U.S. patent number 6,214,536 [Application Number 09/433,757] was granted by the patent office on 2001-04-10 for method of detecting lung disease.
This patent grant is currently assigned to The University of North Carolina at Chapel Hill. Invention is credited to Richard C. Boucher, Jr..
United States Patent |
6,214,536 |
Boucher, Jr. |
April 10, 2001 |
Method of detecting lung disease
Abstract
A method of facilitating the obtaining of a mucus sample from at
least one lung of a subject comprises administering to at least one
lung of the subject, in an amount effective to hydrate lung mucous
secretions and/or stimulate cilia beat frequency therein, uridine
5'-triphosphate, an active analog thereof, or a pharmaceutically
acceptable salt of either thereof, and, optionally, concurrently
administering to said at least one lung a physiologically
acceptable salt in an amount effective to hydrate lung mucus
secretions therein. A sputum or mucus sample is then collected from
said at least one lung, which sample can then be analyzed for lung
disease. Pharmaceutical compositions useful for carrying out the
method comprise UTP or a salt thereof, alone or in combination with
a physiologically acceptable salt, or a pharmaceutically acceptable
salt of either thereof. The composition may be a liquid/liquid
suspension composition or a dry powder composition.
Inventors: |
Boucher, Jr.; Richard C.
(Chapel Hill, NC) |
Assignee: |
The University of North Carolina at
Chapel Hill (Chapel Hill, NC)
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Family
ID: |
24025091 |
Appl.
No.: |
09/433,757 |
Filed: |
November 4, 1999 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
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776772 |
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6133247 |
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509052 |
Jul 31, 1995 |
5628984 |
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Current U.S.
Class: |
435/4; 424/45;
435/15; 514/50 |
Current CPC
Class: |
A61P
11/10 (20180101); A61K 45/06 (20130101); A61K
33/14 (20130101); A61K 9/0078 (20130101); A61K
31/66 (20130101); A61K 33/14 (20130101); A61K
31/70 (20130101); A61K 31/495 (20130101); A61K
33/14 (20130101); A61K 31/66 (20130101); A61K
31/66 (20130101); A61K 31/495 (20130101); A61K
33/14 (20130101); A61K 31/70 (20130101); A61K
31/7004 (20130101); A61K 31/495 (20130101); A61K
31/165 (20130101); A61K 31/14 (20130101); A61K
33/14 (20130101); A61K 2300/00 (20130101) |
Current International
Class: |
A61K
45/06 (20060101); A61K 33/14 (20060101); A61K
45/00 (20060101); C12Q 001/00 (); C12Q
001/48 () |
Field of
Search: |
;435/4,14 ;514/50
;424/45 |
References Cited
[Referenced By]
U.S. Patent Documents
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3313813 |
April 1967 |
Cragoe et al. |
4132600 |
January 1979 |
Plotkin et al. |
4501729 |
February 1985 |
Boucher et al. |
4950477 |
August 1990 |
Schmitt et al. |
5292498 |
March 1994 |
Boucher, Jr. |
5420116 |
May 1995 |
Puchelle et al. |
5470838 |
November 1995 |
Von Borstel et al. |
5567689 |
October 1996 |
Sommadossi et al. |
5628984 |
May 1997 |
Boucher, Jr. |
5656256 |
August 1997 |
Boucher et al. |
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Foreign Patent Documents
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2571257 |
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Apr 1986 |
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FR |
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1 055 465 |
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Jan 1967 |
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GB |
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WO 92/11016 |
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Aug 1992 |
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WO |
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WO 94/08593 |
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Apr 1994 |
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WO |
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WO 96/18385 |
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May 1996 |
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WO |
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Other References
Boucher et al.; Mechanisms and Therapeutic Actions of Uridine
Triphosphate in the Lung, Adenosine and Adenine Nucleotides Mol.
Biol. To Integr. Physiol. (Proc. Int. Symp.) 5.sup.th 1994 (Pub.
