CN100398154C - 精神神经疾病治疗药 - Google Patents

精神神经疾病治疗药 Download PDF

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CN100398154C
CN100398154C CNB02807257XA CN02807257A CN100398154C CN 100398154 C CN100398154 C CN 100398154C CN B02807257X A CNB02807257X A CN B02807257XA CN 02807257 A CN02807257 A CN 02807257A CN 100398154 C CN100398154 C CN 100398154C
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熊谷裕生
内海润
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Abstract

一种可用于神经疾病、特别是不安腿综合症的治疗的精神神经疾病治疗药。本发明的精神神经疾病治疗药含有(-)-17-(环丙基甲基)-3,14β-二羟基-4,5α-环氧基-6β-[N-甲基-反式-3-(3-呋喃基)丙烯酰胺]吗啡喃盐酸盐这样的阿片样物质κ受体激动性化合物(喷他佐辛除外)作为有效成分。

Description

精神神经疾病治疗药
技术领域
本发明涉及精神神经疾病治疗药。本发明的精神神经疾病治疗药可用于不安腿综合症(Restless legs syndrome,以下往往称为“RLS”)等神经疾病的治疗。
背景技术
RLS被认为是末梢神经障碍之一的神经系统疾病,是在安静时和入睡时下肢产生强烈痒感等极不愉快的异常感觉的一种病症。上肢和躯干部偶尔也会出现痒感,但正象疾病的名称那样,以特别是下肢出现强烈的异常感觉为特征。一旦RLS发作,就不能使脚一动不动,要想减轻症状,就要互相摩擦足底,或是活动脚。因重症病例不能在床上一动不动地躺着,故要起床下地活动。这种下肢不愉快的感觉只有有经验的患者才了解,根据患者的自诉,多表现为“痒感”或是“蚁爬样的感觉(蚁行感)”等。特别是由于多在夜间入睡时发生,故不能保持安静,使入睡乃至中途睡醒后的再入睡困难,使人苦于重度失眠。由于慢性的睡眠不足,导致患者感到疲劳、强烈的焦躁感。作为引起RLS的病症,曾报告有贫血(缺铁性贫血)、肾衰竭、尿毒症、胃切除后、妊娠、代谢性疾病(糖尿病、紫质症、痛风、淀粉样变性症等)、感染症(结核、肺炎、肝炎、脊髓灰质炎等)、下肢静脉血栓、药物起因(异丙嗪、丙氯拉嗪、巴比妥盐类等)、寒冷、精神因素等。(盐泽全司他,《新药与临床》,第49卷,218-255,2000)。
另外,根据美国国立卫生研究所(NIH)的资料(NIH PublicationNo.00-3788,March 2000),指出RLS除了伴随上述病症的二次发病、家族性遗传的因素以外,还有三环类抗抑郁药、选择性5-羟色胺再吸收抑制剂(SSRIs)、锂、多巴胺拮抗药、咖啡因等的药物起因性。
没有对RLS发病率进行过精密的调查,但据推测,RLS发病率美国为总人口的2~15%(NIH Publication No.00-3788)或者为3~8%(美国RLS财团日语版资料,1999),欧洲为1~5%,日本为1~3%(井上雄一他,《新药与临床》,第49卷,244-255,2000)。在各病症中,肾衰竭患者的发病率极高,推测日美患者的50%左右会发病(江川功他,《新药与临床》,第49卷,230-235,2000)。RLS已成为极大地破坏患者的日常生活质量的原因之一。作为与RLS类似的症状和疾病,可以举出周期性肢体运动异常(periodic limb movements,PLM)、肌阵挛综合症、挛缩、痛性挛缩等。
