EP1251840A2 - Verwendung von kaliumkanalaktivatoren zur verabreichung von medikamenten an anormalen gehirnregionen und/oder bösartigen tumoren - Google Patents

Verwendung von kaliumkanalaktivatoren zur verabreichung von medikamenten an anormalen gehirnregionen und/oder bösartigen tumoren

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Publication number
EP1251840A2
EP1251840A2 EP01905141A EP01905141A EP1251840A2 EP 1251840 A2 EP1251840 A2 EP 1251840A2 EP 01905141 A EP01905141 A EP 01905141A EP 01905141 A EP01905141 A EP 01905141A EP 1251840 A2 EP1251840 A2 EP 1251840A2
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Prior art keywords
nonoate
potassium channel
medicant
agent
channel activator
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EP01905141A
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English (en)
French (fr)
Inventor
Keith L. Black
Nagendra S. Ningaraj
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Cedars Sinai Medical Center
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Cedars Sinai Medical Center
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Priority claimed from US09/491,500 external-priority patent/US7018979B1/en
Application filed by Cedars Sinai Medical Center filed Critical Cedars Sinai Medical Center
Publication of EP1251840A2 publication Critical patent/EP1251840A2/de
Withdrawn legal-status Critical Current

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    • C12N15/00—Mutation or genetic engineering; DNA or RNA concerning genetic engineering, vectors, e.g. plasmids, or their isolation, preparation or purification; Use of hosts therefor
    • C12N15/09—Recombinant DNA-technology
    • C12N15/87—Introduction of foreign genetic material using processes not otherwise provided for, e.g. co-transformation
    • C12N15/88—Introduction of foreign genetic material using processes not otherwise provided for, e.g. co-transformation using microencapsulation, e.g. using amphiphile liposome vesicle
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
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    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/04—Nitro compounds
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19—Carboxylic acids, e.g. valproic acid
    • A61K31/195—Carboxylic acids, e.g. valproic acid having an amino group
    • A61K31/197—Carboxylic acids, e.g. valproic acid having an amino group the amino and the carboxyl groups being attached to the same acyclic carbon chain, e.g. gamma-aminobutyric acid [GABA], beta-alanine, epsilon-aminocaproic acid or pantothenic acid
    • A61K31/198—Alpha-amino acids, e.g. alanine or edetic acid [EDTA]
    • 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
    • A61K31/21—Esters, e.g. nitroglycerine, selenocyanates
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
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    • A61K31/28—Compounds containing heavy metals
    • A61K31/295—Iron group metal compounds
    • 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
    • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/4245—Oxadiazoles
    • 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
    • A61K31/475—Quinolines; Isoquinolines having an indole ring, e.g. yohimbine, reserpine, strychnine, vinblastine
    • 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
    • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A61K31/513—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim having oxo groups directly attached to the heterocyclic ring, e.g. cytosine
    • 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
    • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A61K31/519—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings
    • 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
    • A61K31/655—Azo (—N=N—), diazo (=N2), azoxy (>N—O—N< or N(=O)—N<), azido (—N3) or diazoamino (—N=N—N<) compounds
    • 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
    • A61K31/66—Phosphorus compounds
    • A61K31/675—Phosphorus compounds having nitrogen as a ring hetero atom, e.g. pyridoxal phosphate
    • 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
    • A61K31/69—Boron compounds
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K33/00—Medicinal preparations containing inorganic active ingredients
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

  • This invention relates to the medical arts In particular, it relates to a method of enhancing the delivery of a medicant across abnormal microvasculature to a tissue requiring treatment
  • Pathologic neovascularization i e , the proliferation or development of new blood vessels, is essential for the growth and spread of primary, secondary and metastatic malignant tumors It is known that certain properties of the new capillaries and arterioles constituting the neomicrovasculature in solid tumors differ from those of normal microvasculature (J
  • Neomicrovasculature induced by angiogenic factors from malignant cells was reported to possess altered pharmacological reactivity to some vasoconstricting agents, compared with neomicrovasculature that was not induced by neoplastic cells (S P Andrade and W T Beraldo, Pharmacological reactivity of neoplastic and non-neoplastic associated neovasculature to vasoconstrictors, Int J Exp. Pathol 79(6) 425-32 [1998])
  • combretastatin A-4 was shown to cause vascular damage and occlusion selectively in the blood vessels of malignant tumors compared to normal blood vessels (G G Dark et al, Combretastatin A-4, an agent that displays potent and selective toxicity toward tumor vasculature, Cancer Res 57(10) 1829-34 [1997], D J Chaplin et al.
