TECHNICAL FIELD

1 0011 This disclosure is directed to an oxygen-enabled solution for use in mammals including humans and animals.

BACKGROUND

[0002] When blood is lost, the chief immediate need is to cease further blood loss followed by replacing the lost blood volume. This critical need is important for allowing the remaining red blood cells to oxygenate body tissue albeit at a reduced capacity. When the body detects the lower hemoglobin levels, from extreme blood loss, compensatory mechanisms begin. There are currently no resuscitative fluids that provide oxygen to hypoxic cells and tissues following major blood loss.

[0003] Oxygen therapeutics have traditionally been categorized as either hemoglobin- based oxygen carriers (HBOCs) or perfluorocarbons (PFCs). Unlike blood, HBOCs and PFCs do not require blood typing, have a long shelf life, do not transmit blood borne diseases, and in most cases do not need refrigeration. Despite these promising attributes the wide-spread utility of HBOCs and PFCs has been limited by concerns regarding hypertension from systemic arteriola constriction and leukocyte activation, respectively.

SUMMARY

(0004] An oxygen enabled solution configured to release oxygen gas molecules to a mammal including a human individual and an animal. The oxygen enabled solution comprises a therapeutically effective amount of a poly-oxygenated metal hydroxide comprising a clathrate compound containing free O2 gas molecules in a fluid, configured as a colloid or a crystalline solution. The oxygen enabled solution is configured to oxygenate the interstitial tissue of a mammal, such as a mammal having depleted PISF O2 suffering from severe blood loss and/or experiencing hemorrhagic shock. The oxygen enabled fluid may be intravenously administered to the mammal. The oxygen enabled solution is may be a blood additive.

[0005] In some embodiments, the poly-oxygenated metal hydroxide is an aluminum poly-oxygenated hydroxide, such as 0x66™, The poly-oxygenated metal hydroxide particles may have a diameter of less than or equal to 100 um, and specifically having a diameter of less than or equal to 10 nm. The oxygen enable solution is a 75-90% colloid or crystalline solution with 10-25% addition of poly-oxygenated metal hydroxide particles. The poly-oxygenated metal hydroxide may have a concentration range of O.lmg/1 to l OOOmg/L The poly-oxygenated metal hydroxide may have particles that are surface modified and may be PEGylated.

[0006] The condition is a depletion of hemoglobin in the mammal, wherein the poly- oxygenated metal hydroxide acts as an oxygen resuscitative fluid.

BRIEF DESCRIPTION OF THE DRAWINGS

[00071 Figure 1 illustrates a method of intravenously administering a mammal a therapeutically effective amount of a poly-oxygenated metal hydroxide comprising a clathrate compound having free 0 ₂ gas molecules in accordance with this disclosure;

[0008] Figures 2A-2D are diagrams illustrating systemic characteristics of 50% isovolemic hemodilution, including hematocrit, heart rate, mean arterial pressure, and pulse pressure. Measurements were taken immediately prior to (BL) and following (HD tO) hemodilution;

[0009] Figure 3A shows interstitial tissue oxygenation (PESF 0 ₂ ) following 50% volume replacement using 0x66™ in a crystalloid. All Pisi 0 ₂ values (mmHg) were normalized to baseline (BL) for ease of comparison;

[0010] Figure 3B shows interstitial tissue oxygenation (PISF 0 ₂ ) following 50% volume replacement using 0x66™ in a crystalloid, using particles smaller than those in Figure 3B, and further shows interstitial tissue oxygenation using PEGylated 0x66™ particles in a colloid;

[0011] Figure 3C shows survival results of specimens after undergoing hemorrhagic shock following resuscitation using PEGylated 0x66™ particles in a colloid, including complete survival of one specimen;

[0012] Figures 4A and 4B sho systemic parameters including heart rate and mean arterial pressure following isovolemic hemodilution with test solutions;

[0013] Figure 5 shows arteriolar luminal diameters. Arterioles included were smaller than 60 microns at baseline;

[0014] Figure 6 shows the proliferation of hepatocarcinoma cells (HEPG-2) significantly reduced following administration with various concentrations of 0x66™; and

{0015] Figure 7A and Figure 7B illustrate images of cells HEPG-2 cells prior to dosing and after dosing, respectively. DESCRIPTION OF EXEMPLARY EMBODIMENTS

[0016] The following description of exemplary embodiments provides information that enables a person, skilled in the art to make and use the subject matter set forth in the appended claims, but may omit certain details already well-known in the art. The following detailed description is, therefore, to be taken as illustrative and not limiting.

