"Composition for use in treating retinal diseases" A composition is described herein, which comprises: astaxanthin, piperine, boswellic acids, coenzyme Q10, curcuminoids , lutein, zeaxanthin, saffron, copper and, optionally, resveratrol, bromelain, zinc, salicin and further antioxidants from natural sources. The present invention further relates to said composition for use in treating retinal diseases which are ischemic and/or degenerative in nature.

Background art

The retina is the innermost and most differentiated of the 3 tunics which form the wall of the eyeball, extending from the optic nerve to the pupil edge of the iris. It has the function of receiving the light stimuli and transform them into nerve signals which are transmitted up to the brain structures.

From the histological point of view, the retina is made up of two layers :

1. the retinal pigment epithelium or outer leaflet

2. the nervous layer or inner leaflet or retina properly said.

The retina consists of several cell layers and is divided into two areas: a central area, called macula, rich in cones, and a medium and peripheral area, where rod cells prevail. The vasculature of the eye is ensured by two structurally and functionally separate systems, the retinal system and the ciliary system. Injuries and illnesses which impair the normal structure or function of these pathways are among the leading causes of vision impairment and blindness. For example, diabetic retinopathy is the most common disease affecting the retinal vasculature, and l is the leading cause of sight loss among the working age population .

Astaxanthin is a carotenoid which can be extracted from various sources including the Haematococcus sp. , a green alga with high antioxidant power.

Piperine is an alkaloid present in Piper nigrum.

Boswellic acids are obtained from Boswellia serrata.

Bromelain is present in the extracts of Ananas comosus and includes two proteolytic enzymes.

Coenzyme Q10 is a powerful antioxidant.

Curcuminoids are present in the extract of Curcuma longa.

Lutein belongs to the group of xanthophylls, can be extracted from various sources including the flowers of Tagetes erecta.

Resveratrol is a polyphenol found in the skin of the grape and is successfully extracted from various sources, including the roots of Polygonum cuspidatum.

Salicin, found in plants of the Salicacae family, is a β- glucoside with anti-Cox activity.

Saffron is extracted from the stigmas of Crocus sativus .

Zeaxanthin is a carotenoid of the xanthophylls class which can be extracted from various sources, including the flowers of Tagetes erecta.

There is an unmet need for complementary treatment methods and compositions directed to retinal diseases. The present invention meets this need.

Description of the invention

A composition comprising natural extracts, carotenoids and minerals is described. Such a composition proved surprisingly capable of protecting the retina by promoting functional recovery in post-ischemic stress conditions.

Description of the drawings

Figure 1: Comparison of ERG recordings of wave a (A) and b (B) with respect to the Baseline at T3 and T7 in rats pretreated orally once daily through tube feeding with composition C according to the present invention or VHC (vehicle) for 5 days, lh before induction of IR and treated for the next 7 days. The data represent the average and the range of at least 4 animals per treatment group. *p<0.05; **p<0.01; ***p 0001; treatment vs. Baseline. §p<0.05 vs. VHC. One-way ANOVA followed by the post hoc test of Holm-Amshid .

Figure 2: Gene expression of TNFa in retinas of rats pretreated orally once daily through tube feeding with composition C according to the present invention or VHC (vehicle) for 5 days and lh before induction of IR and sacrificed 6h after the ischemic event. The data represent the mean ± SEM of Fold Changes with respect to the calibrator (CTRL NAIVE) . *p<0.05 vs. VHC. Unpaired t-test.

Detailed description of the invention

In one embodiment, the composition according to the present invention comprises: astaxanthin, piperine, boswellic acids, coenzyme Q10, curcuminoids , lutein, copper, saffron, zeaxanthin. In a further embodiment, the composition comprises also: resveratrol, bromelain, zinc, salicin.

In a further embodiment, said composition comprises further antioxidants from natural sources.

