FIELD OF THE INVENTION
[0001] The invention pertains to compositions for treating or preventing memory dysfunction,
cognitive dysfunction, Alzheimer's and dementia, and pre-dementia-related conditions
and/or symptoms or characteristics of such conditions. The invention particularly
relates to low-volume administration forms for use therein.
BACKGROUND OF THE INVENTION
[0002] Memory loss, dementia and reduced brain function are major problems, particularly
in elderly. Significant effort is put in the treatment and/or prevention of these
disorders related with impaired nerve functioning.
[0003] Persons older than 50 years of age are particularly prone to developing such disorders,
by a combination of aging and non-optimal nourishment. These syndromes, generally
known as dementia or Alzheimer's disease (AD), are characterized by neurodegeneration
and the deposition of plaques in the brain. These plaques consist of a number of components
of which beta-amyloid (abeta) is seen as a key element. Abeta is produced from its
precursor protein which resides in the membrane, and is believed to promote pro-inflammatory
responses and to activate neurotoxic pathways causing neuronal dysfunction characterized
by a loss of spines and neurites leading to neuronal death.
[0004] WO 2007/008586 A2 (Martek Biosciences Corp.) and
EP 1 800 675 A1 (Nutricia N.V.) describe compositions for the treatment and/or prevention of dementia,
wherein the composition comprises a lipid fraction comprising polyunsaturated fatty
acids (PU-FAs) such as docosahexaenoic acid (DHA) or docosapentaenoic acid (DPA).
[0005] It has also been shown in
WO 2006/031683 A2 (MIT) to administer uridine or a source thereof in order to improve a neurological
function in a subject. Uridine, in particular in the form of uridine monophosphate
(UMP), is a nutrient that is known to increase the production of phospholipids, thus
changing the membrane composition. However, at present no effects of UMP on abeta
plaque burden have been reported.
[0006] Compositions comprising a uridine nucleoside/nucleotide and a fatty acid, in particular
EPA and/or DHA have been disclosed in
EP 1 666 092 A2 (Trommsdorff GmbH) for treating a variety of diseases among which neurodegenerative
disease such as Alzheimer's Disease, and in
WO 2006/127620 A2 (MIT) for the treatment of a memory disorder.
SUMMARY OF THE INVENTION
[0007] Based on foregoing, one may expect intervention with a mixture of nutrients such
as DHA and UMP to result in an effective strategy to decrease neurodegeneration. However,
the present inventors have recognized that inclusion of active ingredients UMP and
DHA in nutritional and pharmaceutical compositions as taught in the art may result
in an insufficient intake of these active ingredients. The insufficient intake is
caused by a combination of a high volume of the nutritional product in combination
with the limited appetite of the (elderly) patients, with the result that the recommended
dosage of active ingredients (often included in 100- 500 ml nutritional product) is
not ingested. Hence, inclusion of the active ingredients in a nutritional composition
may result in a suboptimal effect in patients with reduced appetite or disturbed eating
behaviour, or rejection of food.
[0008] It would be a straightforward alternative to reduce the dosage volume by incorporating
the active ingredients in a low-volume dosage form, e.g. a pill, tablet or capsule.
However, due to the low volume, some ingredients in the compositions taught in the
art must be left out. The present inventors found however that eliminating (nutritional)
ingredients from the nutritional composition (such as e.g. described in example 1
of
EP 1 800 675 A1), and only administering the UMP and DHA, may result in a low-volume dosage form,
but unfortunately at the cost of the neurodegenerative effect (beta amyloid). In fact,
as demonstrated in the accompanying examples, it may even have an adverse effect on
neurodegeneration. Hence simply incorporation and administration of UMP and DHA in
a low-volume dosage form is not optimal.
[0009] In the art, a need thus exists for producing low-volume dosage forms for reducing
abeta plaque burden and decreasing neurodegeneration, wherein the effects of the active
ingredients are at least similar to those found for full nutraceutical and pharmaceutical
formulations.
[0010] It is an objective of the present invention to provide a low-volume dosage form for
use in reducing abeta plaque burden and neurodegeneration, in the treatment of diseases
related with imparted nerve functioning, in particular dementia or AD or memory disorders.
[0011] Therein, the present inventors surprisingly found that inclusion of a tocopherol
and/or an equivalent thereof (i.e. a compound having vitamin E activity) overcome
the aforementioned disadvantages related with DHA and UMP in low-dosage formulation.
This new finding thus enables the manufacture of low dosage composition that can be
effectively used for the treatment and/or prevention of memory decline and/or cognitive
dysfunction and/or support of healthy brain function, as discussed below in more detail.
DETAILED DESCRIPTION OF THE INVENTION
[0013] The invention thus pertains to a composition comprising per dry weight of unit dose:
(i) 10-1000 mg uridine in nucleobase, nucleoside and/or nucleotide form; (ii) 50-1000
mg docosahexaenoic acid (DHA) ; and (iii) a tocopherol and/or tocotrienol, wherein
said composition has:
- a) a weight of 200 - 3000 mg per unit dose;
- b) an energy content of less than 50 kcal per unit dose; and/or
- c) a volume between 0.1 and 10 ml per unit dose,
and wherein the unit dose is a tablet, gel, dragee, pill, capsule, granule, pellet,
or sachet.
