CN102348718B - 去氧阿肽加定衍生物 - Google Patents
去氧阿肽加定衍生物 Download PDFInfo
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- CN102348718B CN102348718B CN201080012769.5A CN201080012769A CN102348718B CN 102348718 B CN102348718 B CN 102348718B CN 201080012769 A CN201080012769 A CN 201080012769A CN 102348718 B CN102348718 B CN 102348718B
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- deoxyactagardine
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Abstract
本发明总地涉及去氧阿肽加定A和B型的某些化合物。这种化合物适用于治疗微生物感染,例如梭菌感染,如产气荚膜梭菌、艰难梭菌、破伤风梭菌和/或肉毒梭菌,尤其是艰难梭菌,尤其是结肠和/或肠下部的感染以及与微生物感染相关的腹泻。
Description
技术领域
本发明涉及某些新颖的化合物、含有所述化合物的药物组合物以及所述化合物和组合物在微生物感染,尤其是艰难梭菌(C.difficile)感染,尤其是结肠和/或肠下部中的微生物感染的治疗中的用途。
背景技术
已从包括微生物的自然来源中鉴定出许多抗生素化合物。通常所述抗生素化合物具有复杂的化学结构,尤其具有复杂的立体化学结构。
最近,WO 2007/083112鉴定出一系列新颖的基于去氧阿肽加定B(deoxyactagardine B)的化学抗生素。去氧阿肽加定B由利古里亚游动放线菌(Actinoplanes liguriae)合成,且去氧阿肽加定B及其许多衍生物显示良好的抗菌性。
现已确定去氧阿肽加定A和B的新颖化合物具有优化的性质,使得它们尤其适合用于治疗微生物感染,例如梭菌(Clostridium)感染,如产气荚膜梭菌(C.perfringens)、艰难梭菌(C.difficile)、破伤风梭菌(C.tetani)和/或肉毒梭菌(C.botulinum),尤其是艰难梭菌,尤其是结肠和/或肠下部的感染,以及与微生物感染相关的腹泻。
发明内容
一方面,本发明提供式(I)化合物,其药学可接受的盐、水合物以及溶剂合物:
其中,
A是-C1-4烷基;
B是-C1-4烷基;
X是-NH(CH2)pNH2;
p是2到12的整数;
Z是-NR1R2;
R1是H或C1-4烷基,
R2是H、氨基酸或C1-4烷基。
本发明化合物是有利的,因为例如当通过诸如最低抑菌浓度(MIC)的标准测试测定活性时,它们对一种或多种艰难梭菌菌株具有极高的抗菌活性,通常本发明化合物对一种或多种艰难梭菌菌株的MIC为2μg/ml或更低。另外,本发明的某些化合物对艰难梭菌的许多常见菌株具有极高的活性。
而且,本发明化合物尤其适合给药于人和动物,因为它们对体内发现的天然存在的健康肠内菌群具有低的抗菌活性。在治疗由微生物感染(如艰难梭菌)所引起的腹泻的情况下,可预期与经已知抗生素治疗相比经本发明化合物治疗后可观察到症状的复发减少,因为天然菌群具有在经本发明化合物治疗后仍可存活的能力。尤其是,本发明化合物对脆弱拟杆菌(Bacteroides fragilis)、多形拟杆菌(Bacteroides thetaiotaomicron)、长双歧杆菌(Bifidobacterium longum)、鼠李糖乳杆菌(Lactobacillusrhamnosus)显示极低活性,并对厌氧消化链球菌(Peptostreptococcusanaerobius)和青春双歧杆菌(Bifidobacterium adolescentis)显示适度的低活性。
此外,当经口递送本发明化合物时,其未被全身吸收,这使得相对较高浓度的活性成分被递送至结肠/肠内的靶标。因此,由于当经口给药时所述化合物没有全身递送,这可使患者受到副作用影响的任何潜在风险最小化。
艰难梭菌感染和/或过度生长是患者在住院治疗期间常见的问题。这成为健康护理系统的现实负担,并可能对体弱患者(如老年患者)造成生命威胁。
目前,万古霉素是艰难梭菌感染的严重病症的标准治疗法。因此,虽然用于治疗艰难梭菌感染的替代化合物可能是有用的,但要求这种化合物的活性约等于或大于万古霉素的活性。
正在研究某些用于治疗艰难梭菌和/或耐万古霉素的肠球菌的化合物,但活性成分常常被胃或肠内的酸和/或酶降解。这种化合物需要非胃肠给药法或特殊制剂(例如肠溶衣或胶囊制剂),以确保活性成分以未降解形式递送至结肠。令人惊奇地,尽管本发明化合物包含肽组分,但其不被胃酸或酶明显降解。因此,本发明化合物尤其适合经口给药法。这种方式的有利之处在于可灵活地将所述化合物配制成能将未降解活性成分局部递送至结肠的简单有效的制剂。
本发明的某些化合物可通过在利古里亚游动放线菌中将去氧阿肽加定B合成为中间体来制备。去氧阿肽加定B的收率是由加尔巴丁游动放线菌(Actinoplanes garbadinensis)制备的阿肽加定A型中间体收率的两倍或更多倍。从商业/加工观点来看,这点很重要。
