WOUND HEALING COMPOSITIONS INVOLVING MEDICINAL HONEY, MINERAL IONS AND METHYLGLYOXAL, AND METHODS OF USE
20170216369 · 2017-08-03
Inventors
Cpc classification
A61L26/0057
HUMAN NECESSITIES
A61P29/00
HUMAN NECESSITIES
A61P31/00
HUMAN NECESSITIES
A61P17/02
HUMAN NECESSITIES
A61K33/00
HUMAN NECESSITIES
A61K2300/00
HUMAN NECESSITIES
A61K2300/00
HUMAN NECESSITIES
A61K33/06
HUMAN NECESSITIES
A61L2300/102
HUMAN NECESSITIES
A61L15/46
HUMAN NECESSITIES
A61K33/04
HUMAN NECESSITIES
A61L2300/216
HUMAN NECESSITIES
A61K33/04
HUMAN NECESSITIES
A61K33/06
HUMAN NECESSITIES
A61L2300/404
HUMAN NECESSITIES
A61K33/00
HUMAN NECESSITIES
A61L2300/30
HUMAN NECESSITIES
A61K9/0014
HUMAN NECESSITIES
International classification
A61K33/06
HUMAN NECESSITIES
A61L15/40
HUMAN NECESSITIES
A61K33/04
HUMAN NECESSITIES
Abstract
The invention provides compositions based on either medicinal honey containing broad spectrum antibacterial activities of peroxide, polyphenols and methylglyoxal, or an effective amount of an active anti-inflammatory ingredient of mineral solids fortified with methylglyoxal antibacterial activity, or a mixture of both for the treatment of wounds; and methods of treating a wound, comprising contacting a wound with any one of the above compositions or a wound dressing containing any one of the above compositions.
Claims
1. A wound healing composition, comprising: a medicinal honey; and a concentration of methylglyoxal being added to said medicinal honey effective to reduce a number of viable microorganisms at a wound site.
2. The wound healing composition of claim 1, wherein the medicinal honey naturally contains or generates 2-4 mM hydrogen peroxide upon dilution with an aqueous medium.
3. The wound healing composition of claim 1, wherein the medicinal honey naturally contains a polyphenol concentration ranging between 275 and 575 gallic acid equivalents per gram of the medicinal honey.
4. The composition of claim 1, wherein the medicinal honey is buckwheat honey.
5. The composition of claim 1, wherein said concentration of methylglyoxal ranges from 500 to 2000 mg per kg.
6. The wound healing composition of claim 1, wherein the wound healing composition is replaced on a wound at least once.
7. A wound healing composition, comprising: a pharmaceutically acceptable carrier; an effective amount of an active ingredient of mineral solids, said mineral solids including at least one of a magnesium salt, a potassium salt, a calcium salt, a zinc salt, a rubidium salt, a bromide salt, and a sulfate salt; and a concentration of methylglyoxal effective to reduce a number of microorganisms at a wound site being added to said active ingredient.
8. The wound healing composition of claim 7, wherein each of the salts includes a pharmaceutically-acceptable counterion.
9. The wound healing composition of claim 7, wherein the active ingredient of mineral solids includes 1.5-75 parts of magnesium ions, 0.5-75 parts of potassium ions, 0.001-10 parts of calcium ions, 0.0001-10 parts of zinc ions, up to 5 parts of rubidium ions, 0.001-20 parts of bromide ions, and up to 20 parts of sulfate ions, said parts expressing a mass of a respective ions divided by a total mass of the mineral solids.
10. The wound healing composition of claim 7, wherein said methylglyoxal added to said active ingredient ranges from 500 to 2000 mg/kg of the composition.
11. The wound healing composition of claim 7, wherein the pharmaceutically-acceptable carrier includes at least one of water, polyethylene glycol, an ointment, and a cream base.
12. The wound healing composition of claim 7, wherein a pH of the composition is between 3.0-7.0.
13. The wound healing composition of claim 7, wherein the wound healing composition is replaced on a wound at least once.
14. A wound healing composition, comprising: a first would healing composition, including: a medicinal honey; and a concentration of methylglyoxal being added to said medicinal honey effective to reduce a number of viable microorganisms at a wound site; a second wound healing composition, including: a pharmaceutically acceptable carrier; an effective amount of an active ingredient of mineral solids, said mineral solids including at least one of a magnesium salt, a potassium salt, a calcium salt, a zinc salt, a rubidium salt, a bromide salt, and a sulfate salt; and a concentration of methylglyoxal effective to reduce a number of microorganisms at a wound site being added to said active ingredient; and a ratio of a volume of said first wound healing composition to a volume of said second wound healing composition being between 1:9 and 9:1.