Administration form
[0014] For reasons stated above, the low-volume composition distinguishes from nutritional
and dietary compositions (nutraceuticals) and nutritional supplements. The composition
may involve the presence of one or more conventional carriers and/or diluents.
[0015] The composition is in the form of a unit dose. Unit doses are defined as physically
identifiable separate units. One or more unit doses containing the active ingredients
may be comprised in a cartridge, pack or dispenser device. Such a cartridge, pack
or dispenser device can be accompanied by instructions for administration of the composition.
A dosage regimen may involve the administration of one or more unit doses per serving,
typically 1 - 5 unit doses per serving.
[0016] Given its low or reduced volume, the composition is preferably in the form of a solid
or semi-solid dosage unit form. The unit dose is a tablet, gel, including soft gel,
dragee, pill, capsule, granule, pellet, or (powder) sachet, preferably suitable for
oral administration, wherein the active ingredients are present in a therapeutically
effective amount, and combined with one or more diluents, gelling agents or excipients
which are inactive ingredients to dilute or give the active ingredients form or consistency,
and are effective to deliver the active ingredients to a human as prescribed by a
physician.
[0017] Suitable excipients are, in particular, fillers such as sugars, including lactose,
sucrose, mannitol, or sorbitol; cellulose preparations such as, for example, maize
starch, wheat starch, rice starch, potato starch, gelatine, gum tragacanth, methyl
cellulose, hydroxypropylmethyl cellulose, sodium carboxymethyl cellulose, and/or polyvinylpyrrolidone
(PVP). Other suitable pharmaceutical carriers and their formulations are described
in
Remington: The Science and Practice of Pharmacy 1995, edited by E. W. Martin, Mack
Publishing Company, 19th edition, Easton, Pa. If desired, disintegrating agents may be added, such as the cross-linked polyvinyl
pyrrolidone, agar, or alginic acid or a salt thereof such as sodium alginate. Dragee
cores are provided with suitable coatings. For this purpose, concentrated sugar solutions
may be used, which may optionally contain gum Arabic, talc, polyvinyl pyrrolidone,
carbopol gel, polyethylene glycol, and/or titanium dioxide, Fe oxides, lacquer solutions,
and suitable organic solvents or solvent mixtures. Dyestuffs or pigments may be added
to the tablets or dragee coatings for identification or to characterize different
combinations of active compound doses. Gelatine or plasticizers such as glycerol or
sorbitol are often applied to obtain capsules. Capsules can contain the active ingredients
in admixture with filler such as lactose, binders such as starches, and/or lubricants
such as talc or magnesium stearate and, optionally, stabilizers. In soft capsules,
the active compounds may be dissolved or suspended in suitable liquids, such as fatty
oils, emulsifiers, e.g. soy lecithin, liquid paraffin, or liquid polyethylene glycols.
In addition, stabilizers may be added.
[0018] The daily dosage will be adjusted to the individual requirements in each particular
case. It may involve the administration of 1 - 20 unit doses, preferably 2 - 10 unit
doses per day. One of ordinary skill in treating diseases described herein will be
able, without undue experimentation and in reliance on personal knowledge, experience
and the disclosures of this application, to ascertain a therapeutically effective
amount of the compounds of the present invention for a given disease and patient.
Based thereon, the skilled person can determine the amount of unit doses to be administered
per serving and per day. However, further on in the text, daily dosages are defined
which may be of help in determining the number of unit doses to be administered.
[0019] The reduced or low volume composition according to the present invention may be characterized
by one or more of the following features which all relate to the reduced size of the
composition:
In an embodiment (a), the composition preferably has a weight of 200 - 3000 mg per
unit dose, more preferably 300 - 2000 mg per unit dose, most preferably less than
1000 mg per unit dose.
In an embodiment (b), the caloric volume of the composition of the invention is preferably
lower than 50 kcal per unit dose, more preferably lower than 40 kcal per unit dose,
most preferably less than 30 kcal per unit dose. Additionally or alternatively, it
is especially preferred that the energy content of the composition is less than 10
kcal/g, more preferably less than 5 kcal/g, most preferably less than 3 kcal/g. These
numbers apply to the solid weight of the composition, prior to any optional reconstitution
in liquid.
In an embodiment (c), the low or reduced volume composition of the invention preferably
has a volume between 0.1 and 10 ml (cm3) per unit dose, more preferably 0.2 - 8 ml, most preferably at least 0.5 ml, in particular
1 - 5 ml.
[0020] In a preferred embodiment, the low volume composition is characterized by two, more
preferably all three of the aforementioned features of (a) weight, (b) energy content
and (c) volume.
DHA, EPA
[0021] The present invention comprises the use of docosahexaenoic acid (22:6 ω-3; DHA) .
The present composition contains at least DHA, more preferably DHA and EPA.
