CN113766925A - 用于预防、改善或治疗纤维化的chp的用途 - Google Patents
用于预防、改善或治疗纤维化的chp的用途 Download PDFInfo
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- CN113766925A CN113766925A CN202080026734.0A CN202080026734A CN113766925A CN 113766925 A CN113766925 A CN 113766925A CN 202080026734 A CN202080026734 A CN 202080026734A CN 113766925 A CN113766925 A CN 113766925A
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Abstract
本发明涉及用于预防、改善或治疗纤维化的CHP的用途,更详细地,涉及包含CHP的用于预防或治疗纤维化的药学组合物、用于预防或改善纤维化的保健功能食品组合物、抗纤维化组合物、利用CHP的预防、改善或治疗纤维化的方法和/或制备用于预防或治疗纤维化的药学组合物时的CHP的用途。
Description
技术领域
本发明涉及用于预防、改善或治疗纤维化的CHP的用途,更详细地,涉及包含CHP的用于预防或治疗纤维化的药学组合物、用于预防或改善纤维化的保健功能食品组合物、抗纤维化组合物、利用CHP的预防或治疗纤维化的方法和/或制备用于预防或治疗纤维化的药学组合物时的CHP的用途。
背景技术
纤维化(fibrosis)为在由成纤维细胞发生细胞外基质异常生成、积累及沉积的疾病,通过器官或组织的纤维化来发病。纤维化为诱发器官损伤的非常致命的疾病。如一例,特发性肺纤维化(idiopathic pulmonary fibrosis,IPF)是成纤维细胞积累及肌成纤维细胞分化相关的复发性肺泡上皮细胞损伤的结果,是一种在对肺实质(lung parenchyma)组织造成不可逆转的破坏的同时导致细胞外基质(extracellular matrix,ECM)的过度积累的慢性、进行性及致命疾病。
在现有的治疗研究中,使用皮质类固醇及免疫抑制药物,通常靶向纤维化的炎症过程。但是,这种制剂在临床实验中几乎不显示效果,因此需要用于治疗纤维化的新型药物。
另外,在韩国公开专利第10-2013-0006170号中公开了包含以高浓度包含CHP(CYCLO(His-Pro))的大豆水解物的用于调节血糖的组合物,但CHP的抗纤维化效果尚不清楚。
发明内容
技术问题
本发明的目的在于,提供包含CHP的用于预防或治疗纤维化的药学组合物。
本发明的再一目的在于,提供包含CHP的用于预防或改善纤维化的保健功能食品组合物。
本发明的另一目的在于,提供包含CHP的抗纤维化组合物。
本发明的还有一目的在于,提供利用CHP的预防或治疗纤维化的方法。
本发明的又一目的在于,提供制备用于预防或治疗纤维化的药学组合物时的CHP的用途。
技术方案
为了解决如上所述的问题,本发明提供包含CHP或其药学上可接受的盐的用于预防或治疗纤维化的药学组合物。
并且,本发明提供包含CHP或其食品上可接受的盐的用于预防或改善纤维化的保健功能食品组合物。
并且,本发明提供包括向需要的个体给药有效量的CHP的步骤的预防或治疗纤维化的方法。
并且,本发明提供制备用于预防或治疗纤维化的药学组合物时的CHP的用途。
根据本发明的一优选实施例,上述纤维化可在选自由肾、肝、肺、皮肤、心脏、胰腺、泌尿系统、生殖系统、汗腺、神经、脑、骨髓、肌肉及关节组成的组中的一个以上发生。
根据本发明的另一优选实施例,上述纤维化为选自由肺纤维化(PulmonaryFibrosis)、特发性肺纤维化(Idiopathic Pulmonary Fibrosis)、放射性肺损伤(Radiation-induced lung injury)或肺纤维化、肺水肿、囊性纤维化(Cystic Fibrosis)、肝纤维化、心内膜心肌纤维化(Endomyocardial Fibrosis)、心肌梗塞(MyocardialInfarction)、心房纤维化(Artrial Fibrosis)、胶质瘢痕(Glial scar)、肾纤维化(RenalFibrosis)、骨髓纤维化(Myelofibrosis)、关节纤维化(Arthrofibrosis)、脂肪纤维化、皮肤纤维化、神经纤维化及肌肉纤维化组成的组中的一种以上。
并且,本发明提供包含CHP的抗纤维化组合物。
发明的效果
本发明的包含CHP的组合物抑制在如肾、肝、肺、皮肤、心脏、胰腺、泌尿系统、生殖系统、汗腺、神经、脑、骨髓、肌肉及关节的各种组织或器官中发生的纤维化,由此有效预防、改善或治疗纤维化。
附图说明
图1示出从人肾小球及肾小管中分离细胞及原代培养过程(左:肾小球,右:肾小管)。
图2示出人源性近端肾小管上皮细胞纤维化模型中的根据CHP处理浓度(分别为4μg/ml、20μg/ml及100μg/ml)的细胞的形态变化。
图3为通过蛋白质印迹法确认人源性近端肾小管上皮细胞纤维化模型中的根据CHP处理浓度(分别为4μg/ml、20μg/ml及100μg/ml)的E-钙粘蛋白(E-cadherin)、纤连蛋白(fibronectin)及pSTAT3蛋白的表达水平变化的结果。
图4示出人源性肾小球内皮细胞纤维化模型中的根据CHP处理浓度(分别为40μg/ml及100μg/ml)的细胞的形态变化。
图5a为通过蛋白质印迹法确认人源性肝细胞纤维化模型中的根据CHP处理浓度(分别为62.5ng/ml、125ng/ml及250ng/ml)的纤连蛋白的表达水平变化的条带结果,图5b为定量条带的大小并图表化的结果。
图6a为通过蛋白质印迹法确认肝纤维化动物模型中的根据CHP给药浓度(分别为5mg/kg及35mg/kg)的纤连蛋白的表达水平变化的条带结果,图6b为定量条带的大小并图表化的结果。
图7a为通过蛋白质印迹法确认人源性肺细胞纤维化模型中的根据CHP处理浓度(分别为62.5ng/ml及125ng/ml)的纤连蛋白的表达水平变化的条带结果,图7b为定量条带大小并图表化的结果。
图8为将肺纤维化动物模型中的根据CHP给药浓度(分别为5mg/kg及35mg/kg)的转化生长因子β(TGFβ)及胶原3(Collagen 3)基因的表达水平变化图表化的结果。
图9a为通过蛋白质印迹法确认人源性皮肤细胞纤维化模型中的根据CHP处理浓度(分别为62.5ng/ml、125ng/ml、250ng/ml及500g/ml)的纤连蛋白的表达水平变化的条带结果,图9b为定量条带大小并图表化的结果。
图10为将心脏纤维化动物模型中的根据CHP给药浓度(分别为5mg/kg及35mg/kg)的纤维化标志物转化生长因子β、纤连蛋白(Fibronectin)、胶原1(Collagen 1)、胶原2(Collagen 2)、胶原3及胶原4(Collagen 4)基因表达水平变化图表化的结果。
图11为将脂肪纤维化动物模型中的根据CHP给药浓度(分别为5mg/kg及35mg/kg)的纤维化标志物转化生长因子β、纤连蛋白、胶原3及结缔组织生长因子(CTGF)基因表达水平变化图表化的结果。
具体实施方式
以下,更详细地说明本发明。
如上所述,在现有的纤维化相关治疗研究中,使用皮质类固醇及免疫抑制药物,通常靶向纤维化的炎症过程,但这种制剂在临床实验中几乎不显示效果,因此需要用于治疗纤维化的新型药物。
因此,本发明人确认CHP抑制在各种组织或器官中发生的纤维化并有效预防、改善或治疗纤维化,从而完成了本发明。
因此,本发明提供包含CHP或其药学上可接受的盐的用于预防或治疗纤维化的药学组合物和/或包含CHP或其食品上可接受的盐的用于预防或改善纤维化的保健功能食品组合物。
并且,本发明提供包含CHP的抗纤维化组合物。
在本发明中,“CHP(Cyclo-HisPro)”为由作为促甲状腺激素释放激素(thyrotropin-releasing hormone,TRH)的代谢产物的组氨酸-脯氨酸组成的天然存在的环状二肽(dipeptide)或通过促甲状腺激素释放激素代谢过程和de novo在体内合成的生理活性二肽,是指广泛分布在整个大脑和脊髓及胃肠道等的物质。
在本发明的组合物中,上述CHP可使用合成的或市售的。并且,可从包含CHP的物质,如前列腺提取物及大豆水解物等纯化来使用。