15. A wound healing dressing, comprising: the wound healing composition according to claim 1; and a support.
16. A wound healing dressing, comprising: the wound healing composition according to claim 7; and a support.
17. A wound healing dressing, comprising: the wound healing composition according to claim 14; and a support.
18. The wound healing dressing of claim 15, wherein the support includes at least one of a fibrous gauze material, a hydrogel, a foam, a film, a hydrocolloid, a collagen, and an alginate.
19. A method of treating a wound, which comprises contacting a wound with the composition of claim 1.
20. A method of treating a wound, which comprises contacting a wound with the wound dressing of claim 15.
21. The wound healing composition of claim 14, wherein the wound healing composition is replaced on a wound at least once.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0032] The nature and mode of operation of the present invention will now be more fully described in the following detailed description of the invention taken with the accompanying figures, in which:
[0033]
[0034]
[0035]
[0036]
DETAILED DESCRIPTION OF THE INVENTION
[0037] While the present invention is described with respect to what is presently considered to be the preferred aspects, it is to be understood that the invention as claimed is not limited to the disclosed aspects.
[0038] Furthermore, it is understood that this invention is not limited to the particular methodology, materials and modifications described and as such may, of course, vary. It is also understood that the terminology used herein is for the purpose of describing particular aspects only, and is not intended to limit the scope of the present invention, which is limited only by the appended claims.
[0039] Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood to one of ordinary skill in the art to which this invention belongs. Although any methods, devices or materials similar or equivalent to those described herein can be used in the practice or testing of the invention, the preferred methods, devices, and materials are now described.
[0040] The present invention provides three exemplary wound healing compositions. The first composition includes seasonally harvested raw, strained, monofloral buckwheat honey naturally rich in hydrogen peroxide (containing and/or capable of generating 2-4 mM concentration), polyphenols (275-575 gallic acid equivalents of polyphenol compounds per gram of honey) to which is added the natural antibacterial compound, methylglyoxal to a final concentration of 500-2000 mg per kg of final honey product. This MGO-fortified buckwheat honey has broad-spectrum antimicrobial activity effective to reduce the number of viable microorganisms at a wound site.
[0041] A second composition of the present invention includes a pharmaceutically-acceptable carrier, an effective amount of an active mixture of inorganic minerals, and an amount of methylglyoxal (500-2000 mg/kg) that effectively reduces the number of viable microorganisms at a wound site. The active mixture of inorganic minerals include, but are not limited to, a magnesium salt, a potassium salt, a calcium salt, a zinc salt, and a rubidium salt, wherein each of the salts include a pharmaceutically-acceptable anion including bromide, chloride, citrate, and sulfate.
[0042] A third composition of the present invention comprises a mixture of compositions 1 and 2 including a pharmaceutically-acceptable carrier, an effective amount of an active mixture of inorganic minerals, medicinal buckwheat honey that contains, or is capable of generating 2-4 mM hydrogen peroxide, and 275-575 gallic acid equivalents of polyphenol compounds per gram of honey, and methylglyoxal to a final concentration of 500-2000 mg per kg of composition 3 (buckwheat honey with MVE & MGO) such that the composition is endowed with broad spectrum antibacterial activity effective to reduce the number of viable microorganisms at a wound site. The active mixture of inorganic minerals includes, but is not limited to, a magnesium salt, a potassium salt, a calcium salt, a zinc salt, and a rubidium salt, wherein each of the salts includes a pharmaceutically-acceptable anion including bromide, chloride, citrate, and sulfate.
[0043] In any embodiment of the second and third compositions, the active mixture of inorganic minerals comprises 1.5-75 parts of magnesium ions, 0.5-75 parts of potassium ions, 0.001-10 parts of calcium ions, 0.0001-10 parts of zinc ions, up to 5 parts of rubidium ions, 10-80 parts of chloride ions, 0-40 parts of citrate ions, 0.001-20 parts of bromide ions, and up to 20 parts of sulfate ions, said parts being expressed as parts by weight of inorganic mineral solids. In any of the above embodiments, methylglyoxal is added to a concentration in the final formulation of between 500-2000 mg/kg. Alternatively, after the active mixture of inorganic minerals have been formulated with methylglyoxal and a pharmaceutically-acceptable carrier, it is mixed with 10-90 parts of MGO-fortified medicinal honey per 100 parts total, said parts being expressed as parts by weight of the final formulation, where the medicinal honey also contains between 500-2000 mg/kg of methylglyoxal.
