CN1130872A - 炎痛静在治疗由tnf引起的病理疾病中的用途 - Google Patents

炎痛静在治疗由tnf引起的病理疾病中的用途 Download PDF

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CN1130872A
CN1130872A CN94193377A CN94193377A CN1130872A CN 1130872 A CN1130872 A CN 1130872A CN 94193377 A CN94193377 A CN 94193377A CN 94193377 A CN94193377 A CN 94193377A CN 1130872 A CN1130872 A CN 1130872A
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benzydamine
hydrocloride
physiologically acceptable
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V·西奥里
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Angelini Ricerche Sa Consortile Soc
Istituto Ricerca Francesco Angelini SpA
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Abstract

用炎痛静及其生理上可接受的酸加成盐制成药物用于治疗由TNF引起的生理疾病。

Description

炎痛静在治疗由TNF引起的病理疾病中的用途
本发明涉及炎痛静及其生理上可接受的酸加成盐在治疗由TNF(肿瘤坏死因子)引起的病理疾病中的用途。
炎痛静(The Merck Index,9th ed.,1976,page147 no.1136)首次公开是在美国专利3,318,905上,它涉及一组具有止痛,消炎和肌肉松弛活性的物质。
炎痛静已作为盐酸盐在人类治疗中得到广泛应用。通过全身途径,它主要被用作消炎药和止痛药。然而,其典型应用主要是用于包括局部发炎在内的那些疾病的治疗,如肌痛,腱炎,外阴阴道炎,牙龈炎,口炎,口腔粘膜炎等等。
而且,炎痛静水杨酸盐已被用于风湿病的治疗。
TNF是具有相对分子量(Mr)为17,500(17.5KDa)和已知氨基酸序列的非糖基化多肽,并被认为其活性形式是三聚体(Old L.J.,″Science″,1985,230,630-632;Beutler B.et al.,″Nature″,1986,320,585-588;Jones E.Y.et al.,″Nature″,1989,338,225-228;Corti A.et al.,″Biochem.J.″,1992,284,905-910)。
TNF,也称aTNF或恶液质素,属于细胞分裂素家族,因此在刺激免疫反应以防御器官受外部攻击方面起着重要作用(EpsteinF.H.,″The New England J.of Med.″,1987,316,379-385;Urdal D.L.,″Annual Reports in Med.Chem.″,1991,26,221-227)。
另一方面,TNF的过分作用可能使其本身成为造成TNF巨大毒性的实际发病机理(Waage A.et al.,″Immunological Reviews″,1992,No.127,221-230)。
因此,大家一致公认TNF在一些非常严重的急性和慢性病理疾病如败血症休克和恶病质(Epstein F.H.,loc.cit.;Waage A.etal.,loc,cit)及多发性硬化(Dijkstra D.C.et al.,Trends inPharm.Sc.,14,124-129,1993)中起着十分重要的作用。
因此,尽管多年来对TNF的研究目的在于研究其性质,结构和制备方法,但近些年人们已经意识到需要具有干扰TNF产生和作用能力的药剂,以作为治疗手段用于毒性,细菌,病毒或内源性因子,通过刺激巨噬细胞而导致毒性浓度TNF的产生的病理学。
这些化合物尽管以不同的机理干扰TNF,但它们都具有干扰TNF的能力。
更特别的是,已有报道,一些化合物具有保护某些特别敏感细胞系免受TNF毒害作用的能力。
苏拉明(EA-A-O486,809),酞胺哌啶酮(Sampaio E.P.,″J.Exp.Med.″,173,699-703,1991)和一些戊二酰亚胺衍生物如放线菌酮(″Transplant Proc.″,23,254-255,1991),尽管以不同的方式和具有不同的特异性但都干扰TNF的产生。
相反,vinigrol(PCT-WO-91/07953;Weber E.,″J.Org.Chem.″,52,5292-5293,1987)干扰TNF的作用而不改变它的合成。
关于TNF的拮抗作用被辨明之前,那些既知道它们的结构又用于临床的化合物之间没有任何联系。