1995), 525-32, edited by Belardinelli et al. .
Boucher et al.; Mechanisms and Therapeutic Actions of Uridine
Triphosphate in the Lung, Chem Abstracts, 124 Nov. 20, 1995,
Abstract No. 274934z. .
Knowles, et al.; Activation by Extracellular Nucleotides of
Chloride Secretion in the Airway Epithelia of Patients with Cystic
Fibrosis, The New England Journal of Medicine, 325:533-538 (1991).
.
Boucher et al.; Mechanisms and Therapeutic Actions of Uridine
Triphosphate in the Lung, Adenosine and Adenine Nucleotides Mol.
Biol. To Integr. Physiol. (Proc. Int. Symp.) 5.sup.th 1994 (Pub.
1995), 525-32, edited by Belardinelli et al. .
K.N. Olivier, Acute Safety and Effects on Mucociliary Clearance of
Aerosolized Clearance of Aerosolized Uridine 5'-Triphosphate .+-.
Amiloride in Normal Human Adults, Am. J. Respir. Crit.
Care..
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Primary Examiner: Leary; Louise N.
Attorney, Agent or Firm: Myers Bigel Sibley &
Sajovec
Government Interests
This invention was made with Government support under grant number
HL-SPO1-34322 from the National Institutes of Health (NIH). The
Government has certain rights to this invention.
Parent Case Text
RELATED APPLICATIONS
This application is a continuation of U.S. application Ser. No.
08/776,772 filling date Jan. 22, 1997, U.S. Pat. No. 6,133,247,
which is a 371 of PCT/US96/12377 filling date Jul. 24, 1996, and a
continuation-in-part of U.S. patent application Ser. No. 08/509,052
filling date Jul. 31, 1995 now U.S. Pat. No. 5,628,984.
Claims
That which is claimed is:
1. A method of facilitating the obtaining of a mucus sample from at
least one lung of a subject, comprising:
administering to said at least one lung of said subject, in an
amount effective to hydrate lung mucous secretions and/or stimulate
cilia beat frequency therein, a compound of Formula (I) below, or a
pharmaceutically acceptable salt thereof: ##STR2##
wherein:
X.sub.1, X.sub.2, and X.sub.3 are each independently selected from
the group consisting of OH and SH;
R.sub.1 is selected from the group consisting of O, imido,
methylene, and dihalomethylene; and
R.sub.2 is selected from the group consisting of H and Br; and then
collecting a mucus sample from said at least one lung of said
subject, wherein said mucus sample is collected by
expectoration.
2. The method according to claim 1, further comprising the step of
analyzing said collected mucus sample to detect the presence or
absence of lung disease in said subject.
3. The method according to claim 2, wherein said analyzing step
comprises PCR analysis.
4. The method according to claim 1, wherein said compound of
Formula I is administered in a pharmaceutical composition
comprising said compound of Formula I in a concentration of
10.sup.-2 M in 0.9% saline solution by weight.
5. The method according to claim 2, wherein the analyzing step
comprises immunocytochemical analysis.
6. The method according to claim 1, wherein said compound of
Formula (I), or said pharmaceutically acceptable salt thereof, is
administered in an amount sufficient to achieve concentrations
thereof on the airway surfaces of said subject of from about
10.sup.-9 to about 10.sup.-1 Moles/liter.
7. The method according to claim 1, further comprising concurrently
administering to said subject a compound selected from the group
consisting of amiloride, benzamil and phenamil, and
pharmaceutically acceptable salts thereof, in an amount effective
to inhibit the reabsorption of water from lung mucous
secretions.
8. The method according to claim 1, wherein X.sub.2 and X.sub.3 are
OH.
9. The method according to claim 1, wherein R.sub.1 is oxygen.
10. The method according to claim 1, wherein R.sub.2 is H.
11. The method according to claim 1, wherein said compound of
Formula I is selected from the group consisting of uridine
5'-triphosphate, uridine 5'-O-(3-thiotriphosphate), and the
pharmaceutically acceptable salts thereof.