  • Anti-vascular approaches to solid tumour therapy evaluation of combretastatin A4 phosphate, Anticancer Res 19(1 A) 189-95 [1999])
  • Monoclonal antibodies have been directed to antigens and antigemc combinations specific to endothelial cells of pathologic neovasculature, such as vascular cell adhesion molecule
  • VCAM phosphatidylse ⁇ ne
  • PS phosphatidylse ⁇ ne
  • PSMA prostate-specific membrane antigen
  • the blood-brain barrier is a transvascular permeability barrier thought to result from the interendothelial tight junctions formed by the cerebrovascular endothelial cells of brain capillaries and arterioles in both normal and abnormal brain tissue, the maintenance of the blood-brain barrier possibly involves endogenous nitric oxide production and a cyclic GMP-dependent mechanism (Liu, S M and Sundqvist, T , Nitric oxide and cGMP regulate endothelial permeability and F-actin distribution in hydrogen peroxide-treated endothelial cells, Exp Cell Res 235(1) 238-44 [1997])
  • the blood-brain barrier protects the brain from changes in the composition of the systemic blood supply (e g , in electrolytes) or from blood-borne macromolecules, such as immunoglobulins or other
  • Neuwelt et al. used an intracarotid injection of hypertonic mannitol to osmotically disrupt the blood-brain barrier They reported that this enhanced the uptake by brain tissue of inactivated HSV-1 particles that were administered immediately afterward by intracarotid bolus injection (E A Neuwelt et al., Delivery of ultraviolet-inactivated 35S- herpesvirus across an osmotically modified blood-brain barrier, J Neurosurg 74(3) 475-79 [1991], Also, S E Doran etal, Gene expression from recombinant viral vectors in the central nervous system after blood-brain barrier disruption, Neurosurgery 36(5) 965-70 [1995], G Nilaver et al, Delivery of herpesvirus and adenovirus to nude rat intracerebral tumors after osmotic blood-brain barrier disruption, Proc Natl Acad Sci USA 92(21) 9829-33 [1995])
  • LTC sub 4 Intracarotid infusion of leukot ⁇ ene C sub 4 (LTC sub 4) selectively increases the permeability in brain tumor capillaries without affecting the permeability in normal brain capillaries
  • the effect of LTC sub 4 on brain tumor capillaries is, however, limited to small molecules and it can only slightly increase the permeability of those small molecules in abnormal brain tissue relative to normal Accordingly, LTC. sub 4 does not significantly increase the delivery of some larger water soluble molecules to brain tumors or other abnormalities
  • vasoactive nanopeptide bradykinin and agonists or polypeptide analogs thereof have been injected intravenously to increase blood-brain barrier permeability to co-administered neuropharmaceutical or diagnostic agents
  • bradykinin (B Malfroy-Camine, Method for increasing blood-brain barrier permeability by administering a bradyki m agonist of blood-brain barrier permeability, U S Patent No 5,112,596. J W Kozarich et al, Increasing blood brain barrier permeability with permeabihzer pephdes, U S Patent No 5,268,164) Intracarotid infusion of bradykinin will selectively increase permeability 2- to 12-fold in brain tumor and ischemic brain capillaries for molecules ranging in molecular weight from 100 to 70,000 Daltons (Inamura, T et al, Bradykinin selectively opens blood-tumor barrier in experimental brain tumors, J Cereb Blood Flow Metab 14(5) 862-70 [1994]) Bradykinin does not increase permeability in the normal blood brain barrier except at very high doses (Wirth, K et al, DesArg9-D-Arg[Hyp3,Thi5,D-T ⁇ c7,0 ⁇ c8
  • a method for selectively delivering to abnormal brain tissue a neuropharmaceutical agent (e g , 5-fluorouracil, cisplatin, methotrexate, or monoclonal antibodies) or a diagnostic agent (e g , technicium-99 glucoheptonate, gallium-EDTA, and ferrous magnetic or iodinated contrasting agents) employed intracarotid infusion of bradykinin, or a bradykinin analog, such as RMP-7, the bradykinin or bradykinin analog was administered approximately contemporaneously with the agent (K L Black, Method for selective opening of abnormal brain tissue capillaries, U S Patent Nos 5,527,778 and 5,434,137) Enhanced transvascular delivery of HSV-derived viral particles to malignant cells in
  • the calcium-activated potassium channel (K ⁇ ) is an important regulator of blood vessel tone (Nelson MT, Quayle JM Physiological roles and properties of potassium channels in arterial smooth muscle, Am J Physiol 268(4 Pt 1) C799-822[1995], Bang, L et al, Nitroglycerin-mediated vasorelaxatwn is modulated by endothelial calcium-activated potassium channels, Cardiovasc Res 43(3) 772-78 [1999])
  • the KCa channel is ubiquitously distributed in tissues as and subunits Its activity is triggered by depolarization and enhanced by an increase in cytosolic calcium di-cation (Ca 2+ ) A local increase in Ca 2+ is sensed by the extremely sensitive brain -subunit of the K Ca , directed towards the cytoplasm in the cell, that allows a significant potassium cation flux through these channels Under conditions when intracellular cyclic 3', 5' adenosine monophosphate (cAMP) concentration rises in vascular end
  • Minoxidil sulfate and chromakalim are reported to be activators of K ATP (A D Wickenden et al, Comparison of the effects of the K(+)-channel openers cromaka m and minoxidil sulphate on vascular smooth muscle, Br J Pharmacol, 103(1) 1148-52 [1991])
  • guanosine 3',5'-cyclic monophosphate commonly known as cyclic GMP (cGMP)
  • cGMP cyclic GMP
  • effector proteins (1) cGMP-dependent protein kinases, which mediate protein phosphorylation, (2) cGMP-gated ion channel protein kinases, which mediate cation influx across the plasma membrane, and (3) phosphodiesterases, which mediate cyclic nucleotide catabo sm
  • cGMP-dependent protein kinases which mediate protein phosphorylation
  • cGMP-gated ion channel protein kinases which mediate cation influx across the plasma membrane
  • phosphodiesterases which mediate cyclic nucleotide catabo sm
  • cGMP guanylyl cyclase
  • a nitric oxide-activated enzyme Patel, A I and Diamond, J , Activation of guanosine 3 ',5 '-cyclic monophosphate (cGMP)-dependent protein kinase in rabbit aorta by nitroglycerin and sodium nitroprusside, !
  • nitric oxide participates in the regulation of microvascular tone (Joo, F et al, Regulation of the macromolecular transport in the brain microvessels: the role of cyclic GMP, Brain Res 278(1-2) 165-74 1983])
  • glial tumors and ischemic tissue are more immunopositive for nNOS and eNOS relative to normal brain (Cai, Z et al , Prenatal hypoxia-ischemia alters expression and activity of nitric oxide synthase in young rat brain and causes learning deficits, Brain Res Bull 49(5) 359-65 [1999], Nakano, S et al, Increased brain tumor microvessel permeability after intracarotid bradykinm infusion is mediated by nitric oxide, Cancer Research, 56 4027-4031 [1996], Faraci, F M et al, Role of soluble guanylate cyclase in dilator responses of the cerebral microcirculation, Brain Res 821
  • cGMP-dependent protein kinases PKG or cGK
  • ATP-dependent phosphorylation directly or indirectly activate calcium-dependent potassium channels
  • cGMP -dependent protein kinase activates Ca-activated K channels in cerebral artery smooth muscle cells, Am J Physiol 265 [Cell Physiol 34) C299-C303 [1993], Fukao, M et al, Cyclic GMP -dependent protein kinase activates cloned BK Ca channels expressed in mammalian cells by direct phosphorylation at serine 1072, 1 Biol Chem 274(16) 10927-35 [1999], Becker, E M etal, The vasodilator-stimulated phosphoprotein (VASP): target ofYC-1 and nitric oxide effects in human and rat platelets, !
