WO2014059157A1 - Topical vitamin d oral supplement compositions - Google Patents
Topical vitamin d oral supplement compositions Download PDFInfo
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- WO2014059157A1 WO2014059157A1 PCT/US2013/064358 US2013064358W WO2014059157A1 WO 2014059157 A1 WO2014059157 A1 WO 2014059157A1 US 2013064358 W US2013064358 W US 2013064358W WO 2014059157 A1 WO2014059157 A1 WO 2014059157A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/59—Compounds containing 9, 10- seco- cyclopenta[a]hydrophenanthrene ring systems
- A61K31/592—9,10-Secoergostane derivatives, e.g. ergocalciferol, i.e. vitamin D2
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/59—Compounds containing 9, 10- seco- cyclopenta[a]hydrophenanthrene ring systems
- A61K31/593—9,10-Secocholestane derivatives, e.g. cholecalciferol, i.e. vitamin D3
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0053—Mouth and digestive tract, i.e. intraoral and peroral administration
- A61K9/006—Oral mucosa, e.g. mucoadhesive forms, sublingual droplets; Buccal patches or films; Buccal sprays
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/06—Ointments; Bases therefor; Other semi-solid forms, e.g. creams, sticks, gels
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
- A61P1/02—Stomatological preparations, e.g. drugs for caries, aphtae, periodontitis
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
- A61K47/08—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
- A61K47/10—Alcohols; Phenols; Salts thereof, e.g. glycerol; Polyethylene glycols [PEG]; Poloxamers; PEG/POE alkyl ethers
Definitions
- the subject application pertains to topical, vitamin D, oral supplement compositions useful in treating oral inflammation .
- these peptides have been shown to provoke an increased immune response and demonstrate antibacterial activity in the presence of the periodontal pathogen Aggregaitbacter actinomycetemcomitans . It has also been demonstrated that the genes responsible for the production of these antimicrobial peptides can be up-regulated or induced to produce an increased expression of these protective agents in the presence of adjunctively administered, vitamin D supplement, i.e. vitamin D3 [ 1 , 25 (OH) 2D3 ] and its precursors and derivatives. See: McMahone, L, et . al . (Jun 2011) "Vitamin D-mediated induction of innate immunity in gingival epithelial cells," Infect . Immun . , 79(6) 2250-7.
- the present invention is directed to topical vitamin D oral supplement compositions useful in treating oral inflammation.
- Suitable vitamin D for the purposes of the invention include: Vitamin D,
- Vitamin D compounds with hydroxyl groups at 1, 3 and 25 carbon positions
- esters of la, 25-dihydroxy vitamin D 3 esters of la, 25-dihydroxy vitamin D 3 ,
- the vitamin D supplement is contained in aqueous-free emulsion along with a trans-oral mucosal, absorption facilitator .
- the present invention is directed to a topical, vitamin D, oral supplement composition useful in treating oral inflammation comprising: a saliva soluble, aqueous-free, emulsion carrier; an effective level of vitamin D supplement; and a trans-oral mucosal, absorption facilitator, wherein : upon application to the oral mucosa, said composition forms a saliva soluble, mucoadhesive gel, substantive to said oral mucosa; upon continuous exposure of said saliva soluble, mucoadhesive gel to saliva flow, said mucoadhesive gel gradually dissolves effecting controlled release of said vitamin D supplement and said trans-oral mucosal, absorption facilitator onto said oral mucosa; and upon contacting said oral mucosa, said vitamin D supplement and trans-oral mucosal, absorption facilitator passively diffuse through said oral mucosa:
- Vitamin D supplement compositions of the invention when topically applied to the oral mucosa in aqueous-free, emulsion compositions, form gels substantive to the oral mucosa. These gels gradually dissolve in the presence of saliva, releasing vitamin D and a trans-oral mucosal, absorption facilitator which, combined, effect passive diffusion of the vitamin D through the mucosa.
- Incipient periodontal inflammation, gingivitis is known to result from the inflammation reaction to the endotoxins released by the presence of bacterial biofilms in the general area of the tooth anatomy. Left untreated, this condition frequently progresses to the more virulent pathological condition known as periodontitis.
- vitamin D, topical, supplement compositions of the invention provide protection by forming mucoadhesive gels that continuously release vitamin D composition at the inflamed site; thereby inducing passive diffusion of vitamin D into the mucosa which, in turn, increases production of the antimicrobial peptides and provokes a putative therapeutic immune modulating response.
- the diffused vitamin D supplement maintains adequate levels of circulating vitamin D and regulates the in vivo availability and immune response of vitamin D, while minimizing the risk of hypercalcemia.