Description
FIELD OF THE INVENTION
This application concerns lung diagnostic assays in general, and
particularly concerns a lung diagnostic assay in which lung mucus
secretions are hydrated to facilitate collection thereof.
BACKGROUND OF THE INVENTION
The analysis of sputum samples is particularly important in the
treatment and diagnosis of many lung disorders, including lung
cancer and tuberculosis (TB).
In particular, microbial infections of the lung are a serious
problem in patients afflicted with acquired immune deficiency
syndrome (AIDS). Two particularly problematic infections are
Pneumocystis carinii pneumonia infections and mycobacterial
infections.
Pneumocystis carinii pneumonia infections are typically referred to
as "PCP" infections. It is now estimated that approximately 70
percent of patients afflicted with AIDS will contract this disease.
PCP may be treated with pentamidine isethionate, but an unfortunate
side effect of this treatment is its toxicity. Accordingly, there
is a continued need for techniques which permit the rapid and
convenient screening of AIDS patients for this disease, and for the
rapid, early, and accurate diagnosis thereof.
Mycobacteria are a large, diverse, and widely distributed family of
aerobic, nonsporulating, nonmotile bacilli that have a high
cell-wall lipid content and a slow growth rate. Some Mycobacteria
are harmless, while others are significant pathogens. The
pathogenic Mycobacterium include M. tuberculosis, responsible for
tuberculosis, as well as non-tuberculosis Mycobacteria such as M.
avium, responsible for Mycobacterium Avium complex infections.
SUMMARY OF THE INVENTION
A first aspect of the present invention is a method of facilitating
the obtaining of a mucus sample from at least one lung of a
subject. The method comprises administering a physiologically
acceptable salt to at least one lung of the subject in an amount
effective to hydrate lung mucus secretions therein, and
concurrently administering to said at least one lung of the
subject, in an amount effective to hydrate lung mucous secretions,
and/or stimulate mucus secretions therein, and/or stimulate ciliary
beat frequency therein, a compound of Formula (I) below, or a
pharmaceutically acceptable salt thereof: ##STR1##
wherein:
X.sub.1, X.sub.2, and X.sub.3 are each independently selected from
the group consisting of OH and SH;
R.sub.1 is selected from the group consisting of O, imido,
methylene, and dihalomethylene; and
R.sub.2 is selected from the group consisting of H and Br.
The method is accompanied or followed by the step of collecting a
mucus sample from said at least one lung of said subject (e.g., by
said subject expectorating a sputum sample).
Also disclosed is a method of facilitating the obtaining of a mucus
sample from at least one lung of a subject, comprising
administering to at least one lung of said subject, in an amount
effective to hydrate lung mucous secretions, and/or stimulate mucus
secretions therein, and/or stimulate ciliary beat frequency
therein, a compound of Formula (I) as given above, or a
pharmaceutically acceptable salt thereof, and then collecting a
mucus sample from said at least one lung of said subject. The mucus
samples collected may then be analyzed for the presence or absence
of lung disease (e.g., microbial infection, cancer, etc.) in said
subject.
A second aspect of the present invention is pharmaceutical
composition useful for facilitating the collecting of a mucus
sample from at least one lung of a subject, said composition
comprising, alone or in combination, a physiologically acceptable
salt in an amount effective to hydrate lung mucus secretions; and a
compound of Formula (I) as given above, or a pharmaceutically
acceptable salt thereof, in an amount effective to hydrate lung
mucus secretions. The composition may be a liquid composition or a
dry powder composition.
DETAILED DESCRIPTION OF THE INVENTION
Compounds illustrative of the compounds of Formula (I) above (also
referred to as "active compounds" herein) include: (a) uridine
5'-triphosphate (UTP); (b) uridine 5'-O-(3-thiotriphosphate)
(UTP.gamma.S); and (c) 5-bromouridine 5'-triphosphate (5-BrUTP).
