U.S. patent application number 11/633355 was filed with the patent office on 2007-05-10 for synergistic antimicrobial preparations containing chlorite and hydrogen peroxide.
This patent application is currently assigned to S.K. Pharmaceuticals, Inc.. Invention is credited to Hampar L. Karagoezian.
Application Number | 20070104798 11/633355 |
Document ID | / |
Family ID | 39492544 |
Filed Date | 2007-05-10 |
United States Patent
Application |
20070104798 |
Kind Code |
A1 |
Karagoezian; Hampar L. |
May 10, 2007 |
Synergistic antimicrobial preparations containing chlorite and
hydrogen peroxide
Abstract
An anti-microbial preservative for use in ophthalmic and
dermatologic products. The preservative includes from about 0.005
wt. % to about 0.20 wt. % chlorite compound and from about 0.005
wt. % to about 0.05 wt. % peroxy compound. Additionally, the
preservative does not generate chlorine dioxide within the pH range
of 5.0-8.8. Also included are an antimicrobial ophthalmic and
dermatologic compositions for direct application onto an eye or
skin of a living being including from about 0.005 wt. % to about
0.20 wt. % chlorite compound and from about 0.005 wt. % to about
0.05 wt. % peroxy compound. Also included are methods for treating
dryness of the eyes and skin disorders (e.g., wounds, burns,
infections, ulcerations, psoriasis, etc.) and for disinfecting and
cleansing contact lenses while in place upon an eye by applying the
composition to the eye or to the contact lens.
Inventors: |
Karagoezian; Hampar L.; (San
Juan Capistrano, CA) |
Correspondence
Address: |
STETINA BRUNDA GARRED & BRUCKER
75 ENTERPRISE, SUITE 250
ALISO VIEJO
CA
92656
US
|
Assignee: |
S.K. Pharmaceuticals, Inc.
|
Family ID: |
39492544 |
Appl. No.: |
11/633355 |
Filed: |
December 4, 2006 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10614646 |
Jul 7, 2003 |
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11633355 |
Dec 4, 2006 |
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09911638 |
Jul 23, 2001 |
6592907 |
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10614646 |
Jul 7, 2003 |
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09412174 |
Oct 4, 1999 |
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09911638 |
Jul 23, 2001 |
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Current U.S.
Class: |
424/616 ;
424/661 |
Current CPC
Class: |
A61K 9/0048 20130101;
A61P 17/00 20180101; A61K 33/40 20130101; A61P 31/12 20180101; A61P
31/10 20180101; A61L 12/124 20130101; A01N 59/00 20130101; A61P
27/04 20180101; A61K 31/728 20130101; A61K 33/00 20130101; A61P
31/00 20180101; A61P 31/04 20180101; A61L 12/10 20130101; A61K
9/0014 20130101; A61P 17/02 20180101; A61P 27/02 20180101; A61K
33/22 20130101; A61P 17/06 20180101; A61K 33/14 20130101; A61K
33/20 20130101; A61K 31/728 20130101; A61K 2300/00 20130101; A61K
33/14 20130101; A61K 2300/00 20130101; A61K 33/22 20130101; A61K
2300/00 20130101; A61K 33/00 20130101; A61K 2300/00 20130101; A61K
33/40 20130101; A61K 2300/00 20130101 |
Class at
Publication: |
424/616 ;
424/661 |
International
Class: |
A61K 33/40 20060101
A61K033/40; A61K 33/14 20060101 A61K033/14 |
Claims
1. An anti-microbial preservative for use in an ophthalmic product,
the preservative comprising from about 0.005 wt. % to about 0.20
wt. % chlorite compound and from about 0.005 wt. % to about 0.05
wt. % peroxy compound, wherein the preservative does not generate
chlorine dioxide, and wherein the preservative is at a pH range
between about 6.0 and about 8.8.
2. The preservative of claim 1 wherein the chlorite compound is a
metal chlorite.
3. The preservative of claim 2 wherein the metal is sodium.
4. The preservative of claim 2 wherein the metal is selected from
the group consisting of potassium, calcium, and magnesium.
5. The preservative of claim 1 wherein the peroxy compound is
hydrogen peroxide.
6. The preservative of claim 1 wherein the ophthalmic product is an
artificial tear solution.
7. The preservative of claim 1 wherein the ophthalmic product is a
contact lens disinfecting solution.
8. The preservative of claim 1 wherein the ophthalmic product is a
contact lens cleaning solution.
9. The preservative of claim 8 wherein the cleaning solution is
directly applied to a contact lens in place on an eye of a living
being.
10. An antimicrobial ophthalmic composition for direct application
onto an eye of a living being, the composition comprising from
about 0.005 wt. % to about 0.20 wt. % chlorite compound and from
about 0.005 wt. % to about 0.05 wt. % peroxy compound, wherein the
composition does not generate chlorine dioxide, and wherein the
composition is at a pH range between about 6.0 and 8.8.
11. The antimicrobial ophthalmic composition of claim 10 wherein
the chlorite compound is a metal chlorite.
12. The antimicrobial ophthalmic composition of claim 11 wherein
the metal is sodium.
13. The antimicrobial ophthalmic composition of claim 11 wherein
the metal is selected from the group consisting of potassium,
calcium, and magnesium.
14. The antimicrobial ophthalmic composition of claim 10 wherein
the peroxy compound is hydrogen peroxide.
15. The antimicrobial ophthalmic composition of claim 10
additionally comprising a lubricant chosen from the group
consisting of non-ionic polymeric lubricants, anionic polymeric
lubricants, and combinations thereof.
16. The antimicrobial ophthalmic composition of claim 15
additionally comprising a block polymer based surfactant.
17. The antimicrobial ophthalmic composition of claim 15 wherein
the ophthalmic composition additionally comprises: TABLE-US-00025
lubricant 0.05 wt. % to 0.3 wt. %; boric acid 0.15 wt. % to 0.3 wt.
%; sodium chloride 0.50 wt. % to 0.8 wt. %; surfactant 0.05 wt. %
to 0.3 wt. %; HCl or NaOH to adjust pH; and purified water Q.S. to
volume.
18. The antimicrobial ophthalmic composition of claim 17
additionally comprising from about 0.001 wt. % to about 0.50 wt. %
of sodium hyaluronate.
19. The antimicrobial ophthalmic composition of claim 15 wherein
the ophthalmic composition additionally comprises: TABLE-US-00026
lubricant 0.05 wt. % to 0.30 wt. %; sodium phosphate monobasic 0.10
wt. % to 0.25 wt. %; sodium phosphate dibasic 0.10 wt. % to 0.40
wt. %; sodium chloride 0.50 wt. % to 0.80 wt. %; surfactant 0.05
wt. % to 0.30 wt. %; HCl or NaOH to adjust pH; and purified water
Q.S. to volume.
20. The antimicrobial ophthalmic composition of claim 19
additionally comprising from about 0.001 wt. % to about 0.50 wt. %
sodium hyaluronate.
21. The antimicrobial ophthalmic composition of claim 10 wherein
the composition is applied onto an eye for treating dryness of the
eye.
22. The antimicrobial ophthalmic composition of claim 10 wherein
the composition is applied onto an eye for treating an infection of
an eye.
23. The antimicrobial ophthalmic composition of claim 22 wherein
the infection is caused by bacterial keratitis.
24. The antimicrobial ophthalmic composition of claim 22 wherein
the infection is caused by a virus.
25. The antimicrobial ophthalmic composition of claim 22 wherein
the infection is caused by a fungus.
26. The antimicrobial ophthalmic composition of claim 10 wherein
the composition is applied onto an eye for cleansing a contact lens
in place on the eye.
27. A method of treating dryness of a eye of a living being, the
method comprising applying an antimicrobial ophthalmic composition
onto the eye, the composition comprising from about 0.005 wt. % to
about 0.20 wt. % chlorite compound and from about 0.005 wt. % to
about 0.05 wt. % peroxy compound, wherein the composition does not
generate chlorine dioxide, and wherein the composition is at a pH
range between about 6.0 and 8.8.
28. The method of claim 27 wherein the chlorite compound of the
ophthalmic composition is a metal chlorite.
29. The method of claim 28 wherein the metal is sodium.
30. The method of claim 28 wherein the metal is selected from the
group consisting of potassium, calcium, and magnesium.
31. The method of claim 27 wherein the peroxy compound of the
ophthalmic composition is hydrogen peroxide.
32. The method of claim 27 wherein the ophthalmic composition
additionally comprises a lubricant chosen from the group consisting
of non-ionic polymeric lubricants, anionic polymeric lubricants,
and combinations thereof.
33. The method of claim 32 wherein the ophthalmic composition
additionally comprises a block polymer based surfactant.
34. The method of claim 33 wherein the ophthalmic composition
additionally comprises: TABLE-US-00027 lubricant 0.05 wt. % to 0.3
wt. %; boric acid 0.15 wt. % to 0.3 wt. %; sodium chloride 0.50 wt.
% to 0.8 wt. %; surfactant 0.05 wt. % to 0.3 wt. %; HCl or NaOH to
adjust pH; and Purified water Q.S. to volume.
35. The method of claim 34 wherein the ophthalmic composition
additionally comprises from about 0.001 wt. % to about 0.50 wt. %
sodium hyaluronate.
36. The method of claim 33 wherein the ophthalmic composition
additionally comprises: TABLE-US-00028 lubricant 0.05 wt. % to 0.30
wt. %; sodium phosphate monobasic 0.10 wt. % to 0.25 wt. %; sodium
phosphate dibasic 0.10 wt. % to 0.40 wt. %; sodium chloride 0.50
wt. % to 0.80 wt. %; surfactant 0.05 wt. % to 0.30 wt. %; HCl or
NaOH to adjust pH; and purified water Q.S. to volume.
37. The method of claim 36 wherein the ophthalmic composition
additionally comprises from about 0.001 wt. % to about 0.50 wt. %
sodium hyaluronate.
38. A method of cleansing a contact lens in place upon an eye of a
living being, the method comprising applying an antimicrobial
ophthalmic composition onto the lens, the composition comprising
from about 0.005 wt. % to about 0.20 wt. % chlorite compound and
from about 0.005 wt. % to about 0.05 wt. % peroxy compound, wherein
the composition does not generate chlorine dioxide, and wherein the
composition is at a pH range between about 6.0 and 8.8.
39. The method of claim 38 wherein the chlorite compound of the
ophthalmic composition is a metal chlorite.
40. The method of claim 39 wherein the metal is sodium.
41. The method of claim 39 wherein the metal is selected from the
group consisting of potassium, calcium, and magnesium.
42. The method of claim 38 wherein the peroxy compound of the
ophthalmic composition is hydrogen peroxide.
43. The method of claim 38 wherein the ophthalmic composition
additionally comprises a lubricant chosen from the group consisting
of non-ionic polymeric lubricants, anionic polymeric lubricants,
and combinations thereof.
44. The method of claim 38 wherein the ophthalmic composition
additionally comprises a sustained delivery component which limits
the rate at which the chlorite and hydrogen peroxide become
available for generation of oxygen.
45. The method of claim 44 wherein the sustained delivery component
is a polymeric matrix.
46. The method of claim 44 wherein the sustained delivery component
is a liposome.
47. The method of claim 44 wherein the sustained delivery component
is an ointment.
48. The method of claim 44 wherein the sustained delivery component
is selected from the group consisting of a cellulose ester,
hydroxymethylpropyl cellulose, methylhydroxylethyl cellulose,
hydroxypropyl cellulose, hydroxyethyl cellulose, carboxymethyl
cellulose, a salt of a cellulose ester, cellulose acetate,
hydroxyproylmethyl cellulose phthalate, methacrylic acid-ethyl
acetate copolymer, polyvinylpyrrolidone, polyvinyl alcohol,
hyaluronic acid, a phospholipid, phospholipids having a neutral
charge, phospholipids having a negative charge, dipalmytoyl
phosphatidyl choline, dipalmytoyl phosphatidyl serine, and sodium
salts thereof.
49. The method of claim 44 wherein the sustained delivery component
comprises 1 percent to 20 percent by weight of the preparation.
50. The method of claim 47 wherein the ophthalmic composition
comprises: TABLE-US-00029 sodium chlorite 0.005 wt. % to 0.200 wt.
%; hydrogen peroxide 0.005 wt. % to 0.050 wt. %; HPMC 0.05 wt. % to
0.20 wt. %; sodium phosphate 0.01 wt. % to 0.30 wt. %; monobasic
monohydrate HCl or NaOH to adjust to pH 7.4 purified water Q.S. to
volume.
51. The method of claim 38 wherein the ophthalmic composition
additionally comprises a block polymer based surfactant.
52. The method of claim 51 wherein the ophthalmic composition
additionally comprises: TABLE-US-00030 lubricant 0.05 wt. % to 0.30
wt. %; boric acid 0.15 wt. % to 0.30 wt. %; sodium chloride 0.50
wt. % to 0.80 wt. %; surfactant 0.05 wt. % to 0.30 wt. %; HCl or
NaOH to adjust pH; and purified water Q.S. to volume.
53. The method of claim 52 wherein the ophthalmic composition
additionally comprises from about 0.001 wt. % to about 0.50 wt. %
sodium hyaluronate.