由于RLS的病因尚未充分解开,故不能确立根本的治疗方法。美国FDA没有承认适用RLS的药剂,尝试多巴胺激动药、阿片样物质【Opioid】(阿片μ受体激动药)、苯二氮杂
Figure C0280725700041
类、抗痉挛药等各种药物疗法,但效果不是很好,而且存在直到第二天早晨仍感到困倦、连续服用效果减弱等问题,皆不能确立为治疗法。作为适用于RLS的阿片类药剂,目前使用可待因、羟可待因、羟考酮、右丙氧芬、曲马朵、美沙酮等的属于阿片μ受体激动药或阿片μ和κ受体激动药的喷他佐辛,但药效皆不明显,而且存在副作用和依赖性的问题,医疗满足度差(NIHPublication No.00-3788和美国RLS财团英语版资料,2000。喷他佐辛:美国专利No.6,114,326号)。
美国于1990年设立RLS研究财团,除了引导人们对疾病的正确理解和在生活上的注意以外,还支持治疗法的研究。
如上所述,RLS不仅使患者产生极不愉快的感觉,使生活质量降低,而且其确切的病因不明,还不能确立有效的治疗方法,因此成为医疗上的大问题,强烈要求开发更有用的治疗方法。
发明内容
本发明的目的在于,提供一种可用于神经疾病、特别是不安腿综合症的治疗的精神神经疾病治疗药。
本发明者们为了达到上述目的而反复进行了精心的研究,结果发现,阿片样物质κ受体激动性化合物可用于神经疾病、特别是不安腿综合症的治疗,至此完成本发明。
即,本发明提供一种含有阿片样物质κ受体激动性化合物(喷他佐辛除外)作为有效成分的精神神经疾病治疗药。另外,本发明提供阿片样物质κ受体激动性化合物(喷他佐辛除外)在制备精神神经疾病治疗药中的使用。进而,本发明还提供包括给予有效量的阿片样物质κ受体激动性化合物(喷他佐辛除外)的神经疾病的治疗方法。
具体实施方式
本发明的阿片样物质κ受体激动性化合物,不拘于其化学结构的特异性,包括对κ受体显示出亲合性的化合物,但优选对κ受体比对μ和δ受体具有更高选择性。更具体地,作为优选的具体例可以举出下述通式(I)所示的吗啡喃化合物或其药理学容许的酸加成盐:
Figure C0280725700051
[式中,
Figure C0280725700052
表示双键或单键,R1表示碳数1~5的烷基、碳数4~7的环烷基烷基、碳数5~7的环链烯基烷基、碳数6~12的芳基、碳数7~13的芳烷基、碳数4~7的链烯基、烯丙基、碳数1~5的呋喃-2-基烷基或者碳数1~5的噻吩-2-基烷基,R2表示氢、羟基、硝基、碳数1~5的烷酰氧基、碳数1~5的烷氧基、碳数1~5的烷基、-NR9R10,R9为氢、碳数1~5的烷基,R10为氢、碳数1~5的烷基、-C(=O)R11-,R11为氢、苯基、碳数1~5的烷基,R3表示氢、羟基、碳数1~5的烷酰氧基或者碳数1~5的烷氧基,A表示-XC(=Y)-、-XC(=Y)Z-、-X-或-XSO2-(此处,X、Y、Z各自独立地为NR4、S或O,R4为氢、碳数1~5的直链或支链烷基、或者碳数6~12的芳基,式中R4可以相同或不同),B表示原子价键、碳数1~14的直链或支链亚烷基(也可以被选自碳数1~5的烷氧基、碳数1~5的烷酰氧基、羟基、氟、氯、溴、碘、氨基、硝基、氰基、三氟甲基和苯氧基中至少一种以上的取代基所取代,1~3个亚甲基也可以被羰基所取代)、含有1~3个双键和/或三键的碳数2~14的直链或支链的非环状不饱和烃(也可以被选自碳数1~5的烷氧基、碳数1~5的烷酰氧基、羟基、氟、氯、溴、碘、氨基、硝基、氰基、三氟甲基和苯氧基中至少一种以上的取代基所取代,1~3个亚甲基也可以被羰基所取代)、或者含有1~5个硫醚键、醚键和/或氨基键的碳数1~14的直链或支链的饱和或不饱和烃(但是杂原子不直接与A键合,1~3个亚甲基也可以被羰基所取代),R5表示氢或具有下述基本骨架:
Figure C0280725700061
