U.S. patent application number 09/293708 was filed with the patent office on 2001-12-27 for rapid gelling biocompatible polymer composition.
Invention is credited to COKER, GEORGE III, CRUISE, GREGORY, RHEE, WOONZA, SCHROEDER, JACQUELINE, WALLACE, DONALD G..
Application Number | 20010055615 09/293708 |
Document ID | / |
Family ID | 23130216 |
Filed Date | 2001-12-27 |
United States Patent
Application |
20010055615 |
Kind Code |
A1 |
WALLACE, DONALD G. ; et
al. |
December 27, 2001 |
RAPID GELLING BIOCOMPATIBLE POLYMER COMPOSITION
Abstract
This invention relates generally to two-part polymer
compositions that rapidly form covalent linkages when mixed
together. Such compositions are particularly well suited for use in
a variety of tissue related applications when rapid adhesion to the
tissue and gel formation is desired. In particular, they are useful
as tissue sealants, in promoting hemostasis, for drug delivery, in
effecting tissue adhesion, in providing tissue augmentation, and in
the prevention of surgical adhesions.
Inventors: |
WALLACE, DONALD G.; (MENLO
PARK, CA) ; CRUISE, GREGORY; (FREMONT, CA) ;
RHEE, WOONZA; (PALO ALTO, CA) ; SCHROEDER,
JACQUELINE; (BOULDER CREEK, CA) ; COKER, GEORGE
III; (CASTRO VALLEY, CA) |
Correspondence
Address: |
REED & ASSOCIATES
800 MENLO AVENUE
SUITE 210
MENLO PARK
CA
94025
US
|
Family ID: |
23130216 |
Appl. No.: |
09/293708 |
Filed: |
April 16, 1999 |
Current U.S.
Class: |
424/484 ;
424/485; 424/78.02; 424/78.06; 435/975; 523/105; 523/111 |
Current CPC
Class: |
A61L 27/34 20130101;
A61L 27/54 20130101; A61L 24/043 20130101; Y10S 435/975 20130101;
Y10S 424/13 20130101; A61L 31/145 20130101; A61L 31/10 20130101;
A61L 2300/418 20130101; A61L 27/52 20130101; A61L 31/16
20130101 |
Class at
Publication: |
424/484 ;
523/105; 523/111; 424/485; 424/78.02; 424/78.06; 435/975 |
International
Class: |
A61K 031/74; A61K
009/14; B01J 013/00 |
Claims
We claim:
1. A biocompatible two-component gel-forming composition for in
vivo administration, comprising: a first component comprising at
least one sulfhydryl group-containing compound given by the formula
Compound.sub.1-(SH).sub.m, wherein m.gtoreq.2; and a second
component comprising at least one sulfhydryl reactive
group-containing compound given by the formula
Compound.sub.2-Y.sub.n, wherein Y is a sulfhydryl reactive group
and wherein n.gtoreq.2; wherein at least one of the first or second
components is a polyalkylene oxide and wherein the sulfhydryl
groups and the sulfhydryl reactive groups react with one another to
form covalent bonds therebetween when said components are mixed
together to form a gel in less than one minute.
2. The composition of claim 1, wherein m and n are each 4.
3. The composition of claim 1, wherein m and n are each 12.
4. The composition of claim 1, wherein the first component is a
polyalkylene oxide.
5. The composition of claim 1, wherein the second component is a
polyalkylene oxide.
6. The composition of claim 1, wherein the first and second
components are polyalkylene oxides.
7. The composition of claim 6, wherein the polyalkylene oxides are
polyethylene glycol.
8. The composition of claim 1, wherein either the first or second
component is a small organic molecule.
9. The composition of claim 8, wherein the small organic molecule
is a functionally activated succinimidyl or maleimidyl
compound.
10. The composition of claim 1, wherein the covalent bonds are
thioester linkages.
11. The composition of claim 1, wherein the covalent bonds are
thioether linkages.
12. The composition of claim 1, wherein the covalent bonds are
sulfhydryl linkages.
13. The composition of claim 1, further comprising a hemostatic
agent.
14. The composition of claim 1, wherein the hemostatic agent is
thrombin.
15. The composition of claim 1, wherein the first component is
suspended in a buffer solution comprising a mixture of phosphate
buffer and carbonate buffer.
16. The composition of claim 2, wherein the second component
comprises a mixture of succinimidyl polyalkylene oxide and
maleimidyl polyalkylene oxide.
17. A method for treating tissues, comprising the steps of:
administering to a tissue site a first component comprising at
least one sulfhydryl group-containing compound given by the formula
Compound.sub.1-(SH).sub.m, wherein m.gtoreq.2; and simultaneously
or subsequently administering to the tissue site a second component
comprising at least one sulfhydryl reactive group-containing
compound given by the formula Compound.sub.2-Y.sub.n, wherein Y is
a sulfhydryl reactive group and wherein n.gtoreq.2, and wherein at
least one of the first or second components is a polyalkylene
oxide; and allowing the sulfhydryl groups and the sulfhydryl
reactive groups to react with one another to form covalent bonds
therebetween to form a gel in less than one minute.
18. A biocompatible two-component gel-forming composition for in
vivo administration with a gel time of less than one minute,
comprising: polyalkylene oxide-(SH).sub.4 in a liquid medium having
an acidic pH; and polyalkylene oxide-Y.sub.4, wherein Y is
succinimidyl, in a buffer having a pH of between 8 and 10.5.
19. A biocompatible two-component gel-forming composition for in
vivo administration with a gel time of less than one minute,
comprising: polyalkylene oxide-(SH).sub.12; and polyalkylene
oxide-Y.sub.12, wherein Y is a succinimidyl or maleimidyl
group.
20. A biocompatible two-component gel-forming composition for in
vivo administration, comprising: a first component comprising at
least one sulfhydryl group-containing polyalkylene oxide given by
the formula Core-(SH).sub.m, wherein m.gtoreq.2, in a buffer
solution with an acidic pH; and a buffer solution with an alkaline
pH; wherein the sulfhydryl groups react with one another to form
covalent bonds therebetween when said components are mixed together
to form a gel in less than one minute.
Description
FIELD OF THE INVENTION
[0001] This invention relates generally to two-part polymer
compositions that rapidly form covalent linkages when mixed
together. Such compositions are particularly well suited for use in
a variety of tissue related applications when rapid adhesion to the
tissue and gel formation is desired. In particular, they are useful
as tissue sealants, in promoting hemostasis, for drug delivery, in
effecting tissue adhesion, in providing tissue augmentation, and in
the prevention of surgical adhesions.
BACKGROUND OF THE INVENTION
[0002] The use of polymer compositions in tissue engineering is now
widely recognized, particularly those consisting of synthetic
polymers. In contrast to many naturally derived compositions,
synthetic polymer compositions can be formulated to exhibit
predetermined physical characteristics such as gel strength, as
well as biological characteristics such as degradability.
[0003] In a variety of tissue engineering applications, it is
desirable to use compositions that can be administered as liquids,
but subsequently form hydrogels at the site of administration. Such
in situ hydrogel forming compositions are more convenient to use
since they can be administered as liquids from a variety of
different devices, and are more adaptable for administration to any
site, since they are not preformed. Many different mechanisms have
been described that can be used to promote hydrogel formation in
situ. For example, photoactivatable mixtures of water-soluble
co-polyester prepolymers and polyethylene glycol have been
described to create hydrogel barriers, as well as drug release
matrices. In another approach, block copolymers of Pluronic and
Poloxamer have been designed that are soluble in cold water, but
form insoluble hydrogels that adhere to tissues at body temperature
(Leach, et al., Am. J Obstet. Gynecol. 162:1317-1319 (1990)).
Polymerizable cyanoacrylates have also been described for use as
tissue adhesives (Ellis, et al., J. Otolaryngol. 19:68-72 (1990)).
In yet another approach, two-part synthetic polymer compositions
have been described that, when mixed together, form covalent bonds
with one another, as well as with exposed tissue surfaces. (PCT WO
97/22371, which corresponds to U.S. application Ser. No.