[0017] The example embodiments may also be described herein with reference to spatial relationships between various elements or to the spatial orientation of various elements depicted in the attached drawings. In general, such relationships or orientation assume a frame of reference consistent with or relative to a patient in a position to receive treatment. However, as should be recognized by those skilled in the art, this frame of reference is merely a descriptive expedient rather than a strict prescription.

[0018] Despite what is known from physiological principles, there is no practice-based evidence to suggest colloid solutions offer substantive advantages over crystalloid solutions with respect to hemodynamic effects. In addition, there is no evidence to recommend the use of other semisynthetic colloid solutions. Balanced salt solutions are reasonable initial resuscitation fluids, although there is limited practice-based evidence regarding their safety and efficacy. Additionally, the safety of hypertonic solutions has not been established. Ultimately, the selection of the specific resuscitative fluid should be based on indications, contraindications, and potential toxic effects in order to maximize efficacy and minimize toxicity. In addition, the capability of a resuscitative fluid to carry oxygen, as well as to maximize efficacy and minimize toxicity, is desperately needed.

[0019] According to this disclosure, there is a significant therapeutic benefit to intravenously oxygenate blood of a human individual and animal, collectively mammals, and create a more effective resuscitative fluid using a poly-oxygenated metal hydroxide comprising a clathrate compound containing free (¾ gas molecules., and particularly a poly-oxygenated aluminum hydroxide, such as 0x66™ manufactured by Hemotek, LLC of Piano, Texas. 0x66™ is an oxygen gas carrying powder that contain about 66% oxygen, and includes a true clathrate that is a lattice-like structure that provides large areas capturing and holding oxygen gas (02( )) molecules. The Ox66™ poly-oxygenated aluminum hydroxide has a molecular formula AI12H42O36, and oxygen gas molecules are bioavailable to, and used by the body, because the oxygen gas molecules are not bound in the hydroxide complex. 0x66™ exists under STP (standard temperature and pressure) as a clathrate. A clathrate is a chemical substance consisting of a lattice that traps or contains molecules. The molecules trapped or contained within the 0x66™ clathrate are oxygen gas (02(g)). The molecular formula of 0x66™ is AI12H 2O36, which mathematically reduced is Α1(ΟΗ) ₃ ·ό0 ₂ . The 6 free oxygen gas molecules ( 2(g)) are separate from the oxygen molecules covalently bound in the hydroxide complex.

[0020 j This disclosure significantly increases tissue oxygenation of the mammal, known as oxygen tension PO2. In certain applications of 0x66™, the PO2 levels of a hemo-diluted mammal can exceed baseline. Fluid resuscitation with colloid and crystalloid solutions is a global intervention in acute medicine, and while the selection and ultimate use of resuscitation fluids is based on physiological principles, clinician preference determines clinical use. Studies have shown that 0x66™ does not create any negative effects in toxicology studies where 0x66™ was either injected or gavaged in a mammal.

[0021] With enough blood loss, like in amputations and other military trauma situations, red blood cell levels drop too low for adequate PO2 tissue oxygenation, even if volume expanders maintain circulatory volume they do not deliver oxygen. In these situations, the only cuixently available alternatives are blood transfusions, packed red blood cells, or a novel oxygen-enabled resuseitative fluid according to this disclosure.

