CN109996814A - 多激酶抑制剂及在眼部纤维化中的用途 - Google Patents
多激酶抑制剂及在眼部纤维化中的用途 Download PDFInfo
- Publication number
- CN109996814A CN109996814A CN201780058772.2A CN201780058772A CN109996814A CN 109996814 A CN109996814 A CN 109996814A CN 201780058772 A CN201780058772 A CN 201780058772A CN 109996814 A CN109996814 A CN 109996814A
- Authority
- CN
- China
- Prior art keywords
- eye
- formation
- illness
- fibrosis
- kinase inhibitor
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
- 206010016654 Fibrosis Diseases 0.000 title claims abstract description 34
- 230000004761 fibrosis Effects 0.000 title claims abstract description 34
- 229940124303 multikinase inhibitor Drugs 0.000 title claims abstract description 26
- XZXHXSATPCNXJR-ZIADKAODSA-N nintedanib Chemical compound O=C1NC2=CC(C(=O)OC)=CC=C2\C1=C(C=1C=CC=CC=1)\NC(C=C1)=CC=C1N(C)C(=O)CN1CCN(C)CC1 XZXHXSATPCNXJR-ZIADKAODSA-N 0.000 claims abstract description 27
- 229960004378 nintedanib Drugs 0.000 claims abstract description 27
- 238000000034 method Methods 0.000 claims abstract description 23
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 claims abstract description 21
- 201000010099 disease Diseases 0.000 claims abstract description 20
- 238000001356 surgical procedure Methods 0.000 claims abstract description 18
- 230000015572 biosynthetic process Effects 0.000 claims abstract description 15
- 150000003839 salts Chemical class 0.000 claims abstract description 14
- 238000001914 filtration Methods 0.000 claims abstract description 11
- 210000001525 retina Anatomy 0.000 claims abstract description 11
- 208000036038 Subretinal fibrosis Diseases 0.000 claims abstract description 10
- 210000003161 choroid Anatomy 0.000 claims abstract description 10
- 208000010412 Glaucoma Diseases 0.000 claims abstract description 8
- 239000000463 material Substances 0.000 claims abstract description 8
- 238000002513 implantation Methods 0.000 claims abstract description 6
- 208000001351 Epiretinal Membrane Diseases 0.000 claims abstract description 5
- 206010036346 Posterior capsule opacification Diseases 0.000 claims abstract description 5
- 208000002158 Proliferative Vitreoretinopathy Diseases 0.000 claims abstract description 5
- 206010038934 Retinopathy proliferative Diseases 0.000 claims abstract description 5
- 230000008602 contraction Effects 0.000 claims abstract description 5
- 206010020718 hyperplasia Diseases 0.000 claims abstract description 5
- 238000011065 in-situ storage Methods 0.000 claims abstract description 5
- 208000021971 neovascular inflammatory vitreoretinopathy Diseases 0.000 claims abstract description 5
- 230000006785 proliferative vitreoretinopathy Effects 0.000 claims abstract description 5
- 210000004498 neuroglial cell Anatomy 0.000 claims abstract description 4
- 230000002207 retinal effect Effects 0.000 claims abstract description 4
- 210000004087 cornea Anatomy 0.000 claims description 9
- 208000002780 macular degeneration Diseases 0.000 claims description 5
- 230000001771 impaired effect Effects 0.000 claims description 4
- 231100000241 scar Toxicity 0.000 claims description 4
- 206010012689 Diabetic retinopathy Diseases 0.000 claims description 3
- 206010064930 age-related macular degeneration Diseases 0.000 claims description 3
- 201000007914 proliferative diabetic retinopathy Diseases 0.000 claims description 2
- 210000001957 retinal vein Anatomy 0.000 claims description 2
- 206010012688 Diabetic retinal oedema Diseases 0.000 claims 1
- 206010018341 Gliosis Diseases 0.000 claims 1
- 201000011190 diabetic macular edema Diseases 0.000 claims 1
- 230000007387 gliosis Effects 0.000 claims 1
- 230000001537 neural effect Effects 0.000 claims 1
- 208000028006 Corneal injury Diseases 0.000 abstract description 3
- 206010011044 Corneal scar Diseases 0.000 abstract description 3
- 230000036573 scar formation Effects 0.000 abstract 1
- 210000001508 eye Anatomy 0.000 description 67
- 238000011282 treatment Methods 0.000 description 28
- MLDQJTXFUGDVEO-UHFFFAOYSA-N BAY-43-9006 Chemical compound C1=NC(C(=O)NC)=CC(OC=2C=CC(NC(=O)NC=3C=C(C(Cl)=CC=3)C(F)(F)F)=CC=2)=C1 MLDQJTXFUGDVEO-UHFFFAOYSA-N 0.000 description 25
- 239000005511 L01XE05 - Sorafenib Substances 0.000 description 25
- 229960003787 sorafenib Drugs 0.000 description 25
- 210000001519 tissue Anatomy 0.000 description 24
- 150000001875 compounds Chemical class 0.000 description 17
- 206010052428 Wound Diseases 0.000 description 14
- 208000027418 Wounds and injury Diseases 0.000 description 14
- 210000000795 conjunctiva Anatomy 0.000 description 13
- 241001465754 Metazoa Species 0.000 description 12
- 102000008186 Collagen Human genes 0.000 description 11
- 108010035532 Collagen Proteins 0.000 description 11
- 229920001436 collagen Polymers 0.000 description 11
- 239000000203 mixture Substances 0.000 description 10
- ZRKFYGHZFMAOKI-QMGMOQQFSA-N tgfbeta Chemical compound C([C@H](NC(=O)[C@H](C(C)C)NC(=O)CNC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](CCCNC(N)=N)NC(=O)[C@H](CC(N)=O)NC(=O)[C@H](CC(C)C)NC(=O)[C@H]([C@@H](C)O)NC(=O)[C@H](CCC(O)=O)NC(=O)[C@H]([C@@H](C)O)NC(=O)[C@H](CC(C)C)NC(=O)CNC(=O)[C@H](C)NC(=O)[C@H](CO)NC(=O)[C@H](CCC(N)=O)NC(=O)[C@@H](NC(=O)[C@H](C)NC(=O)[C@H](C)NC(=O)[C@@H](NC(=O)[C@H](CC(C)C)NC(=O)[C@@H](N)CCSC)C(C)C)[C@@H](C)CC)C(=O)N[C@@H]([C@@H](C)O)C(=O)N[C@@H](C(C)C)C(=O)N[C@@H](CC=1C=CC=CC=1)C(=O)N[C@@H](C)C(=O)N1[C@@H](CCC1)C(=O)N[C@@H]([C@@H](C)O)C(=O)N[C@@H](CC(N)=O)C(=O)N[C@@H](CCC(O)=O)C(=O)N[C@@H](C)C(=O)N[C@@H](CC=1C=CC=CC=1)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N[C@@H](C)C(=O)N[C@@H](CC(C)C)C(=O)N1[C@@H](CCC1)C(=O)N1[C@@H](CCC1)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N[C@@H](CCC(O)=O)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N[C@@H](CO)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](CC(C)C)C(O)=O)C1=CC=C(O)C=C1 ZRKFYGHZFMAOKI-QMGMOQQFSA-N 0.000 description 10
