Methods to reduce toxicities and to improve bioavailabilities of nanodrugs
10792366 ยท 2020-10-06
Assignee
Inventors
Cpc classification
A61K9/19
HUMAN NECESSITIES
A61K9/0019
HUMAN NECESSITIES
Y10S977/906
GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
Y10S977/773
GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
A61K9/5161
HUMAN NECESSITIES
A23L33/30
HUMAN NECESSITIES
A23L33/115
HUMAN NECESSITIES
A23V2002/00
HUMAN NECESSITIES
A61P35/00
HUMAN NECESSITIES
International classification
A61K47/44
HUMAN NECESSITIES
A61K9/19
HUMAN NECESSITIES
A61K9/00
HUMAN NECESSITIES
A61P35/00
HUMAN NECESSITIES
A23L33/115
HUMAN NECESSITIES
A23L33/00
HUMAN NECESSITIES
Abstract
Provided herein are methods for reducing clearance of nanotherapeutic agents from a subject, wherein the methods comprise administering a nutrition supplement to the subject prior to administration of the nanotherapeutic agent in the treatment of a disease. Methods for improving the bioavailability of the nanotherapeutic agent, methods of reducing the toxicity of the nanotherapeutic agent, and kits comprising the nutrition supplement and nanotherapeutic agent are also provided.
Claims
1. A method of treating cancer in a subject in need thereof, comprising (i) administering to the subject a fat emulsion comprising 20% soybean oil, 1.2% egg yolk, and 2.25% glycerol; and (ii) administering a therapeutically effective amount of a nanotherapeutic agent to the subject, wherein the nanotherapeutic agent comprises a therapeutic agent and a nanocarrier, wherein the nanocarrier is selected from the group consisting of a protein-coated nanoparticle and a polymer-coated nanoparticle; wherein said fat emulsion is administered to the subject about 0.5 hours to about 2 hours before the nanotherapeutic agent is administered to the subject; wherein the cancer is selected from the group consisting of breast cancer, prostate cancer, esophageal cancer, liver cancer, colon cancer, testicular cancer, endometrial cancer, brain cancer, bladder cancer, cancer of the uterus, cancer of the ovary, cervical cancer, lung cancer, sarcoma, bone cancer, pancreatic cancer, renal cancer, stomach cancer, and cancer of the head and neck; wherein the therapeutic agent is dichloro(1,2-diaminocyclohexane)platinum(II); wherein toxic side effects to the liver, kidney, or spleen are reduced as compared with a method of administration of the nanotherapeutic agent without pre-administration of the fat emulsion, and wherein either serum alanine aminotransferase (ALT) or serum creatinine levels are significantly reduced as compared with a method of administration of the nanotherapeutic agent without pre-administration of the fat emulsion.
2. The method of claim 1, wherein clearance of the nanotherapeutic agent from the subject is reduced as compared with a method of administration of the nanotherapeutic agent without pre-administration of the fat emulsion.
3. The method of claim 2, wherein reticuloendothelial system (RES) clearance of the nanotherapeutic agent from the subject is reduced as compared with a method of administration of the nanotherapeutic agent without pre-administration of the fat emulsion.
4. The method of claim 1, wherein the bioavailability of the nanotherapeutic agent in the subject in the treatment of the cancerous disease is improved as compared with a method of administration of the nanotherapeutic agent without pre-administration of the fat emulsion.
5. The method of claim 1, wherein the nanotherapeutic agent further comprises a hyaluronic acid polymer coating.
6. The method of claim 5, wherein the fat emulsion is administered about 1 hour before the nanotherapeutic agent is administered.
7. The method of claim 1, wherein accumulation of the nanotherapeutic in the liver is decreased by about 10% to about 30% compared to accumulation of the nanotherapeutic agent in the liver without pre-administration of the fat emulsion.
8. The method of claim 7, wherein accumulation of the nanotherapeutic in the liver is decreased by about 15% to about 25% compared to accumulation of the nanotherapeutic agent in the liver without pre-administration of the fat emulsion.
9. The method of claim 1, wherein accumulation of the nanotherapeutic agent in the spleen is decreased by about 25% to about 50% compared to accumulation of the nanotherapeutic agent in the spleen without pre-administration of the fat emulsion.
10. The method of claim 9, wherein accumulation of the nanotherapeutic agent in the spleen is decreased by about 35% to about 45% compared to accumulation of the nanotherapeutic agent in the spleen without pre-administration of the fat emulsion.
11. The method of claim 1, wherein accumulation of the nanotherapeutic agent in the kidney is decreased by about 5% to about 15% compared to accumulation of the nanotherapeutic agent in the kidney without pre-administration of the fat emulsion.
12. The method of claim 11, wherein accumulation of the nanotherapeutic agent in the kidney is decreased by about 6% to about 12% compared to accumulation of the nanotherapeutic agent in the kidney without pre-administration of the fat emulsion.
13. The method of claim 4, wherein bioavailability of the nanotherapeutic agent is improved by about 5% to about 20% compared to the bioavailability of the nanotherapeutic agent without pre-administration of the nutrition supplement.
Description
DESCRIPTION OF DRAWINGS
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DETAILED DESCRIPTION
(9) Nanomedicine, particularly nanotechnology-based chemotherapeutics, has the potential to improve drug delivery and may generate new preventative, diagnostic, and therapeutic approaches to cancer in areas where improvements may not be obtained using existing technologies. In general, nanocarriers accumulate in solid tumors as a result of the enhanced permeability and retention (EPR) of macromolecules, thereby enhancing their anti-tumor or tumor-diagnosis activity (see e.g., Heger et al, Nat. Med., 2013, 19, 120; Chow et al, Sci. Transl. Med. 2013, 5, 216rv214; Chauhan et al, Nat. Mater. 2013, 12, 958-962; Wang et al, Annu. Rev. Med. 2012, 63, 185-198; Zamboni et al, Clin. Cancer Res. 2012, 18, 3229-3241; and Cabral et al, Proc. Natl. Acad. Sci. USA, 2013, 110, 11397-11402). Several nanocarrier-based chemotherapeutics, such as Abraxane and Doxil, have been approved for treatment of several types of cancer. Studies have shown that the therapeutic performance of oxaliplatin, which is a third generation Pt drug, can be improved by incorporating the central dichloro-(1, 2-diaminocyclohexane)platinum(II) (DACHPt) motif into the core of these types of nanocarriers (see e.g., Cabral et al, J. Control Release, 2005, 101, 223-232; Murakami et al, Sci. Trans. Med. 2011, 3, 64ra62; Oberoi et al, Chemother. Res. Pract. 2012, 905796; and Wu et al, J. Control Release, 2014, 189, 1-10).
(10) Currently approved anti-cancer nanotherapeutic agents, namely Abraxane, Doxil, DaunoXome, and DepoCyt, work by loading traditional cancer chemotherapeutics into nanocarriers. These chemotherapeutics are believed to inhibit mitosis (paclitaxel loaded in Abraxane), cause DNA intercalation (doxorubicin and daunorubicin loaded in Doxil and DaunoXome), and interfere with DNA synthesis (cytarabine loaded in DepoCyt). Thus, the accumulation of these drugs in mononuclear phagocytic cells in the liver and spleen would cause toxic side effects. For many nanotherapeutic agents, the toxicity in the mononuclear phagocyte system marks an end for further development activities.
(11) A major limitation for both approved and in-development nanotherapeutic agents is their rapid clearance by the cells of the RES/mononuclear phagocyte system (MPS), in particular liver and spleen, which can increase their toxicity to these off-target organs and reduce their efficacy (see e.g., Chow et al, Sci. Trans. Med. 2013, 5, 216rv214; Zamboni et al, Clin. Cancer Res. 2012, 18, 3229-3241; and Albanese et al, Annu. Rev. Biomed. Eng. 2012, 14, 1-16). Strategies that decrease RES uptake and/or increase the bioavailability of nanomedicines can improve tumor targeting and decrease the side effects. Many studies have been conducted to decrease RES clearance and to increase the tumor targeting of nanomedicines by modifying nanoparticle characteristics, such as the size, shape, charge, surface property, and composition (see e.g., Neuberger et al, Journal of Magnatism and Magnetic Materials, 2005, 293, 483-496; Arvizo et al, PLoS One, 2011, 6, e24374; Maesaki et al, Curr. Pharm. Des. 2002, 8, 443-440; Romberg et al, Pharm. Res. 2008, 25, 55-71; Jokerst et al, Nanomedicine (Lond), 2011, 6, 715-728; and Alexis et al, Mol. Pharm. 2008, 5, 505-515. In general, the total accumulation of the anti-cancer nanotherapeutic agents in the tumor represents a small fraction of total injected dose (1-10%). The majority (40-80%) of the injected nanomedicines end up in the liver and spleen (see e.g., Alexis et al.). Moreover, each new modification to the nanotherapeutic agent requires thorough toxicity, pharmacology, and biomechanics studies before translating to a clinical setting.
