WO2005020970A2 - Protease inhibitor compositions for prevention and treatment of skin conditions - Google Patents

Protease inhibitor compositions for prevention and treatment of skin conditions Download PDF

Info

Publication number
WO2005020970A2
WO2005020970A2 PCT/IB2004/003161 IB2004003161W WO2005020970A2 WO 2005020970 A2 WO2005020970 A2 WO 2005020970A2 IB 2004003161 W IB2004003161 W IB 2004003161W WO 2005020970 A2 WO2005020970 A2 WO 2005020970A2
Authority
WO
WIPO (PCT)
Prior art keywords
skin
inhibitor
enzyme
protease
enzymes
Prior art date
Application number
PCT/IB2004/003161
Other languages
French (fr)
Other versions
WO2005020970A3 (en
Inventor
Amy Mcnulty
Original Assignee
Smith & Nephew, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Smith & Nephew, Inc. filed Critical Smith & Nephew, Inc.
Publication of WO2005020970A2 publication Critical patent/WO2005020970A2/en
Publication of WO2005020970A3 publication Critical patent/WO2005020970A3/en

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K8/00Cosmetics or similar toiletry preparations
    • A61K8/18Cosmetics or similar toiletry preparations characterised by the composition
    • A61K8/72Cosmetics or similar toiletry preparations characterised by the composition containing organic macromolecular compounds
    • A61K8/81Cosmetics or similar toiletry preparations characterised by the composition containing organic macromolecular compounds obtained by reactions involving only carbon-to-carbon unsaturated bonds
    • A61K8/817Compositions of homopolymers or copolymers of compounds having one or more unsaturated aliphatic radicals, each having only one carbon-to-carbon double bond, and at least one being terminated by a single or double bond to nitrogen or by a heterocyclic ring containing nitrogen; Compositions or derivatives of such polymers, e.g. vinylimidazol, vinylcaprolactame, allylamines (Polyquaternium 6)
    • A61K8/8182Copolymers of vinyl-pyrrolidones. Compositions of derivatives of such polymers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A61K31/401Proline; Derivatives thereof, e.g. captopril
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K8/00Cosmetics or similar toiletry preparations
    • A61K8/18Cosmetics or similar toiletry preparations characterised by the composition
    • A61K8/30Cosmetics or similar toiletry preparations characterised by the composition containing organic compounds
    • A61K8/40Cosmetics or similar toiletry preparations characterised by the composition containing organic compounds containing nitrogen
    • A61K8/44Aminocarboxylic acids or derivatives thereof, e.g. aminocarboxylic acids containing sulfur; Salts; Esters or N-acylated derivatives thereof
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K8/00Cosmetics or similar toiletry preparations
    • A61K8/18Cosmetics or similar toiletry preparations characterised by the composition
    • A61K8/30Cosmetics or similar toiletry preparations characterised by the composition containing organic compounds
    • A61K8/49Cosmetics or similar toiletry preparations characterised by the composition containing organic compounds containing heterocyclic compounds
    • A61K8/4906Cosmetics or similar toiletry preparations characterised by the composition containing organic compounds containing heterocyclic compounds with one nitrogen as the only hetero atom
    • A61K8/4913Cosmetics or similar toiletry preparations characterised by the composition containing organic compounds containing heterocyclic compounds with one nitrogen as the only hetero atom having five membered rings, e.g. pyrrolidone carboxylic acid
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K8/00Cosmetics or similar toiletry preparations
    • A61K8/18Cosmetics or similar toiletry preparations characterised by the composition
    • A61K8/30Cosmetics or similar toiletry preparations characterised by the composition containing organic compounds
    • A61K8/64Proteins; Peptides; Derivatives or degradation products thereof
    • A61K8/645Proteins of vegetable origin; Derivatives or degradation products thereof
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K8/00Cosmetics or similar toiletry preparations
    • A61K8/18Cosmetics or similar toiletry preparations characterised by the composition
    • A61K8/30Cosmetics or similar toiletry preparations characterised by the composition containing organic compounds
    • A61K8/64Proteins; Peptides; Derivatives or degradation products thereof
    • A61K8/66Enzymes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61QSPECIFIC USE OF COSMETICS OR SIMILAR TOILETRY PREPARATIONS
    • A61Q17/00Barrier preparations; Preparations brought into direct contact with the skin for affording protection against external influences, e.g. sunlight, X-rays or other harmful rays, corrosive materials, bacteria or insect stings
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61QSPECIFIC USE OF COSMETICS OR SIMILAR TOILETRY PREPARATIONS
    • A61Q19/00Preparations for care of the skin
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K2800/00Properties of cosmetic compositions or active ingredients thereof or formulation aids used therein and process related aspects
    • A61K2800/74Biological properties of particular ingredients
    • A61K2800/75Anti-irritant
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K2800/00Properties of cosmetic compositions or active ingredients thereof or formulation aids used therein and process related aspects
    • A61K2800/74Biological properties of particular ingredients
    • A61K2800/78Enzyme modulators, e.g. Enzyme agonists
    • A61K2800/782Enzyme inhibitors; Enzyme antagonists

