CA2107078A1 - Use of riboflavin in the treatment of hiv-linked diseases, herpes, retinitis pigmentosa and malaria - Google Patents
Use of riboflavin in the treatment of hiv-linked diseases, herpes, retinitis pigmentosa and malariaInfo
- Publication number
- CA2107078A1 CA2107078A1 CA002107078A CA2107078A CA2107078A1 CA 2107078 A1 CA2107078 A1 CA 2107078A1 CA 002107078 A CA002107078 A CA 002107078A CA 2107078 A CA2107078 A CA 2107078A CA 2107078 A1 CA2107078 A1 CA 2107078A1
- Authority
- CA
- Canada
- Prior art keywords
- riboflavin
- treatment
- hiv
- vitamin
- herpes
- Prior art date
- Legal status (The legal status 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 status listed.)
- Abandoned
Links
- AUNGANRZJHBGPY-SCRDCRAPSA-N Riboflavin Chemical compound OC[C@@H](O)[C@@H](O)[C@@H](O)CN1C=2C=C(C)C(C)=CC=2N=C2C1=NC(=O)NC2=O AUNGANRZJHBGPY-SCRDCRAPSA-N 0.000 title claims abstract description 62
- AUNGANRZJHBGPY-UHFFFAOYSA-N D-Lyxoflavin Natural products OCC(O)C(O)C(O)CN1C=2C=C(C)C(C)=CC=2N=C2C1=NC(=O)NC2=O AUNGANRZJHBGPY-UHFFFAOYSA-N 0.000 title claims abstract description 37
- 229960002477 riboflavin Drugs 0.000 title claims abstract description 36
- 235000019192 riboflavin Nutrition 0.000 title claims abstract description 28
- 239000002151 riboflavin Substances 0.000 title claims abstract description 28
- 238000011282 treatment Methods 0.000 title claims abstract description 20
- 201000010099 disease Diseases 0.000 title claims abstract description 11
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 title claims abstract description 11
- XQFRJNBWHJMXHO-RRKCRQDMSA-N IDUR Chemical compound C1[C@H](O)[C@@H](CO)O[C@H]1N1C(=O)NC(=O)C(I)=C1 XQFRJNBWHJMXHO-RRKCRQDMSA-N 0.000 title claims abstract description 7
- 208000007014 Retinitis pigmentosa Diseases 0.000 title claims abstract description 6
- 201000004792 malaria Diseases 0.000 title claims abstract description 6
- DFPAKSUCGFBDDF-UHFFFAOYSA-N Nicotinamide Chemical compound NC(=O)C1=CC=CN=C1 DFPAKSUCGFBDDF-UHFFFAOYSA-N 0.000 claims abstract description 8
- 235000019160 vitamin B3 Nutrition 0.000 claims abstract description 8
- 239000011708 vitamin B3 Substances 0.000 claims abstract description 8
- 241000725303 Human immunodeficiency virus Species 0.000 claims description 13
- 239000003814 drug Substances 0.000 claims description 13
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- 208000024891 symptom Diseases 0.000 abstract description 2
- 230000000694 effects Effects 0.000 description 13
- HBOMLICNUCNMMY-XLPZGREQSA-N zidovudine Chemical compound O=C1NC(=O)C(C)=CN1[C@@H]1O[C@H](CO)[C@@H](N=[N+]=[N-])C1 HBOMLICNUCNMMY-XLPZGREQSA-N 0.000 description 12
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- 210000004027 cell Anatomy 0.000 description 4
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- 241000701074 Human alphaherpesvirus 2 Species 0.000 description 3
- WREGKURFCTUGRC-POYBYMJQSA-N Zalcitabine Chemical compound O=C1N=C(N)C=CN1[C@@H]1O[C@H](CO)CC1 WREGKURFCTUGRC-POYBYMJQSA-N 0.000 description 3
- 239000003112 inhibitor Substances 0.000 description 3
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- 206010019233 Headaches Diseases 0.000 description 2
- UFHFLCQGNIYNRP-UHFFFAOYSA-N Hydrogen Chemical compound [H][H] UFHFLCQGNIYNRP-UHFFFAOYSA-N 0.000 description 2
- 206010021135 Hypovitaminosis Diseases 0.000 description 2
- FCASKLHVRFDIJB-UHFFFAOYSA-N Riboflavine Natural products Cc1cc2N=C3C(NC(=O)NC3=O)N(CC(O)C(O)C(O)CO)c2cc1C FCASKLHVRFDIJB-UHFFFAOYSA-N 0.000 description 2
- IOEJYZSZYUROLN-UHFFFAOYSA-M Sodium diethyldithiocarbamate Chemical compound [Na+].CCN(CC)C([S-])=S IOEJYZSZYUROLN-UHFFFAOYSA-M 0.000 description 2
- 230000016571 aggressive behavior Effects 0.000 description 2
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- 235000019162 flavin adenine dinucleotide Nutrition 0.000 description 2
- 239000011714 flavin adenine dinucleotide Substances 0.000 description 2
- 239000011768 flavin mononucleotide Substances 0.000 description 2
- FVTCRASFADXXNN-SCRDCRAPSA-N flavin mononucleotide Chemical compound OP(=O)(O)OC[C@@H](O)[C@@H](O)[C@@H](O)CN1C=2C=C(C)C(C)=CC=2N=C2C1=NC(=O)NC2=O FVTCRASFADXXNN-SCRDCRAPSA-N 0.000 description 2
- FVTCRASFADXXNN-UHFFFAOYSA-N flavin mononucleotide Natural products OP(=O)(O)OCC(O)C(O)C(O)CN1C=2C=C(C)C(C)=CC=2N=C2C1=NC(=O)NC2=O FVTCRASFADXXNN-UHFFFAOYSA-N 0.000 description 2
- 231100000869 headache Toxicity 0.000 description 2
- 239000001257 hydrogen Substances 0.000 description 2
- 229910052739 hydrogen Inorganic materials 0.000 description 2
- 230000002401 inhibitory effect Effects 0.000 description 2
- KPDQZGKJTJRBGU-UHFFFAOYSA-N lumiflavin Chemical compound CN1C=2C=C(C)C(C)=CC=2N=C2C1=NC(=O)NC2=O KPDQZGKJTJRBGU-UHFFFAOYSA-N 0.000 description 2
- 238000004519 manufacturing process Methods 0.000 description 2
- NQDJXKOVJZTUJA-UHFFFAOYSA-N nevirapine Chemical compound C12=NC=CC=C2C(=O)NC=2C(C)=CC=NC=2N1C1CC1 NQDJXKOVJZTUJA-UHFFFAOYSA-N 0.000 description 2
- 230000029553 photosynthesis Effects 0.000 description 2
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- 238000002360 preparation method Methods 0.000 description 2
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- 210000001525 retina Anatomy 0.000 description 2
