U.S. patent application number 13/380131 was filed with the patent office on 2012-05-03 for albumin-free botulinum toxin formulations.
This patent application is currently assigned to Revance Therapeutics ,Inc.. Invention is credited to Curtis L. Ruegg, Stewart A. Thompson, Jacob M. Waugh.
Application Number | 20120107361 13/380131 |
Document ID | / |
Family ID | 43381023 |
Filed Date | 2012-05-03 |
United States Patent
Application |
20120107361 |
Kind Code |
A1 |
Thompson; Stewart A. ; et
al. |
May 3, 2012 |
Albumin-Free Botulinum Toxin Formulations
Abstract
This invention relates to botulinum toxin formulations that are
stabilized without the use of any proteinaceous excipients. The
invention also relates to methods of preparing and using such
botulinum toxin formulations.
Inventors: |
Thompson; Stewart A.;
(Burlingame, CA) ; Ruegg; Curtis L.; (Redwood
City, CA) ; Waugh; Jacob M.; (San Francisco,
CA) |
Assignee: |
Revance Therapeutics ,Inc.
Newark
CA
|
Family ID: |
43381023 |
Appl. No.: |
13/380131 |
Filed: |
June 25, 2010 |
PCT Filed: |
June 25, 2010 |
PCT NO: |
PCT/US2010/040104 |
371 Date: |
January 17, 2012 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
61220433 |
Jun 25, 2009 |
|
|
|
Current U.S.
Class: |
424/239.1 |
Current CPC
Class: |
A61P 29/00 20180101;
A61K 38/4893 20130101; A61K 8/4993 20130101; A61K 8/022 20130101;
A61K 8/66 20130101; A61Q 19/08 20130101; Y02A 50/30 20180101; A61K
8/602 20130101; A61K 47/34 20130101; A61P 21/00 20180101; A61K
8/4973 20130101; A61K 9/14 20130101; A61Q 19/008 20130101; A61P
17/10 20180101; A61P 21/02 20180101; C07K 14/33 20130101; A61K
47/22 20130101; A61K 8/60 20130101; A61K 8/84 20130101; C12Y
304/24069 20130101; A61K 9/19 20130101; A61K 39/08 20130101; A61K
47/42 20130101; A61P 17/00 20180101; A61K 47/26 20130101; A61K
8/4946 20130101; A61K 8/90 20130101; A61K 8/64 20130101; Y02A
50/469 20180101 |
Class at
Publication: |
424/239.1 |
International
Class: |
A61K 39/08 20060101
A61K039/08; A61P 21/02 20060101 A61P021/02; A61Q 19/08 20060101
A61Q019/08; A61K 8/99 20060101 A61K008/99 |
Claims
1. A liquid composition comprising a botulinum toxin, a
non-reducing disaccharide or a non-reducing trisaccharide, a
non-ionic surfactant, and a physiologically compatible buffer;
wherein the concentration of the non-reducing disaccharide or
non-reducing trisaccharide is in the range of 10% to 40% (w/v),
wherein the concentration of the non-ionic surfactant is in the
range of 0.005% to 0.5% (w/v), and wherein the pH of the liquid
composition is in the range of 4.5 to 6.5.
2. The liquid composition according to claim 1, wherein the
non-reducing disaccharide is selected from the group consisting of
trehalose dihydrate, sucrose, and combinations thereof.
3. The liquid composition according to claim 1, wherein the
non-ionic surfactant is selected from the group consisting of
polysorbates, sorbitan esters, Triton X-100, NP-40, poloxamers and
combinations thereof.
4. The liquid composition according to claim 1, wherein the buffer
is prepared using a salt selected from the group consisting of a
salt of citric acid, a salt of acetic acid, a salt of succinnic
acid, a salt of tartaric acid, a salt of maleic acid, and a salt of
histidine.
5. The liquid composition according to claim 1, further comprising
a positively charged backbone with positively charged efficiency
groups attached thereto.
6. The liquid composition according to claim 5, wherein the
positively charged backbone with positively charged efficiency
groups is a peptide with an amino amino acid sequence selected from
the group consisting of RKKRRQRRR-G-(K).sub.15-G-RKKRRQRRR,
RGRDDRRQRRR-G-(K).sub.15-G-RGRDDRRQRRR, and
YGRKKRRQRRR-G-(K).sub.15-G-YGRKKRRQRRR.
7. The liquid composition according to claim 1, wherein the
botulinum toxin is present in a therapeutic amount.
8. The liquid composition according to claim 1, wherein the
botulinum toxin is obtained from serotype of Clostridium botulinum
bacteria selected from the group consisting of types A, B, C, D, E,
F, and G.
9. A powder composition prepared by drying the liquid composition
according to claim 1.
10. The powder composition according to claim 9, wherein the
non-reducing disaccharide is selected from the group consisting of
trehalose dihydrate, sucrose, and combinations thereof.
11. The powder composition according to claim 9, wherein the
non-ionic surfactant is selected from the group consisting of
polysorbates, sorbitan esters, Triton X-100, NP-40, poloxamers and
combinations thereof.
12. The powder composition according to claim 9, wherein the buffer
is prepared using a salt selected from the group consisting of a
salt of citric acid, a salt of acetic acid, a salt of succinnic
acid, a salt of tartaric acid, a salt of maleic acid, and a salt of
histidine.
13. The powder composition according to claim 9, further comprising
a positively charged backbone with positively charged efficiency
groups attached thereto.
14. The powder composition according to claim 13, wherein the
positively charged backbone with positively charged efficiency
groups is a peptide with an amino acid sequence selected from the
group consisting of RKKRRQRRR-G-(K).sub.15-G-RKKRRQRRR,
RGRDDRRQRRR-G-(K).sub.15-G-RGRDDRRQRRR, and
YGRKKRRQRRR-G-(K).sub.15-G-YGRKKRRQRRR.
15. The powder composition according to claim 9, wherein the
lyophilized composition comprises a therapeutic amount of a
botulinum toxin.
16. The powder composition according to claim 9, wherein the
botulinum toxin is obtained from serotype of Clostridium botulinum
bacteria selected from the group consisting of types A, B, C, D, E,
F, and G.
17. A liquid composition comprising a botulinum toxin, a
non-reducing disaccharide or a non-reducing trisaccharide, a
non-ionic surfactant, a bulking agent and a physiologically
compatible buffer; wherein the concentration of the non-reducing
disaccharide is in the range of 0.50 to 3.0% (w/v), wherein the
concentration of the bulking agent is in the range of 1.5% to 7.5%,
wherein the concentration of the non-ionic surfactant is in the
range of 0.005% to 0.5% (w/v); wherein the amount of non-reducing
disaccharide or non-reducing trisaccharide relative to the amount
of bulking agent is selected such that the bulking agent does not
crystallize when the liquid composition is dried; and wherein the
pH of the composition is in the range of 4.5 to 6.5.
18. The liquid composition according to claim 17, wherein the
non-reducing disaccharide is selected from the group consisting of
trehalose dihydrate, sucrose, and combinations thereof.
19. The liquid composition according to claim 17, wherein the
non-ionic surfactant is selected from the group consisting of
polysorbates, sorbitan esters, Triton X-100, NP-40, poloxamers and
combinations thereof.
20. The liquid composition according to claim 17, wherein the
buffer is prepared using a salt selected from the group consisting
of a salt of citric acid, a salt of acetic acid, a salt of
succinnic acid, a salt of tartaric acid, a salt of maleic acid, and
a salt of histidine.
21. The liquid composition according to claim 17, further
comprising a positively charged backbone with positively charged
efficiency groups attached thereto.
22. The liquid composition according to claim 21, wherein the
positively charged backbone with positively charged efficiency
groups is a peptide with an amino acid sequence selected from the
group consisting of RKKRRQRRR-G-(K).sub.15-G-RKKRRQRRR,
RGRDDRRQRRR-G-(K).sub.15-G-RGRDDRRQRRR, and
YGRKKRRQRRR-G-(K).sub.15-G-YGRKKRRQRRR.
23. The liquid composition according to claim 17, wherein the
botulinum toxin is present in a therapeutic amount.
24. The liquid composition according to claim 17, wherein the
botulinum toxin is obtained from serotype of Clostridium botulinum
bacteria selected from the group consisting of types A, B, C, D, E,
F, and G.
25. A powder composition prepared by drying the liquid composition
according to claim 17.
26. The powder composition according to claim 25, wherein the
non-reducing disaccharide is selected from the group consisting of
trehalose dihydrate, sucrose, and combinations thereof.
27. The powder composition according to claim 25, wherein the
non-ionic surfactant is selected from the group consisting of
polysorbates, sorbitan esters, Triton X-100, NP-40, poloxamers and
combinations thereof.
28. The powder composition according to claim 25, wherein the
buffer is prepared using a salt selected from the group consisting
of a salt of citric acid, a salt of acetic acid, a salt of
succinnic acid, a salt of tartaric acid, a salt of maleic acid, and
a salt of histidine.
29. The powder composition according to claim 25, further
comprising a positively charged backbone with positively charged
efficiency groups attached thereto.
30. The powder composition according to claim 29, wherein the
positively charged backbone with positively charged efficiency
groups is a peptide with an amino acid sequence selected from the
group consisting of RKKRRQRRR-G-(K).sub.15-G-RKKRRQRRR,
RGRDDRRQRRR-G-(K).sub.15-G-RGRDDRRQRRR, and
YGRKKRRQRRR-G-(K).sub.15-G-YGRKKRRQRRR.
