Extended production of nitric oxide from a microencapsulated nitrite salt and an aqueous acidified gel
Methods and compositions are provided for generating and applying long-lasting therapeutic nitric oxide (NO) gas from the reaction of a least one microencapsulated nitrite salt and an activating volume of an aqueous acidified gel that has sufficient acidity to convert the nitrite salt to a nitric oxide (NO) and further provides a reducing property that retains the NO in bioactive form.
1. An extended release generator of therapeutic nitric oxide that includes at least two separate reactant components that are not mixed and do not generate or include nitric oxide (NO) until the extended release generator of therapeutic nitric oxide is applied to a patient, the extended release generator comprising:
a first reactant component including a nitrite salt in a chemically-stable form provided by microencapsulation in a polymer matrix that forms a dry environment but that is diffusible to acidic aqueous solutions; and
a second reactant component including a viscous aqueous acidified gel composition comprising an acidifying agent, a reductant, and a gelling agent, characterized by having a viscosity of that provided by aqueous solutions of from 0.73 to 2.18 grams per 100 mL of an aqueous solution of hydroxy ethyl cellulose (HEC) having a mean molecular weight of 750,000, wherein the acidifying agent and reductant may be the same agent,
and wherein the second reactant component has sufficient acidity and reductive capability to covert the nitrite salt to nitric oxide and slow the oxidation of nitric oxide to nitrogen dioxide.
2. The extended release generator of therapeutic nitric oxide of claim 1 , wherein the nitrite salt is selected from one or more of the group consisting of: sodium nitrite, potassium nitrite, calcium nitrite, alkali metal nitrite and alkaline earth nitrite.
3. The extended release generator of therapeutic nitric oxide of claim 1 , wherein the acidifying agent is selected from the group consisting of: citric acid, lactic acid, boric acid, glyceric acid, formic acid ascorbic acid and combinations thereof.
4. The extended release generator of therapeutic nitric oxide of claim 1 , wherein the acidifying agent is boric acid.
5. The extended release generator of therapeutic nitric oxide of claim 1 , wherein the reductant is selected from the group consisting of: ascorbic acid, an ascorbic acid derivative, ascorbate salts, tocopherols, erythrobates, carotenoids, tocotrienols, thiols, and combinations thereof.
6. The extended release generator of therapeutic nitric oxide of claim 1 , wherein citric acid is the acidifying agent and ascorbic acid or ascorbic acid derivative is the reductant.
7. The extended release generator of therapeutic nitric oxide of claim 1 , wherein the ascorbic acid or ascorbic acid derivative is the acidifying agent and the reductant.
8. The extended release generator of therapeutic nitric oxide of claim 1 , wherein the gelling agent is selected from the group consisting of: hydroxymethyl cellulose, hydroxyethyl cellulose, gelatin, agar, natural gums, starches pectins, and combinations thereof.
9. The extended release generator of therapeutic nitric oxide of claim 1 , wherein the polymer matrix of the first reactant component comprises a polymer selected from the group consisting of: ethyl cellulose, natural polymers, hyaluronic acid, alginic acid, biodegradable polyesters, polyanhydrides, poly(ortho esters), polyphosphazenes, polysaccharides and combinations thereof.
10. The extended release generator of therapeutic nitric oxide of claim 9 , wherein the natural polymer is zein.
11. A kit for providing extended release therapeutic nitric oxide to a patient comprising at least two separated reactant components that do not generate or include a nitric oxide (NO) until the reactant components are mixed at a time that they are applied to a patient, the reactant components including:
a first reactant component including a nitrite salt provided in a chemically stable form as a dry microencapsulated reactant that is diffusible to acidic aqueous solutions; and
a second reactant component including an activating volume of a viscous aqueous acidified gel composition comprising an acidifying agent, a reductant, and a gelling agent, characterized by having a viscosity of that provided by aqueous solutions of from 0.73 to 2.18 grams per 100 mL of an aqueous solution of hydroxyethyl cellulose (HEC) having a mean molecular weight of 750,000, wherein the acidifying agent and reductant may be the same agent,
and wherein the second reactant component has sufficient acidity and reductive capability to convert the nitrite salt to nitric oxide and slow the oxidation of nitric acid to nitrogen dioxide.
12. The kit of claim 11 , wherein ascorbic acid or a derivative thereof is the acidifying agent and the reductant.
13. The kit of claim 11 , further comprising an instruction to the patient to apply both the reactant component including the microencapsulated nitrite salt and the separate reactant component including the activating volume of aqueous acidified gel solution to a tissue in need thereof.
14. The kit of claim 11 , wherein the acidifying agent is citric acid and the reductant is ascorbic acid or an ascorbic acid derivative.
15. The kit of claim 11 , wherein the first reactant component salt is provided in a wound dressing or bandage and the second reactant component is provided in a premeasured container.
16. The kit of claim 11 , wherein the first reactant component is provided as a coating in a condom and the second reactant component is provided in a premeasured container.