil, turpentine and,
optionally, camphor, and optionally other terpenoid components containing
pinene, and its use to provide an antifungal composition containing a
mixture of antifungal essential oils and the carrier system, wherein the
mixture of antifungal essential oils includes an effective amount of each
of Eucalyptus globulus, peppermint, cedarwood, and Manuka; along with the
use of this composition in the topical treatment of fungal infection,
particularly of the nail.
Description of the
Invention
BACKGROUND OF THE INVENTION
1. Field of Invention
The present invention relates to a carrier for a topical medicament having
improved ability to penetrate thick keratinous tissues, a topical
anti-fungal composition useful for the treatment of dermatophytes
infection in the nail bed and nail plate and a method for treating fungal
nail infections using the composition.
2. Discussion of the Background
Dermatophytes are filamentous fungi that are commonly found in plants and
soil. Nail invasion by these organisms cause disease, with thickening,
discoloration, odor, decay, lysis (loosening of the nail plate from the
base of the nail bed), and deformity such as increased curvature of the
nail plate. In addition to dermatophytes, candida albecans (a yeast) is
also a common pathogen. A small number of diseases are also caused by
molds, considered non-dermatophytes. The medical name for fungal nail
disease is onychomycosis. Fungi live in the nail bed under the toenail and
also involve the nail itself. The fungus is a parasite, and lives on the
keratin, by dissolving the keratin with enzymes known as keratinases. The
most common organisms are Trichophytan Rubrum (which causes between 80-90%
of infections), Trichophytan Mentagrophytes, Epidermophytan Floccosum and
Candida Albecans.
Many times the fungi will cause the nail to produce excess keratin, a
condition known as hyperkeratosis, causing the nail to be thicker and
often deformed. Additionally, the thicker toenail can cause pain, leading
to ingrown nails, and even difficulty in wearing shoes due to the
thickness. The typical treatment for this condition involves having a
podiatrist debride or manually thin the nail, often at great cost to the
patient, insurance, and Medicare.
Nails are made of layers of Keratin a protein, which has lipid bilayers,
phospholipid cell membranes and connections between the cells called
desmosomes. The cells of the toenails are dead, so penetration relies on
diffusion of non polar lipids (non charged) across these structures. The
more fat soluble, the better the penetration. To effectively treat
onychomycosis, it is necessary to get the antifungal medicine through the
nail plate and keratin, which may be very thick, and penetrate to the site
where the organism lives.
One U.S. study suggested a prevalence of Onychomycosis of 18.5% with the
number of persons affected on the rise, which may be partly accounted for
by the aging U.S. population. Onychomycosis affects 32% of the people
between 60-70 years of age, and some studies suggest it may affect 48% of
the population by age 70. Onychomycosis has a stronger prevalence in
immunosuppressed people, such as those with diabetes, poor circulation, or
HIV infection. Toenail infections are several times more common than
fingernail infections. Several oral medicines are effective in treating
these conditions, such as Lamisil and Sporonox. However, these medicines
are prescription medications, costing the patient as much as $1000 to
treat an infection, and requiring extraneous lab tests, because they can
cause damage to the liver and kidneys as well as other side effects.
Topical treatments have historically been somewhat ineffective. One such
topical treatment is Penlac, which is at the top of the list, but requires
a prescription, monthly treatments by the doctor to debride or remove the
dead nail tissue and is expensive (with a small bottle of 6 cc costing
typically over $150). Additionally it is only indicated for disease of the
nail distal to the lunula-white half moon. According to the Physician's
Desk Reference (PDR), two studies using Penlac indicate cure rates of 5.5%
and 8.5%, and an almost cure rate of 6.5% and 12%. Further, the PDR states
that Penlac is not effective against the most common fungus to infect
nails, Trichophytan Rubrum. There other OTC medicines but proof of their
efficacy is difficult to determine.
SUMMARY OF THE INVENTION
Accordingly, one object of the present invention is to provide a carrier
for topical medicaments that can penetrate and transport a broad spectrum
of antifungal compounds through keratinous tissues, such as nail bed and
nail plate.
