CN113398130A - 烟酰胺用于预防和治疗胃肠道功能紊乱的用途 - Google Patents
烟酰胺用于预防和治疗胃肠道功能紊乱的用途 Download PDFInfo
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- CN113398130A CN113398130A CN202010183713.1A CN202010183713A CN113398130A CN 113398130 A CN113398130 A CN 113398130A CN 202010183713 A CN202010183713 A CN 202010183713A CN 113398130 A CN113398130 A CN 113398130A
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Abstract
本发明涉及烟酰胺在制备用于预防和/或治疗胃肠道功能紊乱的药物中的用途。
Description
技术领域
本发明涉及烟酰胺用于预防和/或治疗胃肠道功能紊乱的用途。
背景技术
新型冠状病毒(以下有时简称为2019-nCoV,或者“新冠”,也称为 SARS-CoV-2),在短时间内造成大量感染。2019-nCoV感染的主要特征是肺 炎,约15%的肺炎患者可能出现急性呼吸窘迫综合征(ARDS),4%的患者 可能因多器官衰竭而死亡。
人血管紧张素转换酶2(ACE2)是SARS冠状病毒(SARS-CoV)和 2019-nCOV(也称为SARS-CoV-2)进入细胞的受体。ACE2抑制肾素-血管 紧张素系统(RAS)活化,后者可造成多脏器损伤。
在2019-nCoV肺炎患者的大量初始队列中,有相当一部分(3.7%)出 现腹泻;而在另一个队列中,约20%的严重急性呼吸综合征(SARS)患者 出现腹泻,许多SARS患者在肠道活组织检查中出现炎症变化,有粘膜感染 迹象。
2019-nCoV患者病情非常复杂,发展又迅速,如何选择安全且有效的治 疗其预防和治疗其相关的肠道炎症、腹泻等胃肠道功能紊乱,在起效的同时, 减少副作用,减少不良反应,提高患者生存率,改善患者生活质量,是当前 的一个重要课题,也是难点课题。
发明内容
本发明人为了解决上述问题,对胃肠道功能紊乱,特别是新冠胃肠道功 能紊乱的分子机制进行了深入研究,得到了如下结果:用2019-nCoV的刺突 蛋白刺激细胞后,会导致ACE2受体蛋白内吞(图2),表面表达降低。从 免疫荧光的结果可以看到,ACE2主要分布在结肠黏膜的上皮区域,在慢性 结肠炎,UC和CD患者中表达降低(图3)。该结果显示,在新冠胃肠道功 能紊乱中,ACE2的表达降低,这是本发明人的重要发现,由此,本发明人 为新冠胃肠道功能紊乱的治疗提供了治疗靶点。
此外,本发明人还进一步发现,在慢性结肠炎等结肠炎(colitis)、溃 疡性结肠炎(UC,ulcerative colitis)、克罗恩病(CD,Crohn’s disease)、未 定义(未分化)炎症性肠病(undiffererntiated IBD)等患者的结肠细胞中, ACE2和氨基酸转运体SLC6A19(B0AT1)显著减少(图1)。
ACE2的表达对B0AT1转运中性氨基酸(包括色氨酸等)至关重要。色 氨酸是合成烟酸或烟酰胺(两种维生素B3)的前体。烟酰胺是生成烟酰胺 腺嘌呤二核苷酸(NAD+)和NADH、NADP+和NADPH等衍生物所必需的。
