JP7584766B2 - 脳血管障害および認知症の治療のための医薬組成物 - Google Patents
脳血管障害および認知症の治療のための医薬組成物 Download PDFInfo
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- JP7584766B2 JP7584766B2 JP2020565210A JP2020565210A JP7584766B2 JP 7584766 B2 JP7584766 B2 JP 7584766B2 JP 2020565210 A JP2020565210 A JP 2020565210A JP 2020565210 A JP2020565210 A JP 2020565210A JP 7584766 B2 JP7584766 B2 JP 7584766B2
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Description
本特許出願は、米国仮出願62/790,305号(2019年1月9日出願)に基づくパリ条約上の優先権および利益を主張する者であり、ここに引用することによって、上記出願に記載された内容の全体が、本明細書中に組み込まれるものとする。
本願の開示は、脳血管障害および認知症を予防もしくは治療するための、またはこれら疾患の進行を抑制するための、医薬および方法を提供する。
本発明者等は、これまでに、蛍光ニトロキシドプローブ化合物を用いる、脂質過酸化抑制を検出および評価するためのアッセイ方法およびスクリーニング方法を見出し、また、そのスクリーニング方法を用いた脂質過酸化抑制の活性を示す候補化合物は、腹腔内投与によって、加齢黄斑変性症に対する治療活性を示すことを見出し、報告している(特許文献1)。
群:アポモルヒネ ((R)-(-)-アポモルヒネ 塩酸)、エセロリン ((-)-エセロリンフマル酸塩)、エトキシキン (6-エトキシ-2,2,4-トリメチル-1,2-ジヒドロキノリン)、メチルドパ (メチルドーパ セスキ水和物)、オランザピン(2-メチル-4-(4-メチル-1-ピぺラジニル)-10H-チエノ[2,3-b][1,5]ベンゾジアゼピン)、3-アミノ-4-(フェニルアミノ)安息香酸メチル、3-アミノ-4-((4-メトキシフェニル)アミノ)安息香酸メチル、3-アミノ-4-((3-メトキシフェニル)アミノ)安息香酸メチル、3-アミノ-4-(ベンジルアミノ)安息香酸メチル、3-アミノ-4-((1-フェニルエチル)アミノ)安息香酸メチル、1-(4-(トリフルオロメトキシ)フェニル)インドリン-5-アミン、1-(3,5-ジメチルフェニル)-1H-インドール-6-アミン、1-(3,5-ジメチルフェニル)インドリン-6-アミン、1-(4-メトキシフェニル)-1H-インドール-6-アミン、1-(4-(メチルチオ)フェニル)-1H-インドール-6-アミン、1-(4-(トリフルオロメトキシ)フェニル)-1H-インドール-5-アミン、およびインダパミド (4-クロロ-N-[(2RS)-2-メチル-2,3-ジヒドロ-1H-インドール-1-イル]-3-スルファモイルベンズアミド)からなる群。
[2] 該化合物が、下記群から選ばれる少なくとも1つの化合物である、[1]に記載の医薬組成物:
エトキシキン(6-エトキシ-2,2,4-トリメチル-1,2-ジヒドロキノリン)、およびメチルドパ(メチルドーパ セスキ水和物)からなる群。
[3] 経口投与または腹腔内投与として用いられる、[1]に記載の医薬組成物。
[4] 処置を必要とする対象者が哺乳類である、[1]に記載の医薬組成物。
[5] 処置を必要とする対象者がヒトである、[1]に記載の医薬組成物。
[6] 処置を必要とする対象者が若年性認知症を患っている、[1]に記載の医薬組成物。
[7] 治療学的に有効量の前記[1]に記載の化合物を、処置を必要とする対象者に投与することを特徴とする、脳血管障害または血管性認知症を予防もしくは治療する、または疾患の進行を抑制するための方法。
[8] 処置を必要とする対象者における脳血管障害または血管性認知症を予防もしくは治療するまたは疾患の進行を抑制するための医薬の製造における、前記[1]に記載の化合物の使用。
