CN111135164A - Application of compound and pharmaceutical composition thereof in chronic complications of diabetes - Google Patents
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Abstract
The invention relates to application of dimethylamino michelia lactone fumarate in diabetes chronic complications, belongs to the technical field of medicines, and particularly relates to application of a compound shown in a formula (I) in prevention, treatment or auxiliary treatment of the diabetes chronic complications and application of the compound in preparation of medicines for prevention, treatment or auxiliary treatment of the diabetes chronic complications.
Description
Technical Field
The invention belongs to the technical field of medicines, and particularly relates to an application of sesquiterpene lactone compounds and a pharmaceutical composition thereof in preventing, treating or adjunctively treating chronic complications of Diabetes Mellitus (DM).
Background
With the increasing living standard, lifestyle changes and aging population, the prevalence of DM is rapidly increasing, and 2015 international DM association research data indicates that about 4.15 million DM patients worldwide have become the third largest chronic non-infectious disease in developed countries following cardiovascular disease and tumors. In recent years, the prevalence rate of DM in China is increased explosively, and is increased from 5.5% in 2000 to 10.9% in 2013. Thus, DM is a worldwide public health problem that is a serious hazard to human health.
Due to the discovery and wide application of insulin and oral hypoglycemic drugs, the number of deaths caused by acute complications of DM such as ketoacidosis and hypertonic hyperglycemia is remarkably reduced, and various chronic complications such as diabetic cardiovascular and cerebrovascular diseases, Diabetic Nephropathy (DN), diabetic peripheral neuropathy, diabetic retinopathy and diabetic foot become main factors influencing the life quality and prognosis of DM patients. Diabetic cardiovascular and cerebrovascular diseases are one of the main causes of death and disability of DM patients. DN is one of the most common and most harmful chronic complications in DM patients, with incidence rates as high as about 40% and 20% in type 1 and type 2 DM patients, respectively, being the leading cause of death in end-stage renal disease (ESRD) worldwide, with DN-induced 5-year survival rates for ESRD patients of less than 20%; since 2011, DN has become the leading cause of chronic kidney disease in urban hospitalized patients in China, and in 2016, at least 2430 ten thousand DN patients are in China. Diabetic retinopathy has become the leading cause of blindness in adults in developed countries, and the blindness risk of DM patients in China is 25 times higher than that of non-DM patients. The diabetic foot not only causes the life quality of DM patients to be reduced, but also causes huge economic and social burden, about 5 to 10 percent of patients need amputation, and DM patients account for more than 50 percent of non-traumatic amputation. Therefore, how to effectively prevent and treat various chronic complications of DM has become a common concern in the medical field.
The existing treatments for DM and various chronic complications thereof mainly comprise diet and exercise treatment, hyperglycemia control (oral anti-DM drugs and insulin treatment), hypertension and blood lipid disorders, renin-angiotensin system (RAS) blocking, strict control of urine protein, traditional Chinese medicine and the like, however, even if the strict control of blood glucose, blood pressure and blood lipid can only partially prevent various DM chronic complications from occurring, even though RAS retarder Angiotensin Converting Enzyme Inhibitor (ACEI) and angiotensin II receptor Antagonist (ARB) are first-line drugs which are recognized to have direct kidney protection effect, satisfactory effect is not obtained when ACEI and ARB are used for treating various DM chronic complications such as DN and the like, other drugs such as thiazolidinedione drugs, protein kinase C- β inhibitor, endothelin antagonist and the like can reduce the urine protein of DM, the development of DN is delayed, but laboratory researches or small-sample clinical observations are carried out, the treatment of DM and various chronic complications thereof also has certain curative effect, but the preparation process, quality standard, design and clinical research and quality of the medicines are still limited, and the development of various new medicaments has obvious curative effect, and various chronic complications of DM and clinical effects.
At present, no report about the application of the sesquiterpene lactone compound or the pharmaceutical composition thereof provided by the invention in preventing, treating or adjuvant treating DM chronic complications is found.
Disclosure of Invention
The invention provides application of a compound (dimethylamino michelia lactone fumarate, code ACT001) in formula (I) in preparation of medicines for treating DM chronic complications or in preparation of medicines for adjuvant treatment of DM chronic complications.
