Dental varnishes that release specifically targeted antimicrobial peptides and/or fluoride
11633341 · 2023-04-25
Assignee
Inventors
- Evan Schauer (Los Angeles, CA, US)
- Miroslav Baudys (Marina Del Rey, CA, US)
- Brian C. Varnum (Santa Monica, CA, US)
- Christopher W. Kaplan (Los Angeles, CA, US)
- Randal H. Eckert (Ellensburg, WA)
- Jay Turetzky (Downey, CA, US)
- Angela Soriaga (Culver City, CA, US)
Cpc classification
A61Q11/00
HUMAN NECESSITIES
A61P1/02
HUMAN NECESSITIES
A61K6/20
HUMAN NECESSITIES
C08L33/10
CHEMISTRY; METALLURGY
A61K6/20
HUMAN NECESSITIES
A61K31/496
HUMAN NECESSITIES
C08L33/10
CHEMISTRY; METALLURGY
A61K8/64
HUMAN NECESSITIES
International classification
A61K8/64
HUMAN NECESSITIES
Abstract
In various embodiments a dental varnish system having improved peptide release and fluoride release properties is provided. In various embodiments a dental varnish system that provides release of an antimicrobial peptide, or specifically targeted antimicrobial peptide (STAMP), e.g., the peptide C16G2, is provided, with or without a fluoride. In various embodiments, a dental varnish system that provides release of a fluoride, with or without an antimicrobial peptide or STAMP is provided. In certain embodiments the dental varnish system comprises a first component that is a dry powder, said first component comprising a an antimicrobial peptide, with or without a fluoride, and a bulking agent, and a second component that is a fluid, said second component comprising a varnish solution, where combination of said first component with said second component provides a varnish formulation for application to the surface of a tooth.
Claims
1. A dental varnish system for the sustained delivery of a specifically targeted antimicrobial peptide (STAMP), said varnish system comprising: a first component that is a dry powder, said first component comprising a specifically targeted antimicrobial peptide (STAMP) comprising the amino acid sequence TFFRLFNRSFTQAL GKGGGKNLRIIRKGIHIIKKY (C16G2, SEQ ID NO:1); and a second component that is a fluid, said second component comprising a varnish solution wherein said solution comprises an aminomethacrylate polymer and ethanol 200 proof USP; where combination of said first component with said second component provides a fluid varnish formulation in which said ethanol is a solvent for said dry powder first component, where said formulation when applied to the surface of a tooth delivers an effective amount of said STAMP that retains antimicrobial activity to said surface of said tooth for at least 4 hours after application.
2. The varnish system of claim 1, wherein: said varnish formulation provides release of an effective amount of said STAMP for at least 6 hours after application, or for at least 8 hours after application, or for at least 12 hours after application, or for at least 24 hours after application, or for at least 48 hours after application; and/or said varnish formulation provides a release of at least 80% of said STAMP or AMP within about 8 hours or less, or within about 6 hours or less, or within about 4 hours or less, or within about 2 hours or less, or within about 1 hour or less.
3. The varnish system of claim 1, wherein said first component comprises said STAMP and a pH adjuster.
4. The varnish system of claim 1, wherein: combination of said first component with said second component in substantially equal parts as fluid, or where the first component is a dry powder in a ratio of powder to fluid second component ranging from about 100 mg powder up to about 260 mg powder mixed with 1 ml fluid second component produces a formulation having a pH ranging from about 5.0 to about 7.5, or from about 5.9 to about 6.1, and containing said STAMP or AMP in a form and concentration that is effective to kill S. mutans; or said first component is a dry powder in a ratio of powder to fluid second component of about 127 mg dry powder to 1 ml fluid second component; or said first component is a dry powder in a ratio of powder to fluid second component of about 190 mg dry powder to 1 ml fluid second component; or said first component is a dry powder in a ratio of powder to fluid second component of about 254 mg dry powder to 1 ml fluid second component; or said first component contains only said specifically targeted antimicrobial peptide; or first component contains only said specifically targeted antimicrobial peptide, and a thickener; or said first component contains only said specifically targeted antimicrobial peptide and a preservative; or said first component contains only said specifically targeted antimicrobial peptide, a thickener, and a preservative; and/or wherein: the second component comprises a buffer; and/or said first component or the second component further comprises a salt to adjust tonicity; and/or said first component or said second component further comprises a bulking agent; and/or said first component or said second component further comprises one or more solubilizing/emulsifying agents; and/or said first component or said second component further comprises a chelating agent; and/or said first component or said second component further comprises a preservative; and/or said first component or said second component further comprises a sweetener; and/or said first component or said second component further comprises a colorant; and/or said first component or said second component further comprises flavoring agent; and/or said first component and/or said second component further comprises a thickener; and/or said second component comprises a cationic (positively charged, permanently or pH dependent) random co-polymer based on dimethylaminoethyl methacrylate; and/or said second component comprises Poly(butyl methacrylate-co-(2-dimethylaminoehtyl) methacrylate-co-methyl methacrylate) at 1:2:1 mol ratio.
5. The varnish system of claim 1, wherein: said second component comprises about 28.6 varnish polymer, about 60% ethanol, and about 11.4% flavor; and/or said first component comprises a powder comprising about 10.7% antimicrobial peptide, about 84% Mannitol, about 1.6% Histidine, about 4.2% sucralose and said first component is combined with the second component in a ratio of about 127 mg dry powder to 1 ml of said second component (varnish solution); or said first component comprises a powder comprising about 14.3% antimicrobial peptide, about 80% Mannitol, about 1.6% histidine, about 4.2% sucralose; and said first component is combined with the second component in a ratio of about 190 mg dry powder to 1 ml of said second component (varnish solution); or said first component comprises a powder comprising about 21.4% antimicrobial peptide, about 73% mannitol, about 1.6% histidine, about 4.2% sucralose; and said first component is combined with the second component in a ratio of about 254 mg dry powder to 1 ml of said second component (varnish solution); or said second component comprises poly(butyl methacrylate-co-(2-dimethylaminoehtyl) methacrylate-co-methyl methacrylate at 1:2:1 mol ratio and about 11.4% flavor in 60% ethanol.
6. The varnish system of claim 1, wherein: when said first component is combined with said second component said system forms a varnish comprising: a specifically targeted antimicrobial peptide; D-mannitol; L-histidine; Amino Methacrylate Copolymer; and ethanol; or wherein combination of said first component with said second component provides a varnish formulation selected from the group consisting of: TABLE-US-00023 Component Function Amount per dose C16G2 STAMP Active (anti-S. mutans) 13.60 mg agent D-Mannitol, USP Bulking agent 105.92 mg L-Histidine, USP Buffer 1.97 mg Sucralose, NF Flavoring Agent 5.33 mg Ethanol, 200 proof USP Solvent 521.57 mg Watermelon, Lavender, Flavoring agent 99.09 mg Mint Flavor Amino Methacrylate Polymer 249.26 mg Copolymer, USP FD&C Blue No. 1 Coloring Agent 0.09 mg Sodium Hydroxide, NF In process pH q.s. to pH 6.0 ± 0.1, adjustment NF = National Formulary, q.s. = quantity sufficient; USP = United States Pharmacopeia and TABLE-US-00024 Component Function Amount per dose C16G2 STAMP Active Agent 27.21 mg D-Mannitol, USP Bulking agent 152.33 mg L-Histidine, USP Buffer 2.95 mg Sucralose, NF Flavoring Agent 8.00 mg Ethanol, 200 proof, USP Solvent 521.57 mg Watermelon, Lavender, Flavoring agent 99.09 mg Mint Flavor Amino Methacrylate Polymer 249.26 mg Copolymer, USP FD&C Blue No. 1 Coloring Agent 0.09 mg Sodium Hydroxide, NF In process pH q.s. to pH 6.0 ± 0.1, adjustment and TABLE-US-00025 Component Function Amount per dose C16G2STAMP Active Agent 54.43 mg D-Mannitol, USP Bulking agent 184.97 mg L-Histidine, USP Buffer 3.94 mg Sucralose, NF Flavoring Agent 10.67 mg Ethanol, 200 proof USP Solvent 521.57 mg Watermelon, Lavender, Flavoring agent 99.09 mg Mint Flavor Amino Methacrylate Polymer 249.26 mg Copolymer, USP FD&C Blue No. 1 Coloring Agent 0.09 mg Sodium Hydroxide, NF In process pH q.s. to pH 6.0 ± 0.1. adjustment
7. The varnish system of claim 1, wherein said first component and/or said second component further comprises a fluoride.
8. A dental varnish for the sustained delivery of a specifically targeted antimicrobial peptide (STAMP), said varnish comprising: a specifically targeted antimicrobial peptide (STAMP) comprising the amino acid sequence TFFRLFNRSFTQAL GKGGGKNLRIIRKGIHIIKKY (C16G2, SEQ ID NO:1); and a varnish solution comprising an aminomethacrylate polymer and ethanol 200 proof USP; where said dental varnish provides a fluid varnish formulation in which said ethanol is a solvent for said specifically targeted antimicrobial peptide, where said formulation when applied to the surface of a tooth delivers a tooth and delivery of an effective amount of said STAMP that retains antimicrobial activity to said surface of said tooth for at least 4 hours after application.
9. The varnish of claim 8, wherein: said varnish provides release of an effective amount of said STAMP for at least 6 hours after application, or for at least 8 hours after application, or for at least 12 hours after application, or for at least 24 hours after application, or for at least 48 hours after application; and/or said varnish formulation provides a release of at least 80% of said STAMP within about 8 hours or less, or within about 6 hours or less, or within about 4 hours or less, or within about 2 hours or less, or within about 1 hour or less.
10. The varnish of claim 8, wherein: said varnish solution comprises a cationic (positively charged, permanently or pH dependent) random co-polymer based on dimethylaminoethyl methacrylate; or said varnish solution comprises Poly(butyl methacrylate-co-(2-dimethylaminoehtyl) methacrylate-co-methyl methacrylate) at 1:2:1 mol ratio.
11. The varnish of claim 8, wherein said varnish comprises one or more agents selected from the group consisting of a bulking agent, a buffer, a flavoring agent, a solvent, an emulsifying agent, a chelating agent, a coloring agent, a sweetener, and an in process pH adjustor.
12. The varnish of claim 8, wherein said varnish comprises: a specifically targeted antimicrobial peptide; D-mannitol; L-histidine; Amino Methacrylate Copolymer; and ethanol; or said varnish comprises a formulation selected from the group consisting of: TABLE-US-00026 Component Function Amount per dose C16G2 STAMP Active (anti-S. mutans) 13.60 mg agent D-Mannitol, USP Bulking agent 105.92 mg L-Histidine, USP Buffer 1.97 mg Sucralose, NF Flavoring Agent 5.33 mg Ethanol, 200 proof USP Solvent 521.57 mg Watermelon, Lavender, Flavoring agent 99.09 mg Mint Flavor Amino Methacrylate Polymer 249.26 mg Copolymer, USP FD&C Blue No. 1 Coloring Agent 0.09 mg Sodium Hydroxide, NF In process pH q.s. to pH 6.0 ± 0.1, adjustment NF = National Formulary, q.s. = quantity sufficient; USP = United States Pharmacopeia and TABLE-US-00027 Component Function Amount per dose C16G2 STAMP Active Agent 27.21 mg D-Mannitol, USP Bulking agent 152.33 mg L-Histidine, USP Buffer 2.95 mg Sucralose, NF Flavoring Agent 8.00 mg Ethanol, 200 proof, USP Solvent 521.57 mg Watermelon, Lavender, Flavoring agent 99.09 mg Mint Flavor Amino Methacrylate Polymer 249.26 mg Copolymer, USP FD&C Blue No. 1 Coloring Agent 0.09 mg Sodium Hydroxide, NF In process pH q.s. to pH 6.0 ± 0.1, adjustment and TABLE-US-00028 Component Function Amount per dose C16G2 STAMP Active Agent 54.43 mg D-Mannitol, USP Bulking agent 184.97 mg L-Histidine, USP Buffer 3.94 mg Sucralose, NF Flavoring Agent 10.67 mg Ethanol, 200 proof USP Solvent 521.57 mg Watermelon, Lavender, Flavoring agent 99.09 mg Mint Flavor Amino Methacrylate Polymer 249.26 mg Copolymer, USP FD&C Blue No. 1 Coloring Agent 0.09 mg Sodium Hydroxide, NF In process pH q.s. to pH 6.0 ± 0.1. adjustment
13. The varnish of claim 8, wherein said first formulation and/or said dental varnish further comprises a fluoride.
14. A dental varnish kit, said kit comprising: a container containing dental varnish according to claim 8.
15. A kit for providing a dental varnish system of claim 1, said kit comprising: a container containing said first component; and a second container containing said second component.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION
(8) In various embodiments tooth varnishes and varnish systems are provided that provide an improved fluoride release profile and/or that provide for release of an effective dose of one or more specifically targeted antimicrobial peptide(s) (STAMPS) and/or simple antimicrobial peptide(s) (AMPs) during the time a dental varnish is expected to reside on the tooth surface (e.g., a realistic maximum of about 8 hours) before sloughing off due to salivary flow and eating/drinking. In certain embodiments the tooth varnish systems comprise a first component (e.g., a first dry powder component) that contains the fluoride and/or specifically targeted antimicrobial peptide (or AMP) and a second fluid component that comprises the varnish. At the time of use, the two components are combined to produce the final varnish which is then applied to one or more tooth surfaces. The varnish quickly dries to provide a protective, fluoride-releasing and/or STAMP (or AMP) releasing coating on the tooth surface(s).
