Dispense interface
09889260 ยท 2018-02-13
Assignee
Inventors
- Frederic Laugere (Bedfordshire, GB)
- Cristian Popa (Norfolk, GB)
- Ben Impey (Cambridgeshire, GB)
- Andrew MacLeod (Cambridgeshire, GB)
Cpc classification
A61M2005/3128
HUMAN NECESSITIES
A61M5/19
HUMAN NECESSITIES
A61M5/3294
HUMAN NECESSITIES
A61M5/16827
HUMAN NECESSITIES
International classification
A61M5/32
HUMAN NECESSITIES
A61M5/315
HUMAN NECESSITIES
A61M5/19
HUMAN NECESSITIES
A61M5/168
HUMAN NECESSITIES
Abstract
The invention relates to a dispense interface comprising a body comprising at least a first channel structure and a second channel structure, wherein each of the at least two channel structures comprises at least a first inlet channel comprising a first inlet opening and a second inlet channel comprising a second inlet opening, wherein each of the at least two inlet openings of one channel structure is configured for fluid communication with a respective reservoir of at least two reservoirs and wherein at least one connecting channel configured for a fluid communication between at least one outlet opening and one of the at least two channel structures is provided.
Claims
1. A dispense interface comprising: a body comprising at least a first channel structure and a second channel structure, wherein the first channel structure comprises at least a first inlet channel comprising a first inlet opening and a second inlet channel comprising a second inlet opening, wherein the second channel structure comprises at least a third inlet channel comprising a third inlet opening and a fourth inlet channel comprising a fourth inlet opening, wherein the first inlet opening of the first channel structure is configured for fluid communication with a first reservoir and the second inlet opening of the first channel structure is configured for fluid communication with a second reservoir, wherein the third inlet opening of the second channel structure is configured for fluid communication with a third reservoir and the fourth inlet opening of the second channel structure is configured for fluid communication with a fourth reservoir, and wherein at least one connecting channel configured for a fluid communication between at least one outlet opening and one of the at least two channel structures is provided in such a way that only one channel structure is in fluid communication with the outlet opening at the same time, wherein at least one separate member comprising at least the at least one connecting channel and the at least one outlet opening is provided, wherein the at least one separate member is configured for a fluid tight connection with the body.
2. The dispense interface according to claim 1, wherein a first double-ended needle assembly comprising at least a first double-ended needle and a second double-ended needle is provided, wherein the first double-ended needle assembly is configured for a fluid tight connection with the at least two inlet openings of one channel structure.
3. The dispense interface according to claim 1, wherein the body is formed as a cylinder comprising a distal end surface and a proximal end surface, wherein the at least two inlet openings of at least one channel structure are arranged at an edge region of the proximal end surface.
4. The dispense interface according to claim 3, wherein the at least two inlet openings of at least one channel structure are arranged on a straight line which passes the center of the proximal end surface.
5. The dispense interface according to claim 1, wherein the body comprises at least a first part and a second part, wherein the first part is a cylindrical axis comprising the at least one outlet opening and the at least one connecting channel and wherein the second part comprising at least the first channel structure and the second channel structure is at least rotatably mounted on the first part.
6. The dispense interface according to claim 5, wherein the first part comprises a first double-ended needle assembly, wherein the first double-ended needle assembly is arranged at the proximal end of the first part in such a way that the first double-ended needle assembly is tightly connectable with the at least two inlet openings of one channel structure of the second part.
7. The dispense interface according to claim 5, wherein a stop element is arranged at the distal end of the first part, wherein at least one elastic element is arranged between the stop element and the second part and wherein the elastic element is configured to exert a force onto the second part into a proximal direction.
8. The dispense interface according to claim 7, wherein the second part is configured for releasing the fluid tight connection between the first double-ended needle assembly and the at least two inlet openings of a first channel structure by a movement in a distal direction and wherein the second part is configured for establishing a fluid tight connection between the first double-ended needle assembly and the at least two inlet openings of a second channel structure by a rotational movement and a movement in a proximal direction of the second part.
9. The dispense interface according to claim 1, wherein at least one inlet opening is sealed by a pierceable material.
10. The dispense interface according to claim 1, wherein at least one part of the body is produced by injection molding.
11. The dispense interface according to claim 1, wherein at least one non-return valve is provided.
12. A system comprising: a dispense interface according to claim 1, and an ejection device, wherein the dispense interface is attachable to the ejection device.