[0044] The composition includes a pharmaceutically-acceptable carrier, such as but not limited to water or polyethylene glycol or an ointment or cream base, which results in a therapeutic composition having a pH in the range of approximately 3-7.5, inclusive. Preferably, the composition has a pH in the range of about 3.5-6.5, inclusive. As used herein, a composition comprising “MVE salts” refers to a composition that includes magnesium, potassium, calcium, zinc, and rubidium cations, together with pharmaceutically acceptable counterions including bromide and sulfate.
[0045] In another aspect, the present invention provides a wound dressing. The wound dressing is used with any of the above embodiments of the composition and a support. In any embodiment of the dressing, the support includes, but is not limited to, a fibrous gauze material, a hydrogel, a foam, a film, a hydrocolloid, an alginate, a collagen, or a combination of any two or more of the afore-mentioned.
[0046] In yet another embodiment, the present invention includes a method of treating a wound. The method includes contacting a wound with any of the above embodiments of the wound dressing.
[0047] A “chronic wound,” “non-healing wound,” slow-to-heal wound,” or “stalled wound,” as used herein, refers to a wound that fails to heal over a 4-12 week timeframe from inception of the wound to complete closure of the skin at the wound site. Such wounds commonly include external dermal wounds or wounds of mucosal membranes such as sinonasal or endometrial wounds.
[0048] Skin wounds designated as “chronic” or “non-healing” or “slow-to-heal” or “stalled” are commonly observed in clinical settings as venous leg ulcers, diabetic foot ulcers, pressure ulcers, arterial ulcers, ulcers of mixed etiology, burns, or non-healing surgical wounds. Other types of non-healing wounds are observed in less frequent conditions, such as, fistulae, dermatitis or vasculitis wounds, skin cancers, and radiation burns. This list is not exhaustive and is provided to show examples of such non-healing wounds. Differentiated from “acute” wounds that spontaneously heal without complications in a matter of days or weeks through the four normal phases of the “wound-healing curve” (hemostasis, inflammation, proliferation, and remodeling), chronic wounds may persist for months or years and occasionally can last a lifetime, and are therefore commonly referred to as “non-healing” wounds. There is a need for treatment of any of these types of non-healing wounds since spontaneous healing has failed to occur. In chronic wounds, at the cellular biological level, there is commonly a prolonged inflammatory phase often caused by elevated proteases or active infection.
[0049] In yet another embodiment of the present invention, the various compositions are used prophylactically to prevent surgical wounds in high-risk patients from post-operative wound dehiscence and non-healing. More than 53 million people undergo surgical procedures annually in the United States, with about half of these occurring under general anesthesia. Post-operative wound dehiscence has been investigated in several studies and a small incidence has shown to be an issue of concern in all age groups, including the pediatric population, but with a higher incidence in the older population. The failure of these surgical wounds to heal in a normal time frame pushes them into the category of chronic wounds. Diabetes, obesity, cancer therapy, and vascular abnormalities, which are all increasing in incidence in the Western population, contribute to delayed healing and are considered risk factors. The prophylactic application of any of the present inventive compositions to surgical incisions post-operatively in ‘high-risk’ patients will aid in reducing the incidence of non-healing surgical wounds.
[0050] Some prolonged inflammation and active infections occur simultaneously and prevent wounds of the skin or mucosal membranes from healing. The present disclosure relates to compositions, carriers, and methods for treating wounds of the skin and mucosal membranes. The compositions include medicinal honey fortified with the additional antimicrobial methylglyoxal compound, and an active ingredient of a mixture of inorganic solids originally derived from botanical and Dead Sea sources and including magnesium, potassium, calcium, zinc, rubidium, bromide, and sulfate. The components of the inventive composition surprisingly provide a synergistic effect that results in the suppression of the accumulation of a biochemical marker (e.g. proteases, and pro-inflammatory cytokines) associated with inflammation, and the up-regulation of other biochemical markers (e.g. growth factors and protease inhibitors) associated with wound healing. In addition, the components of the inventive compositions provide antibacterial activity that acts concomitantly with the anti-inflammatory activity to also provide suppression of active infections.
[0051] Compositions according to the present invention are useful for treating common chronic wounds, such as venous leg ulcers, diabetic foot ulcers, pressure ulcers, arterial ulcers, burns, non-healing surgical wounds, chronic rhinosinusitis and metritis. In addition, compositions according to the present invention are also useful for treating abrasions, lacerations, minor cuts, scalds and burns, and other partial thickness wounds. Useful compositions include, but are not limited to, medicinal honey, methylglyoxal, magnesium, potassium, calcium, zinc, rubidium, bromide and sulfate. The compositions are advantageously applied in a cream or ointment base for a period of time (e.g. several hours to several days) that are optionally impregnated into or associated with carrier dressing supports (e.g. fibrous gauze, hydrogel, foam, film, hydrocolloid, collagen, or alginate).