08/769,806.) In a similar approach involving a two-part
composition, a mixture of protein and a bifunctional crosslinking
agent has been described for use as a tissue adhesive (U.S. Pat.
No. 5,583,114.) One difficulty encountered when designing in situ
hydrogel forming compositions is that optimizing the composition to
enhance gel formation may worsen tissue inflammation at the site of
administration. A possible explanation for this effect is that
highly reactive composition components that are capable of rapid
gel formation may adversely affect tissue surfaces.
[0004] The compositions of the present invention have been
formulated to provide for rapid gelation, and also cause less
tissue inflammation at the site of administration than previously
described compositions.
SUMMARY OF THE INVENTION
[0005] The present invention discloses generally two-component
polymer compositions that, when mixed together, rapidly react to
form a matrix at the site of administration. Such compositions
exhibit gel times of less than one minute. In one aspect of the
present invention, one of the components is a sulfhydryl-containing
compound. In another aspect of the present invention, both
components contain multiple functional groups, and at least one of
the compounds contains three or more functional groups. This
ensures sufficient reactivity for formation of a three-dimensional
polymer matrix. Preferably, both compounds contain four or more
functional groups. For extremely fast reacting compositions, both
compounds contain 12 functional groups.
[0006] In one aspect of the present invention, at least one and
preferably both of the compounds are polymers. The non-reactive
portion of the polymeric compound is referred to as its "core".
Suitable polymer cores are synthetic polymers, polyamino acids, and
polysaccharides. In a preferred embodiment, the core is a
polyalkylene oxide, and more preferably it is polyethylene
glycol.
[0007] The molecular weight of the compounds can vary depending on
the desired application. In most instances, the molecular weight is
about 100 to 100,000 mol. wt., and more preferably about 1,000 to
about 20,000 mol. wt. When the core material is polyethylene
glycol, the molecular weight of the compound(s) is/are about 7,500
to about 20,000 mol. wt., and most preferaby they are about 10,000
mol. wt.
[0008] When only one of the compounds is a polymer, the other is a
multifunctionally activated small organic molecule. Suitable small
organic molecules include functionally activated succinimidyl and
maleimidyl compounds.
[0009] The linkage group formed by reacting the two compounds of
the present invention together is a covalent bond formed between
the sulfur atom in the sulfhydryl group of one compound with, e.g.,
the carbon or sulfur atom in the sulfhydryl-reactive group of the
other compound. The linkage may be a thioester, thioether or a
disulfide, although a thioester linkage is preferred.
[0010] In another aspect of the present invention, the compounds
further comprise chain extenders between the polymer core and the
functional groups. Such chain extenders can activate or suppress
reactivity of the functional groups, and can also be used to
provide sites for hydrolysis or degradation. Suitable chain
extenders include poly(amino acids), poly(lactones),
poly(anhydrides), poly(orthoesters), poly(orthocarbonates),
poly(phosphoesters), and enzymatically cleavable peptide
groups.
[0011] The compositions of the present invention form gels with gel
times of less than 1 minute, and more preferably less than 30
seconds, and most preferably less than 15 seconds. The strength
(i.e., elastic modulus or G') of the resultant gels depends on the
application for which the composition is adapted, but is preferably
between about 10.sup.2 to 10.sup.4 dynes/cm.sup.2 for a soft gel,
or between about 10.sup.5 to 10.sup.8 for a harder gel.
[0012] In addition to the two reactive components of the
compositions of the present invention, optional materials can also
be included, such as glycosaminoglycans, proteins such as collagen,
drugs, cells, hemostatic agents, genes, DNA, therapeutic agents,
antibiotics, growth factors, and the like.
[0013] The compositions of the present invention are applied in
liquid or solid form to the site of administration. It is also
possible to supply them premixed but inactive, and then activate
them at the site of administration.
[0014] In another aspect of the present invention, there is
provided a method of treating tissues for the purpose of sealing
tissues, preventing adhesions, providing a platform for delivery of
biologically active agents, or augmenting tissues, comprising
mixing together the two components as described herein at the site
of administration to produce the desired medical affect.
BRIEF DESCRIPTION OF THE DRAWINGS
[0015] FIG. 1 depicts the structure of various sulfhydryl-reactive
groups, with "R" representing the chemical structure to which the
reactive group is attached.
[0016] FIG. 2 depicts the structure of a low molecular weight
multi-functional reactive compound.
[0017] FIG. 3 depicts the rheometric measurements of gelation of a
mixture of reactive tetrafunctional polyethylene glycols.
[0018] FIG. 4a depicts a "12-arm" sulfhydryl reactive PEG compound
as described in Example 13.
[0019] FIG. 4b depicts a "12-arm" succinimidyl reactive PEG
compound as described in Example 13.
[0020] FIG. 5 depicts the formation of two "12-arm" peg compounds
from "4-arm" intermediates as described in Example 13.
DETAILED DESCRIPTION OF THE INVENTION
[0021] The present invention relates to two-part polymer
compositions that form a matrix when mixed together at the site of
administration. Each component of the composition is generally
administered separately to the tissue site. Then, within a very
short time after being mixed together at the site of
administration, the composition forms a gel with sufficient
adhesive and cohesive strength to become anchored in place.
[0022] Definitions
[0023] The following definitions are provided to further describe
various aspects of the preferred embodiments of the present
invention.
[0024] The term "gel" refers to the state of matter between liquid
and solid. As such, a "gel" has some of the properties of a liquid
(i.e., the shape is resilient and deformable) and some of the
properties of a solid (i.e., the shape is discrete enough to
maintain three dimensions on a two dimensional surface.)
Accordingly, "gelation time", also referred to herein as "gel
time", refers to the time it takes for a composition to become
non-flowable under modest stress. This is generally exhibited as
achieving a gel strength, G', of greater than or equal to 10.sup.2
dynes/cm.sup.2 in less than 1 minute.
[0025] The term "cohesive strength" refers to the ability of the
compositions of the present invention to remain intact, i.e., not
rupture, tear or crack, when subjected to physical stresses or
environmental conditions. Cohesive strength is sometimes measured
as a function of "burst strength".
[0026] The term "adhesive strength" refers to the ability of the
compositions of the present invention to be able to remain attached
to the tissues at the site of administration when subjected to
physical stresses or environmental conditions.
[0027] The term "polymer" refers to a molecule consisting of
individual chemical moieties, which may be the same or different,
but are preferably the same, that are joined together. As used
herein, the term "polymer" refers to individual chemical moieties
that are joined end-to-end to form a linear molecule, as well as
individual chemical moieties joined together in the form of a
branched (e.g. a "multi-arm" or "star-shaped") structure.
[0028] The term "biocompatible" refers to the ability of the
compositions of the present invention to be applied to tissues
without eliciting significant inflammation and fibrosis or other
adverse tissue responses.
[0029] The term "synthetic polymer" refers to polymers that are not
naturally occurring and that are produced by chemical or
recombinant synthesis. As such, naturally occurring proteins such
as collagen and naturally occurring polysaccharides such as
hyaluronic acid are specifically excluded. Proteins such as
synthetic collagen, and carbohydrates such as synthetic hyaluronic
acid, and their derivatives, are included.
[0030] The term "activated synthetic polymers" refers to synthetic
polymers that have or have been chemically modified to have at
least one functional group (e.g., a sulfhydryl group) that is
capable of reacting with a corresponding reaction partner (e.g., a
sulfhydryl-reactive group) to form a covalent bond. The term
"multifunctionally activated" refers to synthetic polymers having
two or more nucleophilic or electrophilic groups. Types of
multifunctionally activated synthetic polymers include
di-functionally activated, tri-functionally activated,
tetra-functionally activated, and star-shaped activated polymers
(that have four or more functional groups).
[0031] Composition Components
[0032] The two-part compositions of the present invention comprise
two different compounds, each within a separate part of the
composition and at least one of which is a polymer, that react with
one another to form a covalently crosslinked gel matrix. As such,
they can easily be administered separately, and rapidly form gels
at the site of administration.
