Weight loss abstract
There is disclosed a pharmaceutical composition and method for
metabolic consumption of calories and weight loss. The pharmaceutical
composition is a culture of brown adipose cells, preferably encapsulated
in a porous growth matrix, and a semipermeable membrane encapsulating
the porous matrix wherein the semipermeable membrane has a molecular
weight cutoff of at least 10,000 daltons and, preferably, a lipoprotein
lipase embedded therein. Further disclosed is a pharmaceutical composition
for metabolizing fatty acids into carbon dioxide, water and heat
including a mammalian cell stably transfected with a DNA sequence
coding for a mammalian UCP polypeptide, wherein the transfected
mammalian cell transcribes and translates UCP polypeptide. Also
disclosed is a pharmaceutical composition for metabolizing fatty
acids into carbon dioxide, water and heat including a cDNA sequence
encoding a mammalian UCP sequence, wherein the cDNA sequence is
taken up into a hosts cell, in vivo, and is translated into UCP
polypeptide, causing uncoupling of oxidative metabolism. The present
invention provides a pharmaceutical composition for metabolizing
fatty acids into carbon dioxide, water and heat which includes a
culture of allogeneic brown fat cells, wherein the brown fat cells
are proliferated ex vivo.
Weight loss claims
I claim:
1. A pharmaceutical composition for reducing body fat content comprising
a culture of brown adipose cells encapsulated in a semipermeable
membrane, wherein the semipermeable membrane has a molecular weight
cutoff of at least 10,000 daltons.
2. The pharmaceutical composition of claim 1 wherein the semipermeable
membrane comprises a tubular membrane having two ends, filled with
the culture of brown adipose cells and sealed at both ends.
3. The pharmaceutical composition of claim 1 wherein the semipermeable
membrane is an acrylic copolymer.
4. The pharmaceutical coinposition of claim 1 wherein the semipermeable
membrane comprises a sealed bag.
5. The pharmaceutical composition of claim 1 wherein the culture
of brown fat cells is comprised a porous growth matrix.
6. The pharmaceutical composition of claim 5 wherein the porous
growth matrix comprises calcium alginate beads.
7. The pharmaceutical composition of claim 1 wherein the semipermeable
membrane comprises a lipoprotein lipase.
8. A method of oxidizing calories to reduce body fat content in
a patient in need thereof comprising parenterally administering
or implanting the pharmaceutical composition of claim 1.
9. The method of claim 8 wherein the route of administration of
the pharmaceutical composition is by subcutaneous injection, intramuscular
injection, intraperitoneal injection, intraportal implantation or
intraportal injection.
Weight loss description
TECHNICAL FIELD OF THE INVENTION
The present invention relates to a device, pharmaceutical composition,
therapeutic agent and therapeutic method for metabolic consumption
of calories leading to weight loss for a treated individual. The
pharmaceutical composition comprises brown fat tissue or cells transfected
with a cDNA encoding mitochondrial uncoupling protein.
BACKGROUND OF THE INVENTION
Weight loss methods and techniques have involved some form of reducing
caloric consumption or increasing exercise output to result in utilization
of fat stores (e.g., triglycerides) as an energy source. Reducing
consumption-type therapies have included various sympathomimetic
agents, such as amphetamines and derivatives to increase metabolic
rate while reducing the individuals appetite in an effort to reduce
caloric consumption.
Numerous attempts have been made, with varying degrees of success
and varying degrees of risk to the individual, to reduce body weights
of an individual through reduction of fat stores. One general problem
with most weight loss programs or therapies is that starving or
reducing caloric intake results in metabolism of both fat stores
and muscle mass as energy sources for body metabolism. Therefore,
one goal of weight loss therapies is to be able to reduce body fat
stores while not reducing muscle mass.
There are two types of mammalian fat cells, white fat cells and
brown fat cells. Brown fat cells are characterized by the presence
of numerous mitochondria that have unique metabolic capacity. Brown
fat mitochondria completely catabolize or oxidize fatty acids as
a fuel substrate without utilizing the energy source. More specifically,
brown fat mitochondria oxidize fatty acids into the metabolic products
carbon dioxide and water and heat (energy). Therefore there is a
net oxidation of fuel with no use or storage of energy produced
except in the form of heat (Cannon et al., Essays Biochem. 20:110,
1985).
The primary function of brown fat in mammals is to keep the mammal
warm. Mammals have varying amounts and location of brown fat. Infants
have larger areas of brown fat than adults.