[0052] The present disclosure further provides a method for treating the wound. In some embodiments, the method includes contacting a wound with any composition of the present disclosures wherein the composition includes a medicinal honey fortified with the natural non-peroxide antibacterial compound, methylglyoxal; a pharmaceutically-acceptable carrier; an effective amount of an active ingredient of inorganic solids comprising a magnesium salt, a potassium salt, a calcium salt, a zinc salt, a rubidium salt, a bromide salt, and a sulfate salt; and the natural non-peroxide antibacterial compound, methylglyoxal comprising of an amount between 500-2000 mg/kg honey, effective to reduce the number of viable microorganisms at a wound site. The compositions are applied to the wound, for example, in a liquid, (e.g. by irrigating or lavaging the wound with the liquid) or in a gel or an ointment. Liquid compositions provide immediate availability of the ions and methylglyoxal to the healing tissue. In contrast, gels or ointments provide regulated delivery of the ions, medicinal honey, and methylglyoxal to the healing tissue over a sustained period of time. In some embodiments, the composition is applied to a wound dressing, which is subsequently applied to the wound. Advantageously, a dressing including any of the compositions is contacted with the wound for a period of time (e.g. several hours to several days), thereby providing a moist environment enriched with the MGO-fortified medicinal honey, or the MVE ions and methylglyoxal, or a mixture of both to facilitate healing of the skin or mucosal membrane.
EMBODIMENTS OF THE INVENTION
[0053] Embodiment 1 is a composition including a medicinal honey with high peroxide-induced and polyphenol-facilitated antimicrobial activity, an effective amount of methylglyoxal (500-2000 mg/kg) to add non-peroxide antimicrobial activity, wherein each of the antimicrobial activities provides a different mechanism of antibacterial inhibition thereby providing a broad spectrum antimicrobial activity effective to reduce the number of viable microorganisms at a wound site.
[0054] Embodiment 2 is the composition of embodiment 1 wherein the medicinal honey is monofloral buckwheat honey that naturally generates 2-4 mM hydrogen peroxide and which naturally contains 275-575 gallic acid equivalents of polyphenol compounds per gram of honey, and wherein the amount of methylglyoxal added is 500-2000 mg per kg of honey.
[0055] Embodiment 3 is a composition including a pharmaceutically-acceptable carrier, an effective amount of an active ingredient of inorganic solids including a magnesium salt, a potassium salt, a calcium salt, a zinc salt, a rubidium salt, a bromide salt, and a sulfate salt; and methylglyoxal as an antimicrobial at an amount between 500-2000 mg/kg, which is effective to reduce the number of viable microorganisms at a wound site, wherein each of the salts includes a pharmaceutically acceptable counterion.
[0056] Embodiment 4 is the composition of embodiment 3, wherein the active ingredient of inorganic solids includes 1.5-75 parts of magnesium ions, 0.5-75 parts of potassium ions, 0.001-10 parts of calcium ions, 0.0001-10 parts of zinc ions, up to 5 parts of rubidium ions, 0.001-20 parts of bromide ions, and up to 20 parts of sulfate ions (said parts being expressed as parts by weight of the total weight of inorganic solids), and methylglyoxal representing 500-2000 mg/kg of the final composition.
[0057] Embodiment 5 is a mixture of embodiment 2 and embodiment 4, wherein the ratio of embodiment 2 to embodiment 4 is between 1:9 and 9:1 by weight.
[0058] Embodiment 6 is a wound dressing including the composition of any of embodiments 1 through 5; and a support.
[0059] Embodiment 7 is the wound dressing of embodiment 6, wherein the support includes a fibrous gauze material, a hydrogel, a foam, a film, a hydrocolloid, an alginate, collagen, or a combination of any two or more of the afore-mentioned.
[0060] Embodiment 8 is a method of treating a wound, including contacting a wound with the composition of any one of embodiments 1 through 5.
[0061] Embodiment 9 is a method of treating a wound, including treating a wound with the wound dressing of either one of embodiments 6 or 7.
EXAMPLES
[0062] Objects and advantages of this invention are further illustrated by the following examples, but the particular materials and amounts thereof recited in these examples, as well as other conditions and details, should not be construed to unduly limit this invention.
[0063] Example 1 demonstrates composition 1, embodiments 1 and 2.
[0064] Monofloral buckwheat honey fortified with methylglyoxal at a concentration of 1000 mg/kg is prepared and impregnated into acetate non-woven medical grade dressing (approximately 4 g MGO-fortified buckwheat honey in each 4″×5″ dressing). The dressings are protected with polyethylene liners applied to both sides, and dressings of 4″×5″ are sealed individually in foil pouches constructed of white polyester film fused to aluminum foil that constitutes an excellent barrier. The dressings are then sterilized with gamma radiation and verified as sterile before use.
