Abstract:
The phospholipid complex extracts of  Vitis vinifera  useful for the prevention and the treatment of atherosclerotic pathological conditions and are administered to a patient in need of such treatment.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation of the U.S. National Stage designation of co-pending International Patent Application PCT/EP98/07662, filed Nov. 30, 1998. 
    
    
     FIELD OF THE INVENTION 
     The present invention relates to the use of phospholipid complexes of oligomeric proanthocyanidins containing from 2 to 7 catechin units extracted from  Vitis vinifera  for the preparation of medicaments for the treatment and the prophylaxis of atherosclerosis, and of myocardial and cerebral infarctions. 
     BACKGROUND OF THE INVENTION 
     The extracts of  Vitis vinifera  are already known and used in the therapy of cardiovascular disorders connected with venous insufficiency, in the treatment of impaired conditions of capillary permeability and resistance and in cicatrization. These extracts, which can be obtained from the seeds of the plant as described in British patent application 1,541,469 or in French patent application 2,092,743, are a mixture of polyphenols such as epicatechin and its polymerization products, in part esterified at the C-3 hydroxyl of the monomer with gallic acid. The phospholipid complexes of the extracts of  Vitis vinifera  are described in U.S. Pat. No. 4,963,527 and are at present commercially available under the trademark LEUCOSELECT. The extracts of  Vitis vinifera  detailed in the prior art are obtained by extraction with acetone, usually using an acetone-water mixed solution. 
     SUMMARY OF THE INVENTION 
     The present invention is directed to a method for the treatment of atherosclerosis or of myocardial or cerebral infarctions and an anti-atherosclerotic medicament therefor. The method for the treatment of atherosclerosis or of myocardial or cerebral infarctions includes administering a therapeutically effective amount of an extract of  Vitis vinifera , preferably in a phospholipid complex, to a patient in need of such treatment. Advantageously, the extract can contain oligomeric proanthocyanidins having from about 2 to about 7 catechin units. In one embodiment, the unitary dosage and/or the therapeutically effective amount of the medicament ranges from 50 mg to 500 mg. In another embodiment, the unitary dosage and/or the therapeutically effective amount of the medicament can range from 266 mg to 500 mg. 
     In a preferred embodiment, the medicament is in the form of an orally administrable composition. Alternately or additionally, a pharmaceutically acceptable carrier, adjunct, or excipient may also be present. Preferably, the pharmaceutically acceptable carrier is a soft or hard gelatin capsule or a tablet. More preferably, the capsule or tablet may be administrable orally. 
     Another aspect of the present invention relates to an anti-atherosclerotic medicament that includes a therapeutically effective amount of one or more of the extracts or phospholipid complexes described herein. In a preferred embodiment, the medicament is in the form of an orally administrable composition. Alternatively or additionally, a pharmaceutically acceptable carrier, adjunct, or excipient may also be present. Preferably, the pharmaceutically acceptable carrier is a soft or hard gelatin capsule or a tablet. 
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     It has now surprisingly been found that the complexes prepared according to U.S. Pat. No. 4,963,527 exert, when administered systemically, preferably by the oral route, a marked anti-atherosclerotic activity and effect both in animals and in humans. 
     More specifically, it has been found that the phospholipid complexes of oligomeric proanthocyanidins containing from 2 to 7 catechin units extracted from  Vitis vinifera , prevent or reduce the formation of atherosclerotic plaques in a dose-dependent relationship. 
     Such an activity was evidenced in rabbits fed with hypercholesterolemic diet, so as to induce atherosclerotic lesions similar to the human ones at the vascular level, particularly at the aortic arch, ventral aorta, carotids, and cerebral vessels. In a comparative model, a normal, or control, diet was compared to two hypercholeseterolemic diets, one without and one with the above mentioned phospholipid complexes. It was found that the phospholipid complexes may have changed the macroscopic and microscopic vascular condition, compared with untreated animals, by reducing both the number of atheromatous plaques and their severity, with a surprising vascular-tissular benefit. In another atherosclerosis model, the purpose of which was to examine cerebral protection, the vasal lumen of rabbit internal carotid was surgically reduced, while administering a hypercholesterolemic diet rich in saturated fats. As a result, a decrease in carotid obstruction was exhibited, as well as a reduction of vessel wall thickness, and an increased survival rate of the animals was evidenced. Furthermore, in atherosclerotic patients, a reduction in carotid obstruction due to atheromatous plaques and an improved carotid flow were observed, as evaluated by Doppler ultrasonography. 
     The phospholipid complexes of the proanthocyanidins extracted from  Vitis vinifera  can be used in suitable oral formulations, for example, such as tablets and soft or hard gelatin capsules, at dosages preferably from 50 mg to 500 mg, or alternately from 266 mg to 500 mg, administered preferably two to three times a day, depending on the severity of the ailment to be treated. The preparation of the pharmaceutical formulations can be carried out according to conventional techniques and may optionally include pharmaceutically acceptable carriers, adjuncts, or excipients. 
    