本发明化合物的物理性质(例如溶解性、稳定性等)适合期望的治疗用途。
附图说明
图1显示乳链菌肽和去氧阿肽加定B衍生物对酶消化的易感性。
图2显示艰难梭菌的体内模型的结果。
图3显示口服给药后回收的化合物量。
图4显示实施例1起始材料的HPLC分析。
图5显示实施例1的反应完成后的HPLC分析。
图6显示实施例1化合物经C18 Bond Elut浓缩后的HPLC分析。
图7显示实施例1化合物快速层析后的HPLC分析。
发明详述
本发明中的烷基意指直链或支链烷基,例如甲基、乙基、丙基、异丙基、正丁基或叔丁基。
在一种实施方式中,A的结构相当于含有最多4个碳的天然氨基酸的烷基侧链。
在一种实施方式中,A为-CH3。
在一种实施方式中,A为支链烷基,例如-CH(CH3)2、-CH2CH(CH3)2或-CH(CH3)CH2CH3,如-CH(CH3)2或-CH2CH(CH3)2,特别是-CH2CH(CH3)2。
在一种实施方式中,B的结构相当于包含最多4个碳的天然氨基酸的烷基侧链。
在一种实施方式中,B为-CH3。
在一种实施方式中,B为支链烷基,例如-CH(CH3)2、-CH2CH(CH3)2或-CH(CH3)CH2CH3,如-CH(CH3)2或-CH2CH(CH3)2或如-CH(CH3)2或-CH2CH(CH3)2,特别是-CH(CH3)2。
一方面,A是-CH2CH(CH3)2且B是-CH(CH3)2。
在一种实施方式中,R1是H。
在一种实施方式中,R2是H。
在一种实施方式中,R2是氨基酸残基的L或D异构体形式。在一种实施方式中,R2是-C(O)CH(CH3)NH2的L或D异构体形式。
在一种实施方式中,R2是选自下组的氨基酸残基:丙氨酸、半胱氨酸、天冬氨酸、谷氨酸、苯丙氨酸、甘氨酸、组氨酸、异亮氨酸、赖氨酸、亮氨酸、甲硫氨酸、天冬酰胺、脯氨酸、谷氨酰胺、精氨酸、丝氨酸、苏氨酸、缬氨酸、色氨酸和酪氨酸。
在一种实施方式中,R2是选自苯丙氨酸、酪氨酸及丙氨酸的氨基酸残基(即-C(O)CH(CH3)NH2)。
在一种实施方式中,Z是-NH2。
一方面,A是-CH2CH(CH3)2且B是-CH(CH3)2且Z是-NH2。
在一种实施方式中,p是2、3、4、5、6、7、8、9、10、11或12,例如2、3、7、9或12,特别是7、9或12。在一种实施方式中p是7。在另一种实施方式中p是9或12。
在一种实施方式中,p是3到12或3到8。
上述实施方式的每种或全部相容的组合明确地公开在本发明中,如同单独且明确地描述每种或全部组合。
一方面,本发明提供式(II)化合物,或其药学可接受的盐、水合物或溶剂合物:
本发明化合物对至少一种艰难梭菌菌株的MIC为1μg/ml或更低,且通常对艰难梭菌的其他常见菌株的活性为2μg/ml或更低。本发明的某些化合物(例如式II化合物)对艰难梭菌的许多常见菌株的活性为1μg/ml或更低。
与本发明化合物类似的化合物的制备方法描述于WO 2007/083112中。
本发明化合物可以是药学可接受的盐形式和/或可作为药学可接受的盐给药。关于合适盐的评论请参见Berge等人,J.Pharm.Sci,1977,66,1-19。
通常,药学可接受的盐可容易地用所需酸或碱酌情制备。盐可从溶液中沉淀并通过过滤收集,或可通过溶剂的蒸发而回收,例如,可将式(I)化合物溶于适合的溶剂例如醇(如甲醇)中,然后将酸添加至同一溶剂或其他适合的溶剂中。然后,所得的酸加成盐可直接沉淀,或通过添加弱极性溶剂(例如二异丙基醚或己烷)而沉淀,并通过过滤分离。
本领域技术人员理解,当式(I)或(II)化合物含有一个以上的碱性基团时,也可形成双盐或三盐,且其都属于本发明公开的盐。
适合的加成盐由无机或有机酸形成,其形成无毒盐,实例有乳糖酸盐、扁桃酸盐(包括(S)-(+)-扁桃酸盐、(R)-(-)-扁桃酸盐和(R,S)-扁桃酸盐)、盐酸盐、氢溴酸盐、氢碘酸盐、硫酸盐、硫酸氢盐、硝酸盐、磷酸盐、磷酸氢盐、谷氨酸盐、醋酸盐、三氟醋酸盐、马来酸盐、苹果酸盐、富马酸盐、乳酸盐、酒石酸盐、柠檬酸盐、甲酸盐、葡萄糖酸盐、琥珀酸盐、乙基琥珀酸盐(4-乙氧基-4-氧-丁酸盐)、丙酮酸盐、草酸盐、草酰乙酸盐、糖质酸盐、苯甲酸盐、乙醇酸盐、葡糖醛酸盐、烷基或芳基磺酸盐(例如甲磺酸盐、乙磺酸盐、苯磺酸盐或对甲苯磺酸盐)和羟乙基磺酸盐。一种其他或替代实例是甲磺酸盐。
药学可接受的碱盐包括铵盐、碱金属盐,例如钠和钾盐;碱土金属盐,例如钙和镁盐;以及与有机碱形成的盐,包括伯胺、仲胺和叔胺的盐,例如异丙胺、二乙胺、乙醇胺、三甲胺、二环己基胺和N-甲基-D-葡糖胺的盐。
有机化学领域的技术人员将了解,许多有机化合物可以和溶剂形成复合物,这些化合物在溶剂中反应或从溶剂中沉淀或结晶。这些复合物被称为“溶剂合物”。例如,与水形成的复合物被称为“水合物”。式(I)或(II)化合物的溶剂合物在本发明范围内。式(I)或(II)化合物的盐可形成溶剂合物(例如水合物)且本发明也包括所有这些溶剂合物。