  • VASP vasodilator-stimulated phosphoprotein
  • nitric oxide can activate K ⁇ by both cGMP-dependent and cGMP-independent mechanisms (Chen, C H et al, Nitric oxide activates Ca 2* -activated Kf channels in cultured bovine adrenal chromaffin cells, Neurosci Lett 248(2) 127-29 [1998], Vaali, K et al, Relaxing effects of NO donors on guinea pig trachea in vitro are mediated by calcium-sensitive potassium channels, J Pharmacol Exp Ther 286(1) 110-14 [1998], Sobey,
  • Bradykinin is thought to increase [Ca 2 ⁇ and thus may activate K ⁇ channels While some other known activators of IC ⁇ do not act as vasodilators, for example, 1,3-dihydro-l- [2-hydroxy-5-(trifluoromethyl)phenyl]-5-(trifluoromethyl)-2H-benzimidazol-2-one (NS- 1619,
  • Kc a may play an important role in vasodilatation mediated by vasodilators, such as bradykinin, nitric oxide donors, cyclic guanosine monophosphate (cGMP), and guanylyl cyclase activators (Berg T , Koteng O , Signaling pathways in bradykinin- and nitric oxide-induced hypotension in the normotensive rat; role of Kf -channels, Br J Pharmacol ,121(6) 1113-20 [1997], Bolotina, V M et al.
  • vasodilators such as bradykinin, nitric oxide donors, cyclic guanosine monophosphate (cGMP), and guanylyl cyclase activators
  • Nitric oxide directly activates calcium-dependent potassium channels in vascular smooth muscle, Nature 368(6474) 850-3 [1994], Robertson, B E , et al, cGMP -dependent protein kinase activates Ca-activated K channels in cerebral artery smooth muscle cells, Am J Physiol 265(1 Pt 1) C299-303 [1993], Sobey, C G et al, Mechanisms of bradykinin-induced cerebral vasodilatation in rats.
  • Bradykinins action as a powerful vasodilator is disadvantageous when using bradykinin to open the blood-brain barrier to therapeutic anticancer agents Bradykinin or its analogs may adversely lower blood pressure, reduce cerebral blood flow, or contribute to brain edema in some patients (E g , A M Butt, Effect of inflammatory agents on electrical resistance across the blood-brain barrier inpial microvessels of anesthetized rats, Brain Res 696(1-2) 145-50 [1995]) In addition, bradykinin constricts smooth muscle and stimulates pain receptors Consequently,
  • the present invention relates to a method of delivering a medicant to an abnormal brain region in a mammalian subject, including a human
  • the method includes administering to the subject a potassium channel activator (i e , activator of calcium- or ATP-dependent potassium channels [K Ca or K ATP ])
  • Potassium channel activators include direct agonists (other than bradykinin or bradykinin analogs), such as NS-1619 or minoxidil
  • Potassium channel activators also include compounds that indirectly activate potassium channels, for example nitric oxide, nitric oxide donors, and other activators of guanylyl cyclase Activators of cyclic GMP-dependent protein kinase, which activates calcium-dependent potassium channels, are also included
  • the potassium channel activator is administered to the subject under conditions and in an amount sufficient to increase the permeability to the medicant of a capillary or arteriole delivering blood to cells of the abnormal brain region in the subject Simultaneously or
  • the present invention also relates to a method of delivering a medicant to a malignant tumor in the brain or anywhere in the body of a mammalian subject
  • the method involves administering to the subject a potassium channel activator, such as a potassium channel agonist other than bradykinin or a bradykinin analog, under conditions and in an amount sufficient to increase the permeability to the medicant of a capillary or arteriole delivering blood to cells of the malignant tumor in the subject Simultaneously or substantially simultaneously with the potassium channel activator the medicant is administered to the subject, and it is delivered selectively to the malignant cells compared to non-malignant cells by virtue of the potassium channel activator
  • the inventive method is useful in treating any kind of malignant tumor by increasing the selectivity of drug delivery to neoplastic tissue, thereby minimizing damage to non-malignant tissue from medicants, including cytotoxic chemotherapeutic agents, and focusing the therapeutic or diagnostic action of the agents
  • this invention also directed to a method of treating a
  • the present invention also relates to a pharmaceutical composition that comprises a combination of a potassium channel activator, other than bradykinin or a bradykinin analog, formulated in a pharmaceutically acceptable solution together with a medicant for delivery by intravascular infusion or bolus injection into a mammal, such as a human
  • a pharmaceutical composition that comprises a combination of a potassium channel activator, other than bradykinin or a bradykinin analog, formulated in a pharmaceutically acceptable solution together with a medicant for delivery by intravascular infusion or bolus injection into a mammal, such as a human
  • a pharmaceutical composition is useful in practicing the inventive methods
  • the invention also relates to a kit for enhancing the delivery of a medicant to an abnormal brain region and/or to a malignant tumor
  • IBTX iberiotoxin
  • ODQ a selective inhibitor of soluble guanylyl cyclase, lH-[l,2,4]oxadiazolo[4,3-a]quinozalin-l-one
  • Figure 2 shows the enhancing effect of the nitric oxide donor diethylamine-NONOate (DEA/NO) on blood-tumor barrier permeability to Evans blue stain in malignant RG2 glioma tissue in Wistar rats
  • Figure 2A shows a brain section from a rat treated with phosphate buffered saline (PBS only control)
  • Figure 2B shows a brain section from a DEA/NO-treated rat