[0033] In the compositions of the present invention, each component
is present in one of the two separate parts, or "components", of
the composition, along with other optional ingredients as described
elsewhere herein. The two reactive compounds and the gel matrix
that forms when they are mixed together can be represented by
Formula I as follows:
Compound.sub.1-(SH).sub.m+Compound.sub.2-Y.sub.n.fwdarw.Compound.sub.1-Z-C-
ompound.sub.2 (I)
[0034] Compound.sub.1 has multiple (m.gtoreq.2) sulfhydryl groups
(SH) that react with Compound.sub.2, which has multiple
(n.gtoreq.2) sulfhydryl-reactive groups (Y). It should be
understood that sulfhydryl groups are also "sulfhydryl reactive
groups", since it is well known that sulfhydryl groups will react
with one another under certain conditions. When mixed together, the
two compounds become interconnected via a covalent bond (Z). As
depicted in FIG. 1 for illustration purposes only, there is only
one bond formed between Compound.sub.1 and Compound.sub.2. However,
when m+n.gtoreq.5, and appropriate ratios of the two components are
utilized as described elsewhere herein, the two compounds form
multiple attachments to one another resulting in a
three-dimensional polymer matrix. Preferably, both compounds
contain four or more functional groups, since such
multifunctionality results in a gel matrix with greater overall
cohesive strength. In a particularly preferred embodiment, each of
the compounds is tetrafunctionally activated.
[0035] In another preferred embodiment, the compounds each have 12
functional groups. Such compounds are formed from reacting a first
tetrafunctionally activated polymer with a second tetrafunctionally
activated polymer, wherein the functional groups of each of the two
compounds are a reaction pair, and react together to form "12-arm"
functionally activated polymers. An example of such a "12-arm"
compound is dodeca-sulfhydryl-PEG, 50,000 mol. wt., which is
constructed from a core tetra-functional succinimide ester PEG
coupled to four (exterior) tetra-functional sulfhydryl-PEG
molecules. Such polymers range in size from over 10,000 mol. wt. to
greater than 100,000 mol. wt. depending on the molecular weight of
the tetra-functionally activated polymer starting materials.
[0036] Other types of multifunctional polymers can easily be
synthesized using routine synthesis. However, care should be taken
to produce multi-arm products with consistent arm lengths to avoid
stearic hindrance of the reactive groups. Accordingly, activated
polymers that are suitable for use in the present invention may
have a variety of geometric shapes and configurations.
[0037] Compound Core
[0038] As described above, each of the compounds has multiple
functional groups, either sulfhydryl groups or sulfhydryl-reactive
groups. The non-reactive remainder of the compound is considered to
be its "core". At least one of the two compounds must have a
polymer core in order to form an efficient gel matrix. When one of
the compounds contains a polymer core, the other compound can be a
small organic molecule with multiple sulfhydryl-reactive groups.
However, for most applications, it is preferred for both compounds
to have the same or a different polymer core.
[0039] The polymer core may be a synthetic polyamino acid, a
polysaccharide, or a synthetic polymer. A preferred polymer core
material is a synthetic hydrophilic polymer. Suitable synthetic
hydrophilic polymers include, inter alia, polyalkylene oxide, such
as polyethylene oxide ((CH.sub.2CH.sub.2O).sub.n), polypropylene
oxide ((CH(CH.sub.3)CH.sub.2O).sub.n) or a
polyethylene/polypropylene oxide mixture
((CH.sub.2CH.sub.2O).sub.n--(CH(CH.sub.3)CH.sub.2O).sub.n). A
particularly preferred synthetic hydrophilic polymer is a
polyethylene glycol (PEG) having a molecular weight within the
range of about 100 to about 100,000 mol. wt., more preferably about
1,000 to about 20,000 mol. wt. More preferably still, when the
polymer core is polyethylene glycol, it generally has a molecular
weight within the range of about 7,500 to about 20,000 mol. wt.
Most preferably, the polyethylene glycol has a molecular weight of
approximately 10,000 mol. wt.
[0040] Multifunctionally activated polyalkylene oxides, such as
polyethylene glycol, are commercially available, and are also
easily prepared using known methods. For example, see Chapter 22 of
Poly(ethylene Glycol)Chemistry: Biotechnical and Biomedical
Applications, J. Milton Harris, ed., Plenum Press, NY (1992); and
Shearwater Polymers, Inc. Catalog, Polyethylene Glycol Derivatives,
Huntsville, Ala. (1997-1998). For use as a tissue sealant, the
preferred combination of activated polymers is as follows: the
sulfhydry-reactive group-containing compound is the tetrafunctional
PEG, pentaerythritol poly(ethylene glycol) ether tetra-succinimidyl
glutarate (10,000 mol. wt.); and the sulfhydryl group-containing
compound is the tetrafunctional PEG, pentaerythritol poly(ethylene
glycol) ether tetra-sulfhydryl (10,000 mol. wt.). In both cases,
these "four-arm" PEGs are formed by ethoxylation of
pentaerythritol, where each of the four chains is approximately
2,500 mol. wt., and then derivatized to introduce the functional
groups onto each of the four arms. Also preferred are analogous
poly(ethylene glycol)-like compounds polymerized from di-glycerol
instead of pentaerythritol.
[0041] When only one of the reactive compounds comprises a polymer
core, the other reactive compound is a multifunctionally active
small organic molecule. Such compounds include the di-functional
di-succinimidyl esters and di-maleimidyl compounds, as well as
other well known commercially available compounds (Pierce Chemical
Co., Rockford, Ill.). In addition, one of skill in the art could
easily synthesize a low molecular weight multi-functional reactive
compound using routine organic chemistry techniques. On such
compound is shown in FIG. 2, which is a penta-erythritol coupled to
four glutarates, with each arm capped with N-hydroxy-succinimidyl
esters (NHS). Analogous compounds can be synthesized from inositol
(radiating 6 arm), lactitol (9 arm) or sorbitol (linear 6-arm). The
end-capped reactive group can just as easily be sulfhydryl,
maleimidyl, vinyl-sulfone, etc., instead of NHS. The polymer or the
small molecule can carry either reactive end group as long as there
are reactive pairs in the composition such as NHS and SH,
maleimidyl and SH, etc.
[0042] Reactive Groups and Matrix Linkages In the present
invention, the linkage, Z, comprises a covalent bond between the
sulfur atom in the sulfhydryl group-containing compound and, e.g.,
the carbon or sulfur atom in the sulfhydryl-reactive
group-containing compound. Accordingly, the linkage may be a
thioester, a thioether, a disulfide, or the like. A wide variety of
sulfhydryl-reactive groups and the types of linkages they form when
reacted with sulfhydryl groups are well known in the scientific
literature. For example, see Bodanszky, M., Principles of Peptide
Synthesis, 2nd ed., pages 21 to 37, Springer-Verlog, Berlin (1993);
and Lundbland, R. L., Chemical Reagents for Protein Modification,
2nd ed., Chapter 6, CRC Press, Boca Raton, Fla. (1991).
[0043] For most applications, sulfhydryl reactive groups that react
with sulfhydryl groups to form thioester linkages are preferred.
Such compounds are depicted in FIG. 1 and include, inter alia, the
following compounds, with the numbers in parentheses corresponding
to the structures shown in FIG. 1: mixed anhydrides, such as
PEG-glutaryl-acetyl-anhydride (1),
PEG-glutaryl-isovaleryl-anhydride (2),
PEG-glutaryl-pivalyl-anhydride (3) and related compounds as
presented in Bodanszky, p. 23; Ester derivatives of phosphorus,
such as structures (4) and (5); ester derivatives of p-nitrophenol
(6) of p-nitrothiophenol (7), of pentafluorophenol (8), of
structure (9) and related active esters as presented by Bodanszky,
pp. 31-32, and Table 2; esters of substituted hydroxylamines, such
as those of N-hydroxy-phthalimide (10), N-hydroxy-succinimide (11),
and N-hydroxy-glutarimide (12), as well as related structures in
Bodanszky; Table 3; esters of 1-hydroxybenzotriazole (13),
3-hydroxy-3,4-dihydro-benzotriazine-4-one (14) and
3-hydroxy-3,4-dihydro-quinazoline-4-one; derivatives of
carbonylimidazole; and isocyanates. With these compounds, auxiliary
reagents can also be used to facilitate bond formation, such as
1-ethyl-3-[3-dimethylaminopropyl] carbodiimide can be used to
facilitate coupling of carboxyl groups (i.e., glutarate and
succinate) with sulfhydryl groups.