本发明所使用的术语“前药”意指例如通过在血液中水解而在体内转化为具有医学效果的活性形式的化合物。药学可接受的前药描述在T.Higuchi和V.Stella,″Prodrugs as Novel Delivery Systems″,A.C.S.Symposium Series的14卷;Edward B.Roche,ed.,″Bioreversible Carriers inDrug Design″,American Pharmaceutical Association and Pergamon Press,1987;以及D.Fleisher,S.Ramon和H.Barbra″Improved oral drug delivery:solubility limitations overcome by the use of prodrugs″,Advanced DrugDelivery Reviews(1996)19(2)115-130页,各文献以引用方式合并于此。
前药是任何共价键合的载体,当这种前药给药于患者时,其在体内释放式(I)或(II)化合物。前药通常通过修饰官能团而制备,这种修饰方式使得修饰物通过常规操作裂解或在体内裂解从而生成母体化合物。例如,前药包括本发明化合物,其中羟基、胺基和巯基与当给药于患者时裂解形成羟基、胺基和巯基的任何基团键合。因此,前药的典型例子包括(但不限于)式(I)或(II)化合物的醇基、巯基和胺官能团的醋酸盐、甲酸盐和苯甲酸盐衍生物。此外,对于羧酸(-COOH),可采用酯,例如甲酯、乙酯等。酯在人体的体内环境下本身可具有活性和/或可水解。适合的药学可接受的体内可水解酯基包括容易在人体中分解为母酸或其盐的那些酯基。
以下提到的本发明化合物包括式(I)或(II)化合物及其药学可接受的盐和衍生物。
关于立体异构体,式(I)或(II)化合物具有一个以上的不对称碳原子。在所绘的通式(I)或(II)中,实心楔形键表示该键在纸平面的上方。断裂键表示该键在纸平面的下方。
应理解,式(I)或(II)化合物的取代基也可具有一个或多个不对称碳原子。
结构(I)或(II)化合物可以单个对映体或非对映体的形式存在。所有这些异构体形式包含于本发明内,包括其混合物。
非对映异构物或顺式和反式异构体的分离可通过常规方法实现,例如分步结晶法、层析法或HPLC。试剂的立体异构混合物也可视情况由相应的光学纯中间体制备或利用适合的手性载体通过相应混合物的拆分(例如通过HPLC),或通过由相应混合物与适合的光学活性酸或碱反应所形成的非对映异构盐的分步结晶而制备。本发明描述的式(I)或(II)化合物也延伸至其互变异构形式,例如,酮/烯醇互变异构体。
式(I)或(II)化合物可以是晶形或无定形。此外,式(I)或(II)化合物的某些晶形可以多晶形物存在,所有形式都属于本发明。
另一方面,本发明提供用于治疗,特别是治疗患有可通过抗微生物化合物改善的病症的人或动物患者的药物组合物,该组合物包含作为活性成分的本发明化合物或其药学可接受的衍生物以及药学可接受的赋形剂、稀释剂和/或载体。
另一方面,本发明提供含有治疗有效量的本发明化合物和药学可接受的赋形剂、稀释剂和/或载体(包括其组合)的药物组合物。
本发明还提供制备药物组合物的方法,该方法包括将本发明化合物或其药学可接受的衍生物与药学可接受的赋形剂、稀释剂和/或载体混合。
本发明化合物可以配制为用于人用药物或兽用药物的任何便利的给药方式,因此本发明范围包括包含本发明化合物的适用于人用药或兽用药的药物组合物。这种组合物借助一种或多种适合的赋形剂、稀释剂和/或载体,可提供用于常规方式。用于治疗用途的可接受的赋形剂、稀释剂和载体是药学领域所熟知的,例如描述在Remington′s PharmaceuticalSciences,Mack Publishing Co.(A.R.Gennaro编,1985)中。可根据预定给药途径和标准的药品惯例来选择药用赋形剂、稀释剂和/或载体。所述药物组合物可包括任何适宜的粘合剂、润滑剂、悬浮剂、包衣剂和增溶剂作为赋形剂、稀释剂和/或载体,或者在赋形剂、稀释剂和/或载体以外还包括任何适宜的粘合剂、润滑剂、悬浮剂、包衣剂和增溶剂。
所述药用组合物中可包括防腐剂、稳定剂、染料及增香剂。防腐剂的例子包括苯甲酸钠、山梨酸和对羟基苯甲酸的酯。也可使用抗氧化剂和悬浮剂。
一些实施方式中,本发明试剂也可与环糊精组合使用。已知环糊精可与药物分子形成包合和非包合络合物。药物-环糊精络合物的形成可以改变药物分子的溶解度、溶解速率、生物利用率和/或稳定性。通常药物-环糊精络合物适用于大部分剂型和给药途径。除了与药物直接络合外,环糊精可用作辅助添加剂,例如作为载体、稀释剂或增溶剂。α-、β-和γ-环糊精是最常用的,适合的例子记载在WO 91/11172、WO 94/02518和WO 98/55148中。
可利用已知的制粉法如湿法制粉来将本发明化合物制成粉,以获得适于形成片剂或其他制剂形式的粒径。可通过本领域已知方法制备本发明化合物的细分的(纳米颗粒)制剂,例如参见国际专利申请WO 02/00196(SmithKline Beecham)。
给药(递送)途径包括但不限于以下一种或多种:经口(例如作为干粉/自由流动微粒制剂、片剂、胶囊或作为可摄取的溶液或悬浮液)、直肠、经颊和舌下给药。本发明化合物尤其适于经口递送。
在一些情况下,可通过以下途径递送本发明化合物:局部、粘膜(例如作为用于吸入的鼻喷雾剂或气雾剂)、经鼻、胃肠外(例如通过可注射形式)、胃肠、脊柱内、腹膜内、肌内、静脉内、子宫内、眼内、皮内、颅内、气管内、阴道内、脑室内、脑内、皮下、经眼(包括玻璃体内或瞳孔内)或透皮途径。