Brown adipose tissue (BAT) is primarily concerned with maintenance
of homeothermy through non-shivering thermogenesis (Cannon et al.,
Essays Biochem. 20:110, 1985). BAT has a high degree of vascularity,
abundant mitochondria and high cytochrome concentrations in its
mitochondria. Humans have brown fat located primarily in the back
of the neck and subscapular regions. BAT is also located in the
thorax, around the pericardium and sinoatrial node, along the aorta,
around adrenal glands, and around sympathetic ganglia in the abdomen
(Smith et al., Physiol. Rev. 49:330, 1969). With increasing age
or obesity, brown fat becomes paler in color and more difficult
to distinguish from white adipose tissue. White adipose tissue normally
represents 15-25% of body weight and may reach up to 60% of body
weight in massive obesity. Generally, BAT usually comprises less
than 1% of total adult body weight.
Brown adipocytes (BA) contain multilocular lipid droplets and numerous
mitochondria. BAT contains an abundant capillary plexus supplied
by lobular arteries and drained by lobular veins. Further, BAT contains
direct arteriovenous anastomoses, similar to those seen in liver
(Nnodim et al., Am. J. Physiol. 182:283, 1988). BAT and blood vessels
supplying BAT are innervated by sympathetic nerves as the only innervation
from the autonomic nervous system (Cottle et al., Histochem. J.
17:1279, 1985).
White adipose tissue exports lipid to other tissues on demand.
BAT oxidizes both endogenous and exogenous fatty acids. Therefore,
BAT's physiologic role includes temperature regulation and possible
maintenance of energy balance. When BAT was surgically removed from
Osborne-Mendel or Zucker rats, the animals demonstrated increased
body fat accumulation. Thus when functional BAT is reduced there
is increased body fat accumulation. Decreased BA thermogenesis leads
to altered energy balance and increased white fat deposition.
Brown fat cells uniquely contain and preferentially express an
uncoupling protein called thermogenin, mitochondrial uncoupling
protein or UCP. UCP uncouples the usual process of catabolism and
storage of energy in the form of adenosine triphosphate (ATP) (Cannon
et al., FEBS Lett. 150: 129, 1982). UCP is a 32 kD protein found
in the inner membrane of BA mitochondria. UCP serves as a proton
channel to decrease the transmembrane proton gradient which drives
the electron transport system (Nicholls et al., Biochem. Biophys.
Acta 549:1, 1979). This uncouples oxidative phosphorylation of ATP
from oxidation of fat fuel substrates and increases the rate of
oxidation. Norepinephrine activates uncoupling of oxidative phosphorylation
mediated by UCP. Norepinephrine is thought to exert its effect through
cAMP-activated hydrolysis of triacylglycerols to release free fatty
acid. Free fatty acids mimic the effect of norepinephrine and are
themselves potent uncouplers of oxidative phosphorylation. Purine
nucleotides are considered negative modulators (Jezek et al., Fed
Eur. Biochem. 243:1147, 1989).
UCP is expressed in response to external stimuli of cold -acclimation
in hamsters and rats. Based upon gene expression in the mouse, four
hours of cold stress to the whole animal led to a seven-fold increase
in UCP mRNA. Administration of norepinephrine also increased UCP
mRNA to a lesser extent. UCP expression can also be induced in preadipocytes
grown in culture. UCP mRNA translation was maximally stimulated
by Norepinephrine when the cells were in confluence and in the presence
of insulin or thyroid hormones (e.g., T3, T4, etc.). See, for example,
Rehnmark et al., Exp. Cell Res. 182:75, 1989 and Rehnmark et al.,
J. Biol. Chem. 265:16464, 1990.
UCP is a proton/anion transporter found in the inner mitochondrial
membrane of brown adipocytes. The mouse, rat, hamster and human
genes encoding for UCP have been isolated and sequenced. UCP gene
expression is controlled at the level of transcription by signals
that are activated after stimulation of brown adipocytes by norepinephrine.
The UCP sequence is strongly homologous to several other ubiquitous
mitochondrial carriers, such as ANT (adenine nucleotide translocator)
and a mitochondrial phosphate carrier. Jacobsson et al. (J. Biol.
Chem. 260:16250, 1985) reported an isolation of a murine cDNA clone
derived from brown adipose tissue mRNA. The cDNA was cold-inducible.
No sequence data were provided. Bouillard et al. (J. Biol. Chem.
261:1487, 1986) reported a complete cDNA sequence and corresponding
protein sequence for rat UCP. The rat UCP gene has no N-terminal
signal extension. Rat UCP has a calculated molecular weight of 33,042
daltons and 306 amino acid residues. Ridley et al. (Nucleic Acids
Res. 14:4025, 1986) also reports the cDNA and corresponding protein
sequence for rat UCP as a 306 amino acid polypeptide. Ridley et
al. state that the rat UCP cDNA sequence is 91.5% homologous to
hamster UCP on the protein level. Kozak et al. (J. Biol. Chem. 263:12274,
1988) report two cDNA sequences for murine UCP. The polypeptide
has six .alpha.-helical hydrophobic transmembrane domains, each
encoded by an exon.