Definitions

  • the invention relates to compositions and methods for treatment or prophylaxis of skin conditions such as diaper dermatitis, erythema, or other skin conditions caused by prolonged exposure to certain enzymes.
  • Diaper rash or diaper dermatitis is an inflammation of the skin in the diaper area of newborn infants, infants, and children. While this condition is common to infants, it is certainly not limited to infants. Individuals who suffer from incontinence and use absorbent articles, colostomy patients, patients who are nonambulatory, and the elderly may also develop this condition.
  • human feces contain endogenic digestive enzymes, e.g. proteolytic and/or lipolytic enzymes such as trypsin, chymotrypsin, elastase, and pancreatic lipase.
  • proteolytic and/or lipolytic enzymes such as trypsin, chymotrypsin, elastase, and pancreatic lipase.
  • pancreatic lipase are enzymes of pancreatic or gastrointestinal, e.g. intestinal origin, produced to digest food.
  • the enzymes may cause irritation, predispose the skin to infection by microorganisms, contribute to skin breakdown, and cause (and/or exacerbate) various skin conditions.
  • the effect of fecal enzymes can be aggravated further by the presence of urine. In fact, prolonged exposure to urine itself may cause erythema and skin breakdown.
  • Urine is normally slightly acidic. Feces of adults are normally neutral or slightly alkaline, while that of infants is slightly acidic. Some believe that it is the acidic agents which are believed to be highly irritating in the diaper area, while others believe it is primarily the alkaline components that contribute to diaper dermatitis.
  • Urine consists of approximately 93-97% water and 3-7% solids which include urea, uric acid, creatine, creatinine, ammonia, and inorganic substances such as chlorides, calcium, magnesium, and phosphorous. In effect, the urea contained in the urine is broken down into ammonium hydroxide by the ureases which leads to an increase in pH.
  • the enzymes produced at time of digestion such as the proteases and the lipases of pancreatic or intestinal origin, increase their activity and thus their irritating power increases.
  • the lipases attack the triglycerides of the sebum and provoke the release of fatty acids.
  • the corneum made permeable by hyperhydration, rubbing, and digestion by enzymes, loses its function as a barrier and allows other irritating molecules, such as ammonia, fecal enzymes, bacteria, and biliary salts, which might not be irritating by themselves, to migrate through the compromised skin barrier.
  • an actual digestion of the epidermis of the infant's skin could occur due to the action of ureases, lipases and proteases.
  • diaper dermatitis many researchers have sought to develop treatments to combat the destructive effects caused when enzymes contained in feces and/or urine contact human skin for prolonged periods of time.
  • Certain anti- enzyme compounds have been included in topically-applied compositions for treatment or prevention of diaper rash.
  • a water-soluble lipase inhibitor such as zinc chloride has been included in a barrier-like carrier such as polyethylene glycol.
  • Currently available treatments for diaper rash are generally based upon the use of zinc oxide, vitamins (A, D, and D3), or some combination thereof.
  • active ingredients are incorporated into a cream or salve by blending them into various purified semisolid ointment bases, such as mineral oil, petrolatum, soft paraffin, lanolin, and the like. These ointments are intended to protect the skin from contact with irritants.
  • Another conventional method of preventing or alleviating diaper rash is to apply powders to keep the skin dry.
  • powders are also easily washed off and do not provide an effective barrier over time.
  • many of the barriers used in conventional treatments are not effective.
  • Most prophylactics or treatments for diaper dermatitis are barriers that rub off with exposure to fecal and urinary insult, leaving the skin exposed to such irritants.
  • Some researchers have studied the possibility of including substances that inhibit digestive enzymes into diaper rash creams, wipes, or into the diapers themselves.
  • some proteolytic and lipolytic enzyme inhibitors react with the active site of the target enzyme and destroy the enzyme's ability to function.
  • the notion is that delivering such enzymes to a patient's skin allows the inhibitors to function as a barrier to enzyme activity to prevent diaper rash.
  • organophilic clays that absorb and inactivate proteolytic enzymes
  • protease inhibitors are intended to prevent enzymes from contacting the skin and render them incapable of causing irritation.
  • Other methods include applying an inhibitor in an ointment, cream, or gel to the location of the inflammation.
  • Some inhibitors discussed by the literature for use according to this method include soybean trypsin inhibitor, aprotinin, hexamidine, p-aminobenzamidine, leupeptin, pepstatin A, chymostatin, and trypsin-chymotrypsin inhibitor. See e.g., WO 99/45973, WO 99/45974, EP 0 958 833 A1, and WO/01/52842, the contents of each of which are incorporated herein by reference.
  • a further method that has been explored for the treatment or prophylaxis of diaper dermatitis has been to add an antimicrobial protease inhibitor to a pre-moistened wipe.
  • the antimicrobial protease inhibitor can be added directly to the wipe or directly to the liquid that moistens the wipe.
  • Exemplary antimicrobial protease inhibitors are aromatic diamidines, such as pentamidine and/or hexamidine, and particularly hexamidine diisethionate.
  • Elestab hexamidine diisethionate
  • Elestab HP 100 Elestab HP 100
  • Elestab is a hexamidine derivative and was initially marketed as an antimicrobial. It has also been marketed as an anti-dandruff product. Hexamidines have been shown to have enzyme inhibitory activity. However, while Elestab initially shows good inhibitory activity against trypsin, its inhibitory activity decreases rather quickly over time in a prepared solution. In other words, Elestab has a short shelf-life in solution, rendering it unworkable for purposes that require a solution that can remain stable and active over an extended period of time. Accordingly, it is highly ineffective for use in a preparation of an emulsion product, such as a lotion, cream or spray, which may remain on a shelf for many months at a time.
  • an emulsion product such as a lotion, cream or spray
  • Elestab tends to be stable in the absence of water, but loses its stability when combined with water or other emulsification components. As such, Elestab is not appropriate for incorporation into an emulsified product. The inventor has recognized this fact and developed a product that provides a significant improvement over emulsified products using hexamidine.
  • compositions of the present invention have a very short shelf life, requiring the care provider to maintain a constant replenishing supply on hand. Diapers also do not provide the additional protection of barrier between the skin and the proteases.
  • the compositions of the present invention have a long shelf life, i.e. they maintain their activity in emulsion, even after being stored for an extended period of time, so that the care provider does not need to constantly replenish the supply on hand.
  • Formulations according to certain aspects of this invention have an elegant, non-greasy feel, and will not add to clean up procedures.
  • the emulsions of the present invention generally have a better feel than typical barrier ointments of petrolatum and zinc oxide which can be sticky, and hard to apply and remove.
  • a formulation that acts as an effective inhibitor of fecal and urinary enzymes and that provides a superior barrier to these enzymes, preventing them from damaging the skin.
  • a product that can remain stable in solution for extended periods of time.
  • an inhibitor formulation that is substantially resistant to being washed off the skin.
  • an inhibitor formulation that is not greasy or messy. It is an object of various embodiments of this invention to meet these needs.
  • enzymes e.g. proteolytic and/or lipolytic enzymes such as trypsin, chymotrypsin, elastase, and lipase.
  • the lipid-containing and protein-containing components of the skin can be broken down, resulting in irritation and inflammation, predisposing the skin to infection by microorganisms, contributing to skin breakdown, and causing and/or exacerbating various skin conditions.
  • the skin may often be exposed to such enzymes by untreated bodily fluid discharges, or around the point of entry of ostomy tubes into, or attachment of ostomy pouches to, the body.
  • Such bodily fluids and enzymes and the way in which they often come into contact with the skin for any appreciable period of time include: fistulas, e.g. enterocutaneous fistulas, drain tubes or the point of insertion of catheters into tissue injury or the urinary tract, leaving the skin exposed to such irritants around the fistula, tube or catheter; many tissues contain substances such as enzymes, e.g lipolytic enzymes, such as phospholipases, and where the site is presenting an inflammatory response, proteases, such as serine proteases, e.g. elastase, trypsin, chymotrypsin and thrombin; cysteine proteases; matrix metalloproteases, e.g.
  • collagenase and carboxyl (acid) proteases may be present; exudate from chronic wounds, such as venous leg ulcers and diabetic foot ulcers, which contains proteolytic enzymes (proteases), such as serine proteases, e.g. elastase, trypsin, chymotrypsin and thrombin; cysteine proteases; matrix metalloproteases, e.g.
  • proteolytic enzymes such as serine proteases, e.g. elastase, trypsin, chymotrypsin and thrombin
  • cysteine proteases e.g.
  • collagenase and carboxyl (acid) proteases; that are deleterious to the peri-wound skin when it is exposed to such enzymes for any appreciable period of time in untreated discharges, or in therapy, including vacuum wound therapy, where the exudate may be pulled onto the skin; mucous secretions, such as nasal, bronchial and pulmonary secretions, and seminal plasma, which contain serine proteases, such as chymotrypsin-like enzymes, e.g.
  • the peri-nasal and/or -oral skin may be exposed to such enzymes for an appreciable period of time by untreated nasal, bronchial and/or pulmonary discharges, or around endotracheal tubes or the point of insertion of tracheostomy tubes; saliva and gastric secretions, which contain lipases of oral or gastric origin; the peri-oral skin may be exposed to such enzymes for an appreciable period of time by untreated drool, or gastric discharges, such as gastric reflux; gastric or enteric secretions, which contain serine proteases and lipases; the skin may be exposed to such enzymes around the point of entry of relevant ostomy tubes into, or of attachment of ostomy pouches or collection bags to, the body, such as in gastrostomies, ileostomies, jejunostomies and colostomies; and sweat, which contains various proteases and which may often come into contact with large
  • Enzyme inhibitors act in a number of different ways to inhibit or destroy the enzyme's ability to function. As noted above, for example, some enzyme inhibitors react with the active site of the target enzyme and destroy the enzyme's ability to function. Others degrade or sequester the enzyme to the same effect. Yet others act as a sacrificial substrate, on which the enzyme acts rather than on its usual target, in this case the skin, so that the inhibitor destroys the enzyme's ability to function.
  • the term 'inhibitor' herein includes inhibitors with any and all such modes of action.
  • Formulations within the scope of the invention include those for the treatment or prophylaxis of skin conditions caused by prolonged exposure to enzymes present in bodily fluids, such as dermatitis or inflammation of the skin, which include an enzyme inhibitor and a polymer which acts as a carrier for the inhibitor and also binds to the skin of the patient for prolonged delivery of the inhibitor.
  • Certain embodiments incorporate a polymer that binds to the skin, creates a non-occlusive barrier, and that is substantially resistant to being washed or rubbed off.
  • the invention also relates to methods of preparing such formulations and to methods of treatment or prophylaxis of skin conditions associated with prolonged exposure to enzymes present in bodily fluids, using such formulations.
  • the type of delivery vehicle used will be important in keeping the inhibitor in contact with the enzymes and away from the skin.
  • Certain aspects of the invention are thus directed to an enzyme inhibitor formulation comprising a polymer barrier and an enzyme inhibitor, wherein the polymer barrier binds the enzyme inhibitor to a patient's skin and is substantially resistant to being washed or rubbed off.
  • the polymer barrier may be a Skinvisible® M- series, D-series or S-series polymer.
  • the addition of a polymer, such as an M-, a D- or an S-series Skinvisible® polymer is an important aspect of the invention.
  • the features of the preferred polymers are that they should be non-sticky, long lasting and substantially resistant to being washed or rubbed off.
  • aspects of the invention are directed to an enzyme inhibitor formulation having an extended shelf life for use in the treatment or prophylaxis of skin conditions comprising an enzyme inhibitor that maintains its activity in emulsion for at least about one year.
  • aspects of the invention are directed to an enzyme inhibitor formulation having an extended shelf life for use in the treatment or prophylaxis of skin conditions comprising a cosmetic enzyme inhibitor that maintains its activity in emulsion for at least about one year.
  • Cosmetic enzyme inhibitors are defined hereinafter.
  • inhibitors that have been studied previously may initially have high anti-enzyme activity, this activity is short lived in aqueous environments. Therefore, many of the inhibitors of the prior art are unsuitable for inclusion into an emulsion such as a lotion, cream or spray.
  • compositions comprising enzyme inhibitors that have been found to be stable over time.
  • lotions prepared with dipalmitoyl hydroxyproline (DPHP) and Preregen® retain their activity over a number of months.
  • Formulations within the scope of the invention also include those for the treatment or prophylaxis of skin conditions caused by prolonged exposure to digestive enzymes present in bodily fluids, such as dermatitis or inflammation of the skin, which include a digestive enzyme inhibitor and a polymer which acts as a carrier for the inhibitor and also binds to the skin of the patient for prolonged delivery of the inhibitor.
  • Certain embodiments incorporate a polymer that binds to the skin, creates a non-occlusive barrier, and that is substantially resistant to being washed or rubbed off.
  • digestive enzyme means a proteolytic and/or lipolytic enzyme which may be of any bodily origin. It is not limited to pancreatic or gastrointestinal, e.g. intestinal, origin. Examples include (without limitation) trypsin, chymotrypsin, elastase, and lipase,
  • the invention also relates to methods of preparing such formulations and to methods of treatment or prophylaxis of skin conditions associated with prolonged exposure to digestive enzymes present in bodily fluids, using such formulations.
  • the type of delivery vehicle used will be important in keeping the inhibitor in contact with the digestive enzymes and away from the skin.
  • Certain aspects of the invention are thus directed to a digestive enzyme inhibitor formulation comprising a polymer barrier and a digestive enzyme inhibitor, wherein the polymer barrier binds the enzyme inhibitor to a patient's skin and is substantially resistant to being washed or rubbed off.
  • the polymer barrier may be a Skinvisible® M- series, D-series or S-series polymer.
  • a polymer such as an M-, a D- or an S-series Skinvisible® polymer
  • the features of the preferred polymers are that they should be non-sticky, long lasting and substantially resistant to being washed or rubbed off.
  • Other aspects of the invention are directed to a digestive enzyme inhibitor formulation having an extended shelf life for use in the treatment or prophylaxis of skin conditions comprising a digestive enzyme inhibitor that maintains its activity in emulsion for at least about one year.