[0022] In a further aspect the present composition preferably contains a significant amount
of EPA. EPA is converted to DPA (ω-3), increasing subsequent conversion of docosapentaenoic
acid (22:5 ω-3; DPA) to DHA in the brain. Hence, the present composition preferably
contains a significant amount of EPA, so to further stimulate
in vivo DHA formation.
[0023] The DHA and EPA are preferably provided as triglycerides, diglycerides, monoglycerides,
free fatty acids or their salts or esters, phospholipids, lysophospholipids, glycerol
ethers, lipoproteins, ceramides, glycolipids or combinations thereof. Preferably,
the present composition comprises at least DHA in triglyceride form.
[0024] In terms of daily dosage, the present method preferably comprises the administration
of 50 - 5000 mg (DHA+EPA) per day, more preferably 100-3000 mg per day, most preferably
200 - 1000 mg per day. DHA is preferably administered in an amount of 50 - 4000 mg
per day, more preferably 100 - 2500 mg per day, most preferably 200 - 1000 mg per
day. If at all, EPA is preferably administered in an amount of 50 - 4000 mg per day,
more preferably 100 - 2500 mg per day, most preferably 200 - 1000 mg per day. These
amounts of EPA apply if it is used alone or in combination with DHA.
[0025] In terms of unit dosage, the proportion of (DHA+EPA) of the total fatty acids is
preferably 5-95 wt.%, more preferably 10- 80 wt.%, most preferably 15-70 wt.%. The
present composition preferably comprises 5-95 wt.% DHA based on total fatty acids,
preferably 10-75 wt.% DHA based on total fatty acids, more preferably 10-60 wt.% DHA
based on total fatty acids. The present composition preferably comprises 5-95 wt.%
EPA based on total fatty acids, preferably 10-75 wt.% EPA, most preferably 15 - 60
wt%, based on total fatty acids.
[0026] The ratio of the weights of DHA to EPA is preferably larger than 1.0, more preferably
1.2-10, more preferably 2-8. The above-mentioned ratios and amounts take into account
and optimise several aspects, including taste (too high LCP levels reduce taste, resulting
in a reduced compliance), balance between DHA and precursors thereof to ensure optimal
effectiveness in relation to maximum dosage and in view of the low-volume product
formulations of the invention.
[0027] The present method preferably comprises the administration of DHA in a composition
comprising 50 - 1000 mg DHA per unit dose, more preferably 100-500 mg DHA per unit
dose, most preferably 100 - 400 mg DHA per unit dose, at least 200 mg DHA per unit
dose. A unit dose according to the present method preferably comprises 5 - 95 wt%
DHA, more preferably 10 - 75 wt% DHA, more preferably 20 - 60 wt%, most preferably
25 - 50 wt%, based on the total dry weight of the unit dose. The preferred ranges
per unit dose mentioned in this paragraph for DHA also apply to EPA, if present.
[0028] The present composition preferably contains a very low amount of arachidonic acid
(AA; 22:4 ω-6). The arachidonic acid is believed to counteract the effects of the
present composition. The present subject normally ingests sufficient (precursors of)
AA, and an excess daily dosage may stimulate inflammatory responses, inhibiting daily
activities. Preferably the weight ratio DHA/AA in the present composition is at least
5, preferably at least 10, more preferably at least 15. The present method preferably
comprises the administration of a composition comprising less than 5 wt.% arachidonic
acid based on total fatty acids, more preferably below 2.5 wt.%. The ratio omega-6/omega-3
fatty acids, in the present product, are preferably below 0.5, more preferably below
0.2.
[0029] The present composition preferably contains at least one oil selected from fish oil,
algal oil, genetically modified plants containing DHA, and egg lipids. Preferably
the present composition contains fish oil comprising DHA and EPA.
Nucleotides
[0030] The present composition comprises uridine and/or an equivalent thereof, preferably
at least one uridine or an equivalent thereof selected from the group consisting of
uridine (i.e. ribosyl uracil), deoxyuridine (deoxyribosyl uracil), uridine phosphates
(UMP, dUMP, UDP, UTP), nucleobase uracil and acylated uridine derivatives. Preferably
the present composition comprises an uridine phosphate selected from the group consisting
of uridine monophosphate (UMP), uridine diphosphate (UDP) and uridine triphosphate
(UTP). Most preferably the present composition comprises UMP, as UMP is most efficiently
being taken up by the body. Preferably at least 50 wt.% of the uridine in the present
composition is provided by UMP, more preferably at least 75 wt.%, most preferably
at least 95 wt.%.
[0031] The present method preferably comprises the administration of uridine (the cumulative
amount of uridine, deoxyuridine, uridine phosphates, nucleobase uracil and acylated
uridine derivatives) in an amount of 0.01-6 g per day, preferably 0.1-2 g per day,
more preferably 0.2-1 g per day.
[0032] Preferably the present composition comprises uridine phosphate, preferably uridine
monophosphate (UMP). The UMP is very efficiently taken up by the body. Hence, inclusion
of UMP in the present composition enables a high effectivity at the lowest dosage
and/or the administration of a low volume to the subject.