31. The powder composition according to claim 30, wherein the
lyophilized composition comprises a therapeutic amount of a
botulinum toxin.
32. The powder composition according to claim 25, wherein the
botulinum toxin is obtained from serotype of Clostridium botulinum
bacteria selected from the group consisting of types A, B, C, D, E,
F, and G.
33. A kit comprising a powder composition according claim 9 or 25,
and a syringe.
34. A method for stabilizing a botulinum toxin formulation, the
method comprising combining a botulinum toxin, a non-reducing
disaccharide or a non-reducing trisaccharide, a non-ionic
surfactant, and a physiologically compatible buffer to form a
liquid composition, wherein the concentration of the non-reducing
disaccharide is in the range of 10% to 40% (w/v), wherein the
concentration of the non-ionic surfactant is in the range of 0.005%
to 0.5% (w/v), and wherein the pH of the liquid composition is in
the range of 4.5 to 6.5.
35. The method according to claim 34, further comprising the step
of drying the liquid composition.
36. The method according to claim 35, wherein the step of drying
comprises lyophilizing or vacuum-drying the liquid composition.
37. A liquid composition comprising a botulinum toxin, a
non-reducing sugar, a non-ionic surfactant, a positively charged
peptide with an amino acid sequence selected from the group
consisting of RKKRRQRRR-G-(K).sub.15-G-RKKRRQRRR,
RGRDDRRQRRR-G-(K).sub.15-G-RGRDDRRQRRR, and
YGRKKRRQRRR-G-(K).sub.15-G-YGRKKRRQRRR; a physiologically
compatible buffer, and optionally a bulking agent; wherein the pH
of the composition is in the range of 4.5 to 6.5.
38. The liquid composition according to claim 37, wherein the amino
acid sequence of the positively charged peptide is
RKKRRQRRR-G-(K).sub.15-G-RKKRRQRRR.
39. The liquid composition according to claim 38, wherein the
non-reducing sugar is selected from the group consisting of
trehalose, sucrose, or raffinose.
40. The liquid composition according to claim 39, wherein the
non-ionic surfactant is selected from the group consisting of
polysorbate 20, polysorbate 40, polysorbate 60, polysorbate 80,
Span 20, Span 60, Span 65, and Span 80.
41. The liquid composition according to claim 40, wherein
physiologically compatible buffer is selected from the group
consisting of citric acid, acetic acid, succinnic acid, tartaric
acid, maleic acid, histidine, citrate/acetate, citrate/histidine,
citrate/tartrate, maleate/histidine, succinate/histidine and
phosphate buffer.
42. The liquid composition according to claim 41, wherein the
botulinum toxin is a 150 kD botulinum toxin protein of Clostridium
botulinum serotype A, B, C, D, E, F, or G.
43. The liquid composition according to claim 37, wherein the amino
acid sequence of the positively charged peptide is
RGRDDRRQRRR-G-(K).sub.15-G-RGRDDRRQRRR.
44. The liquid composition according to claim 43, wherein the
non-reducing sugar is selected from the group consisting of
trehalose, sucrose, or raffinose.
45. The liquid composition according to claim 44, wherein the
non-ionic surfactant is selected from the group consisting of
polysorbate 20, polysorbate 40, polysorbate 60, polysorbate 80,
Span 20, Span 60, Span 65, and Span 80.
46. The liquid composition according to claim 45, wherein
physiologically compatible buffer is selected from the group
consisting of citric acid, acetic acid, succinnic acid, tartaric
acid, maleic acid, histidine, citrate/acetate, citrate/histidine,
citrate/tartrate, maleate/histidine, succinate/histidine and
phosphate buffer.
47. The liquid composition according to claim 46, wherein the
botulinum toxin is a 150 kD botulinum toxin protein of Clostridium
botulinum serotype A, B, C, D, E, F, or G.
48. The liquid composition according to claim 37, wherein the amino
acid sequence of the positively charged peptide is
YGRKKRRQRRR-G-(K).sub.15-G-YGRKKRRQRRR.
49. The liquid composition according to claim 48, wherein the
non-reducing sugar is selected from the group consisting of
trehalose, sucrose, or raffinose.
50. The liquid composition according to claim 49, wherein the
non-ionic surfactant is selected from the group consisting of
polysorbate 20, polysorbate 40, polysorbate 60, polysorbate 80,
Span 20, Span 60, Span 65, and Span 80.
51. The liquid composition according to claim 50, wherein
physiologically compatible buffer is selected from the group
consisting of citric acid, acetic acid, succinnic acid, tartaric
acid, maleic acid, histidine, citrate/acetate, citrate/histidine,
citrate/tartrate, maleate/histidine, succinate/histidine and
phosphate buffer.
52. The liquid composition according to claim 51, wherein the
botulinum toxin is a 150 kD botulinum toxin protein of Clostridium
botulinum serotype A, B, C, D, E, F, or G.
Description
[0001] This application claims priority to U.S. Provisional Patent
Application No. 61/220,433, filed on Jun. 25, 2009, the contents of
which are incorporated by reference in their entirety.
FIELD OF THE INVENTION
[0002] This invention relates to pharmaceutical formulations
containing botulinum toxin. In particular, this invention relates
to botulinum toxin formulations that are stabilized by
non-proteinaceous excipients.
BACKGROUND OF THE INVENTION
[0003] Botulinum toxins (also known as botulin toxins or botulinum
neurotoxins) are neurotoxins produced by Clostridium botulinum
bacteria. Botulinum toxins produce paralysis of muscles by
preventing synaptic transmission or release of acetylcholine across
the neuromuscular junction. The action of botulinum toxins
essentially blocks signals that normally would cause muscle spasms
or contractions, resulting in paralysis.
[0004] There are eight naturally occurring serologically related
botulinum toxins, seven of which are known to cause paralysis
(viz., botulinum neurotoxin serotypes A, B, C, D, E, F and G). Each
of these serotypes is distinguished by neutralization with
type-specific antibodies. However, the molecular weight of the
botulinum toxin protein molecule is about 150 kD for all seven of
these active botulinum toxins. As released by the Clostridium
botulinum bacteria, the botulinum toxin is present in a complex
comprising the 150 kD botulinum toxin protein molecule along with
associated non-toxin proteins. The total size of the complex may
vary. For instance, the botulinum toxin type A complex can be
produced by Clostridium botulinum bacteria as 900 kD, 500 kD and
300 kD complexes. Botulinum toxin types B and C complexes are only
produced as 700 kD or 500 kD complexes. Botulinum toxin type D
complexes are produced as both 300 kD and 500 kD complexes.
Botulinum toxin types E and F complexes are only produced as 300 kD
complexes. The complexes are believed to contain non-toxin
hemaglutinin protein and non-toxin and non-toxic non-hemaglutinin
protein. These two non-toxin proteins (which along with the
botulinum toxin molecule comprise the relevant neurotoxin complex)
are believed to provide stability against denaturation to the
botulinum toxin molecule and protection against digestive acids
when toxin is ingested.
[0005] While botulinum toxin is the most lethal naturally occurring
toxin known to man, it has found extensive use as both a
therapeutic and a cosmetic agent. For example, in 1986, the
feasibility of using type A botulinum toxin for treatment of
movement-associated wrinkles in the glabella area was first
demonstrated by Schantz and Scott, in Lewis G E (Ed) Biomedical
Aspects of Botulinum, N.Y.: Academic Press, 143-150 (1981). The use
of botulinum type A for the treatment of wrinkles was published in
1992 (Schantz and Scott, in Lewis G. E. (Ed) Biomedical Aspects of
Botulinum, N.Y.: Academic Press, 143-150 (1981)), and by 1994,
other movement-associated wrinkles on the face were being treated
with type A botulinum toxin (Scott, Ophthalmol, 87:1044-1049
(1980)). The demand for cosmetic botulinum toxin treatments has
grown steadily over the years, with current annual sales of
botulinum toxin in the United States exceeding $ 1 billion dollars
per year.
[0006] One challenging aspect of manufacturing commercial botulinum
toxin formulations is stabilizing the botulinum toxin. Like many
proteins, botulinum toxin may be degraded or denatured by
environmental factors, such as heat, alkaline conditions,
mechanical shear forces, or contact with reactive surfaces or
substances. Furthermore, the difficulty in stabilizing the
botulinum toxin in commercial formulations is exacerbated by the
extreme toxicity of the toxin, which permits only minute amounts of
toxin to be used for therapeutic purposes. If the botulinum toxin
formulation is not properly stabilized, the minute amounts of
botulinum toxin may undergo unwanted reactions and/or adhere to the
inner surfaces of its storage containers, leading to unacceptable
loss of botulinum toxin or activity.
[0007] Commercial botulinum toxin formulations are often
distributed as lyophilized (i.e. freeze dried) or vacuum-dried
powder, in order to prevent degradation and make the botulinum
toxin formulation easier to handle and less expensive to transport.
Prior to use, botulinum toxin powder formulations are reconstituted
with a liquid carrier, such as water or a saline solution. For
instance, one commercially available botulinum toxin formulation is
sold under the trademark BOTOX.RTM. (Allergan, Inc., Irvine,
Calif.). The BOTOX.RTM. formulation is distributed as a
vacuum-dried powder stored in individual vials, each of which
contains about 100 units (U) of Clostridium botulinum toxin type A
complex, 0.5 milligrams of human serum albumin and 0.9 milligrams
of sodium chloride. It has been reported that commercial botulinum
toxin formulation must be stored at a temperature of -10.degree. C.
or less to maintain the labeled potency for the one year shelf
life.