  • inhibitors that have been studied previously may initially have high anti-enzyme activity, this activity is short lived in aqueous environments. Therefore, many of the inhibitors of the prior art are unsuitable for inclusion into an emulsion such as a lotion, cream or spray.
  • the present invention solves this problem by providing compositions comprising digestive enzyme inhibitors that have been found to be stable over time. Indeed, lotions prepared with dipalmitoyl hydroxyproline (DPHP) and Preregen® retain their activity over a number of months.
  • DPHP dipalmitoyl hydroxyproline
  • Preregen® retain their activity over a number of months.
  • Formulations within the scope of the invention further include those for the treatment or prohylaxis of skin conditions caused by prolonged exposure to proteases present in bodily fluids, such as dermatitis or inflammation of the skin, e.g. diaper rash, that include a protease inhibitor and a polymer which acts as a carrier for the inhibitor and also binds to the skin of the patient for prolonged delivery of the inhibitor.
  • a protease inhibitor and a polymer which acts as a carrier for the inhibitor and also binds to the skin of the patient for prolonged delivery of the inhibitor.
  • Certain embodiments incorporate an inhibitor that comprises glycine soya protein or dipalmitoyl hydroxyproline.
  • Further embodiments incorporate a polymer that binds to the skin, creates a non-occlusive barrier, and that is substantially resistant to being washed or rubbed off.
  • the invention also relates to methods of preparing such formulations and to methods of treatment or prophylaxis of skin conditions associated with prolonged exposure to proteases present in bodily fluids, using such formulations.
  • the type of delivery vehicle used will be important in keeping the inhibitor in contact with the proteases and away from the skin.
  • Certain aspects of the invention are thus directed to an protease inhibitor formulation comprising a polymer barrier and a protease inhibitor, wherein the polymer barrier binds the protease inhibitor to a patient's skin and is substantially resistant to being washed or rubbed off.
  • the polymer barrier may be a Skinvisible® M- series, D-series or S-series polymer.
  • a polymer such as an M-, a D- or an S-series Skinvisible® polymer, is an important aspect of the invention.
  • the features of the preferred polymers are that they should be non-sticky, long lasting and substantially resistant to being washed or rubbed off.
  • the protease inhibitor may be a glycine soya protein (including formulations with or without oxidoreductases) and/or a dipalmitoyl hydroxyproline composition.
  • a protease inhibitor having an extended shelf life for use in the treatment or prophylaxis of skin conditions caused by prolonged exposure to proteases present in bodily fluids, such as dermatitis or inflammation of the skin, e.g. diaper dermatitis-like skin conditions comprising a cosmetic protease inhibitor that maintains its activity in emulsion for at least about one year.
  • the cosmetic protease inhibitor comprises a glycine soya protein or dipalmitoyl hydroxyproline.
  • the inhibitors that have been studied previously may initially have high anti-enzyme activity, this activity is short lived in aqueous environments. Therefore, many of the inhibitors of the prior art are unsuitable for inclusion into an emulsion such as a lotion, cream or spray.
  • the present invention solves this problem by providing compositions comprising protease inhibitors that have been found to be stable over time. Indeed, lotions prepared with dipalmitoyl hydroxyproline (DPHP) and Preregen® retain their activity over a number of months.
  • DPHP dipalmitoyl hydroxyproline
  • Preregen® retain their activity over a number of months.
  • Further aspects of the invention are directed to a method of treatment or prophylaxis of diaper dermatitis comprising applying a composition comprising glycine soya protein and/or dipalmitoyl hydroxyproline to an affected area of a patient in need thereof.
  • Additional aspects of the invention relate to a method of formulating a diaper dermatitis composition, comprising
  • Formulations within the scope of the invention further include those for the treatment or prophylaxis of skin conditions caused by prolonged exposure to enzymes present in bodily fluids, such as dermatitis or inflammation of the skin, e.g. diaper rash, that include a lipase inhibitor and a polymer which acts as a carrier for the inhibitor and also binds to the skin of the patient for prolonged delivery of the inhibitor.
  • inventions incorporate a polymer that binds to the skin, creates a non-occlusive barrier, and is substantially resistant to being washed or rubbed off.
  • the invention also relates to methods of preparing such formulations and to methods of treatment or prophylaxis of skin conditions associated with prolonged exposure to lipases present in bodily fluids, using such formulations.
  • the type of delivery vehicle used will be important in keeping the inhibitor in contact with the lipases and away from the skin.
  • Certain aspects of the invention are thus directed to a lipase inhibitor formulation comprising a polymer barrier and a lipase inhibitor, wherein the polymer barrier binds the lipase inhibitor to a patient's skin and is substantially resistant to being washed or rubbed off.
  • the polymer barrier may be a Skinvisible® M- series, D-series or S-series polymer.
  • a polymer such as an M-, a D- or an S-series Skinvisible® polymer, is an important aspect of the invention.
  • the features of the preferred polymers are that they should be non-sticky, long lasting and substantially resistant to being washed or rubbed off.
  • aspects of the invention are directed to a lipase inhibitor formulation having an extended shelf life for use in the treatment or prophylaxis of skin conditions comprising a cosmetic lipase inhibitor that maintains its activity in emulsion for at least about one year.
  • inhibitors that have been studied previously may initially have high anti-enzyme activity, this activity is short lived in aqueous environments. Therefore, many of the inhibitors of the prior art are unsuitable for inclusion into an emulsion such as a lotion, cream or spray.
  • Figure 1 shows a schematic of various problems that may cause and/or accompany a skin condition to be treated according to various embodiments of this invention.
  • Figure 2 shows a graph depicting the inhibitory activity of dipalmitoyl hydroxyproline and glycine soya when used in connection with certain methods described by this invention.
  • Figure 3 shows a graph depicting the inhibitory activity of a glycine soya formulation prepared with Preregen for trypsin.
  • Figure 4 shows a graph depicting the inhibitory activity of a dipalmitoyl hydroxyproline for trypsin and elastase.
  • This invention relates to formulations for the treatment or prophylaxis of skin conditions caused by prolonged exposure to enzymes present in bodily fluids.
  • the formulations include an effective amount of at least one enzyme inhibitor that at least partially inhibits enzyme activity.
  • this invention relates to formulations for the treatment or prophylaxis of skin conditions caused by prolonged exposure to digestive enzymes present in bodily fluids.
  • the formulations include an effective amount of at least one enzyme inhibitor that at least partially inhibits digestive enzyme activity.
  • this invention relates to formulations for the treatment or prophylaxis of or preventing certain skin conditions, such as diaper dermatitis and other conditions caused by prolonged contact of the skin with proteases.
  • the formulations include an effective amount of at least one enzyme inhibitor that at least partially inhibits proteolytic enzyme activity.
  • this invention relates to formulations for the treatment or prophylaxis of certain skin conditions, such as diaper dermatitis and other conditions caused by prolonged contact of the skin with lipolytic enzymes, e.g. those in human waste.
  • the formulations include an effective amount of at least one enzyme inhibitor that at least partially inhibits lipolytic enzyme activity.
  • an amount of the composition of the present invention which, when applied to an area of the body, will be effective to at least partially inhibit activity of the bodily fluid enzymes, e.g. fecal and urinary enzymes.
  • Skin is composed of collagen, a protein that polymerizes to form a three-dimensional network of fibers throughout the dermis. Fibroblasts bind to the collagen fibers and cross-link them to generate a strong, stable network. Over time, the points at which cells are attached to the matrix eventually weaken, reducing the ability of fibroblasts to contract the collagen fibers, and resulting in the skin's loss of firmness.
  • Elastin is another fiber-building protein that makes the skin elastic. It gives skin the capacity to stretch in response to a force and then return once the force has been withdrawn. Elastin polymers are held together by bonds that are formed between amino acid residues present in peptide chains. The flexibility of the skin depends on this heavily cross- linked network of elastic fibers. Elastases are enzymes produced by the body's own skin cells. Normally, elastase activity is regulated so that it ensures steady catabolism and turnover of elastin to prevent elastosis problems due to hardening of the dermis.
  • Tyrosine kinases are also enzymes produced by the body's own cells, and are involved in skin melanin synthesis. Normally, their activity is regulated by tyrosine kinase inhibitors, which usually ensure steady catabolism and turnover to prevent excessive melanin synthesis. However, with increasing age, the normal pattern of inhibition and activation of these enzymes changes, leading to the production of age spots.
  • Enzyme inhibitors that are, or could be, used for these cosmetic purposes, e.g. for the prophylaxis or treatment of age spots and wrinkles are known a) in the cosmetic art and b) herein as 'cosmetic enzyme inhibitors'. These include but are not limited to elastase inhibitors and tyrosine kinase inhibitors.
  • the inventor unexpectedly has found, however, that certain compounds used by the cosmetics industry to fight aging are useful for the treatment or prophylaxis of diaper dermatitis.
  • the cosmetics field focuses primarily on protecting the skin from non-enzymic damage from the environment or from elastases produced by the cells in the dermis.
  • one embodiment of the invention is directed to formulations that comprise glycine soya (soybean) protein.
  • the formulations may also optionally include oxidoreductases.
  • oxidoreductases oxidoreductases
  • Glycine soya proteins inhibit members of the serine protease family showing homology at the active center, and thus, inhibit the fecal serine proteases which are associated with skin breakdown due to incontinence.
  • Preregen® is a mixture of natural oxidoreductases (which are capable of neutralizing oxygen free radicals) and isolated plant- peptides (such as glycine soya peptides) which protect the skin against environmental aggressors, such as ozone (O 3 ), UV radiation and detergents. It is preserved using 0.5% Phenonip® (parabens, such as methylparaben, butylparaben, ethylparaben, and propylparaben in phenoxyethanol). Additional solvents that may be included in the formulation are water and glycerin. Prepregen® formulations can remain stable for at least one to two years if properly stored.
  • Preregen® has been found to protect against accelerated skin aging. Skin is increasingly exposed to harmful substances present in the air; ozone is one of the most aggressive atmospheric pollutants. It can destroy the barrier function of the skin by lipid peroxidation and thus trigger irritation reactions. Because of this, researchers in the cosmetic field have sought to develop cosmetic products that inactivate oxygen free radicals in order to provide a protective shield that combats accelerated aging.
  • glycine soya (soybean) protein composition
  • glycine soya protein has particular activity as a trypsin inhibitor.
  • Figure 3 shows a concentration curve for a Glycine soya protein composition. It shows concentration-dependent inhibition of trypsin activity.
  • Glycine soya solutions at various concentrations were incubated with a gelatin-albumin matrix containing a dye. As the trypsin digested the albumin, the dye was released. The dye release was quantified via spectrophotometric analysis. The more dye released, the higher the spectrophotometric value, and the higher the trypsin activity.
  • the glycine soya (soybean) protein/oxidoreductase formulation of the present invention differs significantly from the soybean inhibitors (STI) that have been studied and described by literature in the past.
  • soybean trypsin inhibitor (STI) is a low molecular weight isolate from soybean. It ranges from approximately 20 - 25 kD. It has been most widely studied with respect to trypsin inhibition, and its optimum pH (for activity) is 6.5.
  • Trypsin-chymotrypsin inhibitor is a soybean inhibitor (but not soybean trypsin inhibitor). It is a low molecular weight (Bowman-Birk type) inhibitor, ranging from about 3 - 6 kD. It is a non-specific serine protease inhibitor which can simultaneously inhibit trypsin and chymotrypsin, and is known as being one of the more expensive inhibitors.
  • Preregen® is a synergistic combination of soybean-based peptides with biotechnologically prepared natural oxidoreductases. Its molecular weight ranges; the soy component has a range of about 3 - 30 kD and the oxidoreductase portion is about 35 kD.
  • the soy protein shows optimum activity between pH 5.5 - 6.
  • the inhibitor of this invention is also effective against free radicals (which are formed in contact dermatitis and diaper rash is a form of contact dermatitis).
  • STI is not expected to be effective against free radicals.
  • STI is a Kunitz type protease inhibitor (referring to its mode of action), and trypsin-chymotrypsin inhibitor is a Bowman-Birk type.
  • Preregen® due to its molecular weight range is a combination of soy proteins, some of which are Kunitz type inhibitors and some of which are Bowman-Birk type inhibitors. Therefore, it is a significant improvement over using simply a Kunitz or a Bowman-Birk type inhibitor alone.
  • Preregen® and STI's or soybean inhibitors each have a soy component, they exhibit very different activities.
  • One of ordinary skill in the art would expect them to have different inhibitory effects on the various proteases.
  • An alternate embodiment of the invention is directed to a formulation that comprises dipalmitoyl hydroxyproline (also referred to as "DPHP").
  • Dipalmitoyl hydroxyproline can be derived by grafting a fatty acid (palmitic acid) onto an amino acid (hydroxyproline) to create dipalmitoyl hydroxyproline.
  • a fatty acid palmitic acid
  • hydroxyproline amino acid
  • dipalmitoyl hydroxyproline is useful for the treatment or prophylaxis of diaper dermatitis because of its anti-proteolytic activity.
  • Dipalmitoyl hydroxyproline is a competitive inhibitor for the active site of elastase.
  • Fecal serine proteases (trypsin, chymotrypsin and elastase) all share some homology and accordingly, the present inventor has found that the dipalmitoyl hydroxyproline will be inhibitory to all 3 of these proteases.
  • dipalmitoyl hydroxyproline is plant-derived dipalmitoyl hydroxyproline obtained from Seppic and marketed as Sepilift® DPHP.
  • Sepilift® is marketed as stimulating the remodeling and contraction of collagen fibers, protecting elastic fibers against enzymatic breakdown, and scavenging free radicals. It has been shown to inhibit the overproduction of the elastase enzymes that destroy bonds between different elastin molecules of the skin.
  • dipalmitoyl hydroxyproline also inhibits the elastases and proteases (e.g., trypsin and chymotrypsin) found in feces and urine.
  • proteases e.g., trypsin and chymotrypsin
  • DPHP inhibits trypsin and elastase , which are digestive enzymes that are present in human waste that can attack the skin's integrity.
  • the results from Figure 2 indicate that a lotion made with DPHP provided significant reduction in trypsin activity.