[0022] This disclosure provides a novel oxygen- enabled blood additive, also referred to as a resuseitative fluid, that can effectively oxygenate mammal tissues and provide essential elements to protect and save critical cells and tissues, and the mammal itself. This disclosure is desperately needed on the battlefield, as well as in civilian trauma cases. One exemplary formulation consists of a fluid of 75-90% colloid or crystalline solutions with 10-25% addition of a poly-oxygenated metal hydroxide material, such as but not limited to, nano-sized 0x66™ panicles, resulting in concertaiion ranges of 0.1mg/'l to lOOOmg/L For use as a blood additive, ideal sizes of the Ox66™ particles may be between 10 nm to 100 μιη in size, depending on the treatment. To avoid immune suppression, it is critical in some treatments that the diameter of the 0x66™ particles should ideally be less than 100 nm, and preferably less than 70 nm as these particle sizes have been proven to maximize efficacy and minimize toxicity. [0023] The blood additive compositions can include surface modifications of nano-sized poly-oxygenated metal hydroxide particles with polyethylene glycol (PEG) for increased vascular transit, protein for increased surface to volume ration, or specific charge to enhance absorption and sustained P0 ₂ . These modifications of the poly-oxygenated metal hydroxide material as a blood additive extend the oxygenating capabilities of the material for longer periods of time, thus extending product life, such as specifically in far- forward combat theatres.

[0024] This blood additive composition is extremely significant because the blood additive is agnostic to the blood type of a mammal, meaning that the blood additive can be administered to a human individual without typing the human individual's blood. Thus, even individual's with rare blood types can be effectively treated with the same blood additive. There is no time delay as the blood additive can be immediately administered to an individual in a crisis situation. Further, the blood additive has significant shelf life and can be stored at room temperature in locations where administration of the blood additive can be performed in emergency situations, such as in the battlefield to extend a soldier's life until the soldier can be transported to a quality hospital, or in an ambulance or fire truck. Stabilizing a human individual for hours or even minutes can save a human individual's life.

[0025] As shown in Figure 1, this exemplary embodiment comprises a method 10 of intravenously administering a mammal a therapeutic amount of a composition including a poly- oxygenated metal hydroxide, such as a human individual, or an animal. The poly-oxygenated metal hydroxide composition may comprise a poly-oxygenated aluminum hydroxide, such as 0x66™ particles. One method includes administration of a therapeutically effective resuscitative fluid to increase tissue oxygenation PO2 in the mammal. Another method can include administration of a therapeutically effective composition to treat a condition of a mammal. The method comprises preparing a mammal at ste 12, such as preparing a site on the mammal for receiving a catheter, and intravenously administering a poly-oxygenated metal hydroxide composition at step 14, such as using a catheter. Various methods and treatments are detailed as follows. Study

[0026] A preclinical study was performed to ascertain the efficacy of a poly-oxygenated metal hydroxide in a mammal, comprising 0x66™ particles, and the details of the study and results are included. For this study, Particle Size A diameter is 100 um and Particle Size B diameter is 10 um.

[0027] In this study, male Sprague-Dawley rats underwent a 50% blood volume isovolemic hemodilution exchange with either 0x66™ or phosphate buffered saline (PBS; volume control), since 0x66™ was suspended in PBS, such as lactated Ringers solution (LRS). LRS is a crystalloid electrolyte sterile solution of specified amounts of calcium chloride, potassium chloride, sodium chloride, and sodium lactate in water for injection. LRS is typically is used intravenously to replace electrolytes. Isovolemic hemodilution is the reduction of red blood cells (hematocrit) .with an equal volume of hemodiluent, i.e., crystalloids, colloids or oxygen therapeutics.

-i -i

[0028] The withdrawal/infusion rate was 2.0 ml x min x kg and performed through a cannulated carotid artery and jugular vein. Systemic measurements were recorded via a carmulated femoral artery that was connected to a pressure transducer (MP 150; Biopae Systems, Inc, Goleta, CA), while microcirculatory parameters were collected through phosphorescence quenching and intravital microscopic examination of the exteriorized spinotrapezius muscle. Compared to baseline, a 50% blood volume exchange with either hemodiluent caused a reduction in heart rate, blood pressure, arterial diameter and interstitial fluid (ISF) oxygen tension (P0 ₂ > in all animals. However, 0x66™ animals demonstrated an improvement in ISF PO2 compared to PBS animals. This finding demonstrates that 0x66™ both transports and releases oxygen to the peripheral microcirculation.

[0029] Animals

^• Male Sprague Dawley rats (250 - 300 g)

Anesthetics

^• Isoflurane (induction)

^• Alfaxalone (continuous rate of infusion)

[0030] Surgical Preparation Vessels and tracheal cannulation

Spinotrapezius muscle exteriorized

[0031} Systemic Parameters

^• BIOPAC MP 150 (real-time analysis)

[0032] Tissue Oxygenation

^• Phosphorescence Quenching Microscopy

^• Palladium porphyrin (RO) probe distributed into interstitium.