- 241000283973 Oryctolagus cuniculus Species 0.000 description 9
- 230000033115 angiogenesis Effects 0.000 description 9
- 102000004887 Transforming Growth Factor beta Human genes 0.000 description 8
- 108090001012 Transforming Growth Factor beta Proteins 0.000 description 8
- 239000003814 drug Substances 0.000 description 8
- 238000011160 research Methods 0.000 description 8
- 239000000835 fiber Substances 0.000 description 7
- 230000002969 morbid Effects 0.000 description 7
- 238000002360 preparation method Methods 0.000 description 7
- 108091000080 Phosphotransferase Proteins 0.000 description 6
- 230000002401 inhibitory effect Effects 0.000 description 6
- 206010023683 lagophthalmos Diseases 0.000 description 6
- 239000007788 liquid Substances 0.000 description 6
- 102000020233 phosphotransferase Human genes 0.000 description 6
- 239000000243 solution Substances 0.000 description 6
- 102000004856 Lectins Human genes 0.000 description 5
- 108090001090 Lectins Proteins 0.000 description 5
- 238000006243 chemical reaction Methods 0.000 description 5
- 230000000694 effects Effects 0.000 description 5
- 208000030533 eye disease Diseases 0.000 description 5
- 230000004410 intraocular pressure Effects 0.000 description 5
- ISWRGOKTTBVCFA-UHFFFAOYSA-N pirfenidone Chemical compound C1=C(C)C=CC(=O)N1C1=CC=CC=C1 ISWRGOKTTBVCFA-UHFFFAOYSA-N 0.000 description 5
- 229960003073 pirfenidone Drugs 0.000 description 5
- 230000035755 proliferation Effects 0.000 description 5
- 239000000523 sample Substances 0.000 description 5
- 210000003786 sclera Anatomy 0.000 description 5
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Chemical compound O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 5
- 230000008859 change Effects 0.000 description 4
- 239000003795 chemical substances by application Substances 0.000 description 4
- 239000002552 dosage form Substances 0.000 description 4
- 239000000284 extract Substances 0.000 description 4
- 210000002381 plasma Anatomy 0.000 description 4
- 239000013641 positive control Substances 0.000 description 4
- 230000002980 postoperative effect Effects 0.000 description 4
- 230000001225 therapeutic effect Effects 0.000 description 4
- 239000003981 vehicle Substances 0.000 description 4
- FWBHETKCLVMNFS-UHFFFAOYSA-N 4',6-Diamino-2-phenylindol Chemical compound C1=CC(C(=N)N)=CC=C1C1=CC2=CC=C(C(N)=N)C=C2N1 FWBHETKCLVMNFS-UHFFFAOYSA-N 0.000 description 3
- 241000283977 Oryctolagus Species 0.000 description 3
- 240000007711 Peperomia pellucida Species 0.000 description 3
- 108010019530 Vascular Endothelial Growth Factors Proteins 0.000 description 3
- 102000005789 Vascular Endothelial Growth Factors Human genes 0.000 description 3
- 230000002300 anti-fibrosis Effects 0.000 description 3
- 229940079593 drug Drugs 0.000 description 3
- 239000003937 drug carrier Substances 0.000 description 3
- 239000003889 eye drop Substances 0.000 description 3
- 229940012356 eye drops Drugs 0.000 description 3
- 210000003195 fascia Anatomy 0.000 description 3
- 238000013534 fluorescein angiography Methods 0.000 description 3
- 239000003102 growth factor Substances 0.000 description 3
- 230000006698 induction Effects 0.000 description 3
- 230000005764 inhibitory process Effects 0.000 description 3
- 230000003902 lesion Effects 0.000 description 3
- 108020004999 messenger RNA Proteins 0.000 description 3
- 230000004048 modification Effects 0.000 description 3
- 238000012986 modification Methods 0.000 description 3
- 231100000252 nontoxic Toxicity 0.000 description 3
- 230000003000 nontoxic effect Effects 0.000 description 3
- 239000008194 pharmaceutical composition Substances 0.000 description 3
- 230000002265 prevention Effects 0.000 description 3
- 230000008961 swelling Effects 0.000 description 3
- 230000029663 wound healing Effects 0.000 description 3
- 102000007469 Actins Human genes 0.000 description 2
- 108010085238 Actins Proteins 0.000 description 2
- 102000010834 Extracellular Matrix Proteins Human genes 0.000 description 2
- 108010037362 Extracellular Matrix Proteins Proteins 0.000 description 2
- WSFSSNUMVMOOMR-UHFFFAOYSA-N Formaldehyde Chemical compound O=C WSFSSNUMVMOOMR-UHFFFAOYSA-N 0.000 description 2
- VEXZGXHMUGYJMC-UHFFFAOYSA-N Hydrochloric acid Chemical compound Cl VEXZGXHMUGYJMC-UHFFFAOYSA-N 0.000 description 2
- KAESVJOAVNADME-UHFFFAOYSA-N Pyrrole Chemical compound C=1C=CNC=1 KAESVJOAVNADME-UHFFFAOYSA-N 0.000 description 2
- 206010072170 Skin wound Diseases 0.000 description 2
- 239000000853 adhesive Substances 0.000 description 2
- 230000001070 adhesive effect Effects 0.000 description 2
- 210000001742 aqueous humor Anatomy 0.000 description 2
- 210000001775 bruch membrane Anatomy 0.000 description 2
- 239000000969 carrier Substances 0.000 description 2
- 230000021615 conjugation Effects 0.000 description 2
- 239000000470 constituent Substances 0.000 description 2
- 239000003085 diluting agent Substances 0.000 description 2