(9) In certain embodiments the resulting dental varnish produced by the varnish systems described herein may have a transparent or white color, or a substantially transparent color having a white or off-white tint. The dental varnishes disclosed herein are capable of being transparent or substantially transparent, have a high fluoride release over an extended period of time (e.g., over a 2 hour time period, over a 4 hour time period, over a 6 hour timer period) and/or have a STAMP (or AMP) release profile that is capable of killing and/or inhibiting S. mutans in the oral cavity (e.g., on a tooth or gum surface), and is capable of being smoothly coated onto a patient's tooth.
(10) In various embodiments the dental varnishes described herein may be applied to dried teeth using a suitable applicator, such as a brush, as is well understood by those skilled in the art. Methods of using the dental varnish to seal a tooth include applying the dental varnish to a tooth.
(11) In various embodiments the dental varnish systems described herein comprise a first component containing a fluoride (e.g., a fluoridizing agent) or a first component containing a specifically targeted antimicrobial peptide (STAMP) or a simple antimicrobial peptide (AMP), and a second component containing a polymer, preferably a (meth)acrylate and/or (meth)acrylamide varnish. In certain embodiments the first component is provided as a dry powder, while the second component is provided as a liquid solution. In certain embodiments the two components are combined at the point and time of use to produce a dental varnish ready for application to a subject's tooth. In other embodiments the varnish is provided as a single formulation (e.g., a formulation having ingredients equivalent to a varnish produced by combination of the first and second components).
(12) In certain illustrative, but non-limiting embodiments, the STAMP (or AMP)-releasing varnish can comprise formulations as illustrated in Table 1. As illustrated therein, in certain embodiments, the first component can be provided as a dry powder and comprises one or more STAMP(s) (e.g., C16G2), and a buffer (e.g., His), and a bulking agent (e.g., mannitol), while the second component can be provided as a liquid varnish solution (e.g., 2-propenoic acid, 2-methyl-, butyl ester, polymer with 2-(dimethylamino)ethyl 2-methyl-2-propenoate and methyl 2-methyl-2-propenoate, or EUDRAGIT® E PO (Evonik Industries)). In various embodiments the first component and/or the second component can contain one or more additional agents such as a solvent, a sweetener, a flavor, a fluoride agent, a remineralization agent, and a tint, e.g., as illustrated in Table 1 and as described below.
(13) TABLE-US-00006 TABLE 1 Illustrative dental STAMP (or AMP) varnish system. First Component Second Component (Dry Powder) (Liquid) One or more STAMP(s) Varnish solution and/or AMP(s) Bulking Agent Buffer Optional Ingredients Solvent and/or Solvent Sweetener and/or Sweetener Flavor and/or Flavor Fluoride agent and/or Fluoride agent In process pH adjuster and/or In process pH adjuster Remineralization Agent and/or Remineralization Agent Tint and/or Tint
(14) One particular illustrative embodiment of a STAMP-releasing dental varnish is shown in Table 2.
(15) TABLE-US-00007 TABLE 2 Illustrative STAMP-releasing dental varnish. Component Function Amount per dose C16G2 Drug Substance 13 to 60 mg D-Mannitol, USP Bulking agent 100 to 200 mg L-Histidine, USP Buffer 1.9 to 4 mg Sucralose, NF Flavoring Agent 5 to 12 mg Ethanol, 200 proof, USP Solvent 521.57 mg Watermelon, Lavender, Flavoring agent 99.09 mg Mint Flavor Amino Methacrylate Polymer 249.26 mg Copolymer, USP FD&C Blue No. 1 Coloring Agent 0.09 mg Sodium Hydroxide, NF In process pH q.s. to pH 6.0 ± 0.1 adjustment NF = National Formulary, q.s. = quantity sufficient; USP = United States Pharmacopeia
(16) These components are illustrative and non-limiting and numerous variations will be available to one of skill using the teachings provided herein.
(17) In certain embodiments of the fluoride releasing varnish, as illustrated in Table 3, the first component can be provided as a dry powder and comprises a fluoride (fluoridizing agent such as sodium fluoride) and a bulking agent (e.g., mannitol), while the second component can be provided as a liquid varnish solution (e.g., EUDRAGIT® E PO (Evonik Industries)). In various embodiments the first component and/or the second component can contain one or more additional agents such as a solvent, a sweetener, a flavor, an antiseptic, an antibiotic, a remineralization agent, and a tint, e.g., as illustrated in Table 3 and as described below.
(18) TABLE-US-00008 TABLE 3 Illustrative dental fluoride varnish system. First Component Second Component (Dry Powder) (Liquid) Fluoride Varnish solution Bulking Agent Optional Ingredients Solvent and/or Solvent Sweetener and/or Sweetener Flavor and/or Flavor Antiseptic and/or Antiseptic Antibiotic and/or Antibiotic Remineralization Agent and/or Remineralization Agent Tint and/or Tint
(19) One particular illustrative embodiment of a dental varnish system is shown in Table 4. As illustrated therein the first component (provided in this example as a dry powder) contains a fluoride (fluoridizing agent such as sodium fluoride), a bulking agent, and a sweetener, while the second component contains a varnish, a solvent (e.g., an alcohol such as ethanol), and a flavor.
(20) TABLE-US-00009 TABLE 4 Illustrative dental fluoride varnish system. First Component Second Component (Dry Powder) (Liquid) Fluoride Varnish solution Bulking Agent Solvent Sweetener Flavor Optional Ingredients Sweetener Flavor and/or Antiseptic and/or Antiseptic Antibiotic and/or Antibiotic Remineralization Agent and/or Remineralization Agent Tint and/or Tint
(21) In various embodiments the first component and/or the second component can contain one or more additional agents such as a flavor, an antiseptic, an antibiotic, a remineralization agent, a tint, and the like, e.g., as illustrated in Table 4 and as described below.
(22) These components are illustrative and non-limiting and numerous variations will be available to one of skill using the teachings provided herein.
(23) Specifically Targeted Antimicrobial Peptide(s).
(24) In certain embodiments the STAMP-delivering varnishes described herein contain one or more STAMPs and/or simple AMPs active at a level where upon use, the varnish promotes the benefit sought by the wearer (e.g., inhibition of S. mutans, decrease in caries formation, etc.) without detriment to the oral surface it is applied to.
(25) In certain embodiments the specifically targeted antimicrobial peptide(s) incorporated into the varnishes described herein comprise a targeting peptide that binds Streptococcus mutans. In various embodiments the targeting peptide is attached to an antimicrobial via chemical conjugation. In other embodiments, the targeting peptide is attached directly to an antimicrobial or is attached to the antimicrobial peptide by an amino acid, or is attached to the antimicrobial peptide through a peptide linker to form a single polypeptide comprising at least one targeting domain and at least one antimicrobial domain.
(26) In certain embodiments the STAMP is the C16G2 STAMP whose amino acid sequence consists of the sequence TFFRLFNRSFTQALGKGGGKNLRIIRKGIHIIKKY (SEQ ID NO:2). In certain embodiments the STAMP comprises this sequence. In certain embodiments the STAMP comprises this sequence and contains 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 additional amino acids at one or both termi. The C16G2 STAMP comprises a fragment of the competence stimulating peptide (CSP) having the amino acid sequence TFFRLFNRSFTQALGK (SEQ ID NO:3) as a targeting peptide attached to the antimicrobial peptide KNLRIIRKGIHIIKKY (SEQ ID NO:4) by a Gly.sub.3 linker. In various embodiments the peptide is amidated at the carboxyl terminus.
(27) The STAMPs contemplated for use in the varnishes described herein are not limited to C16G2. Any of a number of targeting peptides (e.g., S. mutans targeting peptides) can be attached to any of a number of antimicrobial peptides, e.g., as described below.
(28) It will be noted that in various embodiments the targeting peptide comprises a peptide that ranges in length from 5 amino acid, or from 6 amino acids, or from 7 amino acids, or from 8 amino acids up to about 50 amino acids, or up to about 40 amino acids, or up to about 30 amino acids, or up to about 20 amino acids. Similarly, in various embodiments, the antimicrobial peptide comprises a peptide that ranges in length from 5 amino acids, or from 6 amino acids, or from 7 amino acids, or from 8 amino acids, or from 9 amino acids, or from 10 amino acids up to about 100 amino acids, or up to about 80 amino acids, or up to about 60 amino acids, or up to about 50 amino acids, or up to about 40 amino acids, or up to about 30 amino acids, or up to about 20 amino acids.
(29) Targeting Peptides that Bind S. mutans.
(30) A number of peptides can be used as targeting peptides in the targeted antimicrobial peptides contemplated herein. In certain embodiments the targeting peptide is one that binds, inter alia to S. mutans. In certain embodiments the targeting peptide specifically binds to S. mutans.
(31) Illustrative peptides that bind S. mutans include, but are not limited to a peptide that comprises or consists of an amino acid sequence selected from the group consisting of SGSLSTFFRLFNRSFTQALGK (CSP, SEQ ID NO:5) or a fragment thereof, EMRLSKFFRDFILQRKK (CSP1, (SEQ ID NO:6) or a fragment thereof, and EMRISRIILDFLFLRKK (CSP2, (SEQ ID NO:7), NIFEYFLE (SEQ ID NO:8). or a fragment thereof.
(32) In certain embodiments the targeting peptide comprises or consists of an the amino acid sequence of competence stimulating peptide (CSP) or a fragment thereof. Illustrative CSP fragments that bind S. mutans are shown in Table 5.
(33) TABLE-US-00010 TABLE 5 Illustrative CSP fragments. Amino Acid Sequence SEQ ID NO TFFRLFNR 9 TFFRLFNRS 10 TFFRLFNRS 11 TFFRLFNRSF 12 TFFRLFNRSFT 13 TFFRLFNRSFTQ 14 TFFRLFNRSFTQA 15 TFFRLFNRSFTQAL 16 TFFRLFNRSFTQALG 17 TFFRLFNRSFTQALGK 18 STFFRLFNR 19 STFFRLFNRS 20 STFFRLFNRS 21 STFFRLFNRSF 22 STFFRLFNRSFT 23 STFFRLFNRSFTQ 24 STFFRLFNRSFTQA 25 STFFRLFNRSFTQAL 26 STFFRLFNRSFTQALG 27 STFFRLFNRSFTQALGK 28 LSTFFRLFNR 29 LSTFFRLFNRS 30 LSTFFRLFNRS 31 LSTFFRLFNRSF 32 LSTFFRLFNRSFT 33 LSTFFRLFNRSFTQ 34 LSTFFRLFNRSFTQA 35 LSTFFRLFNRSFTQAL 36 LSTFFRLFNRSFTQALG 37 LSTFFRLFNRSFTQALGK 38 SLSTFFRLFNR 39 SLSTFFRLFNRS 40 SLSTFFRLFNRS 41 SLSTFFRLFNRSF 42 SLSTFFRLFNRSFT 43 SLSTFFRLFNRSFTQ 44 SLSTFFRLFNRSFTQA 45 SLSTFFRLFNRSFTQAL 46 SLSTFFRLFNRSFTQALG 47 SLSTFFRLFNRSFTQALGK 48 GSLSTFFRLFNR 49 GSLSTFFRLFNRS 50 GSLSTFFRLFNRS 51 GSLSTFFRLFNRSF 52 GSLSTFFRLFNRSFT 53 GSLSTFFRLFNRSFTQ 54 GSLSTFFRLFNRSFTQA 55 GSLSTFFRLFNRSFTQAL 56 GSLSTFFRLFNRSFTQALG 57 GSLSTFFRLFNRSFTQALGK 58 SGSLSTFFRLFNR 59 SGSLSTFFRLFNRS 60 SGSLSTFFRLFNRS 61 SGSLSTFFRLFNRSF 62 SGSLSTFFRLFNRSFT 63 SGSLSTFFRLFNRSFTQ 64 SGSLSTFFRLFNRSFTQA 65 SGSLSTFFRLFNRSFTQAL 66 SGSLSTFFRLFNRSFTQALG 67
(34) Other suitable targeting peptides that bind S. mutans include, but are not limited to peptides that comprise or consist of the amino acid sequence
(35) X.sup.1-X.sup.2-R-R-X.sup.5-X.sup.6-X.sup.7-R-X.sup.9-X.sup.10-X.sup.11-X.sup.12-X.sup.13-X.sup.14-X.sup.15-X.sup.16 (SEQ ID NO: 68) or the inverse of said amino acid sequence, wherein X.sup.1 is a polar amino acid, or A; X.sup.2 is F, W, Q, A, or an analog thereof; X.sup.5 is a hydrophobic amino acid; X.sup.6 is a hydrophobic amino acid, N, Q, or an analog thereof; X.sup.7 is a polar amino acid, A, F, or an analog thereof; X.sup.9 is a polar amino acid, A or an analog thereof; X.sup.10 is a hydrophobic amino acid, Q, A, or an analog thereof; X.sup.11 is a hydrophobic amino acid; X.sup.11 is Q, A, or an analog thereof; X.sup.11 is a non-polar amino acid; X14 is a hydrophobic amino acid; X15 is a non-polar amino acid, N, S, D, or an analog thereof; X16 is a polar amino acid, F, A, or an analog thereof; and said peptide ranges in length up to 100 amino acids. The peptide does not comprise or consist of the amino acid sequence of C16 (TFFRLFNRSFTQALGK (SEQ ID NO:69).