^• Phosphorescence decay curve captured and fit to standard curve for translation to PISF 0 ₂ in mmHg.

[00331 Hemodilution (HD)

• Baseline parameters collected

• 50% isovolemic exchange of blood with test solution at 2.0 ml/kg/min

^• Post-HD parameters collected

^• Animals observed for 2 h post-HD

[0034] Hemodiluents

^• Phosphate Buffered Saline (PBS)

• 0x66™ Size A [ 1 x]

• Ox66™ Size A [1 Ox]

^• 0x66™ Size B [Ix]

^• 0x66™ Size B [IOx]

[0035] Figures 2A-2D show systemic characteristics of 50% isovolemic hemodilution (HD). Measurements were taken immediately prior to baseline (BL) and following hemodilution at (HD tO). The volume exchange of whole blood with PBS (vehicle volume control) resulted in significant reductions in hematocrit, mean arterial pressure, and pulse pressure. The reduction in heart rate lacked statistical strength. ** p < 0.01, *** p < 0.001,

[0036] Figure 3A shows tissue oxygenation (PISF 0 ₂ ) following 50% volume replacement. All P _I S _F ( values (mmHg) were normalized to baseline (BL,) for ease of comparison. PBS alone was used as a vehicle volume control. 0x66™ compounds were suspended in PBS as crystalloids, where particle size A was IO larger than particle size B and trended towards higher oxygen delivery. Both particle sizes were assessed at lx and IOx concentrations, but failed to show a concentration dependence of PISF O2 in this range. * p < 0.05 vs BL. Particle Size A diameter is 100 um and Particle Size B diameter is 10 urn. [0037] Figure 3B shows tissue oxygenation PISF O2) following 50% volume replacement. All PISF O2 values (mmHg) were normalized to baseline (BL) for ease of comparison. PBS alone was used as a vehicle volume control. Figure 3B shows 0x66™ particles diameters being smaller than those shown in Figure 3A that were suspended in PBS as crystalloids, having sizes of 300nm, lOOOnm (1 ura), 2500 ^' nm (2.5 um), and 4800 nm (4.8 urn), compared to the PBS alone. Compared to the results shown in Figure 3A, 0x66™ particles having a diameter of around 10 um suspended in PBS as a crystalloid appear to achieve a superior increase in SSF O2 values (mmHg).

[0038] Figure 3B also shows 0x66™ particles suspended in a Colloid that results in vastly improved 1¾F < values (mmHg) compared to PBS alone, and also compared PBS including 0x66™ particles as a crystalloid having reduced size particles, as shown. This is due in part to the blood additive composition including surface modifications of the nano-sized poly- oxygenated metal hydroxide particles with polyethylene glycol (PEG) for increased vascular transit, protein for increased surface to volume ration, and/or specific charge to enhance absorption and sustained ΡΟ2 The PEGylation particles have a spherical shape that makes them more slippery which results in better capillary transit and less irritation of the capillaries. The PEGylation also serves as an aggregate inhibitor. These modifications of the poly-oxygenated metal hydroxide material as a blood additive provides increased concentration control and extends the oxygenating capabilities of the material for longer periods of time, thus extending product life, such as specifically in far-forward combat theatres,

[0039] Figure 3C shows the results of resuscitation of five male Spraguc-Dawlcy rat specimens after hemorrhagic shock. As shown, two specimens underwent resuscitation with a Colloid including 2.4 um 0x66™ PEGylation particles, and each specimen survived 1 hour after hemorrhagic shock. This is significant as death would have occurred within 10 minutes of hemorrhagic shock.

[0040] Even more significant, one of the three specimens that underwent resuscitation with a Colloid including 4.8 um Ox66™ PEGylation particles showed a significant immediate increase in PISF O2, and survived 8 hours after hemorrhagic shock, when the monitoring was completed and the specimen conti ued to survive, a complete survival. A second specimen showed a significant immediate increase in PISF O2 and survived 3 hours. The third specimen also survived an addition 3 hours. This significant survival of all five specimens after hemorrhagic shock by resuscitating each with a Colloid including 0x66™ PEGylation particles is remarkable. Advantageously, survival from hemorrhagic shock without using a blood product is extremely encouraging, as the Colloid does not require blood typing. When used on individuals on the battlefield, this survival time i significant and allows transport of an individual that undergoes hemorrhagic shock to a treatment facility.