使用的术语“纯化”是指CHP与可从如前列腺提取物的天然来源获取的形式相比,呈浓缩的形式。纯化的成分可从它们的天然来源浓缩或者通过化学合成方法获取。
在本发明中,术语“纤维化(fibrosis)”与“纤维化病症”、“纤维增生病症”、“纤维化疾病”、“纤维增殖性疾病”、“纤维化障碍”及“纤维增殖性障碍”互换使用,指代将成纤维细胞的调节障碍性增殖或活性、纤连蛋白的异常积累和/或胶原组织的病理或过度积累为特征的病症、疾病或障碍。通常,这种病症、疾病或障碍可通过给药具有抗纤维化活性的化合物来治疗。
例如,上述纤维化可在选自由肾、肝、肺、皮肤、心脏、胰腺、泌尿系统、生殖系统、汗腺、神经、脑、骨髓、肌肉及关节组成的组中的一个以上发生。
例如,本发明的纤维化可以为选自由肺纤维化、特发性肺纤维化、放射性肺损伤或肺纤维化、肺水肿、囊性纤维化、肝纤维化、心内膜心肌纤维化、心肌梗塞、心房纤维化、胶质瘢痕、肾纤维化、骨髓纤维化、关节纤维化、脂肪纤维化、皮肤纤维化、神经纤维化及肌肉纤维化组成的组中的一种以上,但并不限定于此。
具体地,本发明的CHP对于在本申请中记述的各种纤维化具有治疗效果。
在本发明的组合物的纤维化的预防、改善或治疗用途中,第一实施方式涉及肾纤维化,其为在肾中发生的纤维化。
肾疾病根据进展状态分为急性肾功能衰竭、慢性肾功能衰竭,或者根据发病原因分为血管复合物的沉积引起的肾小球肾炎、伴随着糖尿病的糖尿病肾病或伴随着高血压的高血压肾病、给药抗生素或抗癌剂等药物引起的中毒性肾病、细菌感染等。无论何种病因引起的肾病,若因慢性肾功能不全导致肾小球滤过率降低至50%以下,在大部分的情况下,肾小球滤过率持续降低,最终导致晚期肾功能衰竭,并诱发血液异常、神经系统并发症、胃肠道并发症、免疫并发症、感染或骨营养不良等并发症,严重时会导致死亡。
慢性肾功能衰竭是指这种肾功能向一个方向(不可逆性)逐渐下降且无法维持生物体的稳态的状态。所有肾病伴随着肾的纤维化,最终导致晚期肾功能衰竭。尤其,慢性肾功能衰退与肾纤维化的进展密切相关,因此,当抑制纤维化的进展时,可抑制慢性肾功能衰竭的进展。
本发明中的术语“肾纤维化”包括因各种原因在肾中发生纤维化的所拥有疾病,纤维化可包括选自由导管(catheter)安装、肾小球硬化、肾小球肾炎、肾炎、急性肾功能衰竭、慢性肾功能衰竭、晚期肾病及代谢疾病组成的组中的一种以上,但并不限定于此。
上述肾炎的种类可以为任意间质性肾炎,例如,可以为链球菌肾炎、葡萄球菌肾炎、肺炎球菌肾炎、伴随着水痘、B型肝炎、C型肝炎、HIV等的病毒性肾炎、由疟疾等寄生虫感染引起的肾炎、伴随着真菌性肾炎、支原体(mycoplasma)肾炎等的感染性间质性肾炎、伴随着系统性红斑狼疮(erythematosus)(狼疮性(lupus)肾炎)、系统性硬皮病(胶原性肾)、干燥(Sjgren)综合征等胶原病的间质性肾炎、伴随着紫癜性肾炎、多动脉炎、急进性肾小球肾炎等的血管免疫疾病的肾炎、伴随着辐射照射的间质性肾炎、由金制剂、NSAID、青霉胺(penicillamine)、博来霉素(bleomycin)等的抗癌剂、抗生素、百草枯(paraquat)等导致的药物性间质性肾炎、由昆虫的蜇伤、花粉、漆树科植物等引起的过敏性肾炎、伴随着淀粉样变性(amyloidosis)肾炎、糖尿病性肾病、慢性肾小球肾炎、恶性肾硬化、多囊性肾病等的肾炎、肾小管间质性肾炎、伴随着妊娠中毒症或癌症的肾炎、膜性增殖性肾小球肾炎、IgA肾病、混合型冷球蛋白血症(cryoglobulinemia)肾炎、肺出血肾炎(Goodpasture's)综合征肾炎、魏格钠肉芽肿病肾炎、急性间质性肾炎等特发性间质性肾炎,但并不局限于此。
如在图2至如4中所证明,CHP在诱发纤维化的近端肾小管上皮细胞中恢复作为接合标志物的E-钙粘蛋白的表达并减少纤连蛋白及pSTAT3蛋白的表达,由此示出根本的抗纤维化效果,与诱发纤维化的原因无关地,可用于治疗各种肾纤维化。
在本发明的组合物的纤维化的预防、改善或治疗用途中,第二实施方式涉及肝纤维化,其为在肝中发生的纤维化。
本发明中的术语“肝纤维化(liver fibrosis)”是指肝的慢性损伤导致纤维组织增殖的症状,可包括选自由慢性肝病、B型肝炎病毒感染、C型肝炎病毒感染、D型肝炎病毒感染、血吸虫、酒精性肝病或非酒精性脂肪肝炎、代谢性疾病、蛋白质缺乏症、冠状动脉疾病、自身免疫性肝炎、囊性纤维化、α-1抗胰蛋白酶缺乏症、原发性胆汁性肝硬化、药物反应及毒素组成的组中的一种以上引起的,但并不局限于此。
肝纤维化为肝硬化的前期病变,是导致慢性肝病的严重肝损伤的结果,由各种细胞因子和生长因子的作用引发。通常,肝纤维化是可逆的,且由薄纤维(thin fibril)组成,在没有形成结节且肝损伤原因是暂时性的情况下,通过细胞凋亡(apoptosis)过程和基质金属蛋白酶(matrix metalloproteinases,MMP)分解增加的细胞外基质,由此可恢复正常,但是,若肝纤维化过程反复持续,则形成厚的纤维(thick fibril),并发展为结节性肝硬化。并且,由于各种炎症诱发因素,肝细胞受损并通过包括胶原的异常细胞外基质蛋白积累的肝纤维化的过程诱发肝硬化,为了调节肝硬化的表达,重要的是调节细胞外基质的积累。肝细胞受损情况下的炎症反应激活休止期的肝星状细胞来分泌细胞外基质和各种细胞因子(cytokine)及趋化因子(chemokine),其中,转化生长因子-β1起到强效的生长抑制剂的作用。转化生长因子-β1为25kD的物质,通过与潜伏的转化生长因子-β1结合蛋白(latentTGF-β1binding protein)结合来以非活性的潜伏(inactive latent)形式分泌,以与1型胶原、4型胶原、层粘连蛋白及饰胶蛋白聚糖(decorin)等的细胞外基质结合的状态存在,并被各种刺激激活。转化生长因子-β1减少胶原酶(collagenase)的生产或增加胶原酶抑制物质生产来调节胶原表达,在巨噬细胞中增加肿瘤坏死因-α(TNF-α)、白细胞介素-1(IL-1)及血小板源性生长因子(PDGF)等的生产,在纤维化过程中起到重要的作用。目前,转化生长因子-β1仅在纤维化进展的位置表达,而在正常肝组织或非活动区域不表达,在肝纤维化中,转化生长因子-β1起到重要作用而周知。
另外,非酒精性脂肪肝可与饮酒无关地由肥胖、糖尿病、高脂血症、药物等原因诱发,是指包括根据进展过程并不伴随炎症反应的单纯脂肪肝(steatosis)和伴随肝细胞的炎症反应(hepatocellular inflammation)的非酒精性脂肪肝炎(NASH,non-alcoholicsteatohepatitis)、晚期纤维化(advanced fibrosis)及肝硬化(liver cirrhosis)的广泛的疾病。
非酒精性脂肪肝病(NAFLD,nonalcoholic fatty liver disease)是现代社会高脂肪及高热量饮食引起的成人病的增加,据报告以发达国家为基准,成人人口的20%~30%表现出非酒精性脂肪肝病,其中,2%~3%会转移至非酒精性脂肪肝炎患者,尤其,在组织学上,表现出纤维化和伴随炎症的脂肪肝炎,发展为肝硬化、肝功能衰竭及肝癌的风险非常高。
由此,在本发明的一实施例中,确立以高脂肪饮食诱导的肝纤维化动物模型,并确认在相应模型中CHP示出连蛋白表达减少效果。
脂肪肝本身并不是病理状态,是一种去除病原体后会自然恢复的可逆的症状。但是,若持续保持在肝组织中脂肪堆积过多的状态,则发生脂肪肝炎,结果重复发生肝细胞坏死和再生,在此过程中,纤维状的细胞外基质增加而发展为肝的纤维化。当肝损伤达到规定阶段时,与病原体的种类无关地,细胞外基质的积累量增加,由于肝细胞不断破坏和再生,形成再生结节(regenerative nodules),从而恶化为不可逆的肝硬化(liver cirrhosis)。
因此,在本发明中,肝纤维化为明确不同于作为可逆症状的脂肪肝的疾病,是指肝组织变为再生结节等的纤维化组织而使肝功能降低的所有疾病。
如图5中所确认,CHP在诱导纤维化的肝细胞中减少作为纤维化蛋白质的纤连蛋白的表达量,如图6中所确认,CHP在诱导肝纤维化的动物模型中减少纤连蛋白的表达,示出根本的抗纤维化效果,与诱导纤维化的原因无关地,还可应用于包括各种肝纤维化在内的从肝硬化发展而来的肝功能衰竭及肝癌。
在本发明的组合物的纤维化预防、改善或治疗用途中,第三实施方式涉及肺纤维化,其为在肺中发生的纤维化。