54. The method of claim 51 wherein the ophthalmic composition
additionally comprises: TABLE-US-00031 lubricant 0.05 wt. % to 0.30
wt. %; sodium phosphate monobasic 0.10 wt. % to 0.25 wt. %; sodium
phosphate dibasic 0.10 wt. % to 0.40 wt. %; sodium chloride 0.50
wt. % to 0.80 wt. %; surfactant 0.05 wt. % to 0.30 wt. %; HCl or
NaOH to adjust pH; and purified water Q.S. to volume.
55. The method of claim 54 wherein the ophthalmic composition
additionally comprises from about 0.001 wt. % to about 0.50 wt. %
sodium hyaluronate.
56. An antimicrobial preservative for use in a dermatology product,
the preservative comprising from about 0.005 wt. % to about 0.20
wt. % chlorite compound and from about .005 wt. % to about 0.05 wt.
% peroxy compound, wherein the preservative does not generate
chlorine dioxide, and wherein the preservative is at a pH range
between about 5.0 and about 8.8.
57. The preservative of claim 56 wherein the chlorite compound is a
metal chlorite.
58. The preservative of claim 57 wherein the metal is sodium.
59. The preservative of claim 57 wherein the metal is selected from
the group consisting of potassium, calcium, and magnesium.
60. The preservative of claim 56 wherein the peroxy compound is
hydrogen peroxide.
61. The preservative of claim 56 wherein the dermatology product is
Decubitus gel or a cream.
62. A method of treating a dermatological condition, the method
comprising applying an antimicrobial dermatological composition
onto the affected skin area, the composition comprising from about
0.005 wt. % to about 0.20 wt. % chlorite compound and from about
0.005 wt. % to about 0.05 wt. % peroxy compound, wherein the
composition does not generate chlorine dioxide, and wherein the
composition is at a pH range between about 5.0 and 8.8.
63. The method of claim 62 wherein the chlorite compound of the
dermatological composition is a metal chlorite.
64. The method of claim 63 wherein the metal is sodium.
65. The method of claim 63 wherein the metal is selected from a
group consisting of potassium, calcium, and magnesium.
66. The method of claim 62 wherein the peroxy compound of the
dermatological composition is hydrogen peroxide.
67. The method of claim 62 wherein the dermatological composition
is Decubitus gel or a cream.
68. The method of claim 67 wherein the dermatological composition
additionally comprises: TABLE-US-00032 lubricant 0.05 wt. % to 0.30
wt. %; boric acid 0.15 wt. % to 0.30 wt. %; sodium chloride 0.50
wt. % to 0.80 wt. %; surfactant 0.05 wt. % to 0.30 wt. %; HCl or
NaOH to adjust pH; and purified water Q.S. to volume.
69. The method of claim 67 wherein the dermatological composition
additionally comprises: TABLE-US-00033 lubricant 0.05 wt. % to 0.30
wt. %; sodium phosphate monobasic 0.10 wt. % to 0.25 wt. %; sodium
phosphate dibasic 0.10 wt. % to 0.40 wt. %; sodium chloride 0.50
wt. % to 0.80 wt. %; surfactant 0.05 wt. % to 0.30 wt. %; HCl or
NaOH to adjust pH; and purified water Q.S. to volume.
70. The method of claim 62 wherein the dermatological composition
additionally comprises a sustained delivery component which limits
the rate at which the chlorite and hydrogen peroxide become
available for generation of oxygen.
71. The method of claim 70 wherein the sustained delivery component
comprises a polymeric matrix.
72. The method of claim 70 wherein the sustained delivery component
comprises a liposome.
73. The method of claim 70 wherein the sustained delivery component
comprises an ointment.
74. The method of claim 70 wherein the sustained delivery component
is selected from the group consisting of a cellulose ester,
hydroxymethylpropyl cellulose, methylhydroxylethyl cellulose,
hydroxypropyl cellulose, hydroxyethyl cellulose, carboxymethyl
cellulose, a salt of a cellulose ester, cellulose acetate,
hydroxyproylmethyl cellulose phthalate, methacrylic acid-ethyl
acetate copolymer, polyvinylpyrrolidone, polyvinyl alcohol,
hyaluronic acid, a phospholipid, phospholipids having a neutral
charge, phospholipids having a negative charge, dipalmytoyl
phosphatidyl choline, dipalmytoyl phosphatidyl serine, and sodium
salts thereof.
75. The method of claim 70 wherein the sustained delivery component
comprises 1 percent to 20 percent by weight of the preparation.
76. The method of claim 73 wherein the ophthalmic composition
comprises: TABLE-US-00034 sodium chlorite 0.005 wt. % to 0.200 wt.
%; hydrogen peroxide 0.005 wt. % to 0.050 wt. %; HPMC 0.05 wt. % to
0.20 wt. %; sodium phosphate 0.01 wt. % to 0.30 wt. %; monobasic
monohydrate HCl or NaOH to adjust to pH 7.4 purified water Q.S. to
volume.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] The present invention is a continuation-in-part of U.S.
patent application Ser. No. 10/614,646 filed on Jul. 7, 2003, which
is a continuation-in-part of U.S. patent application Ser. No.
09/911,638 filed Jul. 23, 2001, which is a continuation-in-part of
U.S. patent application Ser. No. 09/412,174 filed Oct. 4, 1999, the
entirety of the disclosures of which are expressly incorporated
herein by reference.
STATEMENT RE: FEDERALLY SPONSORED RESEARCH/DEVELOPMENT
[0002] Not Applicable
BACKGROUND
[0003] 1. Field of the Invention
[0004] The present invention relates generally to medical
compositions and methods, and more particularly to certain
disinfectant/antimicrobial preparations and methods for using such
preparations i) to disinfect or preserve articles or surfaces, ii)
as a topical antiseptic for application to body parts, iii) to
prevent or deter scar formation; iv) to treat dermatological
disorders such as wounds, burns, ulcers, psoriasis, acne and other
scar forming lesions; and v) to treat ophthalmic disorders such as
infections, inflammation, dry eye, wound healing, and allergic
conjunctivitis.
[0005] 2. Background of the Invention
A. Antimicrobial and Disinfectant/Antiseptic Agents Used for
Disinfection/Antisepsis and Topical Treatment of Wounds, Burns,
Abrasions and Infections
[0006] The prior art has included numerous antimicrobial agents
which have purportedly been useable for disinfection of various
articles and/or for topical application to a living being for
antisepsis and/or treatment of dermal disorders (e.g., wounds,
burns, abrasions, infections) wherein it is desirable to prevent or
deter microbial growth to aid in healing. Such topical
antimicrobial agents have contained a variety of active
microbicidal ingredients such as iodine, mercurochrome, hydrogen
peroxide, and chlorine dioxide. [0007] i. Prior Chlorine Dioxide
Preparations
[0008] Chlorite, a precursor of chlorine dioxide, is known to be
useable as a disinfectant for drinking water and as a preservative
for contact lens care solutions. However, chlorite exhibits only
weak microbicidal activity within a concentration range that is
acceptable and safe for topical application to the skin (e.g.,
50-1000 parts per million). Thus, chlorite has not been routinely
used as an active microbicidal ingredient in preparations for
topical application to the skin. In view of the limited usefulness
of chlorite as an antiseptic or topical microbicide, various
compositions and methods have been proposed for activation or
enhancement of the microbicidal activity of chlorite. Examples of
such compositions and methods for activation or enhancement of the
microbicidal activity of chlorite are described in U.S. Pat. No.
4,997,616 (describing general activation); U.S. Pat. No. 5,279,673
(describing acid activation) and U.S. Pat. No. 5,246,662
(describing transition metal activation).
[0009] Chlorine dioxide (ClO.sub.2) and "stabilized chlorine
dioxide" are known to be useable as antiseptics. Chemically,
chlorine dioxide is an oxidizing agent which has strong
microbicidal activity. Chlorine dioxide is generally regarded as
superior even to gaseous chlorine in certain water treatment
applications where it is used as to eliminate algae and other
organic material and/or to remove odors or tastes. Chlorine dioxide
is also effective as a microbicide, for elimination of bacteria,
viruses, and microbial spores.
[0010] In addition to its use as a microbicide, chlorine dioxide is
a highly reactive, unstable radical which is useable as an
oxidizing agent in a number of other chemical and biochemical
applications. For example, as described in U.S. Pat. No. 4,855,135,
chlorine dioxide can be used for (a) oxidation of double bonds
between two carbon atoms; (b) oxidation of unsaturated fatty acids
(lipids) via double bonds between two carbon atoms; (c)
acceleration of hydrolysis of carboxylic anhydrides; (d) oxidation
of aldehydes to the corresponding carboxylic acids; (e) oxidation
of alcohols; (f) oxidation of amines; (g) oxidation of phenols,
phenolic derivatives and thiophenolic compounds; (h) moderate
oxidation of hydroquinones; (i) oxidation of amino acids, proteins
and polyamides; j) oxidation of nitrates and sulfides; and (k)
alteration of the CHO and CH.sub.2OH radicals of carbohydrates to
produce carboxylic functionality.
[0011] Concentrated chlorine dioxide in its liquid or gaseous state
is highly explosive and poisonous. As a result, concentrated
chlorine dioxide must be handled and transported with great
caution. For this reason, it is generally not feasible to dispense
pure chlorine dioxide for use as a topical antimicrobial agent or
disinfectant. Instead, some antimicrobial or disinfectant
preparations have been formulated to provide for "acid generation"
of chlorine dioxide. Such acid generation solutions contain a metal
chlorite (i.e., a precursor of chlorine dioxide available in
powdered or liquid form) in combination with an acid which will
react with the chlorite to liberate or release chlorine dioxide.
Generally, any acid may be used for acid generation of chlorine
dioxide, including strong acids such as hydrochloric acid and
sulfuric acid and relatively weak acids such as citric and tartaric
acid. Drawbacks or problems associated with these prior chlorine
dioxide generating systems include a) the inconvenience of handing
two separate containers or chemical components, b) the difficulty
of delivering such two-component systems to the intended site of
application, and c) the fact that these prior systems are of acid,
rather than neutral, pH. Moreover, the prior chlorine dioxide
generating systems which utilize acid-induced generation of
chlorine dioxide can, if uncontrolled, cause the generation of
chlorine dioxide to occur quite rapidly and, as a result, the
disinfectant or antimicrobial potency of the solution may be short
lived. Increasing the concentration of chlorite and acid within the
solution may prolong its disinfectant or antimicrobial shelf life,
but such increased concentrations of these chemicals can result in
toxicities or (in topical applications) skin irritation. Such
increased concentrations may also result in the generation of more
chlorine dioxide than is required.
[0012] Various methods have been described to limit or control the
rate at which chlorine dioxide is produced in "acid generation"
solutions. For instance, U.S. Pat. No. Re. 31,779 (Alliger), which
is a reissue of U.S. Pat. No. 4,084,747, describes a germicidal
composition which comprises a water soluble chlorite, such as
sodium chlorite, in combination with lactic acid. The particular
composition possesses improved disinfectant properties, properties
not attained by using the same composition but replacing the lactic
acid with other acids such as phosphoric acid, acetic acid, sorbic
acid, fumaric acid, sulfamic acid, succinic acid, boric acid,
tannic acid, and citric acid. The germ killing composition is
produced by contacting an acid material containing at least 15% by
weight of lactic acid with sodium chlorite in aqueous media. The
methods disclosed of disinfecting and sanitizing a germ-carrying
substrate, such as skin, include either application of the
germ-killing composition, or application of the reactants to
provide in situ production thereof. Also, U.S. Pat. No. 5,384,134
(Kross) describes acid induced generation of chlorine dioxide from
a metal chlorite wherein the chlorite concentration is limited by
the amount of available chlorous acid. In particular, the Kross
patent describes a method for treating dermal disorders wherein a
first gel, which comprises a metal chlorite, is mixed with a second
gel, which comprises a protic acid. The chlorite ions present in
such solution as chlorous acid purportedly comprise no more than
about 15% by weight of the total chlorite ion concentration in the
composition, and the mixture of the two gels purportedly generates
chlorine dioxide over an extended time of up to 24 hours.
[0013] Other prior patents have purported to describe the use of
"stabilized" chlorine dioxide as a means of chlorine dioxide
generation. The term stabilized chlorine dioxide refers to various
compositions in which the chlorine dioxide is believed to be held
in solution in the form of a labile complex. The stabilization of
chlorine dioxide by the use of perborates was disclosed in U.S.
Pat. No. 2,701,781 (de Guevara). According to the de Guevara
patent, an antiseptic solution of stabilized chlorine dioxide can
be formed from an aqueous solution of chlorine dioxide and an
inorganic boron compound with the boron compound and the chlorine
dioxide being present in the solution as a labile complex. The
chlorine dioxide, fixed in this stable condition, is an essential
ingredient of the antiseptic solution. The de Guevara patent
discloses that the chlorine dioxide may be introduced into the
compositions either by in situ generation or it may be generated
externally and introduced into the solution, as by bubbling the
chlorine dioxide gas into the aqueous solution. Various methods may
be employed for the external production of the chlorine dioxide,
such as reaction of sulfuric acid with potassium chlorate or the
reaction of the chlorate with moist oxalic acid. Alternatively,
chlorine dioxide can be generated in situ by reaction of potassium
chlorate and sulfuric acid. Note that whether the chlorine dioxide
is produced in situ or externally, it is essentially an
acid-induced liberation of the chlorine dioxide from potassium
chlorate.