[0041] Figure 4A and 4B shows systemic parameters following isovolemic hemodilution with test solutions. I ID = Hemodilution; tn = time point in minutes following hemodilution. As shown in Figure 4A, heart rates generally followed the scheme of slowing down by HD tO and then returning to baseline by t60. As shown in Figure 4B, mean arterial pressure remained low, but stable following hemodilution with the exception of Size A at lOx concentration. Statistical tests were not performed due to low sample sizes N-2-4).

[0042] Figure 5 shows arteriolar luminal diameters. Arterioles included w ^T ere smaller than 60 microns at baseline.

Summary

[0043] The '50% Isovolemic Hemodiltuion' model produces a good reduction in systemic cardiovascular parameters and tissue oxygenation to assess therapeutic potential of interventions.

[0044] 0x66™ is capable of carrying and delivering oxygen to hypoxic peripheral tissues.

Administering Surface Modified Ox66™ Particles

[0045] In an exemplary embodiment, the administered Ox66™ particles may be surface modified for specific therapeutic uses such as time release, PEGylation, growth factor modification, antibacterial, antimicrobial, protein modification, and enzymes. Treatment of Traumatic Brain Injury (TBI), Strokes, and CTE

[0046] To achieve microcirculation in mammals, such as to treat TBI and strokes, the 0x66™ particles preferably have a diameter of less than 10 nm to pass the blood brain barrier (BBB). The upper limit of pore size enabling passive flow across the BBB is usually <1 nm; however, particles having a diameter of several nanometers can also cross the BBB via carrier- mediated transport using specialized transport proteins. Alternatively, receptor-mediated transport can act as an "escort" for larger particles. This exemplary embodiment comprising intravenously administering a therapeutic amount of a composition including 0x66™ particles having a diameter of less than 10 nm is therapeutically effective in treating a mammal with TBI and BBB. This is an extraordinary accomplishment, and can revolutionize the treatment of not only TBI and BBB, but also other brain conditions/injury including Chronic Traumatic Encephalopathy (CTE), which is a progressive degenerative disease of the brain found in athletes, military veterans, and others with a history of repetitive brain trauma.

Treatment of Diabetes

[0047] To achieve microcirculation in mammals to treat Diabetes, this exemplary embodiment comprises intravenously administering to a mammal a therapeutic amount of a composition including 0x66™ particles as a fluid that is therapeutically effective to increase P0 ₂ in the mammal, such as a human individual, or an animal, to reduce the effects of Diabetes.

Treatment of Cancer

[0048] To treat cancer in mammals, this exemplary embodiment comprises intravenously administering to a mammal a therapeutic amount of a composition including 0x66™ particles as a fluid that is therapeutically effective to reduce the effects of, or eliminate, cancer cells in the mammal, such as a human individual, or an animal. STUDY

[0049] The proliferation of hepatoearcinoma cells (HEPG-2) was significantly reduced following administration with various concentrations of 0x66™, as shown in Figure 6.

[0050] Images shown in Figure 7A and Figure 7B illustrate cells HEPG-2 cells prior to dosing and after dosing, respectively- Erectile Dysfunction

[0051 J To achieve the treatment of erectile dysfunction in mammals, this exemplary embodiment comprises intravenously administering to a mammal a therapeutic amount of a composition including 0x66™ particles that is therapeutically effective to increase oxygenated blood flow thus mitigating physical dysfunction in the mammal, such as a human individual, or an animal, to reduce the effects of erectile dysfunction. In another embodiment, the 0x66™ particles could be embodied in a tablet or capsule form and administered orally.