在纤维化中,尤其,肺纤维化(Pulmonary fibrosis)是指慢性炎症细胞浸润到肺组织的肺泡壁来诱导组织纤维化并引起肺组织的严重结构改变的疾病。一旦因任何原因引起纤维化,肺组织会变硬,肺泡壁变厚,从而减少血液供应的氧气量,导致呼吸困难。目前还没有治疗方法可以完全恢复已经发生纤维化的肺组织,因此,在除纤维化早期发现或肺移植之外,患者通常会出现症状的3年~5年之后死亡。
具体地,在本发明中,术语“肺纤维化”是指由于肺中形成过多的纤维缔结组织或纤维缔结组织的发展(纤维化),使得疤痕(纤维化)组织发展。具体地,肺纤维化是指诱发肺泡及肺的间质组织的肿胀及瘢痕的慢性疾病。如上所述的瘢痕组织取代健康组织来诱发炎症,慢性炎症可被确定为纤维化的前兆。由于如上所述的肺组织的损伤,肺可能变得僵硬,并且个人可能难以自主呼吸。
在本发明中,肺纤维化可包括选自由特发性肺纤维化、放射性肺损伤、非特异性间质性肺炎(Nonspecific Interstitial Pneumonia)、急性间质性肺炎(AcuteInterstitial Pneumonia)、隐源性机化性肺炎(Cryptogenic Organizing Pneumonia)、呼吸性细支气管炎相关间质性肺(Respiratory Bronchiolitisassociated InterstitialLung)疾病、脱屑性间质性肺炎(Desquamative Interstitial Pneumonia)、淋巴样间质性肺炎(Lymphoid Interstitial Pneumonia)、间质性肺纤维化及弥漫性肺纤维化、肺水肿、囊性纤维化及代谢性疾病引起的肺纤维化组成的组中的一种以上,但并不局限于此。
上述肺纤维化可由各种原因引起,例如,吸入细颗粒物(石棉、石尘、金属粉尘、香烟烟雾中的颗粒、硅尘等)而对肺造成微细损伤。并且,肺纤维化还由其他疾病(自身免疫性疾病、病毒或细菌感染等)的次要影响发生,还可由如细胞毒性制剂(博来霉素、白消安及甲氨蝶呤等)、抗生素(呋喃妥因及柳氮磺吡啶等)、心律失常治疗剂(胺碘酮及妥卡尼等)、抗炎药(金及青霉胺等)、非法药物(毒品、可卡因及海洛因等)的特定药物诱发,上述特发性肺纤维化可由除如上所述的原因之外的其他不明原因引起。并且,长期摄入高脂肪饮食会诱发肺纤维化,这是由高脂肪摄入后的炎症水平增加所致。
如图7中所确认,CHP在诱导纤维化的肺细胞中减少作为纤维化蛋白质的纤连蛋白的表达量,如图8中所确认,CHP在诱导肺纤维化的动物模型中减少作为主要纤维化标志物的转化生长因子β及胶原3基因的表达,示出根本的抗纤维化效果,从而与诱导纤维化的原因无关地,可应用于治疗各种肺纤维化。
在本发明的组合物的纤维化预防、改善或治疗用途中,第四实施方式涉及皮肤纤维化。
在本发明中,术语“皮肤纤维化”为皮肤的过度瘢痕形成且是病理性伤口愈合反应的结果。纤维性皮肤疾病的范围很广:硬皮病、肾纤维化皮肤病、混合性缔结组织疾病、硬化性粘液水肿、硬化性水肿及嗜酸性筋膜炎。暴露在化学物质或物理因素(机械创伤、烧伤)也是纤维化皮肤疾病的潜在原因。皮肤纤维化可由免疫、自身免疫及炎症机制主导。成纤维细胞的胶原生成及分解的均衡在皮肤纤维化的病理生理过程中起到重要作用。如转化生长因子-β(TGB-β)及白细胞介素-4(IL-4)的特定细胞因子促进伤口治愈及纤维化。正常皮肤的成纤维细胞是静止的。它们控制缔结组织蛋白的量并具有低增殖活性。皮肤受损后,这些细胞被激活,即,它们表达α-平滑肌肌动蛋白(α-SMA),并合成大量的缔结组织蛋白。激活的细胞通常称为肌肉成纤维细胞。
在本发明中,术语“皮肤纤维化”还意在包括“硬皮病(scleroderma)”。
硬皮病是一种原因不明的慢性自身免疫缔结组织疾病,其特征为在真皮中积累过多的胶质而使皮肤的一部分或全身皮肤变硬增厚的硬化变化和血管系统异常。胶质(Collagen:胶原)构成缔结组织来起到支撑并连接身体组织的作用。硬皮病具有几种形式,具有仅在身体的特定部位表现出症状的形式,还具有在包括内脏器官在内的全身表现出症状的形式。即,分为仅使皮肤的一部分变硬的局限性硬皮病(localized scleroderma)以及在包括皮肤在内的肺、消化系统、肾和心脏等内脏器官因胶质增加而表现出纤维化症状的系统性硬皮病(systemic scleroderma)。系统性硬皮病根据皮肤和内脏器官的侵犯程度、预后、免疫学检查结果分为局限型和广泛型。
在本发明的皮肤纤维化的预防、改善或治疗用途中,皮肤纤维化可包括选自由瘢痕、肥厚性瘢痕、瘢痕疙瘩、局限性硬皮病及系统性硬皮病组成的组中一种以上,但并不局限于此。
硬皮病的原因尚不明确,但认为组织的纤维化起到重要作用。
硬皮病的早期症状非常多样,尤其,在后期,皮肤症状变得明显。硬皮病的常见症状具有关节疼痛、晨僵、疲劳及体重减轻。并且,当暴露在寒冷中时,暂时限制手指、脚趾、鼻子及耳朵的血液供应。这种症状为硬皮病患者的早期症状,是常见症状之一。患有硬皮病的患者的皮肤变硬。这种皮肤变硬的现象在广泛扩散的同时通常发生在身体两侧。最终,组织受损,皮肤色素沉着。
“局限性硬皮病”的女性发病率是男性发病率的2.6倍。局限性硬皮病的75%的患者年龄在20岁~50岁之间,线性硬皮病示出在更早的年龄中发病的倾向。局限性硬皮病分为局限性硬皮病、系统局限性硬皮病、线性局限性硬皮病或皮下局限性硬皮病。
局限性硬皮病通常以红斑或紫红色斑开始,与周围正常皮肤的边界清晰,规定部位的皮肤失去弹性且变硬。该部位呈褐色,在大多情况下,脱色而呈白色。大部分在一处发生,但还具有发生多个的情况,大小互不相同,从硬币大小到成人手掌大小不等。虽导致美容问题,但并不发展为系统性硬化症。在一部分患者中,即使不进行治疗,硬硬的皮肤也可自行软化并恢复。
系统局限性硬皮病为局限性硬皮病的严重形式,是一种大面积的皮肤变硬并观察到色素沉着过多的情况。躯干、臀部、腿部的皮肤广泛变硬。但是,因为没有雷诺(Raynaud)现象、内脏器官侵犯症状,区别于系统性硬化症。
线性局限性硬皮病是皮肤以直线长长地变硬的情况,经常以腿、手臂、前额、前胸的顺序发生,尤其,将在前额以垂直线凹陷发生的情况称为剑伤性硬皮病(en coup desabre),诱发美容问题。与局限性硬皮病不同地,线性硬皮病不仅侵入皮肤,在侵入皮肤下部的肌肉、骨膜组织来固定在下部组织。它在儿童中更常见,有时可在四肢和面部诱发严重的发育不良。
皮下局限性硬皮病表现出脂肪层、筋膜、肌肉以及骨骼的硬化,关节活动可能受限。由于病变发生在深部,未观察到硬皮病的特征性皮肤色素变化。
系统性硬皮病(systemic scleroderma)的女性发病率是男性发病率的4倍,可发生在任何年龄,但最常见于30岁~50岁之间。与局限型相比,广泛型的发病年龄更年轻。雷诺现象为在系统性硬皮病的首发症状,之后,在皮肤和内脏器官中开始发生硬化症状。系统性硬皮病分为皮肤症状和内藏器官症状。
在系统性硬化症中,最初的皮肤症状始于手指和手部。起初,仅表现出雷诺现象,之后,手指和手部变得肿胀、僵硬、变红。皮肤逐渐变硬并扩散至手臂、面部,在广泛型的情况下,在包括躯干在内的全身皮肤持续变硬。当面部出现硬化时,整体上皱纹消失且难以作出表情。鼻子看起来尖尖的,难以张开嘴,嘴唇变薄,嘴巴周围出现放射状皱纹,变得像老人的嘴巴。表现出关节的活动受限、无法一直握住手、手指弯曲且变得尖尖的手指脚趾硬化症。指尖和关节上出现疼痛且难以愈合愈的溃疡。
可表现出广泛的色素沉着过多和局部的色素沉着减退,在侵犯的部位发生脱发且汗液分泌减少。毛细管扩张在面部和上身躯干以圆形斑点形式出现,或者在指甲皱纹周围观察到。若患有雷诺病的患者的指甲皱纹的毛细血管出现异常,则之后可能发生系统性硬化症,毛细血管的变化对判断预后很重要。可观察到皮肤钙化,在手指关节周围相对常见。
内脏器官症状发生在胃肠道、肺、心脏或肾中。在胃肠道中,食道是最常受侵的部位,90%以上的病例均受侵。经常发生食道的蠕动减弱、吞咽困难和反流性食管炎。由于肠道蠕动减弱,可能会出现便秘、腹泻、吸收不良等症状。系统性硬化症患者死亡的最重要的原因为肺部症状,在发生在约70%的患者中。由于肺的纤维化,当运动时,抱怨呼吸困难、咳嗽。经常发生肺泡炎,使得肺功能持续下降。在心脏中,可发生心脏传导障碍、心力衰竭、心包炎的症状,在50%~70%的患者中可发生心肌硬化。在约45%的系统性硬化症患者中发生肾脏症状。表现为突发的急性肾功能衰竭、高血压等,还可发生进展缓慢的尿毒症。
因此,在本发明的皮肤纤维化的预防、改善或治疗用途中,皮肤纤维化无限制地包括如血管和静脉、下颌下腺导管(ducts of submandibular)、胆囊、甲状腺滤泡、汗腺管、卵巢、肾的器官或腺(gland)的内腔;牙龈、舌、上颚、鼻、喉、食道、胃、小肠、直肠、肛门及阴道的上皮细胞;真皮、瘢痕、皮肤及头皮中的任意皮肤组织和上皮细胞的纤维化。
