Self-assembling peptide gel formulation and methods of use
Compositions containing self-assembling peptides and/or self-assembling peptidomimetics (“self-assembling peptides”) can be used to create a long-lasting “lift” or means of elevating tissue to be resected, dissected, manipulated or repaired, as a bulking agent, or as a tissue forming matrix by injection of a solution that forms a solid gel in situ, which is stable for a prolonged period of time from days to a month, is hemostatic, and may prevent adhesions. These self-assembling peptides and methods of use thereof enable better separation of tissues and visualization of margins, more durable and robust lifts, less need for frequent injections that carry risk of undesired perforation, and simultaneous management of adverse effects, such as bleeding, leaking, inflammation and iatrogenic injury during endoscopic, laparoscopic or other minimally invasive, or open surgical procedures in and/or on the body.
1. A method comprising administering in vivo to a site in or on a subject in need thereof an effective amount of a biocompatible, injectable formulation comprising one or more self-assembling peptides which forms a lift or bulking agent having a duration of at least 30 minutes and an injection force of 13 N or greater,
wherein the self-assembling peptides comprise RADARADARADARADA (SEQ ID NO: 1) and/or EARAEARAEARAEARA (SEQ ID NO: 89),
in a concentration between about 2% up to about 6% w/v, to
separate or delineate tissues and/or organs or tumors;
lift, separate, or tunnel beneath or besides tissues, lesions, or a medical apparatus selected from wires, durable equipment, and closure devices;
form a cushion or lift at a target site comprising a lesion,
visualize or access tissue or margins during a procedure;
create an internal cast or structure that provides support around and/or between tissues or organs, enabling them to be stabilized, protected, recover, and/or heal,
provide a bulking agent;
provide a matrix for creation of new tissue; and/or
smooth wrinkles or scars,
wherein the formulation persists for at least one hour.
2. The method of claim 1 , wherein the concentration of self-assembling peptides in the formulation is about 3% w/v, and is injectable from a needle between tissue layers with an injection force of at least 58 N.
3. The method of claim 1 , wherein the formulation comprises one or more therapeutic agents, prophylactic agents, or diagnostic agents.
4. The method of claim 1 , comprising a dye or radiopaque agent.
5. The method of claim 1 for use in separation or delineation of tissues and/or organs.
6. The method of claim 1 for use in lifting, separating, or tunneling beneath or besides tissues, lesions, or a medical apparatus selected from wires, durable equipment, and closure devices.
7. The method of claim 6 for separation and visualization of biliary and pancreatic vessels during surgical procedures.
8. The method of claim 1 for use in visualization or access to tissue or margins during a procedure.
9. The method of claim 1 for use in creation of an internal cast or structure that provides support around and/or between tissues or organs to enable them to be stabilized, protected, recover, and/or heal.
10. The method of claim 9 for making an internal cast.
11. The method of claim 8 for treatment of an arteriovenous malformation or for management of antiretropulsion migration during lithotripsy.
12. The method of claim 1 for use in creation of new tissue.
13. The method of claim 1 for use in smoothing wrinkles or scars.
14. The method of claim 1 for separating a tissue or tumor during resection or repair, comprising injecting the formulation into the tissue adjacent to the tissue or tumor to be repaired, in an amount effective for the formulation to solidify to form a lift, tunnel or barrier around the tissue or tumor which persists throughout the resection or repair.
15. The method of claim 14 , wherein the tissue is a polyp in a mucosal surface.
16. The method of claim 14 , wherein the cushion or lift is of a height and/or shape to facilitate resection of the tissue or tumor.
17. The method of claim 1 , wherein the method is performed percutaneously, endoscopically, laparoscopically or by injection through a needle or catheter.
18. The method of claim 1 , wherein the formulation is administered in the central nervous, gastrointestinal, genitourinary, integumentary, pulmonary, renal, reproductive, and/or vascular systems.
19. The method of claim 1 , wherein the subject is human.
20. The method of claim 1 , wherein the concentration of self-assembling peptides in the formulation is between about 3% w/v and about 4% w/v, inclusive.
21. The method of claim 6 for use in lifting, separating, or tunneling beneath or besides tissues, lesions, or a medical apparatus selected from wires, durable equipment, and closure devices, with durability effective to minimize frequency of injections required to obtain the lift; and with a density effective to produce separation in the presence of pressure applied during a procedure or natural elastic forces.
22. The method of claim 1 wherein the concentration of self-assembling peptides in the formulation is about 2.5% w/v.
23. The method of claim 1 wherein the formulation has a duration of at least two weeks.
24. The method of claim 1 wherein the formulation produces greater lift than saline.