[0008] In commercial formulations of botulinum toxin, human serum
albumin is often added as a bulk carrier and stabilizer. Generally,
albumin may stabilize a therapeutic protein (e.g., botulinum toxin)
by one or more of the following mechanisms: (1) reducing adhesion
of the therapeutic protein to the inner surfaces of storage or
dispensing containers, which include glassware, storage vials, and
the syringe used to inject the pharmaceutical composition; and (2)
reducing denaturation of the therapeutic protein, especially after
reconstituting to prepare a solution of the therapeutic protein.
Human serum albumin has the added advantage of being minimally
immunogenic, which lessens the likelihood that a human patient will
develop antibodies against the botulinum toxin formulation.
[0009] Although human serum albumin has been adopted as a
stabilizer in commercial botulinum toxin formulations, there are
still significant problems associated with this approach. One
serious problem is that albumin is derived from blood and is
therefore susceptible to carrying blood borne pathogens or
infectious agents. For instance, the human serum albumin may carry
the Human Immunodeficiency Virus (HIV). Albumin may also carry
prions, which are proteinaceous infectious agents that are
responsible for causing a neurodegenerative disorder known as
Creutzfeldt-Jacob disease. The prions cause misfolding of proteins
in the brain, resulting in dementia, memory loss, speech
impairment, loss of motor coordination, and death, often within the
span of months after the initial onset of symptoms.
[0010] Attempts to replace human serum albumin with
non-proteinaceous stabilizers generally have been met with
difficulties. A non-proteinaceous polymer may be reactive towards
the botulinum toxin or may contain reactive impurities that degrade
and/or denature the botulinum toxin. For example, some studies have
used a poloxamer as a non-proteinaceous stabilizing compound for
botulinum toxin. However, these studies report that reconstituted
poloxamer-stabilized botulinum toxin formulations demonstrate low
botulinum toxin activity, suggesting that the poloxamer excipient
either failed to properly stabilize the botulinum toxin and/or
induced unwanted degradation reactions to occur.
[0011] Accordingly, it would be highly desirable to have a
botulinum toxin formulation that is stabilized, but without a
proteinaceous excipient, especially without any animal-protein
based excipients. Furthermore, it would be highly desirable to have
a non-proteinaceous stabilizing excipient that does not itself
react with botulinum toxin.
SUMMARY OF THE INVENTION
[0012] In one aspect, this invention relates to botulinum
formulations that are stabilized by non-proteinaceous excipients.
In particular, in preferred embodiments, this invention relates to
botulinum toxin formulations that are stabilized without albumin or
other animal protein-derived excipients.
[0013] One aspect of the invention is to provide a liquid
composition comprising a botulinum toxin, a non-reducing
disaccharide or a non-reducing trisaccharide, a non-ionic
surfactant, and a physiologically compatible buffer capable of
maintaining the pH between 4.5. and 6.5. The concentration of the
non-reducing sugar in the liquid composition is in the range of 10%
through 40% (w/v) and the concentration of the non-ionic surfactant
is in the range of 0.005% through 0.5% (w/v).
[0014] Another aspect of the invention is to provide a powder
composition by drying the liquid composition described above.
[0015] This invention also provides a method for stabilizing a
botulinum toxin formulation. The method comprises combining a
botulinum toxin, a non-reducing disaccharide or a non-reducing
trisaccharide, a non-ionic surfactant, and physiologically
compatible buffer components capable of maintaining the pH between
4.5 and 6.5 to form a liquid composition. The concentration of the
non-reducing sugar in the liquid composition is in the range from
10% to 40% (w/v) and the concentration of the non-ionic surfactant
is in the range from 0.005% to 0.5% (w/v). Optionally, the method
further comprises drying the liquid composition to produce a
stabilized powder composition.
[0016] Another aspect of the invention is to provide a liquid
composition comprising a botulinum toxin, a non-reducing
disaccharide or a non-reducing trisaccharide, a non-ionic
surfactant, a bulking agent and a physiologically compatible
buffer. In these embodiments, the concentration of the non-reducing
disaccharide compositions is in the range of 0.50 to 3.0% (w/v),
the concentration of the bulking agent is in the range of 1.5% to
7.5%, the concentration of the non-ionic surfactant is in the range
of 0.005% to 0.5% (w/v); and the pH of the composition is in the
range of 4.5 to 6.5. Also, the amount of non-reducing disaccharide
or non-reducing trisaccharide relative to the amount of bulking
agent is selected such that the bulking agent does not crystallize
when the liquid composition is dried. The invention also expressly
contemplates powder formulations prepared by drying such liquid
compositions.
[0017] The invention also provides a method for stabilizing a
botulinum toxin formulation comprising combining a botulinum toxin,
a non-reducing disaccharide or a non-reducing trisaccharide, a
non-ionic surfactant, a bulking agent and a physiologically
compatible buffer to form a liquid composition. The concentration
of the non-reducing disaccharide compositions is in the range of
0.50 to 3.0% (w/v), the concentration of the bulking agent is in
the range of 1.5% to 7.5%, the concentration of the non-ionic
surfactant is in the range of 0.005% to 0.5% (w/v); and the pH of
the composition is in the range of 4.5 to 6.5. Optionally, the
method further comprises drying the liquid composition to produce a
stabilized powder composition. Also, the amount of non-reducing
disaccharide or non-reducing trisaccharide relative to the amount
of bulking agent is selected such that the bulking agent does not
crystallize when the liquid composition is dried.
[0018] This invention also provides a liquid composition comprising
a botulinum toxin, a non-reducing sugar, a non-ionic surfactant, a
physiologically compatible buffer, a positively charged peptide and
an optional bulking agent. The positively charged peptide has an
amino acid sequence selected from the group consisting of
RKKRRQRRR-G-(K).sub.15-G-RKKRRQRRR,
RGRDDRRQRRR-G-(K).sub.15-G-RGRDDRRQRRR, and
YGRKKRRQRRR-G-(K).sub.15-G-YGRKKRRQRRR. The pH of the liquid
composition is in the range of 4.5 to 6.5. The invention also
expressly contemplates powder formulations prepared by drying such
liquid compositions.
[0019] Yet another aspect of the invention is to provide a method
for stabilizing a botulinum toxin formulation comprising combining
a botulinum toxin, a non-reducing sugar, a non-ionic surfactant, a
physiologically compatible buffer, a positively charged peptide and
an optional bulking agent. The positively charged peptide has an
amino acid sequence selected from the group consisting of
RKKRRQRRR-G-(K).sub.15-G-RKKRRQRRR,
RGRDDRRQRRR-G-(K).sub.15-G-RGRDDRRQRRR, and
YGRKKRRQRRR-G-(K).sub.15-G-YGRKKRRQRRR. The pH of the liquid
composition is in the range of 4.5 to 6.5. Optionally, the method
further comprises drying the liquid composition to produce a
stabilized powder composition.
BRIEF DESCRIPTION OF THE FIGURES
[0020] FIG. 1: Recovered botulinum toxin activity as a function of
time after storage of a lyophilized botulinum toxin at 40.degree.
C.
[0021] FIG. 2: Recovered botulinum toxin activity as a function of
time after storage of a lyophilized botulinum toxin at different
temperatures.
[0022] FIG. 3: Recovered botulinum toxin activity as a function of
time after storage of a lyophilized botulinum toxin at different
temperatures.
DETAILED DESCRIPTION OF THE INVENTION
[0023] This invention relates to botulinum toxin formulations that
are stabilized without the addition of proteinaceous excipients
derived (i.e., purified) from animal sources, such as albumin. As
such, the botulinum formulations of the invention do not suffer
from the potential problems associated blood borne pathogens or
other types of infectious agents. This invention also provides
methods for preparing botulinum toxin formulations without the
addition of animal-derived proteinaceous excipients. In preferred
embodiments, the formulations do not contain any proteinaceous
excipients at all. However, in certain embodiments, proteinaceous
excipients not derived from animal sources (e.g., recombinant
albumin or recombinant gelatin) may be present in the formulations
of the invention.
[0024] As used herein in connection with the botulinum toxin
formulations of the invention, the term "stabilize" and variations
thereof (e.g., "stabilization", "stabilizing" "stabilized" etc.)
refers to the retention of biological activity of the botulinum
toxin in the formulation over a specified time period as measured
by a 20-mouse LD.sub.50 assay (See L B Pearce, R E Borodic, Tox.
Appl. Pharmacol, v128, p69, 1994 and ICCVAM/NICEA.TM./ECVAM,
Scientific Workshop on Alternate Methods to Refine, Reduce and
Replace the Mouse LD50 Assay for Botulinum Toxin Testing, 14 Nov.