  • Figure 4 indicates that the DPHP material itself is inhibitory to both elastase (-22%) and trypsin (-33%) activity (higher back digest values indicate lower protease digestion of substrate).
  • Sepilift® DPHP is quite a different molecule from any of the inhibitors that have previously been investigated in connection with diaper dermatitis.
  • Studies by the manufacturer (Seppic) show that DPHP is a potent inhibitor of elastase.
  • this product is not considered in the group of classical serine protease inhibitors.
  • the inventor has determined that DPHP does inhibit trypsin, elastase and chymotrypsin, and as such, can be used to treat or prevent diaper dermatitis or other associated skin conditions.
  • DPHP is also different from classical serine protease inhibitors in that the manufacturer has shown it to be a potent inhibitor of free radicals. (Both Preregen® and DPHP share this free radical inhibitory effect.) Finally, DPHP has a molecular weight of 450 daltons. It is smaller than the plant-derived serine protease inhibitors. Previous compositions which incorporated some form of enzyme inhibitor may have side effects if absorbed by the skin. By contrast, the inhibitors of this invention are currently used in the cosmetic market for anti-aging and are generally recognized as safe and without side effects. The enzyme inhibitors used are specifically targeted by the vendors as elastase inhibitors. Elastase breaks down the elastin (which is the protein that provides skin with both its elasticity and strength) in the skin.
  • compositions according to certain aspects of this invention may also include a sacrificial lipase inhibitor.
  • Lipase in combination with other fecal proteases is a potent mediator of skin breakdown.
  • lipases are found in feces and are known to contribute to skin breakdown and skin irritation due to incontinence when in combination with serine proteases.
  • a fatty acid such as coconut oil or any other any other hydrolysable fat such as sunflower oil, castor oil, almond oil or similar oil may be included to act as a sacrificial substrate for lipase.
  • the composition may also include a sacrificial substrate for proteases in general, for example, an amino acid that will inactivate proteases with which it comes into contact.
  • Possible sacrificial substrates include but are not limited to soy amino acids, denatured and native proteins such as gelatins, denatured collagens, and similar proteins.
  • Additional embodiments of the invention may also include a pH buffering system.
  • Fecal enzymes are activated at the elevated pH's which can be found in urine.
  • the buffering system is used to maintain the pH of not only the product, but the skin at a pH of about 5.5 -6.5. This is beneficial because proteolytic enzymes are less active at lower pH values (and show higher proteolytic activity above pH 7).
  • the type of buffering system may include a phosphate ion buffer combination, a lactic acid /lactate system, or any other appropriate buffering system.
  • compositions also include a topical polymer that is capable of binding the enzyme inhibitors and holding them in close contact with the skin for prolonged periods of time.
  • a topical polymer that is capable of binding the enzyme inhibitors and holding them in close contact with the skin for prolonged periods of time.
  • the polymer should adhere to the outer skin layer and form a protective barrier that is substantially resistant to being washed or rubbed off. It should also be substantially resistant to certain chemical insults, particularly enzymatic insults.
  • Particularly useful polymers also reduce skin irritation and dryness.
  • Particularly suitable polymers are polymers in the M-, D- or S-series series from Skinvisible ® .
  • the Skinvisible ® polymers are adapted to adhere to a substrate, such as a patient's skin, and form a protective bond. They are substantially resistant to being washed or rubbed off, and deliver a targeted level of therapeutic or cosmetic agent to the skin. They are manufactured to provide an efficient, long-lasting dose without irritation.
  • the M-series polymers comprise primarily maleic acid methylvinyl-ether copolymer. They form a bond with the skin that resists wash off and that is non- occlusive.
  • the polymer is soluble at about 65°C and maintains a pH range between about 5.5-8.0. They have been used in connection with antimicrobials, sunscreens, antifungals, cosmetics, and moisturizers. They have not been used in connection with a diaper rash treatment.
  • the D-series polymers comprise primarily dextran-70.
  • the S-series polymers comprise primarily starch and polyvinyl pyrrolidone polymers (>10 carbon atoms in the monomer chains.)
  • the Skinvisible® polymers are particularly useful as the delivery system because they are elegant to the touch and are non-greasy. They also bind to the skin and provide a continuous layer in the form of a protective barrier which is long lasting and resistant to wash off.
  • the protease inhibitor used in the formulation is bound to this barrier and thus remains on the skin surface.
  • the formulation not only allows the polymer itself to inhibit the contact of noxious proteases with the skin surface, but it also holds and allows the protease inhibitor to inhibit the harmful proteases.
  • the proteases are likely negated by the inhibitors before they can even act on the skin.
  • one formulation includes a polymeric system that includes an enzyme inhibitor, a buffering system, a sacrificial protease substrate and a sacrificial lipase substrate.
  • This embodiment would likely have its components effective at the following numerals of Figure 1: 1 - polymeric system; 2 - buffering system; 3 - enzyme inhibitor; 4 - sacrificial protease substrate; and 5 - sacrificial lipase substrate.
  • compositions according to various embodiments of this invention may take the form of a cream, ointment, lotion, gel, foam, spray, liquid, or any other topical application method.
  • the formulation includes a thickening and stabilizing system of stearic acid, cetyl alcohol and a polymeric or carbomeric system such as carboxymethylcellulose, microcrystalline cellulose and cellulose gum, carrageenans, sodium polyacrylate or carbomer 934.
  • This system may be replaced with any other thickening system which is stable with the use of the aforementioned ingredients, such as other carbomeric and polymeric combinations, microcrystalline cellulose, and the like.
  • the current compositions may include glyceryl monostearate as a gentle emulsifier.
  • gentle emulsifiers may be used including nonionic emulsifiers, such as polysorbates, and nonionic glucolipids, such as a cetearyl alcohol and cocoglucoside combination.
  • compositions of this invention may also include a monographed skin protectant such as dimethicone or allantoin, colloidal oatmeal, or any other monographed ingredient from 21 CFR Parts 310, 347 and 352 which is deemed appropriate. (These may include monographed items considered appropriate as anorectal or anti-itch drugs. Monographed ingredients refer to those allowable, OTC, drug product ingredients for skin protectant use which are generally recognized as safe by the FDA.)
  • the current composition may also include an odor neutralizer, such as zinc rinoleate or ordenone ® , or any other appropriate odor neutralizer.
  • it may include one or more other skin health benefit agents, such as stearic acid, isoparrafin, petrolatum, fatty acids, fatty acid esters, triglycerides, phospholipids, mineral oils, essential oils, sterols, sterol esters, emollients, moisturizers, waxes, humectants, surfactants, anti-inflammatories, amino acids such as soy or oat amino acids, anti-microbials, anti-puretics, hydroxy acids, microbial or algal extracts, anti-histamines, anti-oxidants, analgesics, astringents, fragrances, dyes, natural or synthetic vitamins, and /or deodorants, examples of which appear in WO 00/38747, the contents of which are incorporated here by reference.
  • skin health benefit agents such as stearic acid, isoparrafin, petrolatum, fatty acids, fatty acid esters, triglycerides, phospholipids
  • excipients examples include polymers of a carboxyvinyl type, polyethyleneglycols, propyleneglycol, waxes, fatty substances, esters and triglycerides of fatty substances, stearic derivatives such as, for example, glycerol stearate, alcohols such as, for example, stearyl alcohol, ketostearyl alcohol, ketyl alcohol, polyol, polyoxyethylene ketyl ether, vegetable oils such as soft almond oil, coconut oil, castor oil.
  • Examples also include mineral oils such as Vaseline oil, glycerin, derivatives of lanolin, talc, wetting agents, thickening agents, stabilizing agents, emulsifying agents, preservatives, perfumes, colorants or other known and currently used excipients.
  • mineral oils such as Vaseline oil, glycerin, derivatives of lanolin, talc, wetting agents, thickening agents, stabilizing agents, emulsifying agents, preservatives, perfumes, colorants or other known and currently used excipients.
  • oils such as mineral oil, fish liver oil, and cod liver oil
  • emollients such as glycerin, olive oil, and lanolin
  • fillers such as cellulose gum, calcium carbonate, karaya gum, gum tragacanth, gum acacia, carboxymethyl cellulose, and polyvinyl acetate
  • vitamins such as vitamins A, D, and D3
  • astringents such as zinc oxide and aluminum acetate
  • protectants such as Peruvian balsam
  • coloring agents coloring agents
  • odorants and other materials which are conventionally used in relieving skin irritation.
  • This invention is also directed toward methods of preparing compositions according to certain embodiments of this invention.
  • One method for the formulation of the composition of this invention is to add the polymeric system from Skinvisible ® to the enzyme inhibitor (either glycine soya (soybean) protein or dipalmitoyl hydroxyproline (DPHP), sacrificial protease substrate and sacrificial lipase substrate.
  • the enzyme inhibitor either glycine soya (soybean) protein or dipalmitoyl hydroxyproline (DPHP)
  • sacrificial protease substrate sacrificial lipase substrate.
  • a gentle emulsifier typically glyceryl monostearate
  • a stabilizing system typically stearic acid and cetyl alcohol
  • the current polymeric protective barrier and protease inhibitor composition is a significant improvement over previous polymeric barriers, dimethicone and zinc oxide (commonly used in diaper rash preparations).
  • the current formulation binds strongly to the skin for hours and only begins to come off the skin via natural exfoliation.
  • the polymer also binds very strongly to hydrophilic and hydrophobic actives.
  • the combination of polymer plus the enzyme inhibitor will be held at the skin surface for long periods of time where it can exert its effect on the proteolytic enzymes of the feces and urine.
  • the current formulation is non-greasy, transparent (or substantially transparent), and will allow for easy cleaning after an incontinent episode. Since scrubbing is not required as it is for some thick, messy barrier creams, the present formulation also helps decrease the chemical and physical irritation caused by cleaning. In other words, the emulsified, aqueous-based products of this invention are easy to apply and remove, and the tissue trauma associated with difficult ointment removal is avoided. The products are elegant to the touch, and allow visual inspection of the skin whereas some ointments and barriers are opaque and prevent visual skin inspection. Certain embodiments of polymers used in connection with this invention are also anti-irritants and have been shown to have moisturizing properties.
  • Table 1 indicates that the initial reaction rate is highest without the formulations of this invention added, which means that the anti-lipase activity of formulations according to this invention provide added protection from skin breakdown due to the presence of incontinence related enzymes.
  • the Glycine soya protein in this case, Preregen
  • DPHP formulations are added, the initial reaction rate is decreased.
  • the rate decrease was 32% and for the DPHP formulation the rate decrease was 93%.
  • Table 1 Inhibition of Lipase Activity by Preregen and DPHP formulations
  • EXAMPLE 2 The inventor selected glycine soya and DPHP by testing numerous potential inhibitors in vitro to assess their activity against protease enzymes.
  • a protease enzyme present in feces or urine such as trypsin, chymotrypsin, or elastase, was placed in contact with a substrate (crosslinked albumin, sulfaniloazo-albumin and gelatin).
  • the protease trypsin, chymotrypsin or elastase
  • the substrate-protease or substrate-protease-protease inhibitor combination was then left to incubate.
  • Figure 2 shows the effectiveness of both a DPHP prototype and a glycine soya prototype for inhibiting the protease, trypsin.
  • a back digest was performed with a spectrally active protease substrate, trypsin, and either DPHP or glycine soya. Trypsin was incubated with either DPHP or glycine soya, and for the control, neither DPHP nor glycine soya was used.
  • the trypsin or trypsin + either DPHP or glycine soya was then placed in contact with a substrate, the results of which are shown in Figures 3 and 4.
  • the substrate used was a crosslinked albumin, sulfaniloazo-albumin and gelatin at a slightly acidic pH.
  • the substrate is susceptible to proteolysis by a wide range of enzymes including collagenase, papain, trypsin, chymotrypsin and bromelain. Digestion of this substrate by protease releases a dye. Color is developed at the end of the reaction period via the addition of 0.1 N NaOH. This color development can be measured spectrophotometrically at OD 450 and the OD value is proportional to enzymatic activity.
  • enzyme or enzyme + inhibitor are placed in contact with substrate and the reaction is allowed to proceed at 37°C for a set time period. After the initial digest, color is developed by the addition of NaOH.
  • the OD 450 reading is directly proportional to the enzyme activity (i.e. the higher the value, the higher the enzyme activity).
  • FIGS. 2 and 4 show the results of back digest tests that were conducted.
  • the enzyme or enzyme + enzyme inhibitor was placed in contact with the substrate for a set amount of time. After this digest, the solutions were poured off, the substrate was washed and an excess of enzyme was placed in contact with the substrate for an additional incubation period. At the end of this incubation, the color was developed as described above, with the addition of 0.1 N, NaOH. Color development was read at OD 450. The color was then compared with controls which had no enzyme. For back digests, higher values are inversely proportional to enzyme activity. Thus, higher values are indicative of increased enzyme inhibition.
  • Figure 3 shows a concentration curve for a Glycine soya protein composition. It shows concentration-dependent inhibition of trypsin activity.
  • Glycine soya solutions at various concentrations were incubated with a gelatin-albumin matrix containing a dye. As the trypsin digested the albumin, the dye was released. The dye release was quantified via spectrophotometric analysis. The more dye released, the higher the spectrophotometric value, and the higher the trypsin activity. Therefore, in this assay, a lower reading suggests inhibition of trypsin activity.
  • a Glycine soya concentration of between 2 to 5 % was found to effectively inhibit the trypsin reaction.
  • glycine soya protein can act as an effective treatment or prevention for diaper dermatitis.
  • a stabilized preparation of hexamidine (Elestab) and another preparation of 4-(2-aminoethyl)-benzenesulfonylfluoride hydrochloride (AEBSF) initially showed very high protease inhibition activity. However, they were left for one month and then tested for activity. After one month at room temperature, the activity of the stabilized AEBSF solution was decreased by 42%. When a sample of Elestab solution was left at room temperature for a month, its inhibitory activity was shown to decrease by about 37% over a freshly prepared Elestab solution.
  • AEBSF aqueous solutions of enzyme inhibitors.
  • the half life for many highly reactive inhibitors was from hours to days. Indeed, the solution lifetime of many reactive inhibitors such as AEBSF and a number of others can be quite short due to their highly reactive nature. In the presence of water they tend to hydrolyze.