- 235000019231 riboflavin-5'-phosphate Nutrition 0.000 description 2
- 239000000126 substance Substances 0.000 description 2
- 241001529453 unidentified herpesvirus Species 0.000 description 2
- 229940088594 vitamin Drugs 0.000 description 2
- 229930003231 vitamin Natural products 0.000 description 2
- 235000013343 vitamin Nutrition 0.000 description 2
- 239000011782 vitamin Substances 0.000 description 2
- 208000030401 vitamin deficiency disease Diseases 0.000 description 2
- 210000004366 CD4-positive T-lymphocyte Anatomy 0.000 description 1
- 210000001266 CD8-positive T-lymphocyte Anatomy 0.000 description 1
- 241000699800 Cricetinae Species 0.000 description 1
- 108010078851 HIV Reverse Transcriptase Proteins 0.000 description 1
- 206010019973 Herpes virus infection Diseases 0.000 description 1
- 241000700588 Human alphaherpesvirus 1 Species 0.000 description 1
- 206010023126 Jaundice Diseases 0.000 description 1
- 229920005479 Lucite® Polymers 0.000 description 1
- 241001430197 Mollicutes Species 0.000 description 1
- 206010028980 Neoplasm Diseases 0.000 description 1
- 208000012641 Pigmentation disease Diseases 0.000 description 1
- 239000004743 Polypropylene Substances 0.000 description 1
- 206010038910 Retinitis Diseases 0.000 description 1
- 239000004098 Tetracycline Substances 0.000 description 1
- 108070000030 Viral receptors Proteins 0.000 description 1
- 239000002253 acid Substances 0.000 description 1
- 239000002671 adjuvant Substances 0.000 description 1
- 150000001412 amines Chemical class 0.000 description 1
- 239000005557 antagonist Substances 0.000 description 1
- 230000036436 anti-hiv Effects 0.000 description 1
- 230000002365 anti-tubercular Effects 0.000 description 1
- 235000019789 appetite Nutrition 0.000 description 1
- 230000036528 appetite Effects 0.000 description 1
- 238000013459 approach Methods 0.000 description 1
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 description 1
- 235000013734 beta-carotene Nutrition 0.000 description 1
- 239000011648 beta-carotene Substances 0.000 description 1
- 150000001579 beta-carotenes Chemical class 0.000 description 1
- 239000006227 byproduct Substances 0.000 description 1
- 201000011510 cancer Diseases 0.000 description 1
- 239000002775 capsule Substances 0.000 description 1
- 235000014633 carbohydrates Nutrition 0.000 description 1
- 150000001720 carbohydrates Chemical class 0.000 description 1
- 239000000969 carrier Substances 0.000 description 1
- 230000015556 catabolic process Effects 0.000 description 1
- 210000000170 cell membrane Anatomy 0.000 description 1
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- 230000007812 deficiency Effects 0.000 description 1
- 238000006731 degradation reaction Methods 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 229960002656 didanosine Drugs 0.000 description 1
- 229940042399 direct acting antivirals protease inhibitors Drugs 0.000 description 1
- 230000008034 disappearance Effects 0.000 description 1
- 230000008030 elimination Effects 0.000 description 1
- 238000003379 elimination reaction Methods 0.000 description 1
- 238000011156 evaluation Methods 0.000 description 1
- 230000002349 favourable effect Effects 0.000 description 1
- VWWQXMAJTJZDQX-UYBVJOGSSA-N flavin adenine dinucleotide Chemical compound C1=NC2=C(N)N=CN=C2N1[C@@H]([C@H](O)[C@@H]1O)O[C@@H]1CO[P@](O)(=O)O[P@@](O)(=O)OC[C@@H](O)[C@@H](O)[C@@H](O)CN1C2=NC(=O)NC(=O)C2=NC2=C1C=C(C)C(C)=C2 VWWQXMAJTJZDQX-UYBVJOGSSA-N 0.000 description 1
- 229940013640 flavin mononucleotide Drugs 0.000 description 1
- 229940093632 flavin-adenine dinucleotide Drugs 0.000 description 1
- 235000013305 food Nutrition 0.000 description 1
- 210000004392 genitalia Anatomy 0.000 description 1
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- 230000002438 mitochondrial effect Effects 0.000 description 1
- 230000000926 neurological effect Effects 0.000 description 1
- 125000003835 nucleoside group Chemical group 0.000 description 1
- 235000016709 nutrition Nutrition 0.000 description 1
- 239000001301 oxygen Substances 0.000 description 1
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- 239000000137 peptide hydrolase inhibitor Substances 0.000 description 1
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- 230000008092 positive effect Effects 0.000 description 1
- 102000004169 proteins and genes Human genes 0.000 description 1
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- 150000007660 quinolones Chemical class 0.000 description 1
- 108010043277 recombinant soluble CD4 Proteins 0.000 description 1
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- 229940064914 retrovir Drugs 0.000 description 1
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- 235000019364 tetracycline Nutrition 0.000 description 1
- 150000003522 tetracyclines Chemical class 0.000 description 1
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- 238000002255 vaccination Methods 0.000 description 1
- 230000000007 visual effect Effects 0.000 description 1
- 150000003722 vitamin derivatives Chemical class 0.000 description 1
- 229960000523 zalcitabine Drugs 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
- A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
- A61K31/519—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings
- A61K31/525—Isoalloxazines, e.g. riboflavins, vitamin B2
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/70—Carbohydrates; Sugars; Derivatives thereof
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
- A61P31/12—Antivirals
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
- A61P31/12—Antivirals
- A61P31/14—Antivirals for RNA viruses
- A61P31/18—Antivirals for RNA viruses for HIV
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
- A61P31/12—Antivirals
- A61P31/20—Antivirals for DNA viruses
- A61P31/22—Antivirals for DNA viruses for herpes viruses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P33/00—Antiparasitic agents
- A61P33/02—Antiprotozoals, e.g. for leishmaniasis, trichomoniasis, toxoplasmosis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P37/00—Drugs for immunological or allergic disorders
- A61P37/02—Immunomodulators
- A61P37/04—Immunostimulants
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
- Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Veterinary Medicine (AREA)
- Pharmacology & Pharmacy (AREA)
- Public Health (AREA)
- Chemical & Material Sciences (AREA)
- General Health & Medical Sciences (AREA)
- Medicinal Chemistry (AREA)
- Animal Behavior & Ethology (AREA)
- Virology (AREA)
- Chemical Kinetics & Catalysis (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- General Chemical & Material Sciences (AREA)
- Organic Chemistry (AREA)
- Molecular Biology (AREA)
- Oncology (AREA)
- Communicable Diseases (AREA)
- Immunology (AREA)
- Tropical Medicine & Parasitology (AREA)
- Engineering & Computer Science (AREA)
- Epidemiology (AREA)
- AIDS & HIV (AREA)
- Bioinformatics & Cheminformatics (AREA)
- Biotechnology (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
- Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
Abstract
2107078 9217173 PCTABS00160 Utilisation de la riboflavine ou vitamine B2 dans le traitement de maladies liées aux virus HIV, dans le traitement de l'herpès, de la rétinite pigmentaire et du paludisme. Cette molécule peut être associée à la vitamine PP ou à l'AZT dans le traitement des maladies liées aux virus HIV. Les essais cliniques montrent une rémission des symptômes de l'herpès et une amélioration de l'état des patients atteints du SIDA.2107078 9217173 PCTABS00160 Use of riboflavin or vitamin B2 in the treatment of diseases linked to HIV viruses, in the treatment of herpes, retinitis pigmentosa and malaria. This molecule can be combined with vitamin PP or AZT in the treatment of diseases linked to HIV viruses. Clinical trials show a remission of herpes symptoms and an improvement in the condition of AIDS patients.
Description
W092'-]73 21 ~ I O ~ 8 PCT/FR92/00296 . ., Utilisation de la ribofla~ine dans le traitement de maladies liées aux virus HIV,de l'herPes, de la rétinite piqmentaire et du paludisme La présente invention concerne de nouvelles indications thérapeutiques de la vitamine B2 ou riboflavine.
Cette molécule prescrite par voie parentérale a des malades sidéens s'est révélée présenter des effets cliniques immédiats, surprenants et très favorables. Elle était destiné jusqu'ici a d'autres indications , en particulier au traitement de certaines affections cutanées.
Selon l'état de la technique antérieure, de nombreuses molécules ont été reconnues ef~icaces in vitro contre le HIV mais leur utilisation in ~ivo n'est pas possible en raison de leur toxicité.
Les principales molécules actuellement utilisées ou en voie d'utilisation appartiennent à
quatre familles thérapeutiques distinctes.
La premiere famille comprend les, médicaments inhibiteurs de la transcriptase reverse subdivisés eux-mêmes en deux catégories constituées par des inhibiteurs nucléosidiques et des inhibiteurs non nucléosidiques.
Parmi les inhibiteurs nucléosidiques , trois molécules sont actuellement utilisees ou en cours d'essais, ce sont l'AZT, le DDI, le DDC.
L'AZT ou zidovudine est le premier et seul remede utilisé ~usgu'ici a grande échelle sur les su~ets sésopositifs malades. Son indication vient d'être étendue aux su~ets séropositifs non malades mais ce remède est susceptible d'entra~ner des complications hématopoïétiques.
La DDT ou didéoxy-inosine est en cours d'essai WO92/17173 , r PCT/FR92/002~
de phase II et III. Il presenterait une certaine toxicité neurologique et pancréatique.
La DDC ou didéoxycytidine est en cours d'étude. Il est prévu de l'utiliser en troisième intention après l'AZT et le DDI et éventuellement en seconde invention apres l'AZT.
Une nouvelle molécule non nucléosidique et inhibitrice de la transcriptase reverse est actuellement en cours d'étude; il s'agit de la BI-RG-587 qui appartient à la famille des dipyridodiazépinones.
La deuxième famille thérapeutique est constituée par les inhibiteurs de la protéase et -plus particulièrement la molécule U8l74g active in vitro sur le HIV.
La troisième famille therapeutique est constituée par le CD4 soluble ou r.CD4, en cours d'étude; c'est le recepteur viral au niveau de la membrane des lymphocytes T4. Il serait utilisé comme un leurre pour le HIV.
Le dithiocarbe ou Imuthiol constitue la quatrieme famille thérapeutique anti-HIV. Il est en cours de développement industriel. Il aurait une action anti-oxydante, anti-radicalaire majeure.