[0033] The present method comprises the administration of a composition comprising uridine
in an amount of 10 - 1000 mg per unit dose, preferably 20 - 600 mg per unit dose,
more preferably 50 - 400 mg per unit dose, in particular at least 100 mg per unit
dose, based on the dry weight of the unit dose. The relative amount of uridine and
its equivalents is preferably 1 - 50 wt%, more preferably 2 - 40 wt%, most preferably
5 - 25 wt%, based on the total dry weight of the unit dose.
[0034] The required unit and daily dosages of the equivalents on a weight base can be calculated
from the dose for uridine by taking equimolar amounts using the molecular weight of
the equivalent and of uridine.
[0035] The present method preferably comprises the administration of uridine monophosphate
(UMP) in an amount of 0.01-3 g per day, preferably 0.1-2 g per day, more preferably
0.2-1 g per day. Preferably 1-37.5 mg UMP per kilogram body weight is administered
per day. The required unit and daily dosages of the equivalents on a weight base can
be calculated from the dose for UMP by taking equimolar amounts using the molecular
weight of the equivalent and of UMP, the latter being 324 Dalton.
[0036] In a further preferred embodiment the present composition preferably does not contain
high amounts of other nucleotides. Hence, preferably the weight ratio adenosine/uridine
in the present composition is below 0.1, more preferably below 0.01, most preferably
0. Preferably the weight ratio guanosine/uridine in the present composition is below
0.1, more preferably below 0.01, most preferably 0. Preferably the weight ratio inosine/uridine
in the present composition is below 0.1, more preferably below 0.01, most preferably
0.
[0037] In the composition, it is preferred that the weight ratio of DHA and/or EPA to uridine
and its equivalents, recalculated in equimolar amounts of UMP, is at least 1, more
preferably at least 1.5. More preferably, DHA is predominant in the composition over
uridine and its equivalents in terms of weight.
[0038] The composition may further include cytidine. Preferably the weight ratio of uridine
to cytidine is larger that 1.0, more preferably 2.0, most preferably more than 5.0.
The term uridine as used herein relates to uridine and/or equivalents thereof. The
term cytidine as used herein relates to cytidine and/or equivalent thereof. Although
cytidine is a precursor of uridine, which passes the blood brain barrier, it is more
efficient and effective to include uridine in the present composition.
Tocopherol
[0039] The present composition further contains a tocopherol and/or tocotrienol. Tocopherols
contain a chromanol ring, with a hydroxyl group that can donate a hydrogen atom to
reduce free radicals and a hydrophobic side chain. The defmition also includes tocotrienols,
which have structures corresponding to tocopherol, except with an unsaturated bond
in each of the three isoprene units that form the hydrocarbon tail. Tocopherols have
a saturated phytyl tail.
[0040] The term "a tocopherol and/or an equivalent thereof", as used in this description,
comprises tocopherols, tocotrienols. Tocopherols and tocotrienols occur in alpha,
beta, gamma and delta forms, determined by the number of methyl groups on the chromanol
ring. Each form has slightly different biological activity. An example of a pharmaceutical
and/or nutritional acceptable derivative is a salt such as, for instance an acetate
or succinate.
[0041] More preferably, the composition comprises tocopherol family members, more preferably
alpha-tocopherol and its nutritional and/or pharmaceutically acceptable equivalents.
[0042] The amount of tocopherol is preferably 0.1 - 50 mg per unit dose, more preferably
1 - 40 mg per unit dose, most preferably less than 30 mg per unit dose. These numbers
correspond to the amount of alpha-tocopherol. The required unit and daily dosages
of the equivalents of alpha-tocopherol on a weight base can be calculated using, for
instance, the table provided below. Therein, the amount of 1.0 mg of the tocopherol
equivalent is recalculated in terms of "x" mg α-TE. R stands for the side groups attached
to the phenyl, which can be methyl or hydrogen, depending on the tocopherol at dispute.
| Tocopherol form |
x mg α-TE |
IU vitamin E |
| RRR-α-tocopherol (d-α-tocopherol) |
1.0 |
1.49 |
| all rac-α-tocopherol (d,l-α-tocopherol) |
0.74 |
1.10 |
| RRR-α-tocopheryl acetate |
0.91 |
1.36 |
| all rac-α-tocopheryl acetate |
0.67 |
1.00 |
| RRR-α-tocopheryl succinate |
0.81 |
1.21 |
| all rac-α-tocopheryl succinate |
0.60 |
0.89 |
| RRR-β-tocopherol |
0.50 |
0.75 |
| RRR-γ-tocopherol |
0.10 |
0.15 |
| RRR-δ-tocopherol |
0.03 |
0.05 |
| RRR-α-tocotrienol |
0.50 |
0.75 |
| RRR-β-tocotrienol |
0.05 |
0.08 |
Proteinaceous content
[0043] The present composition preferably has a low proteinaceous content, including free
amino acids, peptides, (un)hydrolysed proteins, and salts thereof It is preferred
that a unit dose contains less than 300 mg, more preferably less than 200 mg, most
preferably less than 100 mg of proteinaceous material. Most preferably, the composition
is at least free from peptides and proteins, and hydrolysates thereof.