A further object of the present invention is to provide a topical
composition for treatment of fungal infections using this carrier.
A further object of the present invention is to provide a topical
anti-fungal composition effective at treating onychomycosis.
A further object of the present invention is to provide a topical
anti-fungal composition that contains only GRAS ingredients, and requires
no debridement during treatment.
A further object of the present invention is to provide a method for the
topical treatment of nail infections using such anti-fungal compositions.
These and other objects of the present invention have been satisfied by
the discovery of a liquid carrier system comprising a mineral oil and
turpentine, and optionally, camphor and/or one or more additional
terpenoid components containing pinene, and its use to prepare an
anti-fungal composition, comprising:
an effective anti-fungal amount of a mixture of antifungal essential oils
and the carrier system,
wherein the mixture of antifungal essential oils comprises effective
amounts of each of eucalyptus globulus, peppermint, cedarwood, and manuka.
DETAILED DESCRIPTION OF THE INVENTION
The present invention relates to a liquid carrier system comprising a
mineral oil, turpentine, and optionally, camphor and/or one or more
additional terpenoid components containing pinene. When combined with one
or more active ingredients, this carrier system provides penetration of
keratinous tissue and transport and delivery of the active ingredient to
the site in need thereof.
The present invention further relates to an anti-fungal composition,
comprising:
an effective anti-fungal amount of a mixture of antifungal essential oils
and a carrier system,
wherein the mixture of antifungal essential oils comprises effective
amounts of each of eucalyptus globulus, peppermint, cedarwood, and Manuka;
and
wherein the carrier system is as described above.
The antifungal composition of the present invention is preferably in the
form of a liquid, containing slow-to-evaporate whole antifungal oils in a
proven carrier. The carrier system is one important aspect of the present
invention, as it provides the ability to take the fat soluble substances
and penetrate the thick keratin layer of the nail in an effective manner.
The combination of antifungal essential oils has been found to be
effective on most or all of the different types of fungal infections of
the nail (particularly the toenail) in a broad spectrum. Further, the
combination preferably helps overcome the resistance of the different
fungi as they mutate and change in an attempt to avoid being destroyed.
The composition is preferably in a liquid form, since liquids have the
best penetration. Further, the composition is most preferably in a liquid
carrier that is a non evaporative substance, particularly preferably the
carrier system of the present invention. With evaporation, the carrier
tends to disappear before it can penetrate the thick nail plate.
In a most preferred embodiment, the carrier of the present invention, when
put on a non absorbtive material, does not significantly evaporate over a
period of days, and most preferably has essentially a negligible vapor
pressure under normal atmospheric conditions, thus exhibiting no
observable evaporation to any significant extent.
The conventional approach to treatment of nail fungus is to debride the
nail manually to remove as much of the keratin caused by the thickening of
the fungus, in order that penetrations of antifungal medicines can result.
Additionally application of antikeratolytics, such as salicylic acid or
urea, are also used to remove keratin debris. The reason for this is that
keratin is layered as a protective shield against penetration of
substances. It is found in the skin as well. Some conventional products
use various substances to enhance penetration with limited success such as
alcohol, polyethylene glycol, triglycerides, fatty acids, liposomes,
nanospheres, or lecithin. These all have limited ability to penetrate the
skin and are essentially of no use on a thick layer of keratin in
toenails. Because the cell membranes are made of phospholipids, fat
soluble substances can pass between cells called desmosome connections,
through cell membranes and through keratin. U.S. Pat. No. 6,344,190
discloses a composition for treatment of dermatophytes that contains
several essential oil components and a carrier system. However, the
disclosed compositions do not teach a carrier system or combination of
specific essential oils such as required in the present invention
composition. Namely, the only carrier systems specifically named in the
'190 patent appear to be an alcohol ester, such as isoamyl alcohol (an
evaporative carrier) or a commercially available product designated VICKS
VAPO-RUB (a thick greasy carrier system containing a mixture of
unidentified ingredients).