- 210000002744 extracellular matrix Anatomy 0.000 description 2
- 230000006872 improvement Effects 0.000 description 2
- 239000003112 inhibitor Substances 0.000 description 2
- 238000002347 injection Methods 0.000 description 2
- 239000007924 injection Substances 0.000 description 2
- 238000007918 intramuscular administration Methods 0.000 description 2
- 230000007774 longterm Effects 0.000 description 2
- 239000006210 lotion Substances 0.000 description 2
- 239000011159 matrix material Substances 0.000 description 2
- 150000007522 mineralic acids Chemical class 0.000 description 2
- 239000013642 negative control Substances 0.000 description 2
- 210000000056 organ Anatomy 0.000 description 2
- 238000004806 packaging method and process Methods 0.000 description 2
- 238000007911 parenteral administration Methods 0.000 description 2
- 239000000546 pharmaceutical excipient Substances 0.000 description 2
- 230000036470 plasma concentration Effects 0.000 description 2
- ALDITMKAAPLVJK-UHFFFAOYSA-N prop-1-ene;hydrate Chemical group O.CC=C ALDITMKAAPLVJK-UHFFFAOYSA-N 0.000 description 2
- DNIAPMSPPWPWGF-UHFFFAOYSA-N propylene glycol Substances CC(O)CO DNIAPMSPPWPWGF-UHFFFAOYSA-N 0.000 description 2
- 238000011555 rabbit model Methods 0.000 description 2
- 230000002829 reductive effect Effects 0.000 description 2
- 238000007634 remodeling Methods 0.000 description 2
- 230000019491 signal transduction Effects 0.000 description 2
- 210000002460 smooth muscle Anatomy 0.000 description 2
- 239000008223 sterile water Substances 0.000 description 2
- 238000007920 subcutaneous administration Methods 0.000 description 2
- 239000000126 substance Substances 0.000 description 2
- 230000004083 survival effect Effects 0.000 description 2
- 239000000725 suspension Substances 0.000 description 2
- 238000002560 therapeutic procedure Methods 0.000 description 2
- DPJRMOMPQZCRJU-UHFFFAOYSA-M thiamine hydrochloride Chemical compound Cl.[Cl-].CC1=C(CCO)SC=[N+]1CC1=CN=C(C)N=C1N DPJRMOMPQZCRJU-UHFFFAOYSA-M 0.000 description 2
- 238000002627 tracheal intubation Methods 0.000 description 2
- 210000004127 vitreous body Anatomy 0.000 description 2
- ODIGIKRIUKFKHP-UHFFFAOYSA-N (n-propan-2-yloxycarbonylanilino) acetate Chemical compound CC(C)OC(=O)N(OC(C)=O)C1=CC=CC=C1 ODIGIKRIUKFKHP-UHFFFAOYSA-N 0.000 description 1
- 238000011740 C57BL/6 mouse Methods 0.000 description 1
- 206010052114 Conjunctival bleb Diseases 0.000 description 1
- 206010051625 Conjunctival hyperaemia Diseases 0.000 description 1
- 206010010726 Conjunctival oedema Diseases 0.000 description 1
- 206010055665 Corneal neovascularisation Diseases 0.000 description 1
- 206010015548 Euthanasia Diseases 0.000 description 1
- 208000020564 Eye injury Diseases 0.000 description 1
- 201000009794 Idiopathic Pulmonary Fibrosis Diseases 0.000 description 1
- 208000026350 Inborn Genetic disease Diseases 0.000 description 1
- 206010061218 Inflammation Diseases 0.000 description 1
- 208000001344 Macular Edema Diseases 0.000 description 1
- 206010025415 Macular oedema Diseases 0.000 description 1
- 101000808007 Mus musculus Vascular endothelial growth factor A Proteins 0.000 description 1
- 239000002202 Polyethylene glycol Substances 0.000 description 1
- 102000001253 Protein Kinase Human genes 0.000 description 1
- 208000017442 Retinal disease Diseases 0.000 description 1
- 206010066901 Treatment failure Diseases 0.000 description 1
- DPXJVFZANSGRMM-UHFFFAOYSA-N acetic acid;2,3,4,5,6-pentahydroxyhexanal;sodium Chemical compound [Na].CC(O)=O.OCC(O)C(O)C(O)C(O)C=O DPXJVFZANSGRMM-UHFFFAOYSA-N 0.000 description 1
- 239000002253 acid Substances 0.000 description 1
- 208000038016 acute inflammation Diseases 0.000 description 1
- 230000006022 acute inflammation Effects 0.000 description 1
- 230000004520 agglutination Effects 0.000 description 1
- 150000001447 alkali salts Chemical class 0.000 description 1
- 150000001412 amines Chemical class 0.000 description 1
- 238000010171 animal model Methods 0.000 description 1
- 239000012805 animal sample Substances 0.000 description 1
- 230000003367 anti-collagen effect Effects 0.000 description 1
- 239000007864 aqueous solution Substances 0.000 description 1
- 239000007900 aqueous suspension Substances 0.000 description 1
- 238000001574 biopsy Methods 0.000 description 1
- 208000002352 blister Diseases 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000005252 bulbus oculi Anatomy 0.000 description 1
- 239000001768 carboxy methyl cellulose Substances 0.000 description 1
- 150000001732 carboxylic acid derivatives Chemical class 0.000 description 1
- 210000004027 cell Anatomy 0.000 description 1
- 230000012292 cell migration Effects 0.000 description 1
- 230000004663 cell proliferation Effects 0.000 description 1
- 239000003086 colorant Substances 0.000 description 1
- 238000011284 combination treatment Methods 0.000 description 1
- 210000002808 connective tissue Anatomy 0.000 description 1
- 201000000159 corneal neovascularization Diseases 0.000 description 1
- 230000010250 cytokine signaling pathway Effects 0.000 description 1
- 238000005034 decoration Methods 0.000 description 1
- 230000003247 decreasing effect Effects 0.000 description 1
- 230000008021 deposition Effects 0.000 description 1
- 238000010790 dilution Methods 0.000 description 1
- 239000012895 dilution Substances 0.000 description 1