Chemical structural formula:
chemical name: (3R,3aS,9R,9aS,9bS) -3- ((dimethylamino) methyl) -9-hydroxy-6, 9-dimethyl-3, 3a,4,5,7,8,9,9 a-octahydroazuno [4,5-b ] furan-2 (9bH) -one fumarate;
code number: ACT 001;
the molecular formula is as follows: c17H27NO3·C4H4O4；
Molecular weight: 409.47.
the application of the compound in the medicine for preventing, treating or assisting in treating DM chronic complications.
The application of the compound in preparing the medicine for preventing, treating or assisting in treating DM chronic complications.
When the compound of the present invention is used as a medicament, it may be used as it is or in the form of a pharmaceutical composition. The pharmaceutical composition contains 0.1-99%, preferably 0.5-90% of the compound of the invention, and the balance of pharmaceutically acceptable carriers and/or excipients which are nontoxic and inert to human and animals or drugs which are used together with other drugs for preventing, treating or assisting in treating DM chronic complications. The composition can be prepared into injection, tablets, capsules and the like.
The pharmaceutically acceptable carrier or excipient is one or more of solid, semi-solid and liquid diluents, fillers and pharmaceutical adjuvants. The pharmaceutical composition of the present invention is used in the form of a dose per unit body weight. The medicine of the invention can be administered by two forms of injection and oral administration, such as intravenous injection and intramuscular injection, and the oral administration can be tablets and capsules.
Drawings
FIG. 1 is a scheme for the preparation of compounds of formula (I).
FIG. 2 is a flow diagram of a process for the preparation of compounds of formula (I).
Detailed Description
The invention is further illustrated by the following examples for the understanding of the invention, which are not intended to limit the scope of the invention.
Example 1: process for the preparation of compounds of formula (I)
1.1 route to the preparation of the Compounds of formula (I) (FIG. 1)
1.2 Process for the preparation of the Compound of formula (I) (FIG. 2)
Example 2: anti-DM Chronic complication Activity test for Compounds of formula (I)
The DM chronic complication is the main cause of DM disability and death, the pathogenesis of the DM disability and death relates to polyol bypass, protein kinase C, hexosamine activation, advanced glycosylation end product production and the like, and the probably common basis is found in recent years, the activation of the hyperglycemia-induced mitochondrial reactive oxidation product is more and more considered as the central link of hyperglycemia-induced oxidative stress, hyperglycemia causes the over-expression of mitochondrial peroxides by causing protein uncoupling, and finally causes DNA damage, meanwhile, from in vitro model tests and pathological examination to epidemiological studies, many evidences show that the inflammatory response is also one of the main pathogenesis of chronic complications of diabetes, and relates to a complex molecular network and pathway, chemokines such as Monocyte Chemotactic Protein (MCP) -1 and the like, adhesion molecules such as endothelial adhesion molecule 1, vascular cell adhesion protein 1, endothelial cell selective adhesion molecules, selectin E, α -actin 4, transcription factors such as Nuclear Factor (NF) -kappa B, and inflammatory cytokines such as IL-1, interleukin-6-IL- α, the inflammatory response gene plays a role in the development of chronic stress disorder of renal cells, and the inflammatory response of renal cell line is found to the development of chronic complications of diabetes, and the renal cell disorder.
2.1 materials of the experiment
2.1.1 test drugs
The drug of the invention, prepared as described in example 1 above, is designated ACT 001. Irbesartan tablets (anbovid) manufactured by cenofil pharmaceutical limited, lot No. 7a339, 150 mg/tablet.
2.1.2 Experimental animals
Two-month-old SD (Sprague-Dawley) male rats (180-220 g)36, cleaning grade, provided by the southern medical university laboratory animals center, guangzhou, certification No.: yue Zheng Zi word NO. 44002100010097. The experimental preposed animal is adapted to the indoor environment for 7 days at the room temperature of 18-22 ℃ and the relative humidity of 65%. All rats were fed free of water and were fed with conventional feed (protein content 3.14 mg/g).