More preferably, said further natural antioxidants are polymeric anthocyanins derived from blackcurrant. In one embodiment, said composition comprises: 0.1 to 200 mg of concentrated extract from Haematococcus sp. containing no less than 2.0% astaxanthin, 0.01 to 15 mg dry extract, titered at 95% piperine obtained from fruits of Piper nigrum, 10 to 2000 mg of extract from gum resin of Boswellia serrata titered at 70% total boswellic acids and 20% beta boswellic acids, 0 to 500 mg of extract from stem and fruit of Ananas comosus containing bromelain equivalent to gelatin digesting units (GDU) of between 1 and 1000, 0.5 to 100 mg of coenzyme Q10, 1 to 500 mg dry extract from the root of Curcuma longa titered at 95% total curcuminoids , 0.1 to 250 mg extract from flowers of Tagetes erecta titered at 20% lutein, 0 to 500 mg dry extract from Ribes nigrum with an oxygen radical absorption capacity (ORAC) of no less than 2 mmol trolox equivalents per gram of extract, 0.25 to 0.75 mg of copper (from microencapsulated copper sulfate) , 0 to 150 mg of resveratrol purified from roots of Polygonum cuspidatum, 0 to 200 mg dry extract of bark of Salix alba titered at 25% salicin, 1 to 100 mg of dry extract from stigmas of Crocus sativus titered at 2% safranal, 0.1 to 30 mg of extract from flowers of Tagetes erecta titered at 5% zeaxanthin, 0 to 10 mg of zinc (from zinc oxide) . In a further embodiment, said composition comprises: 0.5 to 150 mg of concentrated extract from Haematococcus sp. containing no less than 2.0% astaxanthin, 0.1 to 10 mg dry extract, titered at 95% piperine obtained from fruits of Piper nigrum, 20 to 1500 mg of extract from gum resin of Boswellia serrata titered at 70% total boswellic acids and 20% beta boswellic acids, 2 to 400 mg of extract from stem and fruit of Ananas comosus containing bromelain equivalent to gelatin digesting units (GDU) of between 1 and 1000, 1 to 80 mg of coenzyme Q10, 5 to 400 mg dry extract from the root of Curcuma longa titered at 95% total curcuminoids , 0.1 to 200 mg extract from flowers of Tagetes erecta titered at 20% lutein, 0 to 250 mg dry extract from Ribes nigrum with an oxygen radical absorption capacity (ORAC) of no less than 2 mmol trolox equivalents per gram of extract, 0.25 to 0.75 mg of copper (from microencapsulated copper sulfate), 1.5 to 100 mg of resveratrol purified from roots of Polygonum cuspidatum, 10 to 150 mg dry extract of bark of Salix alba titered at 25% salicin, 2 to 50 mg of dry extract from stigmas of Crocus sativus titered at 2% safranal, 0.2 to 20 mg of extract from flowers of Tagetes erecta titered at 5% zeaxanthin, 2.5 to 7.5 mg of zinc (from zinc oxide) . In a further embodiment, said composition comprises: 1 to 100 mg of concentrated extract from Haematococcus sp. containing no less than 2.0% astaxanthin, 0.2 to 8 mg dry extract, titered at 95% piperine obtained from fruits of Piper nigrum, 25 to 1000 mg of extract from gum resin of Boswellia serrata titered at 70% total boswellic acids and 20% beta boswellic acids, 5 to 300 mg of extract from stem and fruit of Ananas comosus containing bromelain equivalent to gelatin digesting units (GDU) of between 8 and 480, 3 to 75 mg of coenzyme Q10, 10 to 250 mg dry extract from the root of Curcuma longa titered at 95% total curcuminoids, 1 to 150 mg extract from flowers of Tagetes erecta titered at 20% lutein, 0 to 125 mg dry extract from Ribes nigrum with an oxygen radical absorption capacity (ORAC) of no less than 2 mmol trolox equivalents per gram of extract, 0.3 to 0.75 mg of copper (from microencapsulated copper sulfate) , 3 to 75 mg of resveratrol purified from roots of Polygonum cuspidatum,. 30 to 100 mg dry extract of bark of Salix alba titered at 25% salicin, 4 to 40 mg of dry extract from stigmas of Crocus sativus titered at 2% safranal, 0.5 to 18 mg of extract from flowers of Tagetes erecta titered at 5% zeaxanthin, 3 to 7.5 mg of zinc (from zinc oxide) . In a further embodiment, said composition comprises: 1 to 80 mg of concentrated extract from Haematococcus sp. containing no less than 2.0% astaxanthin, 0.5 to 5 mg dry extract, titered at 95% piperine obtained from fruits of Piper nigrum, 40 to 800 mg of extract from gum resin of Boswellia serrata titered at 70% total boswellic acids and 20% beta boswellic acids, 10 to 250 mg of extract from stem and fruit of Ananas comosus containing bromelain equivalent to gelatin digesting units (GDU) of between 8 and 480, 3.5 to 50 mg of coenzyme Q10, 15 to 200 mg dry extract from the root of Curcuma longa titered at 95% total curcuminoids , 3 to 100 mg extract from flowers of Tagetes erecta titered at 20% lutein, 16 to 100 mg dry extract from Ribes nigrum with an oxygen radical absorption capacity (ORAC) of no less than 2 mmol trolox equivalents per gram of extract, 0.35 to 0.65 mg of copper (from microencapsulated copper sulfate) , 6 to 50 mg of resveratrol purified from roots of Polygonum cuspidatum, 35 to 95 mg dry extract of bark of Salix alba titered at 25% salicin, 5 to 25 mg of dry extract from stigmas of Crocus sativus titered at 2% safranal, 1 to 17 mg of extract from flowers of Tagetes erecta titered at 5% zeaxanthin, 3 to 7 mg of zinc (from zinc oxide) . In a further embodiment, said composition comprises: 5 to 50 mg of concentrated extract from Haematococcus sp. containing no less than 2.0% astaxanthin, 0.75 to 4 mg dry extract, titered at 95% piperine obtained from fruits of Piper nigrum, 50 to 600 mg of extract from gum resin of Boswellia serrata titered at 70% total boswellic acids and 20% beta boswellic acids, 20 to 200 mg of extract from stem and fruit of Ananas comosus containing bromelain equivalent to gelatin digesting units (GDU) of between 15 and 370,