One preferred compound of Formula (I) above is the UTP analog
uridine 5'-O-(3-thiotriphosphate) (or "UTP.gamma.S"). These
compounds are known or may be made in accordance with known
procedures, or variations thereof which will be apparent to those
skilled in the art. See generally U.S. Pat. No. 5,292,498 to
Boucher; N. Cusack and S. Hourani, Annals N.Y. Acad. Sci. 603,
172-181 (G. Dubyak and J. Fedan Eds. 1990). For example, UTP may be
made in the manner described in Kenner et al., J. Chem. Soc. 1954,
2288; or Hall and Khorana, J. Chem. Soc. 76, 5056 (1954). See Merck
Index, Monograph No. 9795 (11th Ed. 1989). UTP.gamma.S may be made
in the manner described in R. S. Goody and F. Eckstein, J. Am.
Chem. Soc. 93, 6252 (1971).
For simplicity, Formula I herein illustrates uridine triphosphate
active compounds in the naturally occurring D configuration, but
the present invention also encompasses compounds in the L
configuration, and mixtures of compounds in the D and L
configurations, unless specified otherwise. The naturally occurring
D configuration is preferred.
The active compounds of Formula (I) may be administered by
themselves or in the form of their pharmaceutically acceptable
salts, e.g., an alkali metal salt such as sodium or potassium, an
alkaline earth metal salt, or an ammonium and tetraalkyl ammonium
salt, NX.sub.4.sup.+ (wherein X is a C.sub.1-4 alkyl group).
Pharmaceutically acceptable salts are salts that retain the desired
biological activity of the parent compound and do not impart
undesired toxicological effects.
Amiloride (also known as
3,5,-diamino-6-chloro-N-(diaminomethylene)pyrazinecarboxamide),
benzamil (also known as
3,5-diamino-6-chloro-N-(benzylaminoaminomethylene)
pyrazinecarboxamide) and phenamil (also known as
3,5-diamino-6-chloro-N-(phenylaminoaminomethylene)
pyrazinecarboxamide) are known compounds and are disclosed in U.S.
Pat. No. 3,313,813 to E. Cragoe. The terms "amiloride," "benzamil,"
and "phenamil," as used herein (also referred to as "active
compounds" herein); include the pharmaceutically acceptable salts
thereof, such as (but not limited to) amiloride hydrochloride,
benzamil hydrochloride or phenamil hydrochloride. Amiloride,
benzamil or phenamil used to prepare compositions for the present
invention may alternatively be in the form of a pharmaceutically
acceptable free base of amiloride, benzamil or phenamil. Because
the free base of the compound is less soluble than the salt, free
base compositions are employed to provide more sustained release of
benzamil or phenamil to the lungs.
Physiologically acceptable salts (also sometimes referred to as
"active compounds" herein) used to carry out the method of the
present invention are those that hydrate lung mucus secretions by
facilitating the transport of water from lung endothelial cells
into the mucus. Physiologically acceptable salts are salts that
retain the desired biological activity of hydrating lung mucus
secretions and do not impart undesired toxicological effects.
Physiologically acceptable salts are typically chloride salts, such
as sodium chloride, potassium chloride, choline chloride, and
N-methyl-D-glucamine chloride. Sodium chloride is currently
preferred. These salts may be provided in the form of a dry
respirable powder (discussed below) or as an aqueous solution.
The present invention is concerned primarily with the treatment of
human subjects. Subjects may or may not be cystic fibrosis
patients. The present invention may also be employed for the
treatment of other mammalian subjects, such as dogs and cats, for
veterinary purposes.
The active compounds disclosed herein may be administered to the
lung(s) of a subject by any suitable means. As used herein, the
word "concurrently" means sufficiently close in time to produce a
combined effect (that is, concurrently may be simultaneously, or it
may be two or more events occurring within a short time period
before or after each other). By "at least one lung" is meant that
administration of active compounds may be to one or both lungs of
the subject, but where administration is to only one lung, then
administration of the various active compounds is to the same
lung.