2006). In preferred embodiments, there is 100% retention of the
biological activity of the botulinum toxin over the specified time
period. However, in other embodiments, there is at least a 10%,
20%, 30%, 40%, 50%, 60%, 70%, 80% or 90% retention of the
biological activity of the botulinum toxin over the specified time
period. In certain embodiments, the duration of the specified time
period may be chosen to be consistent with the duration of the
botulinum toxin product manufacturing processes. For instance, the
duration of the specified time period may be chosen to be
sufficient to stabilize the botulinum toxin as it is subjected to
one or more processing steps. In other embodiments, the specified
time will be on the order of weeks, months or even years, such as
the case when the non-toxin formulation components are selected to
permit long-term stabilization of the botulinum toxin formulation
for storage. In certain embodiments, the specified time is at least
two weeks, at least one month, at least three months, at least six
months, at least nine months, at least one year, at least 18 months
or at least two years. In other embodiments, the specified time is
coincident with the time for botulinum toxin to retain a desired
amount of bioactivity using the formulations of the invention,
which time includes, for example, the duration of the activities
stated above. The components used to stabilize the formulation may
be selected to permit stabilization at low temperatures (e.g., -5
to -10.degree. C.) or at ambient temperature, as described
herein.
[0025] In some embodiments, the botulinum toxin formulations of the
invention are provided in solid form. By way of example only, the
formulations may be lyophilized or vacuum-dried to produce a solid
formulation. When a botulinum toxin formulation of the invention is
provided in solid form, and the specified time period over which
stability of the botulinum formulation is measured is a week or
less, the activity that is observed upon reconstitution is said to
be the activity upon initial recovery. In certain preferred
embodiments of the invention, there is at least a 70%, 80%, or 90%
retention in the activity upon initial recovery. In other
embodiments, there is at least a 90%, 91%, 92%, 93%, 94%, 95%, 96%,
97%, 98%, or 99% retention of activity upon initial recovery. In a
particularly preferred embodiment, the activity upon initial
recovery is greater than 99% and can even be 100%.
[0026] In other embodiments, the specified time over which
stability is measured is greater than 12, 13, 14, 15, 16, 17, 18,
19, 20, 21, 22, 23, or 24 months at given storage temperature. When
a botulinum toxin formulation of the invention is provided in solid
form, and the specified time period over which stability of the
botulinum formulation is measured twelve months or greater, the
activity that is observed upon reconstitution is said to be the
activity upon long term storage. In certain preferred embodiments,
there is at least a 70%, 80%, or 90% retention of botulinum toxin
activity upon long term storage. In certain embodiments there is a
90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, or 99% retention of
botulinum toxin activity upon long term storage. In certain
embodiments, there is at least a 90% retention of botulinum toxin
activity after 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, or
24 months of storage at 25.degree. C.; at least a 91% retention of
botulinum toxin activity after 12, 13, 14, 15, 16, 17, 18, 19, 20,
21, 22, 23, or 24 months of storage at 25.degree. C.; at least a
92% retention of botulinum toxin activity after 12, 13, 14, 15, 16,
17, 18, 19, 20, 21, 22, 23, or 24 months of storage at 25.degree.
C.; at least a 93% retention of botulinum toxin activity after 12,
13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, or 24 months of storage
at 25.degree. C.; at least a 94% retention of botulinum toxin
activity after 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, or
24 months of storage at 25.degree. C.; at least a 95% retention of
botulinum toxin activity after 12, 13, 14, 15, 16, 17, 18, 19, 20,
21, 22, 23, or 24 months of storage at 25.degree. C.; at least a
96% retention of botulinum toxin activity after 12, 13, 14, 15, 16,
17, 18, 19, 20, 21, 22, 23, or 24 months of storage at 25.degree.
C.; at least a 97% retention of botulinum toxin activity after 12,
13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, or 24 months of storage
at 25.degree. C.; at least a 98% retention of botulinum toxin
activity after 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, or
24 months of storage at 25.degree. C.; or at least a 99% retention
of botulinum toxin activity after 12, 13, 14, 15, 16, 17, 18, 19,
20, 21, 22, 23, or 24 months of storage at 25.degree. C.
[0027] In some embodiments of the invention, the botulinum toxin
formulations are stored in liquid form, rather than solid form. In
certain preferred embodiments, the liquid botulinum toxin
formulations according to the invention retain at least 60%, 70%,
80%, or 90% of the botulinum toxin activity for up to 8 hours at
room temperature. In a particularly preferred embodiment, liquid
botulinum toxin formulations according to the invention retain 100%
of the botulinum toxin activity for up to 8 hours at room
temperature.
[0028] The excipients in the botulinum formulations of the
invention advantageously reduce or eliminate mechanisms by which
the botulinum toxin is lost during manufacturing and storage.
Without wishing to be limited by theory, it is believed that the
non-proteinaceous excipients of the invention reduce or eliminate
unwanted adhesion of the botulinum toxin to the vessels used for
manufacturing, storage, or delivery of the formulation.
Non-limiting examples of such vessels includes those made with
glass, polystyrene, polypropylene, and other polymers. Furthermore,
and again without wishing to be limited by theory, it is believed
that the non-proteinaceous excipients of the invention reduce or to
prevent unwanted reactions between the botulinum toxin and objects
or substances encountered by the botulinum toxin during
manufacturing, storage, or delivery. In preferred embodiments, the
non-proteinaceous excipients are inert to the other components of
the formulation.
[0029] In some embodiments, the botulinum toxin formulations are
prepared in a powder form for ease of handling, transport, or
storage. The powder form may be prepared by any method known in the
art. Non-limiting examples of such methods include lyophilization,
vacuum-drying, drum-drying and spray drying, with lyophilization
and vacuum-drying being particularly preferred.
[0030] The term "botulinum toxin" as used herein is meant to refer
to any of the known types of botulinum toxin, whether produced by
the bacterium or by recombinant techniques, as well as any such
types that may be subsequently discovered including engineered
variants or fusion proteins. As mentioned above, at the present
time, seven immunologically distinct botulinum neurotoxins have
been characterized, namely botulinum neurotoxin serotypes A, B, C,
D, E, F and G, each of which is distinguished by neutralization
with type-specific antibodies. The botulinum toxin serotypes are
available from Sigma-Aldrich and from Metabiologics, Inc. (Madison,
Wis.), as well as from other sources. The different serotypes of
botulinum toxin vary in the animal species that they affect and in
the severity and duration of the paralysis they evoke.
[0031] The botulinum toxin used in the compositions of this
invention can alternatively be a botulinum toxin derivative, that
is, a compound that has botulinum toxin activity but contains one
or more chemical or functional alterations on any part or on any
chain relative to naturally occurring or recombinant native
botulinum toxins. For instance, the botulinum toxin may be a
modified neurotoxin (e.g., a neurotoxin which has at least one of
its amino acids deleted, modified or replaced, as compared to a
native, or a recombinantly produced neurotoxin or a derivative or
fragment thereof). For instance, the botulinum toxin may be one
that has been modified in a way that, for instance, enhances its
properties or decreases undesirable side effects, but that still
retains the desired botulinum toxin activity. The botulinum toxin
may be any of the botulinum toxin complexes produced by the
bacterium, as described above. Alternatively, the botulinum toxin
may be a toxin prepared using recombinant or synthetic chemical
techniques (e.g. a recombinant peptide, a fusion protein, or a
hybrid neurotoxin, as prepared from subunits or domains of
different botulinum toxin serotypes (see U.S. Pat. No. 6,444,209,
for instance)). The botulinum toxin may also be a portion of the
overall molecule that has been shown to possess the necessary
botulinum toxin activity, and in such case may be used per se or as
part of a combination or conjugate molecule, for instance a fusion
protein. Additionally, the botulinum toxin may be in the form of a
botulinum toxin precursor, which may itself be non-toxic, for
instance a nontoxic zinc protease that becomes toxic on proteolytic
cleavage.
[0032] The term "botulinum toxin complex" or "toxin complex" as
used herein refers to the approximately 150 kD botulinum toxin
protein molecule (belonging to any one of botulinum toxin serotypes
A-G), along with associated endogenous non-toxin proteins (i.e.,
hemagglutinin protein and non-toxin non-hemagglutinin protein
produced by Clostridium botulinum bacteria). Note, however, that
the botulinum toxin complex need not be derived from Clostridium
botulinum bacteria as one unitary toxin complex. For example,
botulinum toxin or modified botulinum toxin may be recombinantly
prepared first and then subsequently combined with the non-toxin
proteins. Recombinant botulinum toxin can also be purchased (e.g.,
from List Biological Laboratories, Campbell, Calif.) and then
combined with non-toxin proteins.
[0033] This invention also contemplates "reduced botulinum toxin
complexes," in which the botulinum toxin complexes have reduced
amounts of non-toxin protein compared to the amounts naturally
found in botulinum toxin complexes produced by Clostridium
botulinum bacteria. In one embodiment, reduced botulinum toxin
complexes are prepared using any conventional protein separation
method to extract a fraction of the hemagglutinin protein or
non-toxin non-hemagglutinin protein from botulinum toxin complexes
derived from Clostridium botulinum bacteria. For example, reduced
botulinum toxin complexes may be produced by dissociating botulinum
toxin complexes through exposure to red blood cells at a pH of 7.3
(e.g., see EP 1514556 Al, hereby incorporated by reference). HPLC,
dialysis, columns, centrifugation, and other methods for extracting
proteins from proteins can be used. Alternatively, when the reduced
botulinum toxin complexes are to be produced by combining
synthetically produced botulinum toxin with non-toxin proteins, one
may simply add less hemagglutinin or non-toxin non-hemagglutinin
protein to the mixture than what would be present for naturally
occurring botulinum toxin complexes. Any of the non-toxin proteins
(e.g., hemagglutinin protein or non-toxin non-hemagglutinin protein
or both) in the reduced botulinum toxin complexes according to the
invention may be reduced independently by any amount. In certain
exemplary embodiments, one or more non-toxin proteins are reduced
by at least about 0.5%, 1%, 3%, 5%, 10%, 20%, 30%, 40%, 50%, 60%,
70%, 80%, or 90% compared to the amounts normally found in
botulinum toxin complexes. In one embodiment, substantially all of
the non-toxin protein (e.g., >95% of the hemagglutinin protein
and non-toxin non-hemagglutinin protein) that would normally be
found in botulinum toxin complexes derived from Clostridium
botulinum bacteria is removed from the botulinum toxin complex. In
another embodiment, only the pure botulinum toxin molecule, without
any hemagglutinin protein and non-toxin non-hemagglutinin protein,
is used. Furthermore, although the amount of endogenous non-toxin
proteins may be reduced by the same amount in some cases, this
invention also contemplates reducing each of the endogenous
non-toxin proteins by different amounts, as well as reducing at
least one of the endogenous non-toxin proteins, but not the
others.