(12) In addition, the development of targeted nanomedicine has made an impact in new drug development in neurology, cardiology, and inflammation. The EPR effect is found not only in cancer, but also in a range of inflammatory diseases, such as atherosclerosis. Accordingly, the disclosure provided herein for methods of administering nutritional supplements can have applications beyond the treatment of cancerous diseases.
Definitions
(13) For the terms for example and such as and grammatical equivalences thereof, the phrase and without limitation is understood to follow unless explicitly stated otherwise. As used herein, the term about is meant to account for variations due to experimental error. All measurements reported herein are understood to be modified by the term about, whether or not the term is explicitly used, unless explicitly stated otherwise. As used herein, the singular forms a, an, and the include plural referents unless the context clearly dictates otherwise.
(14) A therapeutically effective amount of a composition with respect to the subject method of treatment, refers to an amount of the composition(s) in a preparation which, when administered as part of a desired dosage regimen (to a subject, e.g., a human) alleviates a symptom, ameliorates a condition, or slows the onset of disease conditions according to clinically acceptable standards for the disorder or condition to be treated or the cosmetic purpose, e.g., at a reasonable benefit/risk ratio applicable to any medical treatment.
(15) As used herein, the term treating or treatment includes reversing, reducing, or arresting one or more of the symptoms, clinical signs, and underlying pathology of a condition in a manner to improve or stabilize a patient's condition.
(16) Nutrition Supplements
(17) The present application provides, inter alia, a nutrition supplement for use in the methods provided herein. As used herein, the term nutrition supplement refers to a composition for providing nutrition to a subject in need thereof, wherein the subject may not be capable of performing the normal processes of eating and digestion. In some embodiments, the nutrition supplement is a parenteral nutrition supplement (i.e., a nutrition supplement to be to the subject via intravenous administration). In some embodiments, the nutrition supplement comprises one or more nutrients selected from the group consisting of carbohydrates (e.g., glucose), amino acids, lipids, vitamins, and dietary minerals. In some embodiments, the nutrition supplement is a total parenteral nutrition (TPN) supplement. In some embodiments, the nutrition supplement is a peripheral parenteral nutrition (PPN) supplement. In some embodiments, the nutrition supplement is a parenteral nutrition supplement approved by the United States Food and Drug Administration. In some embodiments, the nutrition supplement comprises one or more amino acid supplements. In some embodiments, the nutrition supplement comprises one or more of Aminosyn, AMINOSYN-HBC, AMINOSYN-HF, AMINOSYN-RF, BranchAmin, FreAmine HBC, FreAmine III, HepatAmine, Kabiven, Perikabiven, Novamine, Premasol, ProcalAmine, ProSol, RenAmin, TrophAmine, or any combination thereof.
(18) In some embodiments, the nutrition supplement comprises a fat emulsion. In some embodiments, the nutrition supplement is a fat emulsion. In some embodiments, the nutrition supplement comprises one or more of soybean oil, vegetable oil, fish oil, phospholipids, and glycerol, or any combination thereof. In some embodiments, the nutrition supplement is selected from the group consisting of Intralipid 10%, Intralipid 20%, and Intralipid 30%, or any combination thereof. In some embodiments, the nutrition supplement is Intralipid 20%.
(19) In the methods described herein, an amount of nutrition supplement is administered to the subject in an amount effective to reduce clearance of a nanotherapeutic agent from the subject. As used herein, the term effective amount refers to an amount (or amounts) of a nutrition supplement that reduces clearance of a nanotherapeutic agent without inducing significant toxicity to the host.
(20) An effective amount of nutrition supplement, the frequency of administration, and duration of administration can be determined by a physician, according to the relevant circumstances, including the condition to be treated, the chosen route of administration, the actual nutrition supplement administered, the age, weight, and response of the individual subject, the severity of the subject's symptoms, and the like.
(21) In some embodiments, a single pre-treatment (e.g., a single intravenous administration) of the nutrition supplement is sufficient to reduce clearance of the nanotherapeutic agent from the subject. In some embodiments, the pre-treatment can comprise multiple administrations of the nutrition supplement at various intervals and over different periods of time as required. In some embodiments, the nutrition supplement is administered multiple times (e.g., two, three, four, or more times), and at least one of the administrations is between about 0.1 hours and about 5 hours before the administration of the nanotherapeutic agent. In some embodiments, multiple administrations of the nutrition supplement are administered between about 0.1 hours and about 24 hours before the administration of the nanotherapeutic agent to the subject. In some embodiments, the methods provided herein are repeated multiple times in the treatment of the subject (e.g., steps (i) and (ii) of the methods provided herein are repeated multiple times.
(22) In some embodiments, the nutrition supplement is administered to the subject at a dose of from about 0.5 g/kg to about 5 g/kg, for example, about 0.5 g/kg to about 5 g/kg, about 0.5 g/kg to about 3 g/kg, about 0.5 g/kg to about 1 g/kg, about 1 g/kg to about 5 g/kg, about 1 g/kg to about 3 g/kg, or about 3 g/kg to about 5 g/kg. In some embodiments, the nutrition supplement is administered to the subject at a dose of from about 1 g/kg to about 3 g/kg. In some embodiments, the nutrition supplement is administered to the subject at a dose of about 2 g/kg. In some embodiments, the nutrition supplement is Intralipid 20% and is administered to the subject at a dose of from about 1 g/kg to about 3 g/kg. In some embodiments, the nutrition supplement is Intralipid 20% and is administered to the subject at a dose of about 2 g/kg. In some embodiments, a reduced dosage of the nutrition supplement is administered to the subject compared to the dosage administered to a corresponding subject as a parenteral nutrition supplement. In some embodiments, the reduced dosage is less than about 2 g/kg of the nutrition supplement. In some embodiments, the nutrition supplement is administered to the subject via intravenous administration.
(23) Nanotherapeutic Agents
(24) The present application further provides nanotherapeutic agents for use in the methods provided herein. As used herein, the term nanotherapeutic agent is a term known in the art and refers to one or more therapeutic agents formulated for use in nanomedicine (e.g., a therapeutic agent in combination with a nanocarrier).
(25) In some embodiments, the nanotherapeutic agent comprises a therapeutic agent and a nanocarrier. As used herein, the term nanocarrier refers to a nanomaterial (e.g., a nanoparticle) that is conjugated to the therapeutic agent (e.g., covalently bonded, ionically bonded, a coating on the therapeutic agent, a nanomaterial that encapsulates the therapeutic agent, and the like). Example nanocarriers include, but are not limited to, liposomes, lipid-coated nanoparticles, protein-coated nanoparticles (e.g., albumin and milk protein casein), and polymer-coated nanoparticles (e.g., chitosan, dextran, carboxymethylated dextran, poly(ecaprolactone), hyaluronic acid (HA) polymer, polyethylene glycol (PEG), poly(lactide) (PLA) and poly(lactide-coglycolide) (PLGA), poly(vinyl pyrrolidone), poly(ethyleneimine), poly(aspartic acid), and N-(2-hydroxypropyl) methacrylamide copolymers). Additional examples of nanocarriers include nanocomplex formed with heparin and protamine (see e.g., Thu et al, Nat. Med., 2012, 18, 463-467). Additional examples may be found, for example, in Bulte et al, NMR Biomed, 2004, 17, 484-499, the disclosure of which is incorporated by reference herein in its entirety.
(26) In some embodiments, the surface of a nanocarrier (e.g., a nanoparticle) can comprise one or more reactive functional groups such as thiols, chloromethyl, bromomethyl, hydroxyls, amines, carboxylic acid or activated ester, vinylsulfonyls, aldehydes, epoxies, hydrazides, succinimidyl esters, maleimides, -halo carbonyl moieties (such as iodoacetyls), isocyanates, isothiocyanates, 4-fluoro-5-nitro-benzoate, and aziridines. For example, the surface of a nanocarrier (e.g., a nanoparticle) can comprise a reactive functional group such as a thiol, a carboxylic acid, an amine, 4-fluoro-5-nitro-benzoate, or a carboxylic acid activated ester. Reactive functional groups may be useful for conjugating (i.e., bonding or attaching) the nanocarrier (e.g., a nanoparticle) to the therapeutic agent.