根据不同的递送系统,可以有不同的组合物/制剂要求。例如,本发明药物组合物可配制成利用小型泵或经由粘膜途径(例如作为用于吸入的鼻喷雾剂或气雾剂或可摄取溶液)或胃肠外(其中所述组合物配制成可注射形式,以用于例如通过静脉内、肌内或皮下途径递送)给药。或者,可将所述制剂设计成通过两种途径递送。
在适当情况下,所述药物组合物可通过以下途径给药:吸入给药、以栓剂或子宫托形式给药、以洗液、溶液、霜剂、油膏或细粉剂形式局部给药、利用皮肤贴片给药、以含有赋形剂(例如淀粉或乳糖)的片剂形式、或以胶囊或药丸的单独和与赋形剂混合形式、或以含有增香剂或着色剂的酏剂、溶液或悬浮液形式经口给药、或可通过胃肠外(例如静脉内、肌内或皮下)注射所述药物组合物。对于肠胃外给药,所述组合物最好以无菌水溶液形式使用,该水溶液可包含其他物质,例如足够的盐或单糖,以使该溶液与血液等渗。对于经颊或舌下给药,所述组合物可以常规方式配制的片剂或锭剂形式给药。应理解并非所有化合物都需要通过相同途径给药。同样地,如果所述组合物包含一种以上活性成分,则这些成分可通过不同途径给药。
本发明组合物包括那些特别配制用于胃肠外、经口、经颊、直肠、局部、植入物、经眼、经鼻或经生殖泌尿道给药的形式。在本发明的一个方面,所述药剂经口递送,因此,该药剂是适于经口递送的形式。
如果本发明化合物经胃肠外给药,那么这种给药的例子包括以下一种或多种:静脉内、动脉内、腹膜内、鞘内、心室内、尿道内、胸骨内、颅内、肌内或皮下给药该药剂,和/或使用滴注技术。
本发明化合物可以含有增香剂或着色剂的片剂、胶囊、药丸、酏剂、溶液或悬浮液形式给药(例如经口或局部),用于立即释放、延迟释放、改性释放、持续释放、脉冲释放或控制释放应用。
本发明化合物也可以适于经口或经颊给药的形式(例如溶液、凝胶、糖浆、漱口剂或悬浮液的形式),或任选含有增香剂和着色剂的使用前用水或其他适合的介质重建的干粉形式提供给人类或动物使用。也可使用固体组合物,例如片剂、胶囊、锭剂、软锭、丸剂、大丸剂、粉末、糊剂、颗粒、弹丸或预混合制剂。可根据本领域已知方法制备用于口服使用的固体和液体组合物。这种组合物也可含有一种或多种可为固体或液体形式的药学可接受的载体和赋形剂。
所述片剂可包含赋形剂(例如微晶纤维素、乳糖、柠檬酸钠、碳酸钙、硫酸钙、磷酸氢钙和甘氨酸、甘露醇、预胶化淀粉、玉米淀粉、马铃薯淀粉),崩解剂(例如淀粉乙醇酸钠、交联羧甲基纤维素钠和某些复合硅酸盐),以及制粒粘合剂(例如聚乙烯吡咯烷酮、羟丙基甲基纤维素(HPMC)、羟丙基纤维素(HPC)、蔗糖、明胶和阿拉伯胶)。
另外,可包含润滑剂例如硬脂酸镁、硬脂酸、山萮酸甘油酯和滑石。
也可采用相似类型的固体组合物作为明胶或HPMC(羟丙基甲基纤维素)胶囊中的填充剂。在这点上,优选的赋形剂包括微晶纤维素、乳糖、碳酸钙、硫酸钙、磷酸氢钙和甘露醇、预胶化淀粉、玉米淀粉、马铃薯淀粉或高分子量聚乙二醇。对于水性悬浮液和/或酏剂,所述试剂可与下列物质组合:各种甜味剂或增香剂、着色物质或染料;乳化剂和/或悬浮剂;以及稀释剂(例如水、乙醇、丙二醇和甘油);及其组合。
可用粉末(仅含药物或与选定填充剂混合的)或液体填充胶囊,每个含有一种或多种式(I)或(II)化合物和载体。当用粉末填充该胶囊时,式(I)或(II)化合物和/或载体可经粉碎或微粉化,以提供具有适当粒径的原料。
当本发明化合物以片剂或胶囊经口给药时,其可例如以肠溶衣包覆。例如,根据情况,所述片剂或胶囊可包有薄膜衣(例如购自Rohm PharmaPolymers的EUDRAGIT膜),以使其在胃肠道中控制溶解。所述薄膜可以以阳离子聚合物(例如EUDRAGITE 100(甲基丙烯酸氨基烷基酯共聚物))或以阴离子丙烯酸聚合物(例如EUDRAGITL(甲基丙烯酸共聚物)和EUDRAGIT S)获得。
也可利用可渗透的丙烯酸聚合物,例如EUDRAGITRL(氨基甲基丙烯酸酯共聚物)和EUDRAGITRS。
这些包衣制剂可制备成水分散体,包括任选成分,例如滑石、硅氧烷消泡剂乳液、聚乙二醇。或者所述包衣制剂可制备成有机聚合物溶液。
或者,片剂可利用购自Colorcon的OPADRY(Surelease)包衣系统包衣。水性系统通常包含最高达15%w/w的OPADRY有机溶剂系统通常包含最高达5%w/w的OPADRY
可通过已知技术制备包衣,例如:
1.称重所需量的OPADRY薄膜包衣系统,
2.称重所需量的水或其他溶剂至混合容器中,
3.通过在该容器中心且尽可能靠近该容器底部的混合推进器,搅拌所述溶剂形成涡流,且不将空气引入液体中,
4.将OPADRY粉末稳定且快速地添加至所述涡流中,避免粉末浮在液体表面上,
5.如果需要,渐增搅拌器速度以维持涡流,以及
6.所有粉末成分添加完毕后,降低混合器速度并持续搅拌约45分钟。
包衣可利用片剂包衣机通过已知技术涂覆。
根据所需效果,所涂覆的包衣厚度通常为5到35微米,例如10到30微米,更具体地为10或20微米。或者,视情况可将片剂或胶囊填充到另一胶囊(优选HPMC胶囊例如Capsugel)中,以提供片剂在胶囊中或胶囊在胶囊中的结构,其在给药于患者后,在胃肠道中控制溶解,因此提供类似于肠溶衣的效果。因此一方面,本发明提供式(I)或(II)化合物的固体剂型制剂,例如其中所述制剂具有肠溶衣。
