JP2005527611A - 嚢胞性線維症およびその他のil−8依存性疾患治療用の強心配糖体 - Google Patents
嚢胞性線維症およびその他のil−8依存性疾患治療用の強心配糖体 Download PDFInfo
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Abstract
【解決手段】該方法には、オレアンドリンなどの強心配糖体を含む化合物に該細胞を接触させることが含まれる。強心配糖体は、自発的に分泌されるIL-8および他の前炎症性サイトカインのレベルを低減することにより、嚢胞性線維症および他のIL-8依存性疾患を治療するために使用することが可能である。ナノモル濃度の範疇のオレアンドリンが、CF上皮細胞の培養物からのIL-8の分泌を抑制するということが発見された。また、強心配糖体に対する構造活性相関(SAR)も解明されている。
Description
本願発明は、第二に、強心配糖体を含有する組成物の有効量を、本疾患を患う哺乳動物に対して投与することを含む、高レベルのIL-8に特徴付けられる病状を治療する方法を提供する。本願発明によれば、この哺乳類がヒトであってもよい。また、本願発明によれば、高レベルのIL-8は、心肺バイパス手術、心肺停止、炎症性大腸炎、肺疾患および肺の状態、外傷性脳損傷、脳卒中、移植組織不適合性、アルツハイマー病、パーキンソン病、HIV、ウィルス感染症、ならびにシクロオキシゲナーゼ阻害薬抵抗性の発熱、からなる群より選択される状態に起因するものであり得る。
本願発明は、第三に、強心配糖体を含有する組成物の有効量を、嚢胞性線維症を患うヒトに対して投与することを含む、高レベルのIL-8に特徴付けられる状態(病状)を治療する方法を提供する。
本願発明者は、IB-3細胞によるIL-8の分泌は、野生型CFTRのみならず、CPXおよびリン脂質修飾剤MEA(メチルエチルアミン)により抑制されることを発見した。本願発明者は、CFTE細胞からのIL-8の過剰分泌は、CPXによって抑制されることもまた発見した。この知見は、IL-8の分泌が、CF上皮細胞の機能不全の観点から嚢胞性線維症の病理学の理解に関連するものであるというコンセプトを支持するものである。
さらに図1に示されるように、TNFαR1受容体は、TRADD(TNF Receotpr-1 Associated Deth Domain protein;TNF受容体結合性細胞死ドメインタンパク)、TRAF2(TNF Receptor Associated Factor;TNF受容体関連因子)、RIP(TNF Receptor Interacting Protein;TNF受容体相互作用タンパク質)およびCIAP1/2(Inhibitor of Apotpsis Protein 1;抗アポトーシスタンパク1)を含む遺伝子産物の複合体を通じて、TNFαシグナルをIκBキナーゼシステムへと変換する。これらの名称が示唆するように、このシステムは炎症の調節だけではなく、アポトーシス経路の調節にも密接に関連している。例えば、TRADDアダプターはTNFαRと、下流のアポトーシスコンポーネントであるカスパーゼ7、FLICE、FAS抗原、FANおよびTRAMP(図示せず)等との間の相互作用を変換する。細胞にとって可能な、単純な「分裂または死」の選択という状況において、TNF関連遺伝子産生物の一群というものが、双方の目的に用いられるものであると当初は考えられていた。しかしながら、CF細胞の場合、前炎症性経路と前アポトーシス経路との間の相互作用の潜在性は意味のない推測以上のものであるかもしれないということを十分に理解することが重要である。例えば、CF患者の十二指腸生検で観察される腺窩の腸細胞では、断片化DNAを標識するTUNELにおいて10倍の上昇が報告された(マイウリ(Maiuri)ら1997)。さらに、アポトーシスのマーカーであるFASおよびFASリガンド発現は、CF気管支上皮組織およびCF気管支細胞系の培養物において、非CF対照群に対して著しく上昇した(デュリュー(Durieu)ら1999)。アポトーシスの無秩序な制御は、ΔF508-CFTRを発現する異種C127細胞でも観察された(ゴットリエブ(Gottlieb)ら1996)。