(27) In some embodiments, the nanotherapeutic agent comprises a therapeutic agent and a nanocarrier, wherein the nanocarrier is selected from the group consisting of a liposome, a lipid-coated nanoparticle, a protein-coated nanoparticle, and a polymer-coated nanoparticle.
(28) In some embodiments, the nanotherapeutic agent comprises a therapeutic agent and a polymer coating. In some embodiments, nanotherapeutic agent comprises a therapeutic agent and a hyaluronic acid polymer coating.
(29) In some embodiments, the nanotherapeutic agent comprises a therapeutic agent selected from the group consisting of a chemotherapeutic agent, an anti-inflammatory agent, a steroid, an anti-fungal drug, an anesthetic, and an immunosuppressant.
(30) Example chemotherapeutic agents include, but are not limited to, proteosome inhibitors (e.g., bortezomib), thalidomide, revlimid, DNA-damaging agents (e.g., melphalan, doxorubicin, cyclophosphamide, vincristine, etoposide, carmustine) cisplatin, doxorubicin, taxol, etoposide, irinotecan, topotecan, paclitaxel, docetaxel, epothilones, tamoxifen, 5-fluorouracil, methotrexate, temozolomide, cyclophosphamide, SCH 66336, R115777, L778,123, BMS 214662, gefitinib, erlotinib hydrochloride, antibodies to EGFR, imatinib mesylate, intron, ara-C, gemcitabine, uracil mustard, chlormethine, ifosfamide, melphalan, chlorambucil, pipobroman, triethylenemelamine, triethylenethiophosphoramine, busulfan, carmustine, lomustine, streptozocin, dacarbazine, floxuridine, cytarabine, 6-mercaptopurine, 6-thioguanine, fludarabine phosphate, oxaliplatin, folinic acid, pentostatin, vinblastine, vincristine, vindesine, bleomycin, dactinomycin, daunorubicin, doxorubicin, epirubicin, idarubicin, mithramycin, deoxycoformycin, mitomycin-C, L-asparaginase, teniposide, 17-ethinylestradiol, diethylstilbestrol, testosterone, prednisone, fluoxymesterone, dromostanolone propionate, testolactone, megestrol acetate, methylprednisolone, methyltestosterone, prednisolone, triamcinolone, chlorotrianisene, hydroxyprogesterone, aminoglutethimide, estramustine, medroxyprogesteroneacetate, leuprolide, flutamide, toremifene, goserelin, carboplatin, hydroxyurea, amsacrine, procarbazine, mitotane, mitoxantrone, levamisole, vinorelbine, anastrazole, letrozole, capecitabine, reloxafine, hexamethylmelamine, bevacizumab, bexxar, velcade, zevalin, trisenox, xeloda, vinorelbine, porfimer, erbitux, liposomal, thiotepa, altretamine, melphalan, trastuzumab, fulvestrant, exemestane, ifosfamide, rituximab, C225, alemtuzumab, clofarabine, cladribine, aphidicolin, sunitinib, dasatinib, tezacitabine, Smll, triapine, didox, trimidox, amidox, 3-AP, MDL-101,731, bendamustine, ofatumumab, and GS-1101 (also known as CAL-101). Example nanotherapeutic agents comprising chemotherapeutic agents include, but are not limited to, Abraxane, Marqibo, Doxil/Caelyx, DepoCyt, and Onivyde.
(31) Example anti-inflammatory agents include, but are not limited to, aspirin, choline salicylates, celecoxib, diclofenac potassium, diclofenac sodium, diclofenac sodium with misoprostol, diflunisal, etodolac, fenoprofen, flurbiprofen, ibuprofen, ketoprofen, meclofenamate sodium, mefenamic acid, nabumetone, naproxen, naproxen sodium, oxaprozin, piroxican, rofecoxib, salsalate, sodium salicylate, sulindac, tolmetin sodium, and valdecoxib. One example of a nanotherapeutic agent comprising an anti-inflammatory agent is Visudyne.
(32) Example steroids include, but are not limited to, corticosteroids such as cortisone, dexamethasone, hydrocortisone, methylprednisolone, prednisolone, and prednisone.
(33) Example anti-fungal agents include, but are not limited to, polyene anti-fungal agents (e.g., amphotericin B and candicidin), imidazole anti-fungal agents (e.g., bifonazole, clotrimazole, and econazole), triazole anti-fungal agents (e.g., albaconazole, efinaconazole, and fluconazole), thiazole anti-fungal agents (e.g., abafungin), allylamine anti-fungal agents (e.g., amorolfin, butenafine, and naftifine), echinocandins (e.g., anidulafungin and caspofungin). One example of a nanotherapeutic agent comprising an anti-fungal agent is Amphotericin B (AmB).
(34) Example anesthetics include, but are not limited to local anesthetics (e.g., lidocaine, procain, and ropivacaine), intravenous anesthetics (e.g., amobarbital, methohexital, diazepam, lorazepam, etomidate, ketamine, propofol, alfentanil, and fentanyl). One example of a nanotherapeutic agent comprising an anesthetic agent is DepoDur.
(35) Example immunosuppressants include, but are not limited to, azathioprine, chlorambucil, cyclophosphamide, cyclosporine, daclizumab, infliximab, methotrexate, and tacrolimus. Example nanotherapeutic agents comprising an immunosuppressant include, but are not limited to, certolizumab pegol and glatiramer acetate.
(36) In some embodiments, the nanotherapeutic agent comprises a chemotherapeutic agent. In some embodiments, the chemotherapeutic agent is a platinum-containing chemotherapeutic agent. Example platinum-containing chemotherapeutic agents include but are not limited to cisplatin, carboplatin, oxaliplatin, and dichloro(1,2-diaminocyclohexane)platinum(II) (DACHPt). In some embodiments, the platinum-containing is selected from the group consisting of cisplatin, carboplatin, oxaliplatin, and dichloro(1,2-diaminocyclohexane)platinum(II) (DACHPt). In some embodiments, the chemotherapeutic agent is oxaliplatin or dichloro(1,2-diaminocyclohexane)platinum(II) (DACHPt). In some embodiments, the chemotherapeutic agent is dichloro(1,2-diaminocyclohexane)platinum(II) (DACHPt).
(37) In some embodiments, the nanotherapeutic agent comprises a chemotherapeutic agent and a polymer coated nanoparticle. In some embodiments, the nanotherapeutic agent comprises a chemotherapeutic agent and a hyaluronic acid polymer coated nanoparticle. In some embodiments, the nanotherapeutic agent comprises a platinum-containing chemotherapeutic agent and a hyaluronic acid polymer coated nanoparticle. In some embodiments, the nanotherapeutic agent comprises oxaliplatin or dichloro(1,2-diaminocyclohexane)platinum(II) (DACHPt) and a hyaluronic acid polymer coated nanoparticle. In some embodiments, the nanotherapeutic agent comprises dichloro(1,2-diaminocyclohexane) latinum(II) (DACHPt) and a hyaluronic acid polymer coated nanoparticle. In some embodiments, the nanotherapeutic agent is a dichloro(1,2-diaminocyclohexane)platinum(II) (DACHPt) hyaluronic acid polymer nanotherapeutic agent.
(38) In some embodiments, a reduced dosage of the nanotherapeutic agent is administered to the subject compared to the dosage administered to a corresponding subject without administration of the nutrition supplement. In some embodiments, a reduced dosage of the nanotherapeutic agent is administered to the subject compared to the dosage administered to a corresponding subject without pre-administration of the nutrition supplement. In some embodiments, the reduced dosage comprises a sub-therapeutic amount of the nanotherapeutic agent. In some embodiments, the sub-therapeutic amount is from about 10% to about 90% of the therapeutic amount of the nanotherapeutic agent, for example about 10% to about 90%, about 10% to about 80%, about 10% to about 70%, about 10% to about 60%, about 10% to about 50%, about 10% to about 40%, about 10% to about 30%, about 10% to about 20%, about 20% to about 90%, about 20% to about 80%, about 20% to about 70%, about 20% to about 60%, about 20% to about 50%, about 20% to about 40%, about 20% to about 30%, about 30% to about 90%, about 30% to about 80%, about 30% to about 70%, about 30% to about 60%, about 30% to about 50%, about 30% to about 40%, about 40% to about 90%, about 40% to about 80%, about 40% to about 70%, about 40% to about 60%, about 40% to about 50%, about 50% to about 90%, about 50% to about 80%, about 50% to about 70%, about 50% to about 60%, about 60% to about 90%, about 60% to about 80%, about 60% to about 70%, about 70% to about 90%, about 70% to about 80%, or about 80% to about 90%.