另一方面,本发明提供一种包含保护性胶囊作为外层的固体剂型制剂,例如片剂在胶囊中或胶囊在胶囊中。肠溶衣可提供比无包衣制剂改善的稳定性。本发明化合物也可以在兽药中以液体兽用顿服药(drench)形式(例如活性成分和药学可接受的载体或赋形剂的溶液、悬浮液或分散体)经口给药。
例如,本发明化合物也可以配制成用于人类或兽药的栓剂(例如包含常用栓剂基质),或子宫托(例如包含常用子宫托基质)。
本发明化合物也可以和其他治疗剂联合使用。因此,另一方面,本发明提供包含式(I)或(II)化合物或其药学可接受的衍生物和其他治疗剂的联合。例如,所述联合可以是式(I)或(II)化合物和抗生素(例如万古霉素)的联合。该联合可以是共制剂,或作为单独制剂简单封装在一起,用于同时或相继给药。
当本发明化合物或其药学可接受的衍生物与针对同样疾病状态的第二活性治疗剂联合使用时,各化合物的剂量可以不同于所述化合物单独使用时的剂量。本领域技术人员将容易了解适合的剂量。应了解,用于治疗所需的本发明化合物量将根据被治疗病症的性质及患者年龄和身体状况而改变,且最终将由诊治医师或兽医决定。例如,本发明化合物可视情况用于和其他活性成分(例如皮质类固醇)一起给药。
上述的联合可以药物制剂形式方便地提供,因此包括与药学可接受的载体或赋形剂如上所述联合的药物制剂构成本发明的另一方面。这种联合的个别组分,可通过任何方便途径,在单独或组合的药物制剂中相继或同时给药。
当相继给药时,可首先将本发明化合物给药或首先将第二治疗剂给药。当同时给药时,可以通过相同或不同的药物组合物联合给药。
当在同一制剂中联合时,应理解两种化合物必须稳定且彼此以及和该制剂的其他成分相容。当单独配制时,它们可以在任何方便的制剂中提供(方便地以本领域已知的用于这类化合物的方式)。
所述组合物可含有0.01-99%的活性物质。对于局部给药,例如,所述组合物通常含有0.01-10%,更优选0.01-1%的活性物质。
通常,医师会决定最适于个体患者的实际剂量。用于任何特定个体的特定剂量水平和剂量次数可根据以下多种因素而改变,这些因素包括:所使用的特定化合物的活性、该化合物的新陈代谢稳定性和作用时间长度、年龄、体重、总体健康状况、性别、饮食、给药方式和时间、排泄率、联合用药、特定症状的严重度和个体接受的治疗。
对于经口和肠胃外给药于人而言,药剂的每日剂量水平可以是单一剂量或分剂量。对于全身性给药而言,成人治疗所用的每日剂量为2-100mg/kg体重,优选5-60mg/kg体重,例如,其可根据给药途径和患者状况每日给药1到4次剂量。当所述组合物包含剂量单位时,各单位优选含有100mg到1g的活性成分。治疗的持续时间将由反应率而非任意天数决定。在一种实施方式中,治疗方案持续1、2、3、4、5、6、7、8、9、10、11、12、13、14、15、16、17、18、19、20、21或更多天。
一方面,本发明提供式(I)或(II)化合物在治疗中的用途,尤其通过经口给药式(I)或(II)化合物,例如用于治疗微生物感染(例如艰难梭菌感染,特别是与其相关的腹泻),或一种或多种本文所述的微生物感染的用途。
一方面,提供式(I)或(II)化合物在盲肠炎的治疗(动物受试者)中的用途。
一方面,式(I)或(II)化合物用于控制细菌过度生长综合征。当上胃肠道和/或肠下部中通常较低的细菌性定殖明显增加时,会出现过度生长综合征(BOS)。
一方面,本发明提供式(I)或(II)化合物在预防、治疗或改善IBS(肠易激综合征)中的用途。使用抗生素治疗IBS的例子参见Rifaximin Treatmentfor Symptoms of Irritable Bowel Syndrome.Andrea L.Fumi和KatherineTrexler,The Annals of Pharmacotherap,2008,4,408。
在一种实施方式中,式(I)或(II)化合物用于治疗溃疡性结肠炎,包括防止其复发的预防性治疗。所述化合物特别适于治疗类固醇难治型溃疡性结肠炎。例如参见Steroid-refractory ulcerative colitis treated withcorticosteroids,metronidazole and vancomycin:a case report J.Miner,M.MGillan,P.Alex,M Centola,BMC Gastroenterology 2005,5:3。
本发明化合物尤其适用于长期治疗。
如上所述,本发明化合物可用于治疗人和/或动物。
一方面,提供式(I)或(II)化合物用于制备治疗微生物感染(例如艰难梭菌感染,特别是与其相关的腹泻)的药物。
一方面,提供一种治疗方法,其包括以下步骤:将治疗有效量的式(I)或(II)化合物或含有式(I)或(II)化合物的药物组合物给药于需要其的患者(人或动物),例如用于治疗本文所述的感染/病症或疾病。
本文中,“含有或包含”解释为“包括”。
包含某些元素的本发明的方面旨在延伸至“由相关元素组成”或“基本上由相关元素组成”的替代实施方式。
具体实施方式
实施例1
去氧阿肽加定B(7-氨基-1-庚基酰胺单甲酰胺)