2.2 Experimental methods
2.2.1 animal model making, grouping
Reference is made to the DN model (Yang YB, Zhang Z, Su KL, et al. study on experimental genetic therapy in rates induced by bioterrozocin. West china medical journal 2005,20(2):299-300) using a single intraperitoneal injection of Streptozotocin (STZ). After 1 week of adaptive feeding for all animals, fasting for 12 hours, randomly selecting 30 male SD rats, performing one-time intraperitoneal injection of STZ at 55mg/kg in a fasting state, and preparing the STZ into a 0.5% solution by using a sodium citrate buffer solution (0.1mol/L, pH4.0) before use. After 72h, monitoring blood sugar, and taking the positive of fasting blood sugar >16.6mmol/L, strong urine glucose, urine volume > 150% of original urine volume and urine microalbumin qualitative measurement for three times as a molding standard. The mortality rate of rats in the molding process is 20.00 percent. After 4 weeks the model rats were randomized into 3 groups (n-8): DN model group, irbesartan group, ACT001 group. A normal control group (n-6) was injected with an equal amount of sodium citrate buffer. All rats were housed in the same animal house in metabolic cages, on a standard diet, with free access to water.
2.2.2 drug dose setting, administration
According to the results of the preliminary experiments, ACT001 was administered at 12.5mg/kg. d. The maximum effective dose of irbesartan adult is 300mg per day, and the equivalent dose of rats is calculated to be 25mg/kg.d (Chenqi. Chinese medicine pharmacological research methodology 3 rd edition, Beijing: people's health publishing house, 2011). ACT001 and irbesartan are prepared into solution by distilled water, and the solution is irrigated for 1 time and 8 weeks every day. Rats in the DN model group and the normal control group are drenched with physiological saline with the same amount every day for 8 weeks. DN model rats are injected subcutaneously with 1.5IU/d of common insulin to improve the survival rate of animals.
2.2.3 specimen Collection and processing
After 8 weeks of gavage, the rats were placed in a metabolism cage and a 24-hour urine sample was collected, and 24-hour urine volume and water intake were measured. And (5) weighing. Performing intraperitoneal injection anesthesia with 3% sodium pentobarbital at 35mg/kg, performing abdominal incision, poking abdominal viscera with sterile gauze, exposing abdominal aorta, collecting blood by scalp acupuncture, separating blood serum, and storing at-20 deg.C or-70 deg.C. Weighing kidney tissues, splitting along the median sagittal plane after all the left kidneys are weighed, washing with PBS, removing envelopes, and putting into 10% formaldehyde neutral buffer solution for fixation to be subjected to pathological examination; several pieces of the right suprarenal cortex (volume 0.5 mm) were cut rapidly with a razor blade3～1mm3) Immediately putting the mixture into a 2.5% cold glutaraldehyde solution for fixation, and waiting for electron microscope detection; and (5) washing the rest right kidney tissues by PBS (phosphate buffer solution), and freezing and storing by liquid nitrogen.
2.2.4 Observation index and measuring method
2.2.4.1 general case: mental state, activity, diet, hair color, water intake, urine volume, etc.
2.2.4.2 body weight, relative kidney weight: the Body Weight (BWT) before and after administration was measured for each group of rats, and the change in body weight was calculated. After the rats were sacrificed, the left kidney was removed, washed with PBS, blotted with absorbent paper, and accurately weighed with an electronic balance (KWT), and the relative kidney weight (KWT/BWT) was calculated as follows: KWT/BWT [ KWT (g)/BWT (g) ] × 1000.
2.2.4.3 characterization of urine microalbumin: enzyme-linked immunosorbent assay (ELASA) was used.
2.2.4.424 h urinary protein quantification: the Bradford method was used.
2.2.4.5 biochemistry of blood: an Olimpaau 600 automated biochemical analyzer was used to measure blood glucose (Glu), Urea Nitrogen (UN), creatinine (Cr), alanine Aminotransferase (ALT), aspartate Aminotransferase (AST).
2.2.4.6 renal tissue Malondialdehyde (MDA) content and glutathione peroxidase (GSH-Px) and copper-zinc superoxide dismutase (Cu, Zn-SOD) activity: taking 0.5g of renal cortex, preparing into 10% homogenate with ice-cold normal saline under ice bath condition, centrifuging at low temperature, taking supernatant, wherein MDA content adopts thiobarbituric acid method, GSH-Px activity adopts NADPH coupling method, Cu, Zn-SOD activity adopts biphenyltriol autoxidation method, and the operation is strictly performed according to kit instructions.