[0044] In one embodiment, the proteinaceous content of the composition of the invention
is less than 20 wt%, more preferably less than 10 wt%, based on the dry weight of
the composition.
[0045] Additionally or alternatively, the weight ratio of proteinaceous material over the
sum of DHA, EPA and uridine and its equivalents is preferably less than 1, more preferably
less than 0.5, most preferably less than 0.25, particularly less than 0.1.
Other therapeutics
[0046] It may be appropriate to include any therapeutic which can be used to protect an
individual against any of the conditions or diseases discussed herein, and may include
a drug. Such therapeutic compounds will be well known to the skilled person for the
particular disease or condition treated.
[0047] The active ingredients of the invention may be provided as salts with pharmaceutically
compatible counter ions. Pharmaceutically compatible salts may be formed with many
acids, including but not limited to hydrochloric, sulphuric, acetic, lactic, tartaric,
malic, succinic, etc. Salts tend to be more soluble in aqueous or other protonic solvents
that are the corresponding free base forms.
Uses
[0048] The invention pertains to the use of the above-defined composition for preventing
and/or treating memory decline and/or cognitive dysfunction, Alzheimer's and/or dementia.
In the context of the invention, "dementia" is especially understood "senile dementia".
Senile dementia or dementia is considered to comprise Alzheimer's disease (AD).
[0049] The invention also pertains to the use of said composition for reducing neurodegeneration
and/or reducing the deposition of (abeta) plaques in the brain, and/or for promoting
or supporting healthy brain function.
[0050] In one embodiment the present composition is administered to a prodromal dementia
patient and/or prodromal Alzheimer patient. A "prodromal dementia patient" is a person
who does not suffer from a senile dementia as defined above, but has an increased
likelihood to develop senile dementia. Likewise a "prodromal Alzheimer patient" is
a person who does not suffer from AD, but has an increased likelihood to develop AD.
The diagnostic tools that are used to classify the patients as prodromal patients
are described below and include an accurate diagnosis of brain lesions and biochemical
problems and careful setting of criteria.
[0051] Prodromal patients are defined to be persons that score positively on at least one,
preferably at least two, more preferably at least three of the following criteria:
- a level of more than 350 ng Total-tau per litre cerebrospinal fluid (CSF);
- a weight ratio of abeta-42/ Phospho-tau-181 of less than 6.5 in CSF;
- presence of medial temporal lobe (MTL) atrophy, existing of volume loss of hippocampus,
entorhinal cortex, or amygdala evidenced on Magnetic Resonance Imaging (MRI) with
either qualitative ratings using visual scoring (referenced to well characterised
population with age norms) or quantitative volumetry of regions of interest (referenced
to well characterized population with age norms)
- presence of fronto-temporal lobe (FTL) atrophy evidenced on MRI with qualitative ratings
or quantitative volumetry;
- a level of more than 25 pg F2-iso-prostane (F2-IsoP, isoprostane 8,12-iso-iPF2alpha-VI) per mL CSF.
Further explanations of the significance of concentrations of T-tau, P-tau181, Abeta42
and F2-Isoprostane in CSF for future development of Alzheimer's disease can be found
in:
Hansson O, Zetterberg H, Buchhave P, Londos E, Blennow K, Minthon L (2006) Association
between CSF biomarkers and incipient Alzheimer's disease in patients with mild cognitive
impairment: a follow-up study. Lancet Neurol 5:228-234; and in
Pratico D, Clark CM, Liun F, Lee VYM, Trojanowski JQ (2002) Increase in brain oxidative
stress in mild cognitive impairment: a possible predictor of Alzheimer disease. Arch
Neurol 59:972-976.
[0052] It should be noted that the score of these prodromal patients in tests relating to
the presence of episodic memory impairment or other tests suitable for the judgment
of the presence of the neurological disease, does not meet the criteria for diagnosing
a neurological disease like Alzheimer's disease.
[0053] The invention also pertains to the treatment of age-associated memory impairment
(AAMI), Mild Cognitive Impairment (MCI), significant episodic memory impairments and
to treating elderly with memory and/or cognitive impairments, using the aforementioned
composition.
[0054] It is also an objective of the invention to provide a method for supporting brain
health and/or reducing plaque burden and/or reducing neurodegeneration in a subject
in need thereof, such as a subject suffering from one of the aforementioned disorders,
by administering to said subject the low or reduced volume composition as defined
above.
[0055] Trademarks which provide an implicit link between the composition and one or more
of the intended uses as defined above are also considered to fall within the scope
of the invention.
EXAMPLES
Capsule composition,
[0056] A capsule was prepared comprising a blend of 500 mg marine oils, comprising 60 mg
docosahexaenoic acid. The amount of EPA was 90 mg. It included 150 mg uridine monophosphate
and 6 mg alpha-tocopherol. All numbers were based on the dry weight of the capsule.