本发明人还进一步发现,在结肠炎或IBD患者肠上皮细胞中TCA循环 中,IDH、OGDH和MDH等多个基因缺乏(图1)。这是由于,NAD+是 TCA循环中的几个关键酶和电子转移链中的复合物I所必需的,NAD+少, 将导致上述基因缺乏,从而进一步导致ACE2的表达减少。
基于上述发现,本发明人提出,ACE2和氨基酸转运体表达降低,抑制 烟酰胺合成,通过给药烟酰胺,可以恢复NAD+的正常水平和代谢通路,增 加ACE2的表达。ACE2是肠道氨基酸稳态、微生物生态、免疫平衡的关键 调节分子,其表达下调导致肠道对上皮损伤引起炎症的敏感性大大提高。因 此,给药烟酰胺,可以用于预防/治疗胃肠道功能紊乱(例如,表现为血管紧 张素转换酶2(ACE2)缺乏的胃肠道功能紊乱、表现为氨基酸转运体 SLC6A19(B0AT1)缺乏的胃肠道功能紊乱等),例如,结肠炎、溃疡性结 肠炎、炎症性肠病、以及腹泻等。
而且,针对冠状病毒(例如2019-nCoV)胃肠道功能紊乱,本发明人发 现在这样的胃肠道功能紊乱中,ACE2的表达降低,给药烟酰胺可以靶向 ACE2而改善ACE2的表达。因此,本发明人提出,给药烟酰胺可以作为冠 状病毒相关的(例如与2019-nCoV相关的)胃肠道功能紊乱,例如冠状病毒 相关的结肠炎、溃疡性结肠炎、炎症性肠病、以及腹泻等的靶向治疗手段。
如上所述,本发明涉及以下方面:
[1].烟酰胺在制备用于预防和/或治疗胃肠道功能紊乱的药物中的用途。
[2].上述[1]所述的用途,其中,所述胃肠道功能紊乱选自结肠炎、溃疡 性结肠炎、克罗恩病、炎症性肠病、以及腹泻。
[3].上述[1]或[2]所述的用途,其中,所述胃肠道功能紊乱表现为血管 紧张素转换酶2(ACE2)缺乏。
[4].上述[1]-[3]中任一项所述的用途,其中,所述胃肠道功能紊乱表现 为氨基酸转运体SLC6A19(B0AT1)缺乏。
[5].上述[1]-[4]中任一项所述的用途,其中,所述胃肠道功能紊乱为结 肠炎。
[6].上述[1]-[4]中任一项所述的用途,其中,所述胃肠道功能紊乱为溃 疡性结肠炎或克罗恩病。
[7].上述[1]-[4]中任一项所述的用途,其中,所述胃肠道功能紊乱为炎 症性肠病。
[8].上述[1]-[4]中任一项所述的用途,其中,所述胃肠道功能紊乱为腹 泻。
[9].上述[1]-[8]中任一项所述的用途,其中,所述胃肠道功能紊乱为与 冠状病毒相关的,例如与SARS-CoV-2(也称为2019-nCoV)相关的。
[10].预防和/或治疗胃肠道功能紊乱的方法,该方法包括给予受试者烟 酰胺。
[11].上述[10]所述的方法,其中,所述胃肠道功能紊乱选自结肠炎、溃 疡性结肠炎、克罗恩病、炎症性肠病、以及腹泻。
[12].上述[10]或[11]所述的方法,其中,所述胃肠道功能紊乱表现为血 管紧张素转换酶2(ACE2)缺乏。
[13].上述[10]-[12]中任一项所述的方法,其中,所述胃肠道功能紊乱 表现为氨基酸转运体SLC6A19(B0AT1)缺乏。
[14].上述[10]-[13]中任一项所述的方法,其中,所述胃肠道功能紊乱为 结肠炎。
[15].上述[10]-[13]中任一项所述的方法,其中,所述胃肠道功能紊乱为 溃疡性结肠炎或克罗恩病。
[16].上述[10]-[13]中任一项所述的方法,其中,所述胃肠道功能紊乱为 炎症性肠病。
[17].上述[10]-[13]中任一项所述的方法,其中,所述胃肠道功能紊乱为 腹泻。
[18].上述[10]-[17]中任一项所述的方法,其中,所述胃肠道功能紊乱为 与冠状病毒相关的,例如与2019-nCoV相关的。
