Patent Publication Number: US-2017354624-A1

Title: Topical compositions for treatment of skin irritation

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
     This application is a Continuation-in-Part of U.S. patent application Ser. No. 11/914,429, filed 14 Nov. 2007, which is a National Phase Entry under 35 U.S.C. 371 of PCT Patent Application No. PCT/IL2006/000537, filed 7 May 2006, and which claims priority from Israel Patent Application No. 168603, filed 16 May 2005. All of these publications are incorporated by reference in their entirety. 
    
    
     FIELD AND BACKGROUND OF THE INVENTION 
     The present invention provides a new combination of topically active substances, for the prevention and alleviation of cell damage, caused by preservatives, detergents or drugs, used in topical pharmaceutical, cosmetic or veterinary compositions. 
     Many substances are applied topically to the skin or mucous membranes of humans or animals in order to alter the subject&#39;s appearance, to protect the subject from the environment, or to produce a biological change in the skin or other tissue for therapeutic, preventive or cosmetic purposes. These substances may generically be termed “topical products” and include such topically applied substances as cosmetics, over-the-counter and prescription topical drugs, and a variety of other products such as soaps and detergents. 
     Topical products occur in a variety of forms, including solids, liquids, suspensions, semisolids (such as creams, gels, pastes or “sticks”), powders or finely dispersed liquids such as sprays or mists. Examples of topical products commonly classified as “cosmetics” include skin care products such as creams, lotions, moisturizers and “treatment cosmetics” such as exfoliants and/or skin cell renewal agents; fragrances such as perfumes and colognes, and deodorants; shaving-related products such as creams, “bracers” and aftershaves; depilatories and other hair removal products; skin cleansers, toners and astringents; pre-moistened wipes and washcloths; tanning lotions; bath products such as oils; eye care products such as eye lotions and makeup removers; foot care products such as powders and sprays; skin colorant and make-up products such as foundations, blushes, rouges, eye shadows and liners, lip colors and mascaras; lip balms and sticks; hair care and treatment products such as shampoos, conditioners, colorants, dyes, bleaches, straighteners and permanent wave products; baby products such as baby lotions, oils, shampoos, powders and wet wipes; feminine hygiene products such as deodorants and douches; skin or facial peels applied by dermatologists or cosmeticians; and others. 
     Examples of topical products commonly classified as “topical drugs” are many and varied, and include over-the-counter and/or prescription products such as antiperspirants, insect repellents, sunscreens and sunburn treatments, anti-acne agents, antibiotics, topical respiratory agents, ocular drugs such as eye drops and saline solutions, therapeutic retinoids, anti-dandruff agents, external analgesics such as capsaicin products, topical contraceptives, topical drug delivery systems, gastrointestinal agents such as suppositories, enemas and hemorrhoid treatments, reproductive system agents such as vaginal treatments, oral treatments such as lozenges, and many other products with therapeutic or other effects. Other topical products include hand, facial and body soaps and detergents and other forms of skin cleansers, as well as household detergents and many other household products such as solvents, propellants, polishes, lubricants, adhesives, waxes and others which are either applied topically or are topically exposed to the body during normal use. 
     In a large number of cases topical products contain chemicals which may produce “irritation,” including various inflammation symptoms or signs, when applied to the skin or mucosa. The present invention is directed to compositions for inhibiting the irritation associated with such topical products. 
     The occurrence, frequency and nature of topical-product-induced irritation often varies from user to user. The severity of irritation to the susceptible user may range from subclinical to mild to severe. Typical symptoms of “irritation” include itching (pruritus), stinging, burning, tingling, “tightness,” erythema (redness) or edema (swelling). The irritation response may be due to the direct effect on the skin of certain topical product chemicals or to a response by the immune system directed toward the chemicals alone or in combination with skin components (e.g. antigens). 
     Many ingredients used in topical products are known irritants or are potentially irritating, especially to people with “sensitive skin”. These irritating ingredients include fragrances, preservatives, solvents, propellants and many other ingredients that might otherwise be considered inert components of the products. Additionally, many topical product active ingredients, including chemicals that may also be classified as drugs, produce irritation when applied to the skin. These include, but are not limited to, such ingredients as exfoliants and skin cell renewal agents, anti-acne drugs, antiperspirant compounds, antihistamines, anti-inflammatory agents, skin protective agents, insect repellent chemicals, sunscreens and many others. Where more than one chemical irritant is present, their irritating effects may be additive. Furthermore, chemical ingredients may react with one another, or in the environment of the skin, to form new chemicals which are irritating. The vehicles in which the active drug ingredients are formulated may also produce irritation in sensitive people. 
     Whatever the exact cause of irritation, many attempts have been made to reduce the irritation potential of topical products by identifying chemicals which tend to cause irritation and reducing their concentration or eliminating them from the products. Many of these products are advertised to consumers as “hypoallergenic” or the like to designate a product&#39;s reduced tendency to cause irritation in consumers with sensitive skin. Many skin and mucosal irritation responses, however, are not allergic in origin. In any event, it is often not feasible or practical to identify or eliminate all of the irritating chemical(s), particularly when the irritating chemical(s) are the active ingredient of the product or are required for formulation, preservative or other functional reasons. 
    