In view of the function of BAT to oxidize fuel substrates and BA
to be regulated by norepinephrine, free fatty acids and other metabolic
regulators, there is a need in the art to design a system to utilize
the unique metabolic properties of BA to tip the metabolic balance
toward white adipose tissue catabolism while preserving muscle mass.
The following invention was made to fulfill this need.
SUMMARY OF THE INVENTION
The present invention relates to a device, pharmaceutical composition
and method for metabolizing fatty acids into water, carbon dioxide
and heat and thereby reducing an individual's white adipose tissue
mass without effecting muscle mass. More particularly, the inventive
device is an extracorporeal device for oxidizing fatty acids comprising
a semipermeable membrane having a first and a second side and having
a molecular weight cutoff of at least 10,000 daltons, an oxidizing
component located adjacent to the first side of the semipermeable
membrane comprising an enzyme system with necessary cofactors, brown
fat mitochondria or whole cell cultures of brown adipose cells of
any species or cells transfected with a construct comprising a UCP
DNA sequence and an appropriate mammalian promoter sequence (e.g.,
MMTV, SV40, CMV intermediate early, etc.), wherein the oxidizing
component is capable of oxidizing fatty acids into carbon dioxide,
water and heat, and a means for circulating blood from the individual
to the second side of the semipermeable membrane for triglyceride
hydrolysis and diffusion of free fatty acids to the first side of
the semipermeable membrane for oxidation of fatty acids and returning
treated blood to the individual. Preferably, the oxidizing component
comprises a culture of brown fat cells or other eukaryotic cells
transfected with a gene encoding an uncoupling protein thermogenin
in an expression vector. Preferably the semipermeable membrane has
a lipoprotein lipase (EC 3.1.1.34) embedded therein.
The present invention further provides a pharmaceutical composition
for metabolizing fatty acids into carbon dioxide, water and heat
comprising a culture of brown fat cells or UCP-transfected cells
encapsulated in a porous growth matrix and having a semipermeable
membrane encapsulating the porous growth matrix. The semipermeable
membrane has a molecular weight cutoff of at least 10,000 daltons
and, preferably, a lipoprotein lipase embedded therein. Preferably,
the semipermeable membrane comprises a tubular membrane having two
ends, filled with brown fat cells in the porous growth matrix and
sealed at both ends prior to subcutaneous, intramuscular or intraperitoneal
implantation. Preferably the porous growth matrix comprises alginate
beads or another complex polysaccharide porous matrix suitable for
cellular growth and metabolism.
The present invention further provides a pharmaceutical composition
for metabolizing fatty acids into carbon dioxide, water and heat
comprising a mammalian cell stably transfected with a DNA sequence
coding for a mammalian UCP polypeptide, wherein the transfected
mammalian cell transcribes and translates UCP polypeptide. Preferably,
the transfected mammalian cell further comprises a cDNA sequence
that confers antibiotic sensitivity to the mammalian cell as a "suicide
gene" mechanism to remove the transformed mammalian cell from
the treated individual. Most preferably, the antibiotic is gancyclovir.
The present invention further provides a pharmaceutical composition
for metabolizing fatty acids into carbon dioxide, water and heat
comprising a cDNA sequence encoding a mammalian UCP sequence in
combination with appropriate regulatory [please specify examples]
and promoter sequences, wherein said cDNA sequence is taken up into
a hosts cells, in vivo, and is translated into UCP polypeptide,
causing uncoupling of oxidative metabolism.
The present invention further provides a pharmaceutical composition
for metabolizing fatty acids into carbon dioxide, water and heat
comprising a culture of allogeneic brown fat cells, wherein the
brown fat cells were proliferated ex vivo.
Further still, the present invention provides a method for effecting
weight loss for an individual, wherein the weight loss is due to
loss of white adipose tissue, with minimal loss of muscle mass,
wherein the method for effecting weight loss comprises administration
of an effective amount of a pharmaceutical composition described
herein in sufficient amounts to metabolize at least 55 calories
or 65 g per day of fatty acids.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a schematic diagram of an extracorporeal device for oxidizing
fatty acids, comprising a kidney dialysis machine as a means for
circulating blood from an individual to the first side of the semipermeable
membrane and for returning treated blood back to the individual.
The cell chamber comprises a plurality of "hollow fibers"
comprising semipermeable membranes encapsulating brown adipose cell
cultures arranges to allow blood to circulate around the hollow
fibers.
FIG. 2 provides a more detailed view of the cell chamber of an
extracorporeal device showing metabolic and kinetic pathways of
various biochemicals during operation of the extracorporeal device.