[0065] Panels 1A, 1B, 1C, and 1D, show treatment using dressings impregnated with composition 1 of the present invention, MGO-fortified buckwheat honey, of a large infected amputation in the foot of a diabetic patient. A 47 year-old male with a history of plantar diabetic foot ulcers who had recently had all the toes on his left foot amputated and the dermal layer on a significant portion of the underside of his foot excised to remove infected tissue (Panel 1A) presented with extensive infection in the open wound on the plantar aspect of his foot. After sharp debridement of this severely infected open amputation wound to remove slough, eschar, and necrotic tissue, the manufactured MGO-fortified buckwheat honey dressings were cut to closely fit the wound using sterile scissors and applied to the wound, with dressing changes every two days. On day 0, the wound measured 12 cm×8 cm (Panel 1A: wound area 96 cm.sup.2). The patient was instructed on how to change his own dressings every 48 hours. After three weeks of treatment with the sterile MGO-fortified buckwheat honey dressings, the wound area decreased 7.8-fold to 12.25 cm.sup.2 (Panel 1B), a wound area reduction of 87%. Many wound healing trajectory studies in the literature indicate that a wound area reduction of greater than 50% within 4 weeks of treatment indicates that full wound closure will occur within 12-20 weeks of continued treatment. This wound was no exception to that expectation, fully closing after 12 weeks of treatment with the MGO-fortified buckwheat honey dressings, having a wound area of 2.6 cm.sup.2 after 8 weeks of treatment (Panel 1C), and less than 0.4 cm.sup.2 after 11 weeks of treatment (Panel 1D).
[0066] Example 2 demonstrates composition 1, embodiments 1 and 2.
[0067] Panels 2A, 2B, 2C, and 2D, show treatment using dressings impregnated with composition 1 of the present invention, MGO-fortified buckwheat honey, of a large deep pressure ulcer. The MGO-fortified buckwheat honey dressings were also used to treat a large deep pressure ulcer on the right heel of a 59 year-old male. This patient had a history of diabetes and immobility. Before onset of treatment with the sterile MGO-fortified buckwheat honey dressings, the wound measured approximately 6.3 cm×4.4 cm (Panel 2A: 27.7 cm.sup.2). Again the patient was instructed on how to change his own dressings every 48 hours. After three weeks of treatment with the sterile MGO-fortified buckwheat honey dressings, the wound area had decreased to 11.2 cm.sup.2 (Panel 2B), a 60% reduction in the wound area, and again greater than the 50% wound area reduction within 4 weeks of treatment that is indicative of complete closure within a 12-20 week time frame. This large pressure ulcer had reduced in wound area to 4.4 cm.sup.2 after 9 weeks of treatment (Panel 2C), and as expected, went on to completely close after 13 weeks of treatment with the sterile MGO-fortified buckwheat honey wound dressings (Panel 2D).
[0068] Example 3 demonstrates composition 2, embodiments 3 and 4.
[0069] Panels 3A, 3B, 3C, 3D, 3E, and 3F, show treatment using dressings impregnated with composition 2 of the present invention, MVE ointment with MGO, of a diabetic foot ulcer. A composition herein referred to as “MVE ointment with MGO” was prepared in two parts as follows: Part A, the PEG phase, was prepared by adding 34.205 g polyethylene glycol (PEG)-400 to a PYREX beaker and heating it to 70° C. While constantly stirring the pre-heated PEG-400, 42.274 g PEG-4000 was added slowly until all the solid PEG-4000 was dissolved into the PEG-400 and the PEG phase was left to cool to 50° C. Part B, the aqueous phase, was prepared by weighing 21.21 g deionized water into a glass beaker and, with constant stirring, dissolving into it 1.681 g magnesium chloride, hexahydrate; 0.387 g potassium chloride; 0.02 g magnesium bromide, hexahydrate; 0.0028 g magnesium sulfate, heptahydrate; 0.0164 g calcium chloride dihydrate; 0.0025 g zinc chloride; 0.0018 g rubidium chloride; and 0.1 g sodium benzoate. The total amount of inorganic minerals, herein referred to as MVE (for multivalent electrolytes), was 2.1115% in weight.