(36) In certain embodiments, X.sup.1 is a polar amino acid or A, and in certain embodiments A or T; and/or X.sup.2 is F, W, Q, A, and in certain embodiments F; and/or X.sup.5 is a hydrophobic amino acid in certain embodiments L or A; and in certain embodiments L; and/or X.sup.6 is a hydrophobic amino acid, N or Q, in certain embodiments F, L, N, A, or Q; in certain embodiments hydrophobic; and in certain embodiments F; and/or X.sup.7 is a polar amino acid, A, or F; in certain embodiments a polar amino acid or A; in certain embodiments N, A, S, D, or F; in certain embodiments N or A, and in certain embodiments N; and/or X.sup.9 is a polar amino acid or A, in certain embodiments S or A, and in certain embodiments preferably S; and/or X.sup.10 is a hydrophobic amino acid, Q, or A, in certain embodiments a hydrophobic amino acid, in certain embodiments F or L, and in certain embodiments F; X.sup.11 is a hydrophobic amino acid, in certain embodiments T or A, and in certain embodiments T; and/or X.sup.12 is a Q or A, and in certain embodiments Q; and/or X.sup.13 is a non-polar amino acid, in certain embodiments P or A, and in certain embodiments preferably X; and/or X.sup.14 is a hydrophobic amino acid, in certain embodiments L or A, and in certain embodiments L; and/or X.sup.15 is a non-polar amino acid, N, S, or D, in certain embodiments G, A, F, N, S, or D, and in certain embodiments G or A; and/or X.sup.16 is a polar amino acid, F, or A, in certain embodiments a polar amino acid, in certain embodiments K or Q, and in certain embodiments K.
(37) In certain embodiments the targeting peptide comprises or consists of one or more of the amino acid sequences shown in Table 6.
(38) TABLE-US-00011 TABLE 6 S. mutans targeting peptides. SEQ % Amino Acid ID viability Name Sequence NO remaining C16AG2 (N7, L14) AFFRAFNRAFAQALAK 70 16 C16AG2 (T1) TFFRAFARAFAQAAAK 71 18 C16AG2 (L14) AFFRAFARAFAQALAK 72 20 C16AG2 (L5) AFFRLFARAFAQAAAK 73 21 F2F6F10- TLFRLLNRSLTQALGK 74 26 L2L6L10_C16G2 G15-F15_C26G2 TFFRLFNRSFTQALFK 75 29 F10-L10_C16G2 TFFRLFNRSLTQALGK 76 30 G15-N15_C16G2 TFFRLFNRSFTQALNK 77 30 C16AG2 AFFRAFARAFAQAAAK 78 30 C16AG2 (N7) AFFRAFNRAFAQAAAK 79 34 G15-S15_C16G2 TFFRLFNRSFTQALSK 80 37 C16AG2 (S9) AFFRAFARSFAQAAAK 81 38 C16AG2 (G15) AFFRAFARAFAQAAGK 82 38 C16AG2 (T11) AFFRAFARAFTQAAAK 83 39 K16-Q16_C16G2 TFFRLFNRSFTQALGQ 84 42 F6-L6_C16G2 TFFRLLNRSFTQALGK 85 43 F2-W2_C16G2 TWFRLFNRSFTQALGK 86 45 C16AG2 (F14) AFFRAFARAFAQAFAK 87 46 F2 to Q2_C16G2 TQFRLFNRSFTQALGK 88 47 G15-D15_C16G2 TFFRLFNRSFTQALDK 89 47 G15-A15_C16G2 TFFRLFNRSFTQALAK 90 47 K16-E16_C16G2 TFFRLFNRSFTQALGE 91 48 N7-S7_C16G2 TFFRLFSRSFTQALGK 92 50 K16-A16_C16G2 TFFRLFNRSFTQALGA 93 51 N7-D7_C16G2 TFFRLFDRSFTQALGK 94 52 K16-F16_C16G2 TFFRLFNRSFTQALGF 95 53 C16AG2 TFFRAFARSFTQAAAK 96 56 (T1, S9, T11) C16AG2 TFFRLFARSFTQAAGK 97 57 (T1, L5, S9, T11, G15) ΔA13_ΔG15_C16G2 TFFRLFNRSFTQLK 98 57 K16-S16 C16G2 TFFRLFNRSFTQALGS 99 59 F2-L2_C16G2 TLFRLFNRSFTQALGK 100 63 N7-F6/N21424 TFFRLNFRSFTQALGK 101 65 F10 to Q10_C16G2 TFFRLFNRSQTQALGK 102 73 Scan-16 TFFRLFAAAFTQALGK 103 73 Scan-24 TFFRLFNRSFTQALGK** 104 75 Scan-17 TFFRLFNRSAAAALGK 105 76 N7-F10/N21432 TFFRLFFRSNTQALGK*** 106 76 Scan-22 TFFRLFNRSFTQPLGK 107 77 F2/6/10-A2/6/ TAFRLANRSATQALGK 108 78 10_C16G2 Scan-18 TFFRLFNRSFTQAAAA 109 78 F6 to Q6_C16G2 TFFRLQNRSFTQALGK 110 79 Scan-23 TFFRLFNRSFTQALPK 111 79 TFF-TYY_C16G2 TYYRLFNRSFTQALGK 112 80 ΔN7_C16G2 TFFRLFRSFTQALGK 113 84 F7/11/15 sub TQFRLQNRSQTQALGK 114 93 Q_C16G2 Anti-biofilm activity level (% viability remaining for S. mutans) is shown.
(39) Antimicrobial Peptides.
(40) In certain embodiments, the targeting peptides described herein (e.g., peptides shown in Table 5 and Table 6) can be attached to one or more antimicrobial peptides to form selectively targeted antimicrobial peptides (STAMPS) that are incorporated into the first component of the varnish system(s) and/or the varnishes described herein. In certain embodiments the antimicrobial peptides (e.g., the AMPs described herein) are used as simple AMPs without attachment of targeting moieties. Numerous antimicrobial peptides are well known to those of skill in the art.
(41) In certain embodiments the antimicrobial peptides comprise one or more amino acid sequences described for example below in Table 7). In certain embodiments the antimicrobial peptides comprise one or more amino acid sequences described in the “Collection of Anti-Microbial Peptides” (CAMP) an online database developed for advancement the understanding of antimicrobial peptides (see, e.g., Thomas et al. (2009) Nucleic Acids Res., 1-7.doi:10.1093/nar/gkp1021) available at www.bicnirrh.res.in/antimicrobial.
(42) TABLE-US-00012 TABLE 7 Novel antimicrobial peptides, target microorganisms and MIC values. SEQ ID Organism/MIC Sequence ID NO G2 KNLRIIRKGIHIIKKY* 115 Novispirin KNLRRIIRKGIHIIKKYG 116 G10 Novispirin KNLRRIIRKTIHIIKKYG 117 T10 Novispirin G7 KNLRRIGRKIIHIIKKYG 118 Novispirin T7 KNLRRITRKIIHIIKKYG 119 Ovispirin KNLRRIIRKIIHIIKKYG 120 PGG GLLRRLRKKIGEIFKKYG 121 Protegrin-1 RGGRLCYCRRRFCVCVGR* 122 K-1 S. mutans, 25 μM GLGRVIGRLIKQIIWRR 123 K-2 S. mutans, 12.5 μM VYRKRKSILKIYAKLKGWH 124 K-7 S. mutans, 12.5 μM NYRLVNAIFSKIFKKKFIKF 125 K-8 S. mutans, 4 μM KILKFLFKKVF 126 K-9 S. mutans, 4 μM FIRKFLKKWLL 127 K-10 S. mutans, 4 μM KLFKFLRKHLL 128 K-11 S. mutans, 4 μM KILKFLFKQVF 129 K-12 S. mutans, 8 μM KILKKLFKFVF 130 K-13 S. mutans, 16 μM GILKKLFTKVF 131 K-14 S. mutans, 8 μM LRKFLHKLF 132 K-15 S. mutans, 4 μM LRKNLRWLF 133 K-16 S. mutans, 8 μM FIRKFLQKLHL 134 P. aeruginosa, 12.5 μM MRSA, 25 μM K-17 S. mutans, 8 μM FTRKFLKFLHL 135 K-18 S. mutans, 16 μM KKFKKFKVLKIL 136 K-19 S. mutans, 16 μM LLKLLKLKKLKF 137 K-20 S. mutans, 8 μM FLKFLKKFFKKLKY 138 K-21 S. mutans, 8 μM GWLKMFKKIIGKFGKF 139 K-22 S. mutans, 8 μM GIFKKFVKILYKVQKL 140 1T-88 GRLVLEITADEVKALGEALAN 141 AKI PF -531 A. baumannii, 25 μM YIQFHLNQQPRPKVKKIKIFL 142 P. aeruginosa, 50 μM T. rubrum, 50 μM A. niger, 25 μM B. subtilis, 25 μM C. difficile, 12.5 μM C. jeikeium, 6.25 μM S. epidermidis, 50 μM S. mutans, 12.5 μM PF-527 P. aeruginosa, 50 μM GSVIKKRRKRMAKKKHRKLL 143 T. rubrum, 25 μM KKTRIQRRRAGK A. niger, 50 μM B. subtilis, 12.5 μM C. jeikeium, 6.25 μM MRSA, 50 μM S. epidermidis, 25 μM PF-672 C. albicans, 1.56 μM MRFGSLALVAYDSAIKHSWPR 144 T. rubrum, 0.78 μM PSSVRRLRM A. niger, 3 μM B. subtilis, 0.78 μM E. faecalis, 3.13 μM MRSA, 1.56 μM S. epidermidis, 0.39 μM PF-606 E. coli, 50 μM FESKILNASKELDKEKKVNTA 145 MRSA, 50 μM LSFNSHQDFAKAYQNGKI S. epidermidis, 50 μM S. mutans, 50 μM S. pneumoniae, 50 μM PF-547 T. rubrum, 25 μM WSRVPGHSDTGWKVWHRW 146 B. subtilis, 25 μM S. mutans, 12.5 μM PF-006 A. baumannii, 50 μM MGIIAGIIKFIKGLIEKFTGK 147 B. subtilis, 25 μM MRSA, 50 μM PF-545 A. niger, 50 μM RESKLIAMADMIRRRI 148 B. subtilis, 25 μM MRSA, 50 μM PF-278 C. albicans, 50 μM LSLATFAKIFMTRSNWSLKRF 149 T. rubrum, 50 μM NRL S. epidermidis, 50 μM PF-283 T. rubrum, 50 μM MIRIRSPTKKKLNRNSISDWKS 150 B. subtilis, 50 μM NTSGRFFY S. epidermidis, 50 μM PF-307 C. albicans, 50 μM MKRRRCNWCGKLFYLEEK SK 151 T. rubrum, 50 μM EAYCCKECRKKAKKVKK B. subtilis, 50 μM PF-168 T. rubrum, 50 μM VLPFPAIPLSRRRACVAAPRPR 152 A. niger, 50 μM SRQRAS MRSA, 50 μM PF-538 A. baumannii, 25 μM KNKKQTDILEKVKEILDKKKK 153 C. difficile, 25 μM TKSVGQKLY PF-448 A. niger, 25 μM SLQSQLGPCLHDQRH 154 S. pneumoniae, 50 μM PF-583 MRSA, 50 μM KFQGEFTNIGQSYIVSASHMST 155 S. epidermidis, 50 μM SLNTGK PF-600 E. coli, 50 μM TKKIELKRFVD AF VKKSYENY 156 S. pneumoniae, 50 μM ILERELKKLIKAINEELPTK PF-525 A. niger, 50 μM KF SD Q IDK GQD ALKDKLGDL 157 S. pneumoniae, 50 μM PF-529 A. niger, 50 μM LSEMERRRLRKRA 158 S. pneumoniae, 50 μM PF-148 A. niger, 50 μM RRGCTERLRRMARRNAWDLY 159 B. subtilis, 50 μM AEHFY PF-530 A. baumannii, 25 μM SKFKVLRKIIIKEYKGELMLSI 160 QKQR PF-522 C. difficile, 25 μM FELVDWLETNLGKILKSKSA 161 PF-497 B. subtilis, 50 μM LVLRICTDLFTFIKWTIKQRKS 162 PF-499 B. subtilis, 50 μM VYSFLYVLVIVRKLLSMKKRI 163 ERL PF-322 B. subtilis, 50 μM GIVLIGLKLIPLLANVLR 164 PF-511 S. pneumoniae, 50 μM VMQSLYVKPPLILVTKLAQQN 165 PF-512 S. pneumoniae, 50 μM SFMPEIQKNTIPTQMK 166 PF-520 S. pneumoniae, 50 μM LGLTAGVAYAAQPTNQPTNQ 167 PTNQPTNQPTNQPTNQPRW PF-521 S. pneumoniae, 50 μM CGKLLEQKNFFLKTR 168 PF-523 S. pneumoniae, 50 μM ASKQASKQASKQASKQASKQ 169 ASRSLKNHLL