# Patent

## Title
Medicinal agent for treating fatness, diabetes, and diseases associated with impaired glucose tolerance

## Abstract

The inventive medicinal agent comprises antibodies against beta-subunit of insulin receptor in an activated form produced by means of repeated serial dilution and an external action performed according to homeopathic technology. The inventive method for producing a solid medicinal formulation for perorally treating fatness, diabetes, and other diseases associated with impaired glucose tolerance, consists in mixing the effective amount of carrier, which is showered in a fluidized layer by a water-alcohol dilution of antibodies in the form active against the beta-subunit of the insulin receptor produced by combining the repeated serial dilution, thereby reducing the concentration of antibodies, and an external action according to homeopathic technology, and is dried at a temperature equal to or less than 35° C., with pharmaceutically acceptable additives and in subsequently pelleting the mixture thus obtained by means of direct dry compression.

## Background
FIELD OF THE INVENTION
The invention concerns the field of medicine and may be used for effective treatment and prevention of obesity, diabetes mellitus and other diseases associated with impaired glucose tolerance.
PRIOR ART
Based on the prior knowledge, the medicinal drug (medication) for the treatment of obesity, diabetes mellitus and other diseases associated with impaired glucose tolerance is known (e.g. see Register of Medicinal Drugs of Russia “Encyclopedia of the Drugs”, 14th edition, Moscow, Register of Medicinal Drugs (RMD), 2006, pp. 223-226. pp. 329-332, P. 510, P. 731).
However, the use of such drugs does not provide stable effect, particularly due to the tolerance to them; besides, it may be accompanied by side effects.
A method of obtaining solid oral form of the drug including pressing of dry ground components containing the active substance and pharmaceutically acceptable additives (RU 2203054 C2, A61K9/20, 2003) is also known.
However, such method is not suitable for manufacturing of medicinal drugs containing antibodies as they are made in liquid dosage form for injections and are administered parenterally in order to provide bioavailability.
DISCLOSURE OF THE INVENTION
The invention is intended for development of an effective antibody-based drug used for peroral treatment of obesity, diabetes mellitus and other diseases associated with impaired glucose tolerance with no side effects and the method of its production in solid dosage form.
Solution of the task is ensured by the fact that a peroral drug for the treatment of diabetes mellitus and other diseases associated with impaired glucose tolerance, according to the invention contains antibodies to beta-subunit of the insulin receptor in activated form obtained by multiple successive dilution and external action in accordance with homeopathic technology.
At that the medicinal drug (medication) contains monoclonal, polyclonal, recombinant, immune or natural antibodies to beta-subunit of the insulin receptor in activated form.
Furthermore, the medicinal drug contains mixture of various homeopathic dilutions of antibodies to beta-subunit of the insulin receptor in activated form.
Solution of the task is also ensured by the fact that method of production of solid oral form for the treatment of diabetes mellitus and other diseases associated with impaired glucose tolerance according to the invention includes mixing of effective amount of carrier irrigated in a fluidized bed by combination of aqueous-alcohol dilution of antibodies to beta-subunit of the insulin receptor in activated form obtained by combining multiple successive dilution-reduction in antibody concentration and external action according to homeopathic technology and dried at temperature not exceeding 35ε C., with pharmaceutically acceptable additives and subsequent pelletization of mixture by direct dry pressing.
Lactose with particle size of 150-250 μm is used as a carrier for this method of obtaining solid medicinal form.
The experiments confirmed that the medicinal drug administered orally and prepared by multiple successive dilution and external action, mainly according to homeopathic technology, of antibodies to beta-subunit of the insulin receptor provides modifying effect on physiological processes mediated by beta-subunit of the insulin receptor, particularly on impaired glucose metabolism specific for obesity, diabetes mellitus, etc ensuring therapeutic efficacy of the medicinal drug subject to patent application.
The medicinal drug prepared in accordance with the invention is a novel antibody-based pharmaceutical drug characterized by specific pharmacological activity, high efficacy; absence of side effects, ecological purity and low cost.


EMBODIMENTS OF THE INVENTION
The medicinal drug is prepared in the following way.
A fragment of beta-subunit of human insulin receptor (No. P06213 in the Swissprot database of protein sequences, ID No. 33112647) is used as immunogen for immunization of laboratory animals in order to produce polyclonal immune antibodies or in hybridoma technology for production of recombinant monoclonal and polyclonal antibodies. The fragment is SEQ ID NO: 1. The obtained antibodies are purified by affinity chromatography. Mixture of various fragments may be used as immunogen.