- Periodontal diseases are initiated by a consortia of oral bacteria that elicit local inflammatory responses that lead to bleeding on probing, loss of periodontal attachment, as well as bone and tooth loss. They have been linked to systemic conditions, including heart disease, diabetes, obesity and metabolic syndrome. The association between periodontal diseases and these systemic conditions seems to be due to a low grade inflammatory burden that links them through a common pathophysiological mechanism. Conceivably, locally secreted cytokines and periodontal pathogens can enter into the bloodstream and contribute to damage elsewhere in the body and there appears to be some evidence for that burden.
- TNF- Tumor necrosis factor a
- IL-6 interleukin 6
- TNF- Tumor necrosis factor a
- IL-6 interleukin 6
- Leptin, adiponectin and resistin are adipokines that are secreted primarily by adipose tissues, but also produced by monocytes and macrophages and are able to directly influence inflammation.
- Vitamin D has an important role in bone growth and maintenance, which might be beneficial for maintaining periodontal health. Recently, it has been suggested to have positive effects on periodontal diseases, tooth loss and gingival inflammation not through its effects on bone metabolism, but rather through anti-inflammatory mechanisms. Hence, maintaining adequate serum values of Vitamin D via topical, adjunctive, vitamin D supplement compositions could be important in the prevention and treatment of periodontal diseases.
- Vitamin D has an important role in calcium homeostasis, bone growth and preservation. It has been shown to inhibit antigen-induced T cell proliferation and cytokine production, acting as an immunomodulatory agent .
- vitamin D has been proposed to also have anti- inflammatory properties. Analyzing 6,700 subjects (See: Dietrich, et . al . , Am. J. Clin. Nutr. 2005, 82:575-580) found that individuals in the highest quintile of serum vitamin D presented significantly less bleeding, lower mean pocket depth and clinical attachment loss, number of missing teeth and BMI . It has also been suggested that vitamin D (and calcium) supplementation may have a positive effect on periodontal health, particularly on bleeding on probing, gingival index and PD .
- vitamin D receptors have been linked to generalized aggressive periodontitis (GAgP) (see: Park, et . al . J. Clin. Periodontol. 2006; 33:524-528) and severe chronic periodontitis (see: Wang, et. al. J. Periodontol. 2009; 80:603-608).
- GgP generalized aggressive periodontitis
- severe chronic periodontitis see: Wang, et. al. J. Periodontol. 2009; 80:603-608.
- the highest levels of circulating vitamin D were detected among the individuals that presented less bleeding on probing, lower mean PD, CAL and number of missing teeth, as well as levels of pathogenic bacteria.
- the proposed anti-inflammatory role of vitamin D was confirmed by its positive correlation with adiponectin and negative correlation with IL-6 and leptin.
- vitamin D 1 , 25-dihydroxyvitamin D3 [ 1 , 25 (OH) 2D3 ]
- the active form of vitamin D, 1 , 25-dihydroxyvitamin D3 [ 1 , 25 (OH) 2D3 ] is a secosteroid hormone that regulates calcium and bone metabolism, controls cell proliferation and differentiation and exerts immunoregulatory activities. This range of functions has been exploited clinically to treat a variety of conditions, from secondary hyperparathyroidism to osteoporosis, to autoimmune diseases such as psoriasis. Recent advances in understanding l,25(OH)2D3 functions and novel insights into the mechanisms of its immunomodulatory properties suggest a wider applicability of this hormone in the treatment of oral inflammation.
- the di-hydroxylated, biologically active form of vitamin D3, also known as calcitriol, is a central hormone in calcium homeostasis and bone metabolism, but has also a number of other functions and notably powerful immunomodulatory properties, which are attractive for adjunctive, topical supplementation.
- U.S. Pat. No. 5,952,317 discusses calcitriol derivatives and their uses. Calcitriol can be regulated to thus provide controlled release of vitamin D in vivo over time, by changing or modifying the hydrolysable groups.
- the key feature of the modified vitamin D compounds having desirable biological attributes is that they are derivatives of 25-dihydroxyvitamin D3, or derivatives of 25-dihydroxyvitamin D analogs, in which a hydrolysable group is attached to the hydroxyl group of carbon 25 and, optionally, to any other of the hydroxyl groups present in the molecule.
- a hydrolysable group is attached to the hydroxyl group of carbon 25 and, optionally, to any other of the hydroxyl groups present in the molecule.
- Vitamin D receptor a member of the superfamily of nuclear receptors for steroid hormones and retinoid acid.