(39) In some embodiments, an increased dosage of the nanotherapeutic agent is administered to the subject compared to the dosage administered to a corresponding subject without administration of the nutrition supplement. In some embodiments, an increased dosage of the nanotherapeutic agent is administered to the subject compared to the dosage administered to a corresponding subject without pre-administration of the nutrition supplement. In some embodiments, the increased dosage comprises a supra-therapeutic amount of the nanotherapeutic agent. In some embodiments, the supra-therapeutic amount is from about 110% to about 200% of the therapeutic amount of the nanotherapeutic agent, for example about 110% to about 200%, about 110% to about 190%, about 110% to about 180%, about 110% to about 170%, about 110% to about 160%, about 110% to about 150%, about 110% to about 140%, about 110% to about 130%, about 110% to about 120%, about 120% to about 200%, about 120% to about 190%, about 120% to about 180%, about 120% to about 170%, about 120% to about 160%, about 120% to about 150%, about 120% to about 140%, about 120% to about 130%, about 130% to about 200%, about 130% to about 190%, about 130% to about 180%, about 130% to about 170%, about 130% to about 160%, about 130% to about 150%, about 130% to about 140%, about 140% to about 200%, about 140% to about 190%, about 140% to about 180%, about 140% to about 170%, about 140% to about 160%, about 140% to about 150%, about 150% to about 200%, about 150% to about 190%, about 150% to about 180%, about 150% to about 170%, about 150% to about 160%, about 160% to about 200%, about 160% to about 190%, about 160% to about 180%, about 160% to about 170%, about 170% to about 200%, about 170% to about 190%, about 170% to about 180%, about 180% to about 200%, about 180% to about 190%, or about 190% to about 200%.
(40) In some embodiments, a single administration (e.g., a single intravenous administration) of the nanotherapeutic agent is sufficient for performing the methods provided herein (e.g., reducing clearance of the nanotherapeutic agent from a subject, increasing bioavailability of a nanotherapeutic agent in a subject, reducing toxicity of a nanotherapeutic agent in a subject, and the like). In some embodiments, multiple administrations of the nanotherapeutic agent at various intervals and over different periods of time may be required. In some embodiments, the nanotherapeutic agent is administered multiple times (e.g., two, three, four, or more times), and at least one of the administrations is between about 0.1 hours and about 24 hours after the administration of the nutrition supplement. In some embodiments, multiple administrations of the nanotherapeutic agent occur between about 0.1 hours and about 24 hours after the administration of the nutrition supplement to the subject. In some embodiments, at least one administration of the nanotherapeutic agent is not preceded by an administration of the nutrition supplement. In some embodiments, only the first administration of the nanotherapeutic agent is preceded by administration of the nutrition supplement. In some embodiments, each administration of the nanotherapeutic agent is preceded by administration of the nanotherapeutic agent.
(41) In some embodiments, the amount of nutrition supplement administered is constant over the course of the treatment regimen (e.g., each administration comprises the about the same dose of the nutrition supplement). In some embodiments, the amount of nutrition supplement administered is increased over the course of the treatment regimen (e.g., a second administration comprises an increased dosage of the nutrition supplement compared to the first administration, and the like). In some embodiments, the amount of nutrition supplement administered is decreased over the course of the treatment regimen (e.g., a second administration comprises a decreased dosage of the nutrition supplement compared to the first administration, and the like).
(42) In some embodiments, the amount of nanotherapeutic agent administered is constant over the course of the treatment regimen (e.g., each administration comprises the about the same dose of the nanotherapeutic agent). In some embodiments, the amount of nanotherapeutic agent administered is increased over the course of the treatment regimen (e.g., a second administration comprises an increased dosage of the nanotherapeutic agent compared to the first administration, and the like). In some embodiments, the amount of nanotherapeutic agent administered is decreased over the course of the treatment regimen (e.g., a second administration comprises a decreased dosage of the nanotherapeutic agent compared to the first administration, and the like).
(43) The nanotherapeutic agent can be effective over a wide dosage range and is generally administered in a pharmaceutically effective amount. It will be understood, however, that the amount of the nanotherapeutic agent actually administered will usually be determined by a physician, according to the relevant circumstances, including the condition to be treated, the chosen route of administration, the actual nanotherapeutic agent administered, the age, weight, and response of the individual subject, the severity of the subject's symptoms, and the like.
(44) Methods of Use
(45) The present application further provides a method of treating a disease in a subject (e.g., an autoimmune disease, an inflammatory disease, a fungal infection, or cancer), wherein the treatment comprises (i) administering the nutrition supplement; and (ii) administering a nanotherapeutic agent to the subject, wherein said nutrition supplement is administered to the mammal about 0.1 hours to about 24 hours before the nanotherapeutic agent is administered to the subject.
(46) The present application further provides a nutrition supplement for use in the treatment of a disease in a subject (e.g., an autoimmune disease, an inflammatory disease, a fungal infection, or a cancerous disease) wherein the treatment comprises (i) administering the nutrition supplement; and (ii) administering a nanotherapeutic agent to the subject, wherein said nutrition supplement is administered to the mammal about 0.1 hours to about 24 hours before the nanotherapeutic agent is administered to the subject.
(47) The present application further provides a method of reducing clearance of a nanotherapeutic agent from a subject in the treatment of a disease. In some embodiments, the method comprises (i) administering a nutrition supplement to the subject and (ii) administering the nanotherapeutic agent to the subject. In some embodiments, the nutrition supplement is administered between about 0.1 hours and about 24 hours before the nanotherapeutic agent is administered to the subject. In some embodiments, the method is a method of reducing RES clearance of the nanotherapeutic agent from the subject.
(48) In some embodiments, the method is a method of reducing RES clearance of the nanotherapeutic agent from the subject by about 5% to about 50% compared to a corresponding subject without pre-administration of the nutrition supplement, for example, about 5% to about 50%, about 5% to about 40%, about 5% to about 30%, about 5% to about 20%, about 5% to about 10%, about 10% to about 50%, about 10% to about 40%, about 10% to about 30%, about 10% to about 20%, about 20% to about 50%, about 20% to about 40%, about 20% to about 30%, about 30% to about 50%, about 30% to about 40%, or about 30% to about 40%.
(49) The present application further provides a method of improving the bioavailability of a nanotherapeutic agent in a subject in the treatment of a disease. In some embodiments, the method comprises (i) administering a nutrition supplement to the subject and (ii) administering the nanotherapeutic agent to the subject. In some embodiments, the nutrition supplement is administered between about 0.1 hours and about 24 hours before the nanotherapeutic agent is administered to the subject.
(50) In some embodiments, the method comprises improving the bioavailability of the nanotherapeutic agent by about 5% to about 50%, compared to the bioavailability of the nanotherapeutic agent in a corresponding subject without pre-administration of the nutrition supplement, for example, by about 5% to about 50%, by about 5% to about 40%, by about 5% to about 30%, by about 5% to about 20%, by about 5% to about 10%, by about 10% to about 50%, by about 10% to about 40%, by about 10% to about 30%, by about 10% to about 20%, by about 20% to about 50%, by about 20% to about 40%, by about 20% to about 30%, by about 30% to about 50%, by about 30% to about 40%, or by about 40% to about 50%.
(51) In some embodiments, the method comprises improving the bioavailability of the nanotherapeutic agent by about 5% to about 30%, compared to the bioavailability of the nanotherapeutic agent in a corresponding subject without pre-administration of the nutrition supplement. In some embodiments, the method comprises improving the bioavailability of the nanotherapeutic agent by about 5% to about 20%, compared to the bioavailability of the nanotherapeutic agent in a corresponding subject without pre-administration of the nutrition supplement.
(52) The present application further provides a method of reducing toxicity of a nanotherapeutic agent in a subject in the treatment of a disease. In some embodiments, the method comprises (i) administering a nutrition supplement to the subject and (ii) administering the nanotherapeutic agent to the subject. In some embodiments, the nutrition supplement is administered between about 0.1 hours and about 24 hours before the nanotherapeutic agent is administered to the subject.