[0014] U.S. Pat. No. 4,317,814 (Laso) describes stabilized chlorine
dioxide preparations for treatment of burns in humans. Aqueous
mixtures of perborate stabilized solutions of chlorine oxides, such
as chlorine dioxide, in combination with glycerin are described for
topical application to burned areas and may also be administered by
oral application for treatment of burns. The aqueous solutions of
perborate stabilized chlorine oxides are disclosed as being
prepared by mixing with water the following: sodium chlorite,
sodium hypochlorite, hydrochloric acid, sulfuric acid, an inorganic
perborate, and a peroxy compound, such as sodium perborate. Thus,
the solutions prepared in accordance with the Laso patent contain
chlorine dioxide, hypochlorite and peroxy compounds as strong
oxidizing agents and appear to utilize acid activation of the
chlorine dioxide. The Laso patent states that the methods disclosed
therein resulted in an immediate subsidence of burn related pain in
many cases, that healing was rapid and characterized by an absence
of infection or contraction, and that the burn scars were smooth
and resembled normal tissue, thus eliminating the need for plastic
surgery in certain cases. However, long term storage and stability
are issues with the aqueous solutions described in the
above-identified Laso patent, because such mixtures tend to
generate chlorine dioxide very quickly, thus diminishing the long
term stability of such mixtures.
[0015] U.S. Pat. No. 3,271,242 (McNicholas et al.,) describes
stabilized chlorine dioxide solutions which are formed by combining
chlorine dioxide gas with an aqueous solution containing a peroxy
compound, and subsequently heating the solution to a temperature
which is high enough to drive off all free peroxide, but low enough
not to destroy the chlorine dioxide. McNicholas et al., states that
temperatures "much below" 70 degrees C. are ineffective to drive
off the free peroxide in the solution and that temperatures should
not exceed 92 degrees C. because at higher temperatures the
chlorine dioxide will be driven off. McNicholas further states
that, although not "entirely understood," it was believed that
heating of the solution to drive off free peroxide was necessary
because any free hydrogen peroxide allowed to remain in the
solution would release the chlorine dioxide from the solution.
[0016] ii. Antibiotic Preparations
[0017] Antibiotic compounds have also been commonly used for the
therapeutic treatment of burns, wounds, and skin and eye
infections. While antibiotics may provide an effective form of
treatment, several dangers are often associated with the use of
antibiotics in the clinical environment. These dangers may include
but are not limited to: (1) changes in the normal flora of the
body, with resulting "superinfection" due to overgrowth of
antibiotic resistant organisms; (2) direct antibiotic toxicity,
particularly with prolonged use which can result in damage to
kidneys, liver and neural tissue depending upon the type of
antibiotic; (3) development of antibiotic resistant microbial
populations which defy further treatment by antibiotics.
B. Difficult-To-Treat Dermal Disorders Other Than Wounds, Burns,
Abrasions and Infections
[0018] While even minor wounds and abscesses can be difficult to
treat in certain patients and/or under certain conditions, there
are well known dermal disorders such as psoriasis and dermal
ulcerations, which present particular challenges for successful
treatment. [0019] i. Psoriasis
[0020] Psoriasis is a noncontagious skin disorder that most
commonly appears as inflamed swollen skin lesions covered with
silvery white scale. This most common type of psoriasis is called
"plaque psoriasis". Psoriasis comes in many different variations
and degrees of severity. Different types of psoriasis display
characteristics such as pus-like blisters (pustular psoriasis),
severe sloughing of the skin (erythrodermic psoriasis), drop-like
dots (guttate psoriasis) and smooth inflamed lesions (inverse
psoriasis).
[0021] The cause of psoriasis is not presently known, though it is
generally accepted that it has a genetic component, and it has
recently been established that it is an autoimmune skin disorder.
Approximately one in three people report a family history of
psoriasis, but there is no pattern of inheritance. There are many
cases in which children with no apparent family history of the
disease will develop psoriasis.
[0022] The occurrence of psoriasis in any individual may depend on
some precipitating event or "trigger factor". Examples of "trigger
factors" believed to affect the occurrence of psoriasis include
systemic infections such as strep throat, injury to the skin (the
Koebner phenomenon), vaccinations, certain medications, and
intramuscular injections or oral steroid medications. Once
something triggers a person's genetic tendency to develop
psoriasis, it is thought that in turn, the immune system triggers
the excessive skin cell reproduction.
[0023] Skin cells are programmed to follow two possible programs:
normal growth or wound healing. In a normal growth pattern, skin
cells are created in the basal cell layer, and then move up through
the epidermis to the stratum corneum, the outermost layer of the
skin. Dead cells are shed from the skin at about the same rate as
new cells are produced, maintaining a balance. This normal process
takes about 28 days from cell birth to death. When skin is wounded,
a wound healing program is triggered, also known as regenerative
maturation. Cells are produced at a much faster rate, theoretically
to replace and repair the wound. There is also an increased blood
supply and localized inflammation. In many ways, psoriatic skin is
similar to skin healing from a wound or reacting to a stimulus such
as infection.
[0024] Lesional psoriasis is characterized by cell growth in the
alternate growth program. Although there is no wound at a psoriatic
lesion, skin cells (called "keratinocytes") behave as if there is.
These keratinocytes switch from the normal growth program to
regenerative maturation. Cells are created and pushed to the
surface in as little as 2-4 days, and the skin cannot shed the
cells fast enough. The excessive skin cells build up and form
elevated, scaly lesions. The white scale (called "plaque") that
usually covers the lesion is composed of dead skin cells, and the
redness of the lesion is caused by increased blood supply to the
area of rapidly dividing skin cells.
[0025] Although there is no known cure for psoriasis, various
treatments have been demonstrated to provide temporary relief in
some patients. However, the effectiveness of the currently accepted
treatments for psoriasis is subject to considerable individual
variation. As a result, patients and their physicians may have to
experiment and/or combine therapies in order to discover the
regimen that is most effective. The currently available treatments
for psoriasis are often administered in step-wise fashion. Step 1
treatments include a) topical medications (e.g., topical steroids,
topical retinoids), b) systemic steroids, c) coal tar, d)
anthralin, e) vitamin D3, and sunshine. Step 2 treatments include
a) phototherapy (e.g., ultraviolet radiation), b) photochemotherapy
(e.g., a combination of a topically applied radiation-activated
agent followed by radiation to activate the agent) and c)
combination therapy. Step 3 treatments include a) systemic drug
therapies such as methotrexate, oral retinoids and cyclosporin and
b) rotational therapy. [0026] ii. Dermal Ulcerations
[0027] Dermal ulcerations are known to occur as a result of
pressure, wear, or primary/secondary vascular disorders. Dermal
ulcerations are generally classified according to their etiology,
as follows: [0028] a. Decubitus/Pressure Ulcers--A decubitus ulcer
or pressure sore is a lesion caused by unrelieved pressure
resulting in damage of the underlying tissue. Decubitus ulcers
usually develop over a bony prominence such as the elbow or hip.
The unrelieved pressure, along with numerous contributing factors,
leads to the skin breakdown and persistent ulcerations. [0029] b.
Venous Ulcers--Venous ulcers may result from trauma or develop
after chronic venous insufficiency (CVI). In CVI, venous valves do
not close completely, allowing blood to flow back from the deep
venous system through the perforator veins into the superficial
venous system. Over time, the weight of this column of blood causes
fluid and protein to exude into surrounding tissues, resulting in
swollen, hyperpigmented ankles, tissue breakdown, and ulceration.
Venous ulcers may be shallow or extend deep into muscle. [0030] c.
Arterial Ulcers--Leg ulcers also can develop in patients with
arterial insufficiency caused by arterial vessel compression or
obstruction, vessel wall changes, or chronic vasoconstriction.
Smokers face an especially high risk of arterial disease because
nicotine constricts arteries, encourages deposits of
atherosclerotic plaque, and exacerbates inflammatory arterial
disease (Buerger's disease) and vasoconstrictive disease (Raynaud's
disease or phenomenon). Arterial ulcers, caused by trauma to an
ischemic limb, can be very painful. [0031] d. Diabetic
Ulcers--Arterial insufficiency can be the cause of a nonhealing
ulcer in a patient with diabetes. However, most diabetic ulcers
result from diabetic neuropathy--because the patient cannot feel
pain in his foot, he is unaware of injuries, pressure from
too-tight shoes, or repetitive stress that can lead to skin
breakdown.
[0032] There remains a need in the art for the formulation and
development of new disinfectants and topically applicable
preparations for the treatment of dermal disorders, such as wounds,
burns, abrasions, infections, ulcerations, psoriasis and acne.
C. Contact Lens Soaking and Disinfection
[0033] Whenever a contact lens is removed from an eye, it should be
placed in a soaking and disinfecting solution until it is worn
again. Soaking and disinfecting solutions have the following
functions: [0034] 1. Assist in cleaning the lens of ocular
secretions after the lens is removed form the eye; [0035] 2. To
prevent eye infections by a bacterial contaminated lens; and [0036]
3. To maintain the state of hydrated equilibrium, which the lens
achieves while it is being worn.
D. Contact Lens Cleaning
[0037] During lens wear mucus material, lipids and proteins
accumulate on contact lenses, making lens wear uncomfortable due to
irritation, burning sensation, and redness. Accordingly, vision
becomes blurry. To alleviate the discomforting problem, the soft or
rigid contact lenses should be taken out of the eye, to be cleaned
and disinfected regularly, using an enzymatic cleaner and a
disinfecting solution. One of the serious complications associated
with soft lenses can be a Giant Papillary Conjunctivitis (GPC). It
is believed to be that the occurrence of the giant papillary
conjunctivitis is mostly due to an inflammatory reaction associated
with soft contact lens complication. This is almost always caused
by protein deposits on contact lenses. GPC produces symptoms
ranging from asymptomatic to itching, upper eye-lid edema, red eye,
mucoid discharge, progressive contact lens intolerance. The
in-the-eye cleaner of the present invention effectively cleans the
protein deposits and maintains corneal epithelial cells healthy by
keeping the corneal surface from microbial infection as well as by
supplying molecular oxygen. Thereby, it provides convenience and
benefits to both soft and rigid contact lens wearers.
E. Treatment of Ophthalmic Disorders
[0038] i. Dry Eye
[0039] Dry eye is a syndrome in which tear production is inadequate
or tear composition is inappropriate to properly wet the cornea and
conjunctiva. A variety of disorders of the ocular tears causes
sensations of dryness of the eyes, discomfort of presence of a
foreign object to occur in the eye. In most instances, the tear
film loses its normal continuity and breaks up rapidly so that it
cannot maintain its structure during the interval between
spontaneous blinks. All of those tear abnormalities may have
multiple causes. Perhaps the most common form of dry eye is due to
a decreased aqueous component in the tears. Untreated dry eye can
be further deteriorated to produce more severe epithelial erosion,
strands of epithelial cells, and local dry spots on the cornea,
which can be further complicated by microbial infection. In its
mild form, however, a feeling of dryness and irritation of the eye
can be solved with artificial tears. Thus, artificial tear solution
which has a broad spectrum antimicrobial activity with corneal
lubricating property, can provide not only comfort but also
beneficial effects on recovery of damaged corneal surface. [0040]
ii. Allergic Conjunctivitis
[0041] Airborne or hand borne allergens usually produce allergic
conjunctivitis due to IgE-mediated hypersensitivity reaction. It
presents itching, tearing, dry and sticky eyes, including
lid-swelling, conjunctival hyperemia, papillary reaction, chemosin,
and ropy mucoid discharge. The presence of hyaluronic acid in the
tear, which is included in the formulation of artificial tear,
would protect corneal surface from contacting the allergens. The
broad spectrum antimicrobial agent of the present invention keeps
the corneal surface from bacterial infection and also maintains the
corneal epithelial cells healthy by supplying molecular oxygen.
Thus, it provides beneficial effects on the eyes sensitive to
allergens. [0042] iii. Bacterial Invasion
[0043] Bacterial keratitis is one of the leading causes of
blindness in the world. In the United States, an estimated 30,000
cases occur annually, with the popularity of contact lens wear
having contributed to a rising incidence in the developed world.
Statistical investigation indicates that about 30 of every 100,000
contact lens wearers develop ulcerative keratitis annually in the
United States, thus making the disease a significant public health
issue in view of potential blindness that can occur. While eyelids,
blinking of the eyelids, and corneal and conjunctival epithelial
cells provide barriers to microbial invasion, one or more of these
defense mechanisms can become compromised. Such compromises can
include lid abnormalities, exposure of the corneal surface, poor
tear production, epithelial problems, medication toxicity, trauma,
and incisional surgery. Ocular manifestations of bacterial
keratitis are found in staphylococcus and streptococcus infections
that tend to cause severe infiltration and necrosis which over time
can lead to perforation. Pseudomonal keratitis tends to progress
rapidly. This organism produces destructive enzymes, such as
protease, lipase, and elastase, and exotoxins, which result in
necrotic ulceration and perforation. Serratia keratitis starts as a
superficial para-central ulcer, with the secretion of exotoxins and
protease which can produce aggressive ulceration and perforation.