- the VDR functions as a 1 , 25 (OH) 2D3-activated transcription factor that ultimately influences the rate of RNA polymerase mediated transcription.
- VDRs are present not only in cells typically involved in calcium and bone metabolism, but also in other cell types, such as cells of the immune system. See: Chantal Mathieu and Luciano Adorini. "The coming age of 1,25- dihydroxyvitamin D3 analogs as immunomodulatory agents," TRENDS in Molecular Medicine. Vol 8, No 4, April 2002.
- vitamin D insufficiency could be characterized by circulating levels of 250HD that were greater than vitamin D- deficiency (50 nM or 20ng/ml) but less than 75nM (30 ng/ml) . See: Holick 2009, Ann. Epidemiol. 19: 73-7.
- an immune challenge such as infection with M.tb.
- pathogen-sensing receptors such as TLRs trigger enhanced expression of l - hydroxylase and VDR. Provided there is sufficient 250HD available, this will then elevate local levels of 1,25 (OH) 2D, stimulating transcription of the hCAP gene, with the resulting antimicrobial protein being incorporated into lysosomes to promote bacterial killing. Initially hCAP was thought to act primarily by disrupting bacterial cell membranes. See: Nizet and Gallo, Scan. J. Infect. Pis., 2003; 35:670-676.
- Vitamin D deficiency has been correlated with increased rates of infection. Since the early 19 th century, both environment (i.e. sunlight) and dietary sources of vitamin D (i.e. cod liver) have been identified as treatments for TB . The recent discovery that vitamin D induces antimicrobial peptide gene expression explains, in part, the "antibiotic" effect of vitamin D and has greatly renewed interest in the ability of vitamin D to improve immune function. Subsequent work indicates that this regulation is biologically important for the response of the innate immune system to wound and infection, including oral infections, and that deficiency may lead to suboptimal responses toward bacterial and viral infections. The potential for topical supplementation of vitamin D to respond to oral inflammation is most promising.
- 25(OH)D circulates in the blood bound to the vitamin D- binding protein and is a reliable indicator of vitamin D status. To become fully activated, the 25(OH)D is converted into 1 , 25-dihydroxyvitamin D ( 1 , 25 (OH) 2D) by the mitochondrial l -hydroxylase enzyme (CYP2781). The majority of the body's 1,25 (OH) 2D is synthesized in the primary renal tubules of the kidney, but the synthesis also occurs in numerous extrarenal sites up to cells that express CYP2781.
- VDR vitamin D receptor
- Deficiency in vitamin D is associated with numerous health conditions ranging from bone health to cancer, but with the discovery of antimicrobial peptide gene regulation by the vitamin D pathway, a renewed interest in its impact on the immune system has ensued. It is particularly attractive to realize that adequate levels throughout life may alleviate many of the chronic ills that befall us as we age. "Local" vitamin D levels may be influenced by repetitive, topical administration of vitamin D supplement, throughout the day.
- Vitamin D is known to modulate calcium homeostasis and has a role in the regulation of electrolytes and blood pressure.
- l,25(OH) 2 D 3 the most active metabolite of vitamin D, regulates the immune response and possesses anti-inflammatory activity. See: Current Opinion in Gastroentarology . 2010; 26:591-595.
- VDR vitamin D receptor
- Vitamin D modulates the T cell antigen receptor, further demonstrating that vitamin D has a nonclassical role in immunoregulation .
- the anti-inflammation and anti-infection functions for Vitamin D are newly identified and highly significant activities, relied on by the topical, vitamin D supplement compositions of the invention .
- Vitamin D/VDR have multiple critical functions in regulating the response to intestinal homeostasis, tight junctions, pathogen invasion, commensal bacterial colonization, antimicrobe peptide secretion and mucosal defense.
- microorganisms modulate the VDR signaling pathway .
- Vitamin D is known as a key player in calcium homeostasis and electrolyte and blood pressure regulation. Recently, important progress has been made in understanding how the noncanonical activities of Vitamin D influence the pathogenesis and prevention of human disease. Vitamin D and VDR are directly involved in T cell antigen receptor signaling. The involvement of vitamin D/VDR in anti-inflammation and anti-infection represents a newly identified and highly significant activity for VDR. Studies have indicated that the dysregulation of VDR may lead to exaggerated inflammatory responses, raising the possibility of defects in vitamin D and VDR signaling transduction may be linked to bacterial infection and chronic inflammation including periodontitis.