如图9中所确认,CHP通过减少诱导纤维化的皮肤细胞中的作为纤维化蛋白质的纤连蛋白的表达量来表现出根本的抗纤维化效果,因此,可与诱导纤维化的原因无关地,可应用于治疗各种皮肤纤维化(皮肤硬化症)。
在本发明的组合物的纤维化预防、改善或治疗用途中,第五实施方式涉及心脏纤维化,其为在心脏中发生的纤维化。
在本发明中,术语“心脏纤维化(cardiac fibrosis)”是指基质蛋白过度沉积在心脏细胞之间而使心脏变硬的现象,主要发生在心肌梗塞患者的心脏中,是指心脏的功能减少的主要原因现象,可包括选自由心内膜心肌纤维化、心房纤维化、心力衰竭、心肌梗塞及代谢性疾病引起的心脏纤维化组成的组中的一种以上,但并不限定于此。
纤维化的特征在于,在心肌细胞死亡后发生的纤维化胶原的不均衡积累、炎症、增加的作业负荷、肥大及多种激素、细胞因子及生长因子的刺激。
心脏纤维化也可以为心脏成纤维细胞的不均衡增殖引起的心脏瓣膜异常增厚,进一步地,是指心脏肌肉的成纤维细胞的增殖。纤维细胞(Fibrocyte cells)通常是指胶原,起到提供对于心脏的结构支撑的作用。若过于激活,则该过程成为瓣膜的增厚和纤维化的原因。
心脏的纤维化为心力衰竭及心肌梗塞的主要原因,因此术语“心脏纤维化”可解释为包括通过心脏纤维化诱发的心力衰竭和/或心肌梗塞的含义。
如图10中所确认,CHP减少诱导心脏纤维化的动物模型中的作为主要纤维化标志物的纤连蛋白、胶原1、胶原2、胶原3及胶原4基因的表达,表现出根本的抗纤维化效果,因此,可与原因无关地用于治疗各种心脏纤维化。
在本发明的组合物的纤维化预防、改善或治疗用途中,第六实施方式涉及脂肪纤维化。
在本发明中,术语“脂肪纤维化”是指包括在脂肪组织中发生纤维化的所有疾病。
据报告,当使正常小鼠喂食16周~24周的包含60%脂肪的高脂肪饮食时,发生脂肪组织的纤维化(Hu,M et al.,Evidence-Based Complementary and AlternativeMedicine,1-12,2018;Kwon,E.Y.,&Choi,M.S.,Nutrients,10(10),1415,2018;Nakazeki,Fet al.,Scientific Reports,8(1),2018;Muniappan,L et al..Scientific Reports,7(1),2017;Lancha,A et al.,PLoS ONE,9(5),e98398,2014;Velαzquez,K.T et al.,Physiological Reports,5(18),e13412,2017;Wang,L.,Ye,X.,Hua,Y.,&Song,Y.,Biomedicine&Pharmacotherapy,105,121-129,2018)。
因此,本发明人确立以高脂肪饮食诱导的脂肪纤维化动物模型后,确认了根据给药CHP的作为纤维化标志物的转化生长因子β、纤连蛋白、胶原3及结缔组织生长因子基因的表达变化。结果,如图11中所确认,CHP通过显著减少上述纤维化标志物的表达来表现抗纤维化效果,因此可用于治疗脂肪纤维化。
如上所述,在本发明中确认,在诱导纤维化的各种组织细胞及动物模型中,CHP通过减少各种纤维化标志物基因或蛋白质的表达来表现出抗纤维活性,可预测能够有效应用于在包括肾、肝、肺、皮肤、心脏、胰腺、泌尿系统、生殖系统、汗腺、神经、脑、骨髓、肌肉及关节在内的身体内各种组织和/或器官中发生的纤维化的预防、改善或治疗。
在本发明的用于预防、改善或治疗纤维化的组合物中,术语“预防”、“改善”和/或“治疗”是指所有抑制或延缓疾病或病症的行为、所有使疾病或病症状态好转或有益地改变的行为及所有延缓、停止、逆转疾病或病症的进展的行为。
在本申请中,术语“药学上可接受的”是指在生理上可接受且向人体给药时通常不会引起过敏反应或其相似反应,优选地,上述盐为通过药学上可接受的游离酸(free acid)形成的酸加成盐。
上述药剂学上可接受的盐可以为利用有机酸或无机酸形成的酸加成盐,上述有机酸包括例如甲酸、乙酸、丙酸、乳酸、丁酸、异丁酸、三氟乙酸、苹果酸、马来酸、丙二酸、富马酸、琥珀酸、琥珀酸单酰胺、谷氨酸、酒石酸、草酸、柠檬酸、乙醇酸、葡糖醛酸、抗坏血酸、苯甲酸、邻苯二甲酸、水杨酸、邻氨基苯甲酸、二氯乙酸、氨氧基乙酸、苯磺酸、对甲苯磺酸或甲基磺酸。无机酸包括例如盐酸、溴酸、硫酸、磷酸、硝酸、碳酸或硼酸。酸加成盐优选为氯酸盐或乙酸盐形式,更优选为氯酸盐形式。
除此之外,可接受的盐的其他示例包括γ-氨基丁酸(GABA)盐、加巴喷丁盐、普瑞巴林盐、烟酸盐、己二酸盐、半-丙二酸盐、半胱氨酸盐、乙酰半胱氨酸盐、甲硫氨酸盐、精氨酸盐、赖氨酸盐、鸟氨酸盐或天冬氨酸盐等。
并且,本发明的药学组合物还可包含药学上可接受的载体。药学上可接受的载体可包括例如用于口服给药的载体或用于肠胃外给药的载体。用于口服给药的载体可以包括乳糖、淀粉、纤维素衍生物、硬脂酸镁、硬脂酸等。用于肠胃外给药的载体包括水、适当的油、盐溶液、葡萄糖水溶液、乙二醇等。此外,上述载体还可以包括稳定剂和防腐剂。合适的稳定剂有如亚硫酸氢钠、亚硫酸钠或抗环血酸等的抗氧化剂。合适的防腐剂有苯扎氯铵、对羟基苯甲酸甲酯或对羟基苯甲酸丙酯和氯丁醇。其他药学上可接受的载体可参考以下文献(Remington's Pharmaceutical Sciences,19th ed.,Mack Publishing Company,Easton,PA,1995)。
本发明的药学组合物可以通过任何方法对包括人类的哺乳动物给药。例如,可口服给药或肠胃外给药,肠胃外给药的方法可以为静脉内、肌肉内、动脉内、髓内、硬膜内、心脏内、透皮、皮下、腹膜内、鼻内、肠道、局部、舌下、直肠给药,但并不局限于此。
本发明的药学组合物可根据如上所述的给药途径剂型化为口服给药或肠胃外给药的制剂。在剂型化的情况下,可以通过使用一种以上的缓冲液(例如,盐溶液或磷酸盐缓冲液(PBS))、碳水化合物(例如,葡萄糖、甘露糖、蔗糖或葡聚糖等)、抗氧化剂、抑菌剂、螯合剂(例如,乙二胺四乙酸(EDTA)或谷胱甘肽)、填充剂、增量剂、粘合剂、辅助剂(例如,氢氧化铝)、悬浮剂、增稠剂、润湿剂、崩解剂、表面活性剂、稀释剂或赋形剂来配制。
用于口服给药的固体制剂包括片剂、丸剂、粉末、颗粒、液体、凝胶、糖浆、浆液、悬浮液或胶囊等,这种固体制剂可以通过在本发明的药学组合物混合至少一种赋形剂来制备,上述赋形剂的实例包括淀粉(包括玉米淀粉、小麦淀粉、大米淀粉及马铃薯淀粉等)、碳酸钙(Calcium carbonate)、蔗糖(Sucrose)、乳糖(Lactose)、葡萄糖、山梨糖醇、甘露醇、木糖醇、赤藓糖醇麦芽糖醇、纤维素、甲基纤维素、羧甲基纤维素钠、羟丙基甲基纤维素或明胶等。例如,配合活性成分与固体赋形剂并粉碎其后,向其添加合适的辅助剂后加工成颗粒混合物,从而可获得片剂或糖衣片剂。
除了简单的赋形剂之外,还可以使用如硬脂酸镁和滑石粉等润滑剂。用于口服给药的液体制剂与悬浮剂、内用液体、乳液、糖浆等相对应,除了经常使用的作为简单稀释剂的水或液体石蜡之外,还可以包括几种赋形剂,例如润湿剂、甜味剂、芳香剂或保存剂等。
并且,根据情况,还可添加交联的聚乙烯吡咯烷酮、琼脂、海藻酸或海藻酸钠等作为崩解剂,还可以添加抗凝剂、润滑剂、润湿剂、香料、乳化剂及防腐剂。
在肠胃外给药的情况下,本发明的药学组合物可以通过本领域公知的方法与合适的用于肠胃外给药的载体一同剂型化为注射剂型、透皮给药剂及鼻内吸入剂。上述注射剂必须进行灭菌、并且需要保护其免受如细菌和真菌等微生物的污染。用于注射剂的合适的载体的示例可以包括水、乙醇、多元醇(例如甘油、丙二醇、液体聚乙二醇等)、其混合物和/或包括植物油的溶剂或分散剂,但并不限定于此。更优选地,可将Hanks液、林格氏液、包含三乙醇胺的磷酸盐缓冲盐水(phosphate bufferedsaline,PBS)或注射用无菌水、或等渗溶液(例如10%乙醇、40%丙二醇或5%葡萄糖)用作合适的载体。为了保护上述注射剂免受微生物污染,注射剂还可包含各种抗细菌和抗真菌剂,例如对羟基苯甲酸酯、氯丁醇、苯酚、山梨酸和硫汞撒等。并且,在大多数情况下,上述注射剂还可包含如糖或氯化钠的等渗剂。
透皮给药制剂的形式包括软膏、乳膏、洗剂、凝胶、外用溶液、膏药、涂敷药和气雾剂等。上述“透皮给药”是指将药学组合物局部给药至皮肤上以向皮肤内传递包含在药学组合物的有效量的活性成分。