[0070] When all the salts had dissolved, the aqueous phase was slowly added to the PEG phase with constant stirring, while the temperature of the PEG phase was initially at 50° C. During the addition of the aqueous phase to the PEG phase, outgassing occurred and the temperature of the solution decreased. The pH of this ointment without adjustment is 4.30 (a 10-fold dilution of a small aliquot of the ointment in water was used to measure the pH). The pH of this ointment can be lowered, if desired by the addition of 50% hydrochloric acid. After the mixture had cooled to 40° C., 0.1 g methylglyoxal was added and the total 100 g of ointment was then transferred to tubes for use. Alternatively, the ointment was impregnated into acetate non-woven medical grade dressing and packaged as per the MGO-fortified buckwheat honey dressings described above.
[0071] When applied daily to a diabetic foot ulcer that had become infected and was not healing by previous treatment modalities, the ‘MVE ointment with MGO’ described herein closed the wound in 19 weeks (see Panels 3A-3F).
[0072] Example 4 demonstrates composition 3, embodiment 5.
[0073] Panels 4A, 4B, 4C, 4D, 4E, and 4F, show treatment using dressings impregnated with composition 3 of the present invention, buckwheat honey with MVE & MGO, of a diabetic foot ulcer. A composition, herein referred to as “buckwheat honey with MVE & MGO,” was prepared in three parts as follows: Part A, the PEG phase, was prepared by adding 34.205 g polyethylene glycol (PEG)-400 to a PYREX beaker and heating it to 70° C. While constantly stirring the pre-heated PEG-400, 42.274 g PEG-4000 was added slowly until all the solid PEG-4000 was dissolved into the PEG-400 and the PEG phase was left to cool to 50° C.
[0074] Part B, 2× aqueous phase, was prepared by weighing 21.21 g deionized water into a glass beaker and with constant stirring, dissolving into it 3.362 g magnesium chloride, hexahydrate; 0.774 g potassium chloride; 0.04 g magnesium bromide, hexahydrate; 0.0056 g magnesium sulfate, heptahydrate; 0.0328 g calcium chloride dihydrate; 0.005 g zinc chloride; 0.0036 g rubidium chloride; and 0.1 g sodium benzoate. The total amount of inorganic minerals, herein referred to as MVE (for multivalent electrolytes), was 4.223% in weight. When all the salts had dissolved, the aqueous phase was slowly added to the PEG phase with constant stirring, while the PEG phase was initially at 50° C. During the addition of the aqueous phase to the PEG phase, outgassing occurred and the temperature of the solution decreased. The pH of this ointment without adjustment is 4.30 (a 10-fold dilution of a small aliquot of the ointment in water was used to measure the pH). The pH of this ointment can be lowered, if desired by the addition of 50% hydrochloric acid. After the mixture had cooled to 40° C., 0.1 g methylglyoxal was added.
[0075] Part C, one part by volume of the 2× MVE ointment with MGO, made as described in Part B, was thoroughly mixed with one part by volume of ‘MGO-fortified buckwheat honey,’ to make the final ‘buckwheat honey with MVE & MGO’ product. The ratio of ‘MGO-fortified buckwheat honey’ (s.g.=1.43 g/mL) to ‘MVE ointment with MGO’ (s.g=1.1 g/mL) can be varied, but as used in the treatment of the diabetic foot ulcer in Panel 4, it was mixed 1:1 (v/v), [or 1.3:1 (w/w)]. The buckwheat honey with MVE & MGO′ ointment was then transferred to tubes for use. Alternatively the buckwheat honey with MVE & MGO′ ointment was impregnated into acetate non-woven medical grade dressing and packaged as per the MGO-fortified buckwheat honey dressings described above.
[0076] When applied daily to a non-healing infected diabetic foot ulcer, the ‘buckwheat honey with MVE & MGO’ described herein closed the wound in 17 weeks (see Panel 4). Example 5 demonstrates composition 2, embodiments 3 and 4, variant on Example 3.
[0077] A composition, herein referred to as “PeloSinus,” was prepared by dissolving 1.645 g magnesium chloride, hexahydrate; 0.548 g potassium citrate, monohydrate; 0.019 g magnesium bromide, hexahydrate; 0.0026 g magnesium sulfate, heptahydrate; 0.017 g calcium chloride, dihydrate; 0.0001 g zinc chloride; 0.002 g rubidium chloride; 0.05 g methylglyoxal; and 0.000065 g citric acid in deionized water to a final volume of 100 mL. The total amount of mineral salts, herein referred to as MVE (for multivalent electrolytes), was 2.2337% (w/v). This solution is isotonic with body fluid, having a tonicity of 0.909 g sodium chloride equivalents per 100 mL, and is used for the treatment of internal mucous membranes such as the sinonasal and endometrial linings. It is also used as a wound wash or cleanser. The pH of the solution thus formulated is 6.5. Prior to use the solution is sterilized, for example by filtration or irradiation.