- the effects of l,25(OH) 2 D 3 on the immune system include: modulating the TCR, decreasing Thl/Thl7CD4+ T cells and cytokines, increasing regulatory T cells, downregulating T cell-driven production and inhibiting dendritic cell differentiation.
- l,25(OH) 2 D 3 downregulates the expression of many proinflammatory cytokines, such as IL-1, IL-6, IL-8 and TNF- , in a variety of cell types.
- Immune cells including macrophages, dendritic cells and activated T cells, express the intracellular VDR and are responsive to l,25(OH) 2 D 3 .
- Vitamin D deficiency has been correlated with increased rates of infection.
- l,25(OH) 2 D 3 induces the expression of antimicrobial peptides, such as carthelicidin .
- vitamin D The primary sources of vitamin D are dietary intake and sunlight exposure in the form of vitamin D2 and D3, which are metabolized to 25-hydroxyvitamin D [25(OH)D] in the liver. Further metabolism in the kidneys produces the active form of vitamin D, 1 , 25-dihydroxyvitamin D.
- Periodontitis is characterized by alveolar bone loss induced by the host immune response in bacterial insult. Because vitamin D plays a crucial role in bone maintenance and immunity, there is biologic rationale to suspect that a vitamin D deficiency could negatively affect the periodontium.
- a diagnosis of vitamin D deficiency is made through serum analysis of 25(OH)D levels. The normal range of serum 25(OH)D levels is 20- 74 ng/mL. No absolute threshold for deficiency status is universally accepted, although most authorities agree that levels below 20-30 ng/mL constitute at least a mild deficiency with severe vitamin D deficiency beginning at a level of 12 ng/mL. See: Bashutski, et . al . J. Dent. Res . 90 (8). 1007-1012, 2011. Topical supplementation of vitamin D in the compositions of the invention, influence "local" vitamin D levels of cells under challenge.
- vitamin D levels have been associated with increased gingival inflammation, tooth loss, clinical attachment loss and material periodontal disease during pregnancy.
- Daily administration of vitamin D via topical supplement compositions of the invention are projected to increase "local" vitamin D levels.
- vitamin D supplementation at the time of surgery fails to prevent the negative clinical outcomes associated with baseline deficiency.
- Patients were supplemented with a vitamin D for only a six-week period, and it takes up to 3 months for serum 25(OH)D levels to stabilize after vitamin D intake is increased. See Veith R, et. al. Am. J. Clin. Nutr . 2001 Feb; 73 (2 ): 288-94.
- Six-week vitamin D supplementation alone did not exert long-term effects, since serum 25(OH)D levels returned to baseline levels in placebo patients by 6 months.
- vitamin D supplementation is unable to prevent this effect. Since vitamin D deficiency is highly prevalent, it may be advisable to ensure adequate vitamin D levels well in advance of periodontal surgery, to attain the best possible results. Oral vitamin D supplementation, combined with topical vitamin D supplement compositions of the invention, administered daily for an extended period prior to periodontal surgery, is recommended.
- vitamin D reduced induction of IFN-stimulated proteins with important antiviral activity (e.g., myxovirus resistance A and IFN-stimulated protein of 15 kDa) .
- IFN-stimulated proteins with important antiviral activity e.g., myxovirus resistance A and IFN-stimulated protein of 15 kDa
- vitamin D had no effect on IFN signaling, and isolated IFN induced gene expression.
- Inhibiting NF-kB with an adenovirus vector that expressed a nondegradable form of IkBa mimicked the effects of vitamin D.
- the vitamin D receptor was silenced with small interfering RNA, the vitamin D effects were abolished.
- IkBa and dampening chemokines and IFN- ⁇ there was no increase in viral mRNA or protein or in viral replication.
- vitamin D decreases the inflammatory response to viral infections in airway epithelium without jeopardizing viral clearance. This suggests that adequate vitamin D levels would contribute to reduced inflammation and less severe disease in RSV- infected individuals.
- Vitamin D is increasingly recognized as a pluripotent hormone with functions that extend beyond its classical role in calcium homeostasis. Rapidly growing evidence from epidemiological and basic research studies reveals that vitamin D can modulate immune responses. Vitamin D deficiency is highly prevalent and has been associated with both increased risk of several inflammatory diseases and susceptibility to infections, including periodontitis. The localized tissue-specific generation of active vitamin D is thought to be a key component of nonclassical vitamin D functions that are relied on by the supplement compositions of the invention.
- Vitamin D has been shown to inhibit production of inflammatory chemokines in animal models of inflammatory diseases such as multiple sclerosis and type 1 diabetes.