[0044] In addition to the sulfhydryl reactive compounds that form
thioester linkages, various other compounds can be utilized that
form other types of linkages. For example, compounds that contain
methyl imidate derivatives form imido-thioester linkages with
sulfhydryl groups. Alternatively, sulfhydryl reactive groups can be
employed that form disulfide bonds with sulfhydryl groups, such as
ortho pyridyl disulfide, 3-nitro-2-pyridenesulfenyl,
2-nitro-5-thiocyanobenzoic acid, 5,5'-dithio-bis(2-nitrobenzoic
acid), derivatives of methane-thiosulfate, and 2,4-dinitrophenyl
cysteinyl disulfides. In such instances, auxiliary reagents, such
as the hydrogen peroxide or di-tert-butyl ester of azodicarboxylic
acid, can be used to facilitiate disulfide bond formation.
[0045] Yet another class of sulfhydryl reactive groups form
thioether bonds with sulfhydryl groups. Such groups include, inter
alia, iodoacetamide, N-ethylmaleimide and other maleimides,
including dextran maleimides, mono-bromo-bimane and related
compounds, vinylsulfones, epoxides, derivatives of
O-methyl-isourea, ethyleneimines, aziridines, and
4-(aminosulfonyl-)7-fluoro-2,1,3-benzoxadiazole.
[0046] Chain Extenders
[0047] Functional groups may be directly attached to the compound
core, or they may be indirectly attached through a chain extender.
Such chain extenders are well known in the art. See, for example,
PCT WO 97/22371, which describes "linking groups" that would be
suitable for use as chain extenders in the compositions of the
present invention. Chain extenders are useful to avoid stearic
hindrance problems that are sometimes associated with the formation
of direct linkages between molecules. Alternatively, chain
extenders may be used to link several multifunctionally activated
compounds together to make larger molecules. In a particularly
preferred embodiment, the chain extender can also be used to alter
the degradative properties of the compositions after administration
and resultant gel formation. For example, chain extenders can be
incorporated into one or both of the multifunctionally activated
polymers to promote hydrolysis, to discourage hydrolysis, or to
provide a site for enzymatic degradation. Chain extenders can also
activate or suppress activity of sulfhydryl and sulfhydryl-reactive
groups. For example, electron-withdrawing groups within one or two
carbons of the sulfhydryl group would be expected to diminish its
effectiveness in coupling, due to a lowering of nucleophilicity.
Double-bond carbon and carbonyl carbon would be anticipated to have
this effect. Bulky nearby groups for either partner are anticipated
to diminish coupling rates, due to steric hindrance.
Electron-withdrawing groups adjacent to the reactive carbonyl of
glutaryl-N-hydroxysuccinimidyl would be anticipated to make this
carbonyl carbon even more reactive with the sulfhydryl partner.
[0048] Chain extenders may provide sites for degradation, i.e.,
hydrolysable sites. Examples of hydrolysable chain extenders
include, inter alia, alpha-hydroxy acids such as lactic acid and
glycolic acid; poly(lactones) such as caprolactone, valerolactone,
gamma butyl lactone and p-dioxanone; poly(amino acids);
poly(anhydrides) such as glutarate and succinate;
poly(orthoesters); poly(orthocarbonates) such as trimethylene
carbonate; and poly(phosphoesters). Examples of non-degradable
chain extenders include, inter alia, succinimide, propionic acid
and carboxymethylate. See, for example, PCT WO 99/07417. Examples
of enzymatically degradable chain extenders include
Leu-Gly-Pro-Ala, which is degraded by collagenase; and Gly-Pro-Lys,
which is degraded by plasmin.
[0049] Gel Strength and Gel Time
[0050] The compositions of the present invention are formulated to
exhibit adequate strength and rapid gel time. The elastic modulus,
G', is the preferred measure of gel strength. Preferred
compositions for use as tissue sealants can achieve a gel strength
of about 10.sup.3 to 10.sup.8 dynes/cm.sup.2, and more preferably
10.sup.4 to 10.sup.7 dynes/cm.sup.2. Preferred compositions for use
as hemostatic agents or for adhesion prevention have a gel strength
of at least 10.sup.2 to 10.sup.4 dynes/cm.sup.2 if a soft gel is
desired, or 10.sup.5 to 10.sup.8 dynes/cm.sup.2 if a harder matrix
is desired.
[0051] The gel time of preferred formulations is less than 60
seconds, more preferably less than 30 seconds, and most preferably
less than 15 seconds. The fast gel time ensures maximum material at
the site to be treated and sufficient mechanical properties.
[0052] Optional Composition Constituents
[0053] In addition to the reactive compounds, the compositions of
the present invention may also contain other compounds, which may
be included in one or both of the components of the two-component
compositions, or may be separately administered. In one embodiment,
these compounds may become covalently incorporated into the matrix
itself by becoming crosslinked to one or both of the reactive
compounds after they are mixed together. In another embodiment,
such as would be the case if the compound was unreactive with
either of the reactive compounds, the compound may be administered
in such a way that it become physically or ionically associated
with the matrix-forming compounds after mixing, and thus become
part of the matrix itself.
[0054] Additional compounds that may be added are
glycosaminoglycans and proteins. Suitable glycosaminoglycans
include, inter alia, hyaluronic acid, chitin, chondroitin sulfate
A, B, or C, keratin sulfate, keratosulfate and heparin, and
derivatives thereof. In another embodiment, proteins can be added
for a variety of purposes. For example, collagen may improve
biocompatibility of the matrix, including the potential
colonization by cells, promotion of would healing, etc. Collagen
and any amino group-containing proteins would also contribute to
the structural integrity of the matrix by becoming crosslinked
thereto along with the other matrix components. In particular, if
PEG-succinimidyl esters are used, the amide bonds formed with
collagen will be more stable to hydrolytic degradation than the
bonds formed by the reaction of succinimidyl esters and
sulfhydryls.
[0055] Suitable proteins include, inter alia, collagen,
fibronectin, gelatin and albumin, as well as peptide fragments
thereof. Particularly preferred is collagen, which may be in the
form of afibrillar, microfibrillar or fibrillar collagen. Types I
and III collagen isolated from bovine corium or human placenta, or
prepared by recombinant DNA methods, are suitable. See PCT WO
90/05755 for a description of suitable collagens and collagen
derivatives. It should be understood that when adding collagen to
the composition, it is important to adjust the concentration of the
other composition components to avoid precipitation.
[0056] Additional constituents which may be added to the
composition include antibiotics, growth factors, hemostatic
proteins (such as thrombin, fibrin, fibrinogen, the blood factors,
etc.), cells, genes, DNA, etc.
[0057] Composition Formulation
[0058] The compositions of the present invention comprise two
separate parts, or "components", which may be in liquid or solid
form. In a preferred embodiment, both components are liquids, such
that each can be easily applied separately to the site of
administration. Accordingly, one of the components may be in the
form of a dry powder that becomes mixed with the second component,
which is in liquid form, when each are sprayed separately onto the
tissue, or by mixing at the tissue site. It is also possible to
have both components delivered to the site as powders, to be mixed
with buffer at the site of administration.
[0059] In an alternative embodiment, both components can be mixed
together in a single aqueous medium in which they are both
unreactive, i.e. such as in a low pH buffer. Thereafter, they can
be sprayed onto the tissue site along with a high pH buffer, after
which they will rapidly react and form a gel. This embodiment is
described in Example 9.
[0060] The concentration of the reactive compounds in each of the
composition components necessarily depends on a number of factors.