Abstract

Compositions for the treatment or prophylaxis of skin conditions associated with prolonged exposure to enzymes present in bodily fluids, such as human waste, such as for diaper rash. These include an enzyme inhibitor, such as a protease inhibitor and a polymer with which the inhibitor is delivered. In certain embodiments, the inhibitor may comprise glycine soya protein or dipalmitoyl hydroxyproline. The polymer binds to the skin, creates a non-occlusive barrier, and is substantially resistant to being washed or rubbed off. The invention also relates to methods of preparing such formulations and to methods of treatment or prophylaxis for skin conditions associated with prolonged exposure to enzymes present in bodily fluids, such as human waste.

Description

PROTEASE INHIBITOR COMPOSITIONS FOR PREVENTION AND TREATMENT OF SKIN CONDITIONS
The invention relates to compositions and methods for treatment or prophylaxis of skin conditions such as diaper dermatitis, erythema, or other skin conditions caused by prolonged exposure to certain enzymes.
Diaper rash or diaper dermatitis is an inflammation of the skin in the diaper area of newborn infants, infants, and children. While this condition is common to infants, it is certainly not limited to infants. Individuals who suffer from incontinence and use absorbent articles, colostomy patients, patients who are nonambulatory, and the elderly may also develop this condition.
It is estimated that about 10% of babies between 0 and 2 years of age will develop diaper dermatitis, and that 50-94% of incontinent adults will develop erythema. A certain portion of these individuals may even develop a stage I or II pressure ulcer.
These skin conditions are generally believed to be caused by the metabolic by-products of both urine and feces. Specifically, human feces contain endogenic digestive enzymes, e.g. proteolytic and/or lipolytic enzymes such as trypsin, chymotrypsin, elastase, and pancreatic lipase. (These enzymes are enzymes of pancreatic or gastrointestinal, e.g. intestinal origin, produced to digest food.) When the skin is exposed to such enzymes, the lipid-containing and protein- containing components of the skin (particularly the barrier layer, stratum corneum), can be broken down, resulting in irritation and inflammation. If the enzymes remain in contact with the skin for any appreciable period of time, they may cause irritation, predispose the skin to infection by microorganisms, contribute to skin breakdown, and cause (and/or exacerbate) various skin conditions. The effect of fecal enzymes can be aggravated further by the presence of urine. In fact, prolonged exposure to urine itself may cause erythema and skin breakdown. Urine is normally slightly acidic. Feces of adults are normally neutral or slightly alkaline, while that of infants is slightly acidic. Some believe that it is the acidic agents which are believed to be highly irritating in the diaper area, while others believe it is primarily the alkaline components that contribute to diaper dermatitis.
In new-born babies, diapers can create a more hostile environment than that usually encountered by the skin, increasing the risk of dermatitis. The dermis is attacked and the skin is irritated and/or inflamed. There are acidic components of urine and infant stools which are not present in adult feces and which are particularly irritating. Urine consists of approximately 93-97% water and 3-7% solids which include urea, uric acid, creatine, creatinine, ammonia, and inorganic substances such as chlorides, calcium, magnesium, and phosphorous. In effect, the urea contained in the urine is broken down into ammonium hydroxide by the ureases which leads to an increase in pH.
It is believed by some that when the pH becomes basic, the enzymes produced at time of digestion, such as the proteases and the lipases of pancreatic or intestinal origin, increase their activity and thus their irritating power increases. In particular, the lipases attack the triglycerides of the sebum and provoke the release of fatty acids. The corneum, made permeable by hyperhydration, rubbing, and digestion by enzymes, loses its function as a barrier and allows other irritating molecules, such as ammonia, fecal enzymes, bacteria, and biliary salts, which might not be irritating by themselves, to migrate through the compromised skin barrier. In certain cases, an actual digestion of the epidermis of the infant's skin could occur due to the action of ureases, lipases and proteases. Because of the problems caused by diaper dermatitis, many researchers have sought to develop treatments to combat the destructive effects caused when enzymes contained in feces and/or urine contact human skin for prolonged periods of time. Certain anti- enzyme compounds have been included in topically-applied compositions for treatment or prevention of diaper rash. For example, a water-soluble lipase inhibitor such as zinc chloride has been included in a barrier-like carrier such as polyethylene glycol. Currently available treatments for diaper rash are generally based upon the use of zinc oxide, vitamins (A, D, and D3), or some combination thereof. These active ingredients are incorporated into a cream or salve by blending them into various purified semisolid ointment bases, such as mineral oil, petrolatum, soft paraffin, lanolin, and the like. These ointments are intended to protect the skin from contact with irritants.
While such treatments may be effective for therapy or prophylaxis of simple diaper rashes, severe cases of diaper rash, especially those that are often observed with incontinent adults, have proved resistant to the treatments. Additionally, these treatments tend to be greasy and messy. In order to wash them off, the skin must be rubbed or scrubbed, further irritating the skin.
Another conventional method of preventing or alleviating diaper rash is to apply powders to keep the skin dry. However, powders are also easily washed off and do not provide an effective barrier over time. In fact, many of the barriers used in conventional treatments are not effective. Most prophylactics or treatments for diaper dermatitis are barriers that rub off with exposure to fecal and urinary insult, leaving the skin exposed to such irritants.
Some researchers have studied the possibility of including substances that inhibit digestive enzymes into diaper rash creams, wipes, or into the diapers themselves. For example, some proteolytic and lipolytic enzyme inhibitors react with the active site of the target enzyme and destroy the enzyme's ability to function. The notion is that delivering such enzymes to a patient's skin allows the inhibitors to function as a barrier to enzyme activity to prevent diaper rash.
One method that has been studied is to incorporate organophilic clays (that absorb and inactivate proteolytic enzymes) or protease inhibitors into diapers. The clays are intended to prevent enzymes from contacting the skin and render them incapable of causing irritation.
Other methods include applying an inhibitor in an ointment, cream, or gel to the location of the inflammation. Some inhibitors discussed by the literature for use according to this method include soybean trypsin inhibitor, aprotinin, hexamidine, p-aminobenzamidine, leupeptin, pepstatin A, chymostatin, and trypsin-chymotrypsin inhibitor. See e.g., WO 99/45973, WO 99/45974, EP 0 958 833 A1, and WO/01/52842, the contents of each of which are incorporated herein by reference.
A further method that has been explored for the treatment or prophylaxis of diaper dermatitis has been to add an antimicrobial protease inhibitor to a pre-moistened wipe. The antimicrobial protease inhibitor can be added directly to the wipe or directly to the liquid that moistens the wipe. Exemplary antimicrobial protease inhibitors are aromatic diamidines, such as pentamidine and/or hexamidine, and particularly hexamidine diisethionate.
The most common inhibitor discussed by the prior art literature is hexamidine diisethionate, also marketed as Elestab HP 100 ("Elestab"). Elestab is a hexamidine derivative and was initially marketed as an antimicrobial. It has also been marketed as an anti-dandruff product. Hexamidines have been shown to have enzyme inhibitory activity. However, while Elestab initially shows good inhibitory activity against trypsin, its inhibitory activity decreases rather quickly over time in a prepared solution. In other words, Elestab has a short shelf-life in solution, rendering it unworkable for purposes that require a solution that can remain stable and active over an extended period of time. Accordingly, it is highly ineffective for use in a preparation of an emulsion product, such as a lotion, cream or spray, which may remain on a shelf for many months at a time.
Without wishing to be bound to any theory, the inventor believes that this may be one reason why some prior art references incorporate the product into a diaper or product that remains dry until use - Elestab tends to be stable in the absence of water, but loses its stability when combined with water or other emulsification components. As such, Elestab is not appropriate for incorporation into an emulsified product. The inventor has recognized this fact and developed a product that provides a significant improvement over emulsified products using hexamidine.
In summary, the prior art combinations for diapers and wipes greatly add to the cost of the product and make them economically unfeasible. The compositions have a very short shelf life, requiring the care provider to maintain a constant replenishing supply on hand. Diapers also do not provide the additional protection of barrier between the skin and the proteases. By contrast, the compositions of the present invention have a long shelf life, i.e. they maintain their activity in emulsion, even after being stored for an extended period of time, so that the care provider does not need to constantly replenish the supply on hand. Formulations according to certain aspects of this invention have an elegant, non-greasy feel, and will not add to clean up procedures. The emulsions of the present invention generally have a better feel than typical barrier ointments of petrolatum and zinc oxide which can be sticky, and hard to apply and remove. There is a distinct need in the art for a formulation that acts as an effective inhibitor of fecal and urinary enzymes and that provides a superior barrier to these enzymes, preventing them from damaging the skin. There is also a need for a product that can remain stable in solution for extended periods of time. There is a further need for an inhibitor formulation that is substantially resistant to being washed off the skin. There is an even further need for an inhibitor formulation that is not greasy or messy. It is an object of various embodiments of this invention to meet these needs.
Although the foregoing focuses primarily on known formulations for and methods of treatment or prophylaxis of skin conditions associated with prolonged exposure to enzymes present in human waste, several other bodily fluids contain enzymes, e.g. proteolytic and/or lipolytic enzymes such as trypsin, chymotrypsin, elastase, and lipase.
As with digestive enzymes of pancreatic or gastrointestinal, e.g. intestinal origin, produced to digest food, when the skin is exposed to such enzymes, the lipid-containing and protein-containing components of the skin (particularly the barrier layer, stratum corneum), can be broken down, resulting in irritation and inflammation, predisposing the skin to infection by microorganisms, contributing to skin breakdown, and causing and/or exacerbating various skin conditions. The skin may often be exposed to such enzymes by untreated bodily fluid discharges, or around the point of entry of ostomy tubes into, or attachment of ostomy pouches to, the body.
Such bodily fluids and enzymes and the way in which they often come into contact with the skin for any appreciable period of time include: fistulas, e.g. enterocutaneous fistulas, drain tubes or the point of insertion of catheters into tissue injury or the urinary tract, leaving the skin exposed to such irritants around the fistula, tube or catheter; many tissues contain substances such as enzymes, e.g lipolytic enzymes, such as phospholipases, and where the site is presenting an inflammatory response, proteases, such as serine proteases, e.g. elastase, trypsin, chymotrypsin and thrombin; cysteine proteases; matrix metalloproteases, e.g. collagenase; and carboxyl (acid) proteases may be present; exudate from chronic wounds, such as venous leg ulcers and diabetic foot ulcers, which contains proteolytic enzymes (proteases), such as serine proteases, e.g. elastase, trypsin, chymotrypsin and thrombin; cysteine proteases; matrix metalloproteases, e.g. collagenase; and carboxyl (acid) proteases; that are deleterious to the peri-wound skin when it is exposed to such enzymes for any appreciable period of time in untreated discharges, or in therapy, including vacuum wound therapy, where the exudate may be pulled onto the skin; mucous secretions, such as nasal, bronchial and pulmonary secretions, and seminal plasma, which contain serine proteases, such as chymotrypsin-like enzymes, e.g. cathepsin, and elastases; the peri-nasal and/or -oral skin may be exposed to such enzymes for an appreciable period of time by untreated nasal, bronchial and/or pulmonary discharges, or around endotracheal tubes or the point of insertion of tracheostomy tubes; saliva and gastric secretions, which contain lipases of oral or gastric origin; the peri-oral skin may be exposed to such enzymes for an appreciable period of time by untreated drool, or gastric discharges, such as gastric reflux; gastric or enteric secretions, which contain serine proteases and lipases; the skin may be exposed to such enzymes around the point of entry of relevant ostomy tubes into, or of attachment of ostomy pouches or collection bags to, the body, such as in gastrostomies, ileostomies, jejunostomies and colostomies; and sweat, which contains various proteases and which may often come into contact with large areas of skin for an appreciable period of time, particularly in inguinal and axillary areas, where its evaporation is restricted. There is just as much need for formulations for and methods of treatment or prophylaxis of patients for skin conditions associated with prolonged exposure to enzymes present in these other bodily fluids, such as proteolytic and/or lipolytic enzymes, as for digestive enzymes of pancreatic or gastrointestinal origin in waste.
Enzyme inhibitors act in a number of different ways to inhibit or destroy the enzyme's ability to function. As noted above, for example, some enzyme inhibitors react with the active site of the target enzyme and destroy the enzyme's ability to function. Others degrade or sequester the enzyme to the same effect. Yet others act as a sacrificial substrate, on which the enzyme acts rather than on its usual target, in this case the skin, so that the inhibitor destroys the enzyme's ability to function. The term 'inhibitor' herein includes inhibitors with any and all such modes of action.
Formulations within the scope of the invention include those for the treatment or prophylaxis of skin conditions caused by prolonged exposure to enzymes present in bodily fluids, such as dermatitis or inflammation of the skin, which include an enzyme inhibitor and a polymer which acts as a carrier for the inhibitor and also binds to the skin of the patient for prolonged delivery of the inhibitor. Certain embodiments incorporate a polymer that binds to the skin, creates a non-occlusive barrier, and that is substantially resistant to being washed or rubbed off.
The invention also relates to methods of preparing such formulations and to methods of treatment or prophylaxis of skin conditions associated with prolonged exposure to enzymes present in bodily fluids, using such formulations.
In certain embodiments, the type of delivery vehicle used will be important in keeping the inhibitor in contact with the enzymes and away from the skin. Certain aspects of the invention are thus directed to an enzyme inhibitor formulation comprising a polymer barrier and an enzyme inhibitor, wherein the polymer barrier binds the enzyme inhibitor to a patient's skin and is substantially resistant to being washed or rubbed off. In specific embodiments, the polymer barrier may be a Skinvisible® M- series, D-series or S-series polymer. In those embodiments, the addition of a polymer, such as an M-, a D- or an S-series Skinvisible® polymer, is an important aspect of the invention. The features of the preferred polymers are that they should be non-sticky, long lasting and substantially resistant to being washed or rubbed off.
Other aspects of the invention are directed to an enzyme inhibitor formulation having an extended shelf life for use in the treatment or prophylaxis of skin conditions comprising an enzyme inhibitor that maintains its activity in emulsion for at least about one year.
Other aspects of the invention are directed to an enzyme inhibitor formulation having an extended shelf life for use in the treatment or prophylaxis of skin conditions comprising a cosmetic enzyme inhibitor that maintains its activity in emulsion for at least about one year. Cosmetic enzyme inhibitors are defined hereinafter.
Although the inhibitors that have been studied previously may initially have high anti-enzyme activity, this activity is short lived in aqueous environments. Therefore, many of the inhibitors of the prior art are unsuitable for inclusion into an emulsion such as a lotion, cream or spray.
The present invention solves this problem by providing compositions comprising enzyme inhibitors that have been found to be stable over time. Indeed, lotions prepared with dipalmitoyl hydroxyproline (DPHP) and Preregen® retain their activity over a number of months. Formulations within the scope of the invention also include those for the treatment or prophylaxis of skin conditions caused by prolonged exposure to digestive enzymes present in bodily fluids, such as dermatitis or inflammation of the skin, which include a digestive enzyme inhibitor and a polymer which acts as a carrier for the inhibitor and also binds to the skin of the patient for prolonged delivery of the inhibitor. Certain embodiments incorporate a polymer that binds to the skin, creates a non-occlusive barrier, and that is substantially resistant to being washed or rubbed off.
When used herein "digestive enzyme' means a proteolytic and/or lipolytic enzyme which may be of any bodily origin. It is not limited to pancreatic or gastrointestinal, e.g. intestinal, origin. Examples include (without limitation) trypsin, chymotrypsin, elastase, and lipase,
The invention also relates to methods of preparing such formulations and to methods of treatment or prophylaxis of skin conditions associated with prolonged exposure to digestive enzymes present in bodily fluids, using such formulations.
In certain embodiments, the type of delivery vehicle used will be important in keeping the inhibitor in contact with the digestive enzymes and away from the skin. Certain aspects of the invention are thus directed to a digestive enzyme inhibitor formulation comprising a polymer barrier and a digestive enzyme inhibitor, wherein the polymer barrier binds the enzyme inhibitor to a patient's skin and is substantially resistant to being washed or rubbed off.
In specific embodiments, the polymer barrier may be a Skinvisible® M- series, D-series or S-series polymer. In those embodiments, the addition of a polymer, such as an M-, a D- or an S-series Skinvisible® polymer, is an important aspect of the invention. The features of the preferred polymers are that they should be non-sticky, long lasting and substantially resistant to being washed or rubbed off. Other aspects of the invention are directed to a digestive enzyme inhibitor formulation having an extended shelf life for use in the treatment or prophylaxis of skin conditions comprising a digestive enzyme inhibitor that maintains its activity in emulsion for at least about one year.