- NF-kB proteins are present in the cytoplasm in association with lkBs. IkBs are phosphorylated by IkB kinase following cell stimulation, and they are targeted for destruction by the ubiquitin/proteasome degradation pathway. The degradation of IkB allows NF-kB proteins to translocate to the nucleus, bind to their DNA binding sites and activate a variety of genes. See: Sif Hansdottir, et . al . , The Journal of Immunology. 2010; 184: 965-974.
- vitamin D up-regulates antimicrobial peptides, namely cathelicidin, to enhance clearance of bacteria at various barrier sites and in immune cells.
- Vitamin D modulates the adaptive immune system by direct effects on T cell activation and on the phenotype and function of antigen-presenting cells (ACPs), particularly of DCs.
- ACPs antigen-presenting cells
- the importance of vitamin D on the regulation of cells in the immune system has gained increased appreciation over the past decade with the discovery of the vitamin D receptor (VDR) and key vitamin D metabolizing enzymes expressed by cells of the immune system. Animal studies, early epidemiologic and clinical studies have supported a potential role for vitamin D in maintaining immune system balance.
- vitamin D enhances innate immunity by up-regulating antimicrobial peptides such as cathelicidin in response to infection. This up- regulating of antimicrobial peptides is relied on by the topical supplement compositions of the present invention .
- antimicrobial peptides such as cathelicidin constitute an integral part of the innate immune response to a variety of infections especially at barrier sites, such as oral mucosa.
- 1,25 (OH) 2 D the effects of 1,25 (OH) 2 D on the immune system include decreasing Thl/Thl7 CD4+ T cells and cytokines, increasing regulatory T cells, downregulation of T cell-driven IgG production and inhibition of dendritic cell differentiation. While enhancing protective innate immune responses, 1,25 (OH) 2 D helps maintain self-tolerance by dampening overly zealous adaptive immune responses. See: Diane L. Kamen and Via Taagpricha. Vitamin D and molecular actions on the immune system: modulation of innate and autoimmunity. J . Mol. Med. (2010) 88:441-450.
- Vitamin D administered by topical supplement compositions of the invention, may be beneficial for the treatment of periodontal disease, an inflammatory condition involving activation of host-defense cells by bacterial release of inflammatory mediators, which results in the destruction of supporting periodontal tissues, including connective tissue and alveolar bone.
- Periodontal health improves in patients attending regular periodontal care programs, regardless of their dietary calcium or vitamin D supplements. However, taking calcium and vitamin D supplementation is associated with better periodontal health relative to taking no such supplements.
- Optimal levels of vitamin D should have an immunosuppressive effect on periodontal disease. See: D. Dixon, et . al . Calcium and vitamin D use among adults in periodontal disease maintenance programmes. British Dental Journal. 2009: 208:827-831.
- vitamin D In addition to its action on skeletal homeostasis, vitamin D and, in particular, its hormonally active form, la, 25-dihydroxyvitamin D, has anti-inflammatory and antimicrobial effects via modulation of inflammatory cytokine production by immune cells and stimulated secretion of peptides with antibacterial action by cells of the monocyte-macrophage lineage. These properties lend themselves to topical supplement compositions for treatment of "local" oral infections.
- Vitamin D may reduce susceptibility to gingival inflammation through its anti-inflammatory effects. Gingivitis may be a useful clinical model to evaluate the anti-inflammatory effects of vitamin D. See: Thomas Dietrich, et . al . Am. J. Clin. Nutr. 2005;82-575 DETAILED DESCRIPTION OF THE PRESENTLY PREFERRED
- vitamin D supplement enhances innate immunity by upregulating the antimicrobial peptide, cathelicidin .
- the topical, vitamin D, oral supplement composition in its hormonally active form, la, 25-dihydoxyvitamin D, indicates anti-inflammatory and antimicrobial effects via modulation of inflammatory cytokine production, by stimulating secretion of antibacterial properties.
- a topical, vitamin D, oral supplement composition the anti- inflammatory and antimicrobial effects of la, 25- dihydoxyvitamin D are modulated through vitamin D receptor (VDR) .