附图说明
图1.图1显示出结肠炎或IBD(克罗恩病CD、溃疡性结肠炎UC、未 定义炎症性肠病)患者结肠上皮细胞ACE2和NAD/NADH循环活性降低。 A、显示6960个上皮细胞的tSNE图。单元格按10个子类型进行颜色编码。 Colonocytes细胞由虚线圆圈表示。B、tSNE图显示ACE2的表达(顶部) 和通路得分(底部)。结果表明,结肠形成细胞富集ACE2表达、氨基酸转 运蛋白活性和能量代谢通路。C、点图显示对照组、结肠炎和IBD患者结 肠上皮细胞中ACE、ACE2、NAD/NADH循环相关基因(框,即左栏中部) 和氨基酸转运蛋白(蓝框,即左栏下部)的表达。
图2.图2显示出新冠病毒棘突蛋白(spike protein)导致293T细胞的 ACE2表达降低。A、显示棘突蛋白与转染了Flag-tagged ACE2质粒的293T 细胞共孵育24小时后,ACE2的表达量降低。B、显示ACE2在293T细胞 胞膜定位。新冠病毒棘突蛋白与细胞共孵育后被转运至胞内,同时ACE2也 由胞膜定位变为胞内定位,并与棘突蛋白共定位。结果提示病毒棘突蛋白利 用ACE2进入细胞,并介导ACE2的胞内定位。细胞核为蓝色,ACE2为红 色,棘突蛋白为绿色。
图3.图3为免疫荧光显示正常儿童,慢性结肠炎,CD和UC结肠黏膜 ACE2的分布情况。细胞核为蓝色,ACE2为红色。
具体实施方式
本发明中的胃肠道功能紊乱,涉及例如胃、十二指肠、小肠、结肠等胃 肠道,包括:非感染性和感染性胃肠道疾病,例如炎症性、过敏性、和功能 性胃肠道疾病和胃肠道肿瘤等。胃部疾病例如急慢性胃炎、胃溃疡、胃息 肉、糜烂性胃炎、消化性溃疡、胃肿瘤、十二指肠肿瘤、胃间质瘤、十二 指肠间质瘤等。小肠疾病例如小肠肿瘤、肠系膜淋巴结炎、间质性病变等。 结肠疾病例如结肠炎、溃疡性结肠炎、克罗恩病、肠结核、结肠息肉、结 肠癌等疾病。本发明中的胃肠道功能紊乱也可以包括腹泻。
其中,炎症性胃肠道疾病,例如,炎症性肠病,结肠炎、未分化结肠 炎,克罗恩病(CD),溃疡性结肠炎(UC),未定义炎症性肠病(Undefined Inflammatory bowel disease),急性结肠炎、慢性结肠炎、直肠炎、等;胃 肠炎,例如,浅表性胃炎,溃疡性胃炎,慢性胃炎,慢性胃肠炎,食管狭 窄,食管闭锁,肠狭窄,肠闭锁等;过敏性胃肠道疾病,例如食物过敏引发 的胃肠道疾病,流如嗜酸性粒细胞食管炎,嗜酸性粒细胞胃肠炎、嗜酸性 粒细胞结肠炎、非嗜酸性粒细胞结肠炎、食物蛋白诱导的小肠结肠炎综合 征,食物蛋白诱导的肠病,食物蛋白诱导的直肠结肠炎,非特异性慢性结肠 炎,坏死性小肠结肠炎,巨结肠相关术前术后炎症。优选结肠炎、直肠炎、 未分化结肠炎、克罗恩病、溃疡性结肠炎、急性结肠炎、慢性结肠炎;功能 性胃肠道疾病。上述胃肠道疾病都包括感染性和非感染性的。
本发明中,优选包括结肠炎,炎症性肠病,例如克罗恩病(CD),溃疡性 结肠炎(UC),未定义炎症性肠病,食物过敏引发的胃肠道疾病,如嗜酸性 粒细胞食管炎,嗜酸性粒细胞胃肠炎、嗜酸性粒细胞结肠炎、非嗜酸性粒细 胞结肠炎、食物蛋白诱导的小肠结肠炎综合征,食物蛋白诱导的肠病,食物 蛋白诱导的直肠结肠炎,非特异性慢性结肠炎,坏死性小肠结肠炎,巨结 肠相关术前术后炎症,更优选炎症性肠病,例如结肠炎(例如未分化结肠炎)、 直肠炎、克罗恩病、溃疡性结肠炎、慢性结肠炎、急性结肠炎、嗜酸性粒细 胞结肠炎、非嗜酸性粒细胞结肠炎。在本发明中,结肠炎意在涵盖各种形式 的结肠炎;IBD意在涵盖克罗恩病、溃疡性结肠炎、未分化/未定义IBD等。