FIG. 3 is a graph of the amount of brown fat cells needed to metabolize
a certain amount of calories of grams of fat per day (24 hour period)
when administered as a pharmaceutical composition. Approximately
1.24 g of brown adipose cells will metabolize about 1 g of white
adipose tissue per day.
DETAILED DESCRIPTION OF THE INVENTION
The inventive pharmaceutical composition for metabolizing fatty
acids into carbon dioxide, water and heat comprises a culture of
brown adipose cells encapsulated in a semipermeable membrane. Preferably,
the culture of brown adipose cells are grown in a monolayer culture
prior to encapsulation. Preferably, the culture of brown adipose
cells is first encapsulated in a porous growth matrix, which, in
turn, in then encapsulated by the semipermeable membrane.
Sources of Brown Adipose Cells
The brown adipose tissue can be obtained from many mammalian sources.
Preferably, brown adipose tissue is cultured from the patient so
that the cells can be grown and added to the pharmaceutical composition
in a form of an autologous transplantation. Other human sources
of brown adipose tissue are appropriate without regard to matching
of the major histocompatibility antigens due to immunoisolation
afforded by the semipermeable membrane. Other mammalian sources
of brown adipose tissue are also appropriate, particularly from
those species inhabiting polar climates (Lacey et al., Science 254:1782;
Lanza et al., Proc. Natl. Acad. Sci. USA 88:11100).
The pharmaceutical composition encapsulates the brown adipose cells
in a semipermeable membrane such that larger proteins and immune
cells from the host individual cannot contact the implanted brown
adipose cells. Preferably, brown adipose cells are first encapsulated
in a porous growth matrix, such as an alginate porous matrix, and
then further encapsulated in the semipermeable membrane. However,
fatty acids, carbon dioxide, water and other metabolic byproducts
and essential nutrients can freely migrate across the semipermeable
membrane and throughout the porous growth matrix.
Preparation of Brown Adipose Cells for Encapsulation
In order to prepare the brown adipose cells for immobilization
in a porous growth matrix, cells are obtained by isolating brown
adipose precursor cells from inter scapular brown adipose tissue
of young mammals. Inter scapular brown adipose tissue is dissected
out, under sterile conditions, the tissue is cut into small pieces
and incubated in isolation buffer (123 mM NaCl, 5 mM KCl, 1.3 mM
CaCl.sub.2, 5 mM glucose, 1.5% crude bovine serum albumin and 100
mM HEPES, adjusted to pH 7.4 with NaOH; 0.2% (w/v) collagenase added
and sterile filtered through 0.45 .mu.m and 0.22 .mu.m prior to
use) in siliconized glass vials at 37.degree. C. in a shaking water
bath. During incubation, each vial is shaken vigorously, such as
by vortex, to separate the tissue into a cellular suspension.
The tissue remnants are filtered through a 250 mm nylon screen.
Mature adipocytes and fat droplets from broken cells can float to
the surface after about 30 min and can be collected and discarded.
The remaining intact cells are collected and filtered through a
25 mm nylon screen to remove aggregates. The collected cells are
washed and centrifuged, resuspended in culture medium and inoculated
into flasks for growth. Brown adipose cells can be cultured in common
culture media for cell culture. One example of appropriate media
is Dulbecco's modified Eagle's medium supplemented with 10% fetal
calf serum, 4 nM insulin, 10 mM HEPES, antibiotics (e.g., 50 IU
Penicillin and 50 .mu.g streptomycin) and 25 .mu.g sodium ascorbate.
Other appropriate media include RPMI 1640, Minimal Essential media,
Dulbecco's and Iscove's Modified Dulbecco's Medium.
Encapsulating Brown Adipose Cells or UCP-Transfected Cells in a
Porous Growth Matrix
Procedures for encapsulating cells in the porous growth matrix
for further growth and metabolism of the cells has been described
in, for example, U.S. Pat. 5,073,491, the disclosure of which is
incorporated by reference herein. Briefly, brown adipose cells or
UCP-transfected cells are obtained and isolated by procedures described
herein. Once cultures of brown adipose cells or UCP-transfected
cells are obtained, they are grown in suspension in a liquid growth
medium such as RPMI 1640, Dulbeccos or Minimal Essential Medium.
Culture medium may be supplemented with up to 10% heat inactivated
fetal calf serum, however, the cells are washed several times with
medium or Hanks balance salt solution to remove most proteins from
the calf serum. After washing, the cells are suspended in media
to encapsulate them in the porous growth matrix.
Preferably the porous growth matrix comprises alginate. The term
"alginate" refers to any of the conventional salts of
algin, a polysaccharide of marine algae which may be polymerized
to form a porous matrix. Algin salts include, but are not limited
to, any metal salt such as sodium magnesium, potassium, etc. Preferably,
the alginate porous matrix includes, but is not limited to, a polymeric
composition of gluronic and mannuronic acids and the material has
a relatively low viscosity.