(53) In some embodiments, the method comprises reducing the toxicity of the nanotherapeutic agent in one or more internal organs of the subject. In some embodiments, the method comprises reducing the toxicity of the nanotherapeutic agent in one or more internal organs associated with the RES in the subject.
(54) In some embodiments, the method comprises reducing liver toxicity of the nanotherapeutic agent in the subject. In some embodiments, the method of reducing liver toxicity comprises decreasing accumulation of the nanotherapeutic agent in the liver. Examples of liver toxicity include, but are not limited to, fatal liver toxicity and elevated levels of aspartate aminotransferase and/or ALT.
(55) In some embodiments, the accumulation of the nanotherapeutic agent is decreased by about 5% to about 50% in the liver, compared to accumulation of the nanotherapeutic agent in the liver of a corresponding subject without pre-administration of the nutrition supplement, for example, by about 5% to about 50%, by about 5% to about 40%, by about 5% to about 30%, by about 5% to about 20%, by about 5% to about 10%, by about 10% to about 50%, by about 10% to about 40%, by about 10% to about 30%, by about 10% to about 20%, by about 20% to about 50%, by about 20% to about 40%, by about 20% to about 30%, by about 30% to about 50%, by about 30% to about 40%, or by about 40% to about 50%. In some embodiments, the accumulation of the nanotherapeutic agent is decreased by about 10% to about 30% in the liver, compared to accumulation of the nanotherapeutic agent in the liver of a corresponding subject without pre-administration of the nutrition supplement. In some embodiments, the accumulation of the nanotherapeutic agent is decreased by about 15% to about 25% in the liver, compared to accumulation of the nanotherapeutic agent in the liver of a corresponding subject without pre-administration of the nutrition supplement.
(56) In some embodiments, the method comprises reducing spleen toxicity of the nanotherapeutic agent in the subject. In some embodiments, the method of reducing spleen toxicity comprises decreasing accumulation of the nanotherapeutic agent in the spleen. An example of spleen toxicity includes, but is not limited to, enlarged spleen.
(57) In some embodiments, the accumulation of the nanotherapeutic agent is decreased by about 5% to about 50% in the spleen, compared to accumulation of the nanotherapeutic agent in the spleen of a corresponding subject without pre-administration of the nutrition supplement, for example, by about 5% to about 50%, by about 5% to about 40%, by about 5% to about 30%, by about 5% to about 20%, by about 5% to about 10%, by about 10% to about 50%, by about 10% to about 40%, by about 10% to about 30%, by about 10% to about 20%, by about 20% to about 50%, by about 20% to about 40%, by about 20% to about 30%, by about 30% to about 50%, by about 30% to about 40%, or by about 40% to about 50%. In some embodiments, the accumulation of the nanotherapeutic agent is decreased by about 25% to about 50% in the spleen, compared to accumulation of the nanotherapeutic agent in the spleen of a corresponding subject without pre-administration of the nutrition supplement. In some embodiments, the accumulation of the nanotherapeutic agent is decreased by about 35% to about 45% in the spleen, compared to accumulation of the nanotherapeutic agent in the spleen of a corresponding subject without pre-administration of the nutrition supplement.
(58) In some embodiments, the method comprises reducing kidney toxicity of the nanotherapeutic agent in the subject. In some embodiments, the method of reducing kidney toxicity comprises decreasing accumulation of the nanotherapeutic agent in the kidney. An example of kidney toxicity includes, but is not limited to, nephrotoxicity.
(59) In some embodiments, the accumulation of the nanotherapeutic agent is decreased by about 5% to about 50% in the kidney, compared to accumulation of the nanotherapeutic agent in the kidney of a corresponding subject without pre-administration of the nutrition supplement, for example, by about 5% to about 50%, by about 5% to about 40%, by about 5% to about 30%, by about 5% to about 20%, by about 5% to about 10%, by about 10% to about 50%, by about 10% to about 40%, by about 10% to about 30%, by about 10% to about 20%, by about 20% to about 50%, by about 20% to about 40%, by about 20% to about 30%, by about 30% to about 50%, by about 30% to about 40%, or by about 40% to about 50%. In some embodiments, the accumulation of the nanotherapeutic agent is decreased by about 5% to about 15% in the kidney, compared to accumulation of the nanotherapeutic agent in the kidney of a corresponding subject without pre-administration of the nutrition supplement. In some embodiments, the accumulation of the nanotherapeutic agent is decreased by about 6% to about 12% in the kidney, compared to accumulation of the nanotherapeutic agent in the kidney of a corresponding subject without pre-administration of the nutrition supplement.
(60) In some embodiments, the nutrition supplement is administered between about 0.1 and about 24 hours before the nanotherapeutic agent is administered, for example, between about 0.1 hours and about 24 hours, about 0.1 hours and about 12 hours, about 0.1 hours and about 8 hours, about 0.1 hours and about 4 hours, about 0.1 hours and about 2 hours, about 0.1 hours and about 1 hour, about 0.1 hours and about 0.5 hours, between about 0.5 hours and about 24 hours, about 0.5 hours and about 12 hours, about 0.5 hours and about 8 hours, about 0.5 hours and about 4 hours, about 0.5 hours and about 2 hours, about 0.5 hours and about 1 hour, between about 1 hour and about 24 hours, about 1 hour and about 12 hours, about 1 hour and about 8 hours, about 1 hour and about 4 hours, about 1 hour and about 2 hours, between about 2 hours and about 24 hours, about 2 hours and about 12 hours, about 2 hours and about 8 hours, about 2 hours and about 4 hours, between about 4 hours and about 24 hours, about 4 hours and about 12 hours, about 4 hours and about 8 hours, between about 8 hours and about 24 hours, about 8 hours and about 12 hours, or between about 12 hours and about 24 hours.
(61) In some embodiments, the nutrition supplement is administered between about 0.3 and about 4 hours before the nanotherapeutic agent is administered. In some embodiments, the nutrition supplement is administered between about 0.3 and about 3 hours before the nanotherapeutic agent is administered. In some embodiments, the nutrition supplement is administered between about 0.5 and about 1.5 hours before the nanotherapeutic agent is administered. In some embodiments, the nutrition supplement is administered between about 4 and about 10 hours before the nanotherapeutic agent is administered. In some embodiments, the nutrition supplement is administered between about 10 and about 24 hours before the nanotherapeutic agent is administered. In some embodiments, the nutrition supplement is administered between about 10 and about 15 hours before the nanotherapeutic agent is administered. In some embodiments, the nutrition supplement is administered about 1 hour before the nanotherapeutic agent is administered.
(62) In some embodiments:
(63) the nutrition supplement is selected from the group consisting of Intralipid 10%, Intralipid 20%, and Intralipid 30%, or any combination thereof;
(64) the nanotherapeutic agent comprises a chemotherapeutic agent and a hyaluronic acid polymer coated nanoparticle; and
(65) the nutrition supplement is administered about 1 hour before the nanotherapeutic agent is administered.
(66) In some embodiments:
(67) the nutrition supplement is Intralipid 20%;
(68) the nanotherapeutic agent comprises a chemotherapeutic agent and a hyaluronic acid polymer coated nanoparticle; and
(69) the nutrition supplement is administered about 1 hour before the nanotherapeutic agent is administered.
(70) In some embodiments:
(71) the nutrition supplement is Intralipid 20%;
(72) the nanotherapeutic agent comprises a platinum-containing chemotherapeutic agent and a hyaluronic acid polymer coated nanoparticle; and
(73) the nutrition supplement is administered about 1 hour before the nanotherapeutic agent is administered.
(74) In some embodiments:
(75) the nutrition supplement is Intralipid 20%;
(76) the nanotherapeutic agent comprises oxaliplatin or dichloro(1,2-diaminocyclohexane) platinum(II) (DACHPt) and a hyaluronic acid polymer coated nanoparticle; and
(77) the nutrition supplement is administered about 1 hour before the nanotherapeutic agent is administered.
(78) In some embodiments:
(79) the nutrition supplement is Intralipid 20%;
(80) the nanotherapeutic agent comprises dichloro(1,2-diaminocyclohexane) platinum(II) (DACHPt) and a hyaluronic acid polymer coated nanoparticle; and
(81) the nutrition supplement is administered about 1 hour before the nanotherapeutic agent is administered.
