PARASITICIDAL COMPOSITION
The invention relates to a parasiticidal composition and in particular to a composition for controlling headlice infestation in humans.
Lice infestation in man is generally caused by insects from the families Pediculidae and Pthiridae, in particular Pedicuhis humanus species and Pthirus pubis.
The control of parasite infestations such as headlice has recently been managed by mosaic policies, with insecticides from the groups consisting DDT, cyclodienes, organophosphates, carbamates and pyrethroids.
To ensure the availability of a diversity of insecticidal treatments there is a continuing requirement for novel insecticides to ensure suitable mosaic policies are maintained.
It is an object of the present invention to seek to provide an alternative novel insecticide for the treatment of headlice.
The azole antifungal agents have five-membered organic rings that contain either two or three nitrogen molecules (the imidazoles and the triazoles respectively). Two types of antifungal affect the cell membrane-polyenes and imidazoles.
The clinically useful imidazoles are clotrimazole, miconazole, and ketoconazole, two important triazoles are itraconazole and fluconazole.
In general, the azole antifungal agents are thought to inhibit cytochrome P 50- dependent enzymes involved in the biosynthesis of cell membranes, kitoconazole was the original model for the orally administered antifungal azoles. It can be administered both orally and topically and has a range of activity including infections. It is also active against mucosal candidiasis and a variety of cutaneous mycoses, including dermatophyte infections, pityriasis versicolor, and cutaneous candidiasis.
The triazoles (fluconazole, itraconazole) have become the standard for the azoles, and have replaced amphotericin B for managing certain forms of the systemic mycoses.
The compounds work by binding to sterols in the cell membrane. The principal sterol in fungal cell membranes is ergosterol, while the principal sterol in mammalian cell membranes is cholesterol. Polyenes have a stronger affinity for ergosterol than cholesterol, so they show greater activity against fungal cells than mammalian cells. The binding forms channels of about 0.8nm in diameter, which in turn allows leakage of up to 90% of cellular potassium ions (K+). This is followed by a loss of magnesium ions (Mg++). The loss of K+ ions inhibits a variety of metabolic processes, including glycolysis and respiration.
Imidazoles bind to the fungal cytochrome P-45o. This inhibits production of ergosterol synthesis or its incorporation into the cell membrane. This interferes with the membrane function and permeability. This means many components, including K+, leak out of the cell. Examples include ketoconazole, miconazole, econazole, fluconazole, clotrimazole, and intraconazole.
According to the present invention there is provided a parasiticidal composition comprising an imidazole and/or a triazole and a physiologically acceptable carrier.
It is preferred that the imidazole is selected from one or more of the group consisting of clotrimazole, ketoconazole, and miconazole and that the triazole is selected from fluconazole and itraconazole.
It is preferred that the composition is adapted for topical application to a subject. It is particularly preferred that the composition is adapted for application as a lotion or mousse for the hair.
The composition may further comprise alcohol, such as isopropanol and/or ethanol, and the physiologically acceptable carrier may comprise the alcohol.
The composition may comprise at least about 0.2% v/v imidazole and/or triazole.
The composition may further comprise a constituent having ovicidal activity. The ovicidal agent may comprise a terpene, preferably one or both of d- limonene and geranyl acetate.
It is preferred that the composition is for use in the treatment and/or prevention of human infestation by parasites from the families Pediculidae and Pthiridae.
According to a further aspect of the invention there is provided a process for preparing a parasiticidal composition, which comprises bringing an imidazole and/or a triazole into association with at least one carrier therefor.
According to a yet further aspect of the invention there is provided the use of an imidazole and/or a triazole in the manufacture of a composition for use in controlling parasite infestations in humans, in particular infestation by parasites from the families Pediculidae and Pthiridae.
The invention will further be described by way of illustration by reference to the following experiments.
Method of Testing the Pediculicidal Activity of a Composition.
Samples of clotrimazole, miconazole and ketocanazole were used. In preparation for use the stock chemicals were diluted to the appropriate level using 60% propan-2-ol (isopropyl alcohol, isopropanol) diluted with 40% distilled water.
Solutions of the clotrimazole, miconazole and ketoconazole were made on a weight for weight basis (w/w) in the alcohol vehicle.
Measurement of Pediculicidal Activity by Immersion.
Human lice, pediculus humanus, were obtained from the culture colony maintained by the Medical Entomology Centre. Adult female and male lice, in approximately equal numbers, were used for each test. The lice were fed on the morning of the test and allowed a minimum of 4 hours to recover, during which time they were able to excrete excess water imbibed with their blood meal. Lice were counted into batches that were provided with squares of an
open meshed nylon gauze (tulle), as a substrate upon which to stand, and each batch allocated to a marked 30 millimetre plastic Petri dish.
For the test procedure an aliquot of approximately 5 millilitres of the imidazole solution was poured into the base of a clean 30 millimetre plastic Petri dish.