Other polymerization materials that can form the porous growth
matrix include, for example, gelatin obtained from animal (i.e.,
bovine or swine) skin, carageenin obtained by extraction of various
red seaweeds, and agarose which is a natural gelling fraction of
a polysaccharide complex extracted from agarocytes of algae, such
as Rhodophyceae. The preferred polysaccharide polymeric material
is alginate. Alginate polymerizes from a liquid solution when exposed
to polyvalent cations to form a porous matrix that can entrap cells
and provide a stable growth chamber to allow metabolism or even
hypermetablism of entrapped brown adipose cells and allow for entry
of nutrients and fatty acid fuel and exiting of metabolic by-products
CO.sub.2, water and heat.
The alginate porous growth matrix is obtained by converting water
soluble sodium alginate to insoluble calcium alginate in accordance
with procedures well known in the art. See, for example, Knorr et
al., Food Technol. 39:135, 1985; Chibata et al., Ann. Rev. Biophys.
Bioengin. 10:197, 1981; and Shiria et al., J. Appl. Microbiol. Biotechnol.
26:495, 1987.
An alginate solution is prepared by mixing sodium alginate in a
growth medium (containing cultured brown adipose cells) and a NaCl
solution. A preferred alginate solution contains about 0.85% to
about 4% (w/v) alginate. A most preferred solution contains about
1.0% (w/v) alginate. The alginate solution, containing the suspended
cultured brown adipose cells, is pumped through a tube, preferably
a 5 mm diameter tube, and dripped into a growth chamber of a bioreactor
containing a calcium solution. Preferably, the calcium solution
contains about 50 mM CaCl.sub.2 and about 0.1M NaCl. The pH of the
solutions should be in the range of 6.7-7.3. This will form alginate
beads of approximately 8 mm diameter containing the brown adipose
cells entrapped within. Normally the cells will grow first toward
the periphery of the beads, where there is the greatest concentration
of oxygen and nutrients.
Preparation of a Stably Transfected Mammalian Cell
The present invention further provides a pharmaceutical composition
for metabolizing fatty acids into carbon dioxide, water and heat
comprising a mammalian cell stably transfected with a DNA sequence
coding for a mammalian UCP polypeptide, wherein the transfected
mammalian cell transcribes and translate UCP polypeptide. The cDNA
sequence encoding a human UCP polypeptide has been described in
Bouillaud et al. Clin. Sci. 75:21-27. 1988 and in Cassard et al.
J. Cell Biochem. 43:255-264, 1990). One can obtain a cDNA sequence
and even a genomic sequence of human UCP through standard polymerase
chain reaction (PCR) techniques. The cDNA sequence or genomic DNA
sequence encoding a UCP polypeptide is inserted into the genome
of a mammalian cell growing in culture. Preferably, the mammalian
cell is a fibroblast cell line obtained from the individual to be
treated and cultured ex vivo. Other suitable cells include, for
example, hepatocytes preadipocytes, adipocytes, myoblasts, myocytes,
endothelial cells, and bone marrow stromal cells from the individual
to be treated or syngeneic to the individual. The cDNA sequence
is inserted into the mammalian cell through any one of a number
of techniques, such as transfection, electroporation, or microinjection.
In any of the insertion techniques, the cDNA or genomic DNA sequence
will first be inserted into a stable expression vector. For example,
a pECE expression vector consists of the SV40 early promoter (Ellis
et al. Cell 45:721, 1986) upstream of the gene for the heterologous
protein (e.g., UCP). A region of a cDNA coding for human or mammalian
UCP is inserted into an expression vector by taking a restriction
fragment digest of the cDNA wherein the restriction fragment comprises
at least the entire polypeptide coding region. For example, in the
rat UCP cDNA sequence, a BamHI or Bg/I digestion will provide a
fragment containing the entire coding region.
For transient expression into a cell, a UCP DNA sequence (or inverted
UCP DNA sequence) comprising at least the coding region for a UCP
polypeptide in an expression vectors introduced into the cell by,
for example, calcium phosphate precipitation with glycerol shock
as described by Ebina et al. (Proc. Natl. Acad. Sci. USA 82:8014,
1985). Stable cell lines containing the UCP DNA sequence are established
by co-transfecting the mammalian cells with the UCP cDNA sequence
in a mammalian expression vector and an expression vector to provide
stability for the transfected genome, such as pSV2neo DNA (Southern
and Berg, Mol. Appl. Genetics 1:327, 1982), currently available
from Immunex (Seattle, Wash.). The cells are exposed to the expression
vector containing the UCP DNA sequence for at least 12 hrs and preferable
for 18 to 24 hrs. The cells are washed (possibly first treated with
trypsin to remove adherent cells from their plates) and replated
with culture medium supplemented with glutamine (10 mM) and at least
10% (v/v) fetal calf serum. An antibiotic (preferably geneticin
at about 600 .mu.g/ml) is added, but other antibiotics, such as
penicillin/streptomycin, or gentamycin, can be used. After a period
of incubation of from one to three weeks (with at least thrice week
changing of culture medium) independent colonies are picked on paper
disks saturated with trypsin if the cells are adherent. Each colony
is transferred to a well plate to observation of its colony characteristics.