(82) In some embodiments, the subject is being treated for a disease selected from the group consisting of an autoimmune disease, an inflammatory disease, a fungal infection, or a cancer. In some embodiments, the methods provided herein are performed in combination with the administration of one or more additional therapeutic agents useful for the treatment of the disease. In some embodiments, the one or more additional therapeutic agents is one or more of the therapeutic agents provided herein.
(83) In some embodiments, the disease is an autoimmune disease. Example autoimmune diseases include, but are not limited to, arthritis (e.g., rheumatoid arthritis, osteoarthritis, psoriatic arthritis), multiple sclerosis (e.g., relapsing-remitting multiple sclerosis), systemic lupus erythematous, asthma, autoimmune pancreatitis, psoriasis, glomerulonephritis, encephalitis, myasthenia gravis, Sjgren's syndrome. In some embodiments, the disease is selected from the group consisting of relapsing-remitting multiple sclerosis, rheumatoid arthritis, and psoriatic arthritis.
(84) In some embodiments, the disease is an inflammatory disease. Example inflammatory diseases include, but are not limited to, inflammatory heart disease (e.g., atherosclerosis), thrombosis, meningitis, benign prostatic hypertrophy, inflammatory bowel disease (e.g., Crohn's disease and ulcerative colitis), and inflammatory eye disease (e.g., macular degeneration). In some embodiments, the inflammatory disease is selected from the group consisting of inflammatory heart diseases, inflammatory bowel disease, and inflammatory eye disease.
(85) In some embodiments, the disease is a fungal infection. Example fungal infections include, but are not limited to, aspergillosis, blastomycosis, candidiasis, cryptococcal meningitis, coccidioidomycosis (Valley Fever), C. neoformans infection, C. gattii infection, a fungal eye infection, histoplasmosis, mucormycosis, Pneumocystis pneumonia (PCP), ringworm, and sporotrichosis.
(86) In some embodiments, the disease is a cancer (i.e., a cancerous disease). Example cancers include, but are not limited to, breast cancer, prostate cancer, esophageal cancer, liver cancer, colon cancer, testicular cancer, endometrial cancer, brain cancer, bladder cancer, cancer of the uterus, cancer of the ovary, cervical cancer, lung cancer, sarcoma, bone cancer, pancreatic cancer, renal cancer, stomach cancer, and cancer of the head and neck. In some embodiments, the cancer is selected from the group consisting of breast cancer, ovarian cancer, pancreatic cancer, lung cancer, blood cancer, and head and neck cancer. In some embodiments, the cancer is selected from the group consisting of
(87) In some embodiments, the subject is not concurrently being treated with a nutrition supplement prior to the administration of step i). In some embodiments of the methods provided herein, the subject is not concurrently being treated with a parenteral nutrition supplement prior to the administration of step i). In some embodiments of the methods provided herein, the subject has not been treated with a nutrition supplement within about 24 hours to about 1 week prior to the administration of step i), for example, within about 24 hours to about 1 week, about 24 hours to about 5 days, about 24 hours to about 4 days, about 24 hours to about 3 days, or about 24 hours to about 2 days. In some embodiments of the methods provided herein, the subject has not been treated with a nutrition supplement within about 24 hours prior to the administration of step i).
(88) The present application further provides a method of reducing RES clearance of a nanotherapeutic agent from a subject in the treatment of a disease, the method comprising (i) administering Intralipid 20% to the subject at a dose of about 2 g/kg and (ii) administering a therapeutically effective amount of the nanotherapeutic agent to the subject, wherein:
(89) the Intralipid 20% is administered about 1 hour before the nanotherapeutic agent is administered; and
(90) the nanotherapeutic agent is a dichloro(1,2-diaminocyclohexane)platinum(II)/hyaluronic acid polymer (DACHPt/HANP) coated nanotherapeutic agent.
(91) The present application further provides a method of improving the bioavailability of a nanotherapeutic agent in a subject in the treatment of a disease, the method comprising (i) administering Intralipid 20% to the subject at a dose of about 2 g/kg and (ii) administering a therapeutically effective amount of the nanotherapeutic agent to the subject, wherein:
(92) the Intralipid 20% is administered about 1 hour before the nanotherapeutic agent is administered; and
(93) the nanotherapeutic agent is a dichloro(1,2-diaminocyclohexane)platinum(II)/hyaluronic acid polymer (DACHPt/HANP) coated nanotherapeutic agent.
(94) The present application further provides a method of reducing liver toxicity, spleen toxicity, and kidney toxicity of a nanotherapeutic agent in a subject in the treatment of a disease, the method comprising (i) administering Intralipid 20% to the subject at a dose of about 2 g/kg and (ii) administering a therapeutically effective amount of the nanotherapeutic agent to the subject, wherein:
(95) the Intralipid 20% is administered about 1 hour before the nanotherapeutic agent is administered;
(96) the nanotherapeutic agent is a dichloro(1,2-diaminocyclohexane)platinum(II)/hyaluronic acid polymer (DACHPt/HANP) coated nanotherapeutic agent.
(97) In some embodiments, the nutrition supplement and the nanotherapeutic agent are administered to the subject in separate dosage forms.
(98) In some embodiments, the methods provided herein further comprise monitoring the subject to determine if, for example, treatment with the nanotherapeutic agent results in an improvement of the disease for which the subject is being treated. In some embodiments, the monitoring comprises imaging the subject with an imaging technique. In some embodiments, the monitoring comprises obtaining a biological sample from the subject and analyzing the biological sample using an imaging technique. Example biological samples include, but are not limited to, blood, plasma, serum, urine, or tissue samples. Example imaging techniques include, but are not limited to, magnetic resonance imaging, optical imaging, single-photon emission computed tomography, positron emission tomography imaging, positron emission tomography with computed tomography imaging, positron emission tomography with magnetic resonance imaging, Cerenkov imaging, and ultrasound imaging.
(99) Kits
(100) The present application further provides a kit comprising one or more nutrition supplements provided herein and one or more nanotherapeutic agents provided herein. In some embodiments, the kit is for use in the treatment of a disease in a subject, wherein said kit comprises a nutrition supplement provided herein and a nanotherapeutic agent provided herein. In some embodiments, the disease is a disease provided herein (e.g., an autoimmune disease, an inflammatory disease, a fungal infection, or a cancer). In some embodiments, the nutrition supplement of the kit is to be administered to the subject from about 0.1 hours to about 24 hours before the nanotherapeutic agent is to be administered to the mammal. In some embodiments, the kit further comprises instructions for using the kit. In some embodiments, the instructions comprise instructions for administering the nutrition supplement and nanotherapeutic agent. In some embodiments, the instructions comprise instructions for performing a method provided herein. In some embodiments, the instructions comprise instructions for preparing a nutrition supplement provided herein. In some embodiments, the instructions comprise instructions for preparing a nanotherapeutic agent provided herein. The present application further provides methods for combining one or more nutrition supplements and one or more nanotherapeutic agents within a kit (e.g., in separate packages) for administration to a subject in the treatment of a disease (e.g., for sequential administration to the subject).
(101) In some embodiments, the kit comprises:
(102) i) one or more nutrition supplements provided herein;
(103) ii) one or more nanotherapeutic agents provided herein; and
(104) iii) instructions for performing one or more of the methods provided herein.
(105) In some embodiments, the kit comprises one nutrition supplement provided herein. In some embodiments, the kit comprises one nanotherapeutic agent provided herein.
(106) In some embodiments, the kit comprises:
(107) i) Intralipid 20%;
(108) ii) a nanotherapeutic agent comprising a chemotherapeutic agent and a hyaluronic acid polymer coated nanoparticle; and
(109) iii) instructions for administering the Intralipid 20% from about 0.1 to about 24 hours before the nanotherapeutic agent is administered.
(110) In some embodiments, the kit comprises:
(111) i) Intralipid 20%;
(112) ii) a nanotherapeutic agent comprising a chemotherapeutic agent and a hyaluronic acid polymer coated nanoparticle; and
(113) iii) instructions for administering the Intralipid 20% about 1 hour before the nanotherapeutic agent is administered.
(114) In some embodiments, the kit comprises:
(115) i) Intralipid 20%;
(116) ii) a nanotherapeutic agent comprising a platinum-containing chemotherapeutic agent and a hyaluronic acid polymer coated nanoparticle; and
(117) iii) instructions for administering the Intralipid 20% from about 0.1 hours to about 24 hours before the nanotherapeutic agent is administered.