- 238000002224 dissection Methods 0.000 description 1
- 239000006196 drop Substances 0.000 description 1
- 238000004043 dyeing Methods 0.000 description 1
- 210000005069 ears Anatomy 0.000 description 1
- 239000002532 enzyme inhibitor Substances 0.000 description 1
- 229940125532 enzyme inhibitor Drugs 0.000 description 1
- 238000011156 evaluation Methods 0.000 description 1
- 238000002474 experimental method Methods 0.000 description 1
- 210000000744 eyelid Anatomy 0.000 description 1
- 230000004438 eyesight Effects 0.000 description 1
- 239000004744 fabric Substances 0.000 description 1
- 210000002950 fibroblast Anatomy 0.000 description 1
- 239000000796 flavoring agent Substances 0.000 description 1
- 239000012530 fluid Substances 0.000 description 1
- MHMNJMPURVTYEJ-UHFFFAOYSA-N fluorescein-5-isothiocyanate Chemical compound O1C(=O)C2=CC(N=C=S)=CC=C2C21C1=CC=C(O)C=C1OC1=CC(O)=CC=C21 MHMNJMPURVTYEJ-UHFFFAOYSA-N 0.000 description 1
- 235000013355 food flavoring agent Nutrition 0.000 description 1
- 230000008014 freezing Effects 0.000 description 1
- 238000007710 freezing Methods 0.000 description 1
- 208000016361 genetic disease Diseases 0.000 description 1
- ZFGMDIBRIDKWMY-PASTXAENSA-N heparin Chemical compound CC(O)=N[C@@H]1[C@@H](O)[C@H](O)[C@@H](COS(O)(=O)=O)O[C@@H]1O[C@@H]1[C@@H](C(O)=O)O[C@@H](O[C@H]2[C@@H]([C@@H](OS(O)(=O)=O)[C@@H](O[C@@H]3[C@@H](OC(O)[C@H](OS(O)(=O)=O)[C@H]3O)C(O)=O)O[C@@H]2O)CS(O)(=O)=O)[C@H](O)[C@H]1O ZFGMDIBRIDKWMY-PASTXAENSA-N 0.000 description 1
- 229920000669 heparin Polymers 0.000 description 1
- 229960001008 heparin sodium Drugs 0.000 description 1
- 238000010562 histological examination Methods 0.000 description 1
- 230000002390 hyperplastic effect Effects 0.000 description 1
- 238000002991 immunohistochemical analysis Methods 0.000 description 1
- 238000012744 immunostaining Methods 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- 230000004054 inflammatory process Effects 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 230000002452 interceptive effect Effects 0.000 description 1
- 208000036971 interstitial lung disease 2 Diseases 0.000 description 1
- 238000001990 intravenous administration Methods 0.000 description 1
- 230000009545 invasion Effects 0.000 description 1
- 125000000468 ketone group Chemical group 0.000 description 1
- 229940043355 kinase inhibitor Drugs 0.000 description 1
- 238000002647 laser therapy Methods 0.000 description 1
- 229960003784 lenvatinib Drugs 0.000 description 1
- WOSKHXYHFSIKNG-UHFFFAOYSA-N lenvatinib Chemical compound C=12C=C(C(N)=O)C(OC)=CC2=NC=CC=1OC(C=C1Cl)=CC=C1NC(=O)NC1CC1 WOSKHXYHFSIKNG-UHFFFAOYSA-N 0.000 description 1
- 210000001232 limbus corneae Anatomy 0.000 description 1
- 238000004895 liquid chromatography mass spectrometry Methods 0.000 description 1
- 238000001294 liquid chromatography-tandem mass spectrometry Methods 0.000 description 1
- 201000010230 macular retinal edema Diseases 0.000 description 1
- 230000035800 maturation Effects 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
- 229920000609 methyl cellulose Polymers 0.000 description 1
- 239000001923 methylcellulose Substances 0.000 description 1
- 238000003032 molecular docking Methods 0.000 description 1
- 238000012544 monitoring process Methods 0.000 description 1
- 210000000651 myofibroblast Anatomy 0.000 description 1
- 150000007524 organic acids Chemical class 0.000 description 1
- 230000008506 pathogenesis Effects 0.000 description 1
- 230000001575 pathological effect Effects 0.000 description 1
- 230000037361 pathway Effects 0.000 description 1
- 239000000825 pharmaceutical preparation Substances 0.000 description 1
- 230000000144 pharmacologic effect Effects 0.000 description 1
- 239000003757 phosphotransferase inhibitor Substances 0.000 description 1
- 230000000649 photocoagulation Effects 0.000 description 1
- 230000035479 physiological effects, processes and functions Effects 0.000 description 1
- 229920001223 polyethylene glycol Polymers 0.000 description 1
- 230000008569 process Effects 0.000 description 1
- 230000002062 proliferating effect Effects 0.000 description 1
- 108060006633 protein kinase Proteins 0.000 description 1
- 210000001747 pupil Anatomy 0.000 description 1
- 150000003242 quaternary ammonium salts Chemical class 0.000 description 1
- 230000009467 reduction Effects 0.000 description 1
- 239000011347 resin Substances 0.000 description 1
- 229920005989 resin Polymers 0.000 description 1
- 230000004044 response Effects 0.000 description 1
- 235000019812 sodium carboxymethyl cellulose Nutrition 0.000 description 1
- 229920001027 sodium carboxymethylcellulose Polymers 0.000 description 1
- 239000007787 solid Substances 0.000 description 1
- 239000007921 spray Substances 0.000 description 1
- 239000003381 stabilizer Substances 0.000 description 1
- 238000010186 staining Methods 0.000 description 1
- 230000001629 suppression Effects 0.000 description 1
- 239000000375 suspending agent Substances 0.000 description 1
- 238000012360 testing method Methods 0.000 description 1
- 229940124597 therapeutic agent Drugs 0.000 description 1
- 239000002562 thickening agent Substances 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
- A61K31/496—Non-condensed piperazines containing further heterocyclic rings, e.g. rifampin, thiothixene or sparfloxacin