Cell transfection could also be achieved by electroporation. Briefly,
cultured cells are harvested (after first being treated with trypsin
if adherent), and then suspended in an electroporation buffer. A
DNA construct comprising a DNA sequence encoding a UCP polypeptide
and containing expression and regulatory vectors is placed into
sterile electroporation chambers. A controlled unidirectional pulse
is applied to the chamber. The electroporated cells are replated
into post-electroporation cultures. The electroporation technique
is described in, for example, Andreason and Evans, BioTechniques
6:650, 1988; Toneguzzo et al., Mol. Cell. Biol. 6:703, 1986; and
Tur-Kaspa et al., Mol. Cell. Biol. 6:716, 1986.
Candidate cell types for transient transfection are cells from
the individual to be treated cultured ex vivo, including fibroblasts,
hepatocytes, preadipocytes, myoblasts, myocytes, endothelial cells,
bone marrow stromal cells, and combinations thereof in fixed culture.
Candidates for stably transfected cells include the proceeding cell
types and xenogenic cells of the proceeding cell types and any transformed
mammalian cell line, including 3t3 Ll cells and NIH 3T3 Ras cells.
Preferably, the transfected mammalian cell further comprises a
cDNA sequence that confers antibiotic sensitivity to the mammalian
cell as a "suicide gene" mechanism to remove the transformed
mammalian cell from the treated individual. Most preferably, the
antibiotic is gancyclovir. The thymidine kinase gene of herpes simplex
virus (Colbere-Garapin et al., Proc. Natl. Acad. Sci. USA 76:3755,,
1979) confers sensitivity to acyclovir or gancyclovir (Darby et
al., Nature 289:81,198 I). This gene can be introduced into cells
via electroporation (described herein), by means of a viral transfection
vector, or by microinjection as described by Tabin et al. (Mol.
Cell. Biol. 2:426, 1982) or Dagher et al. (Exp. Cell Res. 198:36,
1992).
The present invention further provides a pharmaceutical composition
for metabolizing fatty acids into carbon dioxide, water and heat
comprising a cDNA sequence encoding a mammalian UCP sequence, wherein
said cDNA sequence is taken up into a hosts cells, in vivo, and
is translated into UCP polypeptide, causing uncoupling of oxidative
metabolism. For example, an adenovirus vector containing the lacZ
gene was successfully introduced into the lumen of intact human
umbilical veins and expression of these genes in epithelial cells
were verified (Lemarchan et al., Proc. Natl. Acad. Sci. USA 89:6482,
1992). Replication deficient, recombinant adenovirus vectors were
also used to transfer human .alpha.l-antitrypsin gene into rat hepatocytes
via intraportal injection. Expression of this gene was detected
for at least four weeks (Jaffe et al., Nature Genetics 1:372, 1992).
A similar adenovirus vector containing the UCP gene with or without
a thymidine kinase gene would be introduced into the intraportal
vein and expressed in the liver of the individual to be treated.
Expression of UCP would continue for a considerable period of time
and result in uncoupling of oxidative phosphorylation and cause
consumption of metabolic substrates.
Formation of the Pharmaceutical Composition
The brown adipose cells or UCP-transfected cells grown in the porous
growth matrix are added to hollow fibers, wherein the hollow fibers
comprise the semipermeable membrane. The semipermeable membrane
can be any such device allowing free diffusion of molecules having
a molecular weight below about 10,000 daltons but preventing migration
of cells and larger proteins across the semipermeable membrane.
A hollow fiber semipermeable membrane can be formed, for example,
by using a wet-dry spinning technique as described in Cabassom Hollow
Fiber Membranes, vol 12, page 492 in Kirk-Othmer Encyclopedia of
Chemical Technology, Wiley, New York ed. 3, 1980. An acrylic copolymer
(e.g., poly(acrylonitrile-co-vinyl chloride) M.sub.n .about.100,000,
M.sub.w .about.300,000 as measured by size-exclusion chromatography)
is dissolved in dimethylsulfoxide (12.5% w/w). The acrylic copolymer
solution is pumped through an outer tube of a spinneret and water
is pumped through the inner tube. Type I hollow fibers are extruded
into the water through an air gap, resulting in an fenestrated outer
wall. Type II fibers are made in an analogous fashion, except the
air gap is replaced with a humidified atmosphere.
