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Compositions Containing Berberine Or Analogs

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Compositions Containing Berberine Or Analogs (19) TZZ _T (11) EP 2 448 577 B1 (12) EUROPEAN PATENT SPECIFICATION (45) Date of publication and mention (51) Int Cl.: of the grant of the patent: A61K 31/4375 (2006.01) A61K 9/00 (2006.01) 14.09.2016 Bulletin 2016/37 A61K 9/06 (2006.01) A61K 9/08 (2006.01) A61P 17/00 (2006.01) A61P 17/06 (2006.01) (2006.01) (2006.01) (21) Application number: 10793513.2 A61P 17/08 A61K 45/06 (22) Date of filing: 30.06.2010 (86) International application number: PCT/CN2010/000983 (87) International publication number: WO 2011/000218 (06.01.2011 Gazette 2011/01) (54) COMPOSITIONS CONTAINING BERBERINE OR ANALOGS THEREOF FOR TREATING ROSACEA OR RED FACE RELATED SKIN DISORDERS ZUSAMMENSETZUNGEN MIT BERBERIN ODER ANALOGEN DAVON ZUR BEHANDLUNG VON MIT ROSACEA ODER ANDEREN GESICHTSRÖTUNGEN ZUSAMMENHÄNGENDEN HAUTERKRANKUNGEN COMPOSITIONS CONTENANT DE LA BERBÉRINE OU DES ANALOGUES DE CELLE-CI POUR TRAITER L ACNÉ ROSACÉE OU DES TROUBLES CUTANÉS ASSOCIÉS À UNE ROUGEUR FACIALE (84) Designated Contracting States: (56) References cited: AL AT BE BG CH CY CZ DE DK EE ES FI FR GB CN-A- 1 085 600 CN-A- 1 182 788 GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO CN-A- 1 923 199 DE-U1-202010 004 750 PL PT RO SE SI SK SM TR JP-A- 63 179 812 KR-A- 20030 082 200 US-A1- 2006 286 054 US-B1- 6 440 465 (30) Priority: 30.06.2009 US 221725 P US-B1- 6 482 839 (43) Date of publication of application: • REUTER JULIANE ET AL: "Botanicals in 09.05.2012 Bulletin 2012/19 dermatology: an evidence-based review.", AMERICAN JOURNAL OF CLINICAL (73) Proprietor: Derman Biomedicine Co. Ltd. DERMATOLOGY 2010, vol. 11, no. 4, 2010, pages Taoyuan County 33380 (TW) 247-267, ISSN: 1175-0561 • LÍVIA SLOBODNÍKOVÁ ET AL: ’Antimicrobial (72) Inventors: activity of Mahonia aquifolium crude extract and • HUNG, Shuen-lu its major isolated alkaloids’, [Online] vol. 18, no. Zhanghua City 500 (TW) 8, 01 August 2004, pages 674 - 676, XP008158021 • CHUNG, Wen-Hung DOI: DOI:10.1002/PTR.1517 ISSN: 0951-418X Nantong County 541 (TW) PHYTOTHERAPY RESEARCH, JOHN WILEY & • CHANG, Tse-Wen SONS LTD. CHICHESTER, GB Retrieved from the Taipei City 103 (TW) Internet: <URL:http://onlinelibrary.wiley.com/doi/10. (74) Representative: Grünecker Patent- und 1002/ptr.1517/pdf> [retrieved on 2004-10-08] Rechtsanwälte PartG mbB Leopoldstraße 4 80802 München (DE) Note: Within nine months of the publication of the mention of the grant of the European patent in the European Patent Bulletin, any person may give notice to the European Patent Office of opposition to that patent, in accordance with the Implementing Regulations. Notice of opposition shall not be deemed to have been filed until the opposition fee has been paid. (Art. 99(1) European Patent Convention). EP 2 448 577 B1 Printed by Jouve, 75001 PARIS (FR) (Cont. next page) EP 2 448 577 B1 • JUQIANG ET AL: "In vitro effects of the traditional • SEKI T ET AL: "Effect of some alkaloids, chinese medicine, berberine, matrine and flavonoids and triterpenoids, contents of baicalin, on the proliferation and lipid synthesis Japanese-Chinese traditional herbal medicines, of immortalized human sebocyte SZ95", on the lipogenesis of sebaceous glands.", SKIN ZHONGHUAPIFUKE ZAZHI - CHINESEJOURNAL PHARMACOLOGY :THE OFFICIALJOURNAL OF OF DERMATOLOGY, ZHONGGUO YIXUE THE SKIN PHARMACOLOGY SOCIETY 1993, vol. KEXUEYUAN PIFUBING YANJIUSUO, NANJING, 6, no. 1, 1993, pages 56-60, XP008176201, ISSN: CN, vol. 38, no. 11, 1 November 2005 (2005-11-01), 1011-0283 pages 662-664, XP008158075, ISSN: 0412-4030 2 1 EP 2 448 577 B1 2 Description 3.1. Genetic contribution BACKGROUND OF THE INVENTION [0005] Earlier studies have indicated genetic predis- position to flushing, the earliest manifestation of facial 1. Rosasea and its major symptoms 5 rosacea10. Additionally, glutathione S-transferase MU-1 (GSTM1) and glutathione S-transferase theta 1 (GSTT1) [0001] Rosacea is a chronic skin disease that mani- null genotype has been reported to be associated with fests redness and swelling, primarily on the face, espe- an increased risk of rosacea11. cially on the central facial area. Other areas affected in- clude the scalp, neck, ears, chest, back and the eyes. 10 3.2. Inflammation and innate immune system Rosacea is characterized by facial flushing, erythema, telangiectasia, and inflammatory episodes with papules [0006] As rosacea progresses, inflammatory lesions and pustules and, in severe cases, rhinophyma. Come- become evident. Unlike acne vulgaris, inflammatory ro- dones are notably absent1. sacea is not a bacterial disease of the pilosebaceous [0002] Patients with rosacea mostly have increased 15 unit. Comedones are usually not present, and only nor- sensitivity of the facial skin and dry, flaking facial derma- mal bacterial flora is identified in skin samples taken from titis, edema of the face, and persistent granulomatous rosacea patients12. The inflammatory stage of rosacea papulonodules2. According to clinical and histopatholog- can be regarded as a form of chronic sterile cellulitis13. ic features, the disease can be classified into 4 subtypes: While the presence of microorganisms has been exam- (a) erythematotelangiectatic, (b) papulopustular, (c) phy- 20 ined as a potential contributing factor to rosacea, results matous, and (d) ocular, each with 3 grades of severity have been inconclusive1. Demodex folliculorum mites (mild, moderate, severe)3. The course of the disease is are considered as commensal and do not play a signifi- typically chronic, with recurrent remissions and relapses. cant pathogenic role in rosacea, although an inflamma- tory reaction to the mites may aggravate symptoms 14. 