[0034] This invention also contemplates the general use of
combinations and mixtures of botulinum toxins, although due to
their differing nature and properties, mixtures of botulinum toxin
serotypes are not generally administered at this time in the
health-care or cosmetic industries.
[0035] The botulinum toxin formulations of the invention comprise a
non-ionic surfactant. Generally, this invention contemplates the
use of any non-ionic surfactant that has the ability to stabilize
botulinum toxin and that is suitable for pharmaceutical use. In
certain embodiments, the non-ionic surfactant is a polysorbate,
non-limiting examples of which include polysorbate 20, polysorbate
40, polysorbate 60, and polysorbate 80. In other embodiments, the
non-ionic surfactant is a sorbitan ester, non-limiting examples of
which include Span 20, Span 60, Span 65, and Span 80. The invention
also contemplates the use of poloxamers, non-limiting examples of
which include poloxamer 181, poloxamer 188, and poloxamer 407. The
invention also contemplates using Triton X-100 or NP-40 as the
non-ionic surfactants. In addition, the invention contemplates
embodiments in which combinations of different non-ionic
surfactants are used in conjunction. In certain preferred
embodiments, the non-ionic surfactant is selected from the group
consisting of polysorbates, poloxamers, and sorbitans, with
polysorbates and sorbitans being particularly preferred. In
preferred embodiments, the concentration of the non-ionic
surfactant is in the range of 0.005% to 0.5%, or in the range of
0.01% to 0.2%, or in the range of 0.02% to 0.1% or in the range of
0.05 to 0.08%. This invention also contemplates formulations where
the concentration of the non-ionic surfactant is 0.01%, 0.02%,
0.03%, 0.04%, 0.05%, 0.06%, 0.07%, 0.08%, 0.09%, 0.10%, 0.11%,
0.12%, 0.13%, 0.14%, or 0.15%.
[0036] The botulinum toxin formulations of the invention comprise a
non-reducing sugar. In preferred embodiments, the non-reducing
sugar has a glass transition temperature above 55.degree. C.,
57.degree. C. or 60.degree. C. Without wishing to be bound by
theory, it is believed that such glass transition temperatures are
sufficiently high to suppress undesirable molecular motions that
cause the botulinum toxin to denature. In certain particularly
preferred embodiments, the non-reducing sugar is a disaccharide,
non-limiting examples of which include trehalose and sucrose. In
other embodiments, the non-reducing sugar is a trisaccharide, a
non-limiting example of which is raffinose. Generally, the
concentration of the non-reducing sugar in the botulinum toxin
formulations of the invention are in the range of 10% to 40% (w/v),
preferably 10% to 25% (w/v), more preferably 15% to 20% (w/v). In
some preferred embodiments, the concentration of the non-reducing
sugar is 10%, 11%, 12%, 13%, 14%, 15%, 16%, 17%, 18%, 19% or 20%
(w/v). When the non-reducing sugar is trehalose, preferably the
hydrated form of trehalose (i.e., trehalose-dihydrate) is used to
prepare the formulation, although use of the anhydrous form of
trehalose is contemplated as well.
[0037] Furthermore, one aspect of this invention is the recognition
that the choice of non-reducing sugar may be used to tailor the
stability of the botulinum toxin formulation as a function of
temperature. For instance, when the botulinum toxin formulation is
subjected to conditions without refrigeration it is advantageous to
use trehalose as the non-reducing sugar, because trehalose confers
stability to the botulinum toxin at ambient temperatures. Thus,
trehalose-containing formulations of the invention may be
advantageously processed at ambient temperatures during various
manufacturing processes without appreciable loss of botulinum toxin
activity. In situations where the botulinum toxin formulation will
be refrigerated (e.g., during long term storage lasting months or
even years), one may choose sucrose as the non-reducing sugar.
Mixtures of sugars are also contemplated by the invention. For
example, in certain embodiments, both sucrose and trehalose are
added to the botulinum toxin formulation. The specific ratio of
components of the sugar mixture will depend upon the effect to be
achieved and can be determined by routine experimentation. Also
within the scope of this invention is the use of different
non-reducing sugars, such as disaccharides, alone or in combination
during different stages of purification, manufacturing, or storage.
Thus, for example, trehalose may be used during initial processing
and/or purification at higher temperatures (e.g., ambient
temperature), followed by removal and replacement of the trehalose
with sucrose. The removal and substitution of one non-reducing
sugar, such as a disaccharide, for another may be accomplished by,
for example, dialysis, chromatography, or other methods known in
the art.
[0038] Another aspect of the invention is the recognition that the
non-reducing sugar (or sugars) specified herein may, for certain
embodiments, act as the primary bulking agent for solid botulinum
toxin formulations. In particular, it has been discovered that the
non-reducing sugars, when added in the amounts specified herein,
can form a stable and mechanically robust cake upon lyophilization
or vacuum-drying of the botulinum toxin formulation. Without
wishing to be limited by theory, it is believed that the
non-reducing sugars in such formulations form an amorphous solid in
which the hydroxyl groups on the non-reducing sugar randomly orient
the non-reducing sugar to maximize hydrogen bonding, which
stabilizes the botulinum toxin and imparts mechanical robustness to
the solid cake. In some preferred embodiments, the non-reducing
sugars described herein are used as the sole bulking agent for the
botulinum toxin formulations. In other preferred embodiments, a
non-reducing sugar acts as the primary bulking agent, but small
amounts of secondary bulking agents are added to the botulinum
toxin formulation. The secondary bulking agents are not
particularly limited, and may be any bulking agent that does not
have an unacceptably adverse affect on the stability of the
botulinum toxin formulation. When using secondary bulking agents
that have a tendency to crystallize, it is preferable to add them
in sufficiently low concentrations, so that they are unable to
crystallize. Without wishing to be limited by theory, it is
believed that crystallization of such secondary bulking agents
would have an adverse affect on the stability of the solid cake
obtained after lyophilization or vacuum-drying.
[0039] A further aspect of the invention is the unexpected result
that non-reducing sugars, at the concentrations described herein,
may be used not only to stabilize lyophilized botulinum toxin
formulations, but also botulinum toxin formulations in the solution
phase.
[0040] In preferred embodiments, the botulinum toxin formulation
comprises a buffer. Generally, any physiologically compatible
buffer capable of maintaining the pH in the range of 4.5 to 6.5,
more preferably in the range of 5 to 6, and most preferably about
5.5, is suitable for the botulinum toxin formulations of the
invention. Non-limiting examples of such buffers include those
involving salts of citric acid, acetic acid, succinnic acid,
tartaric acid, maleic acid, and histidine. Non-limiting examples of
suitable buffer concentrations include buffer concentrations in the
range of 0.400% to 0.600%; 0.450% to 0.575%, or 0.500% to 0.565%.
The invention also contemplates botulinum toxin formulations
comprising a mixture of buffer salts, non-limiting examples of
which include citrate/acetate, citrate/histidine, citrate/tartrate,
maleate/histidine, or succinate/histidine. In certain preferred
embodiments, the buffer is phosphate buffer.
[0041] In certain embodiments, the botulinum toxin formulations
comprise a bulking agent (in addition to the non-reducing sugar(s))
which makes it easier to handle lyophilized forms of the botulinum
toxin formulations. In certain preferred embodiments, the bulking
agents crystallize under lyophilization conditions and do not mix
well with the other excipients when in the solid state. However, in
other preferred embodiments, the bulking agent remains amorphous
under lyophilization conditions, even if it is known to have a
tendency to crystallize during freezing (e.g., mannitol or
glycine). As will be understood by a person of ordinary skill in
the art, whether a bulking agent will crystallize or remain
amorphous during lyophilization is governed by several factors,
including the type of bulking agent, the amount of bulking agent
relative to the other components of the formulation, and the rate
at which the formulation is lyophilized. In certain preferred
embodiments, the amount of non-reducing sugar relative to bulking
agent is adjusted to suppress the crystallization of the bulking
agent. When this is the case, the ratio of non-reducing sugar to
bulking agent, on a weight percent basis, may be greater than 0.33
to 1; 0.5 to 1, 0.75 to 1; 1:1; 2:1, 3:1, or 4:1. Non-limiting
examples of bulking agents contemplated by the invention include
sorbitol, mannitol, glycine, arginine, and histidine. In some
embodiments, the concentration of the bulking agent may be in the
range of 1% to 10%, 2% to 6%, 3% to 5% or 4% to 4.5% (w/v). In
certain preferred embodiments, when a bulking agent is used, the
concentration of the non-reducing sugar may be reduced from the 10%
to 40% (w/v) range to a range of 0.5% to 3.0% (w/v). Furthermore,
in certain preferred embodiments, the ratio of the non-reducing
sugar to the bulking agent is in the range of 0.07 to 2.0,
preferably in the range of 0.4 to 0.6. Thus, by way of example
only, the formulation may comprise mannitol as the bulking agent
and trehalose dihydrate as the non-reducing sugar, with mannitol
present in a concentration range of 1.5% to 7.5% (w/v) and
trehalose dihydrate present in a concentration range of 0.5% to
3.0% (w/v). Preferably, the bulking agent is not sodium
chloride.