Brown adipose cells or UCP-transfected cells in porous grow matrix
are added to the inside of the Type I or Type II hollow fibers by
pipetting the porous matrix and cells into the lumen of a fiber
(approximately 2 cm in length). The fiber is filled up to about
1 mm from an open end. A solution of the same acrylic copolymer
in DMSO is injected as a small drop into the open end of the fiber
to form a sealed end of the fiber. The sealed end is further sealed
by heating and then cooling in media the sealed end. Fibers can
be stored in growth media.
Alternatively, porous growth matrix containing brown adipose cells
or UCP-transfected cells can be placed into semipermeable tubular
membranes or flat "tea bags" having a molecular weight
cutoff of from about 10,000 daltons to about 50,000 daltons (W.
R. Grace & Co.). The tubular membranes are washed in culture
medium and the ends are sealed by heat followed by dipping in a
solution of acrylic copolymer (e.g., XM casting solution Grace)
similar to that used to make the semipermeable membranes.
The filled fibers can be injected or implanted into an individual
to act as metabolism units to catabolize fatty acids. Co-administration
of small amounts of heparin can facilitate hydrolysis of fatty acids
from triglycerides to made fuel more readily available. Preferably,
the pharmaceutical composition can be administered intraperitoneally.
However, the pharmaceutical composition can also be administered
subcutaneously, intramuscularly, or encapsulated cells can be injected
into the portal vein. The rate of caloric consumption by the inventive
pharmaceutical composition depends upon the amount of cultured brown
adipose cell administered. Generally, every gram of pharmaceutical
composition can metabolize 6.2 calories per day, which translates
to about 0.81 grams of fat per day.
The Extracorporeal Device
The extracorporeal device comprises a hollow membrane chamber having
a molecular weight cutoff of at least 10,000 daltons (Amicon) and
having an oxidizing component located on the first side of the membrane
and circulating blood in contact with the second side of the membrane.
The semipermeable membrane is located in a cell chamber allowing
fluids to circulate through a first chamber in contact with the
first side of the semipermeable membrane and a second chamber allowing
blood to circulate through and contact the second side of the semipermeable
membrane. Preferably there are a plurality of semipermeable membrane
devices located within a cell chamber to maximize contact of circulating
blood with semipermeable membrane. Such a dual chambered device
comprising a semipermeable membrane is similar to the hollow membrane
chamber used in kidney dialysis machines. The first chamber is filled
with brown adipose cells or UCP-transfected cells in a porous growth
matrix as described herein. The cells are maintained, when not in
use, with culture medium circulating across the semipermeable membrane
through the second chamber. When in use, blood from an individual
is circulated across the second chamber. A small dose of heparin
1200-2500 IU/hr. is added to the circulating blood to prevent thrombi
formation and to assist hydrolysis of fatty acids from triglycerides
in the circulation blood. The mechanics of blood circulation and
pumping to and from the patient is similar to devices currently
used for kidney dialysis treatment.
The rate of catabolism of fatty acids depends upon the metabolic
state and activation of the brown adipose cells or UCP-transfected
cells in the first chamber. While in use, metabolic rates can be
increased in confluent cultures of cells by infusing Norepinephrine
(NE) (about 0.1 .mu.M) into the first chamber. NE will remain in
and be consumed in the first chamber and not migrate to the patient
via the second chamber. Further, NE can activate transcription of
a fat-specific uncoupling protein called thermogenin (UCP). UCP
expression was maximal when confluent culture brown adipose cells
are activated with NE (Rehnmark et al., J. Biol. Chem. 265:16464,
1990).
It is also possible to promote hydrolysis of fatty acids from circulating
triglycerides in the second chamber by immobilizing and embedding
a lipase enzyme within the semipermeable membrane. An example of
a lipase enzyme is lipoprotein lipase (E.C. 3.1.1.3). A method for
immobilizing an enzyme in a semipermeable membrane is described
in Kitano and Ise, Trends Biochem. 2:5, 1984. Briefly, a dry semipermeable
membrane is dipped into an aqueous solution containing the lipase
enzyme. Enzyme is absorbed into the spongy lumen where is remains
to hydrolyze triglycerides into fatty acids wherein the fatty acids
can freely diffuse across the semipermeable membrane.
The following examples are designed to illustrate the present invention.