PF-524 S. pneumoniae, 50 μM PDAPRTCYHKPILAALSRIVVT 170 DR PF-209 MRSA, 50 μM NYAVVSHT 171 PF-437 S. pneumoniae, 50 μM FQKPFTGEEVEDFQDDDEIPTII 172 CAM135 GWRLIKKILRVFKGL 173 B-33 FKKFWKWFRRF 174 B-34 LKRFLKWFKRF 175 B-35 KLFKRWKHLFR 176 B-36 RLLKRFKHLFK 177 B-37 FKTFLKWLHRF 178 B-38 IKQLLHFFQRF 179 B-39 KLLQTFKQIFR 180 B-40 RILKELKNLFK 181 B-41 LKQFVHFIHRF 182 B-42 VKTLLHIFQRF 183 B-43 KLVEQLKEIFR 184 B-44 RVLQEIKQILK 185 B-45 VKNLAELVHRF 186 B-46 ATHLLHALQRF 187 B-47 KLAENVKEILR 188 B-48 RALHEAKEALK 189 B-49 FHYFWHWFHRF 190 B-50 LYHFLHWFQRF 191 B-51 YLFQTWQHLFR 192 B-52 YLLTEFQHLFK 193 B-53 FKTFLQWLHRF 194 B-54 IKTLLHFFQRF 195 B-55 KLLQTFNQIFR 196 B-56 TILQ SLKNIFK 197 B-57 LKQFVKFIHRF 198 B-58 VKQLLKIFNRF 199 B-59 KLVQQLKNIFR 200 B-60 RVLNQVKQILK 201 B-61 VKKLAKLVRRF 202 B-62 AKRLLKVLKRF 203 B-63 KLAQKVKRVLR 204 B-64 RALKRIKHVLK 205 1C-1 RRRRWWW 206 1C-2 RRWWRRW 207 1C-3 RRRWWWR 208 1C-4 RWRWRWR 209 2C-1 RRRFWWR 210 2C-2 RRWWRRF* 211 2C-3 RRRWWWF* 212 2C-4 RWRWRWF* 213 3C-1 RRRRWWK 214 3C-2 RRWWRRK 215 3C-3 RRRWWWK 216 3C-4 RWRWRWK 217 4C-1 RRRKWWK 218 4C-2 RRWKRRK 219 4C-3 RRRKWWK 220 4C-4 RWRKRWK 221 a-3 LHLLHQLLHLLHQF* 222 a-4 AQAAHQAAHAAHQF* 223 a-5 KLKKLLKKLKKLLK 224 a-6 LKLLKKLLKLLKKF* 225 a-7 LQLLKQLLKLLKQF* 226 a-8 AQAAKQAAKAAKQF* 227 a-9 RWRRWWRHFHHFFH* 228 a-10 KLKKLLKRWRRWWR 229 a-11 RWRRLLKKLHHLLH* 230 a-12 KLKKLLKHLHHLLH* 231 BD-1 FVFRHKWVWKHRFLF 232 BD-2 VFIHRHVWVHKHVLF 233 BD-3 WRWRARWRWRLRWRF 234 BD-4 WRIHLRARLHVKFRF 235 BD-5 LRIHARFKVHIRLKF 236 BD-6 FHIKFRVHLKVRFHF 237 BD-7 FHVKIHFRLHVKFHF 238 BD-8 LHIHAHFHVHIHLHF 239 BD-9 FKIHFRLKVHIRFKF 240 BD-10 FKAHIRFKLRVKFHF 241 BD-11 LKAKIKFKVKLKIKF 242 BD-12 WIWKHKFLHRHFLF 243 BD-13 VFLHRHVIKHKLVF 244 BD-14 FLHKHVLRHRIVF 245 BD-15 VFKHKIVHRHILF 246 BD-16 FLFKHLFLHRIFF 247 BD-17 LFKHILIHRVIF 248 BD-18 FLHKHLFKHKLF 249 BD-19 VFRHRFIHRHVF 250 BD-20 FIEIKLVHKHVLF 251 BD-21 VLRHLFRHRIVF 252 BD-22 LVHKLILRHLLF 253 BD-23 VFKRVLIHKLIF 254 BD-24 IVRKFLFRHKVF 255 BD-25 VLKHVIAHKRLF 256 BD-26 FIRKFLFKHLF 257 BD-27 VIRHVWVRKLF 258 BD-28 FLFRHRFRHRLVF 259 BD-29 LFLHKHAKHKFLF 260 BD-30 FKHKFKHKFIF 261 BD-31 LRHRLRHRLIF 262 BD-32 LILKFLFKFVF 263 BD-33 VLIRILVRVIF 264 BD-34 FRHRFRHRF 265 BD-35 LKHKLKHKF 266 BD-36 FKFKHKLIF 267 BD-37 LRLRHRVLF 268 BD-38 FKFLFKFLF 269 BD-39 LRLFLRWLF 270 BD-40 FKFLFKHKF 271 BD-41 LRLFLRHRF 272 BD-42 FKFLFKF 273 BD-43 LRLFLRF 274 AA-1 HHFFHHFHHFFHHF* 275 AA-2 FHFFHHFFHFFHHF* 276 AA-3 KLLKGATFHFFHHFFHFFHHF 277 AA-4 KLLKFHFFHHFFHFFHHF 278 AA-5 FHFFHHFFHFFHHFKLLK 279 RIP YSPWTNF* 280 LL-37 LLGDFFRKSKEKIGKEFKRIVQ 281 RIKDFLRNLVPRTES Cys-LL-37 CLLGDFFRKSKEKIGKEFKRIV 282 QRIKDFLRNLVPRTES LL-37(17-32) FKRIVQRIKDFLRNLV 283 Cys-LL-37- CLLGDFFRKSKEKIGKEFKRIV 284 Cys QRIKDFLRNLVPRTESC LL-37FK-13 FKRIVQRIKDFLR 285 LL-37FKR FKRIVQRIKDFLRNLVPRTES 286 LL-37GKE GKEFKRIVQRIKDFLRNLVPR 287 LL-37KRI KRIVQRIKDFLRNLVPRTES 288 LL-37LLG LLGDFFRKSKEKIGKEFKRIV 289 LL-37RKS RKSKEKIGKEFKRIVQRIKDFL 290 RNLVPRTES LL-37SKE SKEKIGKEFKRIVQRIKDFLR 291 LL-37-Cys LLGDFFRKSKEKIGKEFKRIVQ 292 RIKDFLRNLVPRTESC BD2.21 KLFKFLRKHLL 293 AFS FLKFLKKFFKKLK 294 FIGAIARLLSKIFGKR 295 GIFSKLAGKKIKNLLISG 296 GIFSKLAGKKIKNLLISGLKG 297 GLFSKFVGKGIKNFLIKGVK 298 KAYSTPRCKGLFRALMCWL 299 KIFGAIWPLALGALKNLIK 300 GWGSFFKKAAHVGKHVGKA 301 ALTHYL RGLRRLGRKIAHGVKKYG 302 RGLRRLGRKIAHGVKKYGPTV 303 LRIIRIAG KIAHGVKKYGPTVLRIIR 304 LLGDFFRKSKEKIGKEFKRIVQ 305 RIKDFLRNLVPRTES FLPLIGRVLSGIL 306 IGKFLKKAKKFGKAFVKILKK 307 GKFLKKAKKFGKAFVKIL 308 WFLKFLKKFFKKLKY 309 RGLRRLGRKIAHGVKKY 310 LLGDFFRKSKEKI 311 ILRWPWWPWRRK 312 KLFGALWPLALGALKNLLK 313
(43) A number of antimicrobial peptides are also disclosed in U.S. Pat. Nos. 7,271,239, 7,223,840, 7,176,276, 6,809,181, 6,699,689, 6,420,116, 6,358,921, 6,316,594, 6,235,973, 6,183,992, 6,143,498, 6,042,848, 6,040,291, 5,936,063, 5,830,993, 5,428,016, 5,424,396, 5,032,574, 4,623,733, which are incorporated herein by reference for the disclosure of particular antimicrobial peptides.
(44) In certain embodiments the antimicrobial peptides comprise one or more amino acid sequences described in the “Collection of Anti-Microbial Peptides” (CAMP) an online database developed for advancement the understanding of antimicrobial peptides (see, e.g., Thomas et al. (2009) Nucleic Acids Res., 2009, 1-7.doi:10.1093/nar/gkp1021) available at www.bicnirrh.res.in/antimicrobial.
(45) In certain embodiments, the antimicrobial peptide is a novaspririn, a novaspirin fragment or analog, e.g., as shown above in Table 7. In certain embodiments constructs are contemplated where one or more of the targeting peptides described herein are attached (e.g., directly or through a linker) to a modulated version of novispirin G10 designated G2 (KNLRIIRKGIHIIKKY (SEQ ID NO:314). In this case, the C terminal amino acids can be removed and an internal arginine can be eliminated to facilitate chemical synthesis. Novispirin G10 (the “parent molecule”) is an antimicrobial alpha-helical octadecapeptide structurally related to cathelicidins and other innate immunity peptides.
(46) Joining Targeting Peptides to Antimicrobial Peptides.
(47) Chemical Conjugation.
(48) In certain embodiments the targeting peptides are attached directly to the antimicrobial peptides antimicrobial peptides via naturally occurring reactive groups or the targeting peptide(s) and/or the antimicrobial peptides can be functionalized to provide such reactive groups.
(49) In various embodiments the targeting peptides are attached to the antimicrobial peptides via one or more linking agents. Thus, in various embodiments the targeting peptides and the antimicrobial peptides can be conjugated via a single linking agent or multiple linking agents. For example, the targeting peptide and the antimicrobial peptide can be conjugated via a single multifunctional (e.g., bi-, tri-, or tetra-) linking agent or a pair of complementary linking agents. In another embodiment, the targeting peptide and the antimicrobial peptides are conjugated via two, three, or more linking agents. Suitable linking agents include, but are not limited to, e.g., functional groups, affinity agents, stabilizing groups, and combinations thereof.
(50) In certain embodiments the linking agent is or comprises a functional group. Functional groups include monofunctional linkers comprising a reactive group as well as multifunctional crosslinkers comprising two or more reactive groups capable of forming a bond with two or more different functional targets (e.g., labels, proteins, macromolecules, semiconductor nanocrystals, or substrate). In some preferred embodiments, the multifunctional crosslinkers are heterobifunctional crosslinkers comprising two or more different reactive groups.
(51) Suitable reactive groups include, but are not limited to thiol (—SH), carboxylate (COOH), carboxyl (—COOH), carbonyl, amine (NH.sub.2), hydroxyl (—OH), aldehyde (—CHO), alcohol (ROH), ketone (R.sub.2CO), active hydrogen, ester, sulfhydryl (SH), phosphate (—PO.sub.3), or photoreactive moieties. Amine reactive groups include, but are not limited to e.g., isothiocyanates, isocyanates, acyl azides, NHS esters, sulfonyl chlorides, aldehydes and glyoxals, epoxides and oxiranes, carbonates, arylating agents, imidoesters, carbodiimides, and anhydrides. Thiol-reactive groups include, but are not limited to e.g., haloacetyl and alkyl halide derivates, maleimides, aziridines, acryloyl derivatives, arylating agents, and thiol-disulfides exchange reagents. Carboxylate reactive groups include, but are not limited to e.g., diazoalkanes and diazoacetyl compounds, such as carbonyldiimidazoles and carbodiimides. Hydroxyl reactive groups include, but are not limited to e.g., epoxides and oxiranes, carbonyldiimidazole, oxidation with periodate, N,N′-disuccinimidyl carbonate or N-hydroxylsuccimidyl chloroformate, enzymatic oxidation, alkyl halogens, and isocyanates. Aldehyde and ketone reactive groups include, but are not limited to e.g., hydrazine derivatives for schiff base formation or reduction amination. Active hydrogen reactive groups include, but are not limited to e.g., diazonium derivatives for mannich condensation and iodination reactions. Photoreactive groups include, but are not limited to e.g., aryl azides and halogenated aryl azides, benzophenones, diazo compounds, and diazirine derivatives.