3 to 25 mg of coenzyme Q10, 30 to 100 mg dry extract from the root of Curcuma longa titered at 95% total curcuminoids , 10 to 50 mg extract from flowers of Tagetes erecta titered at 20% lutein, 20 to 60 mg dry extract from Ribes nigrum with an oxygen radical absorption capacity (ORAC) of no less than 2 mmol trolox equivalents per gram of extract, 0.35 to 0.65 mg of copper (from microencapsulated copper sulfate) , 8 to 25 mg of resveratrol purified from roots of Polygonum cuspidatum, 35 to 95 mg dry extract of bark of Salix alba titered at 25% salicin, 6 to 20 mg of dry extract from stigmas of Crocus sativus titered at 2% safranal, 2 to 15 mg of extract from flowers of Tagetes erecta titered at 5% zeaxanthin, 4 to 7 mg of zinc (from zinc oxide) .

In a further embodiment, said composition comprises: 10 to 30 mg of concentrated extract from Haematococcus sp. containing no less than 2.0% astaxanthin, 1 to 3 mg dry extract, titered at 95% piperine obtained from fruits of Piper nigrum, 60 to 200 mg of extract from gum resin of Boswellia serrata titered at 70% total boswellic acids and 20% beta boswellic acids, 30 to 100 mg of extract from stem and fruit of Ananas comosus containing bromelain equivalent to gelatin digesting units (GDU) of between 50 and 200,

4 to 12 mg of coenzyme Q10, 30 to 70 mg dry extract from the root of Curcuma longa titered at 95% total curcuminoids, 15 to 35 mg extract from flowers of Tagetes erecta titered at 20% lutein, 20 to 40 mg dry extract from Ribes nigrum with an oxygen radical absorption capacity (ORAC) of no less than 2 mmol trolox equivalents per gram of extract, 0.4 to 0.6 mg of copper (from microencapsulated copper sulfate) , 10 to 20 mg of resveratrol purified from roots of Polygonum cuspidatum, 40 to 90 mg dry extract of bark of Salix alba titered at 25% salicin, 7 to 15 mg of dry extract from stigmas of Crocus sativus titered at 2% safranal, 5 to 15 mg of extract from flowers of Tagetes erecta titered at 5% zeaxanthin, 5 to 7 mg of zinc (from zinc oxide) .

The composition according to the present invention has proved surprisingly effective in inhibiting the expression of TNFa and promote the retinal functional recovery in an experimental model in vivo .

This activity is specifically obtained with the composition of the present invention. The different components, when tested individually, are not able to give the effect obtained with the composition, demonstrating a clear synergistic effect between the tested components.