2.2.4.7 renal tissue NF-. kappa.B pathway activation: western Blot experiment detects the ratio of total protein p-IKK/IKK, p-IkB/IkB and nucleoprotein p65/Lamin B of kidney tissues. Extracting total proteins and nucleoproteins of kidney tissues respectively according to requirements, and preparing protein samples by 5xloading buffer denaturation. 50ug of protein per well was subjected to gel electrophoresis and membrane transfer. After the protein membrane is incubated by a primary antibody and a secondary antibody, the protein membrane is developed by adopting an enhanced chemiluminescence method. And (4) analyzing the result by using Quantity One system software, and expressing the protein expression Quantity by using a gray value.
2.2.4.8 expression of TNF- α, MCP-1 and Transforming Growth Factor (TGF) - β 1mRNA in kidney tissue, real-time fluorescent quantitative PCR detection, extracting total RNA from tissue by kit reverse transcription system (24 μ L), 5 × Reaction Buffer (5 μ L), dNTP (1.25 μ L), M-MLV RV (1 μ L), NClean-free water (13.75. mu.L), RNA (3. mu.L), reaction conditions: 60min at 42 ℃; at 70 ℃ for 2 min; 1 cycle. Real-time fluorescent quantitative PCR reaction (25 μ L): 2 × SYBR Premix ExtAQTM (12.5 μ L), DH2O (8.5. mu.L), cDNA (2. mu.L), PCR Forward Prime (1. mu.L), PCR Rervise Prime (1. mu.L), reaction conditions: 95 ℃, 3min, 1 cycle; 95 ℃,20 s, 60 ℃, 40s, 40 cycles. And (4) analyzing results: 2-delta. Ct method was used for analysis (representing the fold change of the expression of the target gene in the experimental group relative to the control group): Δ Δ Ct ═ experimental group (Ct target gene-Ct reference gene) control group (Ct target gene-Ct reference gene).
2.2.4.9 expression of IL-1, IL-6, IL-8mRNA in renal tissue: the reverse transcription reaction, the real-time fluorescence quantitative PCR reaction and the result analysis are the same as the above.
2.2.4.10 renal pathology: hematoxylin and eosin staining common light microscope to observe kidney tissue change, immunofluorescence podocyte specific nucleoprotein WT-1 staining observation podocyte number is counted by taking a small ball as a unit, and transmission electron microscope observation is carried out to observe kidney tissue structure change.
2.3 results of the experiment
2.3.1 number of rats in each group at the end of experiment
In the treatment process, 2 rats and the rest 6 rats respectively die in the DN model group and the ACT001 group, 1 rat and the ③ rat die in the irbesartan group have oral hematoma of 0.8cm multiplied by 0.5cm in the administration process, and have no drug intervention in 1 week, so the calculation is not included, the rest 6 rats and the normal control group have no death and remain 6 rats.
2.3.2 changes in the general status of rats
The rats in the normal group move frequently, act swiftly and respond quickly; the DN model group rats are listened, slow in response, slow in action, withered and lusterless in hair, crouched in body, increased in urine volume and obviously increased in drinking water and food intake compared with the normal group; the mental status of the ACT001 group and the irbesartan group is general, the activity is obviously increased compared with that of the DN model group, and the mental status, the response and the hair color of rats in the ACT001 group are superior to those of rats in the DN model group.
2.3.3 changes in rat body weight, Kidney weight, relative Kidney weight
TABLE 1 rat body weight, renal weight, relative renal weightVariations of (2)
Note: comparison with Normal group*P<0.01; comparison with DN model group△P<0.01。
The weights of rats in each group are not obviously different before the experiment, the weights of the intermediates in the four groups are obviously different after the treatment, and the ACT001 group is obviously improved (P <0.01) compared with the DN model group, but is still lower (P <0.01) than that of a normal control group. The kidney weight and relative kidney weight of rats in the DN model group are higher than those of rats in the normal group, and have significant difference (P is less than 0.01), which indicates that DN modeling is successful and renal hypertrophy exists in the early stage; after treatment, the kidney weight and relative kidney weight of the rats are obviously reduced, and compared with the DN model group, the difference has statistical significance but is still higher than that of the normal group (Table 1).