For example, if the composition components are each 4-arm PEGs
(i.e. PEG-PEG compositions), a concentration of 20-25% by weight in
each of the two components before mixing results in a gel after
mixing with an elastic modulus, G', of approximately
10.sup.5-10.sup.6 dynes/cm.sup.2, which is adequate for use as a
surgical sealant. Using methylated collagen and 4-arm succinimidyl
PEG, concentrations of 2-4% and 0.2-0.4%, respectively, result in
gels with cohesive strengths that are comparable to PEG-PEG gels at
10-15%. Using albumin as one of the components, concentrations of
30% or more achieve a similar cohesive strength. The appropriate
concentration of the compound, and other optional ingredients, in
each component, and thus the relative concentration of the matrix
components in the final gel matrix, can easily be optimized to
achieve the desired gelation time and gel strength using routine
experimentation. Using the preferred four-arm PEGs described above,
the synthetic polymer is generally present at a concentration of 2
to 50% (w/v), and more preferably 10-25%.
[0061] The liquid components of the compositions of the present
invention are each separately prepared by adding the activated
synthetic polymer (in dry form or as a concentrated solution) to a
liquid medium. Suitable liquid media include aqueous buffer
solutions, such as monobasic sodium phosphate/dibasic sodium
phosphate, sodium carbonate/sodium bicarbonate, glutamate or
acetate, at a concentration of 0.5 to 300 mM. In general, the
sulfhydryl-reactive PEG is prepared in water or a dilute buffer,
with a pH of between around 5 to 6. Buffers with pKs between about
8 to 10.5 for preparing the sulfhydryl-PEG component are useful to
achieve fast gelation time of compositions containing mixtures of
sulfhydryl-PEG/SG-PEG. These include carbonate, borate and AMPSO
(3-[(1,1-dimethyl-2-hydroxyethyl)amino]2-hydroxy-propane-sulfonic
acid). In contrast, using a combination of maleimidyl PEG and
sulfhydryl-PEG, a pH of around 5 to 9 is preferred for the liquid
medium used to prepare the sulfhydryl PEG. A particularly preferred
composition for hemostatic applications to actively bleeding tissue
sites comprises a mixture of maleimidyl and succinimidyl PEG as the
first component, and sulfhydryl PEG as the second component. Such
compositions produce gels with enhanced biodegradability and
superior gel times when compared to compositions having only
maleimidyl PEG or succinimicyl PEG alone.
[0062] The pH of the aqueous buffer solution that is used for each
of the two (or more) composition components should be adjusted
using routine optimization to achieve a final pH that is conducive
to rapid gelation, without causing instantaneous gelation which
interferes with the delivery process. For example, both amino PEG
and sulfhydryl PEG need a basic pH to enhance nucleophilicity. The
effects of pH on gel time are discussed below in the Examples.
[0063] Use and Administration
[0064] The compositions of the present invention are generally
delivered to the site of administration in such a way that the two
(or more) individual components of the composition come into
contact with one another for the first time at the site of
administration, or immediately preceding administration. Thus, the
compositions of the present invention are preferably delivered to
the site of administration using an apparatus that allows the two
components to be delivered separately. Such delivery systems
usually involve two-compartment single exit or dual exit spray
devices. Alternatively, the two components can be delivered
separately using any type of controllable extrusion system, or they
can be delivered manually in the form of separate pastes, liquids
or dry powders, and mixed together manually at the site of
administration. Many devices that are adapted for delivery of
two-component tissue sealants/hemostatic agents are well known in
the art and can also be used in the practice of the present
invention.
[0065] Yet another way of delivering the compositions of the
present invention is to prepare the two reactive components (or the
single reactive component in the case of sulfhydryl-containing
components that are designed to form disulfide bonds) in inactive
form as either a liquid or powder. Such compositions can then be
activated after application to the tissue site, or immediately
beforehand, by applying an activator. In one embodiment, the
activator is a buffer solution having a pH that will activate the
composition once mixed therewith. See Example 12 for a description
of a sulfhydryl-containing PEG composition that is maintained at a
low pH until administration, then mixed with a high pH buffer at
the application site to initiate gelation.
[0066] The compositions of the present invention can be used in a
variety of different pharmaceutical applications. In general, the
compositions described herein can be adapted for use in any tissue
engineering application where synthetic gel matrices are currently
being utilized. For example, the compositions of the present
invention are useful as tissue sealants, in tissue augmentation, in
tissue repair, as hemostatic agents, in preventing tissue
adhesions, in providing surface modifications, and in
drug/cell/gene delivery applications. One of skill in the art could
easily determine the appropriate administration protocol to use
with any composition having a known gel strength and gelation time
based on the principles described herein and well known scientific
principles. A more detailed description of several specific
applications is given below:
[0067] Tissue Sealants & Adhesives
[0068] In a preferred application, the compositions described
herein can be used for medical conditions that require a coating or
sealing layer to prevent the leakage of gases, liquid or solids.
The method entails applying both components to the damaged tissue
or organ to seal 1) vascular and or other tissues or organs to stop
or minimize the flow of blood; 2) thoracic tissue to stop or
minimize the leakage of air; 3) gastrointestinal tract or
pancreatic tissue to stop or minimize the leakage of fecal or
tissue contents; 4) bladder or ureters to stop or minimize the
leakage of urine; 5) dura to stop or minimize the leakage of CSF;
and 6) skin or serosal tissue to stop the leakage of serosal
fluid.
[0069] These compositions may also be used to adhere tissues
together such as small vessels, nerves or dermal tissue. The
material can be used 1) by applying it to the surface of one tissue
and then a second tissue may be rapidly pressed against the first
tissue or 2) by bringing the tissues in close juxtaposition and
then applying the material.
[0070] Surgical Adhesions
[0071] A preferred application is a method of reducing the
formation of adhesions after a surgical procedure in a patient. The
method entails applying the material onto the damaged tissue or
organ either by spraying both components together or by applying
previously admixed components. The components will react together
to form a hydrogel on the tissue surface. The medical procedures
include gynecological, abdominal, neurosurgical, cardiac, and
orthopedic indications.
[0072] Drug Delivery
[0073] A preferred application is a method of locally applying a
biologically active substance to patients. The active substance can
be delivered in conjunction with the two components such that the
material can form in situ or as a preformed implant. The active
substance can be either released through diffusion controlled
processes or may be covalently bound to the components such that it
will be released as the resulting hydrogel degrades.
[0074] The biologically active substances can be any of a variety
of organic and inorganic materials, including proteins,
carbohydrates, and nucleic acids. Specific examples include
enzymes, antibiotics, antineoplastic agents, cytokines, local
anesthetics, hormones, antiangiogenic agents, antibodies,
neurotransmitters, psychoactive drugs, drugs affecting reproductive
organs, and therapeutic oligonucleotides.
[0075] Modification of Implants
[0076] A preferred application is a method of applying coatings to
implants to affect the surface properties of implants or to help
adhere implants to tissue surfaces. A coat of components may be
applied to 1) vascular grafts, stents to minimize or stop the
leakage of blood or serosal fluid from these devices; 2) catheters
or breast implants to reduce or stop excessive fibrosis; 3)
artificial patches or meshes to minimize excessive fibrosis and to
help adhere the implants to tissue surfaces.
[0077] Delivery of Cells or Genes
[0078] A preferred application of the compositions is to
encapsulate and thereby deliver cells or genes, which includes
material from natural sources or synthetic DNA, RNA and their
respective antisense forms, to a desired site. The cells can
include mesenchymal stem cells, epithelial cells and
neuroectodermal cells. The cells may either be allogeneic or
xenogenic in origin.
EXAMPLES
Example 1
Preparation of a Two-component Tissue Sealant Composition
[0079] a. First Component Pentaerythritol poly(ethylene
glycol)ether tetra-succinimidyl glutarate ("SG-PEG") (mol. wt.
10,000) is dissolved in 0.5 mM sodium phosphate pH 6.0 at a
concentration of 20% w/v. (This solution is not stable in aqueous
media due to the susceptibility of the active ester to hydrolysis
and should be used within one hour of preparation).
[0080] b. Second Component
[0081] Pentaerythritol poly(ethylene glycol)ether tetra-sulfhydryl
(mol. wt. 10,000) is dissolved in 300 mM sodium phosphate/sodium
carbonate buffer ("P/C buffer"), pH 9.6, at a concentration of 20%
w/v. P/C buffer is prepared as follows: 300 mM sodium monobasic
phosphate is mixed with 300 mM sodium carbonate to achieve pH 9.6.