In order for the bacterial keratitis to become established,
microbial adhesions must bind to host cell receptors. Once this
attachment has occurred, the destructive process of inflammation,
necrosis, and angiogenesis can ensue.
[0044] Present treatment for bacterial keratitis relies primarily
upon the use of broad spectrum antibiotic therapy. Such antibiotics
include sulfonamides, trimethaprin, and quinolones. Also included
are beta-lactams, penicillins, cephalasporins, aminoglycosides,
tetracyclines, chloramphenicol, and erythromycin. While such
antibiotics are in wide spread use, they can also become misused
where antibiotic resistant pathogens emerge. Additionally,
antibiotics only halt the proliferation of bacteria, but do not
inhibit the activity of protease enzymes, endotoxins, or exotoxins.
As is therefore apparent, a significant need is present for a
bactericidal agent that addresses the proliferation of not only
bacteria, but also protease enzymes, endotoxins and exotoxins.
BRIEF SUMMARY
[0045] The present invention provides antimicrobial preparations
(e.g., solutions, gels, ointments, creams, etc.) for disinfection
of articles or surfaces (e.g., contact lenses, counter tops, etc.),
antisepsis of skin or other body parts, prevention or minimization
of scarring, and/or treatment or prophylaxis of dermal (i.e., skin
or mucous membrane) disorders (e.g., wounds, burns, infections,
cold sores, ulcerations, psoriasis, scar forming lesions, acne),
and the treatment of ophthalmic disorders (e.g., infection,
inflammation, dry eye, allergic conjunctivitis, and wound healing).
The antimicrobial preparations of this invention generally comprise
from about 0.001% to about 0.20% by weight of a metal chlorite in
combination with from 0.001% to 0.05% of a peroxy compound such as
hydrogen peroxide. Additionally, the chlorite/peroxide preparations
of the present invention may contain additional components such as
polymeric lubricants and surfactants, and/or may be formulated in a
polymeric drug delivery system or liposomal preparation. The
chlorite/peroxide preparations of the present invention have broad
antimicrobial activity, including for example activity against gram
negative and gram positive bacteria, yeasts and fungi. Moreover,
when applied or administered to treat derial disorders (e.g.,
wounds, burns, infections, ulcerations, acne and psoriasis), the
chlorite/peroxide preparations of the present invention will not
only prevent or lessen microbial infection, but will additionally
provide oxygen to the affected tissue, assist in healing and deter
scar formation.
[0046] Further, in accordance with the invention, there are
provided methods for disinfection of items (e.g., contact lenses)
and methods for treatment of dermal disorders (e.g., wounds, burns,
infections, ulcerations and psoriasis) by application or
administration of a chlorite/peroxide preparation of the present
invention. With respect to contact lens disinfecting solution, as
well as product formulations that will clean contact lenses in the
eye without removing the lenses from the eye for cleaning, the
concentration of the metal chlorite is between about 0.002% to
about 0.20%. With respect to in-eye application, the present
bactericidal product is a sterile, isotonic, buffered, clear,
colorless solution that additionally contains polymeric lubricant
and surfactant. The product has a two-year shelf life when stored
in a container (e.g., a white opaque plastic bottle) at room
temperature as a stabilized peroxy chloral complex of chlorite and
peroxide.
[0047] In addition, the invention includes product formulations
shown to have efficacy in the treatment of dry eye, wound healing,
and allergic conjunctivitis.
[0048] Further in accordance with the invention, there are provided
methods for deterring scar formation by application or
administration of a chlorite/peroxide preparation of the present
invention.
[0049] Further, in accordance with the invention, there are
provided product formulations shown to have supra-additive efficacy
in broad spectrum antimicrobial activity.
[0050] Furthermore, in accordance with the invention, there are
provided methods for deterring eye infections, eye perforations and
inflammation by application or administration of a
chlorite/peroxide preparation of the present invention.
[0051] Further aspects and objects of the present invention will
become apparent to those of skill in the art upon reading and
understanding of the following detailed description and the
examples set forth therein.
BRIEF DESCRIPTION OF THE DRAWINGS
[0052] FIG. 1 is a graph demonstrating the non-production of
chlorine dioxide at room temperature in the chlorite/peroxide
preparation of the present invention at pH level 7.3;
[0053] FIG. 2 is a graph demonstrating the non-production of
chlorine dioxide at room temperature in the chlorite/peroxide
preparation of the present invention at pH level 8.0;
[0054] FIG. 3 is a graph demonstrating the non-production of
chlorine dioxide at room temperature in the chlorite/peroxide
preparation of the present invention at pH level 8.8;
[0055] FIG. 4 is a graph demonstrating the non-production of
chlorine dioxide at room temperature in the chlorite/peroxide
preparation of the present invention at pH level 7.0;
[0056] FIG. 5 is a graph demonstrating the non-production of
chlorine dioxide at room temperature in the chlorite/peroxide
preparation of the present invention at pH level 6.44;
[0057] FIG. 6 is a graph demonstrating the non-production of
chlorine dioxide at room temperature in the chlorite/peroxide
preparation of the present invention at pH level 6.0; and
[0058] FIG. 7 is a graph demonstrating the production of chlorine
dioxide at room temperature in the chlorite/peroxide preparation of
the present invention at a pH level of 1.5.
DETAILED DESCRIPTION
[0059] The following detailed description and examples are provided
for the purpose of describing certain exemplary embodiments of the
invention only, and are not intended to limit the scope of the
invention in any way.
[0060] The present invention provides preparations which contain
chlorite (e.g., a metal chlorite such as sodium chlorite) in
combination with a small amount of hydrogen peroxide in neutral
aqueous (pH 5.0-8.8, preferably pH 7.0-7.8, and more preferably pH
7.0-7.4) solution. These preparations exhibit synergistic
antimicrobial activity without generating chlorine dioxide during
storage at room temperature, thereby rendering the stability of
these solutions acceptable for pharmaceutical use. For example, an
aqueous solution containing 400 ppm chlorite plus 100 ppm hydrogen
peroxide remains stable beyond 18 months at room temperature, and
is effective to reduce Candida albicans activity by 1.0 log within
six hours of challenge, even though the individual components of
such solution are ineffective when applied separately at the same
concentrations to reduce Candida albicans activity. Additionally,
the hydrogen peroxide present within the chlorite/peroxide
solutions of the present invention readily decomposes into
molecular oxygen and water, upon contact with the peroxidase and
catalase enzymes present in tissue and/or some body fluids. Such in
situ generation of molecular oxygen contributes to cell vitality
and enhances wound healing.
[0061] The chlorite/H.sub.2O.sub.2 solutions of the present
invention are sufficiently stable to be formulated in combination
with polymeric lubricants (non-ionic and/or anionic; e.g., HPMC,
Methocel, CMC, hyaluronic acid, etc.,) and/or in combination with
block polymer based surfactants (e.g., pluronics). For example, an
aqueous chlorite/hydrogen peroxide system can be formulated
together with methocel or hyaluronic acid as a lubricant and
pluronics as a surfactant for contact lens disinfectant solution
(viscosity up to 50 cps at 25 degrees C.) in an ophthalmically
acceptable tonicity (e.g., osmolality of at least about 200
mOsmol/kg) and a buffer to maintain the pH of the formulation
within an acceptable physiological range. The formulation of the
contact lens disinfection solution, artificial tear solution, and
in-eye cleaner solution, contains chlorite preferably from about
0.005 to about 0.06 weight/volume percent and hydrogen peroxide
preferably from about 0.0002 to about 0.05 weight/volume percent.
Again, the presence of hydrogen peroxide provides the beneficial
oxygen molecule to the cornea upon contact with catalase in the
tear.
A. Formulations
[0062] The chlorite/peroxide preparations of the present invention
may be formulated in various ways, including liquid solutions,
gels, ointments, creams, sprays, etc. Set forth herebelow are a few
examples of the types of specific formulations which may be
prepared in accordance with this invention. [0063] i. Stable
Chlorite/Peroxide Liquid Solutions
[0064] The following Formula 1 is a first preferred formulation of
a liquid chlorite/peroxide solution of the present invention:
TABLE-US-00001 FORMULA 1 Sodium Chlorite 0.005%-0.10% Hydrogen
Peroxide 0.005%-0.05% Methocel A 0.05%-0.2% Boric Acid 0.15% Sodium
Chloride 0.75% Pluronic F-68/F-127 0.1% HCl or NaOH Adjust pH 7.4
Purified water Q.S. to volume
[0065] The following Formula 2 is a second preferred formulation of
a liquid chlorite/peroxide solution of the present invention:
TABLE-US-00002 FORMULA 2 Sodium Chlorite 0.05% Hydrogen Peroxide
0.02% Carboxymethyl Cellulose 0.01% Boric Acid 0.15% Sodium
Chloride 0.75% Pluronic F-68/F-127 0.1% HCl or NaOH Adjust pH 7.3
Purified water Q.S. to volume
[0066] The chlorite/peroxide solutions of the present invention,
such as the solution of the above-shown preferred formulation, may
be used for a variety of medical and non-medical applications
including but not necessarily limited to a) disinfection of
articles and surfaces such as contact lenses, medical/dental
instruments, counter tops, treatment tables, combs and brushes,
etc.; antisepsis of skin or body parts (e.g., a disinfectant hand
wash, antiseptic facial scrub, etc.,) and b) treatment or
prophylaxis of dermal (i.e., skin or mucous membrane) disorders
such as wounds, burns, infections, ulcerations, cold sores,
psoriasis, acne, and c) deterrence or prevention of scar formation,
and d) treatment of ophthalmic disorders (e.g., infections or
inflammations caused by bacterial keratitis).
[0067] As pointed out earlier, the chlorite/hydrogen peroxide
system of the present invention is sufficiently stable to be
formulated in a polymeric gel form or in a paste form. Furthermore,
such polymeric gel or paste formulation can contain polymers which
delay or control the release of the chlorite/hydrogen peroxide
(e.g., a sustained release delivery system). Such sustained release
formulations provide outstanding benefits of increasing therapeutic
index by maintaining the effective concentration of
chlorite/H.sub.2O.sub.2 for a prolonged time on the injured sites,
by preventing the injured sites from external microbial
contamination by forming a seal over the injured sites, and by
providing oxygen molecule to the injured tissues. Unlike the
conventional ointment, the polymeric gel provides a dry, clean, and
comfortable coating on the injured sites upon application. Such gel
formulations may contain polymeric drug delivery vehicles like
hydroxypropyl methylcellulose (HPMC), methylcellulase (Methocel),
hydroxyethylcellulose (HEC), hyaluronic acid, and
carboxymethylcellulose (CMC), etc. [0068] ii. A Stable
Chlorite/Peroxide Gel
[0069] The following Formula 3 is a presently preferred formulation
of a chlorite/peroxide gel of the present invention: TABLE-US-00003
FORMULA 3 Sodium Chlorite 0.02%-0.10% Hydrogen Peroxide
0.005%-0.05% Methocel A 2.0% Boric Acid 0.15% Sodium Chloride 0.75%
Pluronic F-68/F-127 0.1% HCl or NaOH Adjust pH 7.4 Purified water
Q.S. to volume
[0070] Any of the preparations of the present invention may be
formulated for sustained release of the active components by
forming liposomes of the preparing in accordance with well known
liposomal forming techniques and/or by adding to the formulation a
pharmaceutically acceptable and effective amount (e.g., typically
1-20 percent by weight) of a sustained release component such as a
polymer matrix or one or more of the following: [0071] a cellulose
ester; [0072] hydroxymethylpropyl cellulose; [0073]
methylhydroxyethyl cellulose; [0074] hydroxypropyl cellulose;
[0075] hydroxyethyl cellulose; [0076] carboxymethyl cellulose;
[0077] a salt of a cellulose ester; [0078] cellulose acetate;
[0079] hydroxypropylmethyl cellulose phthalate; [0080] methacrylic
acid-methyl methacrylate copolymer; [0081] methacrylic acid-ethyl
acetate copolymer; [0082] polyvinylpyrolidone; [0083] polyvinyl
alcohol; [0084] hyaluronic acid; [0085] a phospholipid; [0086]
cholesterol; [0087] a phospholipid having a neutral charge; [0088]
a phospholipid having a negative charge; [0089] dipalmytoyl
phoshatidyl choline; [0090] dipalmytoyl phoshatidyl serine; and,
sodium salts thereof. [0091] iii. A Stable Chlorite/Peroxide
Ophthalmic Solution
[0092] The following Formula 4 is a presently preferred formulation
of a chlorite/peroxide contact lens disinfecting solution for use
in cleaning contact lenses residing in or out of the eye. The
formulation additionally functions as a tear product for
lubrication in dry-eye subjects. TABLE-US-00004 FORMULA 4 Sodium
Chlorite 0.002%-0.20% Hydrogen Peroxide 0.005%-0.05% Hyaluronic
Acid 0.001%-0.50% Boric Acid 0.15% Sodium Chloride 0.75% Pluronic
127 0.05%-2.0% HCl or NaOH Adjust pH to 7.4 Purified Water Q.S. to
Volume
[0093] As indicated earlier, the chlorite/peroxide preparation of
the present invention, whether it be in the form of liquid
solution, gel, ointment, cream, spray, etc., is specifically
composed to maintain chlorite such as sodium chlorite and hydrogen
peroxide as active ingredients at a pH range of 5.0-8.8 without
generating chlorine dioxide during storage at room temperature. By
way of illustration, multiple experiments were conducted on the
liquid sodium chlorite/hydrogen peroxide solution in accordance
with Formula 2 at different levels of pH within the specified
range. However, it should be expressly stated herein that such
experimentations should in no way be limited to liquid solution
forms only, but are performed to illustrate the non-production of
chlorine dioxide in the various forms of the present
chlorite/peroxide preparation at different pH levels.