  • Figure 4 shows transendothelial vesicular transport in a RG2 tumor capillary RG2 tumor-bearing brain sections from Wistar rats were prepared after a 15-minute intracarotid infusion with PBS (0 8 mL)(Figure 4A, 54,000x magnification), bradykinin (10 ⁇ g min "1 kg "x )( Figure 4B, 87,000x magnification), or NS-1619 (5 3 ⁇ g min "1 kg “1 , Figure 4C, 87,000x magnification)
  • TEM analysis of the tumor center section shows that K Ca activators bradykinin and NS-1619 increase pinocytotic transport vesicles in the endothelial cytoplasm
  • Figure 5 shows that a potassium channel activator (bradykinin) increases transport of horse radish peroxidase (HRP) from the tumor capillary lumen through endothelial pinocytotic vesicles
  • HRP horse radish peroxidase
  • FIG 7 shows an increase in the unidirectional transport constant caused by the K ATP activator minoxidil sulfate and the K Ca activator bradykinin
  • Figure 8 shows that bradykinin-induced increase in K, was not attenuated by glibenclamide, while IBTX significantly decreased the effect caused by bradykinin
  • Figure 9 shows that the minoxidil sulfate-induced increase in K, was attenuated by glibenclamide, while IBTX failed to block the effect
  • Figure 10 illustrates increased micro vascular permeability in an ischemic brain region as a result of treatment with a potassium channel activator K, is shown for bradykinin-treated (black bars) and control animals (gray bars) in paired histograms, tissues tested were (left to right) caudate putamen, cortex, caudate putamen contralateral side, and cortex contralateral side
  • Figure 10A shows that blood-brain barrier permeability after one hour of ischemia was not affected by bradykinin treatment compared to the vehicle-treated group (MCA occlusion for
  • Figure 10B shows that bradykinin significantly increased permeability in ischemic infarct penumbra after 2 hours of MCA occlusion, followed by 1 hour of reperfusion (Inset autoradiograph)
  • Figure 11 shows that potassium activators enhance permeability of microvasculature in ischemic brain tissue No change in blood-brain barrier permeability at the infarct brain tissue
  • Figure 12A shows the enhancing effect of NS-1619 on blood-tumor barrier permeability to [ 14 C] -aminoisobutyric acid (AIB) tracer (left) compared to the effect on blood-brain barrier permeability in normal brain tissue adjacent (middle) and contralateral (right) to malignant RG2 glioma tissue in Wistar rats
  • Figure 12B shows the enhancing effect of minoxidil sulfate on blood-tumor barrier permeability to [ 14 C]ATB tracer (left) compared to the effect on blood-brain barrier permeability in normal brain tissue adjacent (middle) and contralateral (right) to malignant RG2 ghoma tissue in Wistar rats
  • Figure 14 shows specific inhibition by iberiotoxin (IBTX, 2 3 ⁇ g kg “1 min “1 ) of the permeability increasing effect of NS-1619 (26 5 ⁇ g kg “1 min “1 )
  • the K was determined in RG2 tumor-bearing Wistar rats using [ 14 C]AIB with NS-1619 (26 5 ⁇ g kg "1 min "1 ) with or without
  • Figure 15 shows intense over-expression of K Ca as indicated by anti-K Ca immunostain of glioma tissue (Fig 15B), compared to normal contralateral brain tissue (Fig 15 A) Magnification is lOOx
  • Figure 16 shows intense over-expression of K ATP as indicated by anti-K ATP (anti-Kir 6 2) immunostain of RG2 (Fig 16C) or C6 (Fig 16D) glioma tissue from tumor centers, compared to normal brain tissue (Fig 16 A) and RG2 tumor periphery (Fig 16B) Magnification is lOOx
  • inventive methods are useful for selectively delivering a medicant to abnormal brain regions and/or malignant tumors in mammalian subjects
  • the methods involve administering to the mammalian subject a potassium channel activator, other than bradykinin or a bradykinin analog, under conditions and in an amount sufficient to increase the permeability to the medicant of a capillary or arteriole delivering blood to cells of the abnormal brain region and/or to malignant cells of a malignant tumor present in the subject
  • the increase in permeability ranges from at least 2-to 6-fold, compared to controls without the administration of a potassium channel activator.
  • the relative increase in permeability tends to be greater for large molecular weight medicants (e g., about 10,000 to 250,000 Daltons) than for smaller molecular weight substances (e g , about 50-200 Daltons)
  • the abnormal brain regions include regions of brain tissue physiologically directly affected by a physical or biochemical injury, for example, Alzheimers disease, Parkinsonism, trauma, infection, stroke, brain ischemia, or regions of neoplastic growth within the brain, such as benign or malignant brain tumor tissues
  • the present invention is also useful for selectively delivering a medicant to a malignant tumor in the brain or to a tumor elsewhere in the body of a mammalian subject.
  • the inventive technology is useful in the treatment of all kinds of solid malignant tumors, including gliomas, glioblastomas, oligodendrogliomas, astrocytomas, ependymomas, primitive neuroectodermal tumors, atypical meningiomas, malignant meningiomas, neuroblastomas, sarcomas, melanomas, lymphomas, or carcinomas.
  • the tumor to be treated can be contained in the skull, brain, spine, thorax, lung, peritoneum, prostate, ovary, uterus, breast, stomach, liver, bowel, colon, rectum, bone, lymphatic system, skin, or in any other organ or tissue of the subject.
  • inventive methods are useful in treating any mammal, including a human, non-human primate, canine, feline, bovine, porcine or ovine mammal, as well as in a small mammal such as a mouse, rat, gerbil, hamster, or rabbit.