The final molarity is approximately 117 mm phosphate and 183 mM
carbonate. This solution is stable in aqueous media, but care
should be taken to prevent the exposure of the solution to oxygen
to prevent oxidation to disulfide. Although pH is preferred for
certain compositions, a pH of 8 to 10.5 is generally believed to be
suitable for use in the practice of the present invention.
Example 2
Surgical Sealing of Arteries
[0082] The right carotid artery of New Zealand white rabbits is
exposed. The rabbits are treated with 200 U/kg of heparin and the
vessel is clamped proximally and distally using atraumatic vascular
clamps. A puncture hole is made in the carotid artery using a 27 G
needle. The control rabbits are treated with tamponade until
hemostasis is achieved. For the treated rabbits, approximately 0.5
mL of each of the two components of the compositions prepared as
described in Example 1 are delivered to the defect site using a two
component sprayer (Duo Flow, Hemaedics, Malibu, Calif.). After the
material is allowed to set for 30 sec, the clamps are removed and
the time to hemostasis and the blood loss are measured. The
arteries of the control rabbits also remain clamped for 30 sec for
consistency. The results are shown in Table 1.
1TABLE 1 Blood Loss and Time to Hemostasis as a Function of
Treatment Blood Loss Time to Hemostasis Treatment (g) (sec)
Tamponade (n = 18) 5.7 .+-. 3.4 144 .+-. 34 Hydrogel (n = 17) 1.0
.+-. 2.5 31 .+-. 65
[0083] The above results illustrate that the composition
significantly reduces the amount of blood loss and time to
hemostasis from a punctured artery.
Example 3
Surgical Sealing of a ePTFE graft
[0084] The dogs are treated with heparin to achieve an activated
clotting time of greater than 480 sec. The left iliac of the dogs
is exposed and isolated using atraumatic vascular clamps placed
distally and proximally. A 5 cm segment of the artery is excised
and replaced with an ePTFE (polythetrafluoroethylene) graft of the
same diameter. Prior to the completion of the anastamosis, the
graft was de-aired using a 27 G needle. Approximately 3.0 mL of
each of the two components of the composition prepared according to
Example 1 is delivered to the defect site using a two component
sprayer (Cohesion Technologies, Inc., Palo Alto, Calif.). After the
material is allowed to set for 30 sec, the clamps are removed and
the time to hemostasis and the blood loss are measured. The
procedure was repeated on the left iliac, with the exception of
material application. The right iliac received only tamponade
treatment. The results are shown in Table 2.
2TABLE 2 Blood Loss and Time to Hemostasis as a Function of
Treatment Blood Loss Time to Hemostasis Treatment (g) (sec)
Tamponade (n = 18) 244, 180 >15, >15 Hydrogel (n = 2) 18, 7
3.3, 2.3
[0085] The above results illustrate that this composition
significantly reduces the amount of blood loss and time to
hemostasis from an ePTFE anastamosis.
Example 4
Enhanced Biocompatibility of Thioester-linked Formulations
[0086] Up to six subcutaneous pockets are made on the backs of New
Zealand 5 white rabbits. Approximately 1.0 mL of each of the
components of the composition described in Example 1 is delivered
to the defect site using a two component sprayer (Cohesion
Technologies, Inc., Palo Alto, Calif.) for liquid formulations or a
spatula for formulations that are gelled ex-vivo. The grading key
is shown in Table 3 and the results are shown in Table 4.
3TABLE 3 Grading Key for Biocompatibility Experiments Histological
Score Gross Observations Observations - all tissues appeared normal
all tissues appeared normal, no inflammation + mild foreign body
response mild inflammation ++ moderate foreign body response
moderate inflammation +++ marked foreign body response marked
inflammation ++++ severe foreign body response severe
inflammation
[0087]
4TABLE 4 Results for Biocompatibility Experiments Results Histo-
Gross logical Obser- Obser- Test Description vations vations A
surgical control - + B fibrillar collagen - + C 20% w/v tetra-SG
PEG 10,000 + ++++ ++++ 20% w/v tetra-amino PEG 10,000 D 20% w/v
tetra-SG PEG 10,000 + ++ ++ 20% w/v tetra-sulfhydryl PEG 10,000 E
20% w/v tetra-SG PEG 10,000 + + ++ 20% w/v tetra-amino PEG 10,000;
gelled ex- vivo; treated with mono-SG PEG 5000 F 20% w/v tetra-SG
PEG 10,000 + ++++ ++++ 20% w/v di-sulfhydryl PEG 3,400; gelled ex-
vivo; treated with di-amino PEG 3400
[0088] Experiments A and B show a mild gross and histological
response of fibrillar collagen (Collagen Corporation, Palo Alto,
Calif.) and the surgical control. Experiment C shows a severe
response to hydrogels made with amino-PEG. The response consists of
thick encapsulation of the hydrogel and abscess formation. By
substitution of sulfhydryl-PEG for amino-PEG, as in Experiment D,
the biocompatibility of the hydrogel is significantly improved.
Experiment E involves forming an amino hydrogel ex-vivo and
incubating the hydrogel in a solution of mono-SG PEG, 5000 mol. wt.
During the incubation period, the mono-SG PEG reacts with the free
amines present on the hydrogel network, thus reducing the amount of
free amines on the polymeric network. This treatment enhances the
biocompatibility of the hydrogel. Experiment F involves forming a
sulfhydryl hydrogel ex-vivo and incubating the hydrogel in a
solution of mono-SG PEG, 5000 mol. wt. During the incubation
period, the di-amino PEG reacts with the free SG groups present on
the hydrogel network, thus increasing the amount of free amines on
the polymeric network. This treatment decreases the
biocompatibility of the hydrogel. Thus, these results show the
enhanced biocompatibility of sulfhydryl formulations over amino
formulations.
Example 5
Effect of Buffer and Reactive Group on Gel Times
[0089] A desirable characteristic of the compositions described
herein is their ability to rapidly achieve gelation. In this
experiment, the effects of buffer strength and composition on
gelation kinetics are studied. For all experiments, the
tetra-functional SG PEG described in Example 1 is dissolved in 0.5
mM sodium phosphate, pH 6.0, and the tetra-sulfhydryl PEG described
in Example 1, or the equivalent tetra-amino PEG is dissolved in the
buffer listed in Table 5.
5TABLE 5 Effect of Phosphate vs. Carbonate Buffer on Amino and
Sulfhydryl Formulations Gel Time Test Formulation Buffer (Sec) A
10% w/v tetra-SG PEG 10,000 + 300 mM dibasic 16 10% w/v tetra-amino
PEG 10,000 sodium phosphate pH 9 B 10% w/v tetra-SG PEG 10,000 +
300 mM dibasic 55 10% w/v tetra-sulfhydryl PEG 10,000 sodium
phosphate pH 9 C 10% w/v tetra-SG PEG 10,000 + 300 mM sodium 14 10%
w/v tetra-amino PEG 10,000 carbonate pH 9 D 10% w/v tetra-SG PEG
10,000 + 300 mM sodium 9 10% w/v tetra-sulfhydryl PEG 10,000
carbonate pH 9 E 10% w/v tetra-SG PEG 10,000 + P/C Buffer pH 9.6 3
10% w/v tetra-sulfhydryl PEG 10,000
[0090] Experiments A and B show the difference in gel times in
amino formulations and sulfhydryl formulations in phosphate buffer.
In this buffer, an increase in gelation rate is observed for
sulfhydryl formulations compared to amino formulations. Experiments
C and D show the difference in gelation times in amino formulations
and sulfhydryl formulations in carbonate buffer. As shown, a
decrease in gel time is observed for sulfhydryl formulations in
carbonate buffer. In the preferred P/C Buffer, a gel time of 3
seconds is observed.