本发明优选包括但不限于结肠炎、溃疡性结肠炎、克罗恩病、炎症性肠 病、未定义(未分化)炎症性肠病、以及腹泻等。
本发明中的胃肠道功能紊乱可以表现为血管紧张素转换酶2(ACE2)缺 乏。
本发明中的胃肠道功能紊乱可以表现为氨基酸转运体SLC6A19(B0AT1) 缺乏。
本发明中的胃肠道功能紊乱可以表现为血管紧张素转换酶2(ACE2)缺 乏且氨基酸转运体SLC6A19(B0AT1)缺乏。
本发明中的胃肠道功能紊乱可以为与冠状病毒相关的,例如与 SARS-CoV-2(也称为2019-nCoV)相关的,例如感染了2019-nCoV的患者 的上述各种胃肠道功能紊乱,包括但不限于新冠各种结肠炎、新冠溃疡性结 肠炎、新冠克罗恩病、新冠炎症性肠病、新冠慢性结肠炎、新冠未定义(未 分化)炎症性肠病、以及新冠腹泻等。
本发明中,胃肠道功能紊乱的患者或受试者都没有年龄和性别的限制, 可以为儿童、成人、老人,其中儿童,可以是例如新生儿至12岁,1-6岁等。 本发明中的患者或受试者优选为儿童。
本发明的治疗胃肠道疾病的药物的使用对象还可以是其他哺乳动物,例 如猴子、牛、马、猪、小鼠、大鼠、仓鼠、兔子、猫、狗、羊和山羊等。
本发明的治疗也包括预防,比如由于一些与疾病相关的因素而预计具有 发病的高风险但还没有形成疾病的患者,或已经形成疾病但还没有自觉症状 的患者,给予本发明的药物,或对于治疗疾病之后害怕疾病复发的患者,给 予本发明的药物。
本发明中所述的烟酰胺(Nicotinamide,又称为3-吡啶甲酰胺),是生成 烟酰胺腺嘌呤二核苷酸(NAD+)和NADH、NADP+和NADPH等衍生物所 必需的。
本领域技术人员可以理解,本发明中所述的活性成分烟酰胺的形式并没 有限制,可以是活性化合物本身、游离态、其盐、酯、异构体、旋光异构体、 立体异构体、区域异构体、几何异构体、水合物、非水合物、溶剂化物或非 溶剂化物、无定型、晶体、可药用共晶体或共晶体盐、衍生物、前体药物等 各种形式。前体药物包括在生物体中、在生理条件下,由于酶、胃酸等等的 反应而能够转变为所述活性成分,也就是说,通过酶致氧化、还原、水解等 等而能够转变为活性成分的化合物;由于胃酸而能够通过水解等等转变为活 性成分的化合物,等等。共晶体或共晶体盐是指由两种或多种具体物质构成 的晶体物质,在室温下,每种物质是固体,各自具有不同的物理性质(例如, 结构、熔点、熔融热、吸湿性、溶解度、稳定性,等等)。共晶体和共晶体 盐可以利用本来已知的共结晶方法来制备。
例如,本发明中的活性成分烟酰胺可以是烟酰胺本身、游离态、盐、酯、 异构体、旋光异构体、立体异构体、区域异构体、几何异构体、水合物、非 水合物、溶剂化物或非溶剂化物、无定型、晶体、可药用共晶体或共晶体盐、 衍生物、前体药物等各种形式。
在本发明中,当提及活性成分时,意在涵盖该活性成分的上述各种形式, 例如当提及烟酰胺时,意在涵盖烟酰胺的上述各种形式,包括但不限于游离 形式、酯、盐、衍生物、前药等修饰形式。