[0078] The anti-biofilm activity of this solution was tested in a well-characterized biofilm assay [the assay of which was published by Desrosiers et al., (2007)] and the results are shown in Table 2. Biofilm colonies were grown using two species of bacteria that commonly form biofilm colonies in human wounds, Pseudomonas aeruginosa and Staphylococcus aureus. As can be seen in Table 2, treatment with ‘PeloSinus’ solution reduced Pseudomonas aeruginosa biofilm colony formation by more than 1 log and it reduced Staphylococcus aureus biofilm colony formation by more than 4 logs. Both of these are very significant reductions in the abilities of common wound pathogens to establish in a wound environment. Biofilm is present in about 60% of chronic wounds and is very difficult to eliminate.
TABLE-US-00002 TABLE 2 Anti-Biofilm Activity of ‘PeloSinus’ Formulation Against Pseudomonas aeruginosa and Staphylococcus aureus Biofilm Colonies Saline Control Saline Control Pseudomonas aeruginosa Staphylococcus aureus Plate Plate Count Cells/cm.sup.2 Count Cells/cm.sup.2 Drop 1 15 8.00 × 10.sup.8 Drop 1 5 2.67 × 10.sup.6 Drop 2 26 1.39 × 10.sup.9 Drop 2 4 2.13 × 10.sup.6 Drop 3 24 1.28 × 10.sup.9 Drop 3 3 1.60 × 10.sup.6 Drop 4 21 1.12 × 10.sup.9 Drop 4 4 2.13 × 10.sup.6 Drop 5 29 1.55 × 10.sup.9 Drop 5 2 1.07 × 10.sup.6 Average 1.23 × 10.sup.9 Average 1.92 × 10.sup.6 Log 9.09 Log 6.28 ‘PeloSinus’ ‘PeloSinus’ Pseudomonas aeruginosa Staphylococcus aureus Plate Plate Count Cells/cm.sup.2 Count Cells/cm.sup.2 Drop 1 12 6.40 × 10.sup.7 Drop 1 4 2.13 × 10.sup.2 Drop 2 16 8.53 × 10.sup.7 Drop 2 3 1.60 × 10.sup.2 Drop 3 15 8.00 × 10.sup.7 Drop 3 2 1.07 × 10.sup.2 Drop 4 14 7.47 × 10.sup.7 Drop 4 2 1.07 × 10.sup.2 Drop 5 10 5.33 × 10.sup.7 Drop 5 5 2.67 × 10.sup.2 Average 7.15 × 10.sup.7 Average 1.71 × 10.sup.2 Log 7.85 Log 2.23 Treatment with ‘PeloSinus’ Treatment with ‘PeloSinus’ Anti Biofilm Anti Biofilm Results in a 1.24 Log Reduction Results in a 4.05 Log Reduction of Pseudomonas aeruginosa of Staphylococcus aureus Biofilm (9.09-7.85) Biofilm (6.28-2.23)
[0079] Irrigation of the sinonasal cavities with sterile isotonic ‘PeloSinus’ also demonstrated efficacy in an animal model of chronic rhinosinusitis. Relative to the standard of care, normal saline solution, ‘PeloSinus’ irrigation of the sinuses led to a significantly increased lumen space and faster replenishment of mucocilial cells after surgical mucosal stripping.
[0080] Example 6 demonstrates composition 2, embodiments 3 and 4, variant of Examples 3 and 5.
[0081] Two compositions were prepared for the treatment of metritis in thoroughbred, quarter horse and other valuable mares (also for the treatment of metritis in other animals including dogs). These compositions are referred to herein as “PeloWash” and “PeloFusion,” which together with “PeloPurge,” constitute a treatment system, herein referred to as “PeloMetriSystem.” After successful racing and/or performance careers, thoroughbred, quarter horse and other elite performance mares are valuable for breeding. Many such mares, however, either do not get pregnant or can only have one foal, and then contract metritis and can't get pregnant again. Metritis is a disorder characterized by inflammation of the endometrial lining of the uterus and infection with various bacteria, including Klebsiella, Streptococcus, and Pseudomonas spp. The current standard of care uses irrigation of the endometrial lining of the uterus in mares and dogs with saline (or Lactated Ringer's solution) followed by insertion into the uterus of a solution containing antibiotics. Often systemic antibiotics are given simultaneously. But the continuing problem of bacteria developing resistance to antibiotics continues, and many times antibiotic treatment of metritis is either ineffective or causes undesirable reactions in mares. ‘PeloMetriSystem’ offers an alternative treatment and consists of three solutions as follows:
[0082] Solution 1, a composition herein referred to as “PeloWash,” is prepared by dissolving 16.872 g magnesium chloride, hexahydrate; 5.628 g potassium citrate, monohydrate; 0.190 g magnesium bromide, hexahydrate; 0.026 g magnesium sulfate, heptahydrate; 0.17 g calcium chloride, dihydrate; 0.001 g zinc chloride; 0.02 g rubidium chloride; and 0.00065 g citric acid in deionized water to a final volume of 1000 mL. This solution is isotonic and has a pH of 6.5.