事实上,苏拉明,即8,8′-(羰基双(亚氨基-3,1-亚苯基羰基亚氨基(4-甲基-3,1-亚苯基)羰基亚氨基))双-1,3,5-萘三硫酸,被称为杀锥虫剂。放线菌酮,即4-(2-(3,5-二甲基-2-氧-环己基)-2-羟乙基)-2,6-哌啶酮,被称作杀真菌剂。Vinigrol,即4,8a(1H)-二醇,4,4a,5,6,7,8-六氢-3-(羟甲基)-8,9-二甲基-12-(1-甲基乙基)-(1R-(1α,4β,4αβ,5α,8β,8αβ,9S*,12S*))-1,5-丁酮萘被称作低血压和抗血小板聚集剂。
最后,申请人进行的实验表明常规抗炎药如布洛芬和消炎痛不能拮抗TNF(见实施例1)。
现在,意外地发现炎痛静及其生理上可接受的酸加成盐可以在体外保护敏感细胞的培养物免受TNF毒害作用,在体内避免由于TNF作用在鼠爪上形成浮肿。
至今为止,所进行的实验表明炎痛静及其生理上可接受的酸加成盐对于TNF发挥作用的剂量比达到抗炎效果所服用的剂量要高。
因此,本发明第一个目的是用炎痛静及其生理上可接受的酸加成盐制备治疗由TNF引起的病理疾病的药物。
由TNF引起的病理疾病的典型实例有:败血症休克,恶病质,即伴随肿瘤生成疾病而来的普遍衰竭(Balkwill F.et al.,″TheLancet″,ii Sec.,1229-1232,1987),慢性病毒或细菌感染如结核或AIDS(Barnes P.F.et al.,″The Journal of Immunology″, 145,149-154,1990)或退化疾病如多发性硬化(Dijkstraetal.,loc.cit.)或溃疡性结肠炎。
本发明第二个目的是提供一种治疗方法,包括给患有由TNF引起的病理疾病的病人服用有效量的炎痛静或其生理上可接受的酸加成盐。
对于实际应用,本发明化合物可以它们的固有形式,但优选以药物制剂形式全身使用。
本发明药物制剂可以通过全身或局部途径给药。
当以全身途径给药时,它们可以固体,类片剂,糖衣剂,胶囊,粉剂和缓释形式或液体形式给药,例如,用于肌内或静脉注射的无菌溶液,悬浮液和乳液。
局部使用的药物制剂可以是阴道药剂形式如用于灌洗的溶液,油膏和泡沫剂,用于处理口腔(buccal cavity)的药剂形式如口腔洗液和喷雾剂,以及用于鼻和耳的药剂形式如软膏,糊剂,油膏,泡沫剂,凝胶,溶液和粉剂。
除了常用赋形剂外,本发明制剂中还包含其它合适的药物添加剂如防腐剂,稳定剂,乳化剂,用于调节渗透压的盐,缓冲剂,着色剂和调味剂。
当特殊治疗需要时,本发明制剂也可以包含其它可配伍的活性成分,将它们同时给药有助于治疗。
在实际治疗应用中炎痛静及其生理上可接受的酸加成盐的有效剂量可以在很宽的范围内变化,这取决于一些已知因素,如具体治疗要求,选择的药物制剂和给药途径。然而,最佳有效剂量可由医师根据简单的常规方法方便地确定。
总之,日剂量的优选范围是炎痛静碱从0.1至10mg/kg,或更优选,从3至10mg/kg。当然,在使用其酸加成盐情况下,给药量应相应于上述炎痛静碱的剂量。
本发明药物制剂可以采用药物化学中的常用技术制备,包括混合,粒化和(如果需要)挤压,或为制成所需的制剂将各种成分充分混合和溶解。
下列实施例旨在说明本发明,但不限制它。
实施例1
在体外炎痛静,布洛芬和消炎痛对TNF毒性的效果
根据D.R.Branch等人的方法(J.of Immunological Method-s,143,251-261(1991)),将细胞培养物L929与TNF(鼠的重组体a-TNF“Genzyme”)一起培养,以31μg/ml剂量加入或不加入炎痛静盐酸化物,布洛芬和消炎痛。
该溶液的光密度用带550nm滤光片的Titertek MKII装置测量,得到存活细胞数目的直接测定结果。该结果示于下列表1。
表1
                   光密度(绝对)对照                    0.768TNF+(1μg/ml)           0.133TNF+布洛芬              0.118TNF+消炎痛          0.152TNF+炎痛静          0.573
实施例2
炎痛静对大鼠身上由TNF引起的组织损伤的效果
本试验是在三组,每组5只大鼠(雄性,CD品种,体重101-125g)中进行。通过注射40,000单位(0.1ml)商品TNF(鼠的重组体α-TNF“Genzyme”)溶液到鼠的右后爪造成水肿。
同时,还以40mg/kg剂量给第二组(B组)大鼠皮下注射炎痛静盐酸化物,和以3mg/kg剂量给第三组(C组)大鼠口服消炎痛。
根据C.A.Winter等人在“Proceedings of the Society for Ex-perimental Biologyand Medicine,Vol.III,544-547,1962”上所述方法,用BASILE体积测量计,以表2中所列时间点,测量鼠爪体积。结果列于表2。
表2 炎痛静对大鼠中由TNF引起的组织损伤的效果
        整个过程中鼠爪体积变化(ml)
组   0    30′   1h     3h     6h
A    0    +90    +70    +90    +10
B    0    +50    +30    +30    -10
C    0    +110   +40    +90    +110
A组是对照组,B组是用炎痛静处理的组,C组是用消炎痛处理的组。该数据的意义是p<0.01。

