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The method of therapeutic effects on the body

IPC classes for russian patent The method of therapeutic effects on the body (RU 2228531):
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(57) Abstract:

The invention relates to medicine, namely to immunology, and can be used for the treatment of diseases associated with a dysfunction of the immune system. The essence of this method is the irradiation fraction circulating in the body fluid enriched with lymphocytes, ultraviolet radiation (UVR) in the presence of photoactive chemical agent with the subsequent introduction of a faction in the lymphatic system of the body, and the impact on the body is injected into the lymphatic vessel, svetovolokna and connecting it with a source of UFI. The technical result is to increase the efficiency of therapeutic effects on the body. 2 S. and 2 C.p. f-crystals.

The invention relates to immunology, and in particular to methods of modifying the immune system of the mammal to suppress the functioning of a population of immune cells (lymphocytes). The invention can be used in the treatment of diseases of humans and animals, in particular in some cancers (leukemia, cutaneous T-cell lymphoma and other) and autoimmune diseases (hepatitis b, rheumatoid arthritis, and others).

To ensure sableye lymphocytes.

There is a method of therapeutic effects on the body described in patent PCT/GB 88/00951, including fence lymph patient from the thoracic duct, the irradiation of ultraviolet rays and the return of irradiated lymph in the lymphatic system of the patient.

Under the action of ultraviolet radiation lymphocytes undergo direct destructive change that ultimately leads to their death. Due to the fact that most lymphocytes presents abnormal clones, and destruction mainly exposed to abnormal lymphocytes. This leads to a therapeutic effect.

However, irradiated in this way, the lymphocytes do not have sufficient immunogenicity. That is, when introducing them into the lymphatic system, healthy immunocompetent cells of the lymphoid tissue in contact with such lymphocytes are not able to carry out the reaction, and the resulting immune response aimed at the destruction or suppression of functional and metabolic activity of these abnormal cells by the body itself.

In order to achieve effective suppression of abnormal lymphocytes by the body itself, in a biological fluid, enriched with lymphocytes, BB the second liquid, activated by ultraviolet radiation and is capable of activating the specified ultraviolet radiation to the formation of photoadducts with the receptor sites of the components specified biological fluid, thus providing chemical linkage between specified by photo chemical agent and specified receptor sites.

Added to the biological fluid, enriched with lymphocytes, photoactive chemical agent adsorbed on the cell membranes, the membranes of the nuclei of the cells and their contents, as well as on components of the extracellular fluid. Under the action of ultraviolet radiation photoactive chemical agent enters the active state and becomes highly reactive. Some photoactive chemical agents, for example from the class of furokumariny, in this condition form a covalent linkage between pyrimidine bases complementary strands of DNA in the cell nucleus, blocking the possibility of divergence of the DNA strands during cell division. Thus preventing the proliferation of lymphocytes.

At the same time under the action of UVR sorbed on the receptor sites in/on components of the biological fluid photoactive chemical agenie free radical reactions of lipids of cellular membranes), that leads to a change in the receptor field of membranes and their antigenic determinants, or increases the degree of specific influence the agent (as such agent used complexes media-photoactive group, and the media is a biologically active compound which has a specific overwhelming effect on immunocompetent cells - antibodies, cortisone and other). Thus, during these processes, therapeutic effect is achieved by directly destroyed or suppressed functional and metabolic activity of treated cells, which leads to a "mechanical" reducing the concentration of cells in the treated fluid, on the other hand, the introduction of treated cells and their fragments with highly modified (because of the formation under the action of irradiation of photoadducts involving components of cells and molecules photoactive chemical agent) antigenic structures in the body leads to the formation of the immunological response of the organism aimed at suppressing the abnormal cells. Due to the fact that clones of abnormal cells by the number of cells significantly exceed healthy, and also because it is in them most strongly are Metabo they are able to call after the formation of covalently linked sustainable photoadducts and their introduction into the body system immune response, directed against them.

In U.S. patent No. 613322 describes how therapeutic effects on the body, including the blood of the patient, and separated from it by centrifugation fractions of red blood cells and most of the plasma to obtain a fraction in which the cellular component predominantly lymphocytes. Then produce radiation of a specified fraction enriched in lymphocytes, ultraviolet radiation in the presence of dissolved photoactive chemical agent, which is injected into the patient for 2 h before blood sampling. Further irradiated thus the fraction of injected back into the circulatory system of the patient.