(52) Other suitable reactive groups and classes of reactions useful in forming chimeric moieties (targeted antimicrobial peptides) include those that are well known in the art of bioconjugate chemistry. Currently favored classes of reactions available with reactive chelates are those which proceed under relatively mild conditions. These include, but are not limited to, nucleophilic substitutions (e.g., reactions of amines and alcohols with acyl halides, active esters), electrophilic substitutions (e.g., enamine reactions), and additions to carbon-carbon and carbon-heteroatom multiple bonds (e.g., Michael reaction, Diels-Alder addition). These and other useful reactions are discussed in, for example, March (1985) Advanced Organic Chemistry, 3rd Ed., John Wiley & Sons, New York, Hermanson (1996) Bioconjugate Techniques, Academic Press, San Diego; and Feeney et al. (1982) Modification of Proteins; Advances in Chemistry Series, Vol. 198, American Chemical Society, Washington, D.C.
(53) A “linker” or “linking agent” as used herein, is a molecule that is used to join two or more molecules. In certain embodiments the linker is typically capable of forming covalent bonds to both molecule(s) (e.g., the targeting peptide and the antimicrobial peptide). Suitable linkers are well known to those of skill in the art and include, but are not limited to, straight or branched-chain carbon linkers, heterocyclic carbon linkers, or peptide linkers. In certain embodiments the linkers can be joined to the constituent amino acids through their side groups (e.g., through a disulfide linkage to cysteine). However, in certain embodiments, the linkers will be joined to the alpha carbon amino and carboxyl groups of the terminal amino acids.
(54) A bifunctional linker having one functional group reactive with a group on one molecule (e.g., a targeting peptide), and another group reactive on the other molecule (e.g., an antimicrobial peptide), can be used to form the desired conjugate. Alternatively, derivatization can be performed to provide functional groups. Thus, for example, procedures for the generation of free sulfhydryl groups on peptides are also known (See U.S. Pat. No. 4,659,839).
(55) In certain embodiments the linking agent is a heterobifunctional crosslinker comprising two or more different reactive groups that form a heterocyclic ring that can interact with a peptide. For example, a heterobifunctional crosslinker such as cysteine may comprise an amine reactive group and a thiol-reactive group can interact with an aldehyde on a derivatized peptide. Additional combinations of reactive groups suitable for heterobifunctional crosslinkers include, for example, amine- and sulfhydryl reactive groups; carbonyl and sulfhydryl reactive groups; amine and photoreactive groups; sulfhydryl and photoreactive groups; carbonyl and photoreactive groups; carboxylate and photoreactive groups; and arginine and photoreactive groups. In one embodiment, the heterobifunctional crosslinker is SMCC.
(56) Many procedures and linker molecules for attachment of various molecules to peptides or proteins are known (see, e.g., European Patent Application No. 188,256; U.S. Pat. Nos. 4,671,958, 4,659,839, 4,414,148, 4,699,784; 4,680,338; 4,569,789; and 4,589,071; and Borlinghaus et al. (1987) Cancer Res. 47: 4071-4075).
(57) Fusion Proteins.
(58) In certain embodiments the targeted antimicrobial peptide can be chemically synthesized or expressed as a recombinant fusion protein (i.e., a chimeric fusion protein).
(59) In certain embodiments the chimeric fusion proteins are synthesized using recombinant DNA methodology. Generally this involves creating a DNA sequence that encodes the fusion protein, placing the DNA in an expression cassette under the control of a particular promoter, expressing the protein in a host, isolating the expressed protein and, if required, renaturing the protein.
(60) DNA encoding the fusion proteins can be prepared by any suitable method, including, for example, cloning and restriction of appropriate sequences or direct chemical synthesis by methods such as the phosphotriester method of Narang et al. (1979) Meth. Enzymol. 68: 90-99; the phosphodiester method of Brown et al. (1979) Meth. Enzymol. 68: 109-151; the diethylphosphoramidite method of Beaucage et al. (1981) Tetra. Lett., 22: 1859-1862; and the solid support method of U.S. Pat. No. 4,458,066.
(61) Chemical synthesis produces a single stranded oligonucleotide. This can be converted into double stranded DNA by hybridization with a complementary sequence or by polymerization with a DNA polymerase using the single strand as a template. One of skill would recognize that while chemical synthesis of DNA is limited to sequences of about 100 bases, longer sequences can be obtained by the ligation of shorter sequences.
(62) Alternatively, subsequences can be cloned and the appropriate subsequences cleaved using appropriate restriction enzymes. The fragments can then be ligated to produce the desired DNA sequence.
(63) In certain embodiments, DNA encoding targeted antimicrobial peptides may be cloned using DNA amplification methods such as polymerase chain reaction (PCR). Thus, for example, the nucleic acid encoding a targeting peptide is PCR amplified, using a sense primer containing the restriction site for NdeI and an antisense primer containing the restriction site for HindIII. This produces a nucleic acid encoding the targeting sequence and having terminal restriction sites. Similarly nucleic acids encoding an antimicrobial peptide and/or antimicrobial peptide/linker/spacer can be provided having complementary restriction sites. Ligation of sequences and insertion into a vector produces a vector encoding the fusion protein.
(64) While the targeting peptides and AMPS can be directly joined together, one of skill will appreciate that they can be separated by a peptide spacer/linker consisting of one or more amino acids. Generally the spacer will have no specific biological activity other than to join the proteins or to preserve some minimum distance or other spatial relationship between them. However, the constituent amino acids of the spacer may be selected to influence some property of the molecule such as the folding, net charge, or hydrophobicity.
(65) The nucleic acid sequences encoding the fusion proteins can be expressed in a variety of host cells, including E. coli, other bacterial hosts, yeast, and various higher eukaryotic cells such as the COS, CHO and HeLa cells lines and myeloma cell lines. The recombinant protein gene will be operably linked to appropriate expression control sequences for each host. For E. coli this includes a promoter such as the T7, trp, or lambda promoters, a ribosome binding site and preferably a transcription termination signal. For eukaryotic cells, the control sequences will include a promoter and preferably an enhancer derived from immunoglobulin genes, SV40, cytomegalovirus, etc., and a polyadenylation sequence, and may include splice donor and acceptor sequences.
(66) The plasmids can be transferred into the chosen host cell by well-known methods such as calcium chloride transformation for E. coli and calcium phosphate treatment or electroporation for mammalian cells. Cells transformed by the plasmids can be selected by resistance to antibiotics conferred by genes contained on the plasmids, such as the amp, gpt, neo and hyg genes.
(67) Once expressed, the recombinant fusion proteins can be purified according to standard procedures of the art, including ammonium sulfate precipitation, affinity columns, column chromatography, gel electrophoresis and the like (see, generally, R. Scopes (1982) Protein Purification, Springer-Verlag, N.Y.; Deutscher (1990) Methods in Enzymology Vol. 182: Guide to Protein Purification, Academic Press, Inc. N.Y.). Substantially pure compositions of at least about 90 to 95% homogeneity are preferred, and 98 to 99% or more homogeneity are most preferred for pharmaceutical uses. Once purified, partially or to homogeneity as desired, the polypeptides may then be used therapeutically.
(68) One of skill in the art would recognize that after chemical synthesis, biological expression, or purification, the fusion protein may possess a conformation substantially different than the native conformations of the constituent polypeptides. In this case, it may be necessary to denature and reduce the polypeptide and then to cause the polypeptide to re-fold into the preferred conformation. Methods of reducing and denaturing proteins and inducing re-folding are well known to those of skill in the art (See, Debinski et al. (1993) J Biol. Chem., 268: 14065-14070; Kreitman and Pastan (1993) Bioconjug. Chem., 4: 581-585; and Buchner, et al. (1992) Anal. Biochem., 205: 263-270).
(69) One of skill would recognize that modifications can be made to the fusion proteins without diminishing their biological activity. Some modifications may be made to facilitate the cloning, expression, or incorporation of the targeting molecule into a fusion protein. Such modifications are well known to those of skill in the art and include, for example, a methionine added at the amino terminus to provide an initiation site, or additional amino acids placed on either terminus to create conveniently located restriction sites or termination codons.
(70) As indicated above, in various embodiments an amino acid, or a peptide linker/spacer is used to join the one or more targeting peptides to one or more antimicrobial peptide(s). In various embodiments the peptide linker is relatively short, typically less than about 10 amino acids, preferably less than about 8 amino acids and more preferably about 1 or to or 3 to about 5 amino acids. Suitable illustrative linkers include, but are not limited to PSGSP ((SEQ ID NO:315), ASASA (SEQ ID NO: 316), or GGG. In certain embodiments longer linkers such as (GGGGS)3 (SEQ ID NO:317) can be used. Illustrative linking amino acids and peptide linkers and other linkers are shown in Table 8.
(71) TABLE-US-00013 TABLE 8 Illustrative peptide and non-peptide linkers. SEQ ID Linker NO: P S G AAA GGG SGG SAT PYP ASA GGGG 318 PSPSP 319 PSPSP 320 KKKK 321 RRRR 322 ASASA 323 GGSGGS 324 GGGGS 325 GGGGS GGGGS 326 GGGGS GGGGS GGGGS 327 GGGGS GGGGS GGGGS GGGGS 328 GGGGS GGGGS GGGGS GGGGS GGGGS 329 GGGGS GGGGS GGGGS GGGGS GGGGS GGGGS 330 2-nitrobenzene or O-nitrobenzyl Nitropyridyl disulfide Dioleoylphosphatidylethanolamine (DOPE) S-acetylmercaptosuccinic acid 1,4,7,10-tetraazacyclododecane-1,4,7, 10-tetracetic acid (DOTA) β-glucuronide and β-glucuronide variants Poly(alkylacrylic acid) Benzene-based linkers (for example: 2,5- Bis(hexyloxy)-1,4-bis[2,5-bis(hexyloxy)-4- formyl-phenylenevinylene]benzene) and like molecules Disulfide linkages Poly(amidoamine) or like dendrimers linking multiple target and killing peptides in one molecule Carbon nanotubes Hydrazone and hydrazone variant linkers PEG of any chain length Succinate, formate, acetate butyrate, other like organic acids Aldols, alcohols, or enols Peroxides alkane or alkene groups of any chain length One or more porphyrin or dye molecules containing free amide and carboxylic acid groups One or more DNA orR NA nucleotides, including polyamine and polycarboxyl-containing variants Inulin, sucrose, glucose, or other single, di or polysaccharides Linoleic acid or other polyunsaturated fatty acids Variants of any of the above linkers containing halogen or thiol groups
(In various embodiments any of the amino-acid-based linkers could be L peptides, D peptides, combinations of L and D residues, β-peptides, and the like).
(72) Multiple Targeting Peptides and/or AMPs.
(73) As indicated above, in certain embodiments, the chimeric moieties described herein can comprise multiple targeting peptides attached to a single antimicrobial peptide or multiple antimicrobial peptides attached to a single targeting peptide, or multiple targeting peptides attached to multiple antimicrobial peptides.
(74) Where the chimeric construct is a fusion protein this is easily accomplished by providing multiple domains that are targeting domains attached to one or more antimicrobial peptide domains. In various embodiments the multiple targeting domains and/or multiple effector domains can be attached to each other directly or can be separated by linkers (e.g., amino acid or peptide linkers as described above).
(75) When the chimeric construct is a chemical conjugate linear or branched configurations are readily produced by using branched or multifunctional linkers and/or a plurality of different linkers.
(76) Protecting Groups.
(77) While the various peptides described herein may be shown with no protecting groups, in certain embodiments they can bear one, two, three, four, or more protecting groups. In various embodiments, the protecting groups can be coupled to the C- and/or N-terminus of the peptide(s) and/or to one or more internal residues comprising the peptide(s) (e.g., one or more R-groups on the constituent amino acids can be blocked). Thus, for example, in certain embodiments, any of the peptides described herein can bear, e.g., an acetyl group protecting the amino terminus and/or an amide group protecting the carboxyl terminus.
(78) Fluoride (Fluoridizing Agent)
(79) In various embodiments, fluoride (fluoridizing) agents suitable for use in the dental varnishes described herein include, but are not limited to sodium fluoride, stannous fluoride, sodium monofluorophosphate, zinc hexafluorosilicate, and sodium hexafluorosilicate, ammonium fluoride, calcium fluoro-phosphate (Ca.sub.5[F(PO.sub.4).sub.3]) or fluorapatite, fluorine-doped hydroxyapatite (e.g., Ca.sub.5(PO.sub.4).sub.3(OH,F), calcium fluoride (CaF.sub.2) or fluorite or fluorspar, diofluorisilane, TiF.sub.4, and acidulated fluoride. In certain embodiments the fluoridizing agent may be present in the dental varnish in amounts of from about 0.1 weight percent to about 10 weight percent, such as from about 1 weight percent to about 7.5 weight percent or from about 2 weight percent to about 6 weight percent of the dental varnish (e.g., after combination of the first component with the second component. In certain embodiments the fluoride agent comprises about 0.5 weight percent, or about 1 weight percent, or about 2.5 weight percent, or about 5 weight percent of the varnish.
(80) Bulking Agent
(81) In various embodiments the dental varnishes described herein can comprise a bulking agent that may be provided in the first component or the second component, or in both components. In certain embodiments the bulking agent (e.g., mannitol) is provided in the first component.