[0094] The following experimentations were designed to demonstrate
the stability of chlorite such as sodium chlorite and hydrogen
peroxide antibacterial formulation at neutral, basic and acidic
levels of pH. More specifically, the quantitative levels of sodium
chlorite and the generation of chlorine dioxide were determined at
the pH levels of 7.3, 8.0, 8.8, 7.0, 6.44 and 6.0. 0.1 Normal
hydrochloric acid solution and 0.1 Normal sodium hydroxide solution
were applied to adjust the pH levels in the experimentations.
Sterile 0.9% sodium chloride sterile solution was also applied. A
placebo solution with the following formulation was further applied
in a spectrophotometer (e.g., Lambda 20 Model UV--Vis.
spectrophotometer) to find and measure the levels of sodium
chlorite and the generation of chlorine dioxide at varying pH
levels: TABLE-US-00005 Placebo Solution Hydrogen Peroxide 0.02%
Carboxymethyl Cellulose 0.01% Boric Acid 0.15% Sodium Chloride
0.75% Pluronic F-68/F-127 0.1% HCl or NaOH Adjust pH 7.3 Purified
water Q.S. to volume
[0095] Experiment 1: pH Level of 7.3
[0096] Experiment: Fill the first cuvette with the placebo
solution, wipe it clean, and place the cuvette in the standard beam
path of the spectrophotometer. Fill the second cuvette with the
liquid sodium chlorite/hydrogen peroxide solution, wipe it clean
and place the cuvette in the sample beam path of the
spectrophotometer. Scan the solutions from 200 nm to 400 nm and
record the results. Plot and printout the results, as illustrated
in the graph shown in FIG. 1.
[0097] Result: The liquid solution contained sodium chlorite and
hydrogen peroxide as active ingredients, as well as buffering and
tonicity agents at the pH level of 7.3. The placebo solution
contained hydrogen peroxide as active ingredient, as well as
buffering and tonicity agents at the pH level of 7.3.
[0098] Hydrogen peroxide does not absorb in the 200 nm to 400 nm
range. Therefore, as seen in FIG. 1, absorption peaks for hydrogen
peroxide were not detected.
[0099] Sodium chlorite has an absorption maximum at 260 nm, while
chlorine dioxide which is a degradation product of sodium chlorite
has an absorption maximum at 355 nm-358 nm.
[0100] Scanning the solutions that have a pH of 7.3 between the 200
nm and 400 nm will give a quantitative value for sodium chlorite as
well as chlorine dioxide in the same scan.
[0101] Interpretation: The liquid sodium chlorite/hydrogen peroxide
solution does show sodium chlorite peak at 260 nm, but does not
show any chlorine dioxide peak at 355 nm-358 nm.
[0102] This clearly indicates that at pH level of 7.3, the liquid
sodium chlorite/hydrogen peroxide solution has only sodium
chlorite, and does not contain any quantities of chlorine dioxide.
This is a clear indication that sodium chlorite is stable at pH
level of 7.3, and the sodium chlorite is not breaking up and
forming the chlorine dioxide.
[0103] Experiment 2: pH Level of 8.0
[0104] Experiment: Dispense 25 mL. of the placebo solution and 25
mL. of the liquid sodium chlorite/hydrogen peroxide solution into 2
clean containers. Add 0.1 Normal sodium hydroxide solution to each
container so as to adjust the pH of both the placebo solution as
well as the liquid solution to a pH level of 8.0.
[0105] Fill one of the cuvette with the placebo solution, wipe it
clean, and place the cuvette in the standard beam path of the
spectrophotometer. Fill the second cuvette with the liquid sodium
chlorite/hydrogen peroxide solution, wipe it clean and place the
cuvette in the sample beam path of the spectrophotometer. Scan the
solutions from 200 nm to 400 nm and record the results. Plot and
printout the results, as illustrated in the graph shown in FIG.
2.
[0106] Result: The liquid sodium chlorite/hydrogen peroxide
solution contained sodium chlorite and hydrogen peroxide as active
ingredients, as well as buffering and tonicity agents at the pH
level of 8.0. The placebo solution contained hydrogen peroxide as
active ingredient, as well as buffering and tonicity agents at the
pH level of 8.0.
[0107] As mentioned shortly above, hydrogen peroxide does not
absorb in the 200 nm to 400 nm range. Therefore, as seen in FIG. 2,
absorption peaks for hydrogen peroxide were not detected. As also
mentioned above, sodium chlorite has an absorption maximum at 260
nm, while chlorine dioxide which is a degradation product of sodium
chlorite has an absorption maximum at 355 nm-358 nm.
[0108] Scanning the solutions that have a pH level of 8.0 between
the 200 nm and 400 nm will give a quantitative value for sodium
chlorite as well as chlorine dioxide in the same scan.
[0109] Interpretation: The liquid sodium chlorite/hydrogen peroxide
solution does show sodium chlorite peak at 260 nm, but does not
show any chlorine dioxide peak at 355 nm-358 nm. This clearly
indicates that at the pH level of 8.0, the liquid sodium
chlorite/hydrogen peroxide solution has only sodium chlorite, and
does not contain any quantities of chlorine dioxide. This is a
clear indication that sodium chlorite is stable at the pH level of
8.0, and the chlorite is not breaking up and forming chlorine
dioxide.
[0110] Experiment 3: pH Level of 8.8
[0111] Dispense 25 mL. of the placebo solution and 25 mL. of the
liquid sodium chlorite/hydrogen peroxide solution into 2 clean
containers. Add 0.1 Normal sodium hydroxide solution to each
container so as to adjust the pH of both the placebo solution as
well as the liquid solution to a pH level of 8.8.
[0112] Fill one of the cuvette with the placebo solution, wipe it
clean, and place the cuvette in the standard beam path of the
spectrophotometer. Fill the second cuvette with the liquid sodium
chlorite/hydrogen peroxide solution, wipe it clean and place the
cuvette in the sample beam path of the spectrophotometer. Scan the
solutions from 200 nm to 400 nm and record the results. Plot and
printout the results, as illustrated in the graph shown in FIG.
3.
[0113] Result: The liquid sodium chlorite/hydrogen peroxide
solution contained sodium chlorite and hydrogen peroxide as active
ingredients, as well as buffering and tonicity agents at the pH
level of 8.8. The placebo solution contained hydrogen peroxide as
active ingredient, as well as buffering and tonicity agents at the
pH level of 8.8.
[0114] As already discussed, hydrogen peroxide does not absorb in
the 200 nm to 400 nm range. Therefore, as seen in FIG. 3,
absorption peaks for hydrogen peroxide were not detected. As also
discussed, sodium chlorite has an absorption maximum at 260 nm,
while chlorine Dioxide which is a degradation product of sodium
chlorite has an absorption maximum at 355 nm-358 nm.
[0115] Scanning the solutions that have a pH level of 8.8 between
the 200 nm and 400 nm will give a quantitative value for sodium
chlorite as well as chlorine dioxide in the same scan.
[0116] Interpretation: The liquid sodium chlorite/hydrogen peroxide
solution does show sodium chlorite peak at 260 nm, but does not
show any chlorine dioxide peak at 355 nm-358 nm. This clearly
indicates that at the pH level of 8.8, the liquid sodium
chlorite/hydrogen peroxide solution has only sodium chlorite, and
does not contain any quantities of chlorine dioxide. This is a
clear indication that sodium chlorite is stable at the pH level of
8.8, and the chlorite is not breaking up and forming chlorine
dioxide.
[0117] Experiment 4: pH Level of 7.0
[0118] Experiment: Dispense 25 mL. of the placebo solution and 25
mL. of the liquid sodium chlorite/hydrogen peroxide solution into 2
clean containers. Add 0.1 Normal hydrochloric acid solution to each
container so as to adjust the pH of both the placebo solution as
well as the liquid solution to a pH level of 7.0.
[0119] Fill one of the cuvette with the placebo solution, wipe it
clean, and place the cuvette in the standard beam path of the
spectrophotometer. Fill the second cuvette with the liquid sodium
chlorite/hydrogen peroxide solution, wipe it clean and place the
cuvette in the sample beam path of the spectrophotometer. Scan the
solutions from 200 nm to 400 nm and record the results. Plot and
printout the results, as illustrated in the graph shown in FIG.
4.
[0120] Result: The liquid sodium chlorite/hydrogen peroxide
solution contained sodium chlorite and hydrogen peroxide as active
ingredients, as well as buffering and tonicity agents at the pH
level of 7.0. The placebo solution contained hydrogen peroxide as
active ingredient, as well as buffering and tonicity agents at the
pH level of 7.0. Hydrogen peroxide does not absorb in the 200 nm to
400 nm range. Therefore, as seen in FIG. 4, absorption peaks for
hydrogen peroxide were not detected.
[0121] Sodium chlorite has an absorption maximum at 260 nm, while
chlorine dioxide which is a degradation product of sodium chlorite
has an absorption maximum at 355 nm-358 nm. Scanning the solutions
that have a pH of 7.0 between the 200 nm and 400 nm will give a
quantitative value for sodium chlorite as well as chlorine dioxide
in the same scan.
[0122] Interpretation: The sodium chlorite/hydrogen peroxide
solution does show sodium chlorite peak at 260 nm, but does not
show any chlorine dioxide peak at 355 nm-358 nm. This clearly
indicates that at the pH level of 7.0, the liquid solution has only
sodium chlorite, and does not contain any quantities of chlorine
dioxide. This is a clear indication that sodium chlorite is stable
at pH of 7.0, and the chlorite is not breaking up and forming
chlorine dioxide.
[0123] Experiment 5: pH Level of 6.44
[0124] Experiment: Dispense 25 mL. of the placebo solution and 25
mL. of the liquid sodium chlorite/hydrogen peroxide solution into 2
clean containers. Add 0.1 Normal hydrochloric acid solution to each
container so as to adjust the pH of both the placebo solution as
well as the liquid solution to a pH level of 6.44.
[0125] Fill one of the cuvette with the placebo solution, wipe it
clean, and place the cuvette in the standard beam path of the
spectrophotometer. Fill the second cuvette with the liquid
solution, wipe it clean and place the cuvette in the sample beam
path of the spectrophotometer. Scan the solutions from 200 nm to
400 nm and record the results. Plot and printout the results, as
illustrated in the graph shown in FIG. 5.
[0126] Result: The liquid sodium chlorite/hydrogen peroxide
solution contained sodium chlorite and hydrogen peroxide as active
ingredients, as well as buffering and tonicity agents at the pH
level of 6.44.
[0127] The placebo solution contained hydrogen peroxide as active
ingredient, as well as buffering and tonicity agents at pH=6.44.
Hydrogen peroxide does not absorb in the 200 nm to 400 nm range,
and thus no absorption peaks for hydrogen peroxide were detected.
Sodium chlorite has an absorption maximum at 260 nm, while chlorine
dioxide which is a degradation product of sodium chlorite has an
absorption maximum at 355 nm-358 nm.
[0128] Scanning the solutions that have a pH of 6.44 between the
200 nm and 400 nm will give a quantitative value for sodium
chlorite as well as chlorine dioxide in the same scan.
[0129] Interpretation: The liquid sodium chlorite/hydrogen peroxide
solution does show sodium chlorite peak at 260 nm, but does not
show any chlorine dioxide peak at 355 nm-358 nm. This clearly
indicates that at pH of 6.44, the liquid solution has only sodium
chlorite, and does not contain any quantities of chlorine dioxide.
This is a clear indication that sodium chlorite is stable at pH of
6.44, and the chlorite is not breaking up and forming chlorine
dioxide.
[0130] Experiment 6: pH Level of 6.0
[0131] Experiment: Dispense 25 mL. of the placebo solution and 25
mL. of the liquid sodium chlorite/hydrogen peroxide solution into 2
clean containers. Add 0.1 Normal hydrochloric acid solution to each
container so as to adjust the pH of both the placebo solution as
well as the liquid solution to a pH level of 6.0.
[0132] Fill one of the cuvette with the placebo solution, wipe it
clean, and place the cuvette in the standard beam path of the
spectrophotometer. Fill the second cuvette with the liquid sodium
chlorite/hydrogen peroxide solution, wipe it clean and place the
cuvette in the sample beam path of the spectrophotometer. Scan the
solutions from 200 nm to 400 nm and record the results. Plot and
printout the results, as illustrated in the graph shown in FIG.
6.
[0133] Result: The liquid sodium chlorite/hydrogen peroxide
solution contained sodium chlorite and hydrogen peroxide as active
ingredients, as well as buffering and tonicity agents at the pH
level of 6.0. The placebo solution contained hydrogen peroxide as
active ingredient, as well as buffering and tonicity agents at the
pH level of 6.0. Hydrogen peroxide does not absorb in the 200 nm to
400 nm range. Therefore, as seen in FIG. 6, absorption peaks for
hydrogen peroxide were not detected.