Sickle Cell Anemia

[0052] To achieve the treatmen of sickle cell anemia in mammals, this exemplary embodiment comprises intravenously administering to a mammal a therapeutic amount of a composition including 0x66™ particles (~-Ό.07μιτι) that is therapeutically effective to increase oxygenated blood flow thus mitigating dysfunction in the mammal, such as a human individual, or an animal, to reduce the effects of sickle cell anemia. In another embodiment, the 0x66™ particles could be embodied in a tablet or capsule form and administered orally. In sickle cell anemia, the red blood cells become rigid and tacky and are shaped like sickles hence the name of the disease. These irregularly shaped "sickle" cells do not move through small blood vessels, resulting in slowing or blockage of blood flow and oxygen to parts of the body. This embodiment of 0x66™ particles could oxygenate the body in a crisis and act as an alleviation strategy for sickle cell anemia. Bronchopulmonary Dysplasia (BPD)

[0053] To treat bronchopulmonary dysplasia in mammals, this exemplary embodiment comprises intravenously administering to a mammal a therapeutic amount of a composition including 0x66™ particles as a fluid that is therapeutically effective to reduce the effects of, or eliminate, BPD in the mammal, such as a human individual, or an animal. A critical problem facing preterm infants is adequate lung function. Premature babies can have strokes, chronic lung disease and potential brain damage due to small, fragile blood vessels, and pressurized oxygen required after birth to keep the lungs functional. There is a need for an alternative oxygen therapy that mitigates the aforementioned risks. These preemies frequently encounter complications such as chronic lung disease - sometimes called bronchopulmonary dysplasia (BPD). BPD can occur because the infants still have some inflammation in their lungs and may require extra oxygen or medications to help them breathe comfortably. There are several hyper- oxygenated associated illnesses that a preterm infant will suffer such as retinopathy of prematurity (ROP), periventricular leukomalacia. cerebral palsy, and the previously mentioned bronchopulmonary dysplasia (BPD), to name a few. Administration of 0x66™ provides alternative oxygen delivered by less invasive means yet supplying oxygen to the preterm infant.

Alzheimer's Disease (AD)

[0054 J To treat Alzheimer's disease in mammals, this exemplary embodiment comprises intravenously administering to a mammal a therapeutic amount of a composition including Ox66™ particles as a fluid that is therapeutically effective to reduce the effects f, or eliminate. AD in the mammal, such as a human individual, or an animal. Alzheimer's disease (AD) is classified as a neurodegenerative disorder. The cause and progression of the disease are not well understood. AD is associated with hallmarks of plaques and tangles in the brain. Current treatments only help with the symptoms of the disease and there are no available treatments that stop or reverse the progression of the disease. As of 2012, more than 1,000 clinical trials have been or are being conducted to test various compounds in AD. There is currently no approved drug therapy for AD that will stop or reverse the progression of the disease. There is a clear link between low oxygen levels in the brain and Alzheimer's disease, but the exact mechanisms behind this are not yet fully understood (Alzheimer's Society, Proceedings of the National Academy of Sciences). A healthy brain needs a good supply of oxygen. A disruption of the blood flow through or to the brain causes low oxygen levels. When there is damage or a blockage, or the blood supply itself is low in oxygen then insufficient oxygen will be delivered to the brain cells. 0x66™ offers the potential of micrometer sized (~0.07pm) particles increasing oxygen delivery to the brain. With this offloading of oxygen, there is significant potential to mitigate the development and/or the progression of AD,

Autism

[0055] To treat autism in mammals, this exemplary embodiment comprises intravenously administering to a mammal a therapeutic amount of a composition including 0x66™ particles as a fluid that is therapeutically effective to reduce the effects of, or eliminate, autism in the mammal, such as a human individual, or an animal. Several problems that crop up during labor and shortly after birth appear to increase a child's risk for developing autism. A recent study published in the Journal of Pediatrics, a review of 40 studies published before April 2007, looked at a host of circumstances that may affect babies during labor and delivery. It found 16 circumstances that appear to be tied to a significantly increased risk that a child would develop autism later in life. Researchers note that many of these complications tend to occur together in difficult or high-risk deliveries, making it difficult to linger a single suspect. But broadly, researchers note, they seem to be related to oxygen deprivation and growth retardation.

[0056] The appended claims set forth novel and inventive aspects of the subject matter described above, but the claims may also encompass additional subject matter not specifically recited in detail. For example, certain features, elements, or aspects may be omitted from the claims if not necessary to distinguish the novel and inventive features from what is already known to a person having ordinary skill in the art. Features, elements, and aspects described herein may also be combined or replaced by alternative features serving the same, equivalent, or similar purpose without departing from the scope of the invention defined by the appended claims.