13. A method for using a dispense interface according to claim 1 comprising the steps of: attaching a first double ended needle assembly to the inlet openings of one channel structure of the dispense interface and attaching the dispense interface to an ejection device having at least two reservoirs such that a fluid tight connection is established between the at least two reservoirs and one channel structure of the dispense interface.
14. The method according to claim 13, further comprising the steps of: ejecting a fluid from at least one of the reservoirs through the dispense interface and removing the dispense interface from the ejection device.
Description
BRIEF DESCRIPTION OF THE FIGURES
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DETAILED DESCRIPTION
(17) The ejection device in the form of a drug delivery device illustrated in
(18) The main body 14 contains a micro-processor control unit, an electro-mechanical drive train, and at least two medicament reservoirs. When the end cap or cover 18 is removed from the device 10 (as illustrated in
(19) The drive train may exert a pressure on the bung of each cartridge, respectively, in order to expel the doses of the first and second medicaments. For example, a piston rod may push the bung of a cartridge forward a pre-determined amount for a single dose of medicament. When the cartridge is empty, the piston rod is retracted completely inside the main body 14, so that the empty cartridge can be removed and a new cartridge can be inserted.
(20) A control panel region 60 is provided near the proximal end of the main body 14. Preferably, this control panel region 60 comprises a digital display 80 along with a plurality of human interface elements that can be manipulated by a user to set and inject a combined dose. In this arrangement, the control panel region comprises a first dose setting button 62, a second dose setting button 64 and a third button 66 designated with the symbol OK. In addition, along the most proximal end of the main body, an injection button 74 is also provided (not visible in the perspective view of
(21) The cartridge holder 40 can be removably attached to the main body 14 and may contain at least two cartridge retainers 50 and 52. Each retainer is configured so as to contain one medicament reservoir, such as a glass cartridge. Preferably, each cartridge contains a different medicament.
(22) In addition, at the distal end of the cartridge holder 40, the drug delivery device illustrated in
(23) Once the device is turned on, the digital display 80 shown in
(24) As shown in
(25) As mentioned above when discussing
(26) In
(27)
(28) The needle assembly 400 illustrated in
(29) Similarly, a second or proximal piercing end 408 of the needle assembly 400 protrudes from an opposite side of the circular disc so that it is concentrically surrounded by the sleeve 403. In one needle assembly arrangement, the second or proximal piercing end 408 may be shorter than the sleeve 403 so that this sleeve to some extent protects the pointed end of the back sleeve. The needle cover cap 420 illustrated in
(30) Referring now to
(31) The main outer body 210 comprises a main body proximal end 212 and a main body distal end 214. At the proximal end 212 of the outer body 210, a connecting member is configured so as to allow the dispense interface 200 to be attached to the distal end of the cartridge holder 40. Preferably, the connecting member is configured so as to allow the dispense interface 200 to be removably connected the cartridge holder 40. In one preferred interface arrangement, the proximal end of the interface 200 is configured with an upwardly extending wall 218 having at least one recess. For example, as may be seen from
(32) Preferably, the first and the second recesses 217, 219 are positioned within this main outer body wall so as to cooperate with an outwardly protruding member located near the distal end of the cartridge housing 40 of the drug delivery device 10. For example, this outwardly protruding member 48 of the cartridge housing may be seen in
(33) The main outer body 210 and the distal end of the cartridge holder 40 act to form an axially engaging snap lock or snap fit arrangement that could be axially slid onto the distal end of the cartridge housing. In one alternative arrangement, the dispense interface 200 may be provided with a coding feature so as to prevent inadvertent dispense interface cross use. That is, the inner body of the hub could be geometrically configured so as to prevent an inadvertent cross use of one or more dispense interfaces.