Example 6
Rheometric Measurements
[0091] The first component (tetra-functional Sulfhydryl-PEG, 10,000
mol. wt.) was prepared according to Example 1 and suspended in P/C
Buffer. The second component (tetra-functional SG-PEG, 10,000 mol.
wt.) was prepared according to Example 1 in 0.5 mM phosphate, pH
6.0. The two components (0.6 ml each) were loaded in a dual-syringe
device with joiner and cannula. The cannula contained a mixing
element. The solutions were mixed, and the resultant mixture was
immediately delivered into a parallel plate cell of a Rheometrics
Fluids Spectrometer 8500 (Rheometrics, Inc., Piscataway, N.J.). The
upper platen had a diameter of 25 mm, and the gap between upper and
lower parallel plates was 1.5 mm.
[0092] Gelation began immediately upon mixing of the formulation.
The instrument was started, and G' and G" (elastic and viscous
moduli, respectively) were measured at 1% strain and 1 radian/sec.
In less than a minute, G' was near 10.sup.4 dynes/cm.sup.2, which
is characteristic of a soft rubbery material. G' began to plateau
within 15 min, and continued to rise very gradually for more than
an hour afterwards. G" was in the order of 10.sup.2 dynes/cm.sup.2,
and declined gradually. These results are consistent with a rapidly
gelling material. G' and G" for the unreacted starting materials
was about 1-10 dynes/cm.sup.2. These results are depicted in FIG.
3.
[0093] In this experiment, the rheometer cannot precisely
quantitate G' and G" below about 50 dynes/cm.sup.2. In addition,
the gelation occurred so rapidly that the mixture only filled 30 to
95% of the desired space--there was gelled fluid surrounding the
plate, but not between the plates. Even with these limitations, a
measurement of the elastic (G') and viscous modulus (G") as a
function of time can still be made, and the kinetics of gelation
can be followed. As indicated in this experiment, a G' of greater
than 10.sup.2 dynes/cm.sup.2 in less than one minute indicates
rapid gelation.
Example 7
Effects of Buffers on Gel Time Using Sulfhydryl-PEG and
N-hydroxy-succinimidyl-PEG (NHS-PEG).
[0094] All tests were done with 50 ml of 20% (w/v) 4 arm, 10,000
mol. wt., tetrafunctional SG-PEG mixed with 50 ml of 20% (w/v) 4
arm, 10,000 mol. wt., tetra-functional sulfhydryl-PEG). Different
buffers were used, and the times to gel were noted. The SG-PEG was
dissolved in 0.5 mM phosphate, pH 6.0 for all tests. The
sulfhydryl-PEG was dissolved in the buffers given below at a pH of
9.6 and times to gel are noted.
6TABLE 6 Effect Buffers on Gelation Time. Gel Time Test Buffer
(Sec) A P/C Buffer 8 B 150 mM phosphate 35 C 58 mM phosphate 138 91
mM sodium chloride D 58 mM phosphate <19 91 mM borate E 58 mM
phosphate 8 91 mM AMPSO* *(3
[1,1-dimethyl-2-hydroxy-ethyl)amino]-2-hydroxypropane-sulfonic
acid
[0095] As shown, buffers with pKs between 8 and 10.5 (borate, 8.1;
carbonate, 10.3; AMPSO, 9.0), and mixtures thereof, are
suitable
Example 8
Sulfhydryl-reactive PEGs
[0096] The gelation characteristics of several different
formulations are described below:
[0097] 8a: Gelation of Di Functional Maleimidyl-PEG, 3400 mol. wt.
(MAL-PEG) with Tetra-Sulfhydryl PEG, 10,000 mol. wt.
[0098] A 20% (w/v) solution of MAL-PEG in 0.5 mM sodium phosphate,
pH 6.0, was mixed rapidly with an equal volume of 20% (w/v)
tetra-sulfhydryl PEG in 150 mM sodium phosphate, pH 5.0. Gelation
occurred in 15 sec. The gel became a firm, rubbery solid in a
minute or less.
[0099] 8b: Gelation of Difunctional Iodoacetamide PEG, 3,400
mol.wt. ("IAM-PEG") with Tetra-Sulfhydryl PEG, 10,000 mol. wt.
[0100] IAM-PEG was dissolved at 20% (w/v) in 0.5 mM sodium
phosphate, pH 6.0, and mixed rapidly with a 20% (w/v) solution of
tetra-sulfhydryl PEG in P/C Buffer sodium phosphate-carbonate, pH
9.6. Gelation occurred in less than 40 sec. A firm gel formed
within 2 min.
[0101] 8c: Gelation of Tetra-sulfhydryl PEG, 10,000 mol. wt., with
Dilute Hydrogen Peroxide.
[0102] A 20% (w/v) solution of tetra-sulfhydryl PEG in P/C Buffer,
was mixed with an equal volume of 0.1% (w/v) hydrogen peroxide.
Gelation occurred in 15 sec. A firm gel formed in less than 2
min.
Example 9
Blood Coagulation Activity of Thrombin Incorporated into PEG
Compositions
[0103] This experiment demonstrates that hemostatic PEG gels
containing active thrombin protein can be formed on tissue.
[0104] 9a: Thrombin Incorporated into Tetra-Sulfhydryl PEG Gelled
with Hydrogen Peroxide.
[0105] 20 mg of tetra-sulfhydryl PEG, 10,000 mol. wt., were
dissolved in 80 .mu.l of PC Buffer, and 11 .mu.l of bovine thrombin
at 8850 NIH units/ml in 0.72 M sodium chloride (Thrombin topical,
USP, Gentrac, Inc., Middleton, Wis.) were added. This solution of
tetra-sulfhydryl PEG and thrombin was then mixed with 100 .mu.l of
0.1% (w/v) hydrogen peroxide in water, by stirring rapidly in a 1.5
ml plastic tube. The mixture gelled in less than 40 sec, due to
oxidation of the sulfhydryl groups to disulfide bonds. After 1.5
min, the gel was a firm, rubbery solid. On top of this gel was
layered 200 .mu.l of rabbit blood plasma. The plasma had been
separated from citrated blood and contained approximately 11 mM
citrate. Just prior to addition, this citrated blood plasma was
re-calcified by addition of 8 .mu.l of 0.5 M calcium chloride, to
achieve a concentration of about 20 mM calcium. This re-calcified
blood plasma was observed to form a fibrin clot 1.5 minutes after
layering onto the PEG gel. The clotting reaction was taken as
evidence for the presence of active thrombin in the PEG gel.
[0106] When control studies are performed, a second oxidized
sulfhydryl-PEG gel without thrombin does not clot rabbit plasma
until 20 minutes have elapsed. As a further control, re-calcified
rabbit plasma is held in an identical plastic tube; and it clots
spontaneously after 13 minutes. Therefore, the sulfhydryl-PEG gel
without thrombin clots blood no faster than control re-calcified
plasma.
[0107] When the analogous experiment was attempted with
tetra-sulfhydryl PEG and tetra-SG-PEG, plus thrombin, no enhanced
clotting time of plasma was observed. Clotting of plasma was
delayed beyond 25 minutes. This result is interpreted to indicate
that SG-PEG inactivated thrombin, presumably by binding PEG to
lysine side chains of thrombin and interfering with its enzymatic
activity.
[0108] 9b: Thrombin Incorporated into IAM-PEG/Sulfhydryl-PEG
gel.
[0109] 20 mg of tetra-sulfhydryl PEG, 10,000 mol. wt. are dissolved
in 80 .mu.l of PC Buffer along with 11 .mu.l of thrombin, as in 9a.
above. 20 mg of IAM-PEG are dissolved in 80 .mu.l of 0.5 mM sodium
phosphate, pH 6.0. The two solutions are rapidly mixed in a 1.5 ml
plastic tube. The mixture has a gel time less than 30 sec and is a
rubbery gel by 1.5 minutes. Re-calcified rabbit plasma (200 .mu.l)
is layered on top of the gel, and a fibrin clot forms in this
plasma in less than two minutes after layering onto the gel. A
control reaction without thrombin forms a fibrin clot more than 18
minutes after layering onto the PEG gel. The rapid formation of a
fibrin clot in the sample containing thrombin is taken as evidence
for the presence of active thrombin in the PEG gel.