去氧阿肽加定B(2.5g)、1,7-二氨基庚烷(0.52g)和二异丙基乙胺(0.44ml)溶解在无水二甲基甲酰胺(10ml)中。在2h内,分批添加无水二甲基甲酰胺(5ml)中的苯并三唑-1-基-氧-三-吡咯烷基-鏻六氟磷酸盐(PyBOP)(1.04g)溶液。反应后进行分析型HPLC(见表1)且添加PyBOP直到初始材料耗尽(图4和5)。
表1:用于分离羊毛硫抗生素(lantibiotic)(例如阿肽加定、阿肽加定B或去氧阿肽加定B)和二氨基烷烃衍生产物的分析型HPLC条件
柱:Zorbax 5μC18(2)150×4.6mm
流动相A:20mM磷酸钾缓冲液(pH 7.0)中的30%乙腈
流动相B:20mM磷酸钾缓冲液(pH 7.0)中的65%乙腈
流速:1ml/min
梯度:
时间0min 100% A 0% B
时间10min 0% A 100% B
时间11min 0% A 100% B
时间11.2min 100% A 0% B
循环时间15min
注射体积:10μl
检测:210nm
将粗的反应混合物倒入30%的甲醇水溶液中,且将所得溶液装填到Varian Bond Elut C18柱上(30g)。然后柱子依次用50%、60%、70%、80%、90%的甲醇水溶液冲洗,大部分所需物质在70%级分中洗脱(图6)。硅胶柱层析(洗脱液为二氯甲烷∶乙醇∶氨水10∶8∶1)获得210nm处的紫外线测得纯度>90%的物质(图7)。产量为1.4g。质量计算值(M+2H)+2993,实测值992.91。
产物通过500MHz的13C核磁共振光谱分析(溶剂D3乙腈∶水的比为7∶3)。峰值列表提供于表2。
表2:实施例1的碳13峰值列表
峰值 | [ppm] | 峰值 | [ppm] |
1 | 181.3149 | 47 | 44.6775 |
2 | 175.3919 | 48 | 44.5744 |
3 | 174.8404 | 49 | 43.8023 |
4 | 174.6462 | 50 | 42.6752 |
5 | 174.3911 | 51 | 41.1394 |
6 | 174.2256 | 52 | 40.7135 |
7 | 174.0976 | 53 | 40.0986 |
8 | 173.8498 | 54 | 36.7443 |
9 | 173.4321 | 55 | 36.5221 |
10 | 173.3003 | 56 | 36.0111 |
11 | 173.1919 | 57 | 35.0293 |
12 | 172.8374 | 58 | 33.5143 |
13 | 172.5363 | 59 | 31.0095 |
14 | 172.5226 | 60 | 30.9257 |
15 | 171.6244 | 61 | 30.2204 |
16 | 171.403 | 62 | 29.4444 |
17 | 171.2443 | 63 | 28.9958 |
18 | 171.2186 | 64 | 28.1579 |
19 | 137.4317 | 65 | 27.8264 |
20 | 128.2591 | 66 | 27.3108 |
峰值 | [ppm] | 峰值 | [ppm] |
21 | 125.4133 | 67 | 26.8943 |
22 | 122.6186 | 68 | 26.6716 |
23 | 120.101 | 69 | 26.0067 |
24 | 119.489 | 70 | 25.6053 |
25 | 119.2236 | 71 | 25.5072 |
26 | 112.6147 | 72 | 23.0708 |
27 | 110.3448 | 73 | 22.7664 |
28 | 62.6628 | 74 | 22.7369 |
29 | 62.3103 | 75 | 21.9216 |
30 | 61.9417 | 76 | 20.7945 |
31 | 60.0459 | 77 | 20.7139 |
32 | 59.2589 | 78 | 20.5133 |
33 | 57.6883 | 79 | 19.7487 |
34 | 57.5602 | 80 | 19.6807 |
35 | 57.1782 | 81 | 19.3537 |
36 | 56.3394 | 82 | 18.6924 |
37 | 55.779 | 83 | 17.3511 |
38 | 55.1894 | 84 | 16.1335 |
39 | 54.8993 | 85 | 12.0709 |
40 | 54.8157 | 86 | 1.8865 |
41 | 54.4243 | 87 | 1.7212 |
42 | 53.0651 | 88 | 1.5557 |
43 | 52.6472 | 89 | 1.3899 |
44 | 51.5046 | 90 | 1.2242 |
45 | 47.0088 | 91 | 1.0588 |
46 | 44.8668 | 92 | 0.8934 |
实施例2
实施例1化合物的甲磺酸盐的制备
为获得适于经口或静脉内给药的溶液,发现实施例1化合物的甲磺酸盐是合适的。