The present invention composition and method use a carrier that penetrates
the keratin by being a fat soluble substance, such as hydrocarbons. One
preferred carrier is mineral oil, which is a fat solvent, when combined
with turpentine and, optionally, with camphor (a distillation derivative
obtained from pine or from the cinnamomum camphor tree, a monoterpenoid),
and/or one or more other terpenoid substances. The liquid carrier of the
present invention comprises the combination of a mineral oil and
pine(turpentine). This preferred combination of carrier components helps
to pull the antifungal essential oils of the present invention antifungal
composition through the thick layers of keratin found in the nail. The
present composition does not require debridement of the nails or
keratolytics in order to be effective. The present composition has been
found effective in treating nail fungus just by application directly to
the nail surface on a regular basis. However, while not requiring the
above, the present composition can be used in combination with debridement
or added keratolytics, if desired.
Additionally, the components contained in the present invention
composition are considered GRAS (generally recognized as safe) under U.S.
FDA regulations, and therefore can be sold as an over-the-counter
composition.
To reach the desired area the carrier must be fat soluble (i.e., will
dissolve in fat, remain soluble and forms an essentially homogeneous
solution with fat) and the antifungal agents must also be fat soluble to
penetrate these intercellular fat soluble connections, as well as the
keratin. To be effective, the formula must have the ability to penetrate
the toenail (i.e. move across phospholipid cell membrane, fatty bilayer of
keratin (through keratin), and desmosomes. Most conventional antifungal
compositions are not effective on toenails (absent debridement or
keratolytics) because they are not able to get the antifungal composition
thru the nail plate and skin under the nail called the nail bed.
The present composition has been found to be effective on substantially
all types of nail fungus disorders, whether of distal type, lateral type,
superficial type, or proximal type involving the whole nail. Studies using
sequential photography have shown its effectiveness as 40% cure rate and
25% almost cure rate/improvement. Importantly, the present composition
does not require debribement of the nail to be effective, because the
vehicle for penetration of the nail plate works regardless of the
thickness of the nail. The composition is also broad spectrum, which is
necessary because these organism are polymorphic and can change their
resistance. The combination of multiple effective antifungal essential
oils in the present composition allow for this. While the preferred use
for the present composition is treatment of onychomycotic toenails, the
composition can be used to treat skin fungus infections as well. Upon
treatment of nail fungus with the present composition, it has been noted
that the nails appear to grow faster as treatment progresses. This may be
due to increased nail growth as a result of decreasing the fungal
involvement, or by stimulation of the nail matrix by the present
composition.
The present composition can be in any form suitable for topical
application, particularly to the nail surface. The composition can
preferably take a form including, but not limited to, liquid solutions,
liquid suspensions, liquid dispersions, gels, jellies, cremes, and
ointments. Most preferably for application to the nail, the composition is
in the form of a liquid, either in solution, suspension or dispersion
form. For use on skin, either liquid or gel/jelly forms are preferred. In
use on skin, the composition preferably contains petrolatum as an
additional carrier. The petrolatum may be as is, or may be treated with
ultraviolet light (preferably using a cold UV lamp), which has been
reported to provide additional healing properties through a property
called "radiolatum".
Although not required in the present composition, the composition can
optionally contain one or more keratolytic agents, such as salicylic acid
or urea, as well as other conventional additives and/or auxiliaries used
in topical compositions. Such conventional additives or auxiliaries
include, but are not limited to, fillers, colorants or dyes, skin
conditioners, MSM (methylsulfoxymethane), etc.
Nail fungi are parasites that live and grow in the nail and underlying
skin called nail bed. The fungus lives off the keratin of the nail and
causes the nail to produce more keratin. The fungus produces spores and
tentacles called hyphae that grow out. The fungus also produces
keratinases to eat away at the keratin as well. The keratin is a protein,
and like the outside layer of the skin, tends to prevent things from
penetrating. When the fungus does invade the toenail, it eats away and
rots it, much like a rotting piece of wood. While plants and trees have
natural antibiotic oils in their leaves and bark, to keep away these
invaders, human tissue does not have the same advantage. Based on this
principal, the present composition uses a mixture of antifungal essential
oils. However, the oils alone still have a difficult time penetrating the
thick keratin nail plate. Prior to the present invention, so far as is
known by the present inventor, no one has found a way to do this
effectively as a topical agent. With the present invention composition,
the antifungal essential oils are carried or delivered through this tough,
up to now impenetrable, barrier. The present composition provides a
mixture of antifungal essential oils that is a broad spectrum antifungal
combination so as to cover all the mutant resistances that develop,
prevents keep the fungus from growing, and is not harmful to the nail or
nail matrix.