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/438—The ring being spiro-condensed with carbocyclic or heterocyclic ring systems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/47—Quinolines; Isoquinolines
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0048—Eye, e.g. artificial tears
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P27/00—Drugs for disorders of the senses
- A61P27/02—Ophthalmic agents
Landscapes
- Health & Medical Sciences (AREA)
- Veterinary Medicine (AREA)
- Animal Behavior & Ethology (AREA)
- Pharmacology & Pharmacy (AREA)
- Chemical & Material Sciences (AREA)
- Medicinal Chemistry (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Epidemiology (AREA)
- Ophthalmology & Optometry (AREA)
- General Chemical & Material Sciences (AREA)
- Bioinformatics & Cheminformatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Chemical Kinetics & Catalysis (AREA)
- Organic Chemistry (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
- Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
- Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
Abstract
一种用于预防和/或治疗与眼相关疾病或病症关联的纤维化的方法,包括:向有此需要的对象施用有效量的多激酶抑制剂。所述多激酶抑制剂是尼达尼布、仑伐替尼、其组合或其盐。所述眼相关疾病或病症为角膜透明度、角膜瘢痕形成、继发性白内障形成、青光眼滤过手术、眼部外科手术和植入物、屈光性角膜切除术、激光原位角膜磨镶术、视网膜上膜和视网膜前膜的形成和收缩、增生性玻璃体视网膜病变、视网膜下纤维化/瘢痕形成、视网膜神经胶质增生或脉络膜形成。
Description
对相关申请的交叉引用
本申请要求2017年5月1日提交的编号为62/492,936和2016年7月22日提交的编号为62/365,429的美国临时专利申请的优先权。
技术领域
本发明涉及具有一定范围的多激酶抑制活性的化合物。这些多激酶抑制剂作用于特定的生长因子、细胞因子信号传导途径和/或纤维化反应阶段。本发明还涉及预防和/或治疗与疾病状态、病症和/或外科手术相关联的眼部纤维化的方法,包括角膜瘢痕形成,以及青光眼滤过手术、眼部手术、年龄相关性黄斑变性引起的纤维化,以及增生性玻璃体视网膜病变。
背景技术
眼部纤维化导致全球数百万人的视力严重受损和失明(Friedlander M,J.Clin.Invest.117:576-586,2007;Yu-Wai-Man C和Tee Khaw P,ExpertRev.Ophthalmol.10:65-76,2014)。它涉及所有主要致盲疾病的发病机理或治疗失败。纤维化是由于修复或反应性过程而在器官或组织中形成过量的细胞外基质。这些反应的复杂性导致在研发抗纤维化治疗剂时面临重大挑战,因此,在该患者群体中存在尚未满足的巨大医疗需求。
在这些疾病状态中,存在众多的内源性因子,它们调节细胞增殖、细胞迁移和转化以及细胞外基质沉积和重塑。这些因子包括FGF、VEGF、PDGF等。这些因子中的每一个都已充当预防和/或治疗眼部疾病的靶标。例如,抑制单一生长因子信号传导途径(比如VEGF)已经导致眼部疾病(比如,年龄相关性黄斑变性和糖尿病性视网膜病变)患者的改善。然而,单独抑制一个因子并未得到令人满意的长期结果(Ebenezer D等人,Ophthalmology 121:656-666,2014;Maguire MG等人,Ophthalmology 123:1751-1761,2016)。
明显更好的策略可以是在纤维化反应的多个阶段抑制多种生长因子信号传导途径。使用多激酶抑制剂可以改善长期结果。然而,几种多激酶抑制剂和/或组合疗法在纤维化疾病中尚未显示出功效,这些疾病包括黄斑变性疾病(Kudelka M等人,Expert RevOphthalmol.8:475-484,2013)和特发性肺纤维化(Grimminger F等人,Eur.Respir.J.ERJExpress,March 5,2015;Richeldi L等人,The Lancet,March 29,2017)。
虽然现有技术的激酶抑制剂在治疗某些眼部疾病方面呈现一些成果,但是仍然需要用于治疗眼部纤维化的治疗剂。
发明概述
本发明的一些实施方案提供具有一定范围的多激酶抑制剂活性的药剂。这些多激酶抑制剂可用于治疗眼部纤维化,所述眼部纤维化可与动物和人的疾病状态、病症和/或外科手术有关联。本发明的一些实施方案还涉及这些化合物或组合物的治疗性或预防性用途,以及治疗眼部纤维化的方法,所述眼部纤维化可与疾病状态、病症和外科手术有关联。
在一个方面,本发明提供通过向需要这种治疗或预防的人类对象或动物施用治疗有效量的多激酶抑制剂来治疗和/或预防眼部纤维化的方法,其中所述多激酶抑制剂可以包括但不限于尼达尼布(nintedanib)和/或仑伐替尼(lenvatinib)。
本发明的一些实施方案涉及预防和/或治疗与纤维化相关联的疾病状态、病症和外科手术。
本发明尤其涉及预防或治疗人和动物的眼部纤维化相关联疾病的形成。
根据本发明的一些实施方案,本发明的一种方法涉及施用多激酶抑制剂来治疗或预防与纤维化相关联的疾病状态、病症和外科手术。其中多激酶抑制剂包括但不限于尼达尼布和/或仑伐替尼。
根据本发明的一些实施方案,本发明的化合物/分子可以通过肠胃外、肌内、皮下、眼部、局部、眼内、玻璃体内、病灶内、结膜下和眼球筋膜下(sub-tenon)注射,以及凭借滴眼剂、喷雾剂、粘合剂(adhesive)以及植入物和管内(intra-canalicular)递送进行药物递送,从而治疗疾病。
液体形式的组合物包括但不限于溶液、悬浮液和乳液。活性化合物/分子的无菌水或水-丙二醇溶液是适于施用的液体制剂的示例。
可以采用上述方法来治疗目标的眼相关疾病/病症以及眼部修复/伤口愈合,所述眼相关疾病/病症与以下相关联:角膜透明度受损、角膜瘢痕形成、继发性白内障形成、青光眼滤过手术、眼部外科手术和植入物、屈光性角膜切除术、激光原位角膜磨镶术、视网膜上膜和视网膜前膜的形成和收缩、增生性玻璃体视网膜病变、增生性糖尿病性视网膜病变、糖尿病性黄斑水肿、视网膜下纤维化/瘢痕形成、视网膜神经胶质增生,以及脉络膜形成、年龄相关性黄斑变性和视网膜静脉阻塞。
附图说明
图1显示根据本发明的一些实施方案,通过尼达尼布、索拉非尼和仑伐替尼来抑制兔角膜缝合模型中角膜新生血管形成。
图2显示尼达尼布和仑伐替尼(但是索拉非尼没有抑制作用)对兔角膜缝合诱导的纤维化模型中的纤维组织增生(fibroplasia)、胶原密度和a-SMA(平滑肌肌动蛋白)的抑制。
图3显示青光眼滤过手术的兔模型中的代表性结膜水泡的形成。
图4显示多激酶抑制剂对青光眼滤过手术的兔模型中残存滤泡的治疗效果。
图5显示多激酶抑制剂对兔皮肤伤口模型中TGF β1 mRNA表达的影响。
图6显示激光治疗后两周的眼睛代表性图像。(A)荧光素眼底血管造影;(B)异凝集素B4;和(C)异凝集素B4/DAPI。
发明详述
本发明的一些实施方案涉及预防和/或治疗眼中发生的纤维化(即眼部纤维化)。这种纤维化可与多种眼疾病或病症有关联。这些病症包括由外科手术的不期望的结果引起的那些病症。根据本发明的一些实施方案,用于治疗可与眼疾病或病症相关联的眼部纤维化的方法可包括向需要此疗法的对象提供组合物,所述组合物包含具有所选范围的活性的多激酶抑制剂来抑制所选择的激酶,比如VEGF和TGFβ。
本发明的组合物可包含多激酶抑制剂或其药学上可接受的盐。如本文所用,术语“多激酶抑制剂”指可以抑制多种激酶的抑制剂。如本文所用,术语“药学上可接受的盐”指所公开化合物的衍生物,其中通过制备母体化合物(parent compound)的酸或碱盐对其进行修饰。
药学上可接受的盐的示例包括但不限于碱性残基例如胺的无机或有机酸盐、酸性残基如羧酸的碱性或有机盐等等。药学上可接受的盐包括母体化合物/分子的常规无毒盐或季铵盐,例如,由无毒的无机或有机酸形成。例如,这种常规无毒盐可包括衍生自无机酸比如盐酸的盐。
根据一些实施方案,本发明还包括药物组合物,其含有本发明的一种或多种化合物/分子作为活性成分,以及至少一种药学上可接受的载体、稀释剂或赋形剂。
在一些实施方案中,本发明的化合物/分子可以通过肠胃外、肌内、皮下、眼、局部、眼内、玻璃体内、病灶内、结膜下和眼球筋膜下(sub-tenon)注射途径施用。
确定最适合特定患者的单个方案和剂量水平时,剂量将取决于施用途径、疾病严重性、患者年龄和体重以及主治医师通常考虑的其他因素。即治疗有效剂量将基于患者(年龄、性别、体重等)、疾病状况、施用途径等。本领域技术人员无需进行创造性劳动就能够确定治疗有效剂量。
根据本发明的一些实施方案,施用方案可以在术前(诱导)、术后(创伤/急性炎症、增生、重塑之时或者之前、成熟(maturation)期间)。
根据本发明的一些实施方案,为了从本发明的化合物/分子制备药物组合物,药学上可接受的惰性载体可以是固体或液体。
术语组合物旨在包括活性组分或药学上可接受的盐以及药学上可接受的载体、稀释剂或赋形剂的制剂。
液体形式的组合物包括溶液、悬浮液和乳液。可提及活性化合物/分子的无菌水或水-丙二醇溶液是适于肠胃外施用的液体制剂的示例。液体组合物也可配制成聚乙二醇水溶液的溶液。可以通过将活性组分溶于水并根据需要加入合适的着色剂、调味剂、稳定剂和增稠剂来制备用于口服施用的水溶液。可以通过将细碎的活性组分与粘性材料比如,天然合成树胶、树脂、甲基纤维素、羧甲基纤维素钠和药物制剂领域已知的其他悬浮剂一起分散在水中来制备用于口服使用的水性悬浮液。
药物组合物可以是单位剂型。在此剂型中,将组合物分成含有适量活性成分的单位剂量。单位剂型可以是包装的制剂,所述包装含有大量且分开的制剂。
可以配制组合物以用于任何合适的施用途径和方式。药学上可接受的载体或稀释剂包括适合肠胃外施用的制剂中使用的载体或稀释剂。制剂可以方便地以单位剂型存在,并且可以通过药学领域熟知的任何方法来制备。
将通过以下实施例来说明本发明的一些实施方案。本领域技术人员将理解,这些实施例仅用于说明,并且在不脱离本发明范围的情况下可进行其他修改和改变。
实施例1
使用缝合诱导的眼部纤维化模型来研究眼睛受伤后受试化合物的抗纤维化作用。在显微镜下,将缝合线置于兔角膜基质内。在每只眼睛中,垂直地将一根9-0丝质缝合线放置在角膜中心的颞侧,然后将第二根缝合线置于角膜中心的鼻侧。每根缝合线在距离角膜缘约2mm处有两个基质入侵(Stromal incursion)。从手术后第二天开始,将具有一定范围的多激酶抑制活性的受试化合物和/或载体局部滴注(35μL/眼)在眼睛中,每天三次,持续10天。治疗组包括载体(作为对照)、尼达尼布(0.3%,w/w)、吡非尼酮(1%,w/w)、利奥西呱(0.3%,w/w)、索拉非尼(0.3%,w/w)和仑伐替尼(0.3%,w/w)。每个治疗组使用六只左眼。
在活体阶段,各组(包括对照组)的大体眼部观察相似,为非常轻微至中度结膜充血和肿胀,但是利奥西呱治疗组除外,其在10天观察期内的反应倾向于略微更严重。在第11天处死动物,摘出眼睛并解剖,用于进行组织病理学评估。
结果显示,仑伐替尼、尼达尼布和索拉非尼在减少角膜表面上的血管新生面积方面很有效(图1)。此外,如组织学染色(包括用于区分细胞与周围结缔组织的H&E和Masson三色方案)所证明,尼达尼布和仑伐替尼显著降低纤维组织增生和/或胶原密度,尤其是纤维化反应中的胶原形成(图2)。相反,索拉非尼对纤维组织增生或胶原形成几乎没有或没有影响。此外,通过免疫组织化学分析,尼达尼布和仑伐替尼显著降低α-SMA(平滑肌肌动蛋白)染色。α-SMA是肌成纤维细胞的关键标志物,其在伤口愈合和细胞外基质形成中的功能与纤维化疾病相关。另一方面,相对于载体处理,索拉非尼对α-SMA没有影响(图2)。