在吸入剂的情况下,根据本发明使用的化合物可以使用合适的推进剂例如二氯氟甲烷、三氯氟甲烷、二氯四氟乙烷、二氧化碳或其他合适的气体,以气雾喷雾剂的形式从加压包装或喷雾器方便地传递。在加压的气雾剂的情况下,给药单位可以通过提供阀门来确定,上述阀门递送测量的量。例如,用于吸入器或吹入器中的明胶胶囊及药筒可剂型化为包含化合物及如乳糖或淀粉等的合适粉末材料的粉末混合物。用于肠胃外给药的剂型描述于在药品化学中是通常公知的处方集(Remington's Pharmaceutical Science,15thEdition,1975.Mack Publishing Company,Easton,Pennsylvania 18042,Chapter 87:Blaug,Seymour)。
当本发明的药学组合物包括有效量的CHP时,可提供优选的预防、改善或治疗纤维化的效果。在本申请中,术语“有效量”是指示出与对照组相比更多响应的量,优选为足以预防、改善或治疗纤维化的量。本发明的药学组合物可包含0.01%至99.9%的CHP,剩余量为药学上可接受的载体。包含在本发明的药学组合物的CHP的有效量可根据将组合物产品化的形式而不同。
本发明的药学组合物的总有效量能够以单剂量(single dose)给药至患者,或者以多剂量(multiple dose)通过长期给药的分次治疗方法(fractionated treatmentprotocol)给药。本发明的药学组合物可根据疾病的程度改变有效成分的含量。例如,以CHP为基准,一天按每1kg体重给药0.001mg至100mg,一天给药一次或多次,更优选地,一天按每1kg体重给药0.01mg至10mg,一天给药一次或多次。但是,上述CHP的剂量考虑药学组合物的给药途径及治疗次数、患者的年龄、体重、健康状态、性别、疾病的严重程度、饮食及排泄率等各种因素来确定针对患者的有效剂量,因此,鉴于此,只要是本领域的普通技术人员可确定上述CHP的用于预防、治疗或改善纤维化的特定用途的适当有效剂量。本发明的药学组合物只要显示出本发明的效果,并不特别限制其剂型、给药途径及给药方法。
本发明的用于预防或治疗纤维化的药学组合物可单独使用或与采用手术、放射疗法、激素疗法、化学疗法或生物反应控制剂的方法组合使用。
本发明的用于预防或治疗纤维化的药学组合物还能够以包含CHP的外用制剂等的剂型提供。在该方面,本发明的组合物可以为用于预防或改善纤维化的准药品组合物及包含上述组合物的准药品。
上述外用制剂可直接应用于皮肤或口腔内。在将本发明的用于预防或治疗纤维化的药学组合物用作外用制剂的情况下,还可以包括皮肤科学领域中通常使用的辅助剂,例如脂肪物质、有机溶剂、增溶剂、浓缩剂、胶凝剂、软化剂、抗氧化剂、悬浮剂、稳定剂、发泡剂(forming agent)、芳香剂、表面活性剂、水、离子乳化剂、非离子乳化剂、填充剂、多价螯合剂、螯合剂、保存剂、维生素、阻滞剂、润湿剂、精油、染料、色素、亲水性活性剂、亲脂性活性剂或脂质囊泡等通常用于皮肤外用制剂的任意成分。并且,上述成分能够以通常用于皮肤科学领域的量导入。
在将本发明的组合物以外用制剂提供的情况下,可以为液体制剂、软膏、贴剂、凝胶、乳霜或气雾剂等剂型,但不局限于此。根据本发明的一实例,本发明的准药品可以为包括牙膏、漱口剂及口腔喷雾剂的口腔护理产品、软膏、面膜、泥敷剂、贴剂及透皮吸收剂等。
在将本发明的组合物用作准药品组合物的情况下,可直接添加CHP或者根据常规方法与其他准药品成分一同适当地使用。有效成分的混合量可根据使用目的(预防、保健或治疗)适当地确定。
本发明的药学组合物及保健功能食品组合物的内容可适用于本发明的准药品组合物及准药品。
在本发明中,术语“保健功能食品”意在“功能性食品”及“保健食品”。
在本发明中,术语“功能性食品(functional food)”为与特殊保健食品(food forspecial health use,FoSHU)相同的术语,是指除了供给营养外,以有效发挥生物调节功能的方式加工的医学、医疗效果佳的食品。
在本发明中,术语“保健食品(health food)”是指与普通食品相比具有积极的保健或促进健康效果的食品,保健辅助食品(health supplement food)是指以保健辅助为目的的食品。根据情况,术语功能性食品、保健食品、保健辅助食品互换使用。为了获得改善及恢复肝功能的有用的效果,上述食品可制备为片剂、胶囊、粉末、颗粒、液相制剂、丸剂等的各种形式。
作为这种功能性食品的具体例,通过使用上述组合物,可制备在利用农产品、畜产品或水产品的特性转化的同时具有良好的储藏性的加工食品。
本发明的保健功能食品组合物还可制备为营养补充剂(nutritionalsupplement)、食品添加剂(food additives)及饲料等的形式,以包括人类或家畜的动物为对象。
上述食品组合物的类型可以根据本领域公知的常规方法制备成各种形式。可通过向一般食品添加CHP来制备,上述一般食品包括饮料(包括酒精饮料)、水果及其加工食品(例如水果罐头、瓶装食品、果酱、带皮果酱等)、鱼类、肉类及其加工产品(例如火腿、香肠、咸牛肉等)、面包、面条(例如乌冬面、荞麦面、拉面、意大利面、通心粉等)、果汁、各种饮料、饼干、糖浆、乳制品(例如黄油、奶酷等)、食用植物油、人造黄油、植物蛋白、蒸煮食品、冷冻食品和各种调味料(例如大豆酱、酱油、调味汁等),但并不限定于此。
并且,营养补充剂可通过向胶囊、片剂、丸剂等添加CHP来制备,但不限于此。
并且,保健功能食品可将上述CHP液相化、颗粒化、胶囊化及粉末化来在摄取,例如,可制备为茶、果汁及饮料来饮用(保健饮料),但不限于此。并且,为了将上述CHP用作食品添加剂的形式,能够以粉末或浓缩液形态制备来使用。并且,可使上述CHP与以具有预防或改善纤维化效果而周知的活性成分混合来制备为组合物的形式。
在将本发明的食品组合物用作保健饮品组合物的情况下,上述保健饮料组合物可以包含如在普通饮料中的一些调味剂或天然碳水化合物等作为追加成分。上述的碳水化合物可以是:单糖,如葡萄糖和果糖;双糖,如麦牙糖和蔗糖;多糖,如糊精和环糊精;糖醇,如木糖醇,山梨糖醇和赤藓醇。甜味剂可以使用:天然甜味剂,如祝马丁、甜叶菊萃取物;以及合成甜味剂,如糖精和阿斯巴甜。上述天然碳水化合物的比例通常为每100mL的本发明组合物中为约0.01g~0.04g,优选为约0.02g~0.03g。
CHP可包含在用于预防或改善纤维化的食品组合物中作为有效成分,其量为足以获得上述预防或改善效果的有效量,例如,相对于整个组合物的总重量,优选为0.01重量百分比至100重量百分比,但并不限定于此。本发明的食品组合物可通过与CHP一同混合具有预防或改善纤维化效果而周知的其他活性成分来制备。
除上述之外,本发明的保健功能食品可包含各种营养素、维生素、电解质、调味剂、着色剂、果胶酸及其盐、海藻酸及其盐、有机酸、保护胶体增稠剂、pH值调节剂、稳定剂、防腐剂、甘油、醇类或碳酸化剂等。此外,本发明的保健食品可包含有用于制造天然果汁、果汁饮料和蔬菜饮料的果肉。这种成分可单独使用或混合使用。这种添加剂的比例并不是很重要,但相对于100重量份的本发明的组合物,通常选自0.01重量份~0.1重量份的范围内。
并且,本发明涉及包括向需要的个体给药有效量的CHP的步骤的预防或治疗纤维化的方法。
在本发明的方法中,术语“个体”包括任意动物(例如,人类、马、猪、兔、狗、羊、山羊、非人灵长类动物、牛、猫、豚鼠或啮齿动物),但并不限定于此。这种术语并不表示特定年龄或性别。因此,包括女性/雌性、男性/雄性、成人/成体及新生对象以及胚胎。患者是指患有疾病或障碍的对象。术语“患者”包括人类及兽医学对象。
在本发明的方法中,CHP的效果及其给药途径、给药次数、剂量等的说明与前述内容相同,因此,将省略其记载。
并且,本发明提供制备用于预防或治疗纤维化的药学组合物时的CHP的用途。
以下,通过实施例更加详细地说明本发明。但是,本发明可实施各种变更,可具有各种实施方式,以下所记述的特定实施例及说明仅帮助理解本发明,本发明并不限定于特定公开实施方式。需理解的是,本发明的范围包括本发明的思想及技术范围内的所有变更、等同技术方案或代替技术方案。
本发明实施方式
准备例
在下述实施例中使用的CHP从瑞士巴亨(BACHEM)公司购入并使用。
实施例1
确认根据利用CHP处理的人源性近端肾小管上皮细胞中的抗纤维效果
1-1.分离及培养人源性近端肾小管上皮细胞
如图1所示,从正常成人的肾组织中分离肾小球及肾小管间质组织并将其原代培养,由此分离及培养可利用于细胞实验的纯的人源性肾小球内皮细胞及人源性近端肾小管上皮细胞。