[0134] Sodium chlorite has an absorption maximum at 260 nm, while
chlorine dioxide which is a degradation product of sodium chlorite
has an absorption maximum at 355 nm-358 nm.
[0135] Scanning the solutions that have a pH of 6.0 between the 200
nm and 400 nm will give a quantitative value for sodium chlorite as
well as chlorine dioxide in the same scan.
[0136] Interpretation: The sodium chlorite/hydrogen peroxide
solution does show sodium chlorite peak at 260 nm, but does not
show any chlorine dioxide peak at 355 nm-358 nm. This clearly
indicates that at pH level of 6.0, the liquid solution has only
sodium chlorite, and does not contain any quantities of chlorine
dioxide. This is a clear indication that sodium chlorite is stable
at pH of 6.0, and the chlorite is not breaking up and forming
chlorine dioxide.
[0137] Experiment 7: pH Level of 1.5
[0138] Experiment: Dispense 25 mL. of the placebo solution and 25
mL. of the liquid sodium chlorite/hydrogen peroxide solution into 2
clean containers. Add 0.1 Normal hydrochloric acid solution to each
container so as to adjust the pH of both the placebo solution as
well as the bactericidal solution to a pH of 1.5.
[0139] Fill one of the cuvette with the placebo solution, wipe it
clean, and place the cuvette in the standard beam path of the
spectrophotometer. Fill the second cuvette with the liquid
solution, wipe it clean and place the cuvette in the sample beam
path of the spectrophotometer. Scan the solutions from 200 nm to
400 nm and record the results. Plot and printout the results, as
illustrated in the graph shown in FIG. 7.
[0140] Result: The liquid sodium chlorite/hydrogen peroxide
solution contained sodium chlorite and hydrogen peroxide as active
ingredients, as well as buffering and tonicity agents at pH of 1.5.
The placebo solution contained hydrogen peroxide as active
ingredient, as well as buffering and tonicity agents at pH of 1.5.
As explained earlier, hydrogen peroxide does not absorb in the 200
nm to 400 nm range, and as such, no absorption peaks for hydrogen
peroxide were detected.
[0141] Also explained earlier, sodium chlorite has an absorption
maximum at 260 nm, while chlorine dioxide which is a degradation
product of sodium chlorite has an absorption maximum at 355 nm-358
nm. Scanning the solutions that have a pH of 1.5 between the 200 nm
and 400 nm will give a quantitative value for sodium chlorite as
well as chlorine dioxide in the same scan.
[0142] Interpretation: The liquid sodium chlorite/hydrogen peroxide
solution does not show sodium chlorite peak at 260 nm, but does
show a large chlorine dioxide peak at 355 nm-358 nm. This clearly
indicates that at the pH level of 1.5, the liquid sodium
chlorite/hydrogen peroxide solution does not have any sodium
chlorite. Rather, it clearly shows that the sodium chlorite has
been degraded and converted to chlorine dioxide. This is a clear
indication that at pH of 1.5, sodium chlorite is very unstable, and
all chlorite that is present in the liquid solution is converted to
chlorine dioxide.
[0143] Results for Experiments 1-7
[0144] The liquid sodium chlorite/hydrogen peroxide solution
contained sodium chlorite and hydrogen peroxide as active
ingredients, as well as buffering and tonicity agents at the pH
levels of 1.5, 6.0, 6.44, 7.0, 7.3, 8.0 and 8.8.
[0145] The placebo solution contained hydrogen peroxide as active
ingredient, as well as buffering and tonicity agents at the pH
levels of 1.5, 6.0, 6.44, 7.0, 7.3, 8.0 and 8.8.
[0146] Hydrogen peroxide does not absorb in the 200 nm to 400 nm
range.
[0147] Sodium chlorite has an absorption maximum at 260 nm, while
chlorine dioxide has an absorption maximum at 355 nm-358 nm.
[0148] Scanning the solutions between the 200 nm and 400 nm gave a
quantitative value for sodium chlorite as well as chlorine dioxide
in the same scan.
[0149] Interpretation of Results for Experiments 1-7
[0150] The liquid sodium chlorite/hydrogen peroxide solutions at
the pH levels of 6.0, 6.44, 7.0, 7.3, 8.0 and 8.8 does show the
presence of sodium chlorite peak at 260 nm, but does not show the
presence of chlorine dioxide peak at 355 nm-358 nm.
[0151] In contrast, the liquid sodium chlorite/hydrogen peroxide
solution at pH of 1.5 does not show the presence of sodium chlorite
peak at 260 nm, but does show the presence of chlorine dioxide peak
at 355 nm-358 nm.
[0152] Conclusion of Results for Experiments 1-7
[0153] The results clearly show that one can quantitatively
determine the level of sodium chlorite as well as chlorine dioxide
which is present in the liquid sodium chlorite/hydrogen peroxide
solution at the pH levels of 1.5, 6.0, 6.44, 7.0, 7.3, 8.0 and
8.8.
[0154] The results also show that the storage of the liquid sodium
chlorite/hydrogen peroxide solution at about room temperature
(e.g., in a white opaque bottle exposed to air at room temperature)
does not produce any chlorine dioxide as determined by the absence
of any absorbance at 355 nm-358 nm.
[0155] In conclusion, the results of Experiments 1-7 clearly
indicate that the liquid sodium chlorite/hydrogen peroxide solution
retains sodium chlorite at the pH range of 6.0-8.8 without the
generation of chlorine dioxide. The liquid solution, however,
degrades and generates chlorine dioxide upon the acidification of
the solution to pH of 1.5. Thus, these results also strongly
indicate that the liquid sodium chlorite/hydrogen peroxide solution
does not contain chlorine dioxide when it is manufactured, nor does
the solution degrade to generate chlorine dioxide after storage at
about room temperature at the pH levels of 6.0, 6.44, 7.0, 7.3,
8.0, or 8.8.
[0156] Furthermore, these results present clear evidence that the
liquid sodium chlorite/hydrogen peroxide solution of the present
invention has its bactericidal properties in the pH range studied
due to the sodium chlorite/ hydrogen peroxide and not due to
chlorine dioxide. This is very much unlike other prior art
inventions that have sodium chlorite as a starting material as, but
the active bactericide is the chlorine dioxide which is generated
by the acidification of the sodium chlorite.
B. Examples of Therapeutic Applications
[0157] The following are specific examples of therapeutic
applications of the chlorite/peroxide preparations of the present
invention.
i. EXAMPLE 1
Treatment of Psoriasis-No Crossover
[0158] A human patient having psoriasis plaques present on both
arms is treated as follows:
[0159] Twice daily application to plaques on the left arm only, of
a chlorite/peroxide solution having the following formulation:
TABLE-US-00006 Sodium Chlorite 0.06% Hydrogen Peroxide 0.01% HPMC
2.0% Boric Acid 0.15% HCl or NaOH to adjust pH 7.4 Purified water
Q.S. to volume
[0160] Twice daily application to plaques on the right arm only of
a commercially available 0.1% triamcinolone acetonide cream.
[0161] The chlorite/peroxide treated psoriatic plaques on the right
arm began to become less severe within 24 hours of beginning
treatment and had substantially disappeared within three days of
beginning treatment. However, the triamcinolone acetonide treated
psoriatic plaques present on the left arm remained unchanged and
inflamed during the two week treatment period.
ii. EXAMPLE 2
Treatment of Psoriasis-Crossover
[0162] A human patient having psoriasis plaques present on both
arms is treated for two weeks, as follows:
[0163] Twice daily application to plaques on the left arm only, of
a chlorite/peroxide solution having the following formulation:
TABLE-US-00007 Sodium Chlorite 0.06% Hydrogen Peroxide 0.01% HPMC
2.0% Boric Acid 0.15% HCl or NaOH to adjust pH 7.4 Purified water
Q.S. to volume/100%
[0164] Twice daily application to plaques on the right arm only of
a commercially available 0.1% triamcinolone acetonide cream.
[0165] The chlorite/peroxide treated psoriatic plaques on the right
arm began to become less severe within 24 hours of beginning
treatment and had substantially disappeared within one week of
beginning treatment. However, the triamcinolone acetonide treated
psoriatic plaques present on the left arm remained unchanged and
inflamed during the two week treatment period.
[0166] Beginning the day after the end of the initial two week
treatment period, and continuing for a second two week treatment
period, the patient was treated as follows:
[0167] Twice daily application to plaques on the left arm only of
the same commercially available 0.1% triamcinolone acetonide cream
described hereabove in this example.
[0168] Twice daily application to plaques on the right arm only, of
the same chlorite/peroxide sustained release gel described
hereabove in this example.
[0169] Within 24 hours of commencing the second treatment period,
the psoriatic lesions on the right arm began to subside. By day
three and continuing through the end of the second two week
treatment period, the psoriatic lesions on the right arm had
substantially disappeared.
iii. EXAMPLE 3
Treatment of Cold Sores
[0170] A patient with painful, fluid-containing cold sores (i.e.,
chancre sores) on his lips was treated twice daily by application
to the lips of a chlorite/peroxide preparation prepared in
accordance with Formula 1 above.
[0171] Within 6 to 12 hours of the first application of the
chlorite/peroxide preparation, the patient reported that the pain
had subsided. Within 24 hours of the first application of the
chlorite/peroxide preparation, the fluid contained within the cold
sores had substantially dissipated and the cold sores appeared dry.
Within six days of the first application of the chlorite/peroxide
preparation the cold sores had substantially disappeared and the
lips appeared normal, whereas cold sores of such severity typically
require substantially longer than six days to completely disappear
and heal.
iv. EXAMPLE 4
Treatment of Venous Ulcer
[0172] A patient with a venous ulcer on the right leg of 3-4 cm
diameter which had been present for 9-12 months was treated by
twice daily application to the ulcer of gauze soaked with a
chlorite/peroxide liquid solution prepared in accordance with
Formula 1 above.
[0173] Within three days after commencement of treatment the ulcer
appeared clean and dry. Within 14 days of the commencement of
treatment the ulcer began to decrease in size and healthy new
tissue was observed about its periphery. At 35 days after
commencement of treatment, the ulcer had completely healed, without
scarring, and the area where the ulcer had been located was free of
pain.
v. EXAMPLE 5
Treatment of Diabetic Decubitus Ulcer
[0174] A non-ambulatory, diabetic patient with decubitus ulcers on
both legs and some toes, of 12-18 month duration, was treated by
daily application of clean, sterile gauze to the ulcers and
saturation of each gauze, three times each day, with a liquid
chlorite/peroxide solution prepared in accordance with Formula 1
above. Within four to seven days of commencing the
chlorite/hydrogen peroxide treatments the ulcers began to appear
less inflamed, clean and dry. About seven to ten days after
commencement of the chlorite/hydrogen peroxide treatment,
granulation tissue began to form within the ulcers. Within 12 to 14
days, re-epithelialization was observed to have begun within the
ulcerated areas except for one toe ulcer which had been
particularly severe and had permeated to the bone of the toe.
Within 30 to 45 days of the commencement of treatment, all of the
ulcers except for the severe toe ulcer had completely closed and
re-epithelialized, without irregular scar formation. Also, at 30 to
45 days after the commencement of treatment, the toe ulcer had also
become substantially smaller (but was not completely closed) and
the patient was able to walk. The liquid and or gel formulations of
the present invention, such as Formulas 1 and 2 above, may also be
applied topically to prevent scar formation due to wounds, burns,
acne, infections, trauma, surgical incision, or any other
scar-forming lesion or disorder.
vi. EXAMPLE 6
a. Treatment of Dry Eye Conditions
[0175] Subjects with dry eye conditions have itchy and scratchy
eyes. In extreme cases, the subjects have more serious problems
that can interfere with health maintenance. Subjects were treated
with a preferred tear product of the following formulation:
TABLE-US-00008 Sodium Chlorite 0.005%-0.02% Hydrogen Peroxide 0.01%
Methylcellulose A4M 0.075% Hyaluronic Acid 0.10%-0.125% Boric Acid
0.15% Sodium Chloride, USP 0.75% Pluronic 127 0.10% HCl or NaOH
Adjust pH to 7.4 Purified Water Q.S. to Volume
[0176] Testing of dry eye subjects with rose bengal stain or
fluorescein gives a good indication regarding the condition of the
corneal epithelial health, while rose bengal staining provides a
good indication of the number of dead epithelial cells on the
cornea as well as conjunctiva.
[0177] Two subjects with dry eye condition were tested with rose
bengal stain, and the quantitative staining to the cornea and
conjunctiva was documented by photographs. The subjects started
using the above preferred tear product at a dosage of two drops
three times per day. At the end of two weeks, the two subjects were
tested with rose bengal stain and the level of staining was
quantitatively documented by photography. The results showed a 50%
to 70% reduction in rose bengal staining, which clearly indicates
that the preferred tear formulation was ameliorating the corneal
and conjunctival cells from dying.
[0178] In addition to an objective determination of the health of
the epithelial cells, the two subjects were tested subjectively
regarding the safety and efficacy of the preferred tear product.