The method of immune and monoclonal antibodies is described, for example, in the book Immunological methods/Edited by G. Frimel, Moscow, Medicina, 1987, pp. 9-33.
Method of natural antibodies production is described in the book “Natural antibodies to low-molecular compounds”. M. A. Myagkova, Moscow, MGUL, 2001 (ISBN 5-8135-0058-8), pp. 70-114.
Method of recombinant antibodies production is described in the article by Laffly E., Sodoyer R. Hum. Antibodies. Monoclonal and recombinant antibodies, 30 years after.—2005—Vol. 14.—N 1-2. pp. 33-55.
Isolated antibodies are subjected to successive and multiple dilution-reducing their concentration and subjecting them to external, usually mechanical treatment e.g. according to homeopathic technology of potentiating (see Homeopathic medicinal drugs. Guidelines on description and manufacturing. V. Shvabe, Moscow, 1967, pp. 12-38; or G. Keller, Homeopathy, Moscow, Medicina, 2000, part 1, pp. 37-40). At that steady concentration reduction is performed by successive dilution of 1 part by volume of the starting substance (antibodies) in 9 parts by volume (for decimal D dilution) or in 99 parts by volume for centesimal C dilution) or in 999 parts by volume for millesimal dilution) of neutral solvent—distilled water and/or 70% ethyl alcohol with multiple vertical shaking of each dilution obtained and using mainly separate containers for each subsequent dilution until the required dilution is achieved.
Ultrasound, electromagnetic or other physical influence can be used for external treatment in the process of concentration reduction.
To improve therapeutic effect of the drug mixture of various homeopathic dilutions may be used.
The obtained dilution in the form of aqueous or alcohol solution may be used as a liquid dosage form for peroral administration into the body (in the form of drops) or for subsequent preparation of solid oral form.
At the stage of producing of solid dosage form for peroral therapy in the fluidized bed, e.g. of Huttlin Pilotlab type manufactured by Huttlin GmbH, irrigation in fluidized bed of granules of neutral substance—lactose (milk sugar) with particle size of 150-250 μm prepared according to the aforementioned technology using aqueous-alcohol dilution (preferably, centesimal) of the activated form of antibodies to beta-subunit of the insulin receptor with simultaneous drying at temperature not exceeding 35ε C. is conducted.
Calculated amount of the prepared “saturated” lactose is loaded into the mixer and mixed with microcrystalline cellulose administered at 10.0-15.0 mass % of the total loading weight. Then “nonsaturated” lactose is added to mixture (to reduce price and slightly facilitate and accelerate technological process without reducing therapeutic efficacy by means of reduction of pharmaceutical substance concentration in the tablet if required: aqueous-alcohol dilution of activated form of antibodies) in 30-80 mass % of the total loading weight and magnesium stearate at 0.8-1.2 mass % of the total loading weight and they are stirred evenly.
Obtained dry homogeneous mixture is supplied to the pelletizing machine, for example, tablet-press Korsch-XL 400, to form round 150-500 mg tablets using direct dry pressing.
Example 1
Patient K., 62 years old, obesity of 3rd degree (body mass index 36) has long been suffering from insulin-independent diabetes. He takes sugar-reducing drugs (for the last months glibenclamide at a dose of 10 mg/day). On the background of glibenclamide intake hypoglycemia periodically developed, the patient complained of headache, dizziness, etc. Glibenclamide was assigned in combination with polyclonal rabbit antibodies to beta-subunit of the insulin receptor (mixture of homeopathic dilutions C12+C30+C200) at a dose of 5 drops per os twice a day. No cases of hypoglycemia were registered during 4-week treatment, glucose tolerance was normalized. After 1.5-month treatment the patient stopped taking glibenclamide, glucose level was within the normal range. Body mass index reduced up to 33. Continuation of the antibody-based drug therapy was recommended.
Example 2
Patient M., 46 years old, complained of rapid fatigability. The examination revealed obesity of 2nd degree. Recommendations: 1 tablet “saturated” with potentiated antibodies—homeopathic dilution C30 of monoclonal antibodies to beta-subunit of the insulin receptor—three times per day. Six-week drug administration resulted in weight reduction by 7% and improvement of physical tolerance.
Example 3
Patient K., 36 years old, complained of insomnia, increased food intake, dyspnea. The examination showed obesity of 3rd degree, body mass index 41 kg/m. The intake of the drug in tablet form containing antibodies to beta-subunit of the insulin receptor (mixture of homeopathic dilutions C12+C30+C200)—2 tablets twice per day—allowed to normalize appetite and reduce BMI up to 36 kg/m2 within 4 weeks.
Example 4
Patient D., 43 years old, underwent a course of obesity treatment. Complained of ineffective dietary treatment. Five-week administration of the drug containing antibodies to beta-subunit of the insulin receptor in homeopathic dilution C200 at a dose of 1 tablet 4 times/day allowed to reduce the patient's body weight by 10%.
Example 5