Outre les quàtre types de remèdes precedemment cités, il faut signaler que certaines molécules, comme les quinolones et les tetracyclines, auraient montre certains effets in vitro sur la réplication du HIV.
Elles agiraient sur les mycoplasmes considérés actuellement par le Professeur MONTAGNIER comme un co-facteur du HIV.
Enfln la vaccination est en cours d'étude. Les diff~rents résultats observés jusqu'à maintenant sont controversés.
~ 2/17l73 21~ 7 0 ~ 8 PCT/FR92~00296 Si l'on fait un bilan de la techni~ue utilisée jusqu'ici, un constat peut être établi; à l'heure actuelle, les molecules utilisees contre le HIV, si elles apportent une certaine rémission à la maladie, ne paraissent pas empecher l'évolution fatale. Par ailleurs, leur activité est souvent entachée d'effets secondaires parfois graves .
La photosynthèse est universelle; le virus du Sida est soumis à la photosynthèse, il est activé par l'ultra-violet.
Il est aussi bien connu que les virus Herpès HSVl et HSV2 sont activés par les ultra-violets: la récurrence de l'infection herpétique liée à l'HSVl lors d'un ensoleillement important est bien connue.
Le HSV2 à tropisme génital semble lui aussi répondre a l'irradiation ultra-violette . Le HSV2 irradié par les rayons ultra-violets produit un cancer chez le hamster et transforme les cellules de rat in vitro (A. Mammette, virologie médicale, p.45).
Quant aux virus HIV, s'ils sont susceptibles d'être détruits par différentes méthodes physigues, ils résistent par contre fort bien à une irradiation ultra-violette.
Le demandeur a testé la riboflavine sur des malades sidéens en raison de certaines lésions cutanées présentées par ceux-ci, et à la suite des recherches qu'il a effectuées a propos du corps humain et la lumiere.
Le demandeur a montré de manière surprenante que la r~boflavine , appelée aussi vitamine B2, présente une actlvité inhibitrice de l'infection par des virus HIV et peut être utllisée dans le traitement de~ malad~es liées a ces virus.
Le demandeur a d'autre part mis en évidence WO92/~7173 ~ V 7~ PCT/FR92/0029~
que cette molécule peut être aussi utilisée dans le traitement d'infections ou de maladies pouvant être en relation avec un exces d'ensoleillement telle que celles dues aux virus de l'herpès .
Enfin, le demandeur a montré l'action de cette molécule dans le traitement preventi et curatif du paludisme et de la retinite pigmentaire.
La présente invention a donc pour objet l'utilisation de la riboflavine pour l'obtention d'un médicament destiné au traitement préventif et curatif-des maladies liees aux virus HIV et en particulier au traitement du Sida.
Un autre objet de la présente inven~ion est l'utilisation de cette molécule pour l'obtention de medicaments destines au traitement preventif et curatif de l'herpès, de la retinite pigmentaire et/ou du paludisme.
De manière plus générale, ces molécules peuvent etre utilisées pour l'obtention de médicaments destinés au traitement préventif et curatif de maladies en rapport avec la lumiere.
Quelques exemples de photoprotection par des produits ou substances pigmentées en jaune sont bien connues: ainsi les bêta-carotenes en stimulant la pigmentation cutanée protegent la peau contre les U.V.
et les malades atteints de rétinite pigmentaire portent des lunettes jaune-orangé pour freiner l'évolutivité de la maladie. Leur vi9ion colorée est alors amputée de sa couleur bleue.
Il est remarquable de noter que la riboflavine existe à l'état physiologique en quantité appréciable au niveau de la rétine. On peut supposer qu'en cas de carence en vitamlne B2 la rétine qui ne serait plus protégée par cette molécule photoprotectrice subirait ~ ~92~7l73 2 1~ 7 ~ 7 8 PCT/FR92/00296 une agression par les ultra-violets et les radicaux libres qu'ils génèrent, cette agression provoquant ou aggravant des lésions au niveau des cellules visuelles.
De manière preIérentielle ,la vitamine PP ou l'AZT sont associés à la riboflavine. ~vantageusement la riboflavine et la vitamine PP sont en quantités synergétiques.
La riboflavine ou ferment jaune de Warburg joue un rôle essentiel au niveau de la chaîne respiratoire cellulaire où elle agit en symbiose avec la vitamine PP elle-même connue pour certains effets photoprotecteurs puisqu'elle est prescrite dans les lucites. Ces deux vitamines sont des transporteurs d'hydrogène; cette action de transfert entre hydrogène et oxygène au niveau des membranes cellulaires et mitochondriales laisse supposer sans que pour autant le demandeur soit liés par cette hypothèse un effet anti-radicalaire, c'est-à-dire anti-oxydant, des vitamines B2 et PP.
Dans le cadre du Sida, la synergie thérapeutique est d'autant plus intéressante que nombre de symptômes connus de la carence en vitamine B2 ainsi que de la carence en vitamine PP se retrouvent chez les malades sidéens.
Les médicaments selon l'invention sont avantageusement à ùsage oral ou parentéral.
Les substances pigmentées en jaune et jaune-orangé absorbent les radiations ultra-violettes et bleues.
La molécule de rlboflavine est de coloration jaune-orangé sous forme cristallisée. En solution, elle donne une fluorescence jaune-vert; son exposltion, même quelques minutes, a la lumiere ultra-WO92/17173 PCT/FR92/0029~ W092 '-] 73 21 ~ IO ~ 8 PCT / FR92 / 00296 . ., Use of ribofla ~ ine in the treatment of diseases linked to HIV viruses, herpes, sting retinitis and malaria The present invention relates to new therapeutic indications for vitamin B2 or riboflavin.