(34) A mounting hub is provided at a distal end of the main outer body 210 of the dispense interface 200. Such a mounting hub can be configured to be releasably connected to a needle assembly. As just one example, this connecting means 216 may comprise an outer thread that engages an inner thread provided along an inner wall surface of a needle hub of a needle assembly, such as the needle assembly 400 illustrated in
(35) The dispense interface 200 further comprises a first inner body 220. Certain details of this inner body are illustrated in
(36) In addition, as can be seen in
(37) Preferably, this dispense interface 200 further comprises a valve arrangement. Such a valve arrangement could be constructed so as to prevent cross contamination of the first and second medicaments contained in the first and second reservoirs, respectively. A preferred valve arrangement may also be configured so as to prevent back flow and cross contamination of the first and second medicaments.
(38) In one preferred system, dispense interface 200 includes a valve arrangement in the form of a valve seal 260. Such a valve seal 260 may be provided within a cavity 231 defined by the second inner body 230, so as to form a holding chamber 280. Preferably, cavity 231 resides along an upper surface of the second inner body 230. This valve seal comprises an upper surface that defines both a first fluid groove 264 and second fluid groove 266. For example,
(39) Together, the first and second grooves 264, 266 converge towards the non-return valves 262 and 268 respectively, to then provide for an output fluid path or a holding chamber 280. This holding chamber 280 is defined by an inner chamber defined by a distal end of the second inner body both the first and the second non return valves 262, 268 along with a pierceable septum 270. As illustrated, this pierceable septum 270 is positioned between a distal end portion of the second inner body 230 and an inner surface defined by the needle hub of the main outer body 210.
(40) The holding chamber 280 terminates at an outlet port of the interface 200. This outlet port 290 is preferably centrally located in the needle hub of the interface 200 and assists in maintaining the pierceable seal 270 in a stationary position. As such, when a double ended needle assembly is attached to the needle hub of the interface (such as the double ended needle illustrated in
(41) The hub interface 200 further comprises a second inner body 230. As can be seen from
(42) Axially sliding the main outer body 210 over the distal end of the drug delivery device attaches the dispense interface 200 to the multi-use device. In this manner, a fluid communication may be created between the first needle 240 and the second needle 250 with the primary medicament of the first cartridge and the secondary medicament of the second cartridge, respectively.
(43)
(44) When the interface 200 is first mounted over the distal end of the cartridge holder 40, the proximal piercing end 244 of the first piercing needle 240 pierces the septum of the first cartridge 90 and thereby resides in fluid communication with the primary medicament 92 of the first cartridge 90. A distal end of the first piercing needle 240 will also be in fluid communication with a first fluid path groove 264 defined by the valve seal 260.
(45) Similarly, the proximal piercing end 254 of the second piercing needle 250 pierces the septum of the second cartridge 100 and thereby resides in fluid communication with the secondary medicament 102 of the second cartridge 100. A distal end of this second piercing needle 250 will also be in fluid communication with a second fluid path groove 266 defined by the valve seal 260.
(46)
(47) As illustrated in
(48) In one preferred arrangement, the dispense interface is configured so that it attaches to the main body in only one orientation, that is it is fitted only one way round. As such as illustrated in
(49)
(50) The body 502 comprises multiple channel structures wherein in the present example only a first channel structure 504 and a second channel structure 506 are provided with reference signs for sake of clarity. The first channel structure 504 comprises a first inlet channel 508 and a second inlet channel 510. Each of the inlet channels 508, 510 comprises an inlet opening 516, 518. The inlet openings 516, 518 are arranged at an edge region of the body 502. Thereby, the inlet openings 516, 518 of the first channel structure 504 may be arranged on a straight line 530 which passes the center 528 of the proximal end surface 552 of the body 502.
(51) An inlet channel 508, 510 may comprise a first channel part which is substantially linear and runs parallel with the axis of the body 502 and a second part following the first part, wherein the second part is substantially linear and runs parallel to the distal end surface of the body 502. The second part of the inlet channel is an open recess 524. A channel can be established by connecting a separate member 532 at the distal end 554 of the drum 502, as will be explained hereinafter.
(52) The second channel structure 506 comprises a first inlet channel 512 comprising a first inlet opening 520 and a second inlet channel 514 comprising a second inlet opening 522. Preferably, all channel structures 504, 506 in the body 502 are similarly formed.
(53) Furthermore, a connecting channel 534 and an outlet opening 536 are provided. In the present example, the connecting channel 534 and the outlet opening 536 are provided by a separate component 532 which can be tightly connected to the body 502. Thereby, the connecting channel 534 is configured for a fluid communication between the two inlet channels 508, 510, 512, 514 of (only) one channel structure 504, 506. In particular, only one channel structure 504, 506 can be in fluid communication with the outlet opening 536 at the same time.