The present invention carrier or delivery system comprises a mineral oil
(lipid solvent), and turpentine, and optionally camphor and/or one or more
additional terpenoids containing pinene. (In addition, several of the
anti-fungal essential oils can act both in an antifungal role as well as a
carrier role, such as camphor (which can be distilled from pine).,
The antifungal essential oils are preferably plant extracts and are fat
soluble. The composition comprises a mixture of antifungal essential oils
comprising camphor, eucalyptus globulus, peppermint, cedarwood oil (cedar
atlas from cedrus atlantica), and manuka oil (from lepospermum scoparium).
In addition to these, the mixture of antifungal essential optionally can
further comprise amounts of sage, juniper, clove, lavender, cinnamon bark
and leaf oil, grapeseed, jojoba oil, anise, rosewood, eucalyptus
citroidora, tea tree (from malaleuca altemafolia), and nutmeg.
Importantly, the mixture of antifungal essential oils is preferably
substantially free of the presence of thymol. Within the context of the
present invention, the term "substantially free of thymol" is used to
indicate that the essential oils used do not have detectable amounts of
thymol, as determined by gas chromatographic analysis of the essential oil
itself. In one embodiment of the present invention, the composition
further comprises grapeseed extract and anise, which together increase
effectiveness of the composition against yeasts known as polygyols,
potentially up to a 30-40 fold increase in effectiveness.
The amount of each antifungal essential oil used is preferably in the
range of from 0.1% to 40%, based on total composition amount. More
preferably, the antifungal essential oils are present in an amount of from
0.1% to 10%, most preferably from 1% to 7%, based on total composition
amount. These amounts do not have to be the same for each antifungal
essential oil, and the amount of each individual essential oil present in
the composition is independent of the identity or amount of other
components used. The carrier components are preferably each,
independently, present in amounts of from 0.1-40% by weight, based on
total composition amount. More preferably, the mineral oil is present in
an amount of from 5-30% by weight. The turpentine can also be in similar
amounts as mineral oil, with camphor (when present) being present
preferably in smaller amounts, comparable to the amount of individual
antifungal essential oils. Camphor can act both as part of the carrier
system and as one of the antifungal essential oils of the antifungal
composition of the present invention. The carrier system itself can be
used for delivery of any desired fat soluble active agent(s), particularly
for treatment of disorders related to keratinous tissues.
The method for using the present composition comprises application of the
composition directly to the nail surface. Preferably, the applications are
performed from 1 to 4 applications per day, and are continued until the
infection is eliminated, preferably for a period of 3 to 12 months.
Afterward, the composition can be used on a regular basis (approximately
every 2-3 days) to prevent reoccurrence of the infection and encourage
nail health. More preferably, the composition is applied from 1 to 2 times
per day directly to the nail surface, most preferably immediately after
bathing. The application is performed using any type of applicator,
including but not limited to, fingers, brushes, swabs, etc. The
application should preferably be sufficient to form a thin film of the
composition on most or all of the nail surface. While the application can
also include the skin area surrounding the nail, this can cause temporary
skin irritation in some patients.
Claim 1 of 17 Claims
1. A method for the treatment of fungal
infection, comprising: topically applying to an area of skin or nail in
need thereof, an effective amount of a composition comprising: an
effective anti-fungal amount of a mixture of fat-soluble essential oils
and a carrier system, wherein the mixture of fat-soluble essential oils
comprises an amount of from 0.1 to 10% by weight, based on total
composition amount, of each of Eucalyptus globulus oil, peppermint oil,
cedarwood oil, and manuka oil; and wherein the carrier system comprises a
mineral oil and turpentine; wherein each of the mineral oil and turpentine
are present in an amount of from 0.1-40% by weight. ____________________________________________
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