Active compounds are preferably administered by administering an
aerosol suspension of respirable particles comprised of the active
compound or active compounds, which the subject inhales. The active
compound can be aerosolized in a variety of forms, such as, but not
limited to, dry powder inhalants, metered dose inhalants, or
liquid/liquid suspensions. The respirable particles may be liquid
or solid. The particles may optionally contain other therapeutic
ingredients such as amiloride, benzamil or phenamil, with the
selected compound included in an amount effective to inhibit the
reabsorption of water from airway mucous secretions, as described
in U.S. Pat. No. 4,501,729 (applicant specifically intends the
disclosure of this and all other patent references cited herein be
incorporated herein by reference).
The particulate pharmaceutical composition may optionally be
combined with a carrier to aid in dispersion or transport. A
suitable carrier such as a sugar (i.e., lactose, sucrose,
trehalose, mannitol) may be blended with the active compound or
compounds in any suitable ratio (e.g., a 1 to 1 ratio by
weight).
Particles comprised of active compound for practicing the present
invention should include particles of respirable size: that is,
particles of a size sufficiently small to pass through the mouth or
nose and larynx upon inhalation and into the bronchi and alveoli of
the lungs. In general, particles ranging from about 1 to 10 microns
in size (more particularly, less than about 5 microns in size) are
respirable. Particles of non-respirable size which are included in
the aerosol tend to deposit in the throat and be swallowed, and the
quantity of non-respirable particles in the aerosol is preferably
minimized. For nasal administration, a particle size in the range
of 10-500 .mu.m is preferred to ensure retention in the nasal
cavity.
Liquid pharmaceutical compositions of active compound for producing
an aerosol may be prepared by combining the active compound with a
suitable vehicle, such as sterile pyrogen free water. The
hypertonic saline solutions used to carry out the present invention
are preferably sterile, pyrogen-free solutions, comprising from one
to fifteen percent (by weight) of the physiologically acceptable
salt, and more preferably from three to seven percent by weight of
the physiologically acceptable salt. Where compounds of Formula (I)
or the pharmaceutically acceptable salts thereof are included in
the hypertonic saline solution, they are typically included in a
concentration ranging from about 10.sup.-4 M to about 10.sup.-1 M,
and more preferably in a concentration ranging from about 10.sup.-2
M to about 10.sup.-1 M. Other therapeutic compounds such as
amiloride, benzamil or phenamil-may optionally be included (when
such compounds are included, the saline solution is preferably not
more than 0.3 percent by weight of the physiologically acceptable
salt, and more preferably is 0.12 percent by weight of the
physiologically acceptable salt).
Solid particulate compositions containing respirable dry particles
of micronized active compound may be prepared by grinding dry
active compound with a mortar and pestle, and then passing the
micronized composition through a 400 mesh screen to break up or
separate out large agglomerates. The active compound may be
formulated alone (i.e., the solid particulate composition may
consist essentially of the active compound) or in combination with
a dispersant, diluent or carrier, such as sugars (i.e., lactose,
sucrose, trehalose, mannitol) or other acceptable excipients for
lung or airway delivery, which may be blended with the active
compound in any suitable ratio (e.g., a 1 to 1 ratio by weight).
The dry powder solid particulate composition may be obtained by
methods known in the art, such as spray-drying, milling,
freeze-drying, etc. Again, other therapeutic compounds such as
amiloride, benzamil or phenamil may also be included.
Aerosols of liquid particles comprising the active compound may be
produced by any suitable means, such as with a pressure-driven jet
nebulizer or an ultrasonic nebulizer. See, e.g., U.S. Pat. No.