(82) Illustrative bulking agents include, but are not limited to, mannitol, lactose, sucrose, trehalose, sorbitol, glucose, raffinose, arginine, glycine, histidine, dextran, erythritol, glycylglycine, glycine, histidine, polyethylene glycol, and combinations thereof.
(83) In various embodiments the bulking agent may be present in the dental varnish in amounts of from about 1 weight percent to about 95 weight percent, such as from about 5 weight percent to about 35 weight percent, or from about 8 weight percent to about 30 weight percent, or from about 7 weight percent up to about 12 weight percent. In certain embodiments the bulking agent comprises about 8.5 weight percent of the dental varnish (e.g., after combination of the first component with the second component).
(84) Varnish
(85) In various embodiments the dental varnishes and varnish systems described herein typically comprise a polymerized varnish that is comprised of polymer monomers that when said polymerized varnish is applied to the tooth surface forms a dry varnish coating on the tooth surface. In certain embodiments the varnish comprises one, two, three, or a plurality of, or all the plurality of polymer monomers selected from the group of (meth)acrylates and methacrylate esters. Illustrative monomers include, but are not limited to, ethylene glycol dimethacrylate, hydroxyethyl methacrylate (HEMA), and the like.
(86) In certain embodiments the varnish systems and varnishes comprises dimethylaminoethyl methacrylate, butyl methacrylate, and methylmethacrylate. In certain embodiments the varnish comprises dimethylaminoethyl methacrylate, butyl methacrylate, and methylmethacrylate in a ratio of 2:1:1 (also known as poly(butyl methacrylate-co-(2-dimethylaminoethyl) methacrylate-co-methyl methacrylate) 1:2:1, CAS NO: 24938-16-7). This formulation is commercially available as EUDRAGIT® E PO (Evonik Industries).
(87) In various embodiments the varnish polymers may be present in the dental varnish formulation in amounts of from about 5 weight percent to 90 weight percent, such as from about 10 weight percent to about 50 weight percent or from about 12 weight percent to about 35 weight percent (e.g., after combination of the first component with the second component). In certain embodiments the varnish comprises about 26 weight percent of the dental varnish formulation (e.g., after combination of the first component with the second component).
(88) Solvent
(89) In various embodiments the dental varnishes and varnish systems described herein can comprise a solvent that may be provided in the first component, in the second component, or in both components. In certain embodiments the solvent (e.g., ethanol, acetone, or ethyl acetate, or similar solvents known by those skilled in the art) is provided in the second component along with the varnish.
(90) Illustrative solvents suitable for use in the dental varnish systems and varnishes described herein include one or more alcohols, one or more hydrocarbons, ketones, esters, or combinations thereof. In some embodiments, the solvent comprises a mixture of alcohol and hydrocarbons. In various embodiments the dental varnish formulations may include individual solvents (e.g. ethyl alcohol only) or mixtures of alcohols, individual hydrocarbons or their mixtures, or mixtures of alcohols with hydrocarbons.
(91) Alcohols suitable for use in the dental varnish systems and varnishes described herein include, but are not limited to, C.sub.2-C.sub.4 alcohols, including C.sub.3 alcohols, wherein said alcohols may be linear, branched and/or cyclic. Alcohols include ethyl alcohol, propyl alcohol (including its isomers n-propyl alcohol and isopropyl alcohol), butyl alcohol (including its isomers, namely n-butyl alcohol, sec-butyl alcohol, iso-butyl alcohol, and t-butyl alcohol), and blends thereof. In certain embodiments the use of alcohols outside the C.sub.2-C.sub.4 range is also contemplated. In certain embodiments the solvent comprises or consists of ethyl alcohol.
(92) Suitable hydrocarbons include, but are not limited to, C.sub.5-C.sub.7 hydrocarbons, wherein the hydrocarbons may be linear, branched and/or cyclic, and may be alkanes and/or alkenes. A hydrocarbon component may comprise a single hydrocarbon or a blend of two or more hydrocarbons. Specific suitable hydrocarbons include, but are not limited to isopentane, n-pentane, n-hexane, isohexanes, cyclohexene, cyclohexane, methylcyclopentane, n-heptane, methyl cyclohexane, 2,5-dimethylhexane, cyclohexene, methyl cyclohexene, 1-heptene, and mixtures thereof. In certain embodiments the use of hydrocarbons outside the C.sub.5-C.sub.7 range is also contemplated.
(93) In various embodiments the solvent may be present in the dental varnish systems and varnishes in amounts of from about 10 weight percent to about 90 weight percent, such as from about 20 weight percent to about 80 weight percent or from about 50 weight percent to about 75 weight percent. In certain embodiments where the solvent comprises hexane, the solvent may be present in an amount ranging from about 1 weight percent or from about 10 weight percent up to about 15 weight percent, where the solvent comprises alcohol, the solvent may be present in an amount ranging from about 1 weight percent or from about 10 weight percent up to about 84 weight percent, or up to about 50 weight percent, or up to about 30 weight percent, or up to about 25 weight percent, or up to about 15 weight percent, or in certain embodiments from about 1 weight percent up to about 15 weight percent, or from about 10 weight percent up to about 25 weight percent, or from about 20 weight percent up to about 30 weight percent. In certain embodiments the solvent comprises about 55 weight percent of the dental varnish (e.g., after combination of the first component with the second component.
(94) Sweetener
(95) In various embodiments the dental varnish systems and varnishes disclosed herein may include one or more sweeteners. The sweeteners can be provided in the first component or in the second component, or in both components. In certain embodiments the sweetener (e.g., sucralose) is provided in the first component.
(96) Illustrative sweeteners include, but are not limited to, sucralose, xylitol, sorbitol, aspartame, sodium saccharin, acesulfame potassium (potassium salt of 6-methyl-1,2,3-oxathiazin-4(3H)-one-dioxide), and mixtures thereof. Such sweeteners may be in the dental varnish in amounts of from about 0.01 weight percent to about 4 weight percent, such as from about 0.05 weight percent to about 1 weight percent, or from about 0.1 weight percent up to about 0.5 weight percent or up to about 1.5 weight percent or from about 0.1 weight percent to about 1 weight percent.
(97) Flavor.
(98) In various embodiments the dental varnish systems and varnishes disclosed herein may include one or more flavors. The flavors can be provided in the first component or in the second component, or in both components. In certain embodiments the flavor (e.g., dinoberry) is provided in the second component (e.g., in the varnish solution).
(99) Illustrative flavors include, but are not limited to, dinoberry, menthol, peppermint, spearmint, wintergreen, anise, apricot, cinnamon, fennel, lavender, neem, ginger, vanilla, lemon, orange, spearmint, cherry, citric acid, strawberry, vanilla, coconut, bubble gum flavor, and mixtures thereof.
(100) In various embodiments the flavors (flavoring additives) may be in the dental varnish in amounts of from about 0.1 weight percent to about 20 weight percent, such as from about 1 weight percent to about 15 weight percent or from about 7 weight percent to about 13 weight percent of the dental varnish (e.g., after combination of the first component with the second component).
(101) Antiseptic Agents.
(102) In various embodiments the dental varnish systems and varnishes disclosed herein may include one or more antiseptic agents. When present, the antiseptic agent(s) can be provided in the first component or in the second component, or in both components.
(103) As used herein, the term “antiseptic agent” includes both bactericidal and bacteriostatic agents. Such an agent can be an anti-plaque agent and/or an anti-caries agent, if, when provided in an effective amount to a recipient, it is capable of preventing or attenuating the accumulation of plaque or caries. A variety of antiseptic agents can be utilized in the dental varnishes described herein.
(104) Illustrative, but non-limiting antiseptics include the cationic nitrogen-containing antibacterial materials that are well known to the art (see, e.g., the section on “Quaternary Ammonium and Related Compounds” in the article on “Antiseptics and Disinfectants” in Kirk-Othmer Encyclopedia of Chemical Technology, 2nd ed. (Vol. 2, pp. 632-6455). Such materials have been used in oral compositions to counter plaque formation caused by bacteria in the oral cavity. Among the most common and efficacious of these antibacterial, antiplaque quaternary ammonium compounds are cetylpyridinium chloride and benzalkonium chloride. Other cationic ammonium antibacterial agents of this type are described in U.S. Pat. Nos. 2,984,639, 3,325,402, 3,431,208, 3,703,583, and 4,339,430, British Patent No. 1,319,396, and German Patent No. 2,332,383, which are incorporated herein by reference for the antibacterial/antiseptic agents described therein.
(105) In certain embodiments the antiseptic agent comprises an agent selected from the group consisting of alcohol, an iodophor, sodium hypochlorite, chlorhexidine, benzalkonium chloride, cetylpyridinium chloride, benzethonium chloride, diisobutylphenoxyethoxyethyl dimethyl benzyl ammonium chloride, dodecyl trimethyl ammonium bromide, dodecyl dimethyl (2-phenoxyethyl) ammonium bromide, benzyl dimethyl stearyl ammonium chloride, cetyl pyridinium chloride, and quaternized 5-amino-1,3-bis (2-ethyl-hexyl)-5-methyl hexa hydropyrimidine.
(106) In certain embodiments the antiseptic agent comprises an iodophor such as povidone iodine.
(107) In certain embodiments the antiseptic agent comprises cetylpyridinium chloride, which is efficacious, compatible with the other components of the dental varnish, and inexpensive.
(108) In various embodiments the antiseptic agent may be present in the dental varnish in amounts of from about 0.01 weight percent up to about 35 weight percent, or up to about 20 weight percent, or up to about 15 weight percent, or up to about 10 weight percent, such as from about 0.05 weight percent to about 5 weight percent or from about 0.1 weight percent to about 3 weight percent (e.g., after combination of the first component with the second component). In certain embodiments the antiseptic agent comprises about 1 weight percent of the dental varnish (e.g., after combination of the first component with the second component).
(109) Antibiotic
(110) In various embodiments the dental varnish systems and varnishes disclosed herein may include one or more antibiotics. When present, the antibiotic(s) can be provided in the first component or in the second component, or in both components.
(111) Illustrative antibiotics include, but are not limited to penicillins, tetracyclines (e.g., tetracycline HCl), minocycline, doxycycline, metronidazole, ciprofloxacin, clindamycin, amoxicillin, metronidazole, combinations of amoxicillin-metronidazole, combinations of ciprofloxacin-metronidazole, and the like.
(112) In various embodiments the antibiotic may be present in the dental varnish in amounts of from about 2 weight percent to about 30 weight percent, such as from about 10 weight percent to about 25 weight percent or from about 20 weight percent to about 25 weight percent (e.g., after combination of the first component with the second component). In certain embodiments the antibiotic comprises about 21.4 weight percent of the dental varnish (e.g., after combination of the first component with the second component).
(113) Remineralization Agent(s).
(114) In various embodiments the dental varnish systems and varnishes disclosed herein may include one or more remineralization agents to aid remineralization and/or tooth hardness. When present, the remineralization agent(s) can be provided in the first component or in the second component, or in both components.
(115) Illustrative remineralization agents include, but are not limited to, hydroxyapatite, fluorapatite, Tri-Calcium Phosphate (TCP), CaKPO.sub.4, Ca.sub.2NaK(PO.sub.4).sub.2, casein phosphopeptide/amorphous calcium phosphate, bioactive glass, ACP (calcium sulfate and dipotassium phosphate), xylitol, and a polyphenol (e.g., proanthocyanidin (PA).
(116) Tri-Calcium phosphate (TCP) is a hybrid material created with a milling technique that fuses beta tricalcium phosphate and sodium lauryl sulfate or fumaric acid. This blending results in a “functionalized” calcium and a “free” phosphate, designed to increase the efficacy of fluoride remineralization. TCP provides catalytic amounts of calcium to boost fluoride efficacy and can coexist with fluoride in a dental varnish as contemplated herein.
(117) In casein phosphopeptide/amorphous calcium phosphate remineralization agents, casein phosphopeptides (CPPs) are typically produced from the tryptic digest of casein, aggregated with calcium phosphate and purified through ultrafiltration. Casein has the ability to stabilize calcium and phosphate ions by releasing small sequences of casein phosphopeptides (CPPs) through partial enzymic digestion that led to the development of a remineralization technology based on casein phosphopeptide-stabilized amorphous calcium phosphate complexes (CPP-ACP) and casein phosphopeptide-stabilized amorphous calcium fluoride phosphate complexes (CPP-ACFP).
(118) The ACP technology utilizes a two-phase delivery system to keep the calcium and phosphorous components from reacting with each other before use. Accordingly, the two phases of the ACP technology can be incorporated into the two components comprising the dental varnish systems described herein. Current sources of calcium and phosphorous are two salts, calcium sulfate and dipotassium phosphate. When the two salts are mixed, they rapidly form ACP that can precipitate on to the tooth surface. This precipitated ACP can then readily dissolve into the saliva and can be available for tooth remineralization.