  • the potassium channel activator is an activator of either a calcium-activated potassium channel (K Ca ) of any conductance level, whether of large, intermediate, or small conductance, or of an ATP-sensitive potassium channel (K ATP ). Included are direct agonists of K Ca , such as 1 ,3-dihydro- 1 -[2-hydroxy-5-(trifluoromethyl)phenyl]-5-(trifluoromethyl)-
  • K Ca calcium-activated potassium channel
  • K ATP ATP-sensitive potassium channel
  • potassium channel activators include compounds that indirectly activate potassium channels, for example activators of soluble guanylyl (i.e., guanylate) cyclase, such as nitric oxide, nitric oxide donors, metalloporphyrins (e.g., zinc or tin protoporphyrin IX), YC-1 (a benzyl indazole derivative), or guanylyl cyclase activating proteins (GCAPs).
  • activators of soluble guanylyl (i.e., guanylate) cyclase such as nitric oxide, nitric oxide donors, metalloporphyrins (e.g., zinc or tin protoporphyrin IX), YC-1 (a benzyl indazole derivative), or guanylyl cyclase activating proteins (GCAPs).
  • activators of soluble guanylyl (i.e., guanylate) cyclase such as
  • minoxidil 2,4-diamino-6-piperidino pyramidine-3 -oxide
  • pinacidil ((+/-)-N-cyano-N'-4-pyridinyl-N"-(l,2,2-trimethyl propyl)- guanidine
  • a preferred potassium channel activator is nitric oxide gas, which is fully permeable across biological membranes.
  • Inhalable nitric oxide gas can be administered to the subject by mask in a controlled gas mixture as is known in the art. (E.g., Kieler- Jensen, N. et al.
  • the concentration in the gas mixture of nitric oxide (NO) is preferably about 1 to 100 ppm NO, more preferably about 4 to 80 ppm NO, and most preferably about 20 to 40 ppm
  • Nitric oxide donors are compounds that produce NO-related physiological activity when applied to biological systems
  • NO-donors can mimic an endogenous NO-related response or substitute for an endogenous NO deficiency
  • NO-donors can mimic an endogenous NO-related response or substitute for an endogenous NO deficiency
  • NO-donors can mimic an endogenous NO-related response or substitute for an endogenous NO deficiency
  • NO-donors can mimic an endogenous NO-related response or substitute for an endogenous NO deficiency
  • NO + , NO 0 , or NO " NO
  • the redox state of NO makes a substantial difference to the NO donors reactivity towards other biomolecules, the profile of by-products, and the bioresponse (Feelisch, M , The use of nitric oxide donors in pharmacological studies, Naunyn-Schmiedebergs Arch Pharmacol 358 113-22 [1998])
  • Some classes of NO donors require enzymatic cat
  • nitric oxide donors include organic nitrate compounds, which are nitric acid esters of mono- and polyhydric alcohols Typically, these have low water solubility, and stock solutions are prepared in ethanol or dimethyl sulfoxide (DMSO) Examples are glyceryl trinitrate (GTN) or nitroglycerin (NTG), pentaerythrityl tetranitrate (PETN). isosorbide dinitrate (ISDN), and isosorbide 5-mononitrate (IS-5-N) Administration of organic nitrates can be done intravenously, intraperitoneally, intramuscularly, transdermally, or in the case of PETN, ISDN, NTG, and IS-5-N, orally
  • GTN glyceryl trinitrate
  • NTG nitroglycerin
  • PETN pentaerythrityl tetranitrate
  • ISDN isosorbide dinitrate
  • IS-5-N isosorbide 5-mononitrate
  • S-nitrosothiol compounds including S-nitroso-N-ace1yl-D,L-per ⁇ ciUamine (SNAP), S-nitrosoglutathione (SNOG), S-nitrosoalbumin,
  • S-nitrosocysteine S-nitrosothiol compounds are particularly light-sensitive, but stock solutions kept on ice and in the dark are stable for several hours, and chelators such as EDTA can be added to stock solutions to enhance stability Administration is preferably by an intravenous or intra-arterial delivery route
  • nitric oxide donors include sydnonimine compounds, such as molsidomine (N-ethoxycarbonyl-3-morpholino-sydnonimine), linsidomine (SLN-1, 3 -morpholino-sydnonimine or 3 -morpholinylsydnoneimine or
  • a most preferred nitric oxide donor is chosen from among the so-called NONOate compounds
  • the NONOates are adducts of NO with nucleophilic residues (X " ), such as an amine or sulfite group, in which an NO dimer is bound to the nucleophilic residue via a nitrogen atom to form a functional group of the structure X[-N(O)NO] "
  • X nucleophilic residues
  • the NONOates typically release NO at predictable rates largely unaffected by biological reactants, and NO release is thought to be by acid-catalyzed dissociation with the regeneration of X " and NO This property is particularly useful in accordance with the inventive methods of selectively delivering a medicant, because abnormal brain regions and malignant tumors can typically be relatively hypoxic and possess a relatively low ambient pH (e g , pH 6 5-7 0), which concentrates release of NO selectively in the microvasculature of the abnormal brain region or malignant tumor
  • NONOates include most preferably diethylamine-NONOate (DEA/NO, N-Ethylethanamine l , l -Diethyl-2-hydroxy-2-nitrosohydrazine (1 1 ) or l-[N,N-diethylamino]diazen-l-ium-l,2-diolate)
  • Other preferred NONOates include diethylene triamine-NONOate(DETA/NO, 2,2'-Hydroxynitrosohydrazino]bis-ethanamine), spermine-NONOate (SPER/NO, N-(4-[-l-(3-Aminopropyl)-2-hydroxy-2-nitrosohydrazino] butyl)-l,3-propanediamine), propylamino-propylamine-NONOate (PAPA/NO, 3-(2-Hydroxy-2-nitroso-l-propylhydrazino)-l-propanamine or (Z)-l-[N-
  • NONOates are preferably administered intravenously or intra-arterially
  • Nitric oxide donors have different potencies (Ferraro, R et al, Comparative effects of several nitric oxide donors on intracellular cyclic GMP levels in bovine chromaffin cells: correlation with nitric oxide production, Br J Pharmacol 127(3) 779-87 [1999])
  • DEA/NO is among the most potent nitric oxide donors, with a half-life of about 2 to 4 minutes, less potent are PAPA/NO (t 1/2 about 15 minutes), SPER/NO (t 1/2 about 34-40 minutes), even less potent
  • Stock solutions of NO donors are preferably made up freshly before use (at the appropriate pH for each particular NO donor), chilled on ice, and protected from light (e g , by the use of darkened glass vials wrapped in aluminum foil), although organic nitrates can be stored for months to years if the vial is properly sealed
  • final dilutions are prepared in pharmaceutically acceptable buffer and the final pH of the NO donor-containing buffer is checked for physiological suitability, especially when strongly acidic (e g , hydrochlo ⁇ de salts) or alkaline (e g , NONOates) stock solutions are used