The composition according to the present invention comprises natural extracts and provides a valuable complement in the treatment of retinal diseases.

The present invention further relates to an oral formulation combining a composition according to the present invention, as described in claims 1 to 6, with pharmaceutically acceptable excipients known in the art. These excipients allow the compositions of the invention to be formulated as powders, tablets, pills, capsules, liquids, gels, syrups, semiliquid mixtures, suspensions and the like for oral ingestion by an individual. The pharmaceutical preparations for oral use can be obtained as a solid excipient, optionally by grinding a resulting mixture, and processing the mixture of granules, after adding suitable adjuvants, if desired, to obtain tablets or pill cores. In particular, suitable excipients are fillers such as sugars, including lactose or sucrose; cellulose preparations such as maize starch, wheat starch, rice starch, potato starch, gelatin, tragacanth, methylcellulose, hydroxypropyl methylcellulose, sodium carboxymethylcellulose, and/or polyvinylpyrrolidone (PVP) ; and various flavoring agents known in the art, such as cocoa. If desired, disintegrating agents may be added, such as cross-linked polyvinylpyrrolidone, agar, or alginic acid or a salt thereof, such as sodium alginate. Said formulations may be administered in the form of a chewable tablet or of a tablet which disintegrates in the mouth, liquid, powder, powder contained in a sachet, pills, soft gelatin capsule, or hard gelatin capsule. In some embodiments, the compositions of the invention are provided as pharmaceutical compositions as in the form of liquid compositions. Suitable liquid excipients are known in the art; see, for example, Remington's Pharmaceutical Sciences.

A method is also described which is an adjuvant in the treatment of retinal diseases including the administration, to a person who is in need thereof, of the composition according to the present invention, as described in claims 1 to 6. Said composition is administered in a dosage of between 50 mg to 5 g/day, preferably between 100 mg and 2.5 g/day, or between 200 mg and 1.5 g/day, even more preferably between 300 mg and 800 mg/day.

Examples

Example 1: Compositions. Compositions according to the present invention were prepared as follows .

Composition A

20 mg of concentrated extract from Haematococcus sp. containing no less than 2.0% astaxanthin

2.5 mg dry extract, titered at 95% piperine obtained from fruits of Piper nigrum

100 mg of extract from gum resin of Boswellia serrata titered at 70% total boswellic acids and 20% beta boswellic acids

5 mg of coenzyme Q10

50 mg dry extract from the root of Curcuma longa titered at 95% total curcuminoids

25 mg extract from flowers of Tagetes erecta titered at 20% lutein 0.5 mg of copper (from microencapsulated copper sulfate)

10 mg dry extract from stigmas of Crocus sativus titered at 2% safranal

10 mg extract from flowers of Tagetes erecta titered at 5% zeaxanthin

Composition B

20 mg of concentrated extract from Haematococcus sp. containing no less than 2.0% astaxanthin

2.5 mg dry extract, titered at 95% piperine obtained from fruits of Piper nigrum

100 mg of extract from gum resin of Boswellia serrata titered at 70% total boswellic acids and 20% beta boswellic acids

81 mg extract from stem and fruit of Ananas comosus containing bromelain equivalent to gelatin digesting units (GDU) between 1 and 1000 5 mg of coenzyme Q10

50 mg dry extract from the root of Curcuma longa titered at 95% total curcuminoids

25 mg extract from flowers of Tagetes erecta titered at 20% lutein 0.5 mg of copper (from microencapsulated copper sulfate)

15 mg of resveratrol purified from roots of Polygonum cuspidatum 75 mg dry extract of bark of Salix alba titered at 25% salicin 10 mg dry extract from stigmas of Crocus sativus titered at 2% safranal

10 mg extract from flowers of Tagetes erecta titered at 5% zeaxanthin

6.25 mg of zinc (from zinc oxide) .