(119) Bioactive glass (BIOGLASS®) acts as a biomimetic mineralizer matching the body's own mineralizing traits while also affecting cell signals in a way that benefits the restoration of tissue structure and function. Bioglass® in an aqueous environment immediately begins surface reaction in three phases, leaching and exchange of cations, network dissolution of SiO.sub.2 and precipitation of calcium and phosphate to form an apatite layer. The critical stages for glass surface reactions, the initial Na.sup.+ and H.sup.+/H.sub.3O.sup.+ ion exchange and de-alkalinization of the glass surface layer are quite rapid, within minutes of implantation and exposure to body fluids. The net negative charge on the surface and loss of sodium causes localized breakdown of the silica network with the resultant formation of silanol (SiOH) groups, which then repolymerize into a silica-rich surface layer. Within 3-6 h in vitro, the calcium phosphate layer will crystallize into the carbonated hydroxyapatite (CAP) layer, which is essentially the bonding layer. Chemically and structurally, this apatite is nearly identical to bone and tooth mineral. Bioactive glass formulations commonly used contain 45 wt % SiO.sub.2 4.5 wt % Na.sub.2O and CaO and 6 wt % P.sub.2O.sub.5. NOVAMIN®, a trade name for bioactive glass, is manufactured by Novamin Technologies Inc. (Alachua, Fla., USA). It has been demonstrated that fine particulate bioactive glasses (<90 μm) incorporated into an aqueous dentifrice have the ability to clinically reduce the tooth hypersensitivity through the occlusion of dentinal tubules by the formation of the CAP layer.
(120) In certain embodiments, peptides or proteins comprising repeats of the tripeptides DSS or ESS can be incorporated into the first or second component of the varnish. Proteins and peptides containing DSS-like repeats are involved in the rebuilding of tooth structure, such as remineralization of enamel and rebuilding of dentin. Synthetic peptides comprising DSS or ESS repeats are contemplated, as well as proteins that contain these sequence repeats, such as dentin sialophosphoprotein and dentin phosphoprotein.
(121) In certain embodiments, a combination of arginine and insoluble calcium compounds can be present in the first or second component of the varnish. Arginine-calcium carbonate compounds have been shown to occlude exposed dentinal tubules and reduce dental sensitivity, and may contribute to enamel remineralization. In certain embodiments, the amount of arginine-calcium carbonate is from about 1 to 10%, or about 8% by weight.
(122) Xylitol is a non-cariogenic five-carbon sugar alcohol that occurs naturally in plants and is used as a substitute for sugar. Xylitol has the ability to reduce dental plaque formation, make plaque less adhesive, neutralize plaque acids by decreasing the production of lactic acid, reduce the levels of S. mutans, reduce cavities by up to 80%, demonstrate significant long-term reduction in caries (88-93%), assist in the remineralization of tooth enamel, reduce gum tissue inflammation, and help with dry mouth and bad breath.
(123) In certain embodiments, antibacterial or antiseptic with general positive charge can be incorporated into the first or second component. This agents include but are not limited to chlorhexidine, cetylpyridimium chloride, positively charged antimicrobial nanoparticles, and polyhexamethylene biguanide (PHMB). The cationic character of these agents allows for rapid release from the varnish during use.
(124) It has been suggested that the preservation and stability of dentin collagen may be essential during the remineralization process, because it acts as a scaffold for mineral deposition. It has also been suggested that the presence of an organic matrix may reduce the progression of erosion in dentin. One of the important strategies regarding preventive therapies for root caries is to promote remineralization of demineralized dentin.
(125) Polyphenols are plant-derived substances that have antioxidant and anti-inflammatory properties. They are believed to interact with microbial membrane proteins, enzymes and lipids, thereby altering cell permeability and permitting the loss of proteins, ions and macromolecules. One such polyphenol is proanthocyanidin (PA), which is a bioflavanoid-containing benzene-pyran-phenolic acid molecular nucleus. The PA accelerates the conversion of soluble collagen to insoluble collagen during development and increases collagen synthesis to potentially aid in the remineralization of demineralized dentin.
(126) The foregoing remineralization agents are illustrative and non-limiting. Numerous other remineralization agents are known and can readily be incorporated into the varnish systems described herein.
(127) In various embodiments the remineralization agent(s) may be present in the dental varnish in amounts of from about 1 weight percent to about 20 weight percent, or up to about 15 weight percent, or up to about 10 weight percent, or up to about 5 weight percent, such as from about 2 weight percent up to about 5 weight percent (e.g., after combination of the first component with the second component). In certain embodiments the remineralization agent(s) comprise about 2 weight percent of the dental varnish (e.g., after combination of the first component with the second component). In certain embodiments CPP-ACT is present in the dental varnish at about 1 weight percent up to about 2 weight percent. In certain embodiments TCP is present at about 5 weight percent or less. In certain embodiments xylitol (when used as a remineralization is present at about 1 weight percent or about 2 weight percent or about 5 weight percent up to about 30 weight percent. In certain embodiments xylitol is present at about 20 weight percent.
(128) Oxide/Tint
(129) In embodiments, the dental varnish systems and varnishes disclosed herein may be clear or substantially transparent. In alternative embodiments, the dental varnish may include a white or substantially white tint. In further alternative embodiments, the formulation may include blue, green, yellow, or other colored tints. Where a tint is present, the tint can be provided in the first component, in the second component, or in both components.
(130) In certain embodiments when the dental varnish systems or varnishes has such a tint, the varnish will include a tint selected from the group consisting of titanium oxide, zirconium oxide, germanium oxide, tin oxide, zinc oxide, iron oxide, chromium oxide, vanadium oxide, tantalum oxide, niobium oxide, and mixtures thereof. In certain embodiments, the oxide may be present in the dental varnish (e.g., in a varnish produced by combination of the first component with the second component) in amounts of from about 0.01 weight percent to about 3 weight percent or to about 2 weight percent, such as from about 0.01 weight percent to about 1 weight percent or from about 0.08 weight percent to about 1 weight percent.
(131) In certain embodiments where the varnish is provided by the combination of two components, the tint can be provided in the first component or in the second component.
(132) Illustrative STAMP-Releasing Formulations.
(133) Illustrative, but non-limiting formulations of the STAMP-releasing dental varnish systems contemplated here are shown in Tables 9 and 10. These illustrative dental varnish systems comprise a first component that, in various embodiments, is provided as a dry powder containing one or more STAMP(s) and/or AMP(s) (e.g., C16G2) and a second component that provides a liquid varnish formulation. Combination of the first component with the second component provides a varnish formulation for application to the surface of a tooth.
(134) Tables 9 illustrates various embodiments of the first component. As shown therein, the first component can comprise or consist of a STAMP (or AMP), a bulking agent (e.g., mannitol), and a buffer (e.g., His).
(135) TABLE-US-00014 TABLE 9 Illustrative formulations for the first component of a two component dental varnish system. STAMP % in Final 1.4% 2.6% 4.9% Dental Varnish*: Weight Percent in Freeze- Dried Powder (Component 1) STAMP 10.71% 14.3% 21.43% HIS 1.55% 1.55% 1.55% Mannitol. 83.54% 79.96% 72.82% Sucralose 4.20% 4.20% 4.20% *After combination with the second component (e.g. as shown in Table 12).
(136) The first component can be formulated simply by mixing the components at room temperature until fully dissolved. The solution can, optionally be filtered. Then the solution can be lyophilized to form a dry powder.
(137) Tables 10 shows one illustrative, but non-limiting embodiment of the second component. As illustrated therein, the second component can comprises or consist of a varnish (e.g., a (meth)acrylate and/or (meth)acrylamide varnish), a solvent (e.g., ethanol), and optionally a flavor agent, and/or sweetener.
(138) TABLE-US-00015 TABLE 10 An illustrative formulation for the second component of a two component dental varnish system. Component Amount (% w/w) Solvent (e.g., ethanol) 59.95% Varnish (e.g., 28.65% EUDRAGIT ® E) Flavor (e.g. Watermelon 11.39% Lavender Mint)
(139) The second component can be formulated simply by combining the various ingredients at room temperature and mixing until fully dissolved. The resulting varnish solution can be stored in a closed vessel at 4-8° C. or room temperature.
(140) At the time and point of use the dental varnish can be reconstituted by simply combining the second component with the first component and mixing/shaking until the powder component is fully suspended and/or dissolved. The resulting varnish is then ready for reconstitution.
(141) In one illustrative but non-limiting embodiment, 127 mg of the freeze-dried powder is combined with 1 mL of varnish solution. The resulting solution is mixed for about 10 seconds to 5 min, or from about 30 seconds to 2 min, or about 30 seconds and then is ready for application to the surface(s) of a tooth. The first component and second component can be mixed immediately to about 4 hours prior to use, or from immediately to about 2 hours before use, or from immediately to about 1 hour before use, or immediately before use.
(142) Illustrative Fluoride-Releasing Formulations.
(143) Illustrative, but non-limiting formulations of the fluoride-releasing dental varnish systems contemplated here are shown in Tables 11 and 12. These illustrative dental varnish systems comprise a first component that, in various embodiments, is provided as a dry powder containing a fluoride (fluoridizing agent) and a second component that provides a liquid varnish formulation. Combination of the first component with the second component provides a varnish formulation for application to the surface of a tooth.
(144) Tables 11 illustrates various embodiments of the first component. As shown therein, the first component can comprise or consist of a fluoridizing agent (e.g., sodium fluoride), a bulking agent (e.g., mannitol), and a sweetener (e.g., sucralose).
(145) TABLE-US-00016 TABLE 11 Illustrative formulations for the first component of a two component dental varnish system. Fluoride % in Final 0.50% 1% 2% 2.50% 5% Dental Varnish*: Weight Percent in Freeze- Dried Powder (Component 1) NaF 3.94% 7.87% 15.75% 19.69% 39.37% Mannitol 94.66% 90.73% 82.85% 78.91% 59.23% Sucralose 1.40% 1.40% 1.40% 1.40% 1.40% *After combination with the second component (e.g. as shown in Table 12).
(146) The first component can be formulated simply by mixing the components at room temperature until fully dissolved. The solution can, optionally be filtered. Then the solution is lyophilized or spray dried, followed by milling if required, to form a dry powder. The first component can also be formulated by making a dry blend of the components using common techniques for those skilled in the art.
(147) Tables 12 shows one illustrative, but non-limiting embodiment of the second component. As illustrated therein, the second component can comprises or consist of a varnish (e.g., a (meth)acrylate and/or (meth)acrylamide varnish), a solvent (e.g., ethanol), and optionally a flavor agent.
(148) TABLE-US-00017 TABLE 12 An illustrative formulation for the second component of a two component dental varnish system. Amount Component (% w/w) Solvent (e.g., ethanol) 59.96% Varnish (e.g., EUDRAGIT ® E) 28.65% Flavor (e.g., dinoberry) 11.39%
(149) The second component can be formulated simply by combining the various ingredients at room temperature and mixing until fully dissolved. The resulting varnish solution can be stored in a closed vessel at 4-8° C. or room temperature.
(150) At the time and point of use the dental varnish can be reconstituted by simply combining the second component with the first component and mixing/shaking until the powder component is fully suspended and/or dissolved. The resulting varnish is then ready for reconstitution.
(151) In one illustrative but non-limiting embodiment, 127 mg of the freeze-dried powder is combined with 1 mL of varnish solution. The resulting solution is mixed for about 30 seconds and then is ready for application to the surface(s) of a tooth.
(152) Combined Varnish Solution.
(153) In various embodiments the dental varnishes contemplated herein can be provided as a two component system as described above. However, in other embodiments, the dental varnish is provided as a single component system, e.g. a single varnish solution containing the various ingredients as described above. Thus, for example, in certain embodiments, the fluoride dental varnish comprises a fluoride (e.g., NaF), a bulking agent (e.g., mannitol), a methacrylate and/or methacrylamide varnish (e.g., EUDRAGIT® varnish), a solvent (e.g., alcohol), and optionally a sweetener (e.g., sucralose, xylitol, etc.), and/or a flavoring agent.
(154) An illustrative varnish composition is shown in Table 13. As indicated therein, a number of ingredients can be optional and the recited amounts will vary depending on the ingredients incorporated into a particular varnish.
(155) TABLE-US-00018 TABLE 13 Illustrative dental fluoride varnish system. Weight % Illustrative Range Formulation Ingredients Fluoride 1-5 5 Varnish 12-35 25 Bulking Agent 6-30 7.5 Solvent 50-75 52.3 Optional Ingredients Solvent Sweetener 0.5-1.5 0.2 Flavor 7-13 10 Antiseptic 0-5 0 Antibiotic 0-30 0 Remineralization 0-20 0 Agent Tint 0-0.1 0
(156) In certain embodiments the varnish provides release of an effective amount of a fluoride and/or a STAMP (and/or AMP) for at least 1 hour after application, or for at least 2 hours after application, or for at least 4 hours after application, or for at least 6 hours after application, or for at least 8 hours after application, or for at least 12 hours after application, or for at least 24 hours after application, or for at least 48 hours after application.
