Echogenic vehicle for clinical delivery of plasminogen activator and other fibrin-binding therapeutics to thrombi
We disclose a composition comprising an echogenic liposome (ELIP) having an exterior surface, an interior surface, and at least one bilayer comprising at least one lipid selected from the group consisting of saturated phospholipids, unsaturated phospholipids, mixed phospholipids, and cholesterol, and a thrombolytic compound trapped by the ELIP. We also disclose a method of treating a medical condition in a patient characterized by a thrombus in the patient's vasculature, comprising administering to the patient the composition in an amount effective to reduce the size of the thrombus.
1. A composition, comprising:
an intrinsically echogenic liposome (ELIP) having an exterior surface, an interior surface, and at least one bilayer comprising mannitol and at least one lipid selected from the group consisting of saturated phospholipids, unsaturated phospholipids, mixed phospholipids, and cholesterol, wherein the ELIP comprises from about 0 mole parts to about 90 mole parts DPPC, from about 0 mole parts to about 50 mole parts DOPC, from about 10 mole parts to about 50 mole parts DPPG, from about 0 mole parts to about 20 mole parts DPPE, from about 0 mole parts to about 90 mole parts egg PC, and from about 2 mole parts to about 15 mole parts cholesterol, wherein the total amount of DPPC, DOPC, DPPG, DPPE, egg PC, and cholesterol is 100 mole parts, a thrombolytic compound trapped by the ELIP, and
tissue plasminogen activator (tPA) exposed on the exterior surface of the ELIP, wherein the tPA is the only active targeting molecule exposed on the exterior surface of the ELIP, and the enzymatic activity of the tPA exposed on the exterior surface of the ELIP is inhibited.
2. The composition of claim 1 , wherein the enzymatic activity of the tPA exposed on the exterior surface of the ELIP is inhibited with D-phe-L-pro-L-arg-chloromethyl ketone (PPACK), and the tPA exposed on the exterior surface of the ELIP is conjugated to the ELIP by a thioether linkage.
3. The composition of claim 1 , wherein the ELIP comprises about 46 mole parts DPPC, about 24 mole parts DOPC, about 24 mole parts DPPG, and about 6 mole parts cholesterol.
4. The composition of claim 1 , wherein the thrombolytic compound is human tissue plasminogen activator (tPA).
5. The composition of claim 4 , wherein the composition comprises from about 1 μg to about 50 μg entrapped tPA per 1 mg ELIP.
6. The composition of claim 1 , further comprising a glycoprotein (GP) IIb/IIIa inhibitor selected from the group consisting of abciximab, eptifibatide, and tirofiban.
7. The composition of claim 1 , wherein the ELIP comprises about 38 mole parts DPPC, about 24 mole parts DOPC, about 24 mole parts DPPG, about 8 mole parts DPPE, and about 6 mole parts cholesterol.
8. A method of treating a medical condition in a patient characterized by a thrombus in the patient's vasculature, comprising:
administering to the patient, in an amount effective to reduce the size of the thrombus, a composition comprising an intrinsically echogenic liposome (ELIP) having an exterior surface, an interior surface, and at least one bilayer comprising mannitol and at least one lipid selected from the group consisting of saturated phospholipids, unsaturated phospholipids, mixed phospholipids, and cholesterol, wherein the ELIP comprises from about 0 mole parts to about 90 mole parts DPPC, from about 0 mole parts to about 50 mole parts DOPC, from about 10 mole parts to about 50 mole parts DPPG, from about 0 mole parts to about 20 mole parts DPPE, from about 0 mole parts to about 90 mole parts egg PC, and from about 2 mole parts to about 15 mole parts cholesterol, wherein the total amount of DPPC, DOPC, DPPG, DPPE, egg PC, and cholesterol is 100 mole parts; a thrombolytic compound trapped by the ELIP; and tissue plasminogen activator (tPA) exposed on the exterior surface of the ELIP, wherein the tPA is the only active targeting molecule exposed on the exterior surface of the ELIP and the enzymatic activity of the tPA exposed on the exterior surface of the ELIP is inhibited.
9. The method of claim 8 , wherein the enzymatic activity of the tPA exposed on the exterior surface of the ELIP is inhibited with D-phe-L-pro-L-arg-chloromethyl ketone (PPACK), and the tPA exposed on the exterior surface of the ELIP is conjugated to the ELIP by a thioether linkage.
10. The method of claim 8 , wherein the ELIP comprises about 46 mole parts DPPC, about 24 mole parts DOPC, about 24 mole parts DPPG, and about 6 mole parts cholesterol.
11. The method of claim 8 , wherein the thrombolytic compound is human tissue plasminogen activator (tPA).
12. The method of claim 11 , wherein the composition further comprises a glycoprotein (GP) IIb/IIIa inhibitor selected from the group consisting of abciximab, eptifibatide, and tirofiban.
13. The method of claim 8 , wherein administering delivers to the patient from about 1 μg of the thrombolytic compound per kg body weight to about 1 mg of the thrombolytic compound per kg body weight.
14. The method of claim 8 , further comprising ultrasonic imaging of the thrombus.
15. The method of claim 8 , further comprising applying ultrasonic energy to the ELIP and thrombus to enhance thrombolysis.