4,501,729. Nebulizers are commercially available devices which
transform solutions or suspensions of the active ingredient into a
therapeutic aerosol mist either by means of acceleration of
compressed gas, typically air or oxygen, through a narrow venturi
orifice or by means of ultrasonic agitation. Suitable formulations
for use in nebulizers consist of the active ingredient in a liquid
carrier, the active ingredient comprising up to 40% w/w of the
formulation, but preferably less than 20% w/w. The carrier is
typically water (and most preferably sterile, pyrogen-free water)
or a dilute aqueous alcoholic solution, preferably made isotonic,
but may be hypertonic with body fluids by the addition of, for
example, sodium chloride. Optional additives include preservatives
if the formulation is not made sterile, for example, methyl
hydroxybenzoate, antioxidants, flavoring agents, volatile oils,
buffering agents and surfactants.
Aerosols of solid particles comprising the active compound may
likewise be produced with any solid particulate medicament aerosol
generator. Aerosol generators for administering solid particulate
medicaments to a subject produce particles which are respirable, as
explained above, and generate a volume of aerosol containing a
predetermined metered dose of a medicament at a rate suitable for
human administration. One illustrative type of solid particulate
aerosol generator is an insufflator. Suitable formulations for
administration by insufflation include finely comminuted powders
which may be delivered by means of an insufflator or taken into the
nasal cavity in the manner of a snuff. In the insufflator, the
powder (e.g., a metered dose thereof effective to carry out the
treatments described herein) is contained in capsules or
cartridges, typically made of gelatin or plastic, which are either
pierced or opened in situ and the powder delivered by air drawn
through the device upon inhalation or by means of a
manually-operated pump. The powder employed in the insufflator
consists either solely of the active ingredient or of a powder
blend comprising the active ingredient, a suitable powder diluent,
such as lactose, and an optional surfactant. The active ingredient
typically comprises from 0.1 to 100 w/w of the formulation. A
second type of illustrative aerosol generator comprises a metered
dose inhaler. Metered dose inhalers are pressurized aerosol
dispensers, typically containing a suspension or solution
formulation of the active ingredient in a liquified propellant.
During use these devices discharge the formulation through a valve
adapted to deliver a metered volume, typically from 10 to 200
.mu.l, to produce a fine particle spray containing the active
ingredient. Suitable propellants include certain chlorofluorocarbon
compounds, for example, dichlorodifluoromethane,
trichlorofluoromethane, dichlorotetrafluoroethane and mixtures
thereof. The formulation may additionally contain one or more
co-solvents, for example, ethanol, surfactants, such as oleic acid
or sorbitan trioleate, antioxidants and suitable flavoring
agents.
Any propellant may be used in carrying out the present invention,
including both chlorofluorocarbon-containing propellants and
non-chlorofluorocarbon-containing propellants. Thus, fluorocarbon
aerosol propellants that may be employed in carrying out the
present invention including fluorocarbon propellants in which all
hydrogens are replaced with fluorine, chlorofluorocarbon
propellants in which all hydrogens are replaced with chlorine and
at least one fluorine, hydrogen-containing fluorocarbon
propellants, and hydrogen-containing chlorofluorocarbon
propellants. Examples of such propellants include, but are not
limited to: CF.sub.3 --CHF--CF.sub.2 H; CF.sub.3 --CH.sub.2
--CF.sub.2 H; CF.sub.3 --CHF--CF.sub.3 ; CF.sub.3 --CH.sub.2