    
     DISCLOSURE OF THE INVENTION 
     It is an object of the present invention to provide an effective topical composition, for combating damaging effects of irritants to mucous and skin cells. 
     Unless otherwise indicated, all concentrations are given as percent w/w. 
     The present invention relates to topical compositions for combating damaging effects of preservatives or other irritants, found, e.g. in multi-dose eye drops, to mucous cells, especially in the corneal cells and simultaneously beneficial to those tissues. It was found that glycerol counteracts corneal cell damage caused by preservatives such as benzalkonium chloride, cetrimonium bromide, sodium ethylene diamine tetraacetate, etc. Not all the polyhydroxy compounds have such anti-irritant properties. Moreover, it is known that isotonic sodium chloride is toxic to the corneal cells, whereas isotonic glycerol is not toxic. (Follmann, P. et. al. Szemeszet 141, 305-308, 2004.) 
     In addition two physicochemical parameters are very important for a good topical composition: increased viscosity and increased spread of the solution. 
     Increased viscosity is achieved by high molecular weight (equal to more than 0.5 million Dalton) polymers. Increased spread is achieved by surface active agents, however after chronic use the surface active agents usually have damaging effects. (See Animal Studies, a). 
     It has now been found according to the present invention that all of the above mentioned problems of irritation by preservatives, detergents and other cell damaging agents disappear, and the beneficial effects are preserved or increased, by using a combination of xylitol, myoinositol or mannitol with glycerol and/or urea, preferably together with a surface active agent. 
     The advantages resulting from the addition of a surface active agent include a decrease in the surface tension of the aqueous solution, thereby increasing the spread. Thus it has now been found, that polysorbate 90 even at a concentration of 0.002% increases the diminished Break Up Time (BUT) in dry eye patients. It is accepted that 10 sec. or less BUT indicates dry eye syndrome (See Human Studies 1). 
     Thus, according to the present invention there are now provided topical pharmaceutical or cosmetic compositions for the prevention and treatment of irritation of mucous cells, or skin cells, comprising a combination of:
         xylitol, myoinositol or mannitol or any combination of these;   glycerol and/or urea;   water;   in the absence of any oil in water or wax in water emulsion.       

     The present invention provides topical pharmaceutical or cosmetic compositions for the prevention and treatment of irritation of mucous cells, comprising a combination of:
         1.5-5.5% xylitol, myoinositol or mannitol or any combination of these;   0.9-2.0% glycerol;   less than 0.01% inorganic salts;   water;   in the absence of any oil in water or wax in water emulsion.       

     The present invention further provides topical pharmaceutical or cosmetic compositions, for the prevention and treatment of irritation of skin cells, comprising a combination of:
         5-18% xylitol, myoinositol or mannitol or any combination of these;   5-10% glycerol and/or urea;   water;   in the absence of any oil in water or wax in water emulsion.       