The total weight of the capsule was 1.1 g. The capsule further contained glycerine,
polysorbate 40, and calcium alginate.
[0057] One to four of these capsules were recommended daily for preferably more than one
month.
EXPERIMENT 1
[0058] The current experiment tested whether UMP, DHA, UMP+DHA and UMP+DHA+ alpha-tocopherol
could reduce abeta plaques and neurodegeneration in Alzheimer's disease (AD) model
mice, the APP/PS1 mice. These mice start showing plaques in their brains as early
as 4-5 months of age and are considered a good model for AD in scientific literature.
[0059] The mice were fed diets enriched in (1) UMP, (2) DHA, (3) UMP+DHA or (4) UMP+DHA+
alpha-tocopherol starting at 3 months of age, just before the first plaques become
apparent. The diets were fed for a period of 3 months until the age of 6 months. Thereafter
the mice were sacrificed and their brains processed for abeta plaque analyses and
neurodegeneration analyses. The brain was cut into thin slices using a vibratome and
the slices were stained for abeta using an antibody recognizing human abeta and for
neurodegeneration using the amino-cupric staining. The total number of plaques in
the hippocampus was counted and the total surface of the area covered by plaques (plaque
burden) was determined. Total surface area covered with neuritic plaques (staining
positive for amino-cupric) was determined to measure the level of neurodegeneration.
Results
[0060] The results are shown in Figures 1 and 2, for plaque burden and neurodegeneration,
respectively. In each case, Figure "A" shows the effect of the composition (4) in
accordance with the invention, and Figure "B" shows the effect of individual nutrients.
"Multi" refers to composition (4), containing DHA, UMP and alpha-tocopherol.
[0061] Figure 1A shows that intervention reduced plaque burden in the hippocampus of APP/PS1
mice. When UMP or DHA were fed, plaque burden was not affected. The combination of
UMP and DHA resulted in an increase in plaque burden (Fig 1B).
[0062] Mice fed diet (4) showed lower levels of neurodegeneration compared to control diet
fed mice (fig 2A). Mice fed UMP or DHA did not differ from the control whereas UMP+DHA
mice tended to display higher levels of neurodegeneration (Fig 2B).
[0063] From this study it was concluded that intervention with the composition of the invention
is effective in reducing abeta production, reducing abeta plaque formation and reducing
neurodegeneration. Individual nutrients either have no effect on these parameters
or they induce further deterioration compared to mice fed a control diet.
EXPERIMENT 2
[0064] Alzheimer's disease is characterized by a loss of cognitive abilities which can be
explained by a loss of communication between neuronal cells leading to a reduction
in neuronal functioning and eventually neuronal cell death (neurodegeneration). Neuronal
communication is dependent upon the connections (synapses) between neurons where neurotransmitters
from the pre-synaptic neuron are released and bind to receptors on the post-synaptic
neuron. Receptor function is an important factor in neuronal communication. By improving
receptor function, neuronal cells would communicate more effectively which would be
reflected by e.g. lower levels of a receptor agonist to induce the same level of stimulation.
[0065] In the experiment described below, neuronal pheochromocytoma cells (PC12 cells) were
used to study the effect of incubation with nutrients (docosahexaenoic acid (DHA),
uridine monophosphate (UMP), alpha-tocopherol (vitamin E) or combinations thereof)
on receptor functionality.
[0066] To this end, the cells were cultured in a 96-wells format and incubated with control
medium, control medium + alpha-tocopherol, control medium + UMP, control medium +
DHA + alpha-tocopherol, or control medium + DHA + UMP + alpha-tocopherol. Incubation
with DHA alone led to cell death. After 1 day of incubation the medium + additions
were replaced by control medium and the cells were stimulated with 50 µM oxotremorine,
an agonist at the muscarinic acetylcholine receptor, involved in learning and memory.
Oxotremorine induces a depolarization of the membrane which can be measured as a change
in membrane potential. At a fixed dose of the agonist, increases in membrane potential
are thought to reflect improvements in receptor functioning.
Results
[0067] Figure 3 shows the results in terms of membrane potential change under the different
incubation conditions. The "*" marks that the result was significantly different from
DHA+UMP+alpha-tocopherol (Vit E).
[0068] All data are plotted as percentage change in membrane potential compared to control
conditions. The results show that cells incubated with UMP (first bar), alpha-tocopherol
(second bar), and DHA + alpha-tocopherol (third bar) did not affect membrane potential
change. On the other hand, cells incubated with the combination according to the invention
of DHA + UMP + alpha-tocopherol did show an increase in membrane potential change
(F = 19.9;
p = 0.000).
[0069] The present results indicate that incubation with a combination of alpha-tocopherol,
DHA and UMP synergistically improved receptor functioning. Vitamin E and UMP alone,
and the combination of DHA + alpha-tocopherol had no effect on receptor function.
These results suggest that neuronal cells in the brain of Alzheimer's disease patients
may benefit from the combined supplementation of DHA, UMP and alpha-tocopherol by
improving receptor function and neuronal communication to support cognitive abilities
and to reduce neurodegeneration.