在本发明中,活性成分是盐时,这种盐的例子包括金属盐、铵盐、与 有机碱形成的盐、与无机酸形成的盐、与有机酸形成的盐、与碱性或酸性氨 基酸形成的盐,等等。金属盐的优选例子包括:碱金属盐,例如,钠盐、钾 盐,等等;碱土金属盐,例如,钙盐、镁盐、钡盐,等等;以及铝盐。与有 机碱形成的盐的优选例子包括与下列有机碱形成的盐:三甲胺、三乙胺、吡 啶、甲基吡啶、2,6-二甲基吡啶、乙醇胺、二乙醇胺、三乙醇胺、环己胺、 二环己基胺、N,N'-二苄基乙二胺,等等。与无机酸形成的盐的优选例子包括: 与盐酸、氢溴酸、硝酸、硫酸、磷酸等等形成的盐。与有机酸形成的盐的优 选例子包括与下列有机酸形成的盐:甲酸、乙酸、三氟乙酸、苯二酸、富马 酸、草酸、酒石酸、马来酸、枸橼酸、琥珀酸、苹果酸、甲磺酸、苯磺酸、 对甲苯磺酸,等等。与碱性氨基酸形成的盐的优选例子包括与下列碱性氨基 酸形成的盐:精氨酸、赖氨酸、鸟氨酸,等等。与酸性氨基酸形成的盐的优 选例子包括与下列酸性氨基酸形成的盐:门冬氨酸、谷氨酸,等等。
这些当中,优选可药用盐。例如,当活性成分包含酸性官能团时,其实 例包括无机盐,例如,碱金属盐(例如,钠盐、钾盐,等等)、碱土金属盐(例 如,钙盐、镁盐,等等)等等、铵盐等等,当化合物包含碱性官能团时,其 实例包括与无机酸形成的盐,例如,盐酸、氢溴酸、硝酸、硫酸、磷酸等等, 以及与有机酸形成的盐,例如,乙酸、苯二酸、富马酸、草酸、酒石酸、马 来酸、枸橼酸、琥珀酸、甲磺酸、苯磺酸、对甲苯磺酸,等等。
例如,本发明的烟酰胺可以为游离形式、盐形式、酯形式、以及其他各 种衍生物、前药等修饰形式。
本发明中所述的用于胃肠道功能紊乱的烟酰胺,可以以其活性化合物本 身或者活性化合物与药学可接受的载体的混合物的形式给药。
作为药学可接受的载体,可使用作为制剂原料常用的各种有机或无机载 体物质,没有特别限定,可以以固态制剂中的赋形剂、润滑剂、粘合剂、崩 解剂;液态制剂中的溶剂、增溶剂、悬浊化剂、等渗化剂、缓冲剂、去痛剂 等形式配合。另外,也可以根据需要而使用防腐剂、抗氧化剂、稳定剂、着 色剂、甜味剂等制剂添加物。
本发明的烟酰胺用于胃肠道功能紊乱的制剂形式没有特别的限定,可以 作为非口服给药用或口服给药用的药物,例如以脂质体或者外泌体包裹的形 式。本发明的药物可以为散剂、颗粒剂、片剂或者胶囊剂等固态制剂,或糖 浆剂或者乳剂等液体剂中的任一种。治疗胃肠道疾病的药物,可以以下列形 式安全地给予(例如,静脉内、肌内、皮下、器官内、鼻内、皮内、滴剂、 脑内、直肠内、阴道、腹膜内、肿瘤内部、肿瘤近端、病变处,等等):片 剂(包括糖衣片剂、膜包衣片剂、舌下片剂、口腔崩解片、颊含片,等等)、 丸剂、粉剂、颗粒剂、胶囊剂(包括软胶囊、微囊)、锭剂、糖浆剂、液剂、 乳剂、混悬剂、控制释放制剂(例如,立即释放制剂、缓释制剂、缓释微囊)、 气雾剂、膜剂(例如,口腔崩解膜剂、口腔粘膜粘附膜剂)、注射剂(例如,皮 下注射、静脉注射、肌内注射、腹膜内注射)、静脉输液、透皮吸收式的制剂、乳膏剂、软膏剂、洗剂、粘附制剂、栓剂(例如,直肠栓剂、阴道栓剂)、 药粒、鼻制剂、肺制剂(例如,吸入剂)、滴眼液,等等。
本发明的烟酰胺在药物组合物中的含量基于剂型、剂量等而变化。例如, 含量在大约0.1至100wt%的范围。
本发明中的用于胃肠道功能紊乱的烟酰胺的剂量没有特别限定,只要是 治疗有效量的。在本说明书中,术语“治疗有效量”是指对于对象带来治疗效 果的量,例如:在被给药了该量的对象中,与未给药该量的对象相比,疾病 的症状或状态发生缓和、减轻、或消除,或疾病的症状或状态的发展得到延 迟或抑制。治疗有效量可以由医生根据对象的年龄、体重、性别及症状的严 重程度等而适宜确定。例如为,0.1-100mg/kg/day,1-50mg/kg/day, 3-20mg/kg/day,每天给药一次至若干次。