     The present invention further provides topical pharmaceutical or cosmetic compositions, for the prevention and treatment of irritation of skin cells, comprising a combination of:
         5% xylitol;   5% glycerol;   a viscosity-enhancing agent;   an effective amount of a preservative;   optionally, base to adjust the pH to a predetermined value; and,   water;   in the absence of any oil in water or wax in water emulsion.       

     In some preferred embodiments of the invention, the viscosity-enhancing agent is polyacrylate 980. 
     In some particularly preferred embodiments of the invention, it consists of an aqueous gel consisting of:
         5% xylitol;   5% glycerol;   0.4% of a viscosity-enhancing agent;   an effective amount of a preservative;   sufficient NaOH to bring the pH to 4.9; and,   water.       

     In some preferred embodiments of the invention, the preservative used is methylparaben. In some particularly preferred embodiments of the invention, 0.2% methylparaben is used as a preservative. 
     More specifically the present invention preferably provides a non-irritant topical cosmetic or pharmaceutical composition for mucous cells or for the skin, as defined above, for the prevention of cell damage caused by preservatives, detergents or drugs in topically used cosmetic, pharmaceutical or veterinary compositions. 
     In especially preferred embodiments of the present invention there is provided a non-irritant topical cosmetic or pharmaceutical composition for mucous cells or for the skin, as defined above, further comprising an effective amount of at least one pharmaceutically active agent in solution or in suspension, but not in emulsion. 
     In preferred embodiments of the present invention there is provided a non-irritant topical cosmetic or pharmaceutical composition for mucous cells or for the skin, as defined above, further comprising at least one viscosity enhancing agent. 
     While the invention will now be described in connection with certain preferred embodiments in the following examples so that aspects thereof may be more fully understood and appreciated, it is not intended to limit the invention of these particular embodiments. On the contrary, it is intended to cover all alternatives, modifications and equivalents as may be included within the scope of the invention as defined by the appended claims. Thus, the following examples which include preferred embodiments will serve to illustrate the practice of this invention, it being understood that the particulars shown are by way of example and for purposes of illustrative discussion of preferred embodiments of the present invention only and are presented in the cause of proving what is believed to be the most useful and readily understood description of formulation procedures as well as of the principles and conceptual aspects of the invention. 
     EXAMPLES 
     Example 1 
     Moisturizing Eye Drops 
       
     
       
         
           
               
               
               
             
               
                   
                   
               
             
            
               
                   
                 Sodium hyaluronate 
                 0.03 g  
               
               
                   
                 Povidone 
                  2.0 g  
               
               
                   
                 Glycerol 
                  1.0 g  
               
               
                   
                 Mannitol 
                  3.2 g  
               
               
                   
                 Centrimide 
                 0.01 g  
               
               
                   
                 NaOH 
                 q.s. to pH 7.0 
               
               
                   
                 H 2 O 
                 to 100 ml 
               
               
                   
                   
               
            
           
         
       
     
     Example 2 
     Moisturizing Eye Drops 
       
     
       
         
           
               
               
               
             
               
                   
                   
               
             
            
               
                   
                 Glycerol 
                  1.3 g  
               
               
                   
                 Xylitol 
                  2.2 g  
               
               
                   
                 Benzalkonium Chloride 
                 0.01 g  
               
               
                   
                 NaOH 
                 q.s. to pH 7.0 
               
               
                   
                 H 2 O 
                 to 100 ml 
               
               
                   
                   
               
            
           
         
       
     
     Example 3 
     Moisturizing Eye Drops Unit Dose Form for Single Application 
       
     
       
         
           
               
               
               
             
               
                   
                   
               
             
            
               
                   
                 Sodium hyaluronate 
                 0.03 g  
               
               
                   
                 Povidone 
                  2.0 g  
               
               
                   
                 Glycerol 
                  1.0 g  
               
               
                   
                 Myoinositol 
                  3.2 g  
               
               
                   
                 NaOH 
                 q.s. to pH 7.0 
               
               
                   
                 H 2 O 
                 to 100 ml 
               
               
                   
                   
               
            
           
         
       