The gauze bearing lice was immersed in the fluid for 10 seconds, during which time the gauze was turned at least twice to ensure removal of air bubbles. After removal from the fluid the gauze and insects were lightly blotted to remove excess fluid and returned to their marked Petri dish. The same procedure was repeated for the other replicate gauze squares in that batch.
Gauze squares bearing lice were incubated under normal maintenance conditions (30° ± 2° Celsius and 50% ± 15% relative humidity) for the remainder of the test period. At the end of exposure period the insects and gauze were washed using a bland toiletry shampoo (Boots frequent wash shampoo) diluted one part shampoo with fourteen parts water (FWS 1:15) after which they were rinsed three times using 250 millilitres of warm (34° Celsius) tap water poured through and over the gauze squares. They were then blotted dry using medical wipe tissue and incubated under normal maintenance conditions in clean plastic Petri dishes of the appropriate size until the results were recorded.
For these tests lice were exposed for 2 hours.
A control comparison test was performed using the 60% propan-2-ol (isopropanol) solvent, which is routinely used in our laboratory and causes
minimum mortality to lice, in place of the imidazole solution. All other procedures for this comparator were the same as for the test groups.
The results of tests against lice were recorded after 24 hours.
Results
Activity of each imidazole against lice was effectively complete with 2.5% solutions. Dead lice showed signs of dehydration and most had burst guts so that they took on a dark red colour throughout the tissues.
Treatment Replicate Number of lice Mortality %
Total Killed Moribund
Clotrimazole 1 21 19 2 100 in lPA
Miconazole 1 20 17 3 100
Ketoconazole 1 21 4 4 60
Control 1 20 2 0 10.0
Mortality percentages were corrected by Abbott's formula. The percent of mortality in a control was subtracted from the percent mortality in the test and then divided by the percent mortality in the test.
The results indicate that imidazoles are very effective pediculicides.
The mode of action of the present invention is not fully understood, however, it is hypothesised that these actives work on the exoskeleton of the lice.
An insect's exoskeleton (integument) serves not only as a protective covering over the body, but also as a surface for muscle attachment, a water-tight barrier against desiccation, and a sensory interface with the environment.
The typical insect exoskeleton is a multi-layered structure with four functional regions, epicuticle, procuticle, epidermis, and basement membrane.
The epidermis is a single layer of epithelial cells. It is responsible for producing at least part of the basement membrane as well as all of the overlying layers of cuticle.
The procuticle lies immediately above the epidermis. It contains microfibers of chitin surrounded by a matrix of protein that varies in composition from insect to insect and even from place to place within the body of a single insect.
In some parts of the body, procuticle stratifies into a hard, outer exocuticle and a soft, inner endocuticle.
Differentiation of exocuticle involves a chemical process (called sclerotization) that occurs shortly after each molt. During sclerotization, individual protein molecules are linked together by quinone compounds. These reactions "solidify" the protein matrix, creating rigid "plates" of exoskeleton known as sclerites.
Quinone cross-linkages do not form in parts of the exoskeleton where resilin (an elastic protein) is present in high concentrations. These areas are membranes and they remain soft and flexible because they never develop a well-differentiated exocuticle.
The epicuticle is the outermost part of the cuticle. Its function is to reduce water loss and block the invasion of foreign matter. The innermost layer of epicuticle is often called the cuticulin layer, a stratum composed of lipoproteins and chains of fatty acids. A layer of wax molecules lies just above the cuticulin layer, it serves as a barrier to movement of water into or out of the insect's body. In many insects a cement layer covers the wax and protects it from abrasion.
It is proposed that imidazoles act as either sclerotisizers or they simply cause a diffusion gradient across the louse resulting in death. The results tend to indicate also that this effect may be enhanced by the use of an alcoholic vehicle.
Formulation
Using the results of these tests, formulations having parasiticidal activity were prepared as follows:
Lotion Formulation
Imidazole 1.0%
Water 30.0%
Isopropyl Alcohol to 100%
Mousse Formulation
Imidazole 1.0%
Polawax 4.0%
Crodamol DA 2.0%
Propylene Glycol 2.0%
Polysorbate 60 1.0%
Sodium Lauryl Sulphate 0.5%
Isopropyl Alcohol 5.0%
Water 79.5%
Butane 5.0%
Thus, formulations which can be prepared in accordance with this invention include lotions and mousses as well as, potentially, other hair treatments. The precise nature and qualities of additional constituents which are required will vary according to the desired properties of the final product. The skilled worker will be familiar with such constituents and their usage, which can include, for example, surfactants, silicone compounds, suspending agents colourings and perfumes.
To enhance the activity of the compositions according to the invention it has been found that further constituents having ovicidal activity can be added without adversely affecting their efficacy. These further constituents are terpenes and in particular, the teφenes d-limonene and geranyl acetate can be used, each at a concentration of from 0.2% v/v to 1.0% v/v.