  • the product of NO exposure time and NO concentration largely determines the quality and magnitude of the biological response to exogenously supplied NO Short-lived NO donors, such as DEA/NO, are most preferably admimstered by continuous infusion rather than by bolus to avoid delivering only a short burst of NO
  • potassium channel activators include activators of any endogenous species of cyclic GMP-dependent protein kinase (PKG or cGK), that activates a potassium channel directly (e g , by directly phosphorylating K Ca ) or indirectly (e g , by phosphorylating another regulatory protein that directly modulates Kc a activity) Included are activators of cGK I, cGK II, or other isoforms of cGMP-dependent protein kinase (e g , Smolenski, A et al. [1998])
  • PKG activators include, but are not limited to, octobromo-cyclic GMP (8Br-cGMP) and dibutyryl cyclic GMP
  • useful potassium channel activators are pharmaceutically acceptable molecular conjugates or salt forms that still have activity as potassium channel activators as defined herein
  • An example is minoxidil sulfate, but other pharmaceutically acceptable salts comprise anions other than sulfate, such as chloride, carbonate, bicarbonate, nitrate, or the like
  • Other embodiments of pharmaceutically acceptable salts contain cations, such as sodium, potassium, magnesium, calcium, ammonium, or the like
  • useful potassium channel activators are hydrochloride salts
  • the potassium channel activator employed in the inventive methods is one other than the vasodilator bradykinin (Arg-Pro-Pro-Gly-Phe-Ser-Pro-Phe-Arg), or a polypeptide bradykinin analog, such as receptor mediated permeabilizer (RMP)-7 or A7 (e g , Kozarich et ⁇ /, U S Patent No 5,268,164 and PCT Application No WO 92/18529)
  • RMP receptor mediated permeabilizer
  • Other analogs of bradykinin include related peptide structures which exhibit the same properties as bradykinin but have modified amino acids or peptide extensions on either terminal end of the peptide
  • Examples of bradykinin analogs include [phe sup 8 (CH sub 2 NH) Arg sup 9 ]-bradykinin, Nacetyl [phe sup.8 (CH sub 2 ⁇ NH ⁇ Arg sup 9 ] bradykinin and desArg9-bradykinin
  • an effective amount of YC-1 for humans is about 15 to about 45 micrograms per kg body mass, and for nitric oxide donors generally about 15 to about 45 micrograms per kg body mass
  • the optimal amount for each individual for any particular potassium channel activator can be determined by routine means involving close physiological monitoring over the delivery period
  • the dose can be administered in a bolus injection, but is preferably administered by infusion over a period of one to thirty minutes, and most preferably during a period of one to fifteen minutes
  • a dose rate of about 0 75 to about 100 ⁇ g kg "1 min "1 is most suitable.
  • the medicant is administered simultaneously or substantially simultaneously with the potassium channel activator, and the medicant is delivered by the blood stream selectively to the abnormal brain region and/or to the malignant cells compared to normal brain tissue or non-malignant cells
  • Simultaneously means that the medicant is administered contemporaneously or concurrently with the potassium channel activator
  • Substantially simultaneously means that the medicant is administered within about one hour after the potassium channel activator is last administered, preferably within about 30 minutes after, and most preferably, is administered simultaneously with the potassium channel activator
  • substantially simultaneously means that the medicant is administered within about 30 minutes before, and preferably within about 15 minutes before the potassium channel activator is first administered
  • the methods of delivering a medicant to an abnormal brain region and/or to a malignant tumor in a mammalian subject are effective in selectively delivering any medicant across the microvascular of an abnormal brain region and/or malignant tumor
  • the medicant is a drug, i e , a chemotherapeutic agent
  • chemotherapeutic agents including therapeutic cytotoxic agents (e g , cisplatin, carboplatin, methotrexate, 5-fluorouracil, amphotericin), naked DNA expression vectors, therapeutic proteins, therapeutic oligonucleotides or nucleotide analogs, interferons, cytokines, or cytokine agonists or antagonists, adrenergic agents, anticonvulsants, anti-trauma agents, or any neuropharmaceutical agent used to treat or prevent an injury or disorder of the brain
  • Chemotherapeutic agents also include ischemia-protective drugs such as N-methyl-D-aspartate (NMD A)
  • TGF transforming growth factors
  • the medicant also includes anticancer chemotherapeutic agents
  • anticancer chemotherapeutic agents are cytotoxic agents, such as 5-fluorouracil, cisplatin, carboplatin, methotrexate, daunorubicin, doxorubicin, vincristine, vinblastine, or a cytotoxic alkylating agent, such as, but not limited to, busulfan (1,4-butanediol dimethanesulphonate, Myleran, Glaxo
  • the anticancer chemotherapeutic agents are particularly useful in practicing the method of selectively delivering a medicant to a malignant tumor, in the brain or in any other tissue of the body, and in the method of treating a malignant tumor in a human subject
  • Medicants also include any therapeutic viral particle, for example an adenovirus-derived or herpes simplex virus (HSV)-derived viral vector for delivering genetic material to a cellular target in vivo
  • Medicants also include diagnostic agents, such as imaging or contrast agents, for example, radioactively labeled substances (e g , [ 99 Tc]-glucoheptonate), gallium-labeled imaging agents (e.g , gallium-EDTA), ferrous magnetic, fluorescent, luminescent, or iodinated contrast agents
  • any of the afore-mentioned medicants having anticancer activity can also be used in practicing the method of selectively delivering a medicant to a malignant tumor or the method of treating a malignant tumor in a human
  • the medicant can be a molecular substance having a molecular weight between about 50 Daltons and about 250 kD Or it can be a particle, such a s a viral particle, having a diameter between about 50 to 250 nanometers
  • the medicant can be, but is preferably not, an agent that is highly lipid soluble and thus inherently able to penetrate cell membranes, for example nitrosourea.