This parenterally prescribed molecule has been found to have AIDS
immediate, surprising and very favorable. It was intended so far for others indications, in particular for the treatment of certain skin conditions.
According to the state of the prior art, many molecules have been recognized to be effective in vitro against HIV but their use in ~ ivo is not possible due to their toxicity.
The main molecules currently used or in use belong to four distinct therapeutic families.
The first family includes, drugs subdivided reverse transcriptase inhibitors themselves into two categories consisting of nucleoside inhibitors and non inhibitors nucleosides.
Among the nucleoside inhibitors, three molecules are currently in use or in progress AZT, DDI, DDC.
AZT or zidovudine is the first and only remedy used ~ usgu'ici on a large scale on su ~ and esopositive patients. Its indication comes to be extended to non-sick HIV positive people but this remedy is likely to cause hematopoietic complications.
DDT or dideoxy-inosine is being tested WO92 / 17173, r PCT / FR92 / 002 ~
phase II and III. It would present some neurological and pancreatic toxicity.
SDC or dideoxycytidine is in progress of study. It is planned to use it in third intention after AZT and DDI and possibly in second invention after AZT.
A new non-nucleoside molecule and reverse transcriptase inhibitor is currently under study; this is the BI-RG-587 which belongs to the family of dipyridodiazepinones.
The second therapeutic family is made up of protease inhibitors and -plus particularly the molecule U8l74g active in vitro on HIV.
The third therapeutic family is constituted by soluble CD4 or r.CD4, in progress study; it is the viral receptor at the level of the membrane of T4 lymphocytes. It would be used as a decoy for HIV.
Dithiocarb or Imuthiol constitutes the fourth anti-HIV therapeutic family. He is in industrial development course. He would have a antioxidant, major anti-radical action.
Besides the four types of remedies previously mentioned, it should be noted that certain molecules, such as quinolones and tetracyclines, would have shown certain in vitro effects on HIV replication.
They would act on the considered mycoplasmas currently by Professor MONTAGNIER as a co-factor of HIV.
Finally the vaccination is under study. The different results observed so far are controversial.
~ 2 / 17l73 21 ~ 7 0 ~ 8 PCT / FR92 ~ 00296 If we take stock of the technique used so far, an observation can be made; on time current molecules used against HIV, if they bring some remission to the disease, do not seem to prevent the fatal evolution. By elsewhere, their activity is often tainted by effects sometimes serious side effects.
Photosynthesis is universal; the virus AIDS is subject to photosynthesis, it is activated by ultra violet.
It is as well known as the Herpes virus HSVl and HSV2 are activated by ultraviolet light: the recurrence of HSV1-related herpes infection during strong sunlight is well known.
HSV2 with genital tropism also seems respond to ultraviolet radiation. HSV2 irradiated with ultraviolet rays produces cancer in the hamster and transforms the rat cells in in vitro (A. Mammette, medical virology, p.45).
As for HIV viruses, if they are susceptible to be destroyed by different physical methods, they resist on the other hand very well to an irradiation ultra-violet.
The applicant tested riboflavin on AIDS patients due to certain lesions presented by them, and following the research he has done on the human body and the light.
The applicant has surprisingly shown that r ~ boflavin, also called vitamin B2, exhibits activity inhibiting infection by HIV virus and can be used in treatment of ~ sick ~ es linked to these viruses.
The applicant has also highlighted WO92 / ~ 7173 ~ V 7 ~ PCT / FR92 / 0029 ~
that this molecule can also be used in the treatment of infections or diseases that may be relation with an excess of sunshine such as those due to herpes viruses.
Finally, the applicant has shown the action of this molecule in the preventive and curative treatment of malaria and retinitis pigmentosa.
The object of the present invention is therefore the use of riboflavin to obtain a medicine for preventive and curative treatment-diseases linked to HIV viruses and in particular to AIDS treatment.
Another object of the present invention is the use of this molecule to obtain drugs for preventive treatment and healing of herpes, retinitis pigmentosa and / or malaria.
More generally, these molecules can be used for obtaining medicines intended for the preventive and curative treatment of diseases related to light.
Some examples of photoprotection by products or substances pigmented in yellow are good known: thus beta-carotenes by stimulating the skin pigmentation protect the skin from UV rays and patients with retinitis pigmentosa wear yellow-orange glasses to brake the scalability of the disease. Their colorful vi9ion is then amputated of its blue color.
It is remarkable to note that riboflavin exists in physiological state in appreciable quantity in the retina. We can assume that in case of vitamin deficiency B2 the retina which would no longer be protected by this photoprotective molecule would undergo ~ ~ 92 ~ 7l73 2 1 ~ 7 ~ 7 8 PCT / FR92 / 00296 aggression by ultraviolet and radicals free they generate, this provoking aggression or aggravating damage to cells visual.
Preferably, vitamin PP or AZT are associated with riboflavin. ~ advantageously riboflavin and vitamin PP are in abundance synergistic.
Warburg Riboflavin or Yellow Ferment plays an essential role at the chain level cellular respiratory where it acts in symbiosis with vitamin PP itself known for certain effects photoprotective since it is prescribed in lucites. These two vitamins are carriers hydrogen; this transfer action between hydrogen and oxygen at cell membranes and mitochondrial suggests without necessarily the plaintiff be bound by this hypothesis an effect anti-radical, that is to say antioxidant, vitamins B2 and PP.
In the context of AIDS, synergy therapeutic is all the more interesting as number of known symptoms of vitamin deficiency B2 as well as vitamin PP deficiency found in AIDS patients.
The medicaments according to the invention are advantageously for oral or parenteral use.
Substances pigmented in yellow and yellow-orange absorb ultraviolet radiation and blue.