Although the inhibitors that have been studied previously may initially have high anti-enzyme activity, this activity is short lived in aqueous environments. Therefore, many of the inhibitors of the prior art are unsuitable for inclusion into an emulsion such as a lotion, cream or spray.
The present invention solves this problem by providing compositions comprising digestive enzyme inhibitors that have been found to be stable over time. Indeed, lotions prepared with dipalmitoyl hydroxyproline (DPHP) and Preregen® retain their activity over a number of months.
Formulations within the scope of the invention further include those for the treatment or prohylaxis of skin conditions caused by prolonged exposure to proteases present in bodily fluids, such as dermatitis or inflammation of the skin, e.g. diaper rash, that include a protease inhibitor and a polymer which acts as a carrier for the inhibitor and also binds to the skin of the patient for prolonged delivery of the inhibitor. Certain embodiments incorporate an inhibitor that comprises glycine soya protein or dipalmitoyl hydroxyproline. Further embodiments incorporate a polymer that binds to the skin, creates a non-occlusive barrier, and that is substantially resistant to being washed or rubbed off.
The invention also relates to methods of preparing such formulations and to methods of treatment or prophylaxis of skin conditions associated with prolonged exposure to proteases present in bodily fluids, using such formulations. In certain embodiments, the type of delivery vehicle used will be important in keeping the inhibitor in contact with the proteases and away from the skin. Certain aspects of the invention are thus directed to an protease inhibitor formulation comprising a polymer barrier and a protease inhibitor, wherein the polymer barrier binds the protease inhibitor to a patient's skin and is substantially resistant to being washed or rubbed off.
In specific embodiments, the polymer barrier may be a Skinvisible® M- series, D-series or S-series polymer. In those embodiments, the addition of a polymer, such as an M-, a D- or an S-series Skinvisible® polymer, is an important aspect of the invention. The features of the preferred polymers are that they should be non-sticky, long lasting and substantially resistant to being washed or rubbed off.
Additionally or alternatively, the protease inhibitor may be a glycine soya protein (including formulations with or without oxidoreductases) and/or a dipalmitoyl hydroxyproline composition.
Other aspects of the invention are directed to a protease inhibitor having an extended shelf life for use in the treatment or prophylaxis of skin conditions caused by prolonged exposure to proteases present in bodily fluids, such as dermatitis or inflammation of the skin, e.g. diaper dermatitis-like skin conditions comprising a cosmetic protease inhibitor that maintains its activity in emulsion for at least about one year. In specific embodiments, the cosmetic protease inhibitor comprises a glycine soya protein or dipalmitoyl hydroxyproline.
Although the inhibitors that have been studied previously may initially have high anti-enzyme activity, this activity is short lived in aqueous environments. Therefore, many of the inhibitors of the prior art are unsuitable for inclusion into an emulsion such as a lotion, cream or spray. The present invention solves this problem by providing compositions comprising protease inhibitors that have been found to be stable over time. Indeed, lotions prepared with dipalmitoyl hydroxyproline (DPHP) and Preregen® retain their activity over a number of months.
Further aspects of the invention are directed to a method of treatment or prophylaxis of diaper dermatitis comprising applying a composition comprising glycine soya protein and/or dipalmitoyl hydroxyproline to an affected area of a patient in need thereof.
Additional aspects of the invention relate to a method of formulating a diaper dermatitis composition, comprising
(a) providing a polymeric system that can bind to a patient's skin;
(b) combining the polymeric system with glycine soya protein or dipalmitoyl hydroxyproline;
(c) adding a sacrificial protease substrate;
(d) adding a sacrificial lipase substrate;
(e) adding a pH buffering system; and
(f) forming the mixture into a cream or a lotion for topical application.
Formulations within the scope of the invention further include those for the treatment or prophylaxis of skin conditions caused by prolonged exposure to enzymes present in bodily fluids, such as dermatitis or inflammation of the skin, e.g. diaper rash, that include a lipase inhibitor and a polymer which acts as a carrier for the inhibitor and also binds to the skin of the patient for prolonged delivery of the inhibitor.
Further embodiments incorporate a polymer that binds to the skin, creates a non-occlusive barrier, and is substantially resistant to being washed or rubbed off. The invention also relates to methods of preparing such formulations and to methods of treatment or prophylaxis of skin conditions associated with prolonged exposure to lipases present in bodily fluids, using such formulations.
In certain embodiments, the type of delivery vehicle used will be important in keeping the inhibitor in contact with the lipases and away from the skin. Certain aspects of the invention are thus directed to a lipase inhibitor formulation comprising a polymer barrier and a lipase inhibitor, wherein the polymer barrier binds the lipase inhibitor to a patient's skin and is substantially resistant to being washed or rubbed off.
In specific embodiments, the polymer barrier may be a Skinvisible® M- series, D-series or S-series polymer. In those embodiments, the addition of a polymer, such as an M-, a D- or an S-series Skinvisible® polymer, is an important aspect of the invention. The features of the preferred polymers are that they should be non-sticky, long lasting and substantially resistant to being washed or rubbed off.
Other aspects of the invention are directed to a lipase inhibitor formulation having an extended shelf life for use in the treatment or prophylaxis of skin conditions comprising a cosmetic lipase inhibitor that maintains its activity in emulsion for at least about one year.
Although the inhibitors that have been studied previously may initially have high anti-enzyme activity, this activity is short lived in aqueous environments. Therefore, many of the inhibitors of the prior art are unsuitable for inclusion into an emulsion such as a lotion, cream or spray.
The present invention solves this problem by providing compositions comprising lipase inhibitors that have been found to be stable over time. A brief description of the drawings will now be given, in which
Figure 1 shows a schematic of various problems that may cause and/or accompany a skin condition to be treated according to various embodiments of this invention.
Figure 2 shows a graph depicting the inhibitory activity of dipalmitoyl hydroxyproline and glycine soya when used in connection with certain methods described by this invention.
Figure 3 shows a graph depicting the inhibitory activity of a glycine soya formulation prepared with Preregen for trypsin.
Figure 4 shows a graph depicting the inhibitory activity of a dipalmitoyl hydroxyproline for trypsin and elastase.
This invention relates to formulations for the treatment or prophylaxis of skin conditions caused by prolonged exposure to enzymes present in bodily fluids. The formulations include an effective amount of at least one enzyme inhibitor that at least partially inhibits enzyme activity.
In one aspect, this invention relates to formulations for the treatment or prophylaxis of skin conditions caused by prolonged exposure to digestive enzymes present in bodily fluids. The formulations include an effective amount of at least one enzyme inhibitor that at least partially inhibits digestive enzyme activity.
In another aspect, this invention relates to formulations for the treatment or prophylaxis of or preventing certain skin conditions, such as diaper dermatitis and other conditions caused by prolonged contact of the skin with proteases. The formulations include an effective amount of at least one enzyme inhibitor that at least partially inhibits proteolytic enzyme activity. In a further aspect, this invention relates to formulations for the treatment or prophylaxis of certain skin conditions, such as diaper dermatitis and other conditions caused by prolonged contact of the skin with lipolytic enzymes, e.g. those in human waste. The formulations include an effective amount of at least one enzyme inhibitor that at least partially inhibits lipolytic enzyme activity.
The phrase "effective amount" in all the foregoing means an amount of the composition of the present invention which, when applied to an area of the body, will be effective to at least partially inhibit activity of the bodily fluid enzymes, e.g. fecal and urinary enzymes.
The inventor has found that certain compounds that are marketed as cosmetic compounds intended to protect against irritation and accelerated skin aging are unexpectedly useful for the treatment or prophylaxis of diaper dermatitis and other skin conditions. In order to fully describe the invention, it is helpful to understand how anti-aging compounds work.
Regular exposure to sunlight, harsh conditions (such as wind, extreme temperatures and pollution), cigarette smoking, stress, or simply the passing of years takes its toll on skin. Skin loses its elasticity due to breakdown of collagen fibers, develops wrinkles and loses moisture. Accordingly, the cosmetics industry has sought to develop compounds that help fight these conditions.
Skin is composed of collagen, a protein that polymerizes to form a three-dimensional network of fibers throughout the dermis. Fibroblasts bind to the collagen fibers and cross-link them to generate a strong, stable network. Over time, the points at which cells are attached to the matrix eventually weaken, reducing the ability of fibroblasts to contract the collagen fibers, and resulting in the skin's loss of firmness.
Elastin is another fiber-building protein that makes the skin elastic. It gives skin the capacity to stretch in response to a force and then return once the force has been withdrawn. Elastin polymers are held together by bonds that are formed between amino acid residues present in peptide chains. The flexibility of the skin depends on this heavily cross- linked network of elastic fibers. Elastases are enzymes produced by the body's own skin cells. Normally, elastase activity is regulated so that it ensures steady catabolism and turnover of elastin to prevent elastosis problems due to hardening of the dermis.
However, with increasing age, the normal pattern of inhibition and activation of these enzymes is reversed, and elastase activity may be turned on inappropriately, destroying most of the bonds between different elastin molecules and causing a disruption in the elastic fibers network. Accordingly, some areas of the cosmetic industry have researched ways to inhibit these enzymes so that they do not break down the skin bonds.
Tyrosine kinases are also enzymes produced by the body's own cells, and are involved in skin melanin synthesis. Normally, their activity is regulated by tyrosine kinase inhibitors, which usually ensure steady catabolism and turnover to prevent excessive melanin synthesis. However, with increasing age, the normal pattern of inhibition and activation of these enzymes changes, leading to the production of age spots.
Enzyme inhibitors that are, or could be, used for these cosmetic purposes, e.g. for the prophylaxis or treatment of age spots and wrinkles are known a) in the cosmetic art and b) herein as 'cosmetic enzyme inhibitors'. These include but are not limited to elastase inhibitors and tyrosine kinase inhibitors.
The inventor unexpectedly has found, however, that certain compounds used by the cosmetics industry to fight aging are useful for the treatment or prophylaxis of diaper dermatitis. The cosmetics field focuses primarily on protecting the skin from non-enzymic damage from the environment or from elastases produced by the cells in the dermis.
It is not concerned with protecting the skin from attack and/or irritation, inflammation or other skin conditions associated with prolonged exposure to enzymes present in bodily fluids in contact with the skin for any appreciable period of time. It is also not concerned with protecting the skin from attack and/or irritation, inflammation or other skin conditions associated with prolonged exposure to digestive, including proteolytic and lipolytic enzymes (which are enzymes with a quite different activity from the activity of elastases) when present in bodily fluids.
However, the present inventor has found that certain compounds used by the cosmetics industry are useful in preventing skin conditions caused by the digestive enzymes present in feces and urine that attack skin during prolonged exposure.
For example, one embodiment of the invention is directed to formulations that comprise glycine soya (soybean) protein. The formulations may also optionally include oxidoreductases. Without wishing to be bound to any theory, the inventor believes that glycine soya (soybean) protein is useful for the treatment or prophylaxis of diaper dermatitis because due to its structure, it competes for the active site of the protease. Since the active site of most serine proteases (especially the fecal serine proteases trypsin, chymotrypsin and elastase) share some homology and have highly conserved amino acid residues, it is believed that Glycine soya proteins inhibit members of the serine protease family showing homology at the active center, and thus, inhibit the fecal serine proteases which are associated with skin breakdown due to incontinence.
One specific form of this compound, marketed by Centerchem, Inc., is Preregen®. Preregen® is a mixture of natural oxidoreductases (which are capable of neutralizing oxygen free radicals) and isolated plant- peptides (such as glycine soya peptides) which protect the skin against environmental aggressors, such as ozone (O3), UV radiation and detergents. It is preserved using 0.5% Phenonip® (parabens, such as methylparaben, butylparaben, ethylparaben, and propylparaben in phenoxyethanol). Additional solvents that may be included in the formulation are water and glycerin. Prepregen® formulations can remain stable for at least one to two years if properly stored.
The combination of compounds in Preregen® has been found to protect against accelerated skin aging. Skin is increasingly exposed to harmful substances present in the air; ozone is one of the most aggressive atmospheric pollutants. It can destroy the barrier function of the skin by lipid peroxidation and thus trigger irritation reactions. Because of this, researchers in the cosmetic field have sought to develop cosmetic products that inactivate oxygen free radicals in order to provide a protective shield that combats accelerated aging.
In contrast to this use, however, the inventor has found that a glycine soya (soybean) protein composition can protect skin from diaper dermatitis. In particular, as shown by Figure 2, glycine soya protein has particular activity as a trypsin inhibitor. Figure 3 shows a concentration curve for a Glycine soya protein composition. It shows concentration-dependent inhibition of trypsin activity. Glycine soya solutions at various concentrations were incubated with a gelatin-albumin matrix containing a dye. As the trypsin digested the albumin, the dye was released. The dye release was quantified via spectrophotometric analysis. The more dye released, the higher the spectrophotometric value, and the higher the trypsin activity. Therefore, in this assay, a lower reading suggests inhibition of trypsin activity. As seen in Figure 3, a Glycine soya concentration of between 2 to 5 % was found to effectively inhibit the trypsin reaction. Thus, when combined with a polymer that can bind the protein to the skin, glycine soya protein can act as an effective treatment or prevention for diaper dermatitis.
The glycine soya (soybean) protein/oxidoreductase formulation of the present invention differs significantly from the soybean inhibitors (STI) that have been studied and described by literature in the past. For example, soybean trypsin inhibitor (STI) is a low molecular weight isolate from soybean. It ranges from approximately 20 - 25 kD. It has been most widely studied with respect to trypsin inhibition, and its optimum pH (for activity) is 6.5.
Trypsin-chymotrypsin inhibitor is a soybean inhibitor (but not soybean trypsin inhibitor). It is a low molecular weight (Bowman-Birk type) inhibitor, ranging from about 3 - 6 kD. It is a non-specific serine protease inhibitor which can simultaneously inhibit trypsin and chymotrypsin, and is known as being one of the more expensive inhibitors.
By contrast, Preregen® is a synergistic combination of soybean-based peptides with biotechnologically prepared natural oxidoreductases. Its molecular weight ranges; the soy component has a range of about 3 - 30 kD and the oxidoreductase portion is about 35 kD. The soy protein shows optimum activity between pH 5.5 - 6. The inhibitor of this invention is also effective against free radicals (which are formed in contact dermatitis and diaper rash is a form of contact dermatitis). On the other hand, STI is not expected to be effective against free radicals.
Additionally, STI is a Kunitz type protease inhibitor (referring to its mode of action), and trypsin-chymotrypsin inhibitor is a Bowman-Birk type. Preregen® (due to its molecular weight range) is a combination of soy proteins, some of which are Kunitz type inhibitors and some of which are Bowman-Birk type inhibitors. Therefore, it is a significant improvement over using simply a Kunitz or a Bowman-Birk type inhibitor alone.
Thus, although Preregen® and STI's or soybean inhibitors each have a soy component, they exhibit very different activities. One of ordinary skill in the art would expect them to have different inhibitory effects on the various proteases.
An alternate embodiment of the invention is directed to a formulation that comprises dipalmitoyl hydroxyproline (also referred to as "DPHP"). Dipalmitoyl hydroxyproline can be derived by grafting a fatty acid (palmitic acid) onto an amino acid (hydroxyproline) to create dipalmitoyl hydroxyproline. Without wishing to be bound to any theory, the inventor believes that dipalmitoyl hydroxyproline is useful for the treatment or prophylaxis of diaper dermatitis because of its anti-proteolytic activity. Dipalmitoyl hydroxyproline is a competitive inhibitor for the active site of elastase. Fecal serine proteases (trypsin, chymotrypsin and elastase) all share some homology and accordingly, the present inventor has found that the dipalmitoyl hydroxyproline will be inhibitory to all 3 of these proteases.
One form of dipalmitoyl hydroxyproline is plant-derived dipalmitoyl hydroxyproline obtained from Seppic and marketed as Sepilift® DPHP. Sepilift® is marketed as stimulating the remodeling and contraction of collagen fibers, protecting elastic fibers against enzymatic breakdown, and scavenging free radicals. It has been shown to inhibit the overproduction of the elastase enzymes that destroy bonds between different elastin molecules of the skin.
The inventor has found, however, that in addition to inhibiting the skin's natural production of elastases, dipalmitoyl hydroxyproline also inhibits the elastases and proteases (e.g., trypsin and chymotrypsin) found in feces and urine. As shown by Figures 2 and 4, DPHP inhibits trypsin and elastase , which are digestive enzymes that are present in human waste that can attack the skin's integrity. The results from Figure 2 indicate that a lotion made with DPHP provided significant reduction in trypsin activity. Figure 4 indicates that the DPHP material itself is inhibitory to both elastase (-22%) and trypsin (-33%) activity (higher back digest values indicate lower protease digestion of substrate).