EXAMPLE 1
This example illustrates manufacture of a pharmaceutical composition
of the present invention. Brown fat precursor cells are isolated
from interscapular brown adipose tissue of 20-25 day old Sprague-Dawley
rats in an isolation buffer. Isolation buffer is made with 123 mM
NaCl 5 mM KCl, 1.3 mM CaCl.sub.2, 5 mM glucose, 1.5% crude bovine
serum albumin and 100 mM HEPES (adjust to pH 7.4 with NaOH), with
0.2% (w/v) collagenase and sterile filtered through 0.45 .mu.m and
0.22 .mu.m membranes just before use. The rats are killed by cervical
dislocation, and interscapular brown adipose tissue is dissected
out under sterile conditions. The tissue is cut into small pieces
and incubated in isolation buffer in siliconized glass vials for
30 min at 37.degree. C. in a shaking water bath. The vials are vortexed
every five minutes.
Tissue remnants are removed by filtering the tissue through a 250
.mu.m nylon screen into plastic test tubes. The test tubes are left
undisturbed for 30 min to allow mature adipocytes and fat droplets
from broken cells to float. The infranatant is collected through
a needle and filtered through a 25 .mu.m nylon screen to remove
cell aggregates. Brown adipose cells are pelleted by centrifugation
(700.times.g for 10 min) and resuspended in culture medium. Culture
medium is Dulbecco's modified Eagle's medium supplemented with 10%
newborn calf serum, 4 nM insulin, 10 mM HEPES, antibiotics (50 IU
penicillin, 50 .mu.g streptomycin), and 25 .mu.g of sodium ascorbate
per ml of medium. Brown adipose cells are inoculated at a density
of 0.5.times.10.sup.6 cells per 75 mm petri dish containing 5 ml
of culture medium.
Brown adipose cells are grown at 37.degree. C. in 8% CO.sub.2 in
air at 80% humidity. The medium is changed on days 1 and 3 and every
other day thereafter until the cells reach confluence (about 6 to
10 days). After confluency, the cells detach and float in a monolayer
in the petri dish.
Two pieces of flat permselective membrane of at least 10,000 dalton
molecular weight cutoff (W. R. Grace & Co.) are placed under
and over this layer of cells. The membrane is sutured around the
edges to form a completely sealed bag (i.e., a "tea bag").
The tea bag is stored submerged in culture medium at 37.degree.
C. in 8% CO.sub.2 in air at 80% humidity until it is ready for norepinephrine
treatment and implantation.
Alternatively, or in addition, other brown adipose cells are collected
before they spontaneously detach. Culture media is aspirated from
the petri dish and cells are incubated in 3 ml of isolation buffer
in a shaking water bath at 37.degree. C. for 5 min. Petri dishes
are washed with an additional 3 ml of isolation buffer, combined
with the first aspirate, and centrifuged at 400 g for 10 min. The
cell pellet is washed with an additional 4 ml of culture medium
to collect detached brown adipose cells. The cells are suspended
in a solution of 1% (w/v) sodium alginate in phosphate buffered
saline (PBS). This suspension is drawn into a syringe and injected
into a semipermeable tubular membrane (3 cm.times.2.0 mm i.d. with
a 50,000 to 80,000 molecular weight cutoff, W. R. Grace & Co.).
The ends of the tubular membrane are sealed by dipping the ends
into a 12.5% (w/w) solution of poly(acrylonitrile-co-vinyl chloride)
in dimethyl sulfoxide and then touching it with a heated metal spatula.
The sealed tubular membranes are placed in a solution of CaCl.sub.2
for 6 minutes to cross-link the alginate. These pharmaceutical compositions
are kept in culture medium at 37.degree. C. in 8% CO.sub.2 in air
at 80% humidity until ready for norepinephrine treatment and implantation.
Thermogenin expression is stimulated in the encapsulated brown
adipose cells by adding norepinephrine to the hollow fiber or tea
bag encapsulated brown adipose cell cultures at a concentration
of 0.1 .mu.M and incubating in culture medium for at least four
hours. The hollow fiber or tea bag of brown adipose cells is ready
for implantation.
EXAMPLE 2
This example illustrates administration of the pharmaceutical composition
of Example 1 to Zucker rats to effect weight loss without significant
loss of muscle mass. Fa/fa genetically obese Zucker rats are a well
studied animal model for obesity and brown fat metabolism. Development
of obesity in Zucker rats is believed to be due to attenuated energy
expenditure and contributed by defective brown adipose tissue-mediated
thermogenesis. Therefore, Zucker rats are an appropriate animal
model to study hypermetabolic therapy to effect weight loss.
Fa/fa Zucker rats are anesthetized by ether inhalation. From one
to four tea bags (1 to 4 g/rat) from Example 1 are inserted into
the peritoneal cavity through a midline incision. The incision is
closed with 2 layers of 4-0 silk suture. After implantation, the
weight of each rat is carefully monitored and compared with sham-implanted
control animals. Other rats are similarly implanted with (6-10/rat)
hollow fiber cultured brown adipose cells (according to Example
1) or empty control hollow fibers. The weight of these animals is
carefully monitored and compared to the control animals.
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