本发明的用于治疗胃肠道功能紊乱的烟酰胺可以与其他药物联用,给药 时间没有限制,可以将它们同时或以交错方式给药患者。可以基于临床状况 所使用的剂量来恰当地确定所述其他药物的剂量,并且可以根据给药患者、 给药途径、靶向疾病、症状、组合药等来恰当地确定。
实施例
下面参照实施例进一步具体地解释本发明,但本发明并不限制于此。
实施例1.结肠炎以及IBD患者结肠上皮细胞ACE2和NAD/NADH循 环活性测试
实验步骤:通过结肠镜,剥离获取了6个对照儿童,6个慢性结肠炎患 儿,2个溃疡性肠炎(UC)患儿和3个克罗恩病(CD)的结肠黏膜层并做 成单细胞组织悬液,用于进行高通量单细胞转录组测序。
一共获得了6960个上皮细胞。针对所有细胞,依据其特有的基因表达 图谱进行亚型分类,共分成了10个亚型,并根据其基因表达图谱进行了生 物信息分析,利用非线性降维方法(tSNE)进行降维和展示。
得到10个上皮细胞亚型后,分析了ACE2的表达特异性,同时,分析 了氨基酸转运体和能量代谢通路的活跃性。
得到特异表达的ACE2的细胞亚型后,在对照组,慢性结肠炎和炎症性肠病 (UC组和CD组)患儿中比较了氨基酸转运体和细胞代谢相关基因的表达 差异。
结果如图1所示。
结果表明:在肠道上皮各个亚型细胞类群中,人血管紧张素转换酶2 (ACE2)主要表达在结肠细胞中,与之相对应的是这一类细胞的氨基酸转 运蛋白和能量代谢相关的通路也更为活跃(图1A-B)。同时还发现,相比 较对照个体来说,在慢性结肠炎,溃疡性肠炎(UC)以及克罗恩病(CD) 患儿中,ACE2的表达是降低的,同时氨基酸转运体SLC6A19(B0AT1)与 SLC36A1(PAT1)在慢性结肠炎和溃疡性肠炎患儿中也是降低的(图1C)。
ACE2与氨基酸转运体是转运中性氨基酸(包括色氨酸等)中间媒介, 而色氨酸是合成烟酸或烟酰胺(两种维生素B3)的前体。烟酰胺是生成烟 酰胺腺嘌呤二核苷酸(NAD+)和NADH、NADP+和NADPH等衍生物所必 需的。
与此相互对应的,本发明人在慢性结肠炎和炎症性肠病(UC和CD)患 儿中发现,细胞代谢重要通路TCA循环中的IDH、OGDH和MDH等多个 基因表达降低(图1C)。这是由于,NAD+是TCA循环中的几个关键酶和 电子转移链中的复合物I所必需的,NAD+少,将导致上述基因表达降低。
综上所述,本发明人发现,在慢性结肠炎和炎症性肠病患儿中,ACE2 好氨基酸转运体表达降低,抑制烟酰胺合成,造成细胞代谢通路紊乱,影响 细胞的正常的能量代谢。因此通过靶向使用烟酰胺,恢复NAD+的正常水平 和代谢通路,从而达到治疗慢性结肠炎和炎症性肠病等胃肠道功能紊乱的目 的。
实施例2新型冠状病毒(SARS-CoV-2)病原棘突蛋白与HEK293T细 胞表面的ACE2结合介导ACE2的胞吞和降解
实验步骤:图A.将pENTER-ACE2质粒转染至HEK293T细胞(人源 胚胎肾细胞,ATCC),同时加入来自新冠病毒病原棘突蛋白(spike protein) 共孵育24小时。裂解细胞,将裂解液进行Western检测。ACE2带有C端 Flag标签,用抗Flag抗体标记。实验采用β-actin作为内参蛋白。
图B.将pENTER-ACE2质粒转染至293T细胞,同时加入新冠病毒病 原棘突蛋白(spike protein)共孵育0-3小时。细胞固定、破膜后,用抗体标 记染色,DAPI染核。ACE2带有C端Flag标签,用带有APC荧光基团的抗 Flag抗体标记。棘突蛋白(spike protein)融合小鼠Fc区,用带有AF488 的荧光基团的抗小鼠抗体标记。
结果如图2所示。