研究结果显示了通过尼达尼布和仑伐替尼的血管新生、纤维组织增生、胶原相关物质和SMA的组织学减少。此研究的结果还表明,并非所有多激酶抑制剂都会有效治疗纤维化组织反应。特别是,尼达尼布和仑伐替尼有效,但索拉非尼无效。
实施例2
为了研究眼部手术后局部施用的受试化合物的抗瘢痕形成效果,对兔眼进行青光眼滤过手术。术后结膜下伤口愈合是人类青光眼滤过手术后晚期滤泡失败(bleb failure)的主要原因。检测选择的多激酶抑制剂随时间推移对滤泡存活的影响。术后抑制结膜下纤维化将改善滤泡存活。将载体用作阴性对照,并将吡非尼酮用作阳性对照。
从角膜缘后面开始,穿过巩膜进行斜面22号静脉内套管插管,并继续插入直到前房中可见套管,从而在左眼上形成巩膜束。在放置之前,用肝素钠(1000单位)冲洗插管。撤回插管针,并且插管前进到超过瞳孔边缘以防止虹膜堵塞管。将插管修剪约2mm,然后使用缝合线固定至巩膜。用9-0Prolene来缝合筋膜(Tenon's)和结膜。每组使用6只兔子,对每只兔子的左眼进行青光眼滤过手术。治疗组将载体包含为阴性对照,将吡非尼酮(1%,w/w)包含为阳性对照,并包含索拉非尼(0.3%,w/w)和仑伐替尼(0.3%,w/w)。术后,每天三次将滴眼液(35μL)局部施用于眼睛,持续30天。在第30天处死所有动物。
手术过的眼睛在眼科检查中显示高的总眼部检查分(基于改良的Hackett和McDonald眼部分级系统)。在整个研究中监测滤泡。使用校准的卡尺来测量滤泡体积。在第2天,整体滤泡体积均匀增加,第4天体积大幅减少。在第7天,注意到各组之间存在差异,并且在第14天至第30天,大部分滤泡消失,表明由于结膜下瘢痕形成而发生滤泡失败。载体和吡非尼酮组的结果与文献中报告的情况相似(Zhong H等人,Invest Ophthalmol Vis Sci,52:3136-3142,2011)。图3显示的是在每天三次使用0.3%索拉非尼治疗的眼睛中,于第4天的代表性滤泡。
随时间监测滤泡时,与载体和索拉非尼组相比,吡非尼酮(阳性对照)和仑伐替尼治疗在第7天保持滤泡存活(图4)。
在第14天,所有采用索拉非尼治疗的眼睛都表现出滤泡失败。在第30天,用载体和吡非尼酮治疗的所有眼睛均显示出滤泡失败,而仑伐替尼治疗组仍然有滤泡残留(6只动物之一)。
这些结果表明,使用某些多激酶抑制剂(例如,仑伐替尼)而非索拉非尼治疗能够抑制结膜下瘢痕形成模型中与眼部手术相关联的眼部纤维化。
实施例3
并非所有多激酶抑制剂都能有效治疗或预防眼部纤维化的事实表明,有效化合物必须干扰纤维化的多个阶段。我们怀疑TGF-β可参与其中。纤维化是与疾病、创伤、遗传疾病或感染相关联的组织晚期反应性和/或修复性反应。无论涉及的器官或组织为何,纤维化的病理生理学都存在很强的重叠。因此,我们使用更方便的皮肤伤口模型来测试是否需要TGF-β抑制。
在兔的全层皮肤伤口中检查受试化合物。本研究使用7只雄性新西兰白兔,体重范围3.03至3.40kg。使用8mm皮肤穿孔活检,将四个伤口置于两耳的腹侧表面上。在手术后第15天和第29天,通过0.05mL皮内或病灶内注射,施用尼达尼布(1.0%,w/w)、仑伐替尼(1.0%,w/w)和索拉非尼(1.0%,w/w)。在最后一次施用受试药剂后的第14天,对动物实施安乐死。获取创伤部位并分成两半。将一半保存在福尔马林中以用于组织学检查,另一半被冷冻以用于TGF-β分析。
半定量评估组织H&E染色法以检查炎症和血管新生。通过Mason的三色染色法,评估组织纤维化和胶原组织。对接收受试物的四个皮内部位评分取平均值。大多数瘢痕组织由血管新生、成纤维细胞增生、胶原解体和再上皮化构成。
受试化合物尼达尼布(表1)产生少得多的血管新生,并且产生的纤维化与未治疗伤口大致相同。受试伤口的平均总分比未治疗伤口低1.5。总体上,与对照部位相比,受试部位形成的瘢痕较少。
表1.皮内给药1%w/w尼达尼布以治疗兔耳伤的组织病理学结果
血管新生 | 纤维化/胶原 | 再上皮化 | 总分 | |
治疗的平均 | 1 | 3 | 0.5 | 4.5 |
未治疗的对照 | 3 | 3 | 0 | 6 |
与对照部位相比,受试化合物索拉非尼(表2)导致血管新生略微增加以及纤维化类似或增加。总体上,与未处理伤口部位相比,受试化合物没有表现出减少瘢痕形成。
表2.皮内给药1%w/w索拉非尼以治疗兔耳伤的组织病理学结果
血管新生 | 纤维化/胶原 | 再上皮化 | 总分 | |
治疗的平均 | 3 | 2.5 | 0.3 | 5.8 |
未治疗的对照 | 2 | 2 | 0 | 4 |
与对照伤口部位相比,受试化合物仑伐替尼(表3)表现为产生的纤维化减少。治疗部位的总分比对照伤口低0.5。
表3.皮内给药1%w/w仑伐替尼以治疗兔耳伤的组织病理学结果
血管新生 | 纤维化/胶原 | 再上皮化 | 总分 | |
治疗的平均 | 2 | 2.5 | 0 | 4.5 |
载体对照 | 2 | 3 | 0 | 5 |
将治疗的创伤样品中的TGF-βmRNA表达与未治疗样品中的表达进行比较,结果见图5。大体来说,在尼达尼布和仑伐替尼治疗的样品中,TGF-βmRNA表达的平均倍数低于未治疗创伤样品中的表达水平。相反,用多激酶抑制剂索拉非尼治疗的动物的样品未显示出与未治疗创伤样品显著不同的平均TGF-β表达水平。这些结果支持我们的预测:有效的眼部纤维化抑制剂会抑制TGF-β的表达。
这些数据支持以下事实:尼达尼布和仑伐替尼具有治疗与疾病状态、病症和外科手术相关联的眼部纤维化所需的特定范围的多激酶抑制活性。特定范围的多激酶抑制包括抑制TGF-β的信号传导途径等。
实施例4
还在C57BL/6小鼠的视网膜下纤维化模型中评估了受试化合物的抗纤维化作用。使用激光光凝术(75-μm光斑尺寸,0.1-s持续时间,90mW,OcuLight TX532nm),在研究眼的布鲁赫膜(Bruch’s membrane)中产生3-5个病灶。激光应用后5-7天,视网膜下开始形成纤维化。在激光应用当天,在玻璃体内注射具有一定范围的多激酶抑制活性的受试化合物或载体。受试化合物的给药浓度为1%(w/w)的尼达尼布和仑伐替尼。对照组是载体和小鼠VEGF164抗体。每个治疗组有12只小鼠。将约1μL的每种受试化合物、载体或阳性对照玻璃体内注射到每只动物的右眼。在第15天和第35天,用荧光素血管造影术检查眼睛,然后摘除眼睛。在解剖的脉络膜上进行免疫染色用于评估视网膜下纤维化(例如,胶原1、异凝集素B4和/或DAPI)。使用的一级抗体是荧光缀合的异凝集素B4(FITC缀合的异凝集素B4)和抗胶原I型抗体。荧光素眼底血管造影、异凝集素B4和DAPI的代表性图像见图6。与载体治疗组相比,抗VEGF的治疗对视网膜下纤维化没有任何显著影响。尼达尼布和仑伐替尼均显著降低新生血管病灶的大小。研究结果表明,尼达尼布和仑伐替尼在治疗视网膜下纤维化方面具有疗效。因此,这些化合物可用于治疗与增生性视网膜疾病相关联的视网膜下纤维化。
实施例5
为期10天的该研究的目的是评估通过眼中的眼部局部滴注施用时,尼达尼布和仑伐替尼(0.3%w/w)的局部耐受性和眼部分布。每个治疗组使用五至七只雄性新西兰白兔。每只眼睛每天三次接受35μL载体、尼达尼布(0.3%w/w)或仑伐替尼(0.3%)滴眼液,持续10天。在第11天的最后一次给药后,处死动物并摘出眼睛,收集血浆和眼部组织。通过LC-MS/MS来测量这些化合物在组织和血浆中的浓度。
这些化合物在眼部中的多种组织中的组织浓度列于表4和5。0.3%w/w的尼达尼布和仑伐替尼局部滴注向结膜和角膜前组织递送高浓度药物,并在兔的脉络膜和视网膜中产生显著浓度。在眼中维持这种药物暴露水平时,观察到非常轻微到中度的结膜充血和肿胀。在10天观察期内,这些充血和肿胀的程度在各组(包括载体对照物)中都相似。
表4.在兔眼中局部滴注0.3%w/w尼达尼布每日三次,持续10天后,尼达尼布及其代谢物的眼部组织浓度(以ng/gm)。
表5.在兔眼中局部滴注0.3%w/w仑伐替尼每日三次,持续10天后,仑伐替尼的眼部组织浓度(以ng/gm)。
仑伐替尼 | 平均 | SEM | N |
结膜 | 37.13 | 6.01 | 5 |
角膜 | 52.37 | 4.12 | 6 |
房水 | 1.3 | 0.2 | 6 |
虹膜睫状体 | 12.72 | 1.55 | 6 |
玻璃体液 | 0 | 0 | 6 |
脉络膜 | 18.47 | 4.31 | 6 |
视网膜 | 8.72 | 0.80 | 6 |
第11天尼达尼布的平均血浆浓度(±SD)低于可定量下限,其代谢物为1.09(±0.14)ng/mL,而仑伐替尼为98.5(±11)ng/mL。
实施例7:索拉非尼和仑伐替尼作为滴眼液在兔眼中局部滴注后在眼部组织中的分布。
该研究的目的是评估通过在眼中眼部局部滴注施用时,索拉非尼和仑伐替尼(0.3%w/w)的局部耐受性和眼部分布。每个治疗组使用五至六只雄性新西兰白兔。每只右眼每天三次接受35μL载体、索拉非尼(0.3%w/w)或仑伐替尼(0.3%w/w)滴眼液,持续5天。在第5天给药后,处死动物并摘出眼睛,收集血浆和眼部组织。通过LC-MS/MS来测量化合物在组织和血浆中的浓度。
研究组中的动物在研究过程中显示体重增量正常。对右眼进行的眼部检查没有得出显著的结果。在研究期间,所有组中的所有动物的平均总体检查得分接近基线值。使用Tonovet眼压仪来测量眼内压(IOP)。获得六次连续测量值,并记录显示屏上显示的平均IOP。实验期间,在所有组中,右眼的IOP保持在接近略高于基线值。
这些药物的眼部组织浓度见表6和7。0.3%w/w的索拉非尼和仑伐替尼局部滴注向结膜、巩膜和角膜前组织递送高浓度药物,并在兔的脉络膜和视网膜中产生显著浓度。
表6.在兔眼中局部滴注0.3%索拉非尼每日三次,持续5天后,索拉非尼的眼部组织浓度(以ng/gm)。
索拉非尼 | 平均 | SEM | N |
结膜 | 859.8 | 528.9 | 6 |
角膜 | 131.4 | 10.0 | 6 |
巩膜 | 16.36 | 4.00 | 6 |
房水 | 0 | 0 | 6 |
虹膜睫状体 | 3.337 | 0.408 | 6 |
玻璃体液 | 0.11 | 0.08 | 6 |
视网膜 | 17.36 | 2.41 | 6 |
脉络膜 | 8.191 | 0.702 | 6 |
表7.在兔眼中局部滴注0.3%仑伐替尼每日三次,持续5天后,仑伐替尼的眼部组织浓度(以ng/gm)。
给药第5天索拉非尼的平均血浆浓度(±SD)为5.09(±1.27)ng/mL,仑伐替尼为131(±24)ng/mL。
索拉非尼和仑伐替尼在前段组织(包括结膜和角膜)中的浓度都很高且基本相同。这些结果支持以下结论:局部对眼施用的动物疗效模型中的任何差异是由于其药理活性差异,而不是由于其药代动力学特征。
上述实施例表明,眼部应用本发明化合物能够达到足够浓度来产生疗效。
虽然已经用有限数量的实施例说明本发明的一些实施方案,但是本领域技术人员会理解,在不脱离本发明范围的情况下,可进行其他修改和改变。因此,本发明的保护范围应仅受所附权利要求的限制。
Claims (9)
1.一种用于预防和/或治疗与眼相关疾病或病症相关联的纤维化的方法,其包括:向有此需要的对象施用有效量的多激酶抑制剂。
2.根据权利要求1的方法,其中所述多激酶抑制剂是选自以下的至少一种:尼达尼布及其盐、仑伐替尼及其盐。
3.根据权利要求1的方法,其中所述多激酶抑制剂是尼达尼布或其盐。
4.根据权利要求1的方法,其中所述多激酶抑制剂是仑伐替尼或其盐。
5.根据权利要求1的方法,其中所述眼相关疾病或病症选自:角膜透明度受损、角膜瘢痕形成、继发性白内障形成、青光眼滤过手术、眼部外科手术和植入物、屈光性角膜切除术、激光原位角膜磨镶术、视网膜上膜和视网膜前膜的形成和收缩、增生性玻璃体视网膜病变、增生性糖尿病性视网膜病变、糖尿病性黄斑水肿、视网膜下纤维化/瘢痕形成、视网膜神经胶质增生,以及脉络膜形成,以及年龄相关性黄斑变性、视网膜静脉阻塞。
6.根据权利要求1的方法,其中所述眼相关疾病或病症选自:角膜透明度受损、角膜瘢痕形成、继发性白内障形成、青光眼滤过手术、眼部外科手术和植入物、屈光性角膜切除术、激光原位角膜磨镶术、视网膜上膜和视网膜前膜的形成和收缩、增生性玻璃体视网膜病变、视网膜下纤维化/瘢痕形成、视网膜神经胶质增生和脉络膜形成。
7.根据权利要求1的方法,其中所述眼相关疾病或病症选自:角膜透明度受损、角膜瘢痕形成、屈光性角膜切除术和激光原位角膜磨镶术。