[0042] The botulinum toxin formulations of the invention can be
administered via any conventional route of administration. In some
embodiments of the invention, the botulinum toxin formulations are
administered by intramuscular or subcutaneous injection into to the
subject. In other embodiments, the botulinum toxin formulations are
administered topically. Regardless of whether the botulinum toxin
formulations are administered topically or by injection, the
formulations may include a positively charged carrier having
positively charged efficiency groups, as described herein, in order
to facilitate the penetration of the botulinum toxin into the
issues of interest. It should be noted, however, that the
positively charged carrier is not required for stabilization and
that the invention contemplates embodiments in which the
formulations do not comprise such a positively charged carrier. The
botulinum toxin formulations of the invention may also be
administered via a drug delivery device, a non-limiting example of
which is a skin patch.
[0043] When the botulinum toxin formulations are to be administered
topically, it is advantageous to include in the formulations a
positively charged carrier with positively charged branching
groups, as described herein, to promote transdermal penetration of
the botulinum toxin (see also U.S. patent application Ser. Nos.
09/910,432; 11/073,307; 11/072,026; and 10/793,138, each of which
is incorporated by reference in its entirety). Without the use of
the positively charged carrier or some other means of enhancing
transdermal transport, the transdermal flux of topically applied
botulinum toxin would be expected to be quite low. It should be
noted that the invention also contemplates the use of other methods
of enhancing transdermal transport, besides the use of a positively
charge carrier as described herein, with the botulinum toxin
formulations of the invention. Non-limiting examples of such
methods include transdermal delivery of the botulinum toxin
formulations using liposomes, iontophoresis, micelles, and the
like.
[0044] Furthermore, when the botulinum toxin formulations are to be
administered topically, it is often advantageous to mix them with
gelling agents and/or viscosity-modifying agents to increase the
viscosity of the formulation, order make the application of the
botulinum toxin easier and more accurate. Additionally, if a
positively charged carrier is used, these agents help to prevent
the aqueous botulinum toxin/carrier formulation from drying out,
which tends to cause a decrease in the activity of the botulinum
toxin. Particularly preferred agents are those that are uncharged
and do not interfere with the botulinum toxin activity or the
efficiency of the toxin-carrier complexes in crossing skin. The
gelling agents may be certain cellulose-based gelling agents, such
as hydroxypropylcellulose (HPC) for example. In some embodiments,
the botulinum toxin/carrier complex is formulated in a composition
having 2-4% HPC. Alternatively, the viscosity of a solution
containing a botulinum toxin/carrier complex may be altered by
adding polyethylene glycol (PEG). In other embodiments, the
botulinum toxin/carrier solution is combined with pre-mixed viscous
agents, such as Cetaphil.RTM. moisturizer. In other embodiments,
the viscosity modifying agent is a poloxamer, non-limiting examples
of which include poloxamer 188 and poloxamer 407. The
viscosity-modifying agent may also be a polyacrylic acid, a
polyamide, or a vegetable gum (e.g., guar gum). Furthermore,
botulinum toxin formulations as described herein may be mixed with
excipients to form emulsions (including microemulsions),
suspensions, creams, lotions, gels, powders, or other typical solid
or liquid compositions used for application to skin and other
tissues where the compositions may be used. Such compositions may
also contain other ingredients typically used in such products,
such as antimicrobials, moisturizers and hydration agents,
penetration agents, preservatives, emulsifiers, natural or
synthetic oils, solvents, surfactants, detergents, emollients,
antioxidants, fragrances, fillers, thickeners, waxes, odor
absorbers, dyestuffs, coloring agents, powders, and optionally
anesthetics, anti-itch additives, botanical extracts, conditioning
agents, darkening or lightening agents, glitter, humectants, mica,
minerals, polyphenols, silicones or derivatives thereof, sunblocks,
vitamins, and phytomedicinals.
[0045] This invention also provides kits for preparing and/or
administering the botulinum toxin formulations of the invention. In
some embodiments, the kit comprises the botulinum toxin, as well as
such additional excipients that are needed to produce a stabilized
formulation according to the invention. The kit may also comprise a
premix that may in turn be used to produce such a formulation. In
other embodiments, the kit comprises a botulinum toxin formulation
according to the invention that has been lyophilized and a device
for delivering the formulation, a non-limiting example of which is
a syringe.
[0046] The invention provides formulations that deliver a
"therapeutic amount" of botulinum to the subject during treatment.
As used herein, the term "therapeutic amount" refers to an amount
of botulinum toxin that is sufficient to produce the desired effect
(e.g., relaxation of muscles, treatment of wrinkles, treatment of
pain, or reduction of activity of an overactive gland, such as a
sweat gland). The "therapeutic amount" of botulinum toxin is
implicitly understood to be a safe amount that does not cause
unwanted paralysis or other undesired or harmful side effects. The
specific amount of botulinum toxin that is administered will depend
on several factors, including the route of administration, the site
of administration, the indication to be treated, and the serotype
(or serotypes) of botulinum toxin in the specific formulation. For
instance, when the type A serotype botulinum toxin is selected, a
therapeutic amount may be in the range of 10 U to 150 U or 1,000 U
to 2,500 U. In other preferred embodiments, the therapeutic amount
ranges from 400 U to 800 U and 1,000 U to 50,000 U, preferably from
2,000-35,000 U, more preferably from 3,000 U-30,000 U, and even
more preferably from 4,000 U to 25,000 U. In certain embodiments,
the therapeutic amount ranges from 4,000 U to 8,000 U, 9,000 U to
19,000 U, or 20,000 U to 40,000 U.
[0047] The compositions of the invention are applied so as to cause
a desired effect, which may be a cosmetic or a therapeutic effect.
Desired effects include the relaxation of certain muscles with the
aim of, for instance, decreasing the appearance of fine lines
and/or wrinkles, especially in the face, or adjusting facial
appearance in other ways such as widening the eyes, lifting the
corners of the mouth, or smoothing lines that fan out from the
upper lip, or the general relief of muscular tension. The
last-mentioned effect, general relief of muscular tension, can be
effected in the face or elsewhere. The compositions of the
invention may contain an appropriate effective amount of the
botulinum toxin for application as a single-dose treatment, or may
be more concentrated, either for dilution at the place of
administration or for use in multiple applications. The stabilized
botulinum toxin complexes or stabilized reduced botulinum toxin
complexes can be administered to a subject for treating conditions
such as undesirable facial muscle or other muscular spasms,
hyperhidrosis, acne, or conditions elsewhere in the body in which
relief of muscular ache or spasms is desired. The botulinum toxin
is administered delivery to muscles or to other skin-associated
structures. The administration may be made, for example, to the
face, legs, shoulders, back (including lower back), axilla, palms,
feet, neck, groin, dorsa of the hands or feet, elbows, upper arms,
knees, upper legs, buttocks, torso, pelvis, or any other part of
the body where administration of the botulinum toxin is
desired.
[0048] In certain preferred embodiments, the botulinum toxin
formulations of the invention comprise a positively charged carrier
with positively charged efficiency groups. When this is the case,
the positively charged carrier is present in an amount sufficient
to facilitate penetration of the botulinum toxin into the tissues
of interest. As used herein, the term "positively charged" means
that the carrier has a positive charge under at least some
solution-phase conditions, more preferably under at least some
physiologically compatible conditions. More specifically,
"positively charged" means that the group in question contains
functionalities that are charged under all pH conditions, for
instance, a quaternary amine, or contains a functionality which can
acquire positive charge under certain solution-phase conditions,
such as pH changes in the case of primary amines. More preferably,
"positively charged" as used herein refers to those groups that
have the behavior of associating with anions over physiologically
compatible conditions. Polymers with a multiplicity of
positively-charged moieties need not be homopolymers, as will be
apparent to one skilled in the art. Other examples of positively
charged moieties are well known in the prior art and can be
employed readily, as will be apparent to those skilled in the
art.