     
     Example 4 
     Moisturizing Anti-Inflammatory Eye Drops 
       
     
       
         
           
               
               
               
             
               
                   
                   
               
             
            
               
                   
                 Glycerol 
                  1.3 g 
               
               
                   
                 Xylitol 
                  2.2 g 
               
               
                   
                 Sodium diclofenac 
                  0.1 g 
               
               
                   
                 Benzalkonium Chloride 
                 0.01 g 
               
               
                   
                 NaOH 
                 q.s. to pH 7.2 
               
               
                   
                 H 2 O 
                 to 100 ml 
               
               
                   
                   
               
            
           
         
       
     
     Example 5 
     Moisturizing Anti-Inflammatory Eye Drops Unit Dose for Single Application 
       
     
       
         
           
               
               
               
             
               
                   
                   
               
             
            
               
                   
                 Glycerol 
                 1.0 g 
               
               
                   
                 Mannitol 
                 1.6 g 
               
               
                   
                 Xylitol 
                 1.6 g 
               
               
                   
                 Sodium diclofenac 
                 0.1 g 
               
               
                   
                 NaOH 
                 q.s. to pH 7.2 
               
               
                   
                 H 2 O 
                 to 100 ml 
               
               
                   
                   
               
            
           
         
       
     
     Example 6 
     Moisturizing Gel for Skin 
       
     
       
         
           
               
               
               
             
               
                   
                   
               
             
            
               
                   
                 Glycerol 
                  8.0 g 
               
               
                   
                 Mannitol 
                  5.0 g 
               
               
                   
                 Urea 
                  5.0 g 
               
               
                   
                 Glycine 
                  5.0 g 
               
               
                   
                 Methylparaben 
                  0.1 g 
               
               
                   
                 Propylparaben 
                 0.01 g 
               
               
                   
                 Polyacrylate 980 adjusted to pH 4.5 
                  0.7 g 
               
               
                   
                 H 2 O 
                 to 100 ml 
               
               
                   
                   
               
            
           
         
       
     
     Example 7 
     Moisturizing Gel for Skin 
       
     
       
         
           
               
               
               
             
               
                   
                   
               
             
            
               
                   
                 Glycerol 
                 10.0 g 
               
               
                   
                 Xylitol 
                  8.0 g 
               
               
                   
                 Urea 
                  5.0 g 
               
               
                   
                 Glycine 
                  5.0 g 
               
               
                   
                 Methylparaben 
                  0.1 g 
               
               
                   
                 Propylparaben 
                 0.01 g 
               
               
                   
                 Polyacrylate 980 adjusted to pH 4.5 
                  0.7 g 
               
               
                   
                 H 2 O 
                 to 100 ml 
               
               
                   
                   
               
            
           
         
       
     
     Example 8 
     Moisturizing Gel for Skin 
       
     
       
         
           
               
               
               
             
               
                   
                   
               
             
            
               
                   
                 Glycerol 
                  8.0 g 
               
               
                   
                 Myoinositol 
                  4.5 g 
               
               
                   
                 Xylitol 
                  3.5 g 
               
               
                   
                 Urea 
                  5.0 g 
               
               
                   
                 Glycine 
                  5.0 g 
               
               
                   
                 Methylparaben 
                  0.1 g 
               
               
                   
                 Propylparaben 
                 0.01 g 
               
               
                   
                 Polyacrylate 980 adjusted to pH 4.5 
                  0.7 g 
               
               
                   
                 H 2 O 
                 to 100 ml 
               
               
                   
                   
               
            
           
         
       
     
     Example 9 
     Moisturizing Gel with Phytosphingosine Suspension for Skin 
       
     
       
         
           
               
               
               
             
               
                   
                   
               
             
            
               
                   
                 Glycerol 
                  8.0 g 
               
               
                   
                 Xylitol 
                  7.0 g 
               
               
                   
                 Polyethylene Glycol 3350 
                  2.0 g 
               
               
                   
                 Phospholipids 
                 0.25 g 
               
               
                   
                 Phytosphingosine in suspension 
                  0.2 g 
               
               
                   