The rlboflavin molecule is colored yellow-orange in crystallized form. In solution, it gives a yellow-green fluorescence; his exposure even for a few minutes to ultra-light WO92 / 17173 PCT / FR92 / 0029 ~
2 1~ 76~7~
violette entraîne sa décomposition irréversible en son dérivé antagoniste la lumiflavine qui donne une fluorescence bleue en solution.
Malgré une plus grande stabilité de la riboflavine en solution acide, un conditionnement jaune, opaque à la lumière et aux- ultra-violets, serait une garantie supplémentaire à la bonne conservation des remèdes à base de vitamine B2.
Afin d'éviter toute dégradation par les rayons ultra-violets , les médicaments sont préférentielle-ment mis sous conditionnement opaque à la lumière et aux ultra-violets.
La riboflavine présente des propriétés susceptibles de confirmer son action inhibitrice sur la réplication du HIV.
En effet , dans son devenir métabolique, la riboflavine passe par deux métabolites actifs, le FMN
et le FAD ou flavine-mononucléotide et flavine-adénine-dinucléotide .
Il est a noter que certaines molécules dinucléosidiques telles que l'AZT, la DDI, la DDC sont inhibitrices de la transcriptase reverse du HIV.
La présente invention est d'autre part illustrée, sans pour autant être limitée, par les exemples suivants :
EXEMPLE l : Utilisation théraPeutiaue de la riboflavine associée à l'AZT.
Un essai cllnique en milieu hospitalier a été
effectué. Les résultats de cet essai sont les suivants.
Un patient de 30 ans, est atteint d'un SIDA
stade IV est mis sous traitement anti-tuberculeux RE~ROVIR ~AZT) a 6 g~lules par ~our.
Un an plus tard environ , le patient pese 50 . = /0 92117173 21 G 7 0 7 8 PCT/FR92/00296 kg . Il est sub-ictérique, pré-grabataire et se plaint depuis la prise de RETROVIR ~AZT) de violentes céphalées et de poussées de température à 40 C, mais le service hospitalier maintient la prescription.
Le traitement par RIBOFLAVINE comme adjuvant du précédent est instauré environ un mois plus tard.
Dans les semaines qui suivent , l'état général du patient s'améliorP de façon surprenante et spectaculaire puisque le malade est redevenu totalement ambulatoire. Il n'a plus de céphalée ni de température et a repris son appétit et 5 kg .
Sur le plan biologique, le rapport lymphocytes T4 sur lymphocytes T8 a été en progression constante.
Sur la plan clinique, alors que l'AZT n'avait donné aucun résultat positif mais au contraire une intolérance, l'adjonction du traitement par RIBOFLAVINE injectable s'est traduite immédiatement par un effet très positif.
EXEMPLE 2 - Evaluation de l'activité anti-HIVl de la riboflavine sur cellules CEM.
L'effet in vitro sur des cellules de souche CEM-SS infectées par le virus HIYl a aussi été testé
selon le protocole expérimental suivant ~
La multiplication du HIVl ( souche BRU) dans les cellules CEM ou CEM-SS est évaluée, après 5 jours d'infection, par un dosage de la reverse transcriptase ~RT) dont l'activité traduit la présence de virus relargué dans le surnageant de culture. Les composés testés sont a~outés après l'adsorption du virus dans le milieu de culture.
Il a éte montré une activlté anti-HIYl de la rlboflavine pour une dllution au 1/5000 environ d'une ~olutlon de riboflavine a 10 mg/ml (Be~lavine commerc~alisée par la Société ROCHE ).
W092/17173 PCT/FR92/0029~
Pour des concentrations supérieures, on a observé une toxicité de la préparation qui est supposée être due à l'un ou plusieurs des excipients de la préparation commerciale.
L'effet de la riboflavine a aussi été testé
sur un patient atteint par un herpès.
On a observé une disparition totale des signes cliniques de cette infection au bout de 6 jours.
En conclusion, la vitamine B2, par ses propriétés colorimétriques, biologiques et physiologiques, est un traitement de choix de l'infection sidéenne et cela d'autant plus que, sans que cette hypothèse n'engage le demandeur, il pourrait exister une carence de cette vitamine par excès d'ensoleillement et/ou par déséquilibre de la ration alimentaire avec excès de lipides et de glucides aux dépens de la ration protéique; ce déséquilibre nutritionnel, fréquent dans les pays sous-développés, provoque une élimination excessive urinaire de la vitamine B2.
D'autres remèdes photoprotecteurs et plus particulièrement la vitamine PP peuvent lui être ad~oints dans le but de rechercher une action synergique.
Cette nouvelie approche thérapeutique du SIDA
par un remède à base de riboflavine, tel que la Béflavine, utilisé par voie parentérale intrave~neuse ~ raison d'une in~ection quotidienne de 20 mg a permis d'observer une amélioration clinique spectaculaire.
Les avantages de la thérapeutique du Sida par l'utilisation d'un remède composé de vitamine B2 sont important8 par rapport aux traitements dé~à exlstants, en raison tout d'abord de l'absence de contre-indications et d'effets secondaires connus à
~ 921~.7173 2 1 ~ 7 ~ ~ ~ PCT/FR92/00296 l'utilisation thérapeutique de la vitamine B2.
Il est d'ailleurs bien connu , qu'un surdosage s'accompagne de l'élimination urinaire immédiate de l'excès de vitamine B2.
Le deuxième avantage est lié à la fabrication industrielle de remèdes à base de vi~amine B2, à
destinée orale ou parentérale et à usage préventif ou thérapeutique. Ce mode de fabrication est simple et peu onéreux; il faut toutefois souligner qu'un mode de conditionnement jaune-brun ou jaune-orangé, opaque à
la lumière et aux ultra-violets est préférable .
L.
.. : . . . .
.
''-, ' ~ ' ~ 2 1 ~ 76 ~ 7 ~
violet causes its irreversible decomposition into antagonist derivative lumiflavin which gives a blue fluorescence in solution.