[0049] Generally, the positively-charged carrier comprises a
positively charged backbone, which is typically a chain of atoms,
either with groups in the chain carrying a positive charge at
physiological pH, or with groups carrying a positive charge
attached to side chains extending from the backbone. Preferably,
the positively charged backbone itself will not have a defined
enzymatic or therapeutic biologic activity. The linear backbone is
a hydrocarbon backbone which is, in some embodiments, interrupted
by heteroatoms selected from nitrogen, oxygen, sulfur, silicon and
phosphorus. The majority of backbone chain atoms are usually
carbon. Additionally, the backbone will often be a polymer of
repeating units (e.g., amino acids, poly(ethyleneoxy),
poly(propyleneamine), polyalkyleneimine, and the like) but can be a
heteropolymer. In one group of embodiments, the positively charged
backbone is a polypropyleneamine wherein a number of the amine
nitrogen atoms are present as ammonium groups (tetra-substituted)
carrying a positive charge. In another embodiment, the positively
charged backbone is a nonpeptidyl polymer, which may be a hetero-
or homo-polymer such as a polyalkyleneimine, for example a
polyethyleneimine or polypropyleneimine, having a molecular weight
of from about 100 to about 2,500,000 D, preferably from about 250
to about 1,800,000 D, and most preferably from about 1000 to about
1,400,000 D. In another group of embodiments, the backbone has
attached a plurality of side-chain moieties that include positively
charged groups (e.g., ammonium groups, pyridinium groups,
phosphonium groups, sulfonium groups, guanidinium groups, or
amidinium groups). The sidechain moieties in this group of
embodiments can be placed at spacings along the backbone that are
consistent in separations or variable. Additionally, the length of
the sidechains can be similar or dissimilar. For example, in one
group of embodiments, the sidechains can be linear or branched
hydrocarbon chains having from one to twenty carbon atoms and
terminating at the distal end (away from the backbone) in one of
the above-noted positively charged groups. In all aspects of the
present invention, the association between the carrier and the
botulinum toxin is by non-covalent interaction, non-limiting
examples of which include ionic interactions, hydrogen bonding, van
der Waals forces, or combinations thereof.
[0050] In one group of embodiments, the positively charged backbone
is a polypeptide having multiple positively charged sidechain
groups (e.g., lysine, arginine, ornithine, homoarginine, and the
like). Preferably, the polypeptide has a molecular weight of from
about 100 to about 1,500,000 D, more preferably from about 250 to
about 1,200,000 D, most preferably from about 1000 to about
1,000,000 D. One of skill in the art will appreciate that when
amino acids are used in this portion of the invention, the
sidechains can have either the D- or L-form (R or S configuration)
at the center of attachment. In certain preferred embodiments, the
polypeptide has a molecular weight from about 500 to about 5000 D,
more preferably from 1000 to about 4000 D, more preferably from
2000 to about 3000 D. In other embodiments, the polypeptide has a
molecular weight of at least about 10,000.
[0051] In another embodiment, the backbone portion is a polylysine
and efficiency groups, as discussed herein, are attached to the
polylysine. The polylysine may have a molecular weight of from
about 100 to about 1,500,000 D, preferably from about 250 to about
1,200,000 D, and most preferably from about 1000 to about 3000 D.
In one exemplary embodiment, the positively charged carrier with
positively charged efficiency groups is a peptide with the amino
acid sequence RKKRRQRRR-G-(K).sub.15-G-RKKRRQRRR,
RGRDDRRQRRR-G-(K).sub.15-G-RGRDDRRQRRR, or
YGRKKRRQRRR-G-(K).sub.15-G-YGRKKRRQRRR. It also can be any of the
commercially available (Sigma Chemical Company, St. Louis, Mo.,
USA) polylysines such as, for example, polylysine having
MW>70,000 D, polylysine having MW of 70,000 to 150,000 D,
polylysine having MW 150,000 to 300,000 D and polylysine having
MW>300,000 D. The selection of an appropriate polylysine will
depend on the remaining components of the composition and will be
sufficient to provide an overall net positive charge to the
composition and provide a length that is preferably from one to
four times the combined length of the negatively charged
components.
[0052] Alternatively, the backbone can be an analog of a
polypeptide such as a peptoid. See, for example, Kessler, Angew.
Chem. Int. Ed. Engl. 32:543 (1993); Zuckermann et al.
Chemtracts--Macromol. Chem. 4:80 (1992); and Simon et al. Proc.
Nat'l. Acad. Sci. USA 89:9367 (1992)). Briefly, a peptoid is a
polyglycine in which the sidechain is attached to the backbone
nitrogen atoms rather than the alpha-carbon atoms. As above, a
portion of the sidechains will typically terminate in a positively
charged group to provide a positively charged backbone component.
Synthesis of peptoids is described in, for example, U.S. Pat. No.
5,877,278, which is hereby incorporated by reference in its
entirety. As the term is used herein, positively charged backbones
that have a peptoid backbone construction are considered
"non-peptide" as they are not composed of amino acids having
naturally occurring sidechains at the a-carbon locations.
[0053] A variety of other backbones can be used employing, for
example, steric or electronic mimics of polypeptides wherein the
amide linkages of the peptide are replaced with surrogates such as
ester linkages, thioamides (--CSNH--), reversed thioamide
(--NHCS--), aminomethylene (--NHCH.sub.2--) or the reversed
methyleneamino (--CH.sub.2NH--) groups, keto-methylene
(--COCH.sub.2--) groups, phosphinate (--PO.sub.2RCH.sub.2--),
phosphonamidate and phosphonamidate ester (--PO.sub.2RNH--),
reverse peptide (--NHCO--), trans-alkene (--CR.dbd.CH--),
fluoroalkene (--CF.dbd.CH--), dimethylene (--CH.sub.2CH.sub.2--),
thioether (--CH.sub.2S--), hydroxyethylene (--CH(OH)CH.sub.2--),
methyleneoxy (--CH.sub.2O--), tetrazole (CN.sub.4), sulfonamido
(--SO.sub.2NH--), methylenesulfonamido (--CHRSO.sub.2NH--),
reversed sulfonamide (--NHSO.sub.2--), and backbones with malonate
and/or gem-diamino-alkyl subunits, for example, as reviewed by
Fletcher et al. ((1998) Chem. Rev. 98:763) and detailed by
references cited therein. Many of the foregoing substitutions
result in approximately isosteric polymer backbones relative to
backbones formed from a-amino acids.
[0054] In each of the backbones provided above, sidechain groups
can be appended that carry a positively charged group. For example,
the sulfonamide-linked backbones (--SO.sub.2NH-- and
--NHSO.sub.2--) can have sidechain groups attached to the nitrogen
atoms. Similarly, the hydroxyethylene (--CH(OH)CH.sub.2--) linkage
can bear a sidechain group attached to the hydroxy substituent. One
of skill in the art can readily adapt the other linkage chemistries
to provide positively charged sidechain groups using standard
synthetic methods.
[0055] In some embodiments of the invention, the positively charged
carrier comprises positively charged efficiency groups.
Non-limiting examples of efficiency groups include
-(gly).sub.n1-(arg).sub.2, in which the subscript n1 is an integer
of from 0 to 20 more preferably 0 to 8, still more preferably 2 to
5, and the subscript n2 is independently an odd integer of from
about 5 to about 25, more preferably from about 7 to about 17, and
most preferably from about 7 to about 13, HIV-TAT or fragments
thereof, or Antennapedia PTD or a fragment thereof. Preferably the
side-chain or branching groups have the general formula
-(gly).sub.n1-(arg).sub.n2 as described above. Other preferred
embodiments are those in which the branching or efficiency groups
are HIV-TAT fragments that have the formula
(gly).sub.p-RGRDDRRQRRR-(gly).sub.q,
(gly).sub.p-YGRKKRRQRRR-(gly).sub.q, or
(gly).sub.p-RKKRRQRRR-(gly).sub.q, wherein the subscripts p and q
are each independently an integer of from 0 to 20 and the fragment
is attached to the carrier molecule via either the C-terminus or
the N-terminus of the fragment. The side branching groups can have
either the D- or L-form (R or S configuration) at the center of
attachment. Preferred HIV-TAT fragments are those in which the
subscripts p and q are each independently integers of from 0 to 8,
more preferably 2 to 5. Other preferred embodiments are those in
which the branching groups are Antennapedia PTD groups or fragments
thereof that retain the group's activity. These are known in the
art, for instance, from Console et al., J. Biol. Chem. 278:35109
(2003). Preferably, the positively charged carrier includes
side-chain positively charged branching groups in an amount of at
least about 0.05%, as a percentage of the total carrier weight,
preferably from about 0.05 to about 45 weight %, and most
preferably from about 0.1 to about 30 weight %. For positively
charged branching groups having the formula
-(gly).sub.n1-(arg).sub.n2, the most preferred amount is from about
0.1 to about 25%.
[0056] The following examples are meant to provide non-limiting
illustrations of various embodiments of the invention. As a person
of ordinary skill in the art will recognize, modifications may be
made without departing from the spirit and the scope of the
invention.
EXAMPLES
Example 1
Preparation of a Botulinum Toxin Formulation
[0057] An exemplary botulinum toxin formulation of the invention
was prepared by combining appropriate amounts of trehalose
dihydrate, polysorbate-20, histidine, and histidine HCl to produce
a 2.times. formulation stock solution that contained 36% trehalose
dihydrate, 0.05% polysorbate-20, and 1.126% histidine at a pH of
5.5. The solution was cooled to 4.degree. C. Botulinum toxin API
was pelleted by centrifugation from an ammonium sulfate stock
suspension. The toxin pellet was dissolved in 0.56% histidine
buffer pH 5.5 with 0.05% polysorbate-20. This solution was further
diluted with the histidine/polysorbate-20 solution to give a toxin
stock solution of 1.074 .mu.g/mL solution.
[0058] A stock solution of the carrier peptide
RKKRRQRRR-G-(K).sub.15-G-RKKRRQRRR was prepared by dissolving
sufficient peptide into water to produce a solution of 6.0 mg/mL
peptide. Toxin stock solution, peptide stock solution, 0.56%
histidine buffer, and 2.times. formulation stock solution were
combined to produce a formulation bulk drug product consisting of
18% trehalose dihydrate, 0.025% polysorbate-20, 0.56% histidine
buffer, 55 ng/mL toxin and 150 .mu.g/mL carrier peptide.