--CF.sub.3 ; CF.sub.3 --CHCl--CF.sub.2 Cl; CF.sub.3
--CHCl--CF.sub.3 ; cy--C(CF.sub.2).sub.3 --CHCl; CF.sub.3
--CHCl--CH.sub.2 Cl; CF.sub.3 --CHF--CF.sub.2 Cl; CF.sub.3
--CHCl--CFHCl; CF.sub.3 --CFCl--CFHCl; CF.sub.3 --CF.sub.2
--CF.sub.2 H; CF.sub.3 --CF.sub.2 --CH.sub.3 ; CF.sub.2 H--CF.sup.2
--CFH.sub.2 ; CF.sub.3 --CF.sub.2 --CFH.sub.2 ; CF.sub.3 --CF.sub.2
--CH.sub.2 Cl; CF.sub.2 H--CF.sub.2 --CH.sub.3 ; CF.sub.2
H--CF.sub.2 --CH.sub.2 Cl; CF.sub.3 --CF.sub.2 --CF.sub.2
--CH.sub.3 ; CF.sub.3 --CF.sub.2 --CF.sub.2 --CF.sub.2 H; CF.sub.3
--CHF--CHF--CF.sub.3 ; CF.sub.3 --O--CF.sub.3 ; CF.sub.3
--O--CF.sub.2 H; CF.sub.2 H--H--O--CF.sub.2 H; CF.sub.2
H--O--CFH.sub.2 ; CF.sub.3 --O--CH.sub.3 ; CF.sub.3 --O--CF.sub.2
--CF.sub.2 H; CF.sub.3 --O--CF.sub.2 --O--CF.sub.3 ; cy--CF.sub.2
--CF.sub.2 --O--CF.sub.2 --; cy--CHF--CF.sub.2 --O--CF.sub.2 --;
cy--CH.sub.2 --CF.sub.2 --O--CF.sub.2 --; cy--CF.sub.2
--O--CF.sub.2 --O--CF.sub.2 --; CF.sub.3 --O--CF.sub.2 --Br;
CF.sub.2 H--O--CF.sub.2 --Br; and mixtures thereof, where "cy"
denotes a cyclic compound in which the end terminal covalent bonds
of the structures shown are the same so that the end terminal
groups are covalently bonded together. Particularly preferred are
hydrofluoroalkanes such as 1,1,1,2-tetrafluoroethane (propellant
134a) and heptafluoropropane (propellant 227). A stabilizer such as
a fluoropolymer may optionally be included in formulations of
fluorocarbon propellants, such as described in U.S. Pat. No.
5,376,359 to Johnson.
The aerosol, whether formed from solid or liquid particles, may be
produced by the aerosol generator at a rate of from about 10 to 150
liters per minute, more preferably from about 30 to 150 liters per
minute, and most preferably about 60 liters per minute. Aerosols
containing greater amounts of medicament may be administered more
rapidly. Typically, each aerosol may be delivered to the patient
for a period from about 30 seconds to about 20 minutes, with a
delivery period of about five to ten minutes being preferred.
The dosage of the compound of Formula (I), or the pharmaceutically
acceptable salt thereof, will vary depending on the condition being
treated and the state of the subject, but generally may be an
amount sufficient to achieve dissolved concentrations of active
compound on the airway surfaces of the subject of from about
10.sup.-9 to about 10.sup.-2 Moles/liter or even 10.sup.-1
Moles/liter, more preferably from about 10.sup.-5 to about
10.sup.-1 Moles/liter, and most preferably from about 10.sup.-4 to
about 10.sup.-3 to about 10.sup.-1 moles/liter. Depending upon the
solubility of the particular formulation of active compound
administered, the daily dose may be divided among one or several
unit dose administrations.
When the sputum sample is subjected to cytological, bacterial or
DNA analysis for detecting infectious microbial species therein,
the sputum sample may first be digested with a liquefying agent,
such as N-acetyl-L-cystein (NALC) and sodium hydroxide.
As noted above, the present invention is particularly useful for
collecting mucus samples which are used for detecting Pneumocystis
carinii pneumonia and Mycobacteria infections. The term
"Mycobacteria" as used herein has its conventional meaning in the
art referring to acid-fast, non-motile, rod shaped bacteria. See
generally B. Davis et al., Microbiology, 724-742 (#d. Ed. 1980).
All generally belong to the family Mycobacteriaceae. By way of
example, the mycobacteria include, but are not limited to,
Mycobacterium africanum, M. avium, M. bovis, M. bovis-BCG, M.
chelonae, M. fortuitum, M. gordonae, M. intracellulae, M. kansasii,
M. leprae, M. microti, M. paratuberculosis, M. scrofulaceum, and M.
tuberculosis. The present invention is useful in diagnosing both
tuberculosis and non-tuberculosis Mycobacteria, and is useful in
diagnosing M. avium complex infections.