Despite greater stability of the riboflavin acid solution, packaging yellow, opaque to light and ultra-violet, would be an additional guarantee to the correct storage of vitamin B2 remedies.
In order to avoid any degradation by the rays ultraviolet, drugs are preferred-put under light opaque packaging and to ultraviolet.
Riboflavin has properties likely to confirm its inhibitory action on HIV replication.
Indeed, in its metabolic becoming, the riboflavin goes through two active metabolites, the FMN
and the FAD or flavin-mononucleotide and flavin-adenine dinucleotide.
It should be noted that certain molecules dinucleosides such as AZT, DDI, DDC are HIV reverse transcriptase inhibitors.
The present invention is on the other hand illustrated, without being limited, by the following examples:
EXAMPLE 1: Therapeutic use of riboflavin associated with AZT.
A clinical trial in a hospital setting was performed. The results of this test are following.
30 year old patient with AIDS
stage IV is put on anti-tuberculosis treatment RE ~ ROVIR ~ AZT) has 6 capsules per ~ our.
About a year later, the patient weighs 50 . = / 0 92 117 173 21 G 7 0 7 8 PCT / FR92 / 00296 kg. He is sub-icteric, pre-bedridden and complains since taking RETROVIR ~ AZT) violent headache and temperature flare up to 40 C, but the hospital service maintains the prescription.
Treatment with RIBOFLAVINE as an adjuvant the previous one is introduced about a month later.
In the following weeks, the general condition of the patient surprisingly improves and spectacular since the patient has returned fully ambulatory. He no longer has a headache or temperature and regained his appetite and 5 kg.
Biologically, the lymphocyte ratio T4 on T8 lymphocytes has been in constant progression.
Clinically, when AZT did not given no positive result but on the contrary a intolerance, the addition of treatment with RIBOFLAVINE Injection Translated Immediately by a very positive effect.
EXAMPLE 2 Evaluation of the anti-HIVl activity of the riboflavin on CEM cells.
The in vitro effect on stem cells CEM-SS infected with HIYl virus has also been tested according to the following experimental protocol ~
The multiplication of HIVl (BRU strain) in CEM or CEM-SS cells are evaluated, after 5 days infection, by a reverse transcriptase assay ~ RT) whose activity reflects the presence of viruses released into the culture supernatant. Compounds tested are tested after adsorption of the virus in the culture medium.
It has been shown to have anti-HIYl activity on the rlboflavin for a dllution of about 1/5000 of a ~ riboflavin olutlon 10 mg / ml (Be ~ lavine marketed by the ROCHE Company).
W092 / 17173 PCT / FR92 / 0029 ~
For higher concentrations, we have observed toxicity of the preparation which is believed to be due to one or more of the excipients commercial preparation.
The effect of riboflavin has also been tested on a patient with herpes.
There has been a complete disappearance of the signs clinics of this infection after 6 days.
In conclusion, vitamin B2, by its colorimetric, biological and physiological, is a treatment of choice for AIDS infection, especially since without that this hypothesis does not bind the applicant, he could there is an excess of this vitamin sunshine and / or ration imbalance food with excess fat and carbohydrates protein ration costs; this imbalance nutritional, common in underdeveloped countries, causes excessive urinary excretion of the vitamin B2.
Other photoprotective remedies and more particularly vitamin PP can be anointed for the purpose of seeking action synergistic.
This new therapeutic approach to AIDS
by a riboflavin remedy, such as Beflavin, used intravenously parenterally ~ due to 20 mg daily in ~ ection allowed to observe dramatic clinical improvement.
The benefits of AIDS therapy through the use of a vitamin B2 remedy are important8 compared to treatments from ~ to exlstants, first of all because of the absence of counter indications and side effects known to ~ 921 ~ .7173 2 1 ~ 7 ~ ~ ~ PCT / FR92 / 00296 the therapeutic use of vitamin B2.
It is also well known that an overdose is accompanied by the immediate urinary elimination of excess vitamin B2.
The second advantage is related to manufacturing industrial remedies based on vi ~ amine B2, intended for oral or parenteral use and for preventive use or therapeutic. This manufacturing method is simple and cheap; however, it should be noted that a mode of yellow-brown or yellow-orange packaging, opaque to light and ultraviolet is preferable.
L.
..:. . . .
.