Sepilift® DPHP is quite a different molecule from any of the inhibitors that have previously been investigated in connection with diaper dermatitis. Studies by the manufacturer (Seppic) show that DPHP is a potent inhibitor of elastase. However, this product is not considered in the group of classical serine protease inhibitors. There is no indication in the literature that it would be an effective inhibitor of trypsin or chymotrypsin. However, the inventor has determined that DPHP does inhibit trypsin, elastase and chymotrypsin, and as such, can be used to treat or prevent diaper dermatitis or other associated skin conditions.
It is important to note that DPHP is also different from classical serine protease inhibitors in that the manufacturer has shown it to be a potent inhibitor of free radicals. (Both Preregen® and DPHP share this free radical inhibitory effect.) Finally, DPHP has a molecular weight of 450 daltons. It is smaller than the plant-derived serine protease inhibitors. Previous compositions which incorporated some form of enzyme inhibitor may have side effects if absorbed by the skin. By contrast, the inhibitors of this invention are currently used in the cosmetic market for anti-aging and are generally recognized as safe and without side effects. The enzyme inhibitors used are specifically targeted by the vendors as elastase inhibitors. Elastase breaks down the elastin (which is the protein that provides skin with both its elasticity and strength) in the skin.
However, contrary to what is commonly known about glycine soya (soybean) protein or dipalmitoyl hydroxyproline, the inventor has found that they are also potent inhibitors of trypsin and chymotrypsin, both of which are involved in skin breakdown due to incontinence. These enzyme inhibitors have also been shown to counteract the effects of free radicals, which can contribute to diaper dermatitis. Any tissue injury capable of producing an inflammatory response, diaper dermatitis included, will have an important oxidative (free radical) component and as such, will benefit from the addition of a free radical inhibitor. Free radicals may significantly contribute to skin breakdown and are known to be involved in inflammatory responses. Free radicals are also found in higher amounts in elderly people, who are more at risk for incontinence.
Compositions according to certain aspects of this invention may also include a sacrificial lipase inhibitor. Lipase in combination with other fecal proteases is a potent mediator of skin breakdown. Particularly, lipases are found in feces and are known to contribute to skin breakdown and skin irritation due to incontinence when in combination with serine proteases. Thus, a fatty acid such as coconut oil or any other any other hydrolysable fat such as sunflower oil, castor oil, almond oil or similar oil may be included to act as a sacrificial substrate for lipase. The composition may also include a sacrificial substrate for proteases in general, for example, an amino acid that will inactivate proteases with which it comes into contact. Possible sacrificial substrates include but are not limited to soy amino acids, denatured and native proteins such as gelatins, denatured collagens, and similar proteins.
Additional embodiments of the invention may also include a pH buffering system. Fecal enzymes are activated at the elevated pH's which can be found in urine. The buffering system is used to maintain the pH of not only the product, but the skin at a pH of about 5.5 -6.5. This is beneficial because proteolytic enzymes are less active at lower pH values (and show higher proteolytic activity above pH 7). The type of buffering system may include a phosphate ion buffer combination, a lactic acid /lactate system, or any other appropriate buffering system.
The compositions also include a topical polymer that is capable of binding the enzyme inhibitors and holding them in close contact with the skin for prolonged periods of time. This is an important aspect of certain embodiments of the invention. The polymer should adhere to the outer skin layer and form a protective barrier that is substantially resistant to being washed or rubbed off. It should also be substantially resistant to certain chemical insults, particularly enzymatic insults. Particularly useful polymers also reduce skin irritation and dryness. Particularly suitable polymers are polymers in the M-, D- or S-series series from Skinvisible®.
The Skinvisible® polymers are adapted to adhere to a substrate, such as a patient's skin, and form a protective bond. They are substantially resistant to being washed or rubbed off, and deliver a targeted level of therapeutic or cosmetic agent to the skin. They are manufactured to provide an efficient, long-lasting dose without irritation.
The M-series polymers comprise primarily maleic acid methylvinyl-ether copolymer. They form a bond with the skin that resists wash off and that is non- occlusive. The polymer is soluble at about 65°C and maintains a pH range between about 5.5-8.0. They have been used in connection with antimicrobials, sunscreens, antifungals, cosmetics, and moisturizers. They have not been used in connection with a diaper rash treatment.
The D-series polymers comprise primarily dextran-70.
They form stable emulsions and maintain a pH range between about 4.0-8.0. They have been used to encapsulate volatile active ingredients. They have not been used in connection with a diaper rash treatment.
The S-series polymers comprise primarily starch and polyvinyl pyrrolidone polymers (>10 carbon atoms in the monomer chains.)
The Skinvisible® polymers are particularly useful as the delivery system because they are elegant to the touch and are non-greasy. They also bind to the skin and provide a continuous layer in the form of a protective barrier which is long lasting and resistant to wash off. The protease inhibitor used in the formulation is bound to this barrier and thus remains on the skin surface. Thus, the formulation not only allows the polymer itself to inhibit the contact of noxious proteases with the skin surface, but it also holds and allows the protease inhibitor to inhibit the harmful proteases. Thus, even if the barrier (polymer) became compromised, the proteases are likely negated by the inhibitors before they can even act on the skin.
The stages of skin breakdown due to incontinence are shown in Figure 1. The numerals indicate various stages where the different combative agents that are included in formulations according to various embodiments of this invention would operate. For example, one formulation includes a polymeric system that includes an enzyme inhibitor, a buffering system, a sacrificial protease substrate and a sacrificial lipase substrate. This embodiment would likely have its components effective at the following numerals of Figure 1: 1 - polymeric system; 2 - buffering system; 3 - enzyme inhibitor; 4 - sacrificial protease substrate; and 5 - sacrificial lipase substrate.
Compositions according to various embodiments of this invention may take the form of a cream, ointment, lotion, gel, foam, spray, liquid, or any other topical application method. In some embodiments, particularly the cream or lotion embodiments, the formulation includes a thickening and stabilizing system of stearic acid, cetyl alcohol and a polymeric or carbomeric system such as carboxymethylcellulose, microcrystalline cellulose and cellulose gum, carrageenans, sodium polyacrylate or carbomer 934. This system may be replaced with any other thickening system which is stable with the use of the aforementioned ingredients, such as other carbomeric and polymeric combinations, microcrystalline cellulose, and the like.
Alternatively or additionally, the current compositions may include glyceryl monostearate as a gentle emulsifier. Other gentle emulsifiers may be used including nonionic emulsifiers, such as polysorbates, and nonionic glucolipids, such as a cetearyl alcohol and cocoglucoside combination.
Various compositions of this invention may also include a monographed skin protectant such as dimethicone or allantoin, colloidal oatmeal, or any other monographed ingredient from 21 CFR Parts 310, 347 and 352 which is deemed appropriate. (These may include monographed items considered appropriate as anorectal or anti-itch drugs. Monographed ingredients refer to those allowable, OTC, drug product ingredients for skin protectant use which are generally recognized as safe by the FDA.) The current composition may also include an odor neutralizer, such as zinc rinoleate or ordenone®, or any other appropriate odor neutralizer. Additionally, it may include one or more other skin health benefit agents, such as stearic acid, isoparrafin, petrolatum, fatty acids, fatty acid esters, triglycerides, phospholipids, mineral oils, essential oils, sterols, sterol esters, emollients, moisturizers, waxes, humectants, surfactants, anti-inflammatories, amino acids such as soy or oat amino acids, anti-microbials, anti-puretics, hydroxy acids, microbial or algal extracts, anti-histamines, anti-oxidants, analgesics, astringents, fragrances, dyes, natural or synthetic vitamins, and /or deodorants, examples of which appear in WO 00/38747, the contents of which are incorporated here by reference.
Examples of excipients that may be included with formulations are polymers of a carboxyvinyl type, polyethyleneglycols, propyleneglycol, waxes, fatty substances, esters and triglycerides of fatty substances, stearic derivatives such as, for example, glycerol stearate, alcohols such as, for example, stearyl alcohol, ketostearyl alcohol, ketyl alcohol, polyol, polyoxyethylene ketyl ether, vegetable oils such as soft almond oil, coconut oil, castor oil. Examples also include mineral oils such as Vaseline oil, glycerin, derivatives of lanolin, talc, wetting agents, thickening agents, stabilizing agents, emulsifying agents, preservatives, perfumes, colorants or other known and currently used excipients.
Additional ingredients which may be present in the copolymer composition include oils such as mineral oil, fish liver oil, and cod liver oil; emollients such as glycerin, olive oil, and lanolin; fillers such as cellulose gum, calcium carbonate, karaya gum, gum tragacanth, gum acacia, carboxymethyl cellulose, and polyvinyl acetate; vitamins such as vitamins A, D, and D3; astringents such as zinc oxide and aluminum acetate; protectants such as Peruvian balsam; coloring agents; odorants; and other materials which are conventionally used in relieving skin irritation. This invention is also directed toward methods of preparing compositions according to certain embodiments of this invention. One method for the formulation of the composition of this invention is to add the polymeric system from Skinvisible® to the enzyme inhibitor (either glycine soya (soybean) protein or dipalmitoyl hydroxyproline (DPHP), sacrificial protease substrate and sacrificial lipase substrate. A gentle emulsifier, typically glyceryl monostearate, and a stabilizing system, typically stearic acid and cetyl alcohol are added. The mixture is heated to an appropriate temperature and water, preservatives, and thickener are added.
The current polymeric protective barrier and protease inhibitor composition is a significant improvement over previous polymeric barriers, dimethicone and zinc oxide (commonly used in diaper rash preparations). The current formulation binds strongly to the skin for hours and only begins to come off the skin via natural exfoliation. The polymer also binds very strongly to hydrophilic and hydrophobic actives. Thus, the combination of polymer plus the enzyme inhibitor will be held at the skin surface for long periods of time where it can exert its effect on the proteolytic enzymes of the feces and urine.
Where many barrier products are sticky and hard to remove during cleaning, the current formulation is non-greasy, transparent (or substantially transparent), and will allow for easy cleaning after an incontinent episode. Since scrubbing is not required as it is for some thick, messy barrier creams, the present formulation also helps decrease the chemical and physical irritation caused by cleaning. In other words, the emulsified, aqueous-based products of this invention are easy to apply and remove, and the tissue trauma associated with difficult ointment removal is avoided. The products are elegant to the touch, and allow visual inspection of the skin whereas some ointments and barriers are opaque and prevent visual skin inspection. Certain embodiments of polymers used in connection with this invention are also anti-irritants and have been shown to have moisturizing properties. This is beneficial because although incontinence increases the wetness of the skin, many incontinent patients' skin actually lacks moisture. Proper moisturization is critical to skin health. As the skin dries, it may crack and become a suitable environment for bacterial growth. Accordingly, it is desirable to provide a product that enhances the skin's moisture, and possibly to add additional moisturizers to the formulation. Thus, the current polymer will also benefit the patient by increasing or maintaining skin moisturization.
EXAMPLE 1
An experiment was conducted to examine the inhibitory effect of a formulations prepared according to this invention (with coconut oil) on lipase inhibition. Whole milk (containing emulsified fat) was mixed with bile salts to more fully disperse the fat. This mixture was then placed in a test tube with a lipase solution or a lipase solution + prototype formulation and pH was monitored over time. As fatty acids were liberated from the milk via lipase digestion, the pH of the milk solution decreased. The initial reaction rate or pH decrease was calculated over time.
Table 1 indicates that the initial reaction rate is highest without the formulations of this invention added, which means that the anti-lipase activity of formulations according to this invention provide added protection from skin breakdown due to the presence of incontinence related enzymes. In other words, when the Glycine soya protein (in this case, Preregen) or DPHP formulations are added, the initial reaction rate is decreased. For the Preregen formulation the rate decrease was 32% and for the DPHP formulation the rate decrease was 93%. Table 1 : Inhibition of Lipase Activity by Preregen and DPHP formulations
Figure imgf000031_0001
EXAMPLE 2 The inventor selected glycine soya and DPHP by testing numerous potential inhibitors in vitro to assess their activity against protease enzymes. A protease enzyme present in feces or urine, such as trypsin, chymotrypsin, or elastase, was placed in contact with a substrate (crosslinked albumin, sulfaniloazo-albumin and gelatin). Separately, the protease (trypsin, chymotrypsin or elastase) was incubated with a protease inhibitor and then this combination was placed in contact with the substrate. The substrate-protease or substrate-protease-protease inhibitor combination was then left to incubate.
At a defined time, the incubation was stopped by the addition of NaOH. Color was developed and read at OD 450. The intensity of the color developed was directly proportional to the amount of substrate digested by the protease. This allowed the inventor to analyze which protease inhibitors prevented the most substrate digestion. EXAMPLE 3
Figure 2 shows the effectiveness of both a DPHP prototype and a glycine soya prototype for inhibiting the protease, trypsin. A back digest was performed with a spectrally active protease substrate, trypsin, and either DPHP or glycine soya. Trypsin was incubated with either DPHP or glycine soya, and for the control, neither DPHP nor glycine soya was used. The trypsin or trypsin + either DPHP or glycine soya was then placed in contact with a substrate, the results of which are shown in Figures 3 and 4.
The substrate used was a crosslinked albumin, sulfaniloazo-albumin and gelatin at a slightly acidic pH. The substrate is susceptible to proteolysis by a wide range of enzymes including collagenase, papain, trypsin, chymotrypsin and bromelain. Digestion of this substrate by protease releases a dye. Color is developed at the end of the reaction period via the addition of 0.1 N NaOH. This color development can be measured spectrophotometrically at OD 450 and the OD value is proportional to enzymatic activity. In a typical digest, enzyme or enzyme + inhibitor are placed in contact with substrate and the reaction is allowed to proceed at 37°C for a set time period. After the initial digest, color is developed by the addition of NaOH. The OD 450 reading is directly proportional to the enzyme activity (i.e. the higher the value, the higher the enzyme activity).
EXAMPLE 4
A back digest was conducted when particulate suspensions were used as either enzyme or enzyme inhibitor or when lotions were being tested, because the particulate interferes with the OD readings. Figures 2 and 4 show the results of back digest tests that were conducted. The enzyme or enzyme + enzyme inhibitor was placed in contact with the substrate for a set amount of time. After this digest, the solutions were poured off, the substrate was washed and an excess of enzyme was placed in contact with the substrate for an additional incubation period. At the end of this incubation, the color was developed as described above, with the addition of 0.1 N, NaOH. Color development was read at OD 450. The color was then compared with controls which had no enzyme. For back digests, higher values are inversely proportional to enzyme activity. Thus, higher values are indicative of increased enzyme inhibition.
After an initial digest, the supernatant was decanted, and an excess of trypsin was added for further digestion of the substrate. After this final digest, supernatant optical density (OD) was read at 450 nm. (Higher OD values (above control) indicate that more substrate remained after the initial digest, and as such, that trypsin activity was inhibited.)
EXAMPLE 5
Figure 3 shows a concentration curve for a Glycine soya protein composition. It shows concentration-dependent inhibition of trypsin activity. Glycine soya solutions at various concentrations were incubated with a gelatin-albumin matrix containing a dye. As the trypsin digested the albumin, the dye was released. The dye release was quantified via spectrophotometric analysis. The more dye released, the higher the spectrophotometric value, and the higher the trypsin activity. Therefore, in this assay, a lower reading suggests inhibition of trypsin activity. As seen in Figure 3, a Glycine soya concentration of between 2 to 5 % was found to effectively inhibit the trypsin reaction. Thus, when combined with a polymer that can bind the protein to the skin, glycine soya protein can act as an effective treatment or prevention for diaper dermatitis.
EXAMPLE 6
Using the above methods, two protease inhibitors mentioned by the prior art were tested. A stabilized preparation of hexamidine (Elestab) and another preparation of 4-(2-aminoethyl)-benzenesulfonylfluoride hydrochloride (AEBSF) initially showed very high protease inhibition activity. However, they were left for one month and then tested for activity. After one month at room temperature, the activity of the stabilized AEBSF solution was decreased by 42%. When a sample of Elestab solution was left at room temperature for a month, its inhibitory activity was shown to decrease by about 37% over a freshly prepared Elestab solution.
These results for AEBSF correspond to those previously found for aqueous solutions of enzyme inhibitors. The half life for many highly reactive inhibitors (such as AEBSF) was from hours to days. Indeed, the solution lifetime of many reactive inhibitors such as AEBSF and a number of others can be quite short due to their highly reactive nature. In the presence of water they tend to hydrolyze.
The particular embodiments of the invention described above are merely illustrative and are not the only embodiments possible. Those skilled in the art can readily identify additional embodiments and features of the invention that are within the scope of the appended claims.