1-2.在人源性近端肾小管上皮细胞纤维化模型中处理CHP后观察细胞学形态
在上述实施例1-1中分离及原代培养的人源性近端肾小管上皮细胞中处理重组转化生长因子β(2ng/ml)来诱导细胞纤维化,由此发生细胞骨架改建(cytoskeletalremodeling)和形态学变化(变得细长且结构消失),从而确认适当地诱导纤维化(图2)。
之后,当处理各种浓度的CHP(4μg/ml、20μg/ml及100μg/ml)时,通过细胞形态确认了纤维化好转(图2)。
1-3.在人源性近端肾小管上皮细胞纤维化模型中处理CHP后确认E-钙粘蛋白、纤
连蛋白及pSTAT3蛋白表达
在与上述实施例1-2相同的条件下,给药CHP后,通过蛋白质印迹法确认了作为接合标志物(junction marker)的E-钙粘蛋白、作为纤维化标志物的纤连蛋白及作为纤维化转录因子的pSTAT3的蛋白质的表达水平。
结果,如图3所示,随着给药CHP,确认E-钙粘蛋白的蛋白质表达恢复、纤连蛋白及pSTAT3的蛋白质表达减少。
实施例2
确认根据CHP的人源性肾小球内皮细胞中的抗纤维效果
在人源性肾小球内皮细胞纤维化模型中处理CHP后观察细胞形态
与上述实施例1-1的人源性近端肾小管上皮细胞纤维化模型相同地,处理r转化生长因子β(2ng/ml)来在肾小球内皮细胞中诱导细胞纤维化,由此发生细胞骨架改建和形态学变化,从而确认适当地诱导纤维化(图4)。
之后,当处理各种浓度的CHP(40μg/ml及100μg/ml)时,通过细胞形态确认了纤维化好转(图4)。
通过以上结果,可确认CHP对于肾纤维化的优秀的治疗效果。
实施例3
确认根据CHP处理的人源性肝细胞中的抗纤维效果
3-1.培养人源性肝细胞、诱导纤维化后处理CHP
为了培养Huh7肝细胞株,从美国海克隆公司(Hyclone Laboratories Inc)购入DMEM培养基和胎牛血清(FBS),从美国R&D systems公司购入了用于诱导纤维化的转化生长因子β。利用添加10%的胎牛血清的DMEM培养基,在37℃、5%CO2的培养箱中培养,处理转化生长因子β使其浓度成为2ng/ml,同时,处理CHP来使其浓度成为0ng/ml、62.5ng/ml、125ng/ml、250ng/ml,进行处理的48小时后回收细胞。
3-2.在人源性肝细胞纤维化模型中处理CHP后确认纤维化标志物纤连蛋白表达
为了分析作为纤维化蛋白质的纤连蛋白的蛋白质表达,购入美国赛默飞世尔科技公司(Thermo Fisher Scientific Inc.)的RIPA裂解缓冲液(lysis buffer)和HaltTM蛋白酶(Protease)及磷酸酶(Phosphatase)抑制剂混合物,为了蛋白质定量,购入了美国赛默飞世尔科技公司的BCA蛋白定量试剂盒。为了进行蛋白质印迹法,准备了美国赛默飞世尔科技公司的BoltTM蛋白质凝胶电泳系统和美国伯乐(Bio-Rad Laboratories,Inc.)公司的湿转移系统。从美国Abcam公司购入作为肝纤维化标志物的纤连蛋白的抗体和用作上样对照的GAPDH抗体。向回收的Huh7细胞加入100ul的添加有蛋白酶及磷酸酶抑制剂的RIPA缓冲液,通过移液溶解细胞。在冰上放置10分钟后,在4℃的温度下以15000rpm的速度离心分离10分钟。回收上清液并通过BCA定量法测定蛋白质浓度,利用BoltTM蛋白质凝胶电泳系统分离相同量的样品的蛋白质,并转移至硝酸纤维膜(Nitrocellulose membrane)。膜利用5%的脱脂乳(skim milk)在常温条件下封闭(blocking)1小时后,在4℃的温度下与作为一抗的纤连蛋白及GAPDH抗体反应一夜(overnight)。利用TBST洗涤3次,每次10分钟,之后,在常温条件下与二抗反应1小时。利用TBST洗涤3分钟,每次10分钟,与ECL反应来测定表达程度。利用ImageJ程序定量所示出的条带大小,通过将纤连蛋白条带大小值除以GAPDH条带大小值来校正。与对照组的Student's t-test统计法分析统计学显著性。#p<0.05(阴性对照组:转化生长因子β处理对照组)。
实验结果,如图5a及图5b所示,确认如下的倾向,即,当处理转化生长因子β和250ng/ml的CHP时,随着转化生长因子β处理而增加的作为纤维化蛋白质的纤连蛋白的表达量减少。由此,确认CHP可在作为肝细胞株的Huh7细胞中改善纤维化。
实施例4
确认根据给药CHP的肝纤维化动物模型中的抗纤维化效果
长期的高脂肪饮食摄取以诱发肝纤维化的风险因素而周知。由于长期摄取脂肪饮食时出现的胰岛素阻抗性和增加的血中脂肪酸、脂肪因子、细胞因子,在肝组织诱发炎症环境,积累在肝组织的免疫细胞的相互作用促进纤维化,尤其,Th2CD4+T细胞分泌的白细胞介素-13细胞因子从巨噬细胞大量生成作为纤维化关键诱因的转化生长因子β。通过转化生长因子β的信号传导引起肝组织内细胞的转化并促进纤维化的进展(Rosselli,M et al.,Current Pharmaceutical Design,20(31),5010-5024,2014;Wu.D et al.,Science,332:243-7,2011;J Investig Med,60(8):1147-1150,2012;Fichtner-Feigl S et al.,NatMed,12:99-106,2006;Lee CG et al.,J Exp Med,194:809-21,2001)。
向正常小鼠喂食10周~16周的包含60%脂肪的高脂肪饮食时,观察到肝纤维化,并可通过作为代表性纤维化标志物蛋白的纤连蛋白的表达确认(Kim,I.H et al.,AGE,38(4),291-302,2016;Chen,H.J.,&Liu,J.,Biomedicine&Pharmacotherapy,97,1386-1396,2018.1-2)。
4-1.设计实验动物及诱导肝纤维化
为了动物中的肝纤维化实验,从美国的Jackson公司购入摄取6周的包含60%脂肪的高脂肪饮食的12周龄的C57BL/6小鼠,从韩国Saeronbio公司购入作为包含60%脂肪的高脂肪饮食饲料的Research diets D12492,使小鼠摄取17周。小鼠在24±3℃的环境中自由进食和饮水。将摄取6周的高脂肪饮食的C57BL/6小鼠适应1周的饲养环境后称重,并如表1所示,均匀分成3组。CHP以5mg/kg或35mg/k的浓度向每组一天给药一次,口服给药共16周,对于对照组,通过相同方法口服给药相同量的蒸馏水。
表1
4-2.确认给药CHP的肝纤维化动物模型中的纤维化标志物纤连蛋白表达
从Hana Pharm公司购入小鼠的麻醉和解剖所需的异氟烷(Isoflurane),准备了美国维特普公司(VetEquip Inc.)的RC2 Rodent Circuit Controller Anesthesia System。从美国海克隆公司购入磷酸盐缓冲液。为了分离小鼠的肝组织,利用3%~3.5%的异氟烷通过呼吸麻醉将小鼠麻醉。从麻醉的小鼠的心脏采血后,立即摘取肝组织,利用磷酸盐缓冲液洗涤后,切下50mg的肝组织并放入500ul的添加有蛋白酶及磷酸酶抑制剂的RIPA缓冲液,利用德国艾卡(IKA)公司的T10均质机(homogenizer)粉碎其。在冰上放置15分钟后,在4℃的温度下以15000rpm的速度离心分离。为了分析作为纤维化蛋白质的纤连蛋白的表达,通过与实施例3-2相同的方法实施蛋白质印迹法。通过与HFD对照组的Student's t-test统计法分析统计学显著性(*p<0.05,**p<0.01)。
实验结果,如图6a及图6b所示,可确认作为代表性纤维化标志物的纤连蛋白的表达量在CHP给药组中显著减少,效果根据CHP的浓度加强。这表示CHP改善肝纤维化,是可应用于治疗肝纤维化的明确证据。
实施例5
确认根据CHP处理的人源性肺细胞中的抗纤维效果
5-1.培养人源性肺细胞及诱导纤维化后处理CHP
为了培养L-132肺细胞株,从美国海克隆公司购入MEM培养基和胎牛血清,从美国R&D systems公司购入用于诱导纤维化的转化生长因子β。利用添加10%的胎牛血清的MEM培养基,在37℃、5%CO2的培养箱中培养,处理转化生长因子β使其浓度成为2ng/ml,同时,处理CHP来使其浓度成为0ng/ml、62.5ng/ml或125ng/ml,进行处理48小时后回收细胞。
5-2.在人源性肺细胞纤维化模型中处理CHP后确认纤维化标志物纤连蛋白的蛋白