With the introduction of the specified irradiated fraction of blood in the blood stream inside immunogenic photoadduct formed under the action of the unions with the participation of components of the treated fluid and molecules photochemical agent, do not have the opportunity to interact with healthy intact lymphocytes circulating in the blood, because, firstly, for the implementation of therapeutic treatment, the vast majority (75%) of the blood system of the patient's lymphocytes shall be subjected to irradiation, and the second is repeatsthe direct contact immunogenic photoadducts with healthy cells. The main immune response, resulting in the body of the modified antigenic structures with the introduction of photoadducts back into the circulatory system, localized primarily within the spleen. But even in the spleen gets only a limited part of these immunogenic photoadducts that is due to the fact that a significant portion of these immunoreagents present in the blood, is fixed on the surface of macrophages, as well as all the blood passes through the liver, where a large number of macrophages, the main part is introduced into the blood immunogenic adducts is in the liver, and the kidneys and lungs, and only the remainder (up to 10% of the total number) are in the spleen.

This reduces therapeutic effect from exposure to radiation.

The purpose of this invention is to increase a therapeutic effect on a living organism, with the lymphatic system.

Another aim of the invention is to provide a method of therapeutic effects on the body, providing a more intense suppression of abnormal cells and their proliferation.

Another aim of the invention is to provide a method of therapeutic effects on the body, ensuring the invention, the modification of the immune system involves the receipt of a specified body fluids, in which the cellular component predominantly lymphocytes, and the irradiation of ultraviolet rays. Before irradiation in the body per os (or otherwise (intravenous, etc.)) being soluble in a specified biological fluid photoactive chemical agent. Photoactive chemical agent can be injected directly into the biological fluid prior to irradiation. After exposure of the biological fluid is injected into the lymphatic system of the body.

In this way, therapeutic effects on the body formed under the action of ultraviolet radiation, with the participation of components of the treated fluid and molecules photochemical agent immunogenic photoadduct fall on Wednesday with a high content of healthy intact lymphocytes and, therefore, have the opportunity to actively interact with them. This leads to an immediate appearance at the population level healthy immune cells circulating in the lymph. The result is a much more effective suppression of abnormal lymphocytes circulating in the body, which greatly enhances therapeutic effect. Moreover, moving from the lymph in the thoracic duct and is aka the stimulus form a generalized immune response, bringing in all the lymphoid system. It also promotes more intensive suppression of abnormal cells. This increases the effectiveness of therapeutic effects on the body.

As a biological fluid, in which the cellular component predominantly lymphocytes, can be used directly lymph from the lymphatic system of the patient, the fraction of lymph enriched lymphocytes, or fraction enriched blood lymphocytes.

In another variant of the invention, the irradiation is made directly in one of the vessels of the lymphatic system of the body.

Photoactive chemical agent can be represented as:

1) any of the active furokumariny or their combination, methylene blue, pyrene, cholesterolemia, protoporphyrin, porphyrin, acridine, fluorescein, rhodamine, 16-diazotation, ethidium, complexes of transition metals with bleomycin, transition metal complexes with deglycosylation, organoplatinum complexes;

2) a polypeptide selected from the group comprising interleukin, transferin, thymopoietin, insulin, antibodies, monoclonal antibody, which is covalently bonded photocytotoxicity x the ski agent, selected from the group comprising furokumariny, pyrene, cholesterolemia, acridine, porphyrin, protoporphyrin, fluorescein, rhodamine, 16-diazotation, ethidium, complexes of transition metals with bleomycin or diglycolamine, organoplatinum complexes.

Therapeutic effect is as follows.