First of all, slit-lamp biomicroscopy of the subjects during the
two-week treatment period did not show any redness, irritation,
inflammation, or other signs of discomfort. Second, the subjects
indicated that the application of the tear product completely
removed symptoms of redness, itching, scratching, pain, and dryness
due to dry eye while providing lubrication that lasted for several
hours. It is therefore evident that the tear product exhibits both
safety and efficacy in the treatment of dry eye. As is further
recognized in view of the foregoing antimicrobial activity of such
compositions, the tear product will also have efficacy in enhancing
wound healing within the eye such as after surgery where bacterial
infections are to be avoided.
b. Treatment of Allergic Conjunctivitis
[0179] In addition to treating dry eye condition with the above
preferred tear product, the product was also tested in the
treatment of conditions from allergic conjunctivitis. In
particular, two subjects suffering from allergic conjunctivitis
including itchy, scratchy eyes with constant tearing applied two
drops of the product three times per day. This dosage resulted in
the disappearance of the symptoms.
C. Examples of Contact Lens Cleansing
i. EXAMPLE 1
Soaking, Cleaning and Disinfecting
[0180] The following formulation is a preferred disinfecting
solution applicable to the cleaning of contact lenses by
conventional soaking. TABLE-US-00009 Sodium Chlorite 0.05% Hydrogen
Peroxide 0.02% Methylcellulose A4M 0.075% Hyaluronic Acid
0.05%-0.10% Boric Acid 0.15% Pluronic 127 0.25%-0.50% Sodium
Chloride USP 0.75% HCl or NaOH Adjust pH to 7.4 Purified Water Q.S.
to Volume
[0181] Six subjects using soft hydrophilic contact lenses soaked
the lenses in the above disinfecting solution and then placed the
lenses directly into the eyes. Soaking was performed nightly or on
an as-needed basis. All six subjects reported that the lenses felt
very comfortable, and that no adverse effects (e.g., burning,
stinging, redness, pain) were experienced. Additionally, the
solution extended the comfort and clean condition of the lenses for
several weeks beyond such extension experienced with other
commercially available disinfecting solutions.
[0182] The disinfecting solution can be used with soft hydrophilic
lenses of varying water content (e.g., 38% to 75%), as well as with
silicone acrylate rigid gas permeable lenses. Cycling studies of
soft lenses soaked daily in the solution for 30 days showed no
damage or change in the physical and chemical characteristics of
the lenses. Eye comfort, as earlier noted, is achieved through
non-binding and non-accumulating of preservative in soft or rigid
gas permeable lenses, while such binding and accumulation can be
found in certain currently commercially available formulations to
cause irritation and discomfort.
ii. EXAMPLE 2
Cleaning While Wearing
[0183] The following formulation is a preferred disinfecting in-eye
solution applicable to the cleaning of contact lenses while they
are being worn by introducing the solution into the eye:
TABLE-US-00010 Sodium Chlorite 0.02% Hydrogen Peroxide 0.01%-0.02%
Methylcellulose A4M 0.075% Hyaluronic Acid 0.075%-0.10% Boric Acid
0.15% Sodium Chloride USP 0.75% Pluronic 127 0.75% HCl or NaOH
Adjust pH to 7.4 Purified Water Q.S. to Volume
[0184] Four subjects applied two drops of the above in-eye solution
three times per day for 30 days to contact lenses while being worn.
Examinations of all of the subjects showed no irritation, burning,
stinging, or adverse effects of any kind. These subjects further
reported that the solution felt soothing and lubricating.
[0185] Two subjects were involved in a comparative study where,
first of all, they wore ACUVUE disposable lenses continuously for
two weeks with occasional removal and cleaning with commercially
available cleaning solutions followed with a saline rinse. After 14
days, the lenses became very gritty and uncomfortable, and were
discarded. Second, the two subjects started with new ACUVUE lenses
and practiced daily application of the present in-eye solution
three times per day without removing or touching the lenses. These
subjects were able to wear the lenses for three to four weeks
before replacement. Additionally, the inconvenience of cleaning the
lenses outside the eye was completely eliminated, as was the risk
of lens loss, tearing, or contamination. It is therefore evident
that the present in-eye cleaning solution provides cleansing
efficacy as well as convenience.
D. In-Vitro and In-Vivo Antimicrobial Efficacy
[0186] i. Synergistic Activity
[0187] Tables I and II compare the antimicrobial effects of (a) 400
ppm sodium chlorite alone; (b) 200 ppm hydrogen peroxide alone; and
(c) 400 ppm sodium chlorite and 200 ppm hydrogen peroxide in
combination against antibiotic-resistant strains of staphylococcus
haemolyticus (Table I) and pseudomonas aeruginosa (Table II) both
isolated from human infected eyes. Tables I and II summarize the
antimicrobial effects observed at time points one and two hours
after introduction of the test solutions. TABLE-US-00011 TABLE I
(staphylococcus haemolyticus:Initial inoculum = 1.01 .times.
10.sup.7:Log 7.03) Log Reduction Log Reduction Time NaClO.sub.2
alone H.sub.20.sub.2 alone NaClO.sub.2 & H.sub.20.sub.2 (hours)
(400 ppm) (200 ppm) (400 ppm & 200 ppm) 1 0.11 0.20 0.69 2 1.01
0.23 2.43
[0188] TABLE-US-00012 TABLE II (pseudomonas aeruginosa:Initial
inoculum = 2.22 .times. 10.sup.6:Log 6.35) Log Reduction Log
Reduction Time NaClO.sub.2 alone H.sub.20.sub.2 alone NaClO.sub.2
& H.sub.20.sub.2 (hours) (400 ppm) (200 ppm) (400 ppm & 200
ppm) 1 0.351 0.01 0.04 2 1.35 0.54 6.35
[0189] In the experiment summarized in Table I, sodium chlorite
alone caused a Log reduction in staphylococcus haemolyticus
bacteria of 0.11 at 1 hour and 1.01 at 2 hours. Hydrogen peroxide
alone caused a Log reduction in staphylococcus haemolyticus
bacteria of 0.20 at 1 hour and 0.23 at 2 hours and the combination
of sodium chlorite and hydrogen peroxide caused a Log reduction in
staphylococcus haemolyticus bacteria of 0.69 at 1 hour and 2.43 at
2 hours. Thus, in this experiment, the antimicrobial effect of the
sodium chlorite-hydrogen peroxide combination was significantly
greater than the sums of the effects of the sodium chlorite and
hydrogen peroxide alone, at least at the 2 hour time point.
Accordingly, it is concluded that the sodium chlorite-hydrogen
peroxide combination exhibited a supra-additive effect against the
strain of staphylococcus haemolyticus used in this experiment. In
the experiment summarized in Table II, sodium chlorite along caused
a Log reduction in pseudomonas aeruginosa bacteria of 0.35 at 1
hour and 1.35 at 2 hours. Hydrogen peroxide alone caused a Log
reduction in pseudomonas aeruginosa bacteria of 0.01 at 1 hour and
0.54 at 2 hours and the combination of sodium chlorite and hydrogen
peroxide caused a Log reduction in pseudomonas aeruginosa bacteria
0.04 at 1 hour and 6.35 at 2 hours. Thus, in this experiment, the
antimicrobial effect of the sodium chlorite-hydrogen peroxide
combination was significantly greater than the sums of the effects
of the sodium chlorite and hydrogen peroxide alone, at least in the
2 hour time point. Accordingly, it is concluded that the sodium
chlorite-hydrogen peroxide combination exhibited a supra-additive
effect against the strain of pseudomonas aeruginosa used in this
experiment. [0190] ii. Animal Testing
[0191] S. haemolyticus keratitus was induced in respective right
eyes of 12 rabbits by dropping broth containing 50,000 CFU/ml of S.
haemolyticus onto abraded corneas of these eyes. After 24 hours,
all corneas were likewise infected, and the rabbits were divided
randomly into three groups. The rabbits (five) of Group I then were
treated with the chlorite-hydrogen peroxide formulation defined
above as cleaning while wearing contact lenses (here termed
"Bactericide"); the rabbits (five) of Group II were treated with
commercially available 0.3% ofloxacin antibiotic ophthalmic
solution; and the rabbits (two) of Group III were untreated to
serve as a control.
[0192] At 24 and 48 hours post infection, the rabbits underwent
visual eye examination, photographic documentation and
biomicroscopy. After 24 hours of treatment, three animals each from
Groups I and II and one animal from Group III were sacrificed. The
eyes were enucleated and an 8 mm disc of cornea was homogenized and
plated onto growth media for microbial isolation and
quantification. After 48 hours of treatment, the same procedure was
followed for the remaining animals.
[0193] Tables III, IV and V summarize the results of this
experimentation. As is there apparent, the Bactericide of the
present invention exhibited superior overall results as compared to
the competing commercially available regimens. The results
therefore confirm that the clinical efficacy of the Bactericide is
better than the antibiotic treatment. In addition to having
excellent bactericidal properties, it is demonstrated that
bactericide superiority is probably attributable to inactivation of
bacterial proteolytic enzymes (thus decreasing bacterial virulence)
and inactivation of bacterial toxins responsible for inflammation
and hyperemia. TABLE-US-00013 TABLE III IN-VIVO ANTIMICROBIAL
EFFICACY IN INFECTIOUS S. HAEMOLYTICUS KERATITIS IN RABBITS Post
Treatment Group I Group II Group III Time Bactericide 0.3%
Ofloxacin Untreated Control 24 hours i) 0 CFU i) 23,000 CFU 39,000
CFU ii) 18,000 CFU ii) 5,000 CFU iii) 0 CFU iii) 11,000 CFU Average
6,000 CFU 13,000 CFU 39,000 CFU 48 hours i) 0 CFU i) 5,000 CFU
231,000 CFU ii) 0 CFU ii) 5,200 CFU Average 0 CFU 5,100 CFU 231,000
CFU
[0194] TABLE-US-00014 TABLE IV IN-VIVO CLINICAL EFFICACY IN
INFECTIOUS S. HAEMOLYTICUS KERATITIS IN RABBITS Group I Group II
Group III Time Bactericide 0.3% Ofloxacin Untreated Control 24
hours inflammation (+2) inflammation(+2) inflammation(+2) after
hyperemia (+2) hyperemia (+2) hyperemia (+2) infection corneal
edema corneal edema (+2) corneal edema (+2) (+2) 24 hours
inflammation (0) inflammation(+2) inflammation(+3) after hyperemia
(0) hyperemia (+2) hyperemia (+3) treatment corneal edema (0)
corneal edema (+2) corneal edema (+3) 48 hours inflammation (0)
inflammation(+1) inflammation(+3) after hyperemia (0) hyperemia
(+1) hyperemia (+3) treatment corneal edema (0) corneal edema (+1)
corneal edema (+3)
[0195] TABLE-US-00015 TABLE V IN-VITRO INHIBITION OF PROTEOLYTIC
ENZYME ACTIVITY Inhibition of proteolytic enzyme activity of
Trypsin and porcine pancreatic Elastase Concentration of %
Inhibition of Enzyme Bactericide Enzyme activity Elastase (porcine)
0.18 ppm 46% Trypsin 0.12 ppm 28%
E. Ocular Tolerabilty and Degradation Speed
[0196] i. Ocular Tolerability of High Levels of Hydrogen
Peroxide
[0197] Previously, it was believed that the upper limit of human
ocular tolerability of hydrogen peroxide is about 100 ppm (0.01 wt.
%). See Paugh, J. R., Brennan, N. A., and Efron, N., Ocular
Response to Hydrogen Peroxide, Am. J. Optom. Physiol. Opt. 1988
Feb;65(2):91-8. The following experiments show, however, that when
combined with sodium chlorite, hydrogen peroxide is well tolerated
by human eyes in levels up to 500 ppm (0.05 wt. %). In all of the
following experiments, the hydrogen peroxide was combined with 400
ppm (0.04 wt. %) of sodium chlorite in 0.2% boric acid at pH 7.4
and filtered through a 0.2 .mu.m Acrodisc syringe filter. Two drops
of each formulation were then placed in the cul-de-sac of two
normal human eyes. Upon instillation of the drops, the subjects
were instructed to close their eyelids. The subjects'ocular
symptoms of the treated eyes were observed and graded over a period
of one hour post instillation, for burning and stinging sensation,
pain, redness, tearing, itching, photopsia, photophobia, discharge,
and foreign body sensation. The observations are presented below.