- VDR vitamin D receptor
- the topical, vitamin D, oral supplement composition, the la, 25- dihydoxyvitamin D effects on the immune system include:
- the present invention includes methods:
- vitamin D supplement composition for treating oral inflammation comprising topically administering a vitamin D supplement composition to the oral mucosa comprising:
- a saliva soluble, aqueous-free emulsion carrier a saliva soluble, aqueous-free emulsion carrier
- trans-oral mucosal, absorption facilitator wherein:
- composition upon application to the oral mucosa, said composition forms a saliva soluble, mucoadhesive gel, substantive to said oral mucosa;
- said mucoadhesive gel upon continuous exposure of said saliva soluble, mucoadhesive gel to saliva flow, said mucoadhesive gel gradually dissolves effecting controlled release of said vitamin D supplement and said trans-oral mucosal, absorption facilitator onto said oral mucosa;
- application means for said topical vitamin D oral supplement composition is selected from the group consisting of interproximal devices coated with said composition, oral gels, oral ointments, oral pastes, oral varnishes, oral liquids and combinations thereof;
- treating oral inflammation comprises topically administering vitamin D supplement compositions is applied repetitively throughout the day with a vitamin D supplement gel in combination with daily topical administration with a dental device coated with said composition .
- Vitamin D compositions suitable for topical administration to the oral mucosa, include: an aqueous- free emulsion carrier for the vitamin D that also contains trans-oral mucosal absorption facilitators, wherein said aqueous-free emulsion, upon exposure to saliva, forms a mucoadhesive gel substantive to the oral mucosa.
- the vitamin D/trans-oral mucosal, absorption facilitator mixture gradually releases from the mucoadhesive gel to passively diffuse through the oral mucosa, thereby supplementing system serum levels of vitamin D.
- Topical administration of the vitamin D compositions of the invention to the oral mucosa is preferably carried out with oral gels or dental devices coated with the vitamin D composition.
- topical administration of vitamin D to the oral mucosa is effected by a combination of several administrations of vitamin D supplement topical gel throughout the day, combined with once or twice daily flossing with a dental device composition coated with the vitamin D composition of the invention.
- saliva soluble, aquous-free emulsions include those emulsions that are comprised of polydimethylsiloxane in a nonionic surfactant, as described in the following U.S. Patents: 5,032,387; 5,098,711; 5,538,667 and 5,651,959; all of which are hereby incorporated by reference.
- Preferred nonionic surfactants of the invention capable of forming a mucoadhesive gel in the presence of saliva. These are selected from the group consisting of: poloxamer 237, poloxamer 338, poloxamer 407 and combinations thereof.
- trans-oral mucosal, absorption facilitators are selected from the group consisting of: dexpanthenol , d-Limonene, poloxamer, PEG, benzyl alcohol, carbopol, chitosan, N- trimethylchitosan, menthol and combinations thereof.
- aqueous-free, saliva soluble emulsions for use as carriers of vitamin D supplement compositions of the present invention include emulsions of polydimethylsiloxane (PDMS) at viscosities ranging from between about 1500 cs and about 2.5 million cs .
- PDMS polydimethylsiloxane
- Particularly preferred, aqueous-free emulsions include as the discontinuous phase PDMS at viscosities between 10,500 cs and 2.5 million cs with those nonionic surfactants described in detail in U.S. 5,651,959, as the continuous phase.
- Preferred polydimethylsiloxanes are selected from the group consisting of polydimethylsiloxane: at 1500 cs, at 12,500 cs, at 100,000 cs, at 250,000 cs, at 500,000 cs, at 750, 000 cs, at 1.5 million cs, at 2.2 million cs, at 2.5 million cs and combinations thereof.
- Preferred application means for the topical vitamin D oral supplement compositions of the present invention include: oral gels, oral ointments, oral pastes, oral varnishes, oral liquids and various interproximal devices coated with said topical vitamin D oral supplement compositions.
- Preferred oral gels for purposes of the present invention include those gels disclosed in U.S. Patents: 5,009,881; 5,032,387; 5,057,306; 5,057,307; 5,057,309; 5,538,667 and 5,651,959; all of which are included herein by reference.
- Preferred coated, interproximal devices suitable for releasing vitamin D oral supplement compositions interproximally, include those interproximal devices described in the following U.S. Patents: 4,911,927;
- dental devices are an extremely important adjunct to proper dental hygiene.
- Dental devices have long been used effectively to clean the spaces between the teeth and under the gingival margin. When used properly, dental devices have been found to be effective in inhibiting tooth decay and gum disease. They are recommended by dentists for daily dental hygiene.
- vitamin D supplement compositions in the dental devices of the invention can also be used in tandem and coated with salts containing ions known to inspire remineralization of hydroxyapatite tooth structure.
- salts containing ions known to inspire remineralization of hydroxyapatite tooth structure.
- Such compounds include: calcium, phosphorus and fluorine salts in forms such as dentifrices.