[0083] Solution 2, herein referred to as “PeloPurge” is constituted by mixing 9 parts (by volume) of Solution 1 (‘PeloWash’), with 1 part of 90% dimethylsulfoxide (DMSO) just before use.
[0084] Solution 3, a composition herein referred to as “PeloFusion,” is prepared by dissolving 16.023 g magnesium chloride, hexahydrate; 5.34 g potassium citrate, monohydrate; 0.190 g magnesium bromide, hexahydrate; 0.026 g magnesium sulfate, heptahydrate; 0.17 g calcium chloride, dihydrate; 0.001 g zinc chloride; 0.02 g rubidium chloride; 0.00065 g citric acid; 1 g methylglyoxal; and 30 g polyethylene glycol 4000 in deionized water to a final volume of 1000 mL. This solution is isotonic and has a pH of 6.5.
[0085] Four mares were treated with this ‘PeloMetriSystem’ as follows: First, each mare was tested for the presence of metritis-causing bacteria in their uterus. The endometrial lining of the uterus was washed with two to three liters of “PeloWash.” This was done by placing 1 L of ‘PeloWash’ at a time into a mare's uterus and relatively quickly withdrawing the solution again. Whether 2 or 3 L was used was determined by how much debris was present in the eluent of each wash. If testing indicated that metritis-causing bacteria was present in a mare's uterus, that mare was next washed with 1 L ‘PeloPurge’ solution, which again was relatively quickly withdrawn after application. Finally, 250 mL of ‘PeloFusion’ solution was placed in a mare's uterus and left there. This solution dissipates naturally-some being absorbed, and some pushed out of the uterus. No systemic antibiotics were used.
[0086] Four other ‘control’ mares were treated with the standard of care as follows: First, each mare was tested for the presence of metritis-causing bacteria in their uterus. The endometrial lining of the uterus was washed with two to three liters of normal saline or isotonic Lactated Ringer's solution, 1 L at a time, each liter being relatively quickly withdrawn after insertion. Whether 2 or 3 L was used was determined by how much debris was present in the eluent of each wash. If testing indicated that metritis-causing bacteria was present in a mare's uterus, that mare was next washed with 1 L of 10% DMSO in normal saline or Lactated Ringer's solution, which again was relatively quickly withdrawn after application. Finally, 250 mL of an antibiotic (Amikacin or Timentin) solution in Tris/EDTA buffer was placed in a mare's uterus and left there. The antibiotic in Tris/EDTA solution was left to dissipate naturally by either absorption or being pushed out of the uterus. Some of the control mares were concurrently treated with systemic antibiotics.
[0087] No safety concerns were seen in the group treated with ‘PeloMetriSystem,’ whereas one of the control mares had an undesirable reaction to the use of systemic antibiotics. In addition, three mares in the ‘PeloMetriSystem’-treated group became pregnant after treatment, compared to only two in the control group.
[0088] Metritis is a problem in humans as well, where it is most commonly referred to as Pelvic Inflammatory Disease (PID). PID is an infection of the uterus (womb), fallopian tubes, and other reproductive organs that causes symptoms such as lower abdominal pain. It is a serious complication of some sexually transmitted diseases (STDs), especially chlamydia and gonorrhea. PID often damages the fallopian tubes and tissues in and near the uterus and ovaries. PID often leads to serious consequences including infertility, ectopic pregnancy (a pregnancy in the fallopian tube or elsewhere outside of the womb), abscess formation, and chronic pelvic pain.
[0089] Prompt and appropriate treatment prevents complications of PID caused by scar tissue forming in response to bacterial damage. This scar tissue blocks or interrupts the normal movement of sperm through the fallopian tubes, or eggs into the uterus, and leads to infertility. Treatment with ‘EndoMetriSystem’ will also prove to be a useful treatment for PID in humans.
[0090] Thus, it is seen that the objects of the present invention are efficiently obtained, although modifications and changes to the invention should be readily apparent to those having ordinary skill in the art, which modifications are intended to be within the spirit and scope of the invention as claimed. It also is understood that the foregoing description is illustrative of the present invention and should not be considered as limiting. Therefore, other embodiments of the present invention are possible without departing from the spirit and scope of the present invention.