  • the amount of medicant that is employed is within a conventional dose range for each medicant, however by practicing the inventive method, the increased transvascular permeability afforded can provide a greater selective therapeutic effect per dose or permit a lower effective dose to be used, if desired, for example to lessen systemic toxic effects from anti-cancer medication in a particular subject.
  • the medicant is administered by any appropriate method that can deliver it to the blood stream. Typically, this is by intravenous, intramuscular, or intra-arterial (including intracarotid) injection or infusion. However, for some applications other acceptable delivery routes can be used as long as the dose of medicant enters the blood stream substantially simultaneously with the potassium channel activator.
  • Examples include ingestion (e.g., of a powder, suspension, solution, emulsion, tablet, capsule or caplet); subcutaneous injection; stereotactic injection; or transdermal or transmucosal delivery by adhesive patch, suppository or gel for delivery through the skin, mucosa or epithelium of the mouth including the sublingual epithelium, the rectum, or the vaginal epithelium.
  • ingestion e.g., of a powder, suspension, solution, emulsion, tablet, capsule or caplet
  • subcutaneous injection e.g., of a powder, suspension, solution, emulsion, tablet, capsule or caplet
  • stereotactic injection e.g., stereotactic injection
  • transdermal or transmucosal delivery by adhesive patch, suppository or gel for delivery through the skin, mucosa or epithelium of the mouth including the sublingual epithelium, the rectum, or the vaginal epithelium.
  • the medicant is administered together with the potassium channel activator in a pharmaceutical composition of the present invention.
  • the inventive pharmaceutical composition comprises a combination of a potassium channel activator, other than bradykinin or a bradykinin analog, as described above, formulated in a pharmaceutically acceptable solution together with a medicant, as described above, for delivery by intravascular infusion or bolus injection into a mammal, such as a human.
  • the solution is thus suitably balanced, osmotically (e.g., about 0.15 M saline) and with respect to pH, typically between pH 7.2 and 7.5; preferably the solution further comprises a buffer, such as a phosphate buffer (e.g., in a phosphate buffered saline solution).
  • the solution is formulated to deliver a dose rate of about 0.075 to 1500 micrograms of potassium channel activator per kilogram body mass in a pharmaceutically acceptable fluid volume over a maximum of about thirty minutes.
  • the solution is preferably formulated to deliver a dose rate of about 0.075 to 150 micrograms of potassium channel activator per kilogram body mass in a pharmaceutically acceptable fluid volume over a period of up to about thirty minutes
  • the invention also relates to a kit for enhancing the delivery of a medicant to an abnormal brain region and/or to a malignant tumor
  • the kit is an assemblage of materials or components, including a potassium channel activator, other than bradykinin or a bradykinin analog, as described above
  • the kit contains instructions for using the potassium channel activator to enhance the permeability of abnormal microvascular, including neomicrovasculature, to a medicant in general, or alternatively, to a particular medicant
  • the kit also contains other components, such as a particular medicant in any pharmaceutically acceptable formulation, or paraphernalia for injection or infusion, for example syringes, infusion lines, clamps, and/or infusion bags/bottles, which can contain a pharmaceutically acceptable infusible formulation of the potassium channel activator with or without a particular medicant also contained therein
  • the materials or components assembled in the kit can be provided to the practitioner stored in any convenient and suitable ways that preserve their operability and utility
  • the components
  • RG2 Malignant Cell Line and Tumor Implantation
  • RG2 cells derived from a rat glioma are kept frozen until use, then are thawed and maintained in a monolayer culture in F12 medium with 10% calf serum In some experiments C6 glioma cells were used
  • the Wistar rats (approximately 140-160 g body weight) were anesthetized with intra-peritoneal ketamine (50 mg/kg), and glial cells (1 x 10 5 ) were implanted into the right hemisphere, but not the contralateral hemisphere, by intracerebral injection suspended in 5 ⁇ L F12 medium (1-2% methylcellulose) by a Hamilton syringe
  • the implantation coordinates were 3 -mm lateral to the bregma and 4 5 mm
  • Nitric oxide donors included sodium 2-(N,N-diethylamino)-diazenolate-2-oxide (DEA/NO), a nitric oxide-donor with a half-life of 2 1 min or PAPA/NO ([Z]-l-[N-[3-Amino propyo]-N-[N-propyo amino] diazen-l-ium-l,2-diolate, (Alexis Corp ), a nitric oxide-donor with a half-life of 15 minutes DEA/NO or PAPA/NO were dissolved in PBS and administered to RG2 glioma-bearing rats to determine permeability (K,) of [ 14 C]-AIB without affecting the physiological parameters [ 14 C]-AIB was administered intravenously as a
  • K Unidirectional Transport Constant
  • K The unidirectional transfer constant K, for [ 14 C] ⁇ - aminoisobutyric acid (AIB) was measured in normal tissue and tumor tissue as an indicator of permeability across the blood-tumor and blood-brain barriers Quantitative autoradiography was used to obtain K, values ( ⁇ L g "1 min "1 ) The initial rate for blood-to-brain transfer was calculated using a previously described equation (Ohno, K, et al, Lower limits of cerebrovascular permeability to nonelectrolytes in the conscious rat, Am J Physiol 235(3) H299-307, [1978], Inamura, T , et al. , Bradykinin selectively opens blood-tumor barrier in experimental brain tumors, J.