[0110] 9c: Thrombin Incorporated into NEM-PEG/Sulfhydryl PEG
gel.
[0111] 20 mg of tetra-sulfhydryl PEG, 10,000 mol wt., is dissolved
in 80 .mu.l of 150 mM sodium phosphate, pH 5.0, along with 11 .mu.l
of thrombin, as in 9a. above. 20 mg of NEM-PEG are dissolved in 0.5
mM sodium phosphate, pH 6.0. The two solutions are rapidly mixed in
a plastic tube. Gelation occurs in 15 sec. 15 .mu.l of P/C Buffer,
are layered onto the top of the PEG gel to adjust the pH to 7-9.
Then, 200 .mu.l of re-calcified rabbit plasma are added. A fibrin
clot formed in 1.5 min. after addition of the plasma. Control gels
with no thrombin form a fibrin clot after 30 min. Again, the rapid
formation of a fibrin clot in the PEG gel with thrombin is taken as
evidence for the presence of active thrombin.
[0112] 9d: Gelation of Layered Gels with Thrombin.
[0113] In order to provide a gel formulation from SG-PEG and
sulfhydryl-PEG to which thrombin can be added and remain active, a
"gel layering" technique can be used. First, the
tetra-sulfhydryl-PEG and tetra-SG-PEG gel at 20% solids, prepared
according to Example 1 are sprayed onto sheets as described in
Example 2. The sheets are coarse fibered collagen hydrated by
saline, which simulates a tissue surface. The total volume is
approximately 0.5 ml. This formula gels in 18-15 sec. At 16
seconds, a second gel mixture of tetra-sulfhydryl PEG,
di-maleimidyl PEG, both at 20% solids, and thrombin (700 NIH
units/ml) of total gel mixture, total volume approx. 0.5 ml, are
sprayed on top of the first gel. This second gel layer gels at
about 2 minutes. At 3 min after the first gel is sprayed, 0.4 ml of
re-calcified rabbit blood plasma, prepared as described above are
layered on top of the PEG gel. This plasma clots 1.5 minutes after
it is layered onto the PEG gel. The formation of a fibrin clot at
this early time, compared to a non-thrombin control, is taken as
evidence for active thrombin in the PEG gel.
Example 10
Gelation using Powdered Formulations
[0114] 10 mg of powdered tetra-SG PEG, 10,000 mol. wt., is spread
on the surface of a piece of weighing paper. 10 mg of
tetra-sulfhydryl PEG, 10,000 mol. wt., is dissolved in 80 .mu.l of
P/C buffer. The sulfhydryl-PEG solution is loaded into a 1 cc
syringe with a Haemedics (Malibu, Calif.) spray head and sprayed
onto the SG-PEG on the weighing paper. The sprayed fluid is not
stirred or mixed. It begains to gel in 27 seconds and forms a firm,
rubbery layer by 2 min. This test shows that components in powdered
form are also suitable for use in the present invention.
Example 11
Collagen-Containing Compositions
[0115] Methylated collagen is prepared by the following process:
bovine corium collagen is solubilized using pepsin and purified as
described in U.S. Pat. No. 4,233,360. This purfied, solubilized
collagen is precipitated by neutralization into 0.2M sodium
phosphate, pH 7.2. The precipitate is isolated by centrifugation to
a final concentration of 70 mg/ml. The material is dried for two
days, and then pulverized. Dry methanol containing HCl (to 0.1 N)
is added (40 ml) and stirred for four days. Collagen is separated
from the acidic methanol, vacuum dried and sterilized by
irradiation. The final product is disolved in water at a pH of
3-4.
[0116] For delivery as a sealant, 10 mg of the methylated collagen,
100 mg of tetra-functional sulfhydryl-PEG, 10,000 mol. wt., and 100
mg of tetra-functional SG PEG, 10,000 mol. wt., are dissolved in
water at pH 3-4 to a final volume of 1 ml (first component). The
second component is 1 ml of P/C Buffer. Each component is placed in
a syringe and mixed and sprayed on the desired test site using a
dual-syringe delivery system as described in Example 1. The applied
mixture gels in less than 3 seconds.
[0117] The adhesive and cohesive properties of the gel are examined
in a burst test. This test is conducted on a pressure gauge
apparatus (PSI-Tronix, Model PG5000, Tulare, Calif.) connected by a
pressure line to a circular sample plate with a 2 mm diameter
central orifice. Sealant formulations are sprayed onto the plate to
seal the orifice. To simulate bonding of the formulations to
tissue, the sample plate has a circular sheet of coarse-fibered
collagen fastened to it, with a 2 mm hole pierced into it and
displaced 2-3 mm from the sample plate orifice. Burst strength is
measured as a function of the pressure it takes to force saline at
a flow rate of 5 ml/min through the sealant gel.
[0118] The results are given below in Table 7.
7TABLE 7 Burst Strength Measurements of Collagen-Containing
Compositions Material Burst Strength, mm Hg Sulfhydryl-PEG/SG-PEG
100-180 Sulfhydryl-PEG/SG-PEG/Methylated 122-205 Collagen
[0119] Both formulations have gel times less than 3 seconds. As
shown above, the addition of collagen to the formulation enhances
burst strength.
Example 12
Synthesis of "12-arm" PEG Compounds
[0120] A 12-arm electrophilic PEG compound is formed from 1 mole of
4-arm sulfhydryl PEG, 10,000 mol. wt., and 4 moles of 4-arm SG-PEG,
10,000 mol. wt. The resulting compound is depicted in FIG. 4a. As
shown, the compound core is pentaerythritol PEG ether
tetra-sulfhydryl and the end functional group is succinimide. As
long as the functional groups are reactive with one another to form
chemical bonds, the sulfhydryl group, X, can be replaced with other
nucleophilic groups, such as NH.sub.2, etc., and the succinimidyl
group, Y, can be replaced with other electrophilic groups, such as
maleimide, carbonyl imidazole, or isocyanate. This method is also
used to prepare the 12-arm nucleophilic PEG compound depicted in
FIG. 4b by reacting 4 moles of 4-arm sulfhydryl PEG with 1 mole of
4-arm SG-PEG. The formation of these compounds from their
respective 4-arm intermediates are also shown in FIG. 5. It should
be understood that such reactions produce a heterogeneous
population of activated PEG product, some having less than 12 arms,
and some having more than 12 arms. As used herein, a "12-arm" PEG
also refers to such heterogeneous reaction products that have an
average of about 12 arms on each molecule.
[0121] 12a: 12 Arm Sulfhydryl PEG
[0122] Eight grams of pentaerythritol (polyethylene glycol)ether
tetra sulfhydryl was dissolved in a mixture of 100 mL of methylene
chloride and 100 mL of triethylamine. Two grams of pentaerythritol
(polyethylene glycol)ether tetra succinimidyl glutarate in 40 mL of
methylene chloride was slowly added with stirring at room
temperature under argon overnight. The solvent was removed and the
product was isolated by recrystallilzation in ethanol and
dried.
[0123] 12b: 12 Arm Succinimidyl PEG
[0124] Two grams of pentaerythritol (polyethylene glycol)ether
tetra succinimidyl glutarate was dissolved in 50 mL of methylene
chloride. 0.5 grams of pentaerythritol (polyethylene glycol)ether
tetra amine in 10 mL of methylene chloride was slowly added with
stirring at room temperature under argon overnight. The solvent was
removed and the product was isolated by recrystallization in
ethanol and dried.
[0125] When the two compounds were tested for burst strength as
described in Example 12, they demonstrated a burst strength of
greater than 150 mm Hg and a gel time of less than 2 seconds.
[0126] Numerous modifications may be made to the foregoing systems
without departing from the basic teachings thereof. Although the
present invention has been described in substantial detail with
reference to one or more specific embodiments, those of skill in
the art will recognize that changes may be made to the embodiments
specifically disclosed in this application, yet these modifications
and improvements are within the scope and spirit of the invention
as set forth in the claims which follow. All publications, patents,
and patent applications cited in this specification are
incorporated herein by reference as if each such publication,
patent, or patent application was specifically and individually
indicated to be incorporated herein by reference.
* * * * *