1. A composition comprising per dry weight of unit dose: (i) 10 - 1000 mg uridine in
nucleobase, nucleoside and/or nucleotide form; (ii) 50 - 1000 mg docosahexaenoic acid
(DHA); and (iii) a tocopherol and/or tocotrienol, wherein said composition has:
a) a weight of 200 - 3000 mg per unit dose;
b) an energy content of less than 209.3 kJ [50 kcal] per unit dose; and/or
c) a volume between 0.1 and 10 ml per unit dose,
and wherein the unit dose is a tablet, gel, dragee, pill, capsule, granule, pellet,
or sachet.
2. The composition according to claim 1, having at least two of said features of a) weight,
b) energy content and c) volume.
3. The composition according to claim 1 or 2, wherein the tocopherol is alpha-tocopherol.
4. The composition according to any one of the preceding claims, containing 5 - 75 wt%
DHA, based on the dry weight of said unit dose.
5. The composition according to any one of the preceding claims, containing uridine and
its equivalents in an amount of 1 - 50 wt%, based on the dry weight of said unit dose.
6. The composition according to any one of the preceding claims, wherein the weight ratio
of (ii) to (i) is at least 1.
7. The composition according to any one of the preceding claims, containing less than
300 mg proteinaceous material per unit dose.
8. The composition according to any one of the preceding claims, containing less than
20 wt% of proteinaceous material based on the dry weight of the composition.
9. The composition according to any one of the preceding claims, wherein the weight ratio
of proteinaceous material over the sum of (i) and (ii) is less than 1.
10. The composition according to any one of the preceding claims, for use in the treatment
and/or prevention of a disorder selected from the group of memory dysfunction, cognitive
dysfunction, Alzheimer's and dementia.
11. The composition according to any one of claims 1 - 9, for use in reducing neurodegeneration,
for use in reducing the deposition of plaques in the brain and/or for use in promoting,
optimizing and/or supporting brain function or brain health.
12. A cartridge, pack or dispenser device containing one or more of the compositions according
to any one of claims 1 - 9, accompanied by instructions for administration of said
composition.
13. Use of the composition according to any one of claims 1 - 9 in the manufacture of
a preparation for treatment and/or prevention of a disorder selected from the group
of memory dysfunction, cognitive dysfunction, Alzheimer's and dementia.
14. Use of the composition according to any one of claims 1 - 9 in the manufacture of
a preparation for reducing neurodegeneration, for reducing the deposition of plaques
in the brain and/or for promoting, optimizing and/or supporting brain function or
brain health.
1. Zusammensetzung, die pro Trockengewicht einer Einheitsdosis umfasst: (i) 10 bis 1000
mg Uridin in einer Nukleobase-, Nukleosid- und/oder Nukleotidform, (ii) 50 bis 1000
mg Docosahexaensäure (DHA) und (iii) ein Tocopherol und/oder Tocotrienol, wobei die
Zusammensetzung aufweist:
a) ein Gewicht von 200 bis 3000 mg pro Einheitsdosis,
b) einen Energiegehalt von weniger als 209,3 kJ [50 kcal] pro Einheitsdosis und/oder
c) ein Volumen zwischen 0,1 und 10 ml pro Einheitsdosis,
und wobei die Einheitsdosis eine Tablette, ein Gel, ein Dragee, eine Pille, eine Kapsel,
ein Granulat, ein Kügelchen oder ein Portionsbeutel ist.
2. Zusammensetzung nach Anspruch 1, die mindestens zwei der Merkmale von a) Gewicht,
b) Energiegehalt und c) Volumen aufweist.
3. Zusammensetzung nach Anspruch 1 oder 2, wobei das Tocopherol alpha-Tocopherol ist.
4. Zusammensetzung nach einem der vorhergehenden Ansprüche, die 5 bis 75 Gew.-% DHA auf
der Basis des Trockengewichts der Einheitsdosis enthält.
5. Zusammensetzung nach einem der vorhergehenden Ansprüche, die Uridin und dessen Äquivalente
in einer Menge von 1 bis 50 Gew.-% auf der Basis des Trockengewichts der Einheitsdosis
enthält.
6. Zusammensetzung nach einem der vorhergehenden Ansprüche, wobei das Gewichtsverhältnis
von (ii) zu (i) mindestens 1 beträgt.
7. Zusammensetzung nach einem der vorhergehenden Ansprüche, die weniger als 300 mg Protein-enthaltendes
Material pro Einheitsdosis enthält.
8. Zusammensetzung nach einem der vorhergehenden Ansprüche, die weniger als 20 Gew.-%
Protein-enthaltendes Material auf der Basis des Trockengewichts der Zusammensetzung
enthält.
9. Zusammensetzung nach einem der vorhergehenden Ansprüche, bei der das Gewichtsverhältnis
von Protein-enthaltendem Material bezogen auf die Summe von (i) und (ii) weniger als
1 beträgt.