The present invention is explained in greater detail in the
following non-limiting Examples.
EXAMPLE 1
Delivery of UTP Followed by Hypertonic Saline
A subject is caused to inhale an aerosol of UTP solution (10.sup.-2
M UTP in 0.9% (by weight) sterile pyrogen-free saline solution)
delivered by a Pari LC Plus nebulizer for 10 minutes. Immediately
afterwards, the subject is caused to inhale an aerosol of
hypertonic saline solution (3% sterile pyrogen-free saline
solution), delivered by a nebulizer for 10 minutes. During
inhalation of the aerosols and after inhalation of the aerosols,
the subject is encouraged to cough, and all sputum is collected
during aerosol inhalation and over a 20 minute interval following
cessation of aerosol inhalation. The sputum is captured in a
plastic sputum container. The sputum so obtained is analyzed for
content pending the clinical requirement, including analyses of
cytologies for pulmonary neoplasm, and the presence of infectious
agents, for example, Pneumocystis carinii, by silver staining and
immunofluorescence techniques. The technique is applicable for the
diagnoses of other micro-organisms in the lower lung, including
bacterial, viral, amd mycoplasma, using culture,
immunocytochemical, and molecular (PCR, in situ hybridization)
techniques.
EXAMPLE 2
Delivery of UTP with Amiloride
This example is carried out in essentially the same manner as
example 1 above, except that the UTP is dissolved in a 0.12%
sterile pyrogen-free NaCl solution, and the solution also contains
10.sup.-2 M amiloride.
EXAMPLE 3
Delivery of Hypertonic Saline Followed by UTP
This Example is carried out in essentially the same manner as
Example 1 above, except that the hypertonic saline solution is
delivered first, and the UTP solution is delivered immediately
thereafter. Durations of delivery and concentrations remain the
same.
EXAMPLE 4
Concurrent Delivery of UTP in Hypertonic Saline
This Example is carried out by modification of Example 1 above,
with 10.sup.-1 UTP being diluted in the hypertonic saline solution
so that a single solution is delivered to the patient by inhalation
of an aerosol generated by a nebulizer for a period of 15
minutes.
EXAMPLE 5
Delivery of UTP Followed by Sample Collection
This procedure is carried out in essentially the same manner as
Example 1 above, except that there is no separate administration of
a hypertonic saline solution.
A subject is caused to inhale an aerosol of UTP solution (10.sup.-2
M UTP in 0.9% (by weight) sterile pyrogen-free saline solution)
delivered by a Pari LC Plus nebulizer for 10 minutes. During
inhalation of the aerosol and after inhalation of the aerosol, the
subject is encouraged to cough, and all sputum is collected during
aerosol inhalation and over a 20 minute interval following
cessation of aerosol inhalation. The sputum is captured in a
plastic sputum container. The sputum so obtained is analyzed as
described in Example 1. The technique is applicable for the
diagnoses of other micro-organisms in the lower lung, including
bacterial, viral, and mycoplasma, using culture,
immunocytochemical, and molecular (PCR, in situ hybridization)
techniques.
EXAMPLE 6
Delivery of Solid Particulate UTP
This example is carried out in essentially the same manner as
Example 5 above, except the subject is administered a respirable
dry powder consisting essentially of solid particulate UTP or a
pharmaceutically acceptable salt such as trisodium UTP prepared as
described above, or as described in U.S. Pat. No. 5,292,498 to
Boucher. A sputum sample is collected from the subject as described
in Examples 1 and 5 above, and analyzed as described in Examples 1
and 5 above.
The foregoing examples are illustrative of the present invention,
and are not to be construed as limiting thereof. Among other
things, volumes, times, and amounts can be varied from those
specifically set forth above. Accordingly, the invention is defined
by the following claims, with equivalents of the claims to be
included therein.
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