Claims

What is claimed is:
1. An enzyme inhibitor composition for topical application for the treatment or prophylaxis of skin conditions caused by prolonged exposure to enzymes present in bodily fluids, comprising an enzyme inhibitor and a polymer barrier, wherein the polymer barrier binds the protease inhibitor to a patient's skin and is substantially resistant to being washed or rubbed off.
2. An enzyme inhibitor composition according to claim 1 , wherein the enzyme inhibitor is a digestive enzyme inhibitor.
3. An enzyme inhibitor composition according to claim 1 , wherein the enzyme inhibitor is a protease inhibitor.
4. An enzyme inhibitor composition according to claim 1 , wherein the enzyme inhibitor is a lipase inhibitor.
5. An enzyme inhibitor composition according to claim 3, wherein the protease inhibitor comprises a dipalmitoyl hydroxyproline.
6. An enzyme inhibitor composition according to claim 3, comprising a cosmetic protease inhibitor that maintains its activity in emulsion for at least about one year.
7. A protease inhibitor composition according to claim 3, wherein the protease inhibitor comprises a glycine soya protein or dipalmitoyl hydroxyproline.
8. A protease inhibitor composition according to claim 3, wherein the cosmetic protease inhibitor comprises a combination of glycine soya protein and oxidoreductases.
. A protease inhibitor composition according to claim 3, further comprising a sacrificial protease substrate, a sacrificial lipase substrate, or a sacrificial protease substrate and a sacrificial lipase substrate.
10. An enzyme inhibitor composition according to claim 1 , wherein the polymer barrier comprises a Skinvisible® M-series, D-series or S- series polymer.
PCT/IB2004/003161 2003-08-29 2004-08-27 Protease inhibitor compositions for prevention and treatment of skin conditions WO2005020970A2 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US10/651,820 2003-08-29
US10/651,820 US20050048105A1 (en) 2003-08-29 2003-08-29 Protease inhibitor compositions for prevention and treatment of skin conditions

Publications (2)

Publication Number Publication Date
WO2005020970A2 true WO2005020970A2 (en) 2005-03-10
WO2005020970A3 WO2005020970A3 (en) 2005-07-07

Family

ID=34217488

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2004/003161 WO2005020970A2 (en) 2003-08-29 2004-08-27 Protease inhibitor compositions for prevention and treatment of skin conditions

Country Status (2)

Country Link
US (1) US20050048105A1 (en)
WO (1) WO2005020970A2 (en)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20130338198A1 (en) * 2010-12-10 2013-12-19 Skinvisible Pharmaceuticals, Inc. Composition for treating dermatitis and ichthyosis, and method for treating dermatitis and ichthyosis
US9408810B2 (en) 2010-06-01 2016-08-09 Belle-Aire Frangrances, Inc. Oral odor control method and product

Families Citing this family (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7582307B2 (en) * 2003-11-26 2009-09-01 Harmony Labs, Inc. Dermatological composition
US20060275237A1 (en) * 2005-05-09 2006-12-07 Bissett Donald L Skin care compositions containing idebenone
NZ547991A (en) * 2005-06-22 2008-08-29 Bristol Myers Squibb Co Enzyme inhibiting sprayable skin barrier compositions comprising enzyme inhibitors derived from potatoes
US20070048246A1 (en) * 2005-09-01 2007-03-01 Biophysica Research, Inc. Novel skin care compositions
US7758885B2 (en) * 2005-11-14 2010-07-20 Coloplast A/S Cleansing lotion with moisturising, protecting and odor controlling agents and cloth comprising said lotion
US20080268050A1 (en) * 2007-04-30 2008-10-30 Gerrish Donald L Sprayable topical skin barriers
RU2548794C2 (en) * 2010-08-06 2015-04-20 Сисейдо Компани, Лтд. Elastase inhibitor
US20130004590A1 (en) * 2011-06-28 2013-01-03 Lin Connie B Zinc oxide/acid containing compositions and methods for treating and/or preventing enzymatic irritation
US9949902B2 (en) 2012-06-29 2018-04-24 Kimberly-Clark Worldwide, Inc. Stable emulsion for prevention of skin irritation and items using same
US9393197B2 (en) 2012-06-29 2016-07-19 Kimberly-Clark Worldwide, Inc. Stable emulsion for prevention of skin irritation and articles using same
US9511006B2 (en) 2012-06-29 2016-12-06 Kimberly-Clark Worldwide, Inc. Dispersible moist wipe with emulsion for prevention of skin irritation
KR102635298B1 (en) * 2018-10-31 2024-02-13 (주)아모레퍼시픽 oil-in-water composition with high emulsion stability

Citations (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3470292A (en) * 1965-06-01 1969-09-30 Colgate Palmolive Co Film-forming composition containing a phosphatide and a siloxane
US5190917A (en) * 1986-12-24 1993-03-02 John Lezdey Treatment of psoriasis
US5346886A (en) * 1993-11-15 1994-09-13 John Lezdey Topical α-1-antitrypsin, non-aqueous lipid miscible, benzalkonium chloride compositions for treating skin
FR2746008A1 (en) * 1996-03-14 1997-09-19 Thorel Jean Noel Compositions containing vitamin C and protease inhibitor
US5869033A (en) * 1996-04-12 1999-02-09 Enviroderm Pharmaceuticals,Inc. Method of preventing skin irritation caused by fecal enzymes
US5945095A (en) * 1995-06-21 1999-08-31 L'oreal Cosmetic composition including a polymeric particle dispersion
WO1999045974A1 (en) * 1998-03-12 1999-09-16 The Procter & Gamble Company Protease inhibitors in absorbent articles
WO1999045972A2 (en) * 1998-03-09 1999-09-16 Stichting Voor De Technische Wetenschappen Skin substitute and a topical composition for skin wounds
WO2001018181A2 (en) * 1999-09-10 2001-03-15 The Procter & Gamble Company Enzyme inhibitors
WO2001034099A1 (en) * 1999-11-05 2001-05-17 Johnson & Johnson Consumer Companies, Inc. Soy depigmenting and skin care compositions
FR2803753A1 (en) * 2000-01-19 2001-07-20 Serobiologiques Lab Sa Cosmetic or pharmaceutical preparation containing Arrabidaea chica extract, effective e.g. as antioxidant, antiinflammatory agent and/or elastase inhibitor in skin care or sun protective compositions
US20030044436A1 (en) * 2001-08-20 2003-03-06 Roszell James A. Topical composition, topical composition precursor, and methods for manufacturing and using

Family Cites Families (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4556560A (en) * 1983-01-24 1985-12-03 The Procter & Gamble Company Methods for the treatment and prophylaxis of diaper rash and diaper dermatitis
FR2651125B1 (en) * 1989-08-23 1992-10-02 Roussel Uclaf PHARMACEUTICAL COMPOSITIONS OF THE "WATER PASTE" TYPE.
US5194261A (en) * 1990-11-27 1993-03-16 Virgil Pichierri Diaper rash treatment
US6207596B1 (en) * 1998-11-09 2001-03-27 The Procter & Gamble Company Disposable premoistened wipe containing an antimicrobial protease inhibitor
US6582683B2 (en) * 2000-01-04 2003-06-24 Skinvisible Pharmaceuticals, Inc. Dermal barrier composition
US6503524B1 (en) * 2000-06-16 2003-01-07 Kimberly-Clark Worldwide, Inc. Delivery of a skin health benefit agent to a treated substrate for transfer to skin
US6479060B1 (en) * 2001-09-04 2002-11-12 Healthpoint, Ltd. Elegant hydrogenated castor oil ointments

Patent Citations (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3470292A (en) * 1965-06-01 1969-09-30 Colgate Palmolive Co Film-forming composition containing a phosphatide and a siloxane
US5190917A (en) * 1986-12-24 1993-03-02 John Lezdey Treatment of psoriasis
US5346886A (en) * 1993-11-15 1994-09-13 John Lezdey Topical α-1-antitrypsin, non-aqueous lipid miscible, benzalkonium chloride compositions for treating skin
US5945095A (en) * 1995-06-21 1999-08-31 L'oreal Cosmetic composition including a polymeric particle dispersion
FR2746008A1 (en) * 1996-03-14 1997-09-19 Thorel Jean Noel Compositions containing vitamin C and protease inhibitor
US5869033A (en) * 1996-04-12 1999-02-09 Enviroderm Pharmaceuticals,Inc. Method of preventing skin irritation caused by fecal enzymes
WO1999045972A2 (en) * 1998-03-09 1999-09-16 Stichting Voor De Technische Wetenschappen Skin substitute and a topical composition for skin wounds
WO1999045974A1 (en) * 1998-03-12 1999-09-16 The Procter & Gamble Company Protease inhibitors in absorbent articles
WO2001018181A2 (en) * 1999-09-10 2001-03-15 The Procter & Gamble Company Enzyme inhibitors
WO2001034099A1 (en) * 1999-11-05 2001-05-17 Johnson & Johnson Consumer Companies, Inc. Soy depigmenting and skin care compositions
FR2803753A1 (en) * 2000-01-19 2001-07-20 Serobiologiques Lab Sa Cosmetic or pharmaceutical preparation containing Arrabidaea chica extract, effective e.g. as antioxidant, antiinflammatory agent and/or elastase inhibitor in skin care or sun protective compositions
US20030044436A1 (en) * 2001-08-20 2003-03-06 Roszell James A. Topical composition, topical composition precursor, and methods for manufacturing and using

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9408810B2 (en) 2010-06-01 2016-08-09 Belle-Aire Frangrances, Inc. Oral odor control method and product
US20130338198A1 (en) * 2010-12-10 2013-12-19 Skinvisible Pharmaceuticals, Inc. Composition for treating dermatitis and ichthyosis, and method for treating dermatitis and ichthyosis

Also Published As

Publication number Publication date
WO2005020970A3 (en) 2005-07-07
US20050048105A1 (en) 2005-03-03

Similar Documents

Publication Publication Date Title
KR100598199B1 (en) Film-forming compositions for protecting skin from body fluids and articles made therefrom
JP2533471B2 (en) Absorbent articles
WO2005020970A2 (en) Protease inhibitor compositions for prevention and treatment of skin conditions
US6932976B2 (en) Enzyme blocking skin protectant cream
KR20070040390A (en) Absorbent articles comprising a bodily exudate modifying agent and a film-forming skin care formulation
KR20010041799A (en) Protease inhibitors in absorbent articles
GB2335596A (en) Polyalkyleneglycol Copolymers as Lipase Inhibitors
EP1107719A1 (en) Absorbent article which maintains or improves skin health
JP2001523714A (en) Skin rash prevention composition
US8426384B2 (en) Wound-healing pharmaceutical compositions in the form of a sterile powder based on amino acids and sodium hyaluronate
US20030060380A1 (en) Bio-compatible remover composition for removing medical grade and other adhesives, and kit including the same
EP1322349B1 (en) Protectant film for skin
US6464994B1 (en) Diaper dermatitis preventative medication and a method for making and using same
JP2001523713A (en) Composition for protecting the skin
AU2009265208B2 (en) Delivery product for topical compositions
AU2012202971A1 (en) Divalent cation/talc containing compositions and methods for treating and/or preventing enzymatic irritation
JP2008044916A (en) Bedsore-treating agent
CA2325337C (en) Use of live yeast cell derivative to treat bed sore pressure ulcers
WO2024073721A1 (en) Methods and absorbent articles for inhibiting fecal protease activity
WO2023245291A1 (en) Compositions for the prevention and treatment of moisture-associated skin damage
EP2648722A1 (en) Compositions for treating dermatitis and ichthyosis, and methods for treating dermatitis and ichthyosis
CZ20003302A3 (en) Absorption article containing protease inhibitor and method of using thereof
AU2012202973A1 (en) Divalent cation/talc containing compositions and methods for treating and/or preventing enzymatic irriation
AU2012202975A1 (en) Divalent cation/talc containing compositions and methods for treating and/or preventing enzymatic irritation

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A2

Designated state(s): AE AG AL AM AT AU AZ BA BB BG BR BW BY BZ CA CH CN CO CR CU CZ DE DK DM DZ EC EE EG ES FI GB GD GE GH GM HR HU ID IL IN IS JP KE KG KP KR KZ LC LK LR LS LT LU LV MA MD MG MK MN MW MX MZ NA NI NO NZ OM PG PH PL PT RO RU SC SD SE SG SK SL SY TJ TM TN TR TT TZ UA UG US UZ VC VN YU ZA ZM ZW

AL Designated countries for regional patents

Kind code of ref document: A2

Designated state(s): BW GH GM KE LS MW MZ NA SD SL SZ TZ UG ZM ZW AM AZ BY KG KZ MD RU TJ TM AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HU IE IT LU MC NL PL PT RO SE SI SK TR BF BJ CF CG CI CM GA GN GQ GW ML MR NE SN TD TG

121 Ep: the epo has been informed by wipo that ep was designated in this application
DPEN Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed from 20040101)
122 Ep: pct application non-entry in european phase