2. Other red face related skin disorders 25 [0007] Yamasaki et al found an abnormally high level of cathelicidins by histopathological staining in skin le- [0003] Rosacea is the most common red face skin dis- sions from patients with rosacea. Human epidermal ke- order. Other red face related skin disorders, which share ratinocytes stimulated by cathelicidin peptides were symptomatic similarities and probably pathological caus- found to increase the release of IL-8. Injection of cathe- es, include acne vulgaris, seborrheic dermatitis, photo- 30 licidin peptides into the skin of mice caused inflammatory dermatitis and contact dermatitis. These red face related changes with increased neutrophil infiltration and micro- conditions may range from feelings of heat and sensitivity vessels characteristic of the skin disorder of rosacea in to flushing or burning with intense sensitivity4. Patients humans15. Cathelicdins possibly have dual roles in im- with rosacea and other red face related skin disorders munity because it can both kill microorganisms and stim- often exhibit extreme sensitivity to environmental and 35 ulate host inflammatory responses such as inducing IL- topical factors5. Steroid-induced rosacealike dermatitis 8 release16. Other inflammatory cytokines found to be (or steroid rosacea) is a papular or pustular lesions with increased in rosacea include IL-1alpha and transforming erythematous and edematous base with or without tel- growth factor beta-217,18. angiectasia., which is caused by prolonged application of topical steroids to the face or as a rebound condition 40 3.3. Vascular mediators after discontinuation of topical steroids 6. 7 (Chen AY Zir- was MJ, 2009; Lee DH, Li K, Suh DH 2008). EGFR in- [0008] Inflammatory mediators may be responsible for hibitors, such as cetuximab, erlotinib, gefitinib, cause ac- the vasodilation seen in rosacea patients. For example, neiform dermatitis on face or other skin area, including substance P, histamine, serotonin, bradykinin, or pros- papulopustular reaction, erythema, telangiectasias, and 45 taglandins have been suggested19 . Smith et al has re- flushing in 30 to 90 % of patients and may also superin- ported an increased expression of vascular endothelial fected with bacteria, such as staphylococcus aureus8,9 growth factor and its receptors in rosacea20. (Wollenberg A, Kroth J et al, 2010; Lacouture ME, Mait- land ML et al, 2010). 4. Current management of rosasea 50 3. Pathogenesis of rosacea [0009] A number of antibiotics, such as tetracycline and doxycycline have been used in treating rosacea. It [0004] The etiology of rosacea is not well understood. has been suggested that such antibiotics render anti-in- Various factors have been suggested to contribute to the flammatory rather than antimicrobacterial effects. How- development and manifestation of rosacea. None of55 ever, other anti-inflammatory agents are not effective in them, however, has been definitely confirmed1. treating rosacea. Immunosuppressive agents such as corticosteroids often worsen the inflammatory condition of rosacea1. 3 3 EP 2 448 577 B1 4 [0010] Topical metronidazole and certain systemic an- sacea and other skin problems 31. The composition of this tibiotics are often used as first-line therapy for rosacea. invention includes antimicrobial agents selected from Oral tetracycline, doxycycline, and minocycline are com- several agents including berberine. In these neutraceu- monly used for treating rosacea. The efficacy of oral an- tical compositions, berberine is included as one of the tibiotics is probably due more to anti-inflammatory rather 5 many ingredients and its concentration is not specified. than to antibiotic effects 21. Azelaic acid 15% gel was ap- There has been a 10% Mahonia aquifolium cream (Re- proved by FDA of USA in 2002 for the topical treatment lieva™, Apollo Pharmaceutical Canada Inc) containing of mild to moderate rosacea22. Other traditional topical 0.1% berberine for the treatment of psoriasis 32. US pat- agents that have been used in a "off label" fashion include ent application 2006/0286054 describes the treatment of clindamycin, sulfacetamide and sulfur, but their mecha- 10 skin disorders and discloses compositions comprising nism is not well understood. psorberine, which is an undefined extract from the Ma- honia aquifolium plant39. 5. The use of berberine in non-skin disorders [0015] The therapeutic effect of berberine in treating rosacea and other red face-related skin disorder is un- [0011] Berberine (Natural Yellow 18, 6-dihydro-9,10- 15 known.
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