[9] 処置を必要とする対象者における脳血管障害または血管性認知症を予防もしくは治療するまたは疾患の進行の抑制に使用するための、前記[1]に記載の化合物。
[10] 前記[1]に記載の化合物を含む、脳血管障害または血管性認知症を予防もしくは治療する、または疾患の進行を抑制するための飲食品。
[11] 健康食品、機能性食品、特定保健用食品、栄養補助食品、疾病リスク低減表示が付された食品、または病者用食品である、前記[10]に記載の飲食品。
[12] 治療学的に有効量の前記[1]に記載の化合物を投与することによる、マトリックスメタロプロテアーゼ-9(MMP-9)によるミエリンベーシックタンパク質の減少に起因する疾患を治療する、または疾患の進行を抑制するための方法。
脳血管障害とは、総称して脳の血管が障害を受けることによって生じる疾患を意味する。脳血管障害とは、脳出血(出血性脳血管障害)および脳梗塞(虚血性脳血管障害)とに大別される。本明細書中で使用する脳血管障害は、脳出血および脳梗塞の両方を包含し、脳梗塞が好ましい。脳出血は更に、血管を詰まらせる原因によって脳血栓および脳塞栓に分類される。本明細書中で使用される脳血管障害とは、これらの疾患または障害の1つ以上の症状を含む。
から選ばれる少なくとも1つの化合物(以下、本明細書中、「本発明の活性薬物」または「本化合物」と呼称することがある)の有効量、および医薬的に許容し得る担体を含む、経口投与または腹腔内投与の医薬組成物(以下、本明細書中、「本発明の医薬組成物」と呼称することがある)、を提供する。
・アポモルヒネ ((R)-(-)-アポモルヒネ 塩酸)
・エセロリン ((-)-エセロリンフマル酸塩)
・エトキシキン (6-エトキシ-2,2,4-トリメチル-1,2-ジヒドロキノリン)
・メチルドパ (メチルドーパ セスキ水和物)
・オランザピン(2-メチル-4-(4-メチル-1-ピぺラジニル)-10H-チエノ[2,3-b][1,5]ベンゾジアゼピン)
・3-アミノ-4-(フェニルアミノ)安息香酸メチル
・3-アミノ-4-((4-メトキシフェニル)アミノ)安息香酸メチル
・3-アミノ-4-(ベンジルアミノ)安息香酸メチル
・3-アミノ-4-((1-フェニルエチル)アミノ)安息香酸メチル
・1-(4-(トリフルオロメトキシ)フェニル)インドリン-5-アミン
・1-(3,5-ジメチルフェニル)-1H-インドール-6-アミン
・1-(3,5-ジメチルフェニル)インドリン-6-アミン
・1-(4-メトキシフェニル)-1H-インドール-6-アミン
・1-(4-(メチルチオ)フェニル)-1H-インドール-6-アミン
・1-(4-(トリフルオロメトキシ)フェニル)-1H-インドール-5-アミン
・インダパミド(4-クロロ-N-[(2RS)-2-メチル-2,3-ジヒドロ-1H-インドール-1-イル]-3-スルファモイルベンズアミド)
活性薬物としての本化合物は、上記化合物およびその医薬的に許容し得る塩の形態を含む。また、本発明の活性薬物またはその医薬的に許容し得る塩は、その水和物または溶媒等の溶媒和物を含む。更に、本発明は、本発明の活性薬物のあらゆる形態の結晶体を含む。
群:アポモルヒネ((R)-(-)-アポモルヒネ 塩酸)、エセロリン((-)-エセロリンフマル酸塩)、エトキシキン(6-エトキシ-2,2,4-トリメチル-1,2-ジヒドロキノリン)、メチルドパ(メチルドーパ セスキ水和物)、オランザピン(2-メチル-4-(4-メチル-1-ピぺラジニル)-10H-チエノ[2,3-b][1,5]ベンゾジアゼピン)、およびインダパミド (4-クロロ-N-[(2RS)-2-メチル-2,3-ジヒドロ-1H-インドール-1-イル]-3-スルファモイルベンズアミド
からなる群、
から選ばれる少なくとも1つの化合物であることが好ましい。
群:エトキシキン(6-エトキシ-2,2,4-トリメチル-1,2-ジヒドロキノリン)、およびメチルドパ(メチルドーパ セスキ水和物)からなる群、
から選ばれる少なくとも1つの化合物であることがより好ましい。
実施例に使用した化合物、マウスまたは試薬等は、市販のものを入手するか、あるいは公知の方法に従って製造した。