8.根据权利要求1的方法,其中所述眼相关疾病或病症选自:继发性白内障形成、青光眼滤过手术以及眼部外科手术和植入物。
9.根据权利要求1的方法,其中所述眼相关疾病或病症选自:视网膜上膜和视网膜前膜的形成和收缩、增生性玻璃体视网膜病变、视网膜下纤维化/瘢痕形成、视网膜神经胶质增生和脉络膜形成。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201762492936P | 2017-05-01 | 2017-05-01 | |
US62/492,936 | 2017-05-01 | ||
PCT/US2017/043186 WO2018022437A2 (en) | 2016-07-22 | 2017-07-30 | Multikinase inhibitors and uses in ocular fibrosis |
Publications (2)
Publication Number | Publication Date |
---|---|
CN109996814A true CN109996814A (zh) | 2019-07-09 |
CN109996814B CN109996814B (zh) | 2023-08-11 |
Family
ID=65234297
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CN201780058772.2A Active CN109996814B (zh) | 2017-05-01 | 2017-09-30 | 多激酶抑制剂及在眼部纤维化中的用途 |
Country Status (9)
Country | Link |
---|---|
US (1) | US11278546B2 (zh) |
EP (1) | EP3619232B1 (zh) |
JP (1) | JP6813916B2 (zh) |
KR (1) | KR102307421B1 (zh) |
CN (1) | CN109996814B (zh) |
AU (1) | AU2017301410C1 (zh) |
CA (1) | CA3031457C (zh) |
ES (1) | ES2949382T3 (zh) |
WO (1) | WO2018022437A2 (zh) |
Families Citing this family (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
KR20240043821A (ko) | 2015-06-06 | 2024-04-03 | 클라우드브레이크 테라퓨틱스, 엘엘씨 | 익상편을 치료하기 위한 조성물 및 방법 |
CA3025325A1 (en) | 2016-06-02 | 2017-12-07 | Cloudbreak Therapeutics, Llc | Compositions and methods of using nintedanib for improving glaucoma surgery success |
US20190388407A1 (en) * | 2017-02-12 | 2019-12-26 | Aiviva Biopharma, Inc. | Multikinase inhibitors of vegf and tfg beta and uses thereof |
JP2021534153A (ja) * | 2018-08-15 | 2021-12-09 | アイビバ バイオファーマ インコーポレイテッド | Vegfおよびtgfベータのマルチキナーゼ阻害剤およびその使用 |
US20220008336A1 (en) * | 2018-11-26 | 2022-01-13 | Aiviva Biopharma, Inc. | Pharmaceutical biodissolvable gels for drug delivery |
AU2020346812A1 (en) * | 2019-09-10 | 2022-01-27 | Cloudbreak Therapeutics, Llc | Methods for alleviating pterygium-associated worry about eye appearance |
CN113057142B (zh) * | 2021-03-30 | 2022-12-09 | 四川大学华西医院 | 一种视网膜内和/或视网膜下纤维化动物模型的构建方法 |
Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2013126799A1 (en) * | 2012-02-22 | 2013-08-29 | Trustees Of Tufts College | Compositions and methods for ocular delivery of a therapeutic agent |
CN104884049A (zh) * | 2012-11-08 | 2015-09-02 | 克莱尔塞德生物医学股份有限公司 | 用于在人类受试者中治疗眼部疾病的方法和装置 |
WO2016209555A1 (en) * | 2015-06-22 | 2016-12-29 | Allgenesis Biotherapeutics Inc. | Ophthalmic formulations of tyrosine kinase inhibitors, methods of use thereof, and preparation methods thereof |
WO2017062694A1 (en) * | 2015-10-07 | 2017-04-13 | Diane Tang-Liu | Compositions and methods of treating skin fibrotic disorders |
CN109561985A (zh) * | 2016-06-02 | 2019-04-02 | 拨云生物医药科技(广州)有限公司 | 使用尼达尼布改善青光眼手术成功情况的组合物和方法 |
Family Cites Families (15)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4660546A (en) * | 1984-11-07 | 1987-04-28 | Robert S. Herrick | Method for treating for deficiency of tears |
US5767079A (en) | 1992-07-08 | 1998-06-16 | Celtrix Pharmaceuticals, Inc. | Method of treating ophthalmic disorders using TGF -β |
US7306799B2 (en) * | 1999-06-08 | 2007-12-11 | Regeneron Pharmaceuticals, Inc. | Use of VEGF inhibitors for treatment of eye disorders |
US20080213274A1 (en) * | 2005-10-28 | 2008-09-04 | Sabbadini Roger A | Compositions and methods for the treatment and prevention of fibrotic, inflammatory, and neovascularization conditions of the eye |
US20090203693A1 (en) * | 2006-06-29 | 2009-08-13 | Eisai R & D Management Co., Ltd. | Therapeutic agent for liver fibrosis |
CA2708004C (en) * | 2006-12-04 | 2015-12-01 | Promedior, Inc. | Conjoint therapy for treating fibrotic diseases |
US8642067B2 (en) * | 2007-04-02 | 2014-02-04 | Allergen, Inc. | Methods and compositions for intraocular administration to treat ocular conditions |
US9376393B2 (en) * | 2012-01-05 | 2016-06-28 | Clanotech Ab | Quinoline compounds which are anti-angiogenic integrin alpha5 beta1 inhibitors for use in the treatment of fibrosis or fibrosis-related diseases |
US10980804B2 (en) | 2013-01-18 | 2021-04-20 | Foundation Medicine, Inc. | Methods of treating cholangiocarcinoma |
CA3172586A1 (en) | 2013-07-31 | 2015-02-05 | Avalyn Pharma Inc. | Aerosol imatininb compounds and uses thereof |
US20160317438A1 (en) * | 2015-04-29 | 2016-11-03 | Psivida Us, Inc. | Injectable sustained release intraocular device |
KR20240043821A (ko) | 2015-06-06 | 2024-04-03 | 클라우드브레이크 테라퓨틱스, 엘엘씨 | 익상편을 치료하기 위한 조성물 및 방법 |
JP2018525078A (ja) | 2015-07-22 | 2018-09-06 | インセプト・リミテッド・ライアビリティ・カンパニーIncept,Llc | 被覆された涙点プラグ |
WO2017136486A1 (en) | 2016-02-04 | 2017-08-10 | Jinsong Ni | Antibody-drug synergism technology for treating diseases |
US10772885B2 (en) | 2016-09-26 | 2020-09-15 | Reyoung (Suzhou) Biology Science & Technology Co., Ltd. | Composition for treating ocular diseases and methods of usage and making |
-
2017
- 2017-07-21 US US16/319,265 patent/US11278546B2/en active Active
- 2017-07-30 WO PCT/US2017/043186 patent/WO2018022437A2/en unknown
- 2017-09-30 KR KR1020197005374A patent/KR102307421B1/ko active IP Right Grant
- 2017-09-30 EP EP17835012.0A patent/EP3619232B1/en active Active
- 2017-09-30 AU AU2017301410A patent/AU2017301410C1/en active Active
- 2017-09-30 ES ES17835012T patent/ES2949382T3/es active Active
- 2017-09-30 CN CN201780058772.2A patent/CN109996814B/zh active Active
- 2017-09-30 CA CA3031457A patent/CA3031457C/en active Active
- 2017-09-30 JP JP2019524135A patent/JP6813916B2/ja active Active