Antidiabetic activity of aqueous solution of the drug containing activated form of rabbit polyclonal antibodies to beta-subunit of the insulin receptor (mixture of homeopathic dilutions C12+C30+C200) was studied in the model of outbred male rats with streptozotocin-induced diabetes. The drug was administered intragastrically at a dose of 2.5 mL/kg per rat for 50 days. Insulin (Actrapid HM at 12 units/kg/day subcutaneously) and glibenclamide (MP Biomedical at a dose of 8 mg/kg/day per os) were used as reference drugs. The results showed significant activity of the drug exceeding the one of the reference drugs. On day 7 of the treatment blood and urine glucose levels were significantly reduced, glucose tolerance was normalized. On day 14 these parameters almost reached the normal values. The drug effect persisted for all 50 days of the treatment. Insulin and glibenclamid administration provided antidiabetic effect of various degrees on aforementioned parameters; however, the effect intensity was significantly lower than that in the group of animals receiving activated form of antibodies to beta-subunit of the insulin receptor.
Example 6
Patient M., 15 years old, diagnosis of 1 type diabetes mellitus, disease duration—7 years. Due to reduced efficacy of insulin therapy (long-term insulin drugs) the following recommendations were made: activated form of monoclonal murine antibodies to beta-subunit of human insulin receptor (mixture of homeopathic dilutions C12+C30+C200)—1 tablet for dissolution in the mouth 2 times/day. After 2-week treatment insulin therapy efficacy was significantly improved; due to this insulin dose was reduced from 0.5 units/kg/day to 0.3 units/kg/day. Further (in 3 months) the dose of insulin was reduced up to 0.1 units/kg/day.
Example 7
Patient S., 53 years old, BMI 30, has been suffering from insulin-independent diabetes mellitus for 8 years, the syndrome of diabetic foot is present. The great toe of the right leg was amputated one year ago. The patient complained of non-healing (1.5 months) ulcers on the right leg in the area of amputated toe. The patient was assigned with rabbit polyclonal antibodies to beta-subunit of human insulin receptor (mixture of homeopathic dilution D6+C30+C50) at a dose of 1 tablet once daily (the tablet has to be dissolved in the mouth). Three weeks later healing of ulcerative process was registered, and insulin tolerance was reduced. The patient went on taking the drug for 3 months that resulted in stabilization of glycemia. The patient noted significant body weight loss (IMT reduced to 28).
Example 8
Patient Z., 72 years old, complained of subcompensated insulin-independent diabetes mellitus. Recombinant human antibodies to beta-subunit of human insulin receptor in homeopathic dilution C30 at a dose of 1 tablet per os 3 times/day were recommended. Seven days later hyperglycemia was reduced, two weeks later glucose level was normalized, and physical tolerance was improved.
Example 9
Patient D., 8 years old, diagnosis of I type diabetes mellitus since 5 years old. The course of the disease quickly progresses. On admission glycemia was 20 mmol/l; the patient received human recombinant insulin at a dose of 30 units/day. Intake of polyclonal rabbit antibodies to C-terminal fragment of beta-subunit of the insulin receptor (mixture of homeopathic dilutions C12+C30+C200) at a dose of 2 tablets 2 times/day (tablet has to be dissolved in the mouth) was recommended; insulin administration continued at the same dose. In 3 days of the treatment glycemia reduced to 15.5 mmol/l; in 2 weeks of the treatment the level of glucose normalized and remained stable. The improvement achieved made it possible to reduce insulin dose in 3 months after the onset of the treatment up to 10 units/day. It was recommended to continue the treatment.
Example 10
Patient A, 51 years old. For a long time she has been observed by endocrinologist for decompensated 1 type diabetes mellitus with signs of nephropathy, neuropathy, skin lesions and retinopathy. In addition to insulinotherapy administration of ultra low doses of goat polyclonal antibodies to beta-subunit of the insulin receptor (mixture of homeopathic dilutions C12+C30+C200) at a dose of 1 tablet 3 times/day (the tablet has to be dissolved in the mouth) was assigned. Two weeks later skin itching and proteinuria (from 0.4 g/L to 0.1 g/L) were significantly reduced, skin ulcers on the legs were almost healed. The patient noted improved general state, reduced dyspnea, increased ability to work. Prolongation of the treatment was recommended in order to reduce the dosage of insulin injections.

## Claims

1. A medication for peroral treatment of diabetes mellitus, impaired glucose tolerance and obesity associated with diabetes mellitus or impaired glucose tolerance, comprising a homeopathically potentized form of at least one antibody to the beta-subunit of the insulin receptor.

2. The medication according to claim 1 wherein said at least one antibody is a monoclonal, polyclonal, recombinant, immune or natural antibody.

3. The medication according to claim 1 wherein said homeopathically potentised form of antibody comprises mixture of various homeopathic dilutions.

4. A method for producing a solid oral dosage form of claim 1, the method comprising:
providing a carrier;
irrigating said carrier with a homeopathically potentized form of at least one antibody to the beta-subunit of the insulin receptor;
mixing said carrier with pharmaceutically acceptable additives;
drying said carrier at a temperature not exceeding 35° C.; and
forming said irrigated carrier into said oral dosage form by direct dry pressing.

5. The method according to claim 4 wherein the carrier is lactose with a particle size of from about 150 μm to about 250 μm.