- salts include, but are not limited to, fluoride or fluoride-containing compounds such as sodium fluoride, potassium fluoride, ammonium fluoride, sodium difluoride, potassium difluoride, ammonium difluoride, sodium silicofluoride, zinc fluoride, and stannous fluoride.
- fluoride or fluoride-containing compounds such as sodium fluoride, potassium fluoride, ammonium fluoride, sodium difluoride, potassium difluoride, ammonium difluoride, sodium silicofluoride, zinc fluoride, and stannous fluoride.
- Other dentifrices include, for example, ureases, acid phosphates, calcium carbonate, and magnesium carbonate.
- the dentifrice is preferably included in the dental device in the amount sufficient to provide an effective, topical concentration at the tooth surface.
- active components which may be incorporated within the interproximal device include hydrogen peroxide or other peroxide-producing components such as PVP/H 2 O 2 or Carbamide peroxide, Fluoride, tooth acidulating agents such as buffered or acidulated phosphofluoride, sodium monofluorophosphate, plaque control agents, tartar control agents, antibiotics to treat pyorrhea and gingivitis, teeth whitening and bleaching agents, pH buffering agents, antifungal agents, remineralizing agents, hemostatic agents, immunological agents and nonionic and cationic ant ibacterials such as benzothonium chloride, acetyl trimethyl ammonium bromide, sanguinaria, triclosan (nonionic) , tetracycline, cetyl pyridinium chloride and benzythonium chloride .
- hydrogen peroxide or other peroxide-producing components such as PVP/H 2 O 2 or Carbamide peroxide, Fluoride, tooth acidulating
- Additional active components that can be included in the dental devices of the present invention include Vitamin A, surfactants and pharmacological agents such as anti ⁇ cancer agents, stimulants, bone growth agents, antigens, hormones, steroids, anti-inflammatory agents and analgesic agents.
- the dental device comprises a coagulant to inhibit any bleeding which may be produced by flossing.
- the coagulant is mixed in the device coating so as to directly contact the gum tissue.
- the coagulants may include vitamin K, calcium ions in the form of water-soluble calcium salts and blood factors that initiate the coagulation cascade.
- the coagulants may be solubilized in non ⁇ toxic solvents, such as ethanol, polyethylene terepthalate or diethyl ether.
- Flavorants may be added to the dental devices of the present invention by techniques known in the art, such as adding the flavorant directly to the device after extrusion or by applying a flavored coating to the surface of the device, or by transferring volatile flavors to the device from a flavor reservoir.
- Known flavorants such as mint, cinnamon and bubble gum, which are commercially available through various suppliers including IFF Corporation, Dayton, NJ; are suitable for use in the dental devices of the present invention.
- Other flavorants may also be added by the compression coating process described in the references cited.
- Colorants may be added to the dental devices of the present invention to color the dental device in order to provide a visual stimulus to the consumer.
- Colorant can be added to the nylon or other pellets used to form the strand before extrusion begins. Any one of commercially available, FDA approved colorants for use with nylon resins may be used. Colors may correspond to the flavor of the dental device, e.g., red for cinnamon or green for mint. Further, multiple colors may be extruded simultaneously so that, for example, one side of the filament is red and other green.
- the device may further incorporate colorant agents or fluorescent dye to identify residual plaque deposits, such as, for example, FD&C Red 3 and FD&C Red 4.
- the invention is further described by the enclosed illustrative examples of topical gels and dental tape used to apply the vitamin D compositions of the invention to the oral mucosa and to interproximal surfaces, respectively.
- a 500 mL stainless steel beaker was fitted with an overhead stirrer. Water, 135.834 gm, was added and moderate stirring began. The additional ingredients for this vessel were added. Sorbitol 70%, 102 gm; glycerin, 15 gm; potassium sorbate, 0.45 gm; sodium saccharin, 0.225 gm; sucralose, 0.6 gm, and flavors, 0.9525 gm, were added with moderate stirring at room temperature.
- a 2 gallon stainless steel vessel was fitted with an overhead stirrer and placed on a hotplate.
- An aqueous- free emulsion [poloxamer 407/polydimethylsiloxane (12, 500 cs)] (90:10) 1964 gm, was placed in the vessel and melted while stirring. The temperature rose to 90 degrees C and the following ingredients were added: Pluracare L-1220, 120 gm; stearyl alcohol, 600 gm; microwax ML445 and polyethylene glycol 8000 were added to the molten aqueous-free emulsion. A homogenizer was placed in the vessel and emulsification resulted from 10 minutes of action.