    
     EXAMPLES 
     Certain preferred embodiments of the present invention will be illustrated in greater detail by reference to the following examples and comparative examples, which are included to exemplify, but not to limit, the scope of the present invention. 
     Examples 1-3 
     Comparative Model for Assessing the Effect of the Phospholipid Complex of Extracts of  Vitis vinifera  in a diet on the Severity of Atherosclerosis in Rabbits 
     Three groups of eight New Zealand rabbits each, were treated as follows: 
     Group (1): Control, normal diet 
     Group (2): Hypercholesterolemic diet (0.2% cholesterol) 
     Group (3): Hypercholesterolemic diet+phospholipid complex of extracts of  Vitis vinifera  (0.2% cholesterol+2% Leucoselect®). 
     After 8 weeks, during which cholesterol, LDL/VLDL, HDL and triglyceride levels were measured, the animals were sacrificed. The number, the size, and the distribution of the atherosclerotic lesions on the thoracic and abdominal sections of the aorta were evaluated. Aorta strips were fixed and stained with Sudan IV to better visualize the lesions and to help evaluate the vasal cholesterol and the content in oxidized cholesterol by gas chromatography. 
     The results reported in Table 1 clearly demonstrate that the treatment with phospholipid complexes of extracts of  Vitis vinifera , as in Example (3), decreases in a statistically significant way the atherosclerotic lesions induced by hypercholesterolemic diet of Example (2) and more closely resembles the control diet of Example (1). 
     
       
         
               
               
             
           
               
                 TABLE 1 
               
               
                   
               
               
                 Treatment 
                 area percent of the lesion 
               
               
                   
               
             
             
               
                 Group (1) 
                  1% 
               
               
                 Group (2) 
                 27% 
               
               
                 Group (3) 
                  5%* 
               
               
                   
               
               
                 *p &lt; 0.01 compared with Group (2)  
               
             
          
         
       
     
     Examples 4-6 describe capsules or tablets containing 50 mg to 500 mg of phospholipid complex of extracts of  Vitis vinifera.    
     Example 4 
     Capsules Containing Phospholipid Complex of Extracts of  Vitis vinifera    
     Composition: 
     
       
         
               
               
               
             
           
               
                   
                   
               
             
             
               
                   
                 Complex of extract of  Vitis vinifera  with soy 
                 200 mg  
               
               
                   
                 phosphatidylcholine 
               
               
                   
                 Lactose 
                 57 mg 
               
               
                   
                 Modified starch 
                 40 mg 
               
               
                   
                 Magnesium stearate 
                  3 mg 
               
               
                   
                   
               
             
          
         
       
     
     Example 5 
     Gastro-resistant Tablets Containing Phospholipid Complex of Extracts of  Vitis vinifera    
     Composition: 
     
       
         
               
               
               
             
           
               
                   
                   
               
             
             
               
                   
                 Complex of extract of  Vitis vinifera  with soy 
                 250 mg  
               
               
                   
                 phosphatidylcholine 
               
               
                   
                 Microcrystalline cellulose 
                 118 mg  
               
               
                   
                 Precipitated silica 
                 3 mg 
               
               
                   
                 Magnesium stearate 
                 4 mg 
               
               
                   
                 Methacrylic acid anionic polymer and esters thereof 
                 2 mg 
               
               
                   
                 Talc 
                 8 mg 
               
               
                   
                 Magnesium carbonate 
                 8 mg 
               
               
                   
                 Maize star 
                 5 mg 
               
               
                   
                 Gum arabic 
                 159 mg 
               
               
                   
                   
               
             
          
         
       
     
     Example 6 
     Soft-gelatin Capsules Containing Phospholipid Complex of Extracts of  Vitis vinifera    
     Composition: 
     
       
         
               
               
               
             
           
               
                   
                   
               
             
             
               
                   
                 Complex of extract of  Vitis vinifera  with soy 
                 266 mg 
               
               
                   
                 phosphatidylcholine 
               
               
                   
                 Peanut oil 
                 209 mg 
               
               
                   
                 Partially hydrogenated vegetable oils 
                 100 mg 
               
               
                   
                 Soy lecithin 
                  5 mg