                 Polyacrylate 980 or 974 
                  1.0 g 
               
               
                   
                 Methylparaben 
                  0.1 g 
               
               
                   
                 Propylparaben 
                 0.01 g 
               
               
                   
                 H 2 O 
                 to 100 ml 
               
               
                   
                   
               
            
           
         
       
     
     Suitable preservatives, suspending agents, excipients and other additives can be incorporated. The preferred pH (to be adjusted) of the compositions of examples 6 to 9 is pH 4.0 to 6.0. 
     Methods: 
     Human Studies 
     a. 23 dry eye patients received in both eyes 5 drops of Fluorescein-Novesin mixture. After 30 seconds the right eye was treated with 1 drop from the treatment bottle. The patient was asked to blink 2-3 times, then the fluorescein BUT was measured. Afterwards the left eye was treated with 1 drop from the Control bottle, the patient was asked to blink 2-3 times. Then the fluorescein BUT was measured.
         Materials: Control—0.9% NaCl (saline); surface tension 72 mN/m   Treatment=as Control+0.002% Tween 80; surface tension 49 mN/m (dyn/cm)   Results:       

                                             Left eye—Control   Right Eye—Treatment                          7.7 ± 0.4 s   12.7 ± 1.5 s                       Paired differences 5.0 ± 1.4 s (p~0.001)            
b. Examination of Treatment, of Conjunctival Damage, in Dry Eye Syndrome.
 
     One month study, use of the eye drops three times a day: 
     Left eye=essentially isotonic Glycerol (marketed product) (L). 
     Right eye=50% isotonic Glycerol+50% isotonic Xylitol (R). 
     
       
         
           
               
               
            
               
                   
               
               
                   
                 Rose Bengal score (Oxford Scale) 
               
            
           
           
               
               
               
            
               
                   
                 Before 
                 One Month 
               
            
           
           
               
               
               
               
               
            
               
                 Patient No. 
                 R 
                 L 
                 R 
                 L 
               
               
                   
               
            
           
           
               
               
               
               
               
            
               
                 1 
                 3 
                 3 
                 1 
                 2 
               
               
                 2 
                 2 
                 3 
                 0 
                 2 
               
               
                 3 
                 2 
                 3 
                 0 
                 2 
               
               
                 4 
                 3 
                 3 
                 1 
                 2 
               
               
                 5 
                 1 
                 3 
                 1 
                 2 
               
               
                 mean 
                 2.2 
                 3 
                 0.6 
                 2 
               
               
                   
               
            
           
         
       
     
     
       
         
           
               
               
            
               
                   
               
               
                   
                 Personal satisfaction 
               
            
           
           
               
               
               
            
               
                   
                 Before 
                 One Month 
               
            
           
           
               
               
               
               
               
            
               
                 Patient No. 
                 R 
                 L 
                 R 
                 L 
               
               
                   
               
            
           
           
               
               
               
               
               
            
               
                 1 
                 0 
                 0 
                 2 
                 1 
               
               
                 2 
                 0 
                 0 
                 2 
                 1 
               
               
                 3 
                 0 
                 0 
                 2 
                 1 
               
               
                 4 
                 0 
                 0 
                 2 
                 1 
               
               
                 5 
                 0 
                 0 
                 2 
                 1 
               
               
                 mean 
                 0 
                 0 
                 2 
                 1 
               
               
                   
               
               
                 0 = not satisfied 
               
               
                 1 = better 
               
               
                 2 = much better 
               
            
           
         
       