'' -, '~' ~
Claims (10)
usage oral ou parentéral. 9. Use according to one of the claims 1 to 8, characterized in that said medicament is at oral or parenteral use.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR91/04218 | 1991-04-02 | ||
| FR9104218A FR2674753B1 (en) | 1991-04-02 | 1991-04-02 | NEW THERAPEUTIC INDICATIONS, PARTICULARLY FOR THE TREATMENT OF AIDS, OF AN ALREADY EXISTING MEDICINAL PRODUCT FROM A DENIMOUS MOLECULE OF CONTRAINDICATIONS AND ADVERSE REACTIONS. |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2107078A1 true CA2107078A1 (en) | 1992-10-03 |
Family
ID=9411559
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002107078A Abandoned CA2107078A1 (en) | 1991-04-02 | 1992-04-02 | Use of riboflavin in the treatment of hiv-linked diseases, herpes, retinitis pigmentosa and malaria |
Country Status (7)
| Country | Link |
|---|---|
| EP (1) | EP0578733A1 (en) |
| JP (1) | JPH06506212A (en) |
| AU (1) | AU1654092A (en) |
| CA (1) | CA2107078A1 (en) |
| FR (1) | FR2674753B1 (en) |
| OA (1) | OA09819A (en) |
| WO (1) | WO1992017173A2 (en) |
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| NZ244270A (en) * | 1991-09-13 | 1995-07-26 | Eisai Co Ltd | Injectable composition comprising riboflavin |
| EP0643775B1 (en) * | 1992-05-28 | 2004-07-21 | Centre For Molecular Biology And Medicine, | Quinone derivatives for enhancing cellular bioenergy |
| FR2696319B1 (en) * | 1992-10-02 | 1994-12-30 | Jean Berque | Use of non-toxic biological products and mainly riboflavin in the manufacture of condoms and protective gloves. |
| GB2319474A (en) * | 1993-10-19 | 1998-05-27 | Radopath Ltd | Anti-viral agents |
| GB9321558D0 (en) * | 1993-10-19 | 1993-12-08 | Radopath Ltd | Anti-viral agents |
| JPH07188052A (en) * | 1993-12-27 | 1995-07-25 | Sanwa Kagaku Kenkyusho Co Ltd | Interferon activity-enhancing agent and antivirus activity-enhancing composition containing the enhancing agent and interferon |
| US6277337B1 (en) | 1998-07-21 | 2001-08-21 | Gambro, Inc. | Method and apparatus for inactivation of biological contaminants using photosensitizers |
| US7498156B2 (en) | 1998-07-21 | 2009-03-03 | Caridianbct Biotechnologies, Llc | Use of visible light at wavelengths of 500 to 550 nm to reduce the number of pathogens in blood and blood components |
| US7049110B2 (en) | 1998-07-21 | 2006-05-23 | Gambro, Inc. | Inactivation of West Nile virus and malaria using photosensitizers |
| US6258577B1 (en) | 1998-07-21 | 2001-07-10 | Gambro, Inc. | Method and apparatus for inactivation of biological contaminants using endogenous alloxazine or isoalloxazine photosensitizers |
| US7220747B2 (en) | 1999-07-20 | 2007-05-22 | Gambro, Inc. | Method for preventing damage to or rejuvenating a cellular blood component using mitochondrial enhancer |
| US7094378B1 (en) | 2000-06-15 | 2006-08-22 | Gambro, Inc. | Method and apparatus for inactivation of biological contaminants using photosensitizers |
| US6268120B1 (en) | 1999-10-19 | 2001-07-31 | Gambro, Inc. | Isoalloxazine derivatives to neutralize biological contaminants |
| US7648699B2 (en) | 2000-06-02 | 2010-01-19 | Caridianbct Biotechnologies, Llc | Preventing transfusion related complications in a recipient of a blood transfusion |
| TW590780B (en) | 2000-06-02 | 2004-06-11 | Gambro Inc | Additive solutions containing riboflavin |
| US7985588B2 (en) | 2000-06-02 | 2011-07-26 | Caridianbct Biotechnologies, Llc | Induction of and maintenance of nucleic acid damage in pathogens using riboflavin and light |
| US9044523B2 (en) | 2000-06-15 | 2015-06-02 | Terumo Bct, Inc. | Reduction of contaminants in blood and blood products using photosensitizers and peak wavelengths of light |
| US6548241B1 (en) | 2000-11-28 | 2003-04-15 | Gambro, Inc. | Storage solution containing photosensitizer for inactivation of biological contaminants |
| EP1371370B1 (en) | 2001-03-21 | 2009-09-09 | Eisai R&D Management Co., Ltd. | Drugs containing reduced vitamin b2 |
Family Cites Families (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| FR2096712A1 (en) * | 1970-06-29 | 1972-02-25 | Giraux Georges | Steroid/b group vitamin compsns - for prevention and treatment of skin-photosensitivity disorders |
| GB1431841A (en) * | 1973-01-15 | 1976-04-14 | Evans S C | Ophthalmic-nutritional preparations |
| DE2559569A1 (en) * | 1975-10-22 | 1977-04-28 | Josef Hofmann | Aq. vitamin rich carrier pigeon feedstuff compsn. - to produce optimal feathering and for rearing purposes |
| US4500524A (en) * | 1982-09-15 | 1985-02-19 | Trustees Of Boston University | Tranquilizing and reducing or preventing seizures |
| JPS61275228A (en) * | 1985-03-14 | 1986-12-05 | バクスタ−、トラベノ−ル、ラボラトリ−ズ、インコ−ポレイテツド | Photodynamic inactivity of virus in therapeutical protein composition |
| DE3542309A1 (en) * | 1985-11-29 | 1987-06-04 | Cardona Federico Dr | Medicinal antioxidant |
| AU7040091A (en) * | 1989-10-06 | 1991-04-28 | Beth Israel Hospital Association, The | Methods and apparatus for treating disease states using oxidized lipoproteins |
| CA2068427A1 (en) * | 1989-11-09 | 1991-05-10 | Patricia A. Agin | Riboflavin as a tanning enhancer |
-
1991
- 1991-04-02 FR FR9104218A patent/FR2674753B1/en not_active Expired - Fee Related
-
1992
- 1992-04-02 EP EP92909405A patent/EP0578733A1/en not_active Withdrawn
- 1992-04-02 JP JP4508599A patent/JPH06506212A/en active Pending
- 1992-04-02 WO PCT/FR1992/000296 patent/WO1992017173A2/en not_active Ceased
- 1992-04-02 CA CA002107078A patent/CA2107078A1/en not_active Abandoned
- 1992-04-02 AU AU16540/92A patent/AU1654092A/en not_active Abandoned
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1993
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Also Published As
| Publication number | Publication date |
|---|---|
| FR2674753B1 (en) | 1995-03-10 |
| EP0578733A1 (en) | 1994-01-19 |
| WO1992017173A2 (en) | 1992-10-15 |
| FR2674753A1 (en) | 1992-10-09 |
| JPH06506212A (en) | 1994-07-14 |
| WO1992017173A3 (en) | 1993-01-07 |
| AU1654092A (en) | 1992-11-02 |
| OA09819A (en) | 1994-04-15 |
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