Claims (12)

1.炎痛静及其生理上可接受的酸加成盐的用途,即制成药物用于治疗由TNF引起的生理疾病。
2.根据权利要求1的炎痛静及其生理上可接受的酸加成盐的用途,其中TNF引起的生理疾病为包括败血症休克,恶病质,及伴随肿瘤生成疾病,慢性病毒和细菌感染,退化疾病的普遍衰竭在内的疾病。
3.根据权利要求2的炎痛静及其生理上可接受的酸加成盐的用途,其中结核病是细菌感染。
4.根据权利要求2的炎痛静及其生理上可接受的酸加威盐的用途,其中AIDS是病毒感染。
5.根据权利要求2的炎痛静及其生理上可接受的酸加成盐的用途,其中多发性硬化或溃疡性结肠炎是退化疾病。
6.治疗由TNF引起的病理疾病的方法,其特征在于给需要治疗的病人服用有效量的炎痛静或其生理上可接受的酸加成盐。
7.根据权利要求6的方法,其特征在于由TNF引起的生理疾病为包括败血症休克,恶病质,及伴随肿瘤生成疾病,慢性病毒和细菌感染,退化疾病的普遍衰竭在内的疾病。
8.根据权利要求7的方法,其特征在于结核病是细菌感染。
9.根据权利要求7的方法,其特征在于AIDS是病毒感染。
10.根据权利要求7的方法,其特征在于多发性硬化或溃疡性结肠炎是退化疾病。
11.根据权利要求6-10之中任一方法,其特征在于炎痛静(以炎痛静碱形式)的有效剂量是每天0.1-10mg/kg。
12.根据权利要求6-11之中任一方法,其特征在于炎痛静(以炎痛静碱形式)的有效剂量是每天3-10mg/kg。
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EP0711163B1 (en) 2001-10-24
CZ25596A3 (en) 1996-07-17
LV11524B (en) 1996-12-20
HU226805B1 (en) 2009-10-28
NO960347D0 (no) 1996-01-26
PT711163E (pt) 2002-04-29
WO1995003799A1 (en) 1995-02-09
CN1085528C (zh) 2002-05-29
CA2167926A1 (en) 1995-02-09
US6300358B1 (en) 2001-10-09
RU2160102C2 (ru) 2000-12-10
JP3587851B2 (ja) 2004-11-10

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