(这些式中,Q表示-NH-、-O-或-S-,T表示-CH2-、-NH-、-S-或-O-,1为0~5的整数,m和n各自独立地为0以上的整数,二者之和为5以下的整数)的有机基团(也可以被选自碳数1~5的烷基、碳数1~5的烷氧基、碳数1~5的烷酰氧基、羟基、氟、氯、溴、碘、氨基、硝基、氰基、异硫氰酸酯基、三氟甲基、三氟甲氧基、亚甲基二氧基中至少一种以上的取代基所取代),R6表示氢,R7表示氢、羟基、碳数1~5的烷氧基、碳数1~5的烷酰氧基、或者R6与R7一起表示-O-、-CH2-、-S-,R8表示氢、碳数1~5的烷基、碳数1~5的烷酰基,另外,通式(I)包括(+)体、(-)体、(±)体]。
应予说明,本说明书中,当存在像“烷基”和“烷氧基”那样的直链状和支链状的基团的场合,只要没有特别指明,包括这两种基团。另外,上述通式(I)中R5的定义中的“具有基本骨架的有机基团”,是指从作为上述基本骨架所示的构成各化合物的环上脱除1个氢原子而形成的1价基团以及在该基团上取代了上述取代基的基团。
通式(I)所示的化合物中,R1优选为碳数1~5的烷基、碳数4~7的环烷基甲基、碳数5~7的环链烯基甲基、碳数7~13的苯基烷基、碳数4~7的链烯基、烯丙基、碳数1~5的呋喃-2-基-烷基、碳数1~5的噻吩-2-基-烷基,特别优选为甲基、乙基、丙基、丁基、异丁基、环丙基甲基、烯丙基、苄基、苯乙基、呋喃-2-基-甲基、噻吩-2-基-甲基。
R2优选为氢、羟基、硝基、乙酰氧基、甲氧基、甲基、乙基、丙基、氨基、二甲基氨基、乙酰氨基、苯甲酰氨基,更优选为氢、羟基、硝基、乙酰氧基、甲氧基、甲基、二甲基氨基,特别优选为氢、羟基、乙酰氧基、甲氧基。
R3优选为氢、羟基、乙酰氧基、甲氧基,特别优选为羟基、乙酰氧基、甲氧基。
A具体地优选为-NR4C(=O)-、-NR4C(=S)-、-NR4C(=O)O-、-NR4C(=O)NR4-、-NR4C(=S)NR4-、-NR4C(=O)S-、-OC(=O)-、-OC(=O)O-、-SC(=O)-、-NR4-、-O-、-NR4SO2-、-OSO2-,特别优选为-NR4C(=O)-、-NR4C(=S)-、-NR4C(=O)O-、-NR4C(=O)NR4-、-NR4C(=S)NR4-、-NR4SO2-。R4优选为氢、碳数1~5的直链或支链烷基,特别优选为碳数1~5的直链或支链烷基,其中优选甲基、乙基、丙基、丁基、异丁基。其中,优选-XC(=Y)-(此处,X表示NR4、S或O,Y表示O,R4表示氢或碳数1~5的烷基)、-XC(=Y)Z-、-X-、或-XSO2-(此处,X表示NR4,Y表示O或S,Z表示NR4或O,R4表示氢或碳数1~5的烷基),更优选-XC(=Y)-或-XC(=Y)Z-(此处,X表示NR4,Y表示O,Z表示O,R4表示碳数1~5的烷基)。其中,优选-XC(=Y)-(此处,X表示NR4,Y表示O,R4表示碳数1~5的烷基)。
B的优选例子可以举出-(CH2)n-(n=0~10)、-(CH2)n-C(=O)-(n=1~4)、-CH=CH-(CH2)n-(n=0~4)、-C≡C-(CH2)n-(n=0~4)、-CH2-O-、-CH2-S-、-(CH2)2-O-CH2-、-CH=CH-CH=CH-(CH2)n-(n=0~4),特别优选-(CH2)n-(n=1~3)、-CH=CH-(CH2)n-(n=0~4)、-C≡C-(CH2)n-(n=0~4)、-CH2-O-、-CH2-S-。其中,更优选碳数1~3的直链亚烷基、-CH=CH-、-C≡C-、-CH2O-、或-CH2S-。特别优选-CH=CH-或-C≡C-。(当然,这些优选例子中也包含用上述各种取代基取代、而带有取代基的基团)。
R5优选为氢或具有下述基本骨架:
Figure C0280725700081
(Q、T、l、m和n的定义与上述相同)
的有机基团(也可以被选自碳数1~5的烷基、碳数1~5的烷氧基、碳数1~5的烷酰氧基、羟基、氟、氯、溴、氨基、硝基、氰基、异硫氰酸酯基、三氟甲基、三氟甲氧基、亚甲基二氧基中的至少一种以上的取代基所取代),而且,上述R5中,优选氢、苯基、噻嗯基、呋喃基(这些有机基团也可以被选自碳数1~5的烷基、碳数1~5的烷氧基、碳数1~5的烷酰氧基、羟基、氟、氯、溴、碘、氨基、硝基、氰基、异硫氰酸酯基、三氟甲基、三氟甲氧基、亚甲基二氧基中的至少一种以上的取代基所取代)。