Patent Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2013126799A1 (en) * | 2012-02-22 | 2013-08-29 | Trustees Of Tufts College | Compositions and methods for ocular delivery of a therapeutic agent |
CN104884049A (zh) * | 2012-11-08 | 2015-09-02 | 克莱尔塞德生物医学股份有限公司 | 用于在人类受试者中治疗眼部疾病的方法和装置 |
WO2016209555A1 (en) * | 2015-06-22 | 2016-12-29 | Allgenesis Biotherapeutics Inc. | Ophthalmic formulations of tyrosine kinase inhibitors, methods of use thereof, and preparation methods thereof |
WO2017062694A1 (en) * | 2015-10-07 | 2017-04-13 | Diane Tang-Liu | Compositions and methods of treating skin fibrotic disorders |
CN109561985A (zh) * | 2016-06-02 | 2019-04-02 | 拨云生物医药科技(广州)有限公司 | 使用尼达尼布改善青光眼手术成功情况的组合物和方法 |
Non-Patent Citations (2)
Title |
---|
CHAUDHARY NI等: "Inhibition of PDGF, VEGF and FGF signalling attenuates fibrosis", 《THE EUROPEAN RESPIRATORY JOURNAL》 * |
EREN K等: "The Suppression of Wound Healing Response with Sirolimus and Sunitinib Following Experimental Trabeculectomy in a Rabbit Model", 《CURRENT EYE RESEARCH》 * |
Also Published As
Publication number | Publication date |
---|---|
JP6813916B2 (ja) | 2021-01-13 |
CA3031457A1 (en) | 2018-02-01 |
CA3031457C (en) | 2023-02-21 |
KR20190134588A (ko) | 2019-12-04 |
US11278546B2 (en) | 2022-03-22 |
JP2019524880A (ja) | 2019-09-05 |
US20190275034A1 (en) | 2019-09-12 |
EP3619232C0 (en) | 2023-06-07 |
AU2017301410C1 (en) | 2020-08-06 |
AU2017301410B2 (en) | 2020-04-30 |
WO2018022437A3 (en) | 2018-03-08 |
CN109996814B (zh) | 2023-08-11 |
WO2018022437A2 (en) | 2018-02-01 |
AU2017301410A1 (en) | 2019-02-14 |
EP3619232B1 (en) | 2023-06-07 |
EP3619232A4 (en) | 2021-01-13 |
EP3619232A2 (en) | 2020-03-11 |
ES2949382T3 (es) | 2023-09-28 |
KR102307421B1 (ko) | 2021-09-30 |
WO2018022437A8 (en) | 2019-01-10 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
CN109996814A (zh) | 多激酶抑制剂及在眼部纤维化中的用途 | |
Pfeiffer et al. | A randomized trial of a Schlemm's canal microstent with phacoemulsification for reducing intraocular pressure in open-angle glaucoma | |
Fernández-Barrientos et al. | Fluorophotometric study of the effect of the glaukos trabecular microbypass stent on aqueous humor dynamics | |
Denis et al. | A first-in-human study of the efficacy and safety of MINIject in patients with medically uncontrolled open-angle glaucoma (STAR-I) | |
Figus et al. | The supraciliary space as a suitable pathway for glaucoma surgery: Ho-hum or home run? | |
Ondrejka et al. | 360 ab-interno Schlemm’s canal viscodilation in primary open-angle glaucoma | |
CN109561985A (zh) | 使用尼达尼布改善青光眼手术成功情况的组合物和方法 | |
CN102695511A (zh) | 抑制眼部瘢痕形成的转化生长因子-β受体抑制剂的用途 | |
Kozera et al. | Effectiveness of iStent trabecular microbypass system combined with phacoemulsification versus phacoemulsification alone in patients with glaucoma and cataract depending on the initial intraocular pressure | |
Wałek et al. | Efficacy of postoperative management with 5-fluorouracil injections after XEN Gel Stent implantation | |
CN109152769A (zh) | 西罗莫司用于治疗伴有持续性水肿的渗出性年龄相关性黄斑变性的用途 | |
Hindman et al. | Impact of topical anti-fibrotics on corneal nerve regeneration in vivo | |
Koerber et al. | Four-year efficacy and safety of iTrack ab-interno canaloplasty as a standalone procedure and combined with cataract surgery in open-angle glaucoma | |
Stawowski et al. | Comparison of ExPress Mini‐Device Implantation Alone or Combined with Phacoemulsification for the Treatment of Open‐Angle Glaucoma | |
Hayashi et al. | Intraocular pressure elevation after cataract surgery and its prevention by oral acetazolamide in eyes with pseudoexfoliation syndrome | |
Kerr et al. | Primary needling of the ab interno gelatin microstent reduces postoperative needling and follow-up requirements | |
CN108159051B (zh) | 3-甲基腺嘌呤在制备治疗视网膜下纤维化的药物中的应用 | |
CN102781452A (zh) | 减少与皮质类固醇的眼内使用相关的眼压的发生率的方法 | |
Ahmed et al. | Long-term results of the safety and effectiveness of a novel microshunt in Japanese patients with primary open-angle glaucoma | |
Okka et al. | Effects of latrunculin B on outflow facility, intraocular pressure, corneal thickness, and miotic and accommodative responses to pilocarpine in monkeys | |
Kim et al. | Effect of combined goniotomy and phacoemulsification on intraocular pressure in open‐angle glaucoma patients | |
RU2575966C2 (ru) | Способ лечения неоваскулярной глаукомы | |
Güler et al. | Effect of dexamethasone intravitreal implant (Ozurdex®) on corneal endothelium in retinal vein occlusion patients: corneal endothelium after dexamethasone implant injection | |
Kwon et al. | Comparative study of corneal wetting agents during 25-gauge microincision vitrectomy surgery under a noncontact wide-angle viewing system | |
Codreanu et al. | In vivo study comparing an X‐shaped polymethylmethacrylate and a cylindrical collagen implant for deep sclerectomy |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
PB01 | Publication | ||
PB01 | Publication | ||
SE01 | Entry into force of request for substantive examination | ||
SE01 | Entry into force of request for substantive examination | ||
TA01 | Transfer of patent application right | ||
TA01 | Transfer of patent application right |
Effective date of registration: 20190719 Address after: Nevada Applicant after: AIVIVA HOLDING Ltd. Address before: Grand Cayman, Cayman Islands Applicant before: AIVIVA HOLDING Ltd. |
|
GR01 | Patent grant | ||
GR01 | Patent grant |