Abstract
Description
Claims
Priority Applications (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU2013329170A AU2013329170B2 (en) | 2012-10-12 | 2013-10-10 | Topical vitamin D oral supplement compositions |
CN201380053186.0A CN104968351A (en) | 2012-10-12 | 2013-10-10 | Topical vitamin D oral supplement compositions |
CA2886067A CA2886067C (en) | 2012-10-12 | 2013-10-10 | Topical vitamin d oral supplement compositions |
JP2015536896A JP6420766B2 (en) | 2012-10-12 | 2013-10-10 | Vitamin D oral supplement composition for topical use |
EP13844920.2A EP2887945A4 (en) | 2012-10-12 | 2013-10-10 | Topical vitamin d oral supplement compositions |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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US13/650,963 | 2012-10-12 | ||
US13/650,963 US9149528B2 (en) | 2011-10-13 | 2012-10-12 | Topical vitamin D oral supplement compositions |
Publications (1)
Publication Number | Publication Date |
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WO2014059157A1 true WO2014059157A1 (en) | 2014-04-17 |
Family
ID=50478114
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PCT/US2013/064358 WO2014059157A1 (en) | 2012-10-12 | 2013-10-10 | Topical vitamin d oral supplement compositions |
Country Status (6)
Country | Link |
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EP (1) | EP2887945A4 (en) |
JP (1) | JP6420766B2 (en) |
CN (2) | CN104968351A (en) |
AU (1) | AU2013329170B2 (en) |
CA (1) | CA2886067C (en) |
WO (1) | WO2014059157A1 (en) |
Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5665374A (en) * | 1995-06-05 | 1997-09-09 | Whitehill Oral Technologies, Inc. | Ultramulsion containing interdental delivery devices |
Family Cites Families (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0831762A4 (en) * | 1995-06-05 | 1999-08-11 | Whitehill Oral Tech Inc | Oral care ultramulsion based products |
CA2557809A1 (en) * | 2004-03-01 | 2005-09-09 | Bioxell Spa | Treatment of interstitial cystitis with vitamin d compounds |
JP5256425B2 (en) * | 2005-04-08 | 2013-08-07 | リングアル コンセグナ ピーティーワイ エルティーディー | Oral delivery system |
US20070166244A1 (en) * | 2006-01-19 | 2007-07-19 | The Procter & Gamble Company | Compositions comprising silicone pressure sensitive adhesives for delivering oral care substances |
WO2009153634A1 (en) * | 2008-06-19 | 2009-12-23 | University Of Witwatersrand, Johannesburg | A transmucosal delivery system |
-
2013
- 2013-10-10 JP JP2015536896A patent/JP6420766B2/en not_active Expired - Fee Related
- 2013-10-10 WO PCT/US2013/064358 patent/WO2014059157A1/en active Application Filing
- 2013-10-10 CN CN201380053186.0A patent/CN104968351A/en active Pending
- 2013-10-10 EP EP13844920.2A patent/EP2887945A4/en not_active Withdrawn
- 2013-10-10 CN CN201910163471.7A patent/CN109908157A/en active Pending
- 2013-10-10 AU AU2013329170A patent/AU2013329170B2/en not_active Ceased
- 2013-10-10 CA CA2886067A patent/CA2886067C/en active Active
Patent Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5665374A (en) * | 1995-06-05 | 1997-09-09 | Whitehill Oral Technologies, Inc. | Ultramulsion containing interdental delivery devices |
Non-Patent Citations (3)
Title |
---|
DIMELOE ET AL.: "Regulatory T cells, inflammation and the allergic responseThe role of glucocorticoids and Vitamin D", JOURNAL OF STEROID BIOCHEMISTRY & MOLECULAR BIOLOGY, vol. 120, May 2010 (2010-05-01), pages 86 - 95, XP027263554 * |
MCMAHON ET AL.: "Vitamin D-Mediated Induction of Innate Immunity in Gingival Epithelial Cells", INFECTION AND IMMUNITY, vol. 79, no. 6, June 2011 (2011-06-01), pages 2250 - 2256, XP055234213 * |
See also references of EP2887945A4 * |
Also Published As
Publication number | Publication date |
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AU2013329170A1 (en) | 2015-04-09 |
EP2887945A1 (en) | 2015-07-01 |
EP2887945A4 (en) | 2016-03-23 |
CA2886067A1 (en) | 2014-04-17 |
CN109908157A (en) | 2019-06-21 |
JP6420766B2 (en) | 2018-11-07 |
CN104968351A (en) | 2015-10-07 |
AU2013329170B2 (en) | 2018-03-29 |
JP2015533167A (en) | 2015-11-19 |
CA2886067C (en) | 2021-04-06 |
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