本発明の医薬組成物の製剤例を以下に示すが、これらに限定されるものではない。
錠剤
一般的に知られる錠剤の製剤化の方法に従って、錠剤を製造する。具体的には、本化合物としてのメチルドパ、トウモロコシデンプン、および乳糖を混合機中で混合し、その混合物にカルボキシメチルセルロースカルシウム、およびヒドロキシプロピルセルロースを加えて造粒し、得られた顆粒を乾燥後整粒し、その整粒した顆粒に、ステアリン酸マグネシウムを加えて混合し、打錠機で打錠する。また、本化合物の添加量を変えることにより、100mgの錠剤中の所望する含有量(例えば、10mg、25mg、または50mg)の錠剤を製造することができる。
本発明の化合物の脳血管障害または血管性認知症の処置などの効力を調べた試験を記載する。
血管性認知症疾患モデルマウスの作製
まず、一般的な血管性認知症疾患モデルマウスの作製方法(例えば、Shibata M, Ohtani R, Ihara M, et al., Stroke 35: 2598-2603, 2004、またはIhara M, Taguchi A, Maki T, et al., Methods Mol Biol 1135: 95-102, 2014)に従って、マウスには、右総頸動脈に0.18mm、および左総頸動脈に0.16mmの微小コイルを装着させた。
次に、血管性認知症疾患モデルマウス(Bilateral common artery stenosis (BCAS) modelと称する)を図1に示す下記のスケジュールに従って作製した。
エトキシキンまたはメチルドパを、100μモル/kgの用量で経口投与または腹腔内投与により、3回/週の割合で試験終了時まで(例えば、1~4週間)投与した。なお、コントロールとして健常マウスを用いた場合の試験結果をあわせて示す。
血液脳関門破壊抑制の試験
試験例1で調製した血管性認知症疾患モデルマウスを手術7日目に安楽死させた。マウス(N(匹数)=4匹)の海馬および線条体組織は、ベンジルスルホニルフルオリド(benzylsulfonyl fluoride)とプロテアーゼインヒビターカクテル(protease inhibitor cocktail)およびオルトバナジン酸ナトリウム(sodium orthovanadate)を含む20 倍量の溶解バッファー(lysis buffer)中にてホモジネートを作成した。ホモジネートを氷上で冷却しながら超音波で破砕し、遠心分離後、上清をビシンコニン酸(BCA)法により蛋白質を定量した。その後、調整した蛋白質サンプルは、一般的に知られる方法に準じて、マトリックスメタロプロテアーゼ-9(MMP-9)に対する抗体を用いたウェスタンブロットの方法に従って、血液脳関門破壊抑制に対する影響を評価した。
Mean + S.D., (n=4), **p<0.01 v.s. ctrl, ##p<0.01, v.s. BCAS
試験結果を図2に示す。化合物1(エトキシキン)(A)および化合物2(メチルドパ)(B)は、血液脳関門破壊の抑制効果を示唆した。
ミエリンベーシックタンパク質(MBP)の減少抑制の試験
試験例1で調製した血管性認知症疾患モデルマウスを手術28日目に安楽死させた。マウス(N(匹数)=6~8匹)の脳の凍結切片を冷アセトンにて10分固定し、PBSで5分間(×3回)洗浄した。0.3%過酸化水素溶液で10分間内因性ペルオキシダーゼのブロッキングを行い、抗MBPポリクローナル抗体にて1日反応させた。その後、PBSで5分間(×3回)洗浄し、2次抗体に60分間反応させた。その後、4',6-ジアミジノ-2-フェニルインドール(DPI)含有固定細胞用のProLong褪色防止用封入剤(ProLong(登録商標) Gold antifade reagent with DAPI)(インビトロ社製)にて封入し、共焦点レーザースキャン顕微鏡(例えば、LSM700)にて観察、撮像した。
試験結果を図3に示す。化合物1(エトキシキン)および化合物2(メチルドパ)は、ミエリンベーシックタンパク質の減少抑制の効果を示唆した。
新奇物体認識試験