质表达
为了分析作为纤维化蛋白质的纤连蛋白表达,通过与实施例3-2相同的方法实施蛋白质印迹法。通过与对照组的Student's t-test统计法分析统计学显著性(#p<0.05(阴性对照组:转化生长因子β处理对照组),**p<0.01(转化生长因子β处理对照组:CHP 125ng/ml处理组))。
实验结果,如图7a及图7b所示,确认了当处理转化生长因子β和125ng/ml的CHP时,随着转化生长因子β处理而增加的作为纤维化蛋白质的纤连蛋白的表达量显著减少。可通过CHP在作为肺细胞株的L-132细胞中改善纤维化的结果确认CHP对于肺纤维化具有优秀的治疗效果。
实施例6
确认根据给药CHP的肺纤维化动物模型中的抗纤维效果
由于长期摄取高脂肪饮食,发生肺纤维化。这似乎是高脂肪摄取导致的炎症水平增加引起的,据报告,当使正常小鼠摄取包含60%脂肪的高脂肪饮食15周时,发生肺纤维化(Ge,X.N et al.,Experimental Lung Research,39(9),365-378,2016)。具体地,长期摄取高脂肪饮食诱导肥胖,肥大的脂肪组织和聚集在此的免疫细胞所分泌的脂肪因子和细胞因子干扰免疫细胞从骨髓向肺移动,从而引起慢性炎症反应(de Vries A et al.,Clin ExpAllergy,39:731-739,2009)。并且,Th2CD4+T细胞分泌的白细胞介素-13细胞因子大量生成作为纤维化关键诱因的转化生长因子β,通过转化生长因子β的信号传导引起肺组织的转化并促进纤维化现象(Fichtner-Feigl S et al.,Nat Med,12:99-106,2006;Lee CG etal.,J Exp Med,194:809-21,2001)。可通过相对于正常增加的转化生长因子β基因等的表达量确认肺的纤维化(Ge,X.N et al.,Experimental Lung Research,39(9),365-378,2016)。
为了动物中的肺纤维化实验,通过与实施例4-1相同的方法确立肺纤维化动物模型。
6-2.确认给药CHP的肺纤维化动物模型中的纤维化标志物即转化生长因子β及胶
原3基因表达
从韩国Hana Pharm公司(HANA PHARM CO.,LTD.)购入小鼠的麻醉和解剖所需的异氟烷,准备了美国维特普公司的RC2 Rodent Circuit Controller Anesthesia System。从美国海克隆公司购入磷酸盐缓冲液。为了分离小鼠的肺组织,利用3%~3.5%的异氟烷通过呼吸麻醉将小鼠麻醉。从麻醉的小鼠的心脏采血后,立即摘取肺组织,切下50mg的肺并放入500μL的NucleoZOL,利用德国艾卡公司的T10均质机粉碎其。接着,根据NucleoZOL的总RNA分离方案提取RNA,利用iScript cDNA合成试剂盒通过逆转录聚合酶链反应(ReverseTranscription Polymerase Chain Reaction)将1μg的RNA合成为cDNA。利用与各基因相对应的正向/反向引物组,通过iQ SYBR Green Supermix进行实时聚合酶链反应来分析合成的cDNA。除以作为管家基因的GAPDH的表达值来校正各基因的表达值。用于实时聚合酶链反应的引物为如表2的碱基序列,由韩国Bioneer公司合成并使用。
表2
使用方差分析(One-way ANOVA)统计分析法分析统计学显著性,通过Dunnett事后测试比较与对照组的显著性(*p<0.05,***p<0.001)。
实验结果,如图8所示,确认在肺示出的作为主要纤维化标志物的转化生长因子β、胶原3基因表达根据CHP给药浓度更加显著地减少。这意味着CHP改善肺纤维化,可确认对于肺纤维化的治疗具有优秀的治疗效果。
实施例7
确认根据CHP处理的人源性皮肤细胞中的抗纤维效果
7-1.培养人源性皮肤细胞及诱导纤维化后处理CHP
为了培养源自HS68皮肤成纤维细胞的细胞株,从美国海克隆公司购入DMEM培养基和胎牛血清,从美国R&D systems公司购入用于诱导纤维化的转化生长因子β。利用添加10%的胎牛血清的DMEM培养基,在37℃、5%CO2的培养箱中培养,处理转化生长因子β使其浓度成为2ng/ml,同时,处理CHP来使其浓度成为0ng/ml、62.5ng/ml、125ng/ml、250ng/ml或500ng/ml,进行处理的48小时后回收细胞。
7-2.在人源性皮肤细胞纤维化模型中处理CHP后确认纤维化标志物纤连蛋白表达
为了分析作为纤维化蛋白质的纤连蛋白表达,通过与实施例3-2相同的方法实施蛋白质印迹法。通过与对照组的Student's t-test统计法分析统计学上的显著性(#p<0.05(阴性对照组:转化生长因子β处理对照组),*p<0.05(转化生长因子β处理对照组:CHP500ng/ml处理组))。
实验结果,如图9a及图9b所示,确认了当处理转化生长因子β和500ng/ml的CHP时,随着转化生长因子β处理而增加的作为纤维化蛋白质的纤连蛋白的表达量显著减少。可通过CHP在作为皮肤细胞株的HS68细胞中改善纤维化的结果确认CHP可用于治疗皮肤纤维化。
实施例8
确认根据给药CHP的心脏纤维化动物模型中的抗纤维效果
周知的心脏纤维化的危险因素包括不良饮食习惯和肥胖、高胆固醇水平等。当长期摄取高脂肪饮食时,发生肥胖引起的血容量过多,使心脏负荷过重,使心脏收缩和舒张功能发生变形。与此同时出现的高血糖、胰岛素抵抗、高脂血症、慢性炎症等的症状在心脏纤维化中起决定性作用而周知(Kaltman AJ,Goldring RM.,Am J Med,60:645-653,1976;XiaY et al.,Histochem Cell Biol,131:471-481,2009;Ulasova E et al.,J Mol CellCardiol.,50:147-156,2011;Lo CS et al.,J Cell Biochem.,103:1999-2009,2008;Cavalera,M et al.,Translational Research,164(4),323-335,2014)。尤其,肥胖引起的心脏肥胖细胞(Cardiac mast cell)的增加和它们的脱颗粒现象向心脏组织提供如转化生长因子β的纤维化诱发因子,并进一步促进心脏纤维化(Kong P,Christia P,Frangogiannis NG,Cell Mol Life Sci.,71:549-574,2014)。
并且,据报告,当正常小鼠长期摄取高脂肪饮食时,出现心脏纤维化。据报告,当使正常小鼠摄取14周~22周的包含60%脂肪的高脂肪饮食时,诱发心脏纤维化,并可确认与正常相比增加的转化生长因子β、胶原基因等的表达量变化(Li,W et al.,Nutrition&Metabolism,14(1);68,2017;Ternacle,J et al.,European Heart Journal,18(11),1283-1291,2017;Zhao,Y et al.,Biochimica et Biophysica Acta(BBA)-MolecularBasis of Disease,1863(8),1991-2000,2017;Xu,Z.,&Kong,X.Q.,Biomedicine&Pharmacotherapy,89,991-1004,2017)。
8-1.设计实验动物及诱导心脏纤维化
为了动物中的心脏纤维化实验,通过与实施例4-1相同的方法确立心脏纤维化动物模型。
8-2.确认给药CHP的心脏纤维化动物模型中的纤维化标志物即转化生长因子β、纤
连蛋白、胶原1、胶原2、胶原3及胶原4因表达
从韩国Hana Pharm公司购入小鼠的麻醉和解剖所需的异氟烷,准备了美国维特普公司的RC2 Rodent Circuit Controller Anesthesia System。从美国海克隆公司购入磷酸盐缓冲液。为了分离小鼠的心脏组织,利用3%~3.5%的异氟烷通过呼吸麻醉将小鼠麻醉。从麻醉的小鼠的心脏采血后,立即摘取心脏组织,切下50mg的心脏,通过与实施例6-2相同的方法进行RNA提取及基因表达分析。用于实时聚合酶链反应的引物为如表3的碱基序列,由韩国Bioneer公司合成并使用。除以管家基因的β-肌动蛋白(β-actin)的表达值来校正各基因的表达值。
表3
使用方差分析统计分析法分析统计学显著性,通过Dunnett事后测试比较与HFD对照组的显著性(*p<0.05,**p<0.01,****p<0.0001)。