2.3.4 quantification of urinary protein in rats in 24h and changes in renal function
Compared with the DN model control group, the rat 24h urine protein quantification of the ACT001 group and the irbesartan group is obviously reduced, and UN and Cr are obviously reduced but are higher than those of the normal group (Table 2).
TABLE 2 rat 24h urine protein quantification, changes in renal function
Note: comparison with Normal group*P<0.01; comparison with DN model group△P<0.01。
2.3.5 changes in blood glucose and liver function in rats
Compared with a DN model control group, the blood sugar of rats in the ACT001 group and the irbesartan group is not obviously reduced and is obviously higher than that of rats in a normal group; there was no significant difference in comparison between ALT and AST in each group of rats (Table 3).
TABLE 3 changes in blood glucose and liver function in rats
Note: comparison with Normal group*P<0.01; comparison with DN model group△P<0.01。
2.3.6 variation of MDA content and GSH-Px, Cu, Zn-SOD activity in rat kidney tissue
Compared with DN model control group, the kidney tissue MDA content of rats in ACT001 group and irbesartan group is obviously reduced, and the activity of GSH-Px and Cu, Zn-SOD is obviously improved (Table 4).
TABLE 4 variation of MDA content and GSH-Px, Cu, Zn-SOD activity in rat kidney tissue
Note: comparison with Normal group*P<0.01; comparison with DN model group△P<0.01。
2.3.7 rat Kidney tissue NF- κ B pathway activation
Rat kidney tissue NF- κ B pathway was inhibited in ACT001 and Irbesartan groups compared to DN model control (Table 5).
TABLE 5 NF- κ B pathway activation in rat kidney tissue
Note: comparison with Normal group*P<0.01; comparison with DN model group△P<0.01。
2.3.8 changes in the relative expression levels of TNF- α, MCP-1 and TGF- β 1mRNA in rat kidney tissue
Compared with DN model control group, the relative expression of mRNA of rat kidney tissues TNF- α, MCP-1 and TGF- β 1 of ACT001 group and irbesartan group are obviously reduced, but are higher than those of normal group (Table 6).
TABLE 6 changes in the relative expression levels of TNF- α, MCP-1, TGF- β 1mRNA in rat kidney tissue
Note: comparison with Normal group*P<0.01; comparison with DN model group△P<0.01。
2.3.9 change of relative expression quantity of IL-1, IL-6 and IL-8mRNA in rat kidney tissue
Compared with DN model control group, the relative expression levels of IL-1, IL-6 and IL-8 in kidney tissues of rats in ACT001 group and irbesartan group are obviously reduced, but are higher than those in normal group (Table 7).
TABLE 7 changes in the relative expression levels of IL-1, IL-6, and IL-8mRNA in rat kidney tissues
Note: comparison with Normal group*P<0.01; comparison with DN model group△P<0.01。
2.3.10 pathological changes in rat kidney tissue
And (3) observation under a light lens: the glomerulus structures of rats in a normal group are clear, the glomerulus structures are not enlarged or shrunk, the sacculus walls are smooth, extracellular matrixes and mesangial cells are normally distributed, and the capillary cavities are clear when the rats are observed under the condition of 100-fold amplification, 200-fold amplification and 400-fold amplification under a light microscope. DN model group rat glomerulus volume obviously increases, glomerulus swelling, congestion, renal vesicle narrows, glomerulus capillary vessel basement membrane (GBM) thickens, mesangial widens, mesangial cell hyperplasia, podocyte obviously swells, cytoplasm is in foam shape, part of renal tubules have epithelial cell hypertrophy and vacuolar degeneration, lumen narrows, renal interstitial edema and partial small vessel vitreous degeneration, and a few interstitial fibrosis can be seen. Rats in ACT001 group and irbesartan group have slightly enlarged glomerulus, swollen and congested glomerulus, slightly thickened GBM, slightly widened mesangium and slightly swollen renal tubular epithelial cells, but lesions are obviously relieved compared with DN model group, and the ACT001 group is more obvious.