(118) In some embodiments, the kit comprises:
(119) i) Intralipid 20%;
(120) ii) a nanotherapeutic agent comprising a platinum-containing chemotherapeutic agent and a hyaluronic acid polymer coated nanoparticle; and
(121) iii) instructions for administering the Intralipid 20% about 1 hour before the nanotherapeutic agent is administered.
(122) In some embodiments, the kit comprises:
(123) i) Intralipid 20%;
(124) ii) a nanotherapeutic agent comprising oxaliplatin or dichloro(1,2-diaminocyclohexane)platinum(II) (DACHPt) and a hyaluronic acid polymer coated nanoparticle; and
(125) iii) instructions for administering the Intralipid 20% about 0.1 hours to about 24 hours before the nanotherapeutic agent is administered.
(126) In some embodiments, the kit comprises:
(127) i) Intralipid 20%;
(128) ii) a nanotherapeutic agent comprising oxaliplatin or dichloro(1,2-diaminocyclohexane)platinum(II) (DACHPt) and a hyaluronic acid polymer coated nanoparticle; and
(129) iii) instructions for administering the Intralipid 20% about 1 hour before the nanotherapeutic agent is administered.
(130) In some embodiments, the kit comprises:
(131) i) Intralipid 20%;
(132) ii) a nanotherapeutic agent comprising dichloro(1,2-diaminocyclohexane)platinum(II) (DACHPt) and a hyaluronic acid polymer coated nanoparticle; and
(133) iii) instructions for administering the Intralipid 20% about 0.1 hours to about 24 hours before the nanotherapeutic agent is administered.
(134) In some embodiments, the kit comprises:
(135) i) Intralipid 20%;
(136) ii) a nanotherapeutic agent comprising dichloro(1,2-diaminocyclohexane)platinum(II) (DACHPt) and a hyaluronic acid polymer coated nanoparticle; and
(137) iii) instructions for administering the Intralipid 20% about 1 hour before the nanotherapeutic agent is administered.
(138) In some embodiments, the kit comprises:
(139) i) one or more packages comprising a nutrition supplement provided herein (e.g., the Intralipid 20%);
(140) ii) one or more packages comprising a nanotherapeutic agent provided herein (e.g., dichloro(1,2-diaminocyclohexane)platinum(II) (DACHPt) and a hyaluronic acid polymer coated nanoparticle); and
(141) iii) instructions for performing one or more of the methods provided herein.
(142) In some embodiments, the kit comprises:
(143) i) a first package comprising the nutrition supplement (e.g., the Intralipid 20%);
(144) ii) a second package comprising the nanotherapeutic agent (e.g., dichloro(1,2-diaminocyclohexane)platinum(II) (DACHPt) and a hyaluronic acid polymer coated nanoparticle); and
(145) iii) instructions for performing one or more of the methods provided herein.
(146) In some embodiments, the kit comprises:
(147) i) a first package comprising Intralipid 20%;
(148) ii) a second package comprising a dichloro(1,2-diaminocyclohexane)platinum(II) (DACHPt) hyaluronic acid polymer nanotherapeutic agent; and
(149) iii) instructions for administering the Intralipid 20% about 0.1 hours to about 24 hours before the nanotherapeutic agent is administered.
(150) In some embodiments, the kit comprises:
(151) i) a first package comprising Intralipid 20%;
(152) ii) a second package comprising a dichloro(1,2-diaminocyclohexane)platinum(II) (DACHPt) hyaluronic acid polymer nanotherapeutic agent; and
(153) iii) instructions for administering the Intralipid 20% about 1 hour before the nanotherapeutic agent is administered.
EXAMPLES
(154) The invention will be described in greater detail by way of specific examples. The following examples are offered for illustrative purposes, and are not intended to limit the invention in any manner. Those of skill in the art will readily recognize a variety of non-critical parameters which can be changed or modified to yield essentially the same results. Suitable starting materials, synthetic methods, and assay methods may also be found, for example, in the disclosure of Liu et al, Sci. Rep. 2015, 5, 10881, the disclosure of which is incorporated by reference herein in its entirety.
(155) General Methods and Materials
(156) Materials and Animals
(157) Intralipid 20% was purchased from Fresenius Kabi (Bad Homburg, Germany). Dichloro(1,2-diamminocyclohexane) platinum(II) (DACHPtCl.sub.2), AgNO.sub.3, and the platinum (Pt) standard were purchased from Sigma-Aldrich (St. Louis, Mo.). Phosphate-buffered-saline (PBS) was obtained from Mediatech (Manassas, Va.).
(158) Male Sprague Dawley (SD) rats with an indwelling jugular vein catheter implanted were purchased from Harlan Laboratories (Indianapolis, Ind.). All experiments involving animal subjects were approved by the Institutional Animal Care and Use Committee of Carnegie Mellon University. Animal care was provided in accordance with the Guide for the Care and Use of Laboratory Animals.
(159) Experimental Design
(160) Male SD rats, with body weights between 250 and 280 g, were used. Intralipid 20% was administered by intravenous injection at a clinical dose of 2 g/kg. PBS was administered to control animals. After 1 h, DACHPt/HANP (2 mg Pt/kg for bioavailability and biodistribution studies, n=14 for Intralipid pre-treatment group and n=14 for control group; 4 mg Pt/kg for toxicity studies, n=3 for Intralipid pre-treatment group and n=3 for control group; 6 mg Pt/kg for another toxicity study to test the serum ALT activity and creatinine level, n=3 for Intralipid pre-treatment group) was injected intravenously. Blood samples were collected at different time points to determine the bioavailability of DACHPt/HANP. At 5-, 24-, and 72-hr post injection of DACHPt/HANP, tissues (liver, spleen, and kidney) were collected for the Pt-level determination. The tissue samples collected at 72-hr post injection were used for histological analysis.
(161) Blood Bioavailability
(162) An indwelling jugular vein catheter was used for repeated blood samplings. Blood samples (100 L) were collected at different time points to determine the changes of bioavailability of DACHPt/HANP upon Intralipid treatment. Blood was sampled after DACHPt/HANP injection at 1, 5, 10, 20, 45, and 60 min, 3, 5, 24, 28, 48, 52, and 72 hr. The blood samples were decomposed in HNO.sub.3 (0.5 mL) at 60 C. overnight and re-dissolved in 0.5 mL of 2 N HCl (see e.g., Cabral et al, J. Control Release, 2005, 101, 223-232; Oberoi et al, Chemother. Res. Pract. 2012, 905796; and Esteban-Fernandez et a, J. Anal. Toxicol. 2008, 32, 140-146). Suitable dilutions were prepared using 5% HCl to reach a final Pt concentration in the range of 0.02 to 1 part per million (ppm). Samples were analyzed for Pt concentration by inductively coupled plasma-mass spectrometry (ICP-MS) [NexION 300X (PerkinElmer, Waltham, Mass.)], with modified procedures from our previous studies (see e.g., Liu et al, Biochim. Biophys. Acta. 2013, 1830, 3447-3453; and International Patent Application No. WO 2014/039874, the disclosure of which is incorporated by reference herein in its entirety). .sup.194Pt, .sup.195Pt, and .sup.196Pt isotopes were analyzed and similar results were obtained from the measurement of these three isotopes. The Pt concentrations shown in this manuscript were calculated from the measurements of .sup.194Pt. Bioavailability was calculated by the area under the curve (AUC), namely the integral of the concentration-time curve, using the trapezoidal rule with the use of KaleidaGraph 4.1 (Synergy Software, Reading, Pa.).
(163) Pt Levels in Tissues
(164) The wet weight of each tissue sample was recorded. Tissue homogenate (0.5 mL) was decomposed in HNO.sub.3 (1 mL) at 60 C. overnight. The rest of the tissue was fixed in 4% paraformaldehyde for histological analyses. The HNO.sub.3-digested samples were evaporated and then re-dissolved in 0.5 mL of 2 N HCl (see e.g., Esteban-Fernandez et a, J. Anal. Toxicol. 2008, 32, 140-146). The Pt concentrations in the solution were analyzed by ICP-MS as described above.
(165) Pathological Analysis and TUNEL Assay
(166) Histological examinations and TUNEL assays were performed by the Transplantation Pathology Laboratory of the University of Pittsburgh Medical Center (Pittsburgh, Pa.). Paraffin-embedded 5-m sections were stained with H & E, or performed TUNEL staining. For histopathological diagnosis, slides were examined by light microscopy and photomicrographs were taken using a Moticam 2300 camera mounted on an Olympus Provis microscope with Mtic Images Plus 2.0 software.