In the body enter one of the above compounds (intravenous, per os, endolymphatic or otherwise). After some time the concentration of the introduced agent is sufficient to perform exposure. From an organism selected biological fluid, the main cellular component of which is represented by lymphocytes and in which there is dissolved photoactive chemical agent. You can take the patient's blood, in a known manner using centrifugation to separate a fraction containing mainly lymphocytes, and a fraction depleted of lymphocytes, back into the blood system of the patient. After this fraction enriched blood lymphocytes, placed in a cuvette. Photoactive chemical agent can be added directly to this cell at this stage of the method, do not enter the agent beforehand about the x above compounds. Dissolved in biological fluids enriched in lymphocytes, the photoactive chemical agent adsorbed on the surface membranes of cells and cellular elements, and, if the agent is able to penetrate into the cell nucleus and has an affinity for DNA - DNA regions.

Then carry out the irradiation of the biological fluid (fraction of blood) in a cell to ultraviolet radiation with a wavelength from 200 to 800 nm, which varies depending on the photoactive chemical agent. Irradiation can be performed using mercury lamps, xenon lamps, lasers.

In the case of agents, interkalirovti in Ternovoy stage between the base pairs of DNA, the effect of radiation leads to irreversible destruction of the DNA or the formation of covalent crosslinks between the bases of the complementary DNA strands involving photochemical agent.

The result is the formation of strong complexes with distinct modified stable antigenic properties. The application associated with the photoactive chemical groups (photo) known natural compounds and pharmacological preparations, for which the cell membranes are the corresponding receptor sites (antibodies, natural polypeptide, aimed at the direct destruction or suppression of functional and metabolic activity of target cells, resulting in formation in irradiated liquid totalitarian nonviable cells and their fragments, can, in the introduction to the lymphatic system to cause a reaction from the healthy components of lymphoid tissue. Due to the fact that metabolic processes inherent in a living cell, proceed much more intensively in pathological cells than in healthy, destruction and loss of functional activity are primarily pathological cells.

In that case, when the processing of biological fluids by ultraviolet radiation is carried out in the presence of photoactive chemical agent having the properties of a photosensitizer, such as psoralen, in an environment with little oxygen content (in particular, at low vacuum sample of biological fluid before treatment) photochemical reactions in the liquid acquire orientation towards education Diadochos psoralen with DNA strands and formation in the liquid along with the inhibition of the processes of fission treated cells artificial Oderov specified uniform antigenic structures.

If you want to initiate polyvalent immune response of the body, then processing biological fluid expediently carried out at elevated oxygen content for intensification oxybiotic reactions photochemical agents in biological substrate. This is easily achieved simply by the irradiation of the liquid with the dissolved drug in the vessel, which under the pressure of the supplied oxygen. In the liquid during the reaction of the radical nature be destruction of many cellular structures and changes in the cell surface of a significant number of immunocompetent cells, the formation of numerous cellular fragments, covalently linked molecules photoagent and has immunogenic properties.

Then the processed fraction of blood injected into the lymphatic system. For this kateteriziruyut imposed in a known manner. It is advisable to do it on one of the extremities.

With the introduction of processed fluid in the lymphatic system a pronounced immune response. Contact immunogenic photoadducts with certain groups of cells in lymphoid organs due to the anatomical position of these cells. In the case of introduction, is it technically more difficult) this immunoreagent delivered to the draining lymph in the area of the lymph nodes, where it interacts with macrophages medulary area and dendritic cells of lymphoid follicles and almost completely passes through the regional lymph nodes, causing a powerful generalized immune response of the entire system. In the lymph missing components, is able to escape inside the intact healthy cells from interacting with immunogenic photoadducts, resulting develops reaction from the healthy cells, aimed at the suppression of abnormal cells. To achieve a significant therapeutic effect by using a small number of immunoreagent.

When endolymphatic introduction of the treated cells in the body there is the possibility of direct interaction immunogenic photoadducts with a healthy immunocompetent cells in vivo, for example, by antiidiotypic reactions. In addition, it is possible that a strong immune response may be associated with initiation directly into the lymphatic system and the reaction of the mixed culture of lymphocytes, especially if treatment of cells was performed with the high concentratin in accordance with the anatomical structure of the lymphatic system before getting into the bloodstream entered the immunogenic fragment of photoadducts will inevitably go through the whole system of regional lymph nodes, which in its way quite a lot, causing a powerful immune response. This significantly increases the likelihood and duration of interaction with healthy cells that enhances the immune response.

The inventive method was carried out in the following specific manner.