将实施例1化合物悬浮在水中,添加过量甲磺酸以得到澄清溶液。通过以下步骤去除过量甲磺酸:将所述溶液装填到已根据制造商的用法说明调节的Bond Elut C18柱上,用水彻底冲洗该柱,并用甲醇洗脱所述甲磺酸盐。蒸发去除溶剂,得到呈白色粉末的甲磺酸盐。
实施例1化合物的甲磺酸盐在水中的溶解度约为20mg/ml。
实施例3(制备实施例1化合物的替代路线)
去氧阿肽加定B[7-(叔丁氧羰基酰胺基)-1-庚基酰胺单甲酰胺]
利用实施例1化合物的方法,由去氧阿肽加定B和7-(叔丁氧羰基酰胺基)-1-氨基庚烷制备。收率为75%,质量计算值(M+2H)+21043,实测值1044.11。在室温下用4N盐酸水溶液处理3h来水解该叔丁氧基碳酸盐。将该混合物中和到pH7,如实施例1所述进行纯化,得到标题化合物。收率为65%。
用类似于实施例1所用方法制备以下化合物。
实施例4
去氧阿肽加定B(2-氨基-1-乙基酰胺单甲酰胺)
用实施例1所述方法,由去氧阿肽加定和1,2-乙二胺制备。
收率96%。质量计算值(M+2H)+2958,实测值959.02。
实施例5
去氧阿肽加定B(3-氨基-1-丙基酰胺单甲酰胺)
用实施例1所述方法,由去氧阿肽加定和1,3-丙二胺制备。
收率87%。质量计算值(M+2H)+2965,实测值965.04。
实施例6
去氧阿肽加定B(5-氨基-1-戊基酰胺单甲酰胺)
用实施例1所述方法,由去氧阿肽加定和1,5-戊二胺制备。
收率83%。质量计算值(M+2H)+2979,实测值980.06。
实施例7
去氧阿肽加定B(9-氨基-1-壬基酰胺单甲酰胺)
用实施例1所述方法,由去氧阿肽加定和1,9-壬二胺制备。
收率84%。质量计算值(M+2H)+21007,实测值1007.51。
实施例8
去氧阿肽加定B(12-氨基-1-十二烷基酰胺单甲酰胺)
用实施例1所述方法,由去氧阿肽加定和1,12-十二烷二胺制备。
收率74%。质量计算值(M+2H)+21028,实测值1027.51。
实施例9
B型羊毛硫抗生素的抗菌活性
本发明化合物在体外和体内显示抗微生物活性。它们具有抗艰难梭菌的活性,而且与去氧阿肽加定B比较具有提高的活性。
在厌氧条件下,在Wilkins-Chalgren厌氧生物用琼脂中,通过两倍连续抗生素稀释进行艰难梭菌菌株的易感性测试。包含万古霉素作为对照药物。将艰难梭菌培养基接种在预还原的Braziers(C.C.E.Y.)琼脂平板上,并在厌氧条件和37℃下生长48小时。将48小时培养物的两到三个菌落接种在5ml预还原的Schaedlers肉汤中,并在厌氧条件和37℃下生长24小时。用预还原的0.9%NaCl稀释该培养物,获得0.5McFarland标准的混浊度,并以105cfu/斑点的最终接种度加到含药物的平板上。包括不含药物的生长对照平板。在厌氧培养室中,在37℃下孵化平板48小时并检测其生长。MIC是完全抑制生长或与不含药物平板上的生长相比,引起生长显著减少的最低药物浓度。
表3:去氧阿肽加定B(DAB)及其衍生物的MIC数据(μg/ml)。(结果值越低,测试化合物的活性越高)
实施例10:B型羊毛硫抗生素在肠液中的稳定性
与A型羊毛硫抗生素(例如乳链菌肽)相比,本发明提供的基于羊毛硫抗生素的化合物对酶降解具有增加的稳定性。具体地,与A型羊毛硫抗生素相比,所述化合物对肠液具有增加的稳定性。
利用模拟肠液(SIF)检测乳链菌肽和实施例1化合物对肠内酶消化的易感性。所述SIF是基于模拟肠液用的标准USP溶液,且已确认其对牛血清白蛋白的活性(Hilger等人,Clin.Exp.Immunol.2001,123,387-94)。在37℃下在SIF中孵化所述化合物,并通过分析型HPLC量化其浓度(用表1所列条件在210nm处进行紫外线检测)。
图1显示乳链菌肽在SIF中快速降解,半衰期为约15到20分钟。乳链菌肽在该介质中的快速降解支持以下观点:乳链菌肽用于治疗结肠感染的临床功效非常有限,除非通过小心配制使该化合物免受降解性酶的影响。
图1也显示实施例1化合物在SIF中基本稳定,可能对于治疗结肠艰难梭菌感染具有适合的稳定性。
实施例11:B型抗生素在仓鼠艰难梭菌相关盲肠炎模型中的体内功效
在CDAD的标准动物模型(仓鼠中克林霉素诱导的盲肠炎)中评估了本发明化合物在治疗艰难梭菌感染中的体内功效。其结果概括于图2中。
向6只一组的几组动物施以约107个细胞的艰难梭菌菌株4013,24小时后,经皮下给药10mg/kg的磷酸克林霉素。再过24小时后,接着用介质、万古霉素或用实施例1化合物以10mg/kg/天的剂量每日处理这些组三次。
所述过程在测试动物中引发了艰难梭菌感染,其中仅用介质处理的所有动物在3天内都死亡。相反,用万古霉素或DAB衍生物处理的所有动物在全部5天的给药期间均存活,证实了这些化合物的保护作用。
实施例12:大鼠模型中的ADME
将实施例1化合物经口给药于大鼠7天,并通过甲醇提取从排泄物回收该化合物。图3显示相对于大鼠给药量的回收物量。虽然回收物量取决于提取次数,但数据显示,在实施例1化合物通过胃肠道后,可回收至少60到70%的未改变的实施例1化合物,且实施例1化合物可在结肠中达到高浓度。
实施例13:大鼠模型中的毒理学