(54) Furthermore, a first double-ended needle assembly 544 comprising a first double ended needle 548 and a second double ended needle 550 is provided. The first double-ended needle assembly 544 can be tightly connected with the body 502, in particular, with a first inlet opening 516, 520 and a second inlet opening 518, 522 of one channel structure 504, 506. In particular, only one channel structure 504, 506 can be in fluid communication with the first double ended needle 548 and the second double ended needle 550 at the same time.
(55) A second needle assembly 542 comprising an ejection needle 546 is provided. The second needle assembly 542 can be an integral part of the separate component 532 or a further separate part which can be tightly connected to the outlet opening 536 of the separate component 532.
(56)
(57) The illustrated dispense interface 500 can be attached to an ejection device, for instance manually by a user. After operating the ejection device, for instance, after ejecting at least one fluid from at least one reservoir of the ejection device, the dispense interface 500 can be removed from the ejection device. In addition, the separate component 532 and the first needle assembly 544 can be removed from the body 502. If the separate component 532 and the first double ended 544 needle assembly are single-use items, the respective components 532, 544 can be discarded.
(58) If a further ejection should be performed, preferably a new separate component 532 and a new first double ended needle assembly 544 can be tightly attached to the body 502. In particular, the separate component 532 and the first double ended needle assembly 544 can be attached to an unused channel structure, like the second channel structure 506. Preferably, each channel structure of the body 502 is used for only ejection procedure. In the present example, since six channel structures are provided, the body 502 or drum 502 can be used six times. It shall be understood that according to other variants of the invention, there may be provided more or less channel structures.
(59)
(60) Furthermore, the first part 604 comprises a first double-ended needle assembly 626 with a first double ended needle 628 and a second double ended needle 630. The first double-ended needle assembly 626 is an integral part of the first part 604. It forms the proximal end 650 of the first part 604.
(61) At the distal end 652 of the first part 604, a stop element 632 is arranged. As can be seen from
(62) The second part 606 may be a rotationally symmetric part having a plurality of channel structures. In the present
(63) As can be further seen, the first part 604 comprises a connecting channel 622. The connecting channel 622 is configured for a fluid communication between the two inlet channels 610, 612 and an outlet opening 624 of the first part 604.
(64) Furthermore, s second needle assembly 642 comprising a needle 644 is provided. In the present example, the second needle assembly 642 comprises a connecting element 648 which corresponds to a connecting element 646 of the first part 604. The first part 604 comprises an external thread 646 for providing a positive fit with the needle assembly 642 to provide a threaded engagement.
(65) The illustrated dispense interface 600 can be attached, for instance manually by a user, to an ejection device for an ejecting process. Preferably, each channel structure is used for only ejection procedure. For attaching a new channel structure to the first double-ended needle assembly 626, the second part 606 can be pushed forward, preferably by a user, in a distal direction 638. Thereby, a force must be exerted which is larger than the force exerted by the elastic element 634. In case a spring 634 is employed, the force to be exerted depends at least on the spring constant.
(66) When the second part 606 is pushed forward such that the double-ended needles 628, 630 are fully exposed, the second part 606 can be rotated. When a first and second opening of an unused channel structures is arranged opposite to the first and second double-ended needle 628, 630, a user can release the second part 606 and due to the force of the elastic element 634, the double-ended needles 628, 630 automatically puncture the sealing layer of the respective inlet openings. After a second needle assembly is attached to the dispense interface 600, the ejection device can be operated and at least one fluid of at least one reservoir can be ejected.
(67) It shall be understood that a new channel structure can also be attached to the double-ended needle assembly 626 after the attachment to the ejecting device.
(68)
(69) The valve arrangements may for instance be integrally formed with another part of the dispense interface. Alternatively, the valve arrangement may for instance be manufactured separately from the other parts of dispense interface.
(70) For instance, the valve arrangement may be inserted (e.g. potted/over-molded) into the body portion. For instance, the valve arrangement may at least partially be inserted (e.g. potted/over-molded) when the body portion are injection molded. For instance, the valve arrangement may at least partially be inserted (e.g. mounted) in a separate step after the body portion have been injection molded.