  • NS-1619 was dissolved in 25% ethanol and diluted with PBS to obtain various concentrations for infusion NS-1619 was administered by intracarotid infusion (dose rates 0, 13, 26 5, 53, 80, 100 and 110 ⁇ g kg "1 min "1 , all at 53 3 ⁇ L/min) to RG2 glioma-bearing rats to determine a dose that produces increased permeability (K,) of [ 14 C]-AIB, which was administered intravenously K, was determined as described above Physiological parameters were monitored during the experiments
  • the unidirectional transport constant (K,) for [ 14 C]-AIB to the tumor center and tissue surrounding tumor was determined after intracarotid infusion of bradykinin (10 ⁇ g min "1 kg "1 for 15 min) or minoxidil sulfate (26 6 ⁇ g min "1 kg "1 for 15 min) or co-infusion of bradykinin with minoxidil sulfate for 15 min Physiological parameters were monitored during the experiments
  • the selective K ATP inhibitor, glibenclamide 13 3 ⁇ g min "1 kg "1 for 15 min was used to determine whether inhibition of K ATP channel blocks bradykinin-inducible or minoxidil sulfate-inducible increases in blood-tumor barrier permeability
  • RG2 glioma cells were implanted into the right hemisphere of rat brains as described above Seven days after implantation, regional permeability study was performed by intracarotid infusion of octobromo-cyclic GMP (8Br-cGMP, 16 7 ⁇ g kg "1 min "1 ), an activator of cyclic GMP-dependent protein kinase (PKG), without or with PKG inhibitors
  • Rat brain tissue was prepared for TEM analysis by the following procedures After experiments involving intracarotid infusion of potassium channel activators, inhibitors, horse radish peroxidase (HRP), and/or vehicle control buffers, rats were infusion-fixed from the heart first with PBS (50-100 mL) followed with 1 0% glutaraldehyde (250 mL) The brain tissue was cut cronally to expose the tumor region, and the region of interest was selected, sliced into small pieces of about 1 mm thickness, and was immersion-fixed in 1 0% glutaraldehyde, at 4°C for 2 hours The sample was rinsed in 5% sucrose / 0 1 M PBS at 4°C, overnight, with continuous shaking and changes of the solution The samples then were immersion-fixed with 1% OsO4 at 4°C for 2 hours with continuous shaking The sample was then dehydrated with an increasing concentration (50-100%) of ethanol at 4°C for 15 minutes with constant shaking and frequent changes of solution Samples
  • the density of the vesicles was determined for three vessels selected from each rat (each treatment group contained 5-6 rats) by taking from each blood vessel four electron micrographs as a test zone at high magnification
  • the test zones were selected randomly, such as at 3, 6, 9, and 12 o'clock on the EM screen
  • the areas of the test zones were measured, and the number of vesicles was counted by a person who was not aware of the background of the micrographs
  • Vesicular density was expressed as the number of vesicles per square micrometer of cytoplasm
  • the proportion of the total vesicular area to the cytoplasmic area was also determined using the same micrographs total vesicular area was measured and the proportion to the cytoplasm which included those vesicles was calculated and expressed as percentage
  • the mean diameter of the vesicles was also calculated
  • Temporary Middle Cerebral Artery fMCA Temporary Middle Cerebral Artery fMCA occlusion MCA occlusion was carried out as described by Liu, Y et al, The time course of glucose metabolism in rat cerebral ischemia with middle cerebral artery occlusion-reperfuswn model and the effect ofMK-80, Neurological Research 18 (6) 505-508 (1996) with slight modifications Briefly, the right MCA was occluded temporarily with a silicone rubber cylinder inserted from the bifurcation of the intracarotid artery after ligation of ipsilateral common and external carotid arteries The cylinder is made of 4-0 nylon 17 mm long surgical thread, coated with silicone mixed with a hardener to grade the diameter of the distal 5 mm to 0 25-0 30 mm The thread was inserted into the intracarotid artery through the external carotid artery near the bifurcation and ligated at the point of insertion The silicone rubber cylinder
  • Evans blue dye was injected intravenously after 50 minutes of reperfusion (five minutes after commencing administration of potassium channel activator and/or inhibitor) Ten minutes after injection of Evans blue, the rat was perfused with 200 mL PBS through the heart to wash off excess Evans blue dye from the brain microvessels
  • Nitric oxide donors also increased the permeability of the blood-tumor barrier
  • Figure 2 shows that RG2 glioma tissue was stained in vivo by Evans blue stain (MW 960 82) in DEA/NO-treated Wistar rats (Figure 2B) compared to PBS-treated controls ( Figure 2 A) These results were comparable to the results obtained by in vivo staining by Evans blue using NS-1619 or YC-1 (data not shown).
  • IBTX alone at the dose investigated did not affect the brain-tumor barrier permeability of abnormal capillaries.
  • Kc a channel protein was immunolocalized using a specific antibody as described above.
  • HRP horse radish peroxidase
  • Tissue 3 Infusion 33 Density of the vesicles Total area of the vesicles (%) c (number/m2) b
  • BG basal ganglia
  • PBS phosphate buffer saline vehicle control
  • BK PBS + bradykinin
  • b Values are means SD
  • n number of rats
  • Q Values are means SD
  • n number of capillaries d
  • Potassium channel activators increase permeability in abnormal brain capillaries of ischemic brain region.
  • Figure 10A shows that the permeability of brain microvasculature was not responsive to a potassium channel activator after only one hour of MCA occlusion. This indicates that properties of the microvasculature are changed by prolonged ischemia as the tissue becomes increasingly abnormal.

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AU2001233052A1 (en) 2001-08-07
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