Composition C

20 mg of concentrated extract from Haematococcus sp. containing no less than 2.0% astaxanthin

2.5 mg dry extract, titered at 95% piperine obtained from fruits of Piper nigrum

100 mg of extract from gum resin of Boswellia serrata titered at 70% total boswellic acids and 20% beta boswellic acids

81 mg extract from stem and fruit of Ananas comosus containing bromelain equivalent to gelatin digesting units (GDU) between 1 and 1000

5 mg of coenzyme Q10

50 mg dry extract from the root of Curcuma longa titered at 95% total curcuminoids

25 mg extract from flowers of Tagetes erecta titered at 20% lutein

0.5 mg of copper (from microencapsulated copper sulfate)

15 mg of resveratrol purified from roots of Polygonum cuspidatum 75 mg dry extract of bark of Salix alba titered at 25% salicin 10 mg dry extract from stigmas of Crocus sativus titered at 2% safranal

10 mg extract from flowers of Tagetes erecta titered at 5% zeaxanthin

6.25 mg of zinc (from zinc oxide) .

30 mg dry extract from Ribes nigrum with an oxygen radical absorption capacity (ORAC) of no less than 2 mmol trolox equivalents per gram of extract.

Example 2 : retinal ischemia-reperfusion injury model in the rat. A model of retinal ischemia-reperfusion (IR) in rats was used, which is widely used in the prior art as a model of acute hypertension-induced retinal degeneration. Adult male Brown-Norway rats weighing about 200 g were pretreated orally once daily through tube feeding with composition C of example 1 (30 mg/day) or vehicle (HCV; Nutilis, 4.25%) . A pre-treatment was made for 5 days, a further treatment was made about an hour before induction of IR and the treatment was continued for the next 7 days. After five days of pretreatment , the animals were anesthetized intraperitoneally with a Zoletil (420 μ/Kg) and Atila (37 μΙ/Kg) solution and following mydriasis induced by instillation of 0.5% tropicamide, IR was induced by the insertion of a 30 gauge needle connected to a container of saline into the anterior chamber of the eye. The reserve of saline solution was placed at a height from the operating table such as to ensure hydrostatic pressure of about 130 mmHg at the needle. The intraocular pressure rise to levels which induce ischemia was confirmed by the "whitening" of the fundus. After 60 minutes, the needle was removed to allow the restoration of the retinal blood flow. In order to assess the damage induced by IR, analysis were conducted to highlight any variations in the retinal cell function by electroretinogram

(ERG) , using a Ganzfeld electroretinograph of Phoenix Research Laboratories. The electroretinogram was recorded in animals adapted to darkness for at least 12h and following anesthesia and mydriasis, two electrodes were inserted in cranial and caudal position, respectively, and the third at the Ganzfeld chamber. The ERG was recorded as the mean of ten green light flashes emitted for 1 millisecond (ms) at an intensity of 80 candles per second per square meter (cd-s/m ² ) . The recording and analysis of the ERG conducted using the LabScribe software were performed before induction (Baseline), at 3 (T3) and 7 (T7) days after IR. In order to assess the retinal function, the amplitude of wave a

(functionality of cone and rod photoreceptors) and wave b (Miiller cell and bipolar cell functionality) were taken into account. In the experiments conducted, a statistically significant reduction was observed in the amplitude of wave a (Figure 1A) and b (Figure IB) in animals treated with VHC or Composition C at 3 days with respect to the Baseline, confirming the onset of the functional damage caused by the ischemic event. In contrast, 7 days after the induction of IR, the statistically significant reduction of the amplitude of wave a and wave b in VHC with respect to the Baseline is retained, but the significance is lost in animals treated with Composition C, indicating that the treatment is able to restore the retinal function to values comparable to the Baseline (Figure 1A and B, light circle) . A significant improvement of the retinal function of both waves a and b was also noted in the animals treated with Composition C with respect to those treated with vehicle at T7 after the induction of IR.

With the objective of evaluating a possible effect of the composition according to the present invention on the gene expression of TNFa, adult male Brown-Norway rats weighing about 200 g were treated once daily orally during the five days before and lh before the induction of retinal IR with VHC (Nutilis, 4.25%) or with Composition C (30 mg/day) . 6h after the ischemic event, the animals were sacrificed and the retinas taken and preserved in 50 μΐ of RNA later. The retina samples were subjected to RNA extraction using TRIzol. β-actin was used as endogenous control and the average ACt of naive controls (CTRL NAIVE) was used as a calibrator. The results obtained by Real Time RT-PCR show that the treatment with Composition C can significantly reduce the retinal TNFa expression level with respect to HCV, thus showing a surprising natural anti-ischemic and antiedema effect (Figure 2) of the composition according to the present invention.