(71)
(72) The diaphragm/flap valve arrangement 3000a has flexible diaphragm/flap 3040. When the fluidic pressure in the inlet 3010 is increased (e.g. during a dose priming or a dose injecting step), the diaphragm/flap 3040 will change from an un-stressed state to a stressed state. In the stressed state, the fluidic pressure bends the diaphragm/flap 3040 as indicated by the arrow in
(73)
(74) The diameter of the movable element 3060 corresponds to the diameter of the tube 3050 such that the movable element 3060 is movable between a first and a second (longitudinal) position in the tube 3050. In the first position (illustrated in
(75)
(76)
(77) When the fluidic pressure in the inlet 3010 is increased (e.g. during a dose priming or a dose injecting step), the first flat spring 3100 will change from an un-stressed state to a stressed state. In the stressed state, the fluidic pressure bends the first flat spring 3100 as indicated by the arrow in
(78)
(79) The flap 3120 is rotatable between a first and a second position. In the first position (illustrated in
(80) When the fluidic pressure in the inlet 3010 is for instance increased (e.g. during a dose priming or a dose injecting step), the flap 3120 will be pushed towards the second position as indicated by the arrow in
(81)
(82) It shall be understood that if a totally unused dispense interface is used, it may be necessary that in a previous step, a packaging must be removed by the user.
(83) When the first double ended needle assembly is attached to the dispense interface, in an optional step, it may be necessary to attach a separate component to the body of the dispense interface. The separate component may already comprise a second needle assembly comprising an ejection needle. The separate component may be configured for establishing a fluid communication from the inlet channels of one channel structure via a connecting channel to an outlet opening of the dispense interface. In other variants of the invention, only the second needle assembly must be attached. For instance, a first part of the body, in particular, the outlet opening of the first part may comprise means for attaching a second needle assembly.
(84) Then, in step 702, the dispense interface can be attached to the ejection device by the user. The needles of the first double-ended needle assembly provide the piercing needles for the first and the second reservoirs. This establishes a fluid tight connection between the primary fluid from the first reservoir with the outlet opening of the dispense device. Simultaneously, this establishes a fluid tight connection between the secondary fluid from the second reservoir with the outlet opening of the dispense device.
(85) The user can then start an ejection procedure with the device in step 703.
(86) After the ejection procedure, the user can remove the dispense interface from the ejection device (step 704).
(87) If all channel structures have been used, the respective dispense interface can be discarded. Otherwise, the user can for instance put the dispense interface in a suitable storage box or the like. When a next ejection is required, the user can take the dispense interface from the storage box and can start the preparation of the dispense interface according to step 701. In particular, an unused channel structure can be attached by the user to a first double ended needle assembly.
(88) The term drug or medicament, as used herein, means a pharmaceutical formulation containing at least one pharmaceutically active compound,
(89) wherein in one embodiment the pharmaceutically active compound has a molecular weight up to 1500 Da and/or is a peptide, a proteine, a polysaccharide, a vaccine, a DNA, a RNA, an enzyme, an antibody or a fragment thereof, a hormone or an oligonucleotide, or a mixture of the above-mentioned pharmaceutically active compound,
(90) wherein in a further embodiment the pharmaceutically active compound is useful for the treatment and/or prophylaxis of diabetes mellitus or complications associated with diabetes mellitus such as diabetic retinopathy, thromboembolism disorders such as deep vein or pulmonary thromboembolism, acute coronary syndrome (ACS), angina, myocardial infarction, cancer, macular degeneration, inflammation, hay fever, atherosclerosis and/or rheumatoid arthritis,
(91) wherein in a further embodiment the pharmaceutically active compound comprises at least one peptide for the treatment and/or prophylaxis of diabetes mellitus or complications associated with diabetes mellitus such as diabetic retinopathy,
(92) wherein in a further embodiment the pharmaceutically active compound comprises at least one human insulin or a human insulin analogue or derivative, glucagon-like peptide (GLP-1) or an analogue or derivative thereof, or exedin-3 or exedin-4 or an analogue or derivative of exedin-3 or exedin-4.