(157) In certain embodiments the formulation of the varnish comprises or consists of a formulation that would be produced by combining a first formulation comprising or consisting of the formulation shown in Table 11 with a second formulation comprising or consisting of the formulation shown in Table 12. In certain embodiments the formulation of the varnish comprises or consists of the formulation that would be produced by combining a first formulation comprising or consisting of the formulation shown in Table 11 with a second formulation comprising or consisting of the formulation shown in Table 12, where the combination ranges from about 50 mg, or from about 100 mg, or from about 125 mg, up to about 200 mg, or up to about 300 mg of the dry powder of the first component with 1 ml of the second component. In certain embodiments the formulation of the varnish comprises or consists of the formulation that would be produced by combining about 127 mg of the dry powder of a first formulation comprising or consisting of the formulation shown in Table 11 with about 1 mL of a second formulation comprising or consisting of the formulation shown in Table 12.
(158) Methods of Use.
(159) In various embodiments methods of use of the varnishes and/or varnish systems described herein are provided. Thus, for example, in certain embodiments a method improving tooth hardness, and/or inhibiting S. mutans, and/or reducing dental cavities in a mammal, is provided where the method involves applying to the surface of a tooth of the mammal a varnish as described herein, and permitting the varnish to form a dry film on said surface of a tooth.
(160) In certain embodiments the method involves combining the first component of the varnish system (e.g., the powder component containing the fluoride agent) with the second component of the varnish system (e.g., a fluid component containing the varnish) to form the dental varnish ready for application. In certain embodiments the combining comprises combining from about 50 mg, or from about 100 mg, or from about 125 mg, up to about 200 mg, or up to about 250 mg of the dry powder of the first component with 1 ml of the second component or combining different amounts of the first and second component to produce the same proportions as these combinations.
(161) In certain embodiments the combining comprises combining a first formulation comprising or consisting of the formulation shown in Table 11 with a second formulation comprising or consisting of the formulation shown in Table 12, where the combination ranges from about 50 mg, or from about 100 mg, or from about 125 mg, up to about 200 mg, or up to about 250 mg of the dry powder of the first component with 1 ml of the second component. In certain embodiments the combining comprises combining about 127 mg of the dry powder of a first formulation comprising or consisting of the formulation shown in Table 11 with about 1 mL of a second formulation comprising or consisting of the formulation shown in Table 12.
(162) The resulting dental varnish is then applied to one or more surfaces of the teeth using methods known to those of skill in the art. For example, the varnish can readily be applied with a brush, a swab, a sponge, via spraying, and in certain embodiments via a dental tray or a mouthwash.
(163) In various embodiments the subject is a non-human mammal. More typically however, the subject will be a human. In various embodiments the human is a human infant or child, an adolescent, an adult, and/or the elderly or infirm.
(164) Illustrative Application Procedure.
(165) Although it is typically not necessary to perform a professional prophylaxis prior to the application of the fluoride varnishes or STAMP-delivering varnishes described herein, in certain embodiments, the teeth are cleaned, e.g., with a toothbrush prior to application. Typically, although not necessarily in certain embodiments, the teeth are dried prior to application by wiping with a cotton gauze and/or by air drying. While drying may be preferred it is not absolutely necessary. Typically, the varnish will adhere even if the teeth are moist. If desired, the teeth can be isolated (e.g. with cotton rolls) to prevent recontamination with saliva. A small amount of the varnish is typically dispensed (e.g., 0.5 ml) and, in various embodiments, the entire dentition may be treated with as little as 0.3-0.6 ml. The varnish is applied with a brush or other means (e.g., as described above). In certain embodiments as a result of the time needed for frequent reloading of the brush/applicator, an alternative technique utilizing, for example, a plastic syringe (e.g., a 5 ml syringe) can be employed. This method allows an efficient application of the varnish which can be particularly useful in cases where speed is important, such as with a difficult pediatric patient. In certain embodiments the subject is instructed to avoid brushing for the rest of the day and normal oral hygiene procedures resume again the following day.
(166) The varnish may be provided in individual dose systems and, in embodiments where the varnish system is utilized, the dose system may provide the first component and second component pre-measured in containers that can provide for rapid and easy combination and mixing of the components.
(167) In certain embodiments, in order to improve efficacy in decay prevention, the varnish is reapplied quarterly, or at least twice yearly.
(168) In certain embodiments the varnishes described herein can be provided in flow through applicators that can be applied to wet or dry teeth without leaving the mouth to re-load the brush or swab.
(169) In various embodiments the dental varnishes and varnish systems described herein are indicated for use as a topical fluoride agent and/or anti-S. mutans agent on moderate and high-risk patients, especially children age 5 and younger. In various embodiments the varnishes and varnish systems can be used: 1) as desensitizing agents for exposed root surfaces, 2) as a fluoridated or anti-S. mutans (anti-caries) cavity varnish, 3) in circumstances where a high concentration of fluoride or STAMP is needed for high caries risk patients, 4) in the elderly to prevent increasingly prevalent root dentin lesions, which may require higher concentration of fluoride and/or STAMP, 5) on advanced enamel carious lesions, which may also require higher fluoride concentration for remineralization and/or STAMP compositions, 6) as a fluoride and/or STAMP treatment for institutionalized patients or in other situations where setting, equipment and patient management might preclude the use of other fluoride (or STAMP) delivery methods, 7) for caries prevention on exposed root surfaces, 8) for remineralization of lesions in root dentin, 9) for fluoride and/or STAMP application around orthodontic bands and brackets, and 10) as a fluoride or STAMP-treatment on patients when there is a concern that a fluoride or STAMP rinse, gel or foam might be swallowed.
(170) Kits.
(171) In various embodiments kits are provided for the delivery and use of the varnish systems and varnishes described herein. In certain illustrative, but non-limiting embodiments, the kit comprises a container containing a fluoride dental varnish or a STAMP- (or AMP-) delivering varnish as described herein, or the kit can contain a varnish system for a fluoride-delivering varnish or for a STAMP-delivering varnish as described herein. Where the kit provides a two-component system, the kit may comprise a first container containing the first component of the varnish system as described herein and a container containing the second component of the varnish system as described herein. In certain embodiments the first container and second container are provided as separate containers. In certain embodiments the first container and second container are separate chambers in a single container device (e.g., a dual barrel syringe, two blisters on a blister pack, etc.). In certain embodiments the kit further comprises an applicator (e.g., brush, a swab, a sponge, a sprayer, etc.) for application of the varnish to a tooth surface.
(172) In addition, the kits can optionally include labeling and/or instructional materials providing directions (i.e., protocols) for the use of the varnish systems and/or varnishes described herein. Certain instructional materials describe how to combine the first component and second component of a varnish system using materials provided in the kit to produce the dental varnish. The instructional materials may also, optionally, teach preferred amounts, application methods, indications and counter indications, etc.
(173) While the instructional materials typically comprise written or printed materials, they are not limited to such. Any medium capable of storing such instructions and communicating them to an end user is contemplated by this invention. Such media include, but are not limited to, electronic storage media (e.g., magnetic discs, tapes, cartridges, chips), optical media (e.g., CD ROM), and the like. Such media may include addresses to internet sites that provide such instructional materials.
EXAMPLE
(174) The following example is offered to illustrate, but not to limit, the claimed invention.
Example 1
STAMP-Releasing Varnish
(175) A novel varnish was formulated that enables rapid release of small and large molecules. The varnish sticks well to dried teeth at application, provides a smooth mouthfeel and lasts 4-6 hours. In certain embodiments the varnish is flavored. In certain illustrative embodiments the varnish comprises a formulation as illustrated in Table 14.
(176)
(177) TABLE-US-00019 TABLE 14 Three illustrative targeted antimicrobial peptide releasing methacrylate polymer tooth varnishes, 15, 30 and 60 mg dose levels (in components and after reconstitution) Lyopowder: Targeted antimicrobial peptide Sucralose (e.g., C16G2) Mannitol Histidine 4.20% 10.71 to 21.4% 73-84% 1.6% Varnish Liquid: Ethanol Methacrylate Polymer Flavor 60.00% 28.60% 11.40% Examples of Dry Powder Formulation: Dose level: 13.6 mg 27.2 mg 54.4 mg C16G2 10.7% 14.3% 21.4% (targeted AMP) Mannitol 84% 80% 73% Histidine 1.6% 1.6% 1.6% Surcalose 4.2% 4.2% 4.2% mg FDP 127 mg 190 mg 254 mg mixed with 1 ml second formulation solution FDP = Freeze-dried Powder
(178) There was no release of C16G2 from the resin-based varnish over 48 hours at 20° C. or 37° C. Additionally, minimal C16G2 could be recovered by extraction and a large unknown peak seen in HPLC suggests a reaction between C16G2 and the Rosin/Shellac varnish. In contrast the three varnish formulations showed good release characteristics.
(179) In various embodiments the varnishes containing the targeted antimicrobial peptide (e.g., C16G2) can also contain fluoride.
(180)
(181)
Example 2
C16G2 Varnish Formulation
(182) In certain embodiments a C16G2 varnish drug product is manufactured for administration as a dental varnish product. This varnish product utilizes generally recognized as safe (GRAS) or compendia excipients. In certain embodiments, as noted above, the C16G2 varnish product is provided in two vials (e.g., glass vials), whose content is combined prior to application. In one illustrative, but non-limiting embodiment, one vial contains a powder blend of C16G2 at doses of 13.6, 27.2, and 54.4 mg and other required excipients. The other vial contains a vehicle solution. The qualitative and quantitative composition of several C16G2 varnish products is shown in Table 15, Table 16, and Table 17 below.
(183) TABLE-US-00020 TABLE 15 Qualitative and quantitative composition of a 13.6 mg C16G2 varnish drug product. Amount Component Function per dose C16G2 Active (anti-S. 13.60 mg mutans) agent D-Mannitol, USP Bulking agent 105.92 mg L-Histidine, USP Buffer 1.97 mg Sucralose, NF Flavoring Agent 5.33 mg Ethanol, 200 proof USP Solvent 521.57 mg Watermelon, Lavender, Flavoring agent 99.09 mg Mint Flavor Amino Methacrylate Polymer 249.26 mg Copolymer, USP FD&C Blue No. 1 Coloring Agent 0.09 mg Sodium Hydroxide, NF In process pH q.s. to pH adjustment 6.0 ± 0.1 NF = National Formulary, q.s. = quantity sufficient; USP = United States Pharmacopeia
(184) TABLE-US-00021 TABLE 16 Qualitative and quantitative composition of a 27.2 mg C16G2 varnish drug product. Amount Component Function per dose C16G2 Drug Substance 27.21 mg D-Mannitol, USP Bulking agent 152.33 mg L-Histidine, USP Buffer 2.95 mg Sucralose, NF Flavoring Agent 8.00 mg Ethanol, 200 proof, USP Solvent 521.57 mg Watermelon, Lavender, Flavoring agent 99.09 mg Mint Flavor Amino Methacrylate Polymer 249.26 mg Copolymer, USP FD&C Blue No. 1 Coloring Agent 0.09 mg Sodium Hydroxide, NF In process pH q.s. to pH adjustment 6.0 ± 0.1 NF = National Formulary, q.s. = quantity sufficient; USP = United States Pharmacopeia
(185) TABLE-US-00022 TABLE 17 Qualitative and quantitative composition of a 54.4 mg C16G2 varnish drug product. Amount Component Function per dose C16G2 Drug Substance 54.43 mg D-Mannitol, USP Bulking agent 184.97 mg L-Histidine, USP Buffer 3.94 mg Sucralose, NF Flavoring Agent 10.67 mg Ethanol, Solvent 521.57 mg 200 proof USP Watermelon, Flavoring agent 99.09 mg Lavender, Mint Flavor Amino Methacrylate Polymer 249.26 mg Copolymer, USP FD&C Blue No. 1 Coloring Agent 0.09 mg Sodium Hydroxide In process pH, q.s. to pH NF adjustment 6.0 ± 0.1 NF = National Formulary, q.s. = quantity sufficient; USP = United States Pharmacopeia
Placebo Varnish Formulation
(186) In certain embodiments for evaluation purposes a placebo varnish is formulated. Typically the placebo varnish utilizes GRAS or compendia excipients. To maintain a study blind, the Placebo product can also be provided in two vials, whose content is combined prior to application. One vial contains a powder blend of the same excipients as the active vial but without C16G2. The other vial contains a vehicle solution. Placebo products also have a similar qualitative and quantitative composition as shown in Table 15, but do not contain C16G2 drug substance and the omitted weight of the active product is compensated for with additional mannitol or other bulking material.
(187) The foregoing varnish formulations are illustrative and not limiting. Using the teachings provided herein numerous other STAMP-releasing varnish formulations will be available to one of skill in the art.
Example 3
Evaluation of Fluoride Varnish System
(188) A varnish system designated C3, was evaluated for its fluoride-release properties. The C3 system comprises a fluoride powder with a bulking agent suspended in a solution of methacrylate polymer dissolved in ethanol.
(189)
(190)
(191) It is understood that the examples and embodiments described herein are for illustrative purposes only and that various modifications or changes in light thereof will be suggested to persons skilled in the art and are to be included within the spirit and purview of this application and scope of the appended claims. All publications, patents, and patent applications cited herein are hereby incorporated by reference in their entirety for all purposes.