TABLE-US-00016 TABLE VI Experiment 1: Human Ocular Response to 100
ppm of Hydrogen Peroxide Time post instillation Zero 30 1 2 3 5 10
60 time seconds minute minutes minutes minutes minutes minutes
Burning/Stinging 0 0 0 0 0 0 0 0 Pain 0 0 0 0 0 0 0 0 Redness 0 0 0
0 0 0 0 0 Tearing 0 0 0 0 0 0 0 0 Itching 0 0 0 0 0 0 0 0 Photopsia
0 0 0 0 0 0 0 0 Photophobia 0 0 0 0 0 0 0 0 Discharge 0 0 0 0 0 0 0
0 Foreign body 0 0 0 0 0 0 0 0 sensation Grading Scale: 0 = None;
+0.5 = Trace; +1 = Mild; +2 = Moderate; +3 = Moderately Severe; +4
= Severe
[0198] TABLE-US-00017 TABLE VII Experiment 2: Human Ocular Response
to 200 ppm of Hydrogen Peroxide Time post instillation Zero 30 1 2
3 5 10 60 time seconds minute minutes minutes minutes minutes
minutes Burning/Stinging 0 0 0 0 0 0 0 0 Pain 0 0 0 0 0 0 0 0
Redness 0 0 0 0 0 0 0 0 Tearing 0 0 0 0 0 0 0 0 Itching 0 0 0 0 0 0
0 0 Photopsia 0 0 0 0 0 0 0 0 Photophobia 0 0 0 0 0 0 0 0 Discharge
0 0 0 0 0 0 0 0 Foreign body 0 0 0 0 0 0 0 0 sensation Grading
Scale: 0 = None; +0.5 = Trace; +1 = Mild; +2 = Moderate; +3 =
Moderately Severe; +4 = Severe
[0199] TABLE-US-00018 TABLE VIII Experiment 3: Human Ocular
Response to 300 ppm of Hydrogen Peroxide Time post instillation
Zero 30 1 2 3 5 10 60 time seconds minute minutes minutes minutes
minutes minutes Burning/Stinging 0 0 0 0 0 0 0 0 Pain 0 0 0 0 0 0 0
0 Redness 0 0 0 0 0 0 0 0 Tearing 0 0 0 0 0 0 0 0 Itching 0 0 0 0 0
0 0 0 Photopsia 0 0 0 0 0 0 0 0 Photophobia 0 0 0 0 0 0 0 0
Discharge 0 0 0 0 0 0 0 0 Foreign body 0 0 0 0 0 0 0 0 sensation
Grading Scale: 0 = None; +0.5 = Trace; +1 = Mild; +2 = Moderate; +3
= Moderately Severe; +4 = Severe
[0200] TABLE-US-00019 TABLE IX Experiment 4: Human Ocular Response
to 400 ppm of Hydrogen Peroxide Time post instillation Zero 30 1 2
3 5 10 60 time seconds minute minutes minutes minutes minutes
minutes Burning/Stinging 0 0 0 0 0 0 0 0 Pain 0 0 0 0 0 0 0 0
Redness 0 0 0 0 0 0 0 0 Tearing 0 0 0 0 0 0 0 0 Itching 0 0 0 0 0 0
0 0 Photopsia 0 0 0 0 0 0 0 0 Photophobia 0 0 0 0 0 0 0 0 Discharge
0 0 0 0 0 0 0 0 Foreign body 0 0 0 0 0 0 0 0 sensation Grading
Scale: 0 = None; +0.5 = Trace; +1 = Mild; +2 = Moderate; +3 =
Moderately Severe; +4 = Severe
[0201] TABLE-US-00020 TABLE X Experiment 5: Human Ocular Response
to 500 ppm of Hydrogen Peroxide Time post instillation Zero 30 1 2
3 5 10 60 time seconds minute minutes minutes minutes minutes
minutes Burning/Stinging 0 0 0 0 0 0 0 0 Pain 0 0 0 0 0 0 0 0
Redness 0 0 0 0 0 0 0 0 Tearing 0 0 0 0 0 0 0 0 Itching 0 0 0 0 0 0
0 0 Photopsia 0 0 0 0 0 0 0 0 Photophobia 0 0 0 0 0 0 0 0 Discharge
0 0 0 0 0 0 0 0 Foreign body 0 0 0 0 0 0 0 0 sensation Grading
Scale: 0 = None; +0.5 = Trace; +1 = Mild; +2 = Moderate; +3 =
Moderately Severe; +4 = Severe
[0202] As can be seen from the above data, hydrogen peroxide levels
up to 500 ppm are very well tolerated by human eyes when in the
presence of sodium chlorite. There were no signs of irritation,
inflammation, or any other adverse effects associated with the
instillation of the formulations containing up to 500 ppm hydrogen
peroxide. These results show that hydrogen peroxide up to 500 ppm
can be very safe and free of any adverse effects to the human eye
when used in conjunction with sodium chlorite. Furthermore as
discussed above, an outstanding synergistic antimicrobial activity
has been discovered with formulations containing sodium chlorite
and hydrogen peroxide. Because the previous literature (See Paugh)
reported that human ocular tolerability of hydrogen peroxide is
about 100 ppm, it is believed that the sodium chlorite must be
stabilizing the hydrogen peroxide by forming a kind of transient
complex molecule (e.g., peroxychlorite), which exhibits the
excellent synergistic antimicrobial activity and degrades to
innocuous products like water, oxygen, and salt upon contact with
biological systems, as will be discussed in greater detail
below.
[0203] ii. Hydrogen Peroxide/Sodium Chlorite Degradation in the
Eye
[0204] The following experiments were designed to determine the
speed of self degradation of the hydrogen peroxide/sodium chlorite
formulation when placed in the human eye and to determine the level
of ocular symptomatology associated with the formulation when used
in an "in the eye" contact lens cleaner product or an artificial
tear product.
Experiment 1
"In the Eye" Contact Lens Cleaner
[0205] An "in the eye" contact lens cleaner containing 0.5 g
carboxymethylcellulose, 0.5 g pluronic, and 0.05 g hydrogen
peroxide/sodium chlorite mixture in 100 mL sterile water was
provided. The cleaner contained 400 ppm sodium chlorite and 100 ppm
hydrogen peroxide for a total of 500 ppm hydrogen peroxide/sodium
chlorite mixture. Two drops of the cleaner were placed in the
cul-de-sac of two normal human eyes. Upon instillation of the
drops, the subjects closed their eyelids and pressed their index
finger on the medial cantus, so as to block the puncta and stop the
tears going into the lachrymal duct.
[0206] At 30 second, 1 minute, 2 minute, and 3 minute intervals,
the subjects'tear samples were obtained by placing a fresh peroxide
test strip in the cul-de-sac of the subjects'eyes. The used
peroxide test strips were removed from the eye and left to dry at
room temperature for 15 minutes. At the completion of the drying
period, the level of hydrogen peroxide/sodium chlorite material
left in the tear was estimated by comparing the color formed on the
peroxide test strip to that of a standard color chart and recorded
as shown below. TABLE-US-00021 TABLE XI Time post instillation Zero
time 30 seconds 1 minute 2 minutes 3 minutes Level of 500 ppm
>25 ppm 10 ppm 2 ppm 0.5 ppm hydrogen peroxide/ sodium
chlorite
[0207] The data presented above shows a rapid reduction in the
level of hydrogen peroxide/sodium chlorite in the tear film of the
treated subjects. The placing of the index finger on the medial
cantus blocks the puncta and does not allow the tears of the
subjects to escape into the lachrymal duct. In addition, the
closing off the eyelids stops the blinking process and thus stops
the pumping action of the tear removal from the treated eyes. As
such, it would appear that the rapid reduction in the level of
hydrogen peroxide/sodium chlorite from the tears is not due to the
loss of the tears of the subjects into the lachrymal duct. Rather,
it is believed that the reduction is due to the presence of
catalase and superoxide desmutase enzymes in the tears of human
subjects. As the drops are placed in the eye of the patients, the
catalase and other enzymes start the rapid enzymatic degradation of
the hydrogen peroxide/sodium chlorite preparation, whereby in a
matter of 3 minutes the level in the tears of the treated subjects
is almost undetectable. The results of this experiment tend to show
that upon instillation in the eye, the hydrogen peroxide/sodium
chlorite mixture behaves like a self destructing preservative with
the end products being water, oxygen, and sodium chloride.
[0208] Additionally, the ocular symptoms of the treated eyes were
observed and graded over a period of one hour post instillation for
burning and stinging sensations, pain, redness, tearing, itching,
photopsia, photophobia, discharge and for foreign body sensation as
shown below. TABLE-US-00022 TABLE XII Time post instillation Zero
30 1 2 3 5 10 15 30 60 time seconds minute minutes minutes minutes
minutes minutes minutes minutes Burning/ 0 0 0 0 0 0 0 0 0 0
Stinging Pain 0 0 0 0 0 0 0 0 0 0 Redness 0 0 0 0 0 0 0 0 0 0
Tearing 0 0 0 0 0 0 0 0 0 0 Itching 0 0 0 0 0 0 0 0 0 0 Photopsia 0
0 0 0 0 0 0 0 0 0 Photophobia 0 0 0 0 0 0 0 0 0 0 Discharge 0 0 0 0
0 0 0 0 0 0 Foreign 0 +0.5 0 0 0 0 0 0 0 0 Body Sensation Grading
Scale: 0 = None; +0.5 = Trace; +1 = Mild; +2 = Moderate; +3 =
Moderately Severe; +4 = Severe
[0209] The above results show that the hydrogen peroxide/sodium
chlorite mixture is very well tolerated by the human eye without
presenting any signs of irritation, inflammation, or any other
adverse effects.
Experiment 2
Artificial Tear Product
[0210] An artificial tear product containing 0.1 5 g sodium
hyaluronate, 0.50 g protector, and 0.06 g hydrogen peroxide/sodium
chlorite mixture in 100 mL sterile water was provided. The
artificial tear product contained 400 ppm sodium chlorite and 200
ppm hydrogen peroxide for a total of 600 ppm hydrogen
peroxide/sodium chlorite mixture. Two drops of the cleaner were
placed in the cul-de-sac of six normal human eyes. Upon
instillation of the drops, the subjects closed their eyelids and
pressed their index finger on the medial cantus, so as to block the
puncta and stop the tears going into the lachrymal duct.
[0211] At zero second, 5 second, 20 second, 30 second, 60 second,
90 second, 120 second, and 180 second intervals, the subjects'tear
samples were obtained by placing a fresh peroxide test strip in the
cul-de-sac of the subjects'eyes. The used peroxide test strips were
removed from the eye and left to dry at room temperature for 15
minutes. At the completion of the drying period, the level of
hydrogen peroxide/sodium chlorite material left in the tear was
estimated by comparing the color formed on the peroxide test strip
to that of a standard color chart and recorded as shown below.
TABLE-US-00023 TABLE XIII Time post instillation 5 20 30 60 90 120
180 Time 0 seconds seconds seconds seconds seconds seconds seconds
Subject 1 150 ppm 60 ppm 45 ppm 38 ppm Subject 2 75 ppm 38 ppm 38
ppm 23 ppm Subject 3 45 ppm 30 ppm 8 ppm 15 ppm Subject 4 60 ppm 15
ppm 11 ppm 15 ppm Subject 5 60 ppm 23 ppm 5 ppm Subject 6 150 ppm
75 ppm 30 ppm 17 ppm Average 600 ppm 375 ppm 105 ppm 58 ppm 40 ppm
30 ppm 15 ppm 12 ppm
[0212] The data presented above shows a rapid reduction in the
level of hydrogen peroxide/sodium chlorite in the tear film of the
treated subjects. The placing of the index finger on the medial
cantus blocks the puncta and does not allow the tears of the
subjects to escape into the lachrymal duct. In addition, the
closing off the eyelids stops the blinking process and thus stops
the pumping action of the tear removal from the treated eyes. As
such, it would appear that the rapid reduction in the level of
hydrogen peroxide/sodium chlorite from the tears is not due to the
loss of the tears of the subjects into the lachrymal duct. Rather,
it is believed that the reduction is due to the presence of
catalase and superoxide desmutase enzymes in the tears of human
subjects. As the drops are placed in the eye of the patients, the
catalase and other enzymes start the rapid enzymatic degradation of
the hydrogen peroxide/sodium chlorite preparation, whereby in a
matter of 3 minutes the level in the tears of the treated subjects
is almost undetectable. The results of this experiment tend to show
that upon instillation in the eye, the hydrogen peroxide/sodium
chlorite mixture behaves like a self destructing preservative with
the end products being water, oxygen, and sodium chloride.
[0213] Additionally, the ocular symptoms of the treated eyes were
observed and graded over a period of one hour post instillation for
burning and stinging sensations, pain, redness, tearing, itching,
photopsia, photophobia, discharge and for foreign body sensation as
shown below. TABLE-US-00024 TABLE XIV Time post instillation Zero
30 1 2 3 5 10 15 30 60 time seconds minute minutes minutes minutes
minutes minutes minutes minutes Burning/ 0 0 0 0 0 0 0 0 0 0
Stinging Pain 0 0 0 0 0 0 0 0 0 0 Redness 0 0 0 0 0 0 0 0 0 0
Tearing 0 0 0 0 0 0 0 0 0 0 Itching 0 0 0 0 0 0 0 0 0 0 Photopsia 0
0 0 0 0 0 0 0 0 0 Photophobia 0 0 0 0 0 0 0 0 0 0 Discharge 0 0 0 0
0 0 0 0 0 0 Foreign 0 +0.5 0 0 0 0 0 0 0 0 Body Sensation Grading
Scale: 0 = None; +0.5 = Trace; +1 = Mild; +2 = Moderate; +3 =
Moderately Severe; +4 = Severe
[0214] The above results show that the hydrogen peroxide/sodium
chlorite mixture is very well tolerated by the human eye without
presenting any signs of irritation, inflammation, or any other
adverse effects.
[0215] It will be appreciated by those skilled in the art, that the
invention has been described hereabove with reference to certain
examples and specific embodiments. However, these are not the only
examples and embodiments in which the invention may be practiced.
Indeed, various modifications may be made to the above-described
examples and embodiments without departing from the intended spirit
and scope of the present invention. Accordingly, the present
embodiments are to be considered on all respects as illustrative
and not restrictive. It is intended that all such modifications be
included within the scope of the following claims.
* * * * *