(93) Insulin analogues are for example Gly(A21), Arg(B31), Arg(B32) human insulin; Lys(B3), Glu(B29) human insulin; Lys(B28), Pro(B29) human insulin; Asp(B28) human insulin; human insulin, wherein proline in position B28 is replaced by Asp, Lys, Leu, Val or Ala and wherein in position B29 Lys may be replaced by Pro; Ala(B26) human insulin; Des(B28-B30) human insulin; Des(B27) human insulin and Des(B30) human insulin.
(94) Insulin derivates are for example B29-N-myristoyl-des(B30) human insulin; B29-N-palmitoyl-des(B30) human insulin; B29-N-myristoyl human insulin; B29-N-palmitoyl human insulin; B28-N-myristoyl LysB28ProB29 human insulin; B28-N-palmitoyl-LysB28ProB29 human insulin; B30-N-myristoyl-ThrB29LysB30 human insulin; B30-N-palmitoyl-ThrB29LysB30 human insulin; B29-N(N-palmitoyl-Y-glutamyl)-des(B30) human insulin; B29-N(N-lithocholyl-Y-glutamyl)-des(B30) human insulin; B29-N-(-carboxyheptadecanoyl)-des(B30) human insulin and B29-N-(-carboxyheptadecanoyl) human insulin.
(95) Exendin-4 for example means Exendin-4(1-39), a peptide of the sequence H His-Gly-Glu-Gly-Thr-Phe-Thr-Ser-Asp-Leu-Ser-Lys-Gln-Met-Glu-Glu-Glu-Ala-Val-Arg-Leu-Phe-Ile-Glu-Trp-Leu-Lys-Asn-Gly-Gly -Pro-Ser-Ser-Gly-Ala-Pro-Pro-Pro-Ser-NH2.
(96) Exendin-4 derivatives are for example selected from the following list of compounds:
(97) TABLE-US-00001 H-(Lys)4-desPro36,desPro37Exendin-4(1-39)-NH2, H-(Lys)5-desPro36,desPro37Exendin-4(1-39)-NH2, desPro36[Asp28] Exendin-4(1-39), desPro36[IsoAsp28] Exendin-4(1-39), desPro36[Met(O)14,Asp28] Exendin-4(1-39), desPro36[Met(O)14,IsoAsp28] Exendin-4(1-39), desPro36[Trp(O2)25,Asp28] Exendin-4(1-39), desPro36[Trp(O2)25,IsoAsp28] Exendin-4(1-39), desPro36[Met(O)14Trp(O2)25,Asp28] Exendin- 4(1-39), desPro36[Met(O)14Trp(O2)25,IsoAsp28] Exendin-4 (1-39); or desPro36[Asp28] Exendin-4(1-39), desPro36[IsoAsp28] Exendin-4(1-39), desPro36[Met(O)14,Asp28] Exendin-4(1-39), desPro36[Met(O)14,IsoAsp28] Exendin-4(1-39), desPro36[Trp(O2)25,Asp28] Exendin-4(1-39), desPro36[Trp(O2)25,IsoAsp28] Exendin-4(1-39), desPro36[Met(O)14Trp(O2)25,Asp28] Exendin- 4(1-39), desPro36[Met(O)14Trp(O2)25,IsoAsp28] Exendin- 4(1-39),
wherein the group -Lys6-NH2 may be bound to the C-terminus of the Exendin-4 derivative;
or an Exendin-4 derivative of the sequence
(98) TABLE-US-00002 H-(Lys)6-desPro36[Asp28] Exendin-4(1-39)-Lys6-NH2, desAsp28Pro36,Pro37,Pro38Exendin-4(1-39)-NH2, H-(Lys)6-desPro36,Pro38[Asp28] Exendin-4(1-39)-NH2, H-Asn-(Glu)5desPro36,Pro37,Pro38[Asp28] Exendin-4(1-39)-NH2, desPro36,Pro37,Pro38[Asp28] Exendin-4(1-39)-(Lys)6-NH2, H-(Lys)6-desPro36,Pro37,Pro38[Asp28] Exendin-4(1-39)-(Lys)6-NH2, H-Asn-(Glu)5-desPro36,Pro37,Pro38[Asp28] Exendin-4(1-39)-(Lys)6-NH2, H-(Lys)6-desPro36[Trp(O2)25,Asp28] Exendin-4(1-39)-Lys6-NH2, H-desAsp28Pro36,Pro37,Pro38[Trp(O2)25] Exendin