作为更具体的例子,优选氢、苯基、4-甲基苯基、3-甲基苯基、2-甲基苯基、3,4-二甲基苯基、3,5-二甲基苯基、4-甲氧基苯基、3-甲氧基苯基、2-甲氧基苯基、3,4-二甲氧基苯基、4-羟基苯基、3-羟基苯基、3,4-二羟基苯基、4-氟苯基、3-氟苯基、2-氟苯基、3,4-二氟苯基、全氟苯基、4-氯苯基、3-氯苯基、2-氯苯基、3,4-二氯苯基、2,4-二氯苯基、2,4,5-三氯苯基、2,4,6-三氯苯基、4-溴苯基、3-溴苯基、2-溴苯基、4-硝基苯基、3-硝基苯基、2-硝基苯基、4-氨基苯基、3-氨基苯基、2-氨基苯基、4-三氟甲基苯基、3-三氟甲基苯基、2-三氟甲基苯基、4-三氟甲氧基苯基、3-三氟甲氧基苯基、2-三氟甲氧基苯基、3,4-亚甲基二氧基苯基、3-呋喃基、2-呋喃基、3-噻嗯基、2-噻嗯基、环戊基、环己基,当然不限于这些基团。
这些通式(I)所示的阿片样物质κ受体激动性化合物,可以按照转利第2525552中所示的方法来制备。
作为阿片样物质κ受体激动性化合物的优选例子,可以举出下述通式(II)所示的化合物或其药理学容许的酸加成盐:
Figure C0280725700091
[式中,R为2个氢或-O-CH2CH2CH2-,Ar为:
Figure C0280725700092
(式中,X、Y独立地表示氢或氯)
Figure C0280725700101
(式中,Z表示O或S)
而且,通式(II)包括(+)体、(-)体、(±)体]。
通式(II)所示的化合物中,优选反式-2-(3,4-二氯苯基)-N-甲基-N-[2-(1-吡咯烷基)环己基]乙酰胺、反式-N-甲基-N-[2-(1-吡咯烷基)环己基]苯并[b]噻吩-4-乙酰胺、(5β,7β,8α)-3,4-二氯-N-甲基-N-[7-(1-吡咯烷基)-1-氧杂螺[4,5]癸-8-基]苯乙酰胺、(5β,7β,8α)-N-甲基-N-[7-(1-吡咯烷基)-1-氧杂螺[4,5]癸-8-基]苯并[b]呋喃-4-乙酰胺、(5β,7β,8α)-N-甲基-N-[7-(1-吡咯烷基)-1-氧杂螺[4,5]癸-8-基]苯乙酰胺。
这些通式(II)所示的阿片样物质κ受体激动性化合物可以按照J.Szmuszkovicz等人,J.Med.Chem.25,1125(1982),D.C.Horwell等人,美国专利申请558737(1983),J.Szmuszkovicz等人,欧洲专利申请EP 126612(1984),P.R.Halfpenny,D.C.Horwell等人,J.Med.Chem.33,286(1990)所示的方法来制备。
另外,作为阿片样物质κ受体激动性化合物的优选例子,可以举出下述通式(III)所示的化合物或其药理学容许的酸加成盐:
[式中,X为氢、氯或三氟甲基,Y为氢或氯,Z为-CH2-、-OCH2CH2O-或=NCO2CH3,而且,通式(III)包括(+)体、(-)体、(±)体]。
通式(III)所示的化合物中,优选4-[(3,4-二氯苯基)乙酰基]-3-[(1-吡咯烷基)甲基]-1-哌嗪羧酸甲酯、1-[(4-三氟甲基苯基)乙酰基]-2-[(1-吡咯烷基)甲基]哌啶、1-[(3,4-二氯苯基)乙酰基]-2-[(1-吡咯烷基)甲基]哌啶、1-[(3,4-二氯苯基)乙酰基]-4,4-亚乙基二氧基-2-[(1-吡咯烷基)甲基]哌啶。
这些通式(III)所示的阿片样物质κ受体激动性化合物可以按照A.Naylor等人,J.Med.Chem.36,2075(1993)、V.Vecchietti等人,J.Med.Chem.34,397(1991)、ibid.欧洲专利申请EP232,612(1987)、EP260,041(1988)、EP275,696(1988)、D.I.C.Scopes等人,J.Med.Chem.35,490(1992)所示的方法来制备。
另外,作为阿片样物质κ受体激动性化合物的优选例子,可以举出下述通式(IV)所示的化合物或其药理学容许的酸加成盐:
Figure C0280725700111
[式中,X、Y独立地为氢或氯,Z为-CH2-、-O-或-S-,而且,通式(IV)包括(+)体、(-)体、(±)体]。
通式(IV)所示的化合物中,优选3-(1-吡咯烷基甲基)-4-[5,6-二氯-1-茚满羰基]-四氢-1,4-噻嗪。
这些通式(IV)所示的阿片样物质κ受体激动性化合物可以按照WO 94/05646所示的方法来制备。
进而,作为阿片样物质κ受体激动性化合物的优选例子,可以举出下述通式(V)所示的化合物或其药理学容许的酸加成盐:
Figure C0280725700121
[式中,X、Y独立地为氢或氯,而且,通式(V)包括(+)体、(-)体、(±)体]。
通式(V)所示的化合物中,优选2-(3,4-二氯苯基)-N-甲基-N-[1-苯基-2-(1-吡咯烷基)乙基]乙酰胺。
这些通式(V)所示的阿片样物质κ受体激动性化合物可以按照J.J.Barlow等人,J.Med.Chem.34,3149(1991)所示的方法来制备。
作为上述通式(I)~(V)所示的阿片样物质κ受体激动性化合物的药理学优选的酸加成盐,可以举出盐酸盐、硫酸盐、硝酸盐、氢溴酸盐、氢碘酸盐、磷酸盐等无机酸盐、醋酸盐、乳酸盐、柠檬酸盐、草酸盐、戊二酸盐、苹果酸盐、酒石酸盐、富马酸盐、苦杏仁酸盐、马来酸盐、苯甲酸盐、苯二甲酸盐等有机羧酸盐、甲磺酸盐、乙磺酸盐、苯磺酸盐、对甲苯磺酸盐、樟脑磺酸盐等有机磺酸盐等,其中,优选盐酸盐、氢溴酸盐、磷酸盐、酒石酸盐、甲磺酸盐等,当然不限于这些。
这些阿片样物质κ受体激动性化合物可以直接地或者与公知的药理学容许的酸、载体、赋形剂等混合制成医药组合物来口服或者非口服给药。
口服剂可以使用片剂和胶囊剂,非口服剂可以配制成注射剂、经皮吸收剂、带剂、软膏剂、霜膏剂、湿布剂、涂布剂、贴剂、外用液剂、滴眼剂、滴耳剂、滴鼻剂等来使用。这些制剂可以采用医药品领域中通常进行的公知的方法来配制。
医药组合物中的阿片样物质κ受体激动性化合物的含量没有特别的限定,例如,对于口服剂,通常配制成每次服用0.1μg~100mg,对于注射剂,通常配制成0.01μg~10mg,对于经皮剂和外用剂,通常配制成每次涂布0.001ng/m2~100μg/m2
另外,给药量可以根据患者的症状和年龄等来适宜地设定,通常,成人每天的有效成分量,在口服给药的场合,为0.1μg~100mg左右,在非口服给药的场合,为0.01μg~10mg左右。
作为适用于本发明治疗药的疾病为神经疾病,具体地可以举出RLS、PLM、肌阵挛综合症、挛缩、痛性挛缩等。特别是不安腿综合症。
实施例
以下,用实施例更具体地说明本发明。
实施例1
(-)-17-(环丙基甲基)-3,14β-二羟基-4,5α-环氧基-6β-[N-甲基-反式-3-(3-呋喃基)丙烯酰胺]吗啡喃盐酸盐1
Figure C0280725700131
将含有上述式所示化合物10μg的溶液封装入明胶皮膜的软胶囊中,制成口服剂。将该口服剂给予2名被诊断为不安腿综合症的患者。2名患者皆自诉下肢有痒痒的异常感觉,有碍睡眠,而在服用该口服剂之后,1名患者在2小时后、另1名患者在4小时后,下肢的异常感觉消失。2名患者在服用后经过至少24小时后,异常感觉消失的效果皆持续,可以不引起夜间睡眠障碍地入睡,故认为该药对不安腿综合症具有明确的治疗效果。
本发明的精神神经疾病治疗药可用于神经疾病、特别是不安腿综合症的治疗。

Claims (1)

1.下述通式(I)所示的吗啡喃化合物或其药理学容许的酸加成盐在制备治疗不安腿综合症的药物中的应用:
Figure C028072570002C1
其中通式(I)表示的吗啡喃化合物或其药理学容许的酸加成盐是(-)-17-(环丙基甲基)-3,14β-二羟基-4,5α-环氧基-6β-[N-甲基-反式-3-(3-呋喃基)丙烯酰胺]吗啡喃或其药理学容许的酸加成盐。
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