Example 2
Lyophilization of a Botulinum Toxin Formulation
[0059] This example provides a lyophilization procedure for a
botulinum toxin formulation according to the invention. 200 .mu.L
aliquots of the formulation bulk drug product described in Example
1 was transferred to each of fifty-five 2-mL glass vials. Grey
butyl rubber lyophilization stoppers were loosely placed on top of
the glass vials. The vials were placed into the lyophilizer and
lyophilization initiated.
[0060] The lyophilization process comprised three main stages: (1)
a freezing stage; (2) a primary drying stage; and (3) a secondary
drying stage. Each of these three main stages contained one or more
individual process steps, which were performed at the temperatures
and pressures as indicated below. The primary drying time required
to complete primary drying varied depending upon the number of
vials and the fill volume in the vials.
Freezing
TABLE-US-00001 [0061] Step Rate/Hold deg C. Minutes 1 H 5 50 2 R
-45 60 3 H -45 120
Freeze, Condenser and Evacuate:
TABLE-US-00002 [0062] Freeze Temperature: -40 deg C. Shelf or
Product Ave Extra Freeze Time: 0 minutes Vacuum Start Permit: -45
Avg Cond deg C. Heat Start Permit: 200 mTorr
Primary Drying
TABLE-US-00003 [0063] Step Rate/Hold deg C. Minutes mTorr 1 H -45
150 150 2 H -33 2520 150 3 R -25 990 150 4 H -25 275 150 5 H -15
240 150 6 H 0 300 150 7 R 25 180 150 8 H 25 120 150
Secondary Drying
TABLE-US-00004 [0064] Step 1 H 27 160 100
Example 3
Stability of botulinum Toxin Formulation with Trehalose
Dihydrate
[0065] FIGS. 1 and 2 show the results of stability studies in which
vials of the botulinum toxin formulation prepared at two different
toxin concentrations with trehalose dihydrate (11 ng/vial and 1.1
ng/vial) were prepared as described above, stored at 4.degree. C.,
25.degree. C. and 40.degree. C. and tested at the indicated time
points to determine the biological activity of the botulinum toxin
for a duration of up to 18 months. The activity was measured using
the LD.sub.50 mouse assay and the activities are reported in FIGS.
1 and 2 as equivalent units of botulinum toxin per vial. At the
beginning of the experiment (t=0), the observed activity was 1802
units of botulinum toxin per vial for the formulation in FIG. 1 and
192 units of botulinum toxin per vial for the formulation in FIG.
2. The observed variability in the botulinum toxin activity in
FIGS. 1 and 2 is believed to result from the inherent noise in the
data obtained using the LD.sub.50 mouse assay and the small sample
number (n=1 vial/temperature-timepoint). Despite this variability,
the data indicate that there is no trend to loss of recovered
activity over this eighteen-month study, even at a storage
temperature of 40.degree. C. These data provide an example of the
stabilization of an exemplary botulinum toxin formulation of the
invention.
Example 4
Stability of botulinum toxin formulation with sucrose
[0066] FIG. 3 shows the results of stability studies in which vials
of the botulinum toxin formulation with sucrose at 11 ng/vial were
prepared using the protocol described above for the
trehalose-containing formulations, stored at 4.degree. C. and
25.degree. C. and tested at the indicated time points to determine
the biological activity of the botulinum toxin for a duration of up
to 18 months. The activity was measured using the LD.sub.50 mouse
assay as described above and the activities are reported in FIG. 3
as equivalent units of botulinum toxin per vial. At the beginning
of the experiment (t=0), the observed activity was 2299 units of
botulinum toxin per vial. The observed variability in the botulinum
toxin activity in FIG. 3 is believed to result from the inherent
noise in the data obtained using the LD.sub.50 mouse assay and the
small sample number (n=1 vial/temperature-timepoint). Despite this
variability, the data indicate that there is no trend to loss of
recovered activity over this eighteen-month study, even at a
storage temperature of 25.degree. C. These data provide an example
of the stabilization of an exemplary botulinum toxin formulation of
the invention.
Example 5
Lyophilization of a Botulinum Toxin Formulation with Bulking
Agents
[0067] In this example, the botulinum toxin formulation was
prepared by combining appropriate amounts of trehalose dihydrate,
mannitol, polysorbate-20, histidine, and histidine HCl to produce a
formulation stock solution that contained 3% trehalose dihydrate,
7.5% mannitol, 0.05% polysorbate-20, and 0.563% histidine at a pH
of 5.5. The solution was cooled to 4.degree. C. Botulinum toxin API
was pelleted by centrifugation from an ammonium sulfate stock
suspension. The toxin pellet was dissolved in the formulation stock
solution. The concentration of this solution was 117 .mu.g/mL. This
solution was further diluted with the same solution to a final
toxin stock solution concentration of 11.7 .mu.g/mL. A sufficient
amount of a carrier peptide having the amino acid sequence
RKKRRQRRR-G-(K).sub.15-G-RKKRRQRRR was dissolved in water to
prepare a 20 mg/mL carrier peptide stock solution. These solutions
were combined to create a formulation bulk drug product with a
final composition of 3% trehalose dihydrate, 7.5% mannitol, 0.05%
polysorbate-20, and 0.563% histidine pH of 5.5, 75 .mu.g/mL carrier
peptide, and 5.5 ng/mL toxin,
[0068] Aliquots of 200 .mu.L of the formulation bulk drug product
were added to each of 192 2-mL glass lyophilization vials. Grey
Butyl rubber stoppers were placed loosely on top of the vials. The
vials were then placed in the lyophilizer and lyophilization was
initiated.
[0069] As in the previous example, the lyophilization process
comprised three main stages: (1) a freezing stage; (2) a primary
drying stage; and (3) a secondary drying stage. Each of these three
main stages contained one or more individual process steps, which
were performed at the temperatures and pressures as indicated
below:
Freezing
TABLE-US-00005 [0070] Step Rate/Hold deg C. Minutes 1 H 5 30 2 R
-45 50 3 H -45 60 4 R -20 25 5 H -20 240 6 R -45 25 7 H -45 60
Freeze, Condenser and Evacuate:
TABLE-US-00006 [0071] Freeze Temperature: -45 deg C. Shelf or
Product Ave Extra Freeze Time: 1 minutes Vacuum Start Permit: -40
Avg Cond deg C. Heat Start Permit: 300 mTorr
Primary Drying
TABLE-US-00007 [0072] Step Rate/Hold deg C. Minutes mTorr 1 H -45
30 150 2 R -28 80 150 3 H -28 900 150 4 R -15 20 150 5 H -15 180
150 6 R -5 20 150 7 H -5 180 150 8 R 27 100 150
Secondary Drying
TABLE-US-00008 [0073] Step 1 H 27 540 100
Sequence CWU 1
1
7135PRTArtificial SequenceDescription of Artificial Sequence
Synthetic polypeptide 1Arg Lys Lys Arg Arg Gln Arg Arg Arg Gly Lys
Lys Lys Lys Lys Lys1 5 10 15Lys Lys Lys Lys Lys Lys Lys Lys Lys Gly
Arg Lys Lys Arg Arg Gln 20 25 30Arg Arg Arg 35239PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
2Arg Gly Arg Asp Asp Arg Arg Gln Arg Arg Arg Gly Lys Lys Lys Lys1 5
10 15Lys Lys Lys Lys Lys Lys Lys Lys Lys Lys Lys Gly Arg Gly Arg
Asp 20 25 30Asp Arg Arg Gln Arg Arg Arg 35339PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
3Tyr Gly Arg Lys Lys Arg Arg Gln Arg Arg Arg Gly Lys Lys Lys Lys1 5
10 15Lys Lys Lys Lys Lys Lys Lys Lys Lys Lys Lys Gly Tyr Gly Arg
Lys 20 25 30Lys Arg Arg Gln Arg Arg Arg 35445PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
4Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly1 5
10 15Gly Gly Gly Gly Arg Arg Arg Arg Arg Arg Arg Arg Arg Arg Arg
Arg 20 25 30Arg Arg Arg Arg Arg Arg Arg Arg Arg Arg Arg Arg Arg 35
40 45551PRTArtificial SequenceDescription of Artificial Sequence
Synthetic polypeptide 5Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly
Gly Gly Gly Gly Gly1 5 10 15Gly Gly Gly Gly Arg Gly Arg Asp Asp Arg
Arg Gln Arg Arg Arg Gly 20 25 30Gly Gly Gly Gly Gly Gly Gly Gly Gly
Gly Gly Gly Gly Gly Gly Gly 35 40 45Gly Gly Gly 50651PRTArtificial
SequenceDescription of Artificial Sequence Synthetic polypeptide
6Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly1 5
10 15Gly Gly Gly Gly Tyr Gly Arg Lys Lys Arg Arg Gln Arg Arg Arg
Gly 20 25 30Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly
Gly Gly 35 40 45Gly Gly Gly 50749PRTArtificial SequenceDescription
of Artificial Sequence Synthetic polypeptide 7Gly Gly Gly Gly Gly
Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly1 5 10 15Gly Gly Gly Gly
Arg Lys Lys Arg Arg Gln Arg Arg Arg Gly Gly Gly 20 25 30Gly Gly Gly
Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly Gly 35 40 45Gly
* * * * *