新奇性を好むというげっ歯類の特性を利用した新奇物体認識試験を行った。予め観察箱に馴化させておいた試験例1で調製した血管性認知症疾患モデルマウス(N(匹数)=8-10匹)を、2時間後同一の観察箱に入れ、2個の同一物体を10分間自由に探索させた(獲得試行)。一定時間経過後、片方の物体を新規の物体に変え、再度動物を観察箱に入れ、物体の探索時間を10分間測定した(テスト試行)。新規物体、学習済み物体の探索時間をそれぞれN、Fとし、下記式:総探索時間(Exploration time)= N+F、弁別指数(Discrimination Index)= (N-F)/(N+F)として算出した。
Mean + S.D., (n=8-10), *p<0.05 v.s. ctrl(control), #p<0.05 v.s.BCAS
試験結果を図4に示す。化合物1(エトキシキン)(A)および化合物2(メチルドパ)(B)は、長期的空間記憶における認知機能障害の改善を示した。
脳血流の影響の試験
試験例1で調製するための血管性認知症疾患モデルマウス(N(匹数)=6~8匹)について、中大脳動脈と前大脳動脈の境界部(Blegma)の脳血流量を、虚血手術直前、直後、1日後、4日後、7日後、14日後に測定した。脳血流量は、レーザドップラー(Laser-Doppler)血流計プローブを頭蓋骨に固定し測定し、脳血流は虚血直前の血流量に対する比率で評価した。
エトキシキンまたはメチルドパを、50、75、あるいは100μモル/kgの用量で経口投与により、3回/週の割合で試験終了時まで(例えば、1~4週間)投与した。
試験結果を図5に示す。化合物1(エトキシキン)(A)および化合物2(メチルドパ)(B)は、脳血流に影響を及ぼさないことを示唆した。
Claims (9)
- 処置を必要とする対象者における脳血管障害または血管性認知症を予防する、または疾患の進行を抑制するための、下記群からなる群から選ばれる少なくとも1つの化合物、および医薬的に許容し得る担体を含む、医薬組成物であって、
該処置を必要とする対象者は若年性認知症を患っており、
群:エトキシキン (6-エトキシ-2,2,4-トリメチル-1,2-ジヒドロキノリン)、およびメチルドパ (メチルドーパ セスキ水和物)からなる群:
ここで、メチルドパまたはエトキシキンの有効量は、それぞれ、1日用量当たり0.001~50mg/体重kgである、
該医薬組成物。 - 経口投与または腹腔内投与として用いられる、請求項1に記載の医薬組成物。
- 処置を必要とする対象者が哺乳類である、請求項1に記載の医薬組成物。
- 処置を必要とする対象者がヒトである、請求項1に記載の医薬組成物。
- 医薬組成物が経口投与または腹腔内投与によって投与される場合、メチルドパまたはエトキシキンの有効量が、それぞれ、1日用量当たり0.1~50mg/体重kgである、請求項1~4のいずれか1項に記載の医薬組成物。
- 医薬組成物が、1日1回または複数回、または、数日~数週に1回または複数回、投与する、請求項1~5のいずれか1項に記載の医薬組成物。
- 処置を必要とする対象者における脳血管障害または血管性認知症を予防するまたは疾患の進行を抑制するための医薬の製造における、エトキシキン (6-エトキシ-2,2,4-トリメチル-1,2-ジヒドロキノリン)、およびメチルドパ (メチルドーパ セスキ水和物)からなる群から選ばれる少なくとも1つの化合物の使用であって、
該処置を必要とする対象者は若年性認知症を患っており、
ここで、メチルドパまたはエトキシキンの有効量は、それぞれ、1日用量当たり0.001~50mg/体重kgである、
該使用。 - エトキシキン (6-エトキシ-2,2,4-トリメチル-1,2-ジヒドロキノリン)、およびメチルドパ (メチルドーパ セスキ水和物)からなる群から選ばれる少なくとも1つの化合物を含む、脳血管障害または血管性認知症を予防する、または疾患の進行を抑制するための飲食品であって、
該処置を必要とする対象者は若年性認知症を患っており、
ここで、メチルドパまたはエトキシキンの有効量は、それぞれ、1日用量当たり0.001~50mg/体重kgである、
該飲食品。 - 健康食品、機能性食品、特定保健用食品、栄養補助食品、疾病リスク低減表示が付された食品、または病者用食品である、請求項8に記載の飲食品。
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