And (3) observing under an electron microscope: the normal group rats are observed 4000 times, 5000 times, 6000 times, 8000 times and 10K times under an electron microscope respectively, the glomeruli and the renal tubules of the normal group rats have clear structures, the GBM is uniform, mesangial cells are normally distributed, and the podocytes of the normal group are in finger-shaped protrusions and attached to the outer side of a glomerular basement membrane. The rat GBM of the DN model group is thickened homogeneously, the GBM thickness difference of different parts in the same glomerulus is obvious, three layers of fine structures at the thickened part are unclear, podocyte swelling, large lipid vacuoles, podium fusion and podocyte reduction can be seen in partial cytoplasm, the mesangial matrix is increased, the mesangial area is enlarged, the mesangial cells are proliferated, the renal tubule basement membrane is thinned or thickened sectionally, the renal tubule epithelial cells are shed, the microvilli is reduced obviously, shortened and even shed, and visible red blood cells are gathered in capillaries. The renal tissue lesions of rats in the ACT001 group and the irbesartan group are obviously reduced compared with those in the DN model group, and the ACT001 group is more obvious.
2.3.11 change in the number of glomerular podocytes in rats
Compared with DN model control group, the number of podocytes of ACT001 group and irbesartan group is obviously increased, and no significant difference is generated compared with normal group (Table 8)
TABLE 8 variation of the number of podocytes per glomerular in rats
Note: comparison with Normal group*P<0.01; comparison with DN model group△P<0.01。
2.4 discussion
2.4.1 animal models
At the end of the experiment (12-13 weeks after STZ injection), the course of the animal model is 3-4 times corresponding to the stage of DN Mogensen, and belongs to early-middle stage DN model.
2.4.2 therapeutic Effect
Dimethylamino michelia lactone fumarate (code number ACT001) can obviously improve the activity of GSH-Px and Cu, Zn-SOD of DN rats, reduce MDA generation, inhibit NF-kB pathway activation, obviously reduce the expression of MCP-1, TNF- α, TGF- β 1, IL-6 and IL-8, thereby relieving oxidative stress injury, inhibiting inflammatory reaction, improving the general state of DN rats in early and middle stages, obviously reducing urine protein, obviously relieving renal pathological damage, protecting renal function and playing a role in treating DM chronic complications.
Example 3: injection solution
The compound prepared in example 1 is dissolved in a small amount of DMSO, and then injection water is added according to the conventional method, fine filtration is carried out, encapsulation and sterilization are carried out, thus preparing injection.
Example 4: tablet formulation
Example 1 the compound prepared and excipients were added at a weight ratio of 5:1 to form a granulate, which was compressed to form tablets.
Example 5: capsule
Example 1 the compound prepared and excipients were added in a weight ratio of 5:1 to make capsules.
The compounds, uses and methods of the invention have been described by specific examples. The invention can be used for other purposes by those skilled in the art by appropriately changing the raw materials, the process conditions and the like without departing from the content of the invention, and all similar substitutes and modifications obvious to those skilled in the art are deemed to be included in the scope of the invention.
Claims (3)
1. The application of dimethylamino michelia lactone fumarate of a compound shown in a formula (I) in preventing, treating or assisting in treating chronic complications of diabetes,
2. the use of a compound according to claim 1 for the preparation of a medicament for the prophylaxis, treatment or co-treatment of chronic complications of diabetes.
3. A pharmaceutical composition for the prevention, treatment or co-treatment of chronic complications of diabetes, comprising as active ingredient at least one compound of formula (I) according to claim 1 and a pharmaceutically acceptable carrier or other compound for the prevention, treatment or co-treatment of chronic complications of diabetes.
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| CN103622954A (en) * | 2012-08-22 | 2014-03-12 | 龙海波 | Applications of sesquiterpene lactone compound and derivative of sesquiterpene lactone compound in treatment of diabetes |
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| CN103622954A (en) * | 2012-08-22 | 2014-03-12 | 龙海波 | Applications of sesquiterpene lactone compound and derivative of sesquiterpene lactone compound in treatment of diabetes |
Non-Patent Citations (2)
| Title |
|---|
| LOPEZ-FRANCO ET AL.: ""Nuclear factor-[kappa]B inhibitors as potential novel anti-Inflammatory Agents for the Treatment of Immune Glomerulonephritis"", 《AMERICAN JOURNAL OF PATHOLOGY》 * |
| YAN ZHAO ET AL.: ""Sesquiterpene lactones inhibit advanced oxidation protein product-induced MCP-1 expression in podocytes via an IKK/NF-kappaB-dependent mechanism"", 《OXIDATIVE MEDICINE AND CELLULAR LONGEVITY》 * |
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