实施例1化合物在大鼠模型中进行7天毒性实验。一项研究使用50mg/kg/天的物质静脉内给药7天。另一项研究使用200mg/kg/天的物质经口给药7天。该静脉内和经口剂量明显超过预期的临床剂量水平(经口给药约3-30mg/kg/天)。在实验期间没有观察到显著的毒理学作用,且尸体剖验未显示器官损害。
将实施例1的化合物以50mg/kg/天经口给药于叙利亚仓鼠时具有耐受性且无明显的毒性迹象。
Claims (10)
1.下式的去氧阿肽加定B(7-氨基-1-庚基酰胺单甲酰胺)、及其药学可接受的盐、水合物和溶剂合物,
其中,X是-NH(CH2)7NH2。
2.药物组合物,包含权利要求1所述的化合物和药学可接受的赋形剂。
3.权利要求2的药物组合物,用于经口或胃肠外给药。
4.权利要求1所述的化合物或权利要求2或3所述的药物组合物在制备用于治疗微生物感染的药物中的用途。
5.权利要求4的用途,其中所述微生物感染是艰难梭菌感染。
6.权利要求5的用途,其中所述艰难梭菌感染在结肠和/或肠的下部。
7.权利要求4的用途,其中所述微生物感染是小肠细菌过度生长。
8.权利要求1所述的化合物或权利要求2或3所述的药物组合物在制备用于溃疡性结肠炎或肠易激综合征的药物中的用途。
9.权利要求1所述的去氧阿肽加定B(7-氨基-1-庚基酰胺单甲酰胺)的制备方法,包括去氧阿肽加定B与1,7-二氨基庚烷在二异丙基乙胺和苯并三唑-1-基-氧-三-吡咯烷基-六氟磷酸盐存在下在二甲基甲酰胺中反应。
10.权利要求9的方法,其中去氧阿肽加定是在利古里亚游动放线菌中合成的。
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Patent Citations (1)
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EP0195359A2 (en) * | 1985-03-22 | 1986-09-24 | GRUPPO LEPETIT S.p.A. | Basic monocarboxyamide derivatives of actagardine having antibiotic activity |
Non-Patent Citations (2)
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SYNTHESIS AND BIOLOGICAL ACTIVITY OF SOME AMIDE DERIVATIVES OF THE LANTIBIOTIC ACTAGARDINE;Adriano Malabarba ET AL;《THE JOURNAL OF ANTIBIOTICS》;19901231;第43卷(第9期);1089-1097 * |
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HRP20141084T1 (hr) | 2015-02-13 |
US8741945B2 (en) | 2014-06-03 |
SG172944A1 (en) | 2011-08-29 |
EA201190071A1 (ru) | 2012-06-29 |
EP2387580B1 (en) | 2014-08-13 |
DK2387580T3 (da) | 2014-10-13 |
NZ594011A (en) | 2013-12-20 |
US20100179207A1 (en) | 2010-07-15 |
IL213927A0 (en) | 2011-07-31 |
TWI453029B (zh) | 2014-09-21 |
US20120277145A1 (en) | 2012-11-01 |
MX2011007313A (es) | 2011-08-04 |
US8283371B2 (en) | 2012-10-09 |
WO2010082018A1 (en) | 2010-07-22 |
CA2749278A1 (en) | 2010-07-22 |
AU2010205472A1 (en) | 2011-07-28 |
CN102348718A (zh) | 2012-02-08 |
ES2520165T3 (es) | 2014-11-11 |
PT2387580E (pt) | 2014-10-30 |
JP2012515195A (ja) | 2012-07-05 |
AU2010205472B2 (en) | 2013-03-14 |
PL2387580T3 (pl) | 2015-01-30 |
TW201029661A (en) | 2010-08-16 |
KR20110119699A (ko) | 2011-11-02 |
EA021683B1 (ru) | 2015-08-31 |
RS53586B1 (en) | 2015-02-27 |
EP2387580A1 (en) | 2011-11-23 |
JP5719312B2 (ja) | 2015-05-13 |
SI2387580T1 (sl) | 2014-11-28 |
ZA201104991B (en) | 2013-10-31 |
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