-4(1-39)-NH2, H-(Lys)6-desPro36,Pro37,Pro38[Trp(O2)25,Asp28] Exendin-4(1-39)-NH2, H-Asn-(Glu)5-desPro36,Pro37,Pro38[Trp(O2)25,Asp28] Exendin-4(1-39)-NH2, desPro36,Pro37,Pro38[Trp(O2)25,Asp28] Exendin-4(1-39)-(Lys)6-NH2, H-(Lys)6-desPro36,Pro37,Pro38[Trp(O2)25,Asp28] Exendin-4(1-39)-(Lys)6-NH2, H-Asn-(Glu)5-desPro36,Pro37,Pro38[Trp(O2)25,Asp28] Exendin-4(1-39)- (Lys)6-NH2, H-(Lys)6-desPro36[Met(O)14,Asp28] Exendin-4(1-39)-Lys6-NH2, desMet(O)14Asp28Pro36,Pro37,Pro38Exendin-4(1-39)-NH2, H-(Lys)6-desPro36,Pro37,Pro38[Met(O)14,Asp28] Exendin-4(1-39)-NH2, H-Asn-(Glu)5-desPro36,Pro37,Pro38[Met(O)14,Asp28] Exendin-4(1-39)-NH2, desPro36,Pro37,Pro38[Met(O)14,Asp28] Exendin-4(1-39)-(Lys)6-NH2, H-(Lys)6-desPro36,Pro37,Pro38[Met(O)14,Asp28] Exendin-4(1-39)-(Lys)6-NH2, H-Asn-(Glu)5desPro36,Pro37,Pro38[Met(O)14,Asp28] Exendin-4(1-39)- (Lys)6-NH2, H-Lys6-desPro36[Met(O)14,Trp(O2)25,Asp28] Exendin-4(1-39)-Lys6-NH2, H-desAsp28Pro36,Pro37,Pro38[Met(O)14,Trp(O2)25] Exendin-4(1-39)-NH2, H-(Lys)6-desPro36,Pro37,Pro38[Met(O)14,Asp28] Exendin-4(1-39)-NH2, H-Asn-(Glu)5-desPro36,Pro37,Pro38[Met(O)14,Trp(O2)25,Asp28] Exendin- 4(1-39)-NH2, desPro36,Pro37,Pro38[Met(O)14,Trp(O2)25,Asp28] Exendin-4(1-39)-(Lys)6-NH2, H-(Lys)6-desPro36,Pro37,Pro38[Met(O)14,Trp(O2)25,Asp28] Exendin-4(S1-39)- (Lys)6-NH2, H-Asn-(Glu)5-desPro36,Pro37,Pro38[Met(O)14,Trp(O2)25,Asp28] Exendin- 4(1-39)-(Lys)6-NH2;
or a pharmaceutically acceptable salt or solvate of any one of the afore-mentioned Exedin-4 derivative.
(99) Hormones are for example hypophysis hormones or hypothalamus hormones or regulatory active peptides and their antagonists as listed in Rote Liste, ed. 2008, Chapter 50, such as Gonadotropine (Follitropin, Lutropin, Choriongonadotropin, Menotropin), Somatropine (Somatropin), Desmopressin, Terlipressin, Gonadorelin, Triptorelin, Leuprorelin, Buserelin, Nafarelin, Goserelin.
(100) A polysaccharide is for example a glucosaminoglycane, a hyaluronic acid, a heparin, a low molecular weight heparin or an ultra low molecular weight heparin or a derivative thereof, or a sulphated, e.g. a poly-sulphated form of the above-mentioned polysaccharides, and/or a pharmaceutically acceptable salt thereof. An example of a pharmaceutically acceptable salt of a poly-sulphated low molecular weight heparin is enoxaparin sodium.
(101) Antibodies are globular plasma proteins (150 kDa) that are also known as immunoglobulins which share a basic structure. As they have sugar chains added to amino acid residues, they are glycoproteins. The basic functional unit of each antibody is an immunoglobulin (Ig) monomer (containing only one Ig unit); secreted antibodies can also be dimeric with two Ig units as with IgA, tetrameric with four Ig units like teleost fish IgM, or pentameric with five Ig units, like mammalian IgM.