Example 1. Cow black and white breed. Diagnosis: Acute lymphocytic leukemia, accompanied by a significant increase of the total number of lymphocytes in the blood - 35 thousand per 1 ml.

From the jugular vein of the cow syringe with a capacity of 300 ml was taken in 250 ml of blood, which is stabilized by heparin - 15 units per 1 ml of Collected blood is separated into fractions by centrifugation for 20 min at a rotation speed of the rotor 2000 rpm

Enriched lymphocyte fraction was collected in a sterile vial with a volume of 25 ml. Remaining plasma and erythrocyte mass was mixed and injected back into the blood stream cows with a syringe through the point of the original punctaria. The procedure was repeated 7 more times, resulting in a vial were recruited 200 ml suspension of cells in plasma.

Then the container with the suspension was added 40 mg of soberana (a preparation containing a mixture of 8-metoksipsoralena and bergapten) and within 10 min of Peremyshl 25 mm 1 mm when the energy of light in the plane of the cell 2 mW/cm2. The speed of movement of the suspension through the cell was 20 ml/min, Almost 90% of the energy of light in the plane of the cell was created by UVA radiation with a maximum near 350 nm.

Then trenirovki lymphatic vessel on its hind legs and has established a catheter, which was introduced irradiated suspension with a speed of 1.5 ml/min

The procedure was performed with an interval of 10-15 days 5 more times. After 3 treatments the animal was observed clinical improvement. After the end of treatment the content of lymphocytes in the blood was 8 thousand cells per 1 ml during the observation time in 11 months of this value has not changed.

Example 2. Patient K., 16 years old, was admitted with a diagnosis of Acute T-cell leukemia in the acute stage. By the time they enter suffered disease within 2 years, during which he received 3 courses of treatment based on traditional chemotherapy. The content of blast cells in the blood was up to 30%.

5 hours before the procedure the patient was administered intravenous solution containing 30 mg 8-metoksipsoralena. Produced draining lymphatic duct on the left leg in the groin area and established the catheter. The entire length of the catheter waderoush lenses with a point source on the basis of a xenon lamp and providing the irradiance at the output end of svetovolokna 1.7 mW (diameter svetovolokna 0.8 mm) in UFA. The exposure time per session up to 120 minutes Interval between sessions from 7 to 14 days. All were conducted 6 sessions. After each session within a few days the patient received 200 mg of allopurinol per day.

At the end of treatment in the peripheral blood blast cells were detected. Leucoformula was typical of leukemic patients in remission.

Example 3. Patient T., 39 years old, was admitted with a diagnosis of Bronchial asthma in the stage of damped exacerbation with respiratory failure.

For 4-6 hours before the procedure the patient was given 30-40 mg beroksana - per os. Was catheterizable lipoproteic on the leg in the groin area on the left. The entire length of the channel of the catheter has entered the light guide connected to a source of ultraviolet radiation. At the output end of svetovolokna the irradiance was 2 mW (diameter svetovolokna 0.8 mm). The exposure time for one of the treatments ranged from 40 to 60 minutes Procedures were performed with an interval of 10 days. Conducted 5 sessions.

Already after the first procedure has disappeared nasal congestion and rinorea. Sharply decreased frequency of asthma attacks, decreased the amount of discharge of phlegm. At the end of treatment were observed ostoich is imposed on the body by irradiation fraction circulating in the body fluid, enriched with lymphocytes, ultraviolet radiation (UVR) in the presence of photoactive chemical agent with the subsequent return of the irradiated fraction of the body, characterized in that the above irradiated fraction injected into the lymphatic system of the body.

2. The method according to p. 1, characterized in that as a photochemical agent use 8-methoxypsoralen, bergapten, isopach, socimerely or combinations thereof, pyrene, cholesterolemia, acridine, porphyrin, protoporphyrin, fluorescein, rhodamine, 16-diazotation, apidium, complexes of transition metals with bleomycin, transition metal complexes with diglycolamine, organoplatinum complexes.

3. The method of therapeutic effects on the body using a photoactive chemical agent and UFI, characterized in that the lymph vessel enter svetovolokna and connect it with the source UFI.

4. The method according to p. 3, characterized in that the photoactive chemical agent use 8-methoxypsoralen.

 

 

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