     
     Essentially the same results were obtained by using myoinositol instead of xylitol. 
     Animal Studies 
     a. 3 rabbits were treated for 3 months twice daily with eye drops, adjusted to pH 7.0. The average cross section of the epithelial conical cells and the percentage of damaged cells were evaluated by electromicroscopy. 
                                         Cross    Damaged            section    Cells       Treatment   in μ 2     %                                            None   590   16        0.9% NaCl   542   28        0.01% Benzalkonium Chloride + 0.9% NaCl   538   29        0.01% Benzalkonium Chloride + 2.5% Glycerol   699   14        0.01% Cetrimonium Bromide + 0.9% NaCl   591   27        0.01% Cetrimonium Bromide + 2.5% Glycerol   625   19        0.1% Na 2 EDTA + 0.9% NaCl   531   15        0.1% Na 2 EDTA + 2.5% Glycerol   616   17       0.025% Polysorbate 80 + 0.9% NaCl   440   25       0.025% Polysorbate 80 + 2.5% Glycerol   600   18        2.5% Glycerol   605   17        0.01% Benzalkonium Chloride + 4.5% Xylitol   554   19        0.01% Benzalkonium Chloride + 5.4% Myoinositol   584   19        0.01% Benzalkonium Chloride + 5.4% Mannitol   570   21                    
b. Prevention of Dry Skin (Irritation) Caused by 2% Sodium Lauryl Sulphate (Method: Modification of Sagiv et al. Skin Res. Technol. 6, 37, 2000)
 
     Daily topical application of molar or isotonic polyols in deionized water, half an hour before application of 2% sodium lauryl sulphate in deionized water (SLS), on one of the two shaved flanks of guinea pigs, for three consecutive days, was examined in order to prevent SLS induced “Dry skin syndrome.” Skin dryness and erythema were measured four days later in vivo: 
     
       
         
           
               
               
               
               
             
               
                   
               
               
                 Name 
                 Concentration 
                 Corneometer 
                 Mexameter 
               
               
                   
               
             
            
               
                 Glycerol 
                   1M 
                  5.5 ± 1.9 (E) 
                  4.1 ± 3.3 (E) 
               
               
                 Glycerol 
                 0.3M 
                 25.9 ± 1.7 (NE) 
                 27.4 ± 2.2 (NE) 
               
               
                 Xylitol 
                 0.3M 
                  2.8 ± 1.0 (E) 
                  0.2 ± 0.4 (E) 
               
               
                 Myoinositol 
                 0.3M 
                  0.3 ± 1.1 (E) 
                  5.1 ± 0.9 (E?) 
               
               
                 Mannitol 
                 0.3M 
                  2.2 ± 1.6 (E) 
                  1.7 ± 0.5 (E) 
               
               
                   
               
            
           
         
       
     
     Treatment of Dry Skin Induced by 2% Sodium Lauryl Sulphate (Sagiv et al, Skin Res. Technol. 6, 37, 2000) 
     
       
         
           
               
               
               
               
             
               
                   
               
               
                 Name 
                 Concentration 
                 Corneometer 
                 Mexameter 
               
               
                   
               
             
            
               
                 Glycerol 
                   1M 
                 3.2 ± 1.7 (E) 
                    1.5 ± 3.0 (E) 
               
               
                 Glycerol 
                 0.3M 
                 3.3 ± 2.3 (E) 
                   21.2 ± 0.9 (NE) 
               
               
                 Xylitol 
                 0.3M 
                 1.3 ± 1.1 (E) 
                    1.2 ± 0.9 (E) 
               
               
                 Myoinositol 
                 0.3M 
                 0.7 ± 1.8 (E) 
                    1.0 ± 0.9 (E) 
               
               
                 Mannitol 
                 0.3M 
                 1.4 ± 0.6 (E) 
                  −0.1 ± 0.3 (E) 
               
               
                   
               
               
                 (E) = Effective = No significant difference or little difference between the treated and untreated side. 
               
               
                 (NE) = Not effective = Very large and significant difference between the treated and untreated side. 
               
            
           
         
       
     
     It was claimed that to be sure of efficacy both the “Corneometer” and “Maxameter” measurements have to be “Effective” (Sagiv et al. Skin Res. Technol. 6, 37, 2000). 
     It will be evident to those skilled in the art that the invention is not limited to the details of the foregoing illustrative examples and that the present invention may be embodied in other specific forms without departing from the essential attributes thereof, and it is therefore desired that the present embodiments and examples be considered in all respects as illustrative and not restrictive, reference being made to the appended claims, rather than to the foregoing description, and all changes which come within the meaning and range of equivalency of the claims are therefore intended to be embraced therein.