(102) The Ig monomer is a Y-shaped molecule that consists of four polypeptide chains; two identical heavy chains and two identical light chains connected by disulfide bonds between cysteine residues. Each heavy chain is about 440 amino acids long; each light chain is about 220 amino acids long. Heavy and light chains each contain intrachain disulfide bonds which stabilize their folding. Each chain is composed of structural domains called Ig domains. These domains contain about 70-110 amino acids and are classified into different categories (for example, variable or V, and constant or C) according to their size and function. They have a characteristic immunoglobulin fold in which two sheets create a sandwich shape, held together by interactions between conserved cysteines and other charged amino acids.
(103) There are five types of mammalian Ig heavy chain denoted by , , , , and . The type of heavy chain present defines the isotype of antibody; these chains are found in IgA, IgD, IgE, IgG, and IgM antibodies, respectively.
(104) Distinct heavy chains differ in size and composition; and contain approximately 450 amino acids and approximately 500 amino acids, while and have approximately 550 amino acids. Each heavy chain has two regions, the constant region (CH) and the variable region (VH). In one species, the constant region is essentially identical in all antibodies of the same isotype, but differs in antibodies of different isotypes. Heavy chains , and have a constant region composed of three tandem Ig domains, and a hinge region for added flexibility; heavy chains and have a constant region composed of four immunoglobulin domains. The variable region of the heavy chain differs in antibodies produced by different B cells, but is the same for all antibodies produced by a single B cell or B cell clone. The variable region of each heavy chain is approximately 110 amino acids long and is composed of a single Ig domain.
(105) In mammals, there are two types of immunoglobulin light chain denoted by and . A light chain has two successive domains: one constant domain (CL) and one variable domain (VL). The approximate length of a light chain is 211 to 217 amino acids. Each antibody contains two light chains that are always identical; only one type of light chain, or , is present per antibody in mammals.
(106) Although the general structure of all antibodies is very similar, the unique property of a given antibody is determined by the variable (V) regions, as detailed above. More specifically, variable loops, three each the light (VL) and three on the heavy (VH) chain, are responsible for binding to the antigen, i.e. for its antigen specificity. These loops are referred to as the Complementarity Determining Regions (CDRs). Because CDRs from both VH and VL domains contribute to the antigen-binding site, it is the combination of the heavy and the light chains, and not either alone, that determines the final antigen specificity.
(107) An antibody fragment contains at least one antigen binding fragment as defined above, and exhibits essentially the same function and specificity as the complete antibody of which the fragment is derived from. Limited proteolytic digestion with papain cleaves the Ig prototype into three fragments. Two identical amino terminal fragments, each containing one entire L chain and about half an H chain, are the antigen binding fragments (Fab). The third fragment, similar in size but containing the carboxyl terminal half of both heavy chains with their interchain disulfide bond, is the crystalizable fragment (Fc). The Fc contains carbohydrates, complement-binding, and FcR-binding sites. Limited pepsin digestion yields a single F(ab)2 fragment containing both Fab pieces and the hinge region, including the HH interchain disulfide bond. F(ab)2 is divalent for antigen binding. The disulfide bond of F(ab)2 may be cleaved in order to obtain Fab. Moreover, the variable regions of the heavy and light chains can be fused together to form a single chain variable fragment (scFv).
(108) Pharmaceutically acceptable salts are for example acid addition salts and basic salts. Acid addition salts are e.g. HCl or HBr salts. Basic salts are e.g. salts having a cation selected from alkali or alkaline, e.g. Na+, or K+, or Ca2+, or an ammonium ion N+(R1)(R2)(R3)(R4), wherein R1 to R4 independently of each other mean: hydrogen, an optionally substituted C1 C6-alkyl group, an optionally substituted C2-C6-alkenyl group, an optionally substituted C6-C10-aryl group, or an optionally substituted C6-C10-heteroaryl group. Further examples of pharmaceutically acceptable salts are described in Remington's Pharmaceutical Sciences 17. ed. Alfonso R. Gennaro (Ed.), Mark Publishing Company, Easton, Pa., U.S.A., 1985 and in Encyclopedia of Pharmaceutical Technology.
(109) Pharmaceutically acceptable solvates are for example hydrates.