10. Zusammensetzung nach einem der vorhergehenden Ansprüche zur Verwendung bei der Behandlung
und/oder Prävention einer Erkrankung, die aus der Gruppe von Gedächtnisstörung, kognitiver
Störung, Alzheimer und Demenz ausgewählt ist.
11. Zusammensetzung nach einem der Ansprüche 1 bis 9 zur Verwendung bei der Verminderung
einer Neurodegeneration, zur Verwendung bei der Verminderung der Abscheidung von Plaques
im Gehirn und/oder zur Verwendung bei der Förderung, der Optimierung und/oder der
Unterstützung der Gehirnfunktion oder der Gesundheit des Gehirns.
12. Kartusche, Packung oder Abgabevorrichtung, die eine oder mehrere der Zusammensetzungen
nach einem der Ansprüche 1 bis 9 zusammen mit Anweisungen zum Verabreichen der Zusammensetzung
enthält.
13. Verwendung der Zusammensetzung nach einem der Ansprüche 1 bis 9 bei der Herstellung
eines Präparats zur Behandlung und/oder Prävention einer Erkrankung, die aus der Gruppe
von Gedächtnisstörung, kognitiver Störung, Alzheimer und Demenz ausgewählt ist.
14. Verwendung der Zusammensetzung nach einem der Ansprüche 1 bis 9 bei der Herstellung
eines Präparats zur Verminderung einer Neurodegeneration, zur Verminderung der Abscheidung
von Plaques im Gehirn und/oder zur Förderung, Optimierung und/oder Unterstützung der
Gehirnfunktion oder der Gesundheit des Gehirns.
1. Composition comprenant par masse sèche de dose unitaire : (i) 10 - 1 000 mg d'uridine
dans une forme de nucléobase, de nucléoside et/ou de nucléotide ; (ii) 50 - 1 000
mg d'acide docosahexaénoïque (DHA) et (iii) un tocophérol et/ou tocotriénol, dans
laquelle ladite composition présente :
a) une masse de 200 - 3 000 mg par dose unitaire ;
b) une teneur en énergie inférieure à 209,3 kJ [50 kcal] par dose unitaire ; et/ou
c) un volume de 0,1 à 10 ml par dose unitaire,
et dans laquelle la dose unitaire est un comprimé, un gel, une dragée, une pilule,
une gélule, un granulé, une boulette ou un sachet.
2. Composition selon la revendication 1, présentant au moins deux desdits aspects de
a) masse, b) teneur en énergie et c) volume.
3. Composition selon la revendication 1 ou 2, dans laquelle le tocophérol est l'alpha-tocophérol.
4. Composition selon l'une quelconque des revendications précédentes, contenant 5-75
% en masse de DHA, rapporté à la masse sèche de ladite dose unitaire.
5. Composition selon l'une quelconque des revendications précédentes, contenant de l'uridine
et ses équivalents dans une quantité de 1-50 % en masse, rapporté à la masse sèche
de ladite dose unitaire.
6. Composition selon l'une quelconque des revendications précédentes, dans laquelle le
rapport massique de (ii) à (i) est d'au moins 1.
7. Composition selon l'une quelconque des revendications précédentes, contenant moins
de 300 mg de matériau protéiné par dose unitaire.
8. Composition selon l'une quelconque des revendications précédentes, contenant moins
de 20 % en masse de matériau protéiné rapporté à la masse sèche de la composition.
9. Composition selon l'une quelconque des revendications précédentes, dans laquelle le
rapport en masse du matériau protéiné par rapport à la somme de (i) et (ii) est inférieur
à 1.
10. Composition selon l'une quelconque des revendications précédentes, pour une utilisation
dans le traitement et/ou la prévention d'un trouble choisi dans le groupe constitué
d'un dysfonctionnement de la mémoire, d'un dysfonctionnement cognitif, de la maladie
d'Alzheimer et de la démence.
11. Composition selon l'une quelconque des revendications 1-9, pour une utilisation dans
la réduction de la neurodégénérescence, pour une utilisation dans la réduction du
dépôt de plaques dans le cerveau et/ou pour une utilisation dans la promotion, l'optimisation
et/ou le soutien de la fonction cérébrale ou de la santé cérébrale.
12. Cartouche, pack ou dispositif de distribution contenant une ou plusieurs des compositions
selon l'une quelconque des revendications 1-9, accompagné d'instructions pour l'administration
de ladite composition.
13. Utilisation de la composition selon l'une quelconque des revendications 1-9 dans la
fabrication d'une préparation pour le traitement et/ou la prévention d'un trouble
choisi dans le groupe constitué d'un dysfonctionnement de la mémoire, d'un dysfonctionnement
cognitif, de la maladie d'Alzheimer et de la démence.
14. Utilisation de la composition selon l'une quelconque des revendications 1-9 dans la
fabrication d'une préparation pour la réduction de la neurodégénérescence, pour la
réduction du dépôt de plaques dans le cerveau et/ou pour la promotion, l'optimisation
et/ou le soutien de la fonction cérébrale ou de la santé cérébrale.