(167) ALT Activity Assay and Creatinine Colorimetric Assay
(168) The activity of ALT in serum was measured by using the ALT Activity Assay Kit purchased from Sigma-Aldrich, according to the supplier's protocol. Serum creatinine level was measured by using the Creatinine Colorimetric/Fluorometric Assay Kit purchased from BioVision.
(169) Statistical Analysis
(170) Statistical analysis was carried out with Student's t test. A p value <0.05 was considered statistically significant.
Example 1. Preparation and Physical Properties of DACHPt/HANP
(171) DACHPt/HANP was prepared with modified procedures from a previously described method (see e.g., Cabral et al, J. Control Release, 2005, 101, 223-232). In brief, DACHPtCl.sub.2 was mixed with silver nitrate ([AgNO.sub.3]/[DACHPt]=2) to form an aqueous complex. The solution was kept in the dark at 25 C. for 24 hr. AgCl precipitates were removed by centrifugation followed by filtration through a 0.22-m hydrophilic polyvinylidene fluoride (PVDF) membrane (Millipore, Billerica, Mass.). Subsequently, HA/Boc-His/PEG graft copolymers, comprising hyaluronic acid (Mw=16 kD), were added to the aqueous complex of DACHPt at a 0.33 molar ratio of DACHPt to carboxylate groups of the HA modified polymers. The mixture was stirred in the dark for three days at 25 C. The reaction mixture was sonicated and then purified by ultrafiltration against deionized water to remove uncoordinated DACHPt. The product was filtered through a 0.22-m PVDF membrane and lyophilized with 10% trehalose.
(172) DACHPt/HANP exhibits an average hydrodynamic diameter of 15030 nm, as determined by dynamic light scattering using a ZetaPlus (Brookhaven, Holtsville, N.Y.). The average Pt-core size is 19.16.2 nm, as measured by using a Cryo transmission electron microscope (Cryo-TEM) [JEM-2100 (JEOL, Tokyo, Japan)].
(173) The particle size and PI of DACHPt/HANP was determined by dynamic light scattering using a ZetaPlus (Brookhaven, Holtsville, N.Y.). Zeta potential was measured by the laser Doppler anemometry (Zeta Plus zeta potential analyzer, Brookhaven Instruments Corporation).
(174) TEM images were taken by using a Cryo transmission electron microscope (Cryo-TEM) [JEM-2100 (JEOL, Tokyo, Japan)] operated at 200 kV with attachment of energy dispersive spectroscopy (EDS). A droplet of DACHPt/HANP solution was adsorbed on a cleaned carbon film supported copper grid. After excess sample was removed, phosphotungstic acid (Merck) was used as negative stain reagent to improve the image contrast. TEM grid was dried in the contamination-free environment and reserved in the electronic dry cabinet for further TEM analysis.
(175) In order to determine the encapsulation efficiency of DACHPt in the nanocomplex, the amount of Pt were quantified by inductively coupled plasma-optical emission spectrometry (ICP-OES) in preparation processes. Encapsulation efficiency (EE %) was calculated using below formula:
Encapsulation efficiency (EE %)=(W.sub.P/W.sub.T)100%
(176) where W.sub.P is the total amount of Pt after purification by passing through a 0.22 m filter and W.sub.T is the total quantity of Pt determined before purification. The physical properties of DACHPt/HANP are shown below in Table 1.
(177) TABLE-US-00001 TABLE 1 Physical Properties of DACHPt/HANP Core Zeta Hydrodynamic Diameter Potential Diameter (nm) PI (nm) pH 6.5 (mV) DACHPt/ 150 30 0.24 0.05 19.1 6.2 17.9 5.5 HANP
Example 2. Intralipid Reduces Toxic Side Effects of Pt-Containing Nanotherapeutic Agents
(178) Intralipid 20% was administered to rats at the clinical dose (2 g/kg) using the clinical route (i.e., intravenously) one hour before i.v. injection of DACHPt/HANP. At 24- and 72-hr post injection of DAHPt/HANP, blood samples were collected to determine serum alanine aminotransferase (ALT) activity and creatinine level to investigate liver and kidney damages. The tissue samples collected at 72-hr post injection were used for histological analysis.
Example 3. Pathological Analysis and Terminal Deoxynucleotidyl Transferase dUTP Nick End Labeling (TUNEL) Assay for Apoptotic Cells in Liver
(179) Light microscopic images of H & E stained liver tissue sections are shown in
Example 4. Spleen Enlargement
(180) Spleen swelling and enlargement were observed from DACHPt/HANP-treated animals, when the animals were sacrificed 72-h post nanotherapeutic agent administration, as shown in
Example 5. Pathological and TUNEL Assay Analyses of Spleen
(181) Light microscopy images of H & E stained (
Example 6. Pathological and TUNEL Assay Analyses of Kidney
(182) Intralipid was found to protect kidney cells from the damage caused by the Pt-nanotherapeutic agent. With Intralipid pre-treatment, the apoptotic cells in kidney, caused by the treatment of DACHPt/HANP, was decreased, as shown in
Example 7. ALT Activity and Creatinine Colorimetric Assays to Assess Liver and Kidney Damages
(183) The serum ALT activity is 54.43.3 IU/L for nave rats. Intralipid treatment did not alter ALT activity (57.12.2 IU/L, as shown in
(184) Consistent with the pathological findings in kidney (
(185) To show the potency of this Intralipid protective effects, the rats (n=3) were pre-treated with Intralipid followed by a higher dosage, 6 mg Pt/kg, of DACHPt/HANP. At 24- and 72-hr post nanotherapeutic agent treatment, serum ALT activities were 289.211.3 IU/L and 191.56.9 IU/L, respectively; creatinine levels were 180.211.3 M and 145.216.2 M. These activities and levels were all significantly lower than the group treated with lower dosage of the nanotherapeutic agent (4 mg Pt/kg), but no Intralipid pre-treatment, as shown in
Example 8. Changes of DACHPt/HANP Accumulation in Tissues Upon Intralipid Pre-Treatment
(186) The Pt concentration in tissue (spleen, liver, and kidney) and blood of nave animals or Intralipid along or phosphate-buffered-saline (PBS) treated animals was below 0.01 part per million (ppm).
Example 9. DACHPt/HANP Accumulation in Liver
(187) In a previous study (see e.g., Liu et al, Biochim. Biophys. Acta, 2013, 1830, 3447-3453), it was found that in rodents, Intralipid reduces RES uptake by 50% of nano- and micron-sized particles in which MRI contrast agents are loaded. The RES plays an important role in the uptake and metabolism of Intralipid (see e.g., Vilaro et al, J. Nutr. 1988, 118, 932-940; and Fraser et al, J. Leukoc. Biol. 1984, 36, 647-649). The blood half-life of Intralipid 20% (clinical dose 2 g/kg) administered by intravenous bolus in rats is 8.73.0 min. The diameter of the Intralipid particles range from 200 to 1000 nm. As shown in
(188) With DACHPt/HANP administration, the Pt concentrations in liver were 8.60.6 and 18.12.2 (g/g wet weight) at 5- and 24-hr post injection, as shown in
(189) With the drug being metabolized in the liver, the Pt concentrations reached similar level at 72 hr: 10.11.6 and 11.83.7 (g/g wet weight), without- and with-Intralipid pre-treatment, respectively.
Example 10. DACHPt/HANP Accumulation in Spleen
(190)
Example 11. DACHPt/HANP Accumulation in Kidney
(191) We have observed that the Pt accumulations in kidney also decreased upon Intralipid pre-treatment, as shown in
(192) With no Intralipid pre-treatment, the Pt concentration in kidney was 4.90.3, 6.11.5, and 7.91.4 (g/g wet weight) at 5-, 24- and 72-hr post DACHPt/HANP injection, as shown in
Example 12. Blood Clearance and Bioavailability
(193) The method described herein with Intralipid pre-treatment changes the clearance and increases the bioavailability of the nanotherapeutic agent. The results show that a single dose of Intralipid increased the bioavailability of DACHPt/HANP by 18.7% during the first 5 hr, as shown in
(194) Changes in the Pt concentrations in blood upon Intralipid pre-treatment are shown in
OTHER EMBODIMENTS
(195) It is to be understood that while the invention has been described in conjunction with the detailed description thereof, the foregoing description is intended to illustrate and not limit the scope of the invention, which is defined by the scope of the appended claims. Other aspects, advantages, and modifications are within the scope of the following claims.