结果表明:棘突蛋白是来自新冠病毒(SARS-CoV-2)病原体的表面蛋 白,介导病毒进入和感染细胞。新冠病毒病原棘突蛋白与转染了ACE2的 293T细胞共孵育24小时,降低了293T细胞中ACE2的总表达量(图A)。 ACE2在293T细胞胞膜定位。新冠病毒病原棘突蛋白与细胞共孵育1小时 后,可见棘突蛋白胞内定位,证明棘突蛋白从细胞外被转运至胞内,且细胞 内的棘突蛋白量随着孵育时间增多。同时,ACE2从胞膜定位变为胞内定位, 并与棘突蛋白共定位。因此以上结果提示病毒棘突蛋白利用ACE2进入细胞, 并介导ACE2的胞内定位,减少ACE2的总表达量和胞膜表达量。
ACE2是非典病毒(SARS)和新型冠状病毒(SARS-CoV-2)结合受体, 可能介导病毒传播和扩增(Zhou P et.al.Nature,2020)。上述实验显示,新 冠病毒感染可能降低肠道细胞中ACE2的表达。ACE2是肠道氨基酸稳态、 微生物生态、免疫平衡的关键调节分子,其表达下调导致肠道对上皮损伤引 起炎症的敏感性大大提高。这可能是冠状病毒感染引起胃肠道功能紊乱的原 因之一。因此本发明人提出,烟酰胺的使用,可调节因为冠状病毒感染而引 起的ACE2降低造成的胃肠道功能紊乱。
实施例3.ACE2在结肠黏膜中的定位和表达。
实验步骤:我们对儿童正常(N=1),慢性结肠炎(N=1),UC(N=1) 和CD(N=1)的结肠黏膜进行石蜡组织免疫荧光染色,通过荧光显微镜检 测ACE2的定位和表达情况。其中一抗为Rabbit-anti ACE2(1:100),二抗为 Goat-anti Rabbit IgG AF555(1:400)。DAPI(4',6-二脒基-2-苯基吲哚 (4',6-diamidino-2-phenylindole))用于细胞核的染色。
结果如图3所示。
结果表明:ACE2主要表达在结肠上皮层,在正常结肠中ACE2表达水 平较其他三个疾病组高,结合实施例1和2提示ACE2可能维持肠道免疫稳 态。因此本发明人提出,烟酰胺的使用可以挽救肠道炎性状态下缺乏ACE2 导致的代谢紊乱。
本发明在其范围中包含各种方式的变化,这些变化并不偏离本发明的范 围。此外,所有的对本领域技术人员而言明显地认为是本发明的变形这样的 情形,都包括本发明权利要求的范围内。
Claims (10)
1.烟酰胺在制备用于预防和/或治疗胃肠道功能紊乱的药物中的用途。
2.权利要求1所述的用途,其中,所述胃肠道功能紊乱选自结肠炎、溃疡性结肠炎、克罗恩病、炎症性肠病、以及腹泻。
3.权利要求1或2所述的用途,其中,所述胃肠道功能紊乱表现为血管紧张素转换酶2(ACE2)缺乏。
4.权利要求1-3中任一项所述的用途,其中,所述胃肠道功能紊乱胃肠道功能紊乱表现为氨基酸转运体SLC6A19(B0AT1)缺乏。
5.权利要求1-4中任一项所述的用途,其中,所述胃肠道功能紊乱为结肠炎。
6.权利要求1-4中任一项所述的用途,其中,所述胃肠道功能紊乱为溃疡性结肠炎或克罗恩病。
7.权利要求1-4中任一项所述的用途,其中,所述胃肠道功能紊乱为炎症性肠病。
8.权利要求1-4中任一项所述的用途,其中,所述胃肠道功能紊乱为腹泻。
9.权利要求1-4中任一项所述的用途,其中,所述胃肠道功能紊乱为与冠状病毒相关。
10.权利要求1-4中任一项所述的用途,其中,所述胃肠道功能紊乱为与SARS-CoV-2(2019-nCoV)相关。
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