实验结果,如图10所示,确认在心脏中示出的作为主要纤维化标志物的纤连蛋白、转化生长因子β、胶原1、胶原3、胶原4基因的表达通过给药CHP而显著减少。但是,未确认根据CHP的浓度更加减少的效果,这可视为CHP仅通过5mg/kg浓度发生充足的效果。CHP抑制心脏纤维化的进展且改善心脏纤维化的该结果意味着CHP可应用于心脏纤维化的治疗。
实施例9
确认根据给药CHP的脂肪纤维化动物模型中的抗纤维效果
已知的防止纤维化的最佳方法是阻断炎症反应。尤其,脂肪组织分泌炎症物质来导致炎症引起的脂肪纤维化的恶性循环。据报告,当使正常小鼠摄取包含60%脂肪的高脂肪饮食16周~24周时,发生脂肪组织的纤维化(Hu,M et al.,Evidence-BasedComplementary and Alternative Medicine,1-12,2018;Kwon,E.Y.,&Choi,M.S.,Nutrients,10(10),1415,2018;Nakazeki,F et al.,Scientific Reports,8(1),2018;Muniappan,L et al..Scientific Reports,7(1),2017;Lancha,A et al.,PLoS ONE,9(5),e98398,2014;Velαzquez,K.T et al.,Physiological Reports,5(18),e13412,2017;Wang,L.,Ye,X.,Hua,Y.,&Song,Y.,Biomedicine&Pharmacotherapy,105,121-129,2018)。当长期摄取高脂肪饮食时,若由于营养过剩发生脂肪细胞的膨胀,则发生中性脂肪积累、脂肪细胞凋亡、脂肪因子和细胞因子的生成、内质网应激、脂肪组织缺氧等,使得免疫细胞浸润至脂肪组织,并发生慢性炎症(Schenk S et al.,J Clin Invest,118:2992-3002,2008;Sun K,Kusminski CM,Scherer PE,J Clin Invest,121:2094-101,2011)。积累在脂肪组织的各种炎症性免疫细胞与巨噬细胞-脂肪细胞之间的相互作用生成作为纤维化关键诱因的转化生长因子β,由此,发生脂肪组织的变形,从而诱发脂肪纤维化(Lee CG et al.,J ExpMed,194:809-21,2001;Fichtner-Feigl S et al.,Nat Med,12:99-106,2006;Pessin,J.E.,&Kwon,H,Journal of Investigative Medicine,60(8),1147-1150,2012)。脂肪组织的纤维化可通过相对于正常脂肪组织增加的代表性纤维化基因标志物的表达确认。
9-1.设计实验动物及诱导脂肪纤维化
为了动物中的脂肪纤维化实验,通过与实施例4-1相同的方法确立脂肪纤维化动物模型。
9-2.确认给药CHP的脂肪纤维化动物模型中的纤维化标志物即转化生长因子β、纤
连蛋白、胶原3及结缔组织生长因子基因表达
从韩国Hana Pharm公司购入小鼠的麻醉和解剖所需的异氟烷,准备了美国维特普公司的RC2 Rodent Circuit Controller Anesthesia System。从美国海克隆公司购入磷酸盐缓冲液。为了分离小鼠的脂肪组织,利用3%~3.5%的异氟烷通过呼吸麻醉将小鼠麻醉。从麻醉的小鼠的心脏采血后,立即摘取附睾脂肪组织(EAT),切下100mg的脂肪,通过与实施例6-2相同的方法进行RNA提取及基因表达分析。用于实时聚合酶链反应的引物为如表4的碱基序列,由Bioneer公司合成并使用。除以作为管家基因的GAPDH的表达值来校正各基因的表达值。
表4
使用方差分析统计分析法分析统计学显著性,通过Dunnett事后测试比较与对照组的显著性(*p<0.05,**p<0.01)。
实验结果,如图11所示,确认在脂肪中示出的作为主要纤维化标志物的纤连蛋白、转化生长因子β、胶原3、结缔组织生长因子基因表达通过给药CHP而显著减少。这意味着CHP改善脂肪纤维化,可确认对于脂肪纤维化治疗具有优秀的治疗效果。
序列表
<110> 诺麦塔制药有限公司
首尔大学医院
首尔大学校产学协力团
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Claims (13)
1.一种用于预防或治疗纤维化的药学组合物,其特征在于,包含CHP或其药学上可接受的盐。
2.根据权利要求1所述的用于预防或治疗纤维化的药学组合物,其特征在于,上述纤维化在选自由肾、肝、肺、皮肤、心脏、胰腺、泌尿系统、生殖系统、汗腺、神经、脑、骨髓、肌肉及关节组成的组中的一个以上发生。
3.根据权利要求1所述的用于预防或治疗纤维化的药学组合物,其特征在于,上述纤维化为选自由肺纤维化、特发性肺纤维化、放射性肺损伤或肺纤维化、肺水肿、囊性纤维化、肝纤维化、心内膜心肌纤维化、心肌梗塞、心房纤维化、胶质瘢痕、肾纤维化、骨髓纤维化、关节纤维化、脂肪纤维化、皮肤纤维化、神经纤维化及肌肉纤维化组成的组中的一种以上。
4.一种用于预防或改善纤维化的保健功能食品组合物,其特征在于,包含CHP或其食品上可接受的盐。
5.根据权利要求4所述的用于预防或改善纤维化的保健功能食品组合物,其特征在于,上述纤维化在选自由肾、肝、肺、皮肤、心脏、胰腺、泌尿系统、生殖系统、汗腺、神经、脑、骨髓、肌肉及关节组成的组中的一个以上发生。
6.根据权利要求4所述的用于预防或改善纤维化的保健功能食品组合物,其特征在于,上述纤维化为选自由肺纤维化、特发性肺纤维化、放射性肺损伤或肺纤维化、肺水肿、囊性纤维化、肝纤维化、心内膜心肌纤维化、心肌梗塞、心房纤维化、胶质瘢痕、肾纤维化、骨髓纤维化、关节纤维化、脂肪纤维化、皮肤纤维化、神经纤维化及肌肉纤维化组成的组中的一种以上。
7.一种抗纤维化组合物,其特征在于,包含CHP或其药学上可接受的盐。
8.一种预防或治疗纤维化的方法,其特征在于,包括向需要的个体给药有效量的CHP的步骤。
9.根据权利要求8所述的预防或治疗纤维化的方法,其特征在于,上述纤维化在选自由肾、肝、肺、皮肤、心脏、胰腺、泌尿系统、生殖系统、汗腺、神经、脑、骨髓、肌肉及关节组成的组中的一个以上发生。
10.根据权利要求8所述的预防或治疗纤维化的方法,其特征在于,上述纤维化为选自由肺纤维化、特发性肺纤维化、放射性肺损伤或肺纤维化、肺水肿、囊性纤维化、肝纤维化、心内膜心肌纤维化、心肌梗塞、心房纤维化、胶质瘢痕、肾纤维化、骨髓纤维化、关节纤维化、脂肪纤维化、皮肤纤维化、神经纤维化及肌肉纤维化组成的组中的一种以上。
11.一种CHP的用途,其特征在于,为在制备用于预防或治疗纤维化的药学组合物时使用的CHP的用途。
12.根据权利要求11所述的CHP的用途,其特征在于,上述纤维化在选自由肾、肝、肺、皮肤、心脏、胰腺、泌尿系统、生殖系统、汗腺、神经、脑、骨髓、肌肉及关节组成的组中的一个以上发生。
13.根据权利要求11所述的CHP的用途,其特征在于,上述纤维化为选自由肺纤维化、特发性肺纤维化、放射性肺损伤或肺纤维化、肺水肿、囊性纤维化、肝纤维化、心内膜心肌纤维化、心肌梗塞、心房纤维化、胶质瘢痕、肾纤维化、骨髓纤维化、关节纤维化、脂肪纤维化、皮肤纤维化、神经纤维化及肌肉纤维化组成的组中的一种以上。
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KR1020200037859A KR102140910B1 (ko) | 2019-03-28 | 2020-03-27 | Chp(사이클로-히스프로)를 포함하는 섬유증의 예방, 개선 또는 치료용 조성물 |
PCT/KR2020/004354 WO2020197359A1 (ko) | 2019-03-28 | 2020-03-30 | 섬유증의 예방, 개선 또는 치료를 위한 chp (사이클로-히스프로)의 용도 |
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EP4122484A4 (en) | 2020-03-20 | 2024-03-27 | Novmetapharma Co., Ltd. | USE OF CYCLO-HIS-PRO (CHP) FOR LOWERING BLOOD PRESSURE |
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