オレアンダーは有毒植物として知られており、オレアンドリンおよびオレアンドロゲニン(oleandrogenin)関連化合物等ならびにその他の関連化合物は、全植物の毒性の原因となる(キングズベリー(Kingsbury)1964)。メルクインデックスによれば、ネコに対する静脈注射におけるLD50値は0.3mg/kgである。LD50値とは、50%(この場合は、ネコ)が死に至る用量を意味する。体重が全て水によって占められ、分布が均質であると仮定すれば、これは、0.6μMの濃度に相当する。これらの仮定は見かけの濃度を最小限としているため、多分、LD-50値はより高いものであろう。死のメカニズムは強心配糖体構造およびオレアンドリンの特性による心肺毒性である。セイヨウキョウチクトウの葉を熱湯で抽出した、一種のお茶は、アンビルゼル(Anvirzel)(登録商標)の商品名でサリュドインテグラル(Salud Integral)(衛生登録番号M-07708)、(ホンジュラス共和国)より、「がん、AIDS、C型肝炎およびその他の免疫系関連疾患の治療」の目的で販売されている。容積10mlのバイアルの組成物には150mgのセイヨウキョウチクトウ抽出物が含まれている。抽出物の詳細は、衛生登録証には記載されていないものの、未知の成分が多数含有されているものと思われる(http://www.saludintegral/hn/company_health_registration.htm)。マンナ(Manna)ら(2000)は、1μM濃度のオレアンドリンが、NFκB含有キナーゼ(NIK)周辺を活性化することにより、種々のがん細胞培養物において、腫瘍壊死因子(TNFα)依存性のNFκB活性化を抑制することを報告している。しかしながら、腫瘍細胞は死滅しない。
心肺停止(CPA)となった後、病院の救急救命室に運ばれた患者もまた、高レベルの血清のIL-8およびTNFαを有していた。これらの値は入室後12時間以内、あるいは心拍再開(ROSC)から6時間以内にピークを迎える(イトウ(Ito)ら2001)。また、イトウ(Ito)ら(2001)は、顕著に高レベルのIL-8を有するこれらの患者において、血清IL-8レベルが死をもたらす、あるいは心拍再開後の1週間以内に脳死をもたらす傾向にあることを報告している。エピネフリンの過剰な投与もまた、心拍再開後の顕著に上昇したIL-8に関連している。血清中のIL-8の起源は特定されていない。しかしながら、ナンデイト(Nandate)ら(1999)のデータを考慮すると、中枢起源を疑うことができるであろう。起源が何であれ、ROSCに続くIL-8産生を阻害する薬剤は、心配停止に関連する罹患率および死亡率の改善に有用である可能性がある。
再膨張性の肺水腫(REPE)は、増加する微小血管透過性および炎症性細胞の蓄積のメカニズムによる、虚脱した肺の再膨張にしばしば付随する(ナカムラ(Nakamura)ら2000)。IL-8の局所的な過剰生産が、このプロセスの原因である。抗IL-8抗体の予備投与は、気管支肺胞洗浄(BAL)液における好中球数を減少させるとともにREPEを抑制する。したがって、IL-8を抑制することが可能な薬剤は、肺における再膨張性の肺水腫に対する有用な治療薬であると思われる。
腎臓移植24時間後の移植患者における血清および尿中のIL-8濃度の増加は、その後の拒絶症状の前兆であることを、この著者らは報告している。肺移植の場合、ドナーの気管支肺胞洗浄(BAL)液中のIL-8増加の値は、重篤な初期段階における移植機能障害および初期段階における移植患者の死亡に関連している(フィッシャー(Fisher)ら2001)。フィッシャー(Fisher)ら(2001)は、しばしば移植用肺の源となる、重度の外傷性傷害を受けた患者では、IL-8ならびにIL-8が誘引する好中球が増加レベルにあることが多いことを示唆している。スタングル(Stangl)ら(2001)は、死体腎臓に比べて、非関連の生体腎臓移植ではIL-8レベルが10倍低いことを示している。このことは、生体腎移植からの長期間に渡る成果が優れたものとなる原因である、と著者らは結論付けている。これらのデータは、臓器そのものの治療または移植患者の治療のいずれかにより、移植片によるIL-8の内因的な産生を低減することが可能な薬剤または健康状態は、拒絶反応の発生率および移植患者の死亡発生率を低減すると思われる。
HIV-1に感染した患者は、しばしば神経疾患およびHIV-1に関連する痴呆に続き、活性化T細胞および感染したマクロファージによる脳の浸潤を発現する。クッシュ(Kutsch)ら(2000)は、HIV-1 Tat(72アミノ酸)ペプチドが、星状細胞中のIL-8および関連サイトカインを強力に誘導することを示している。IL-8伝達物質は一時間以内に観察され、IL-8が産生される。IL-8がHIV-1感染を増強するという事実から、IL-8分泌に介入することが可能な薬剤は、HIV-1関連の痴呆を引き起こす中枢神経系におけるHIV-1感染の予防または抑制に有用であるかもしれない。
ある種の発熱はシクロオキシゲナーゼ阻害剤に対して耐性があることが知られており、IL-8の脳血管内投与により引き起こされるタイプの熱は、このカテゴリーに属する(ザンプロニオ(Zampronio)ら1994)。これらのデータは、脳内のIL-8分泌に介入することが可能な薬剤が、シクロオキシゲナーゼ阻害剤への耐性による発熱に対する解熱剤として有用性があることを示唆している。
7種の化合物がオレアンドリンの変異体として特定されるとともに、これらを試験に供して活性を求めた。このデータを表1に示す。試験に供した化合物の化学構造を図5Aおよび5Bに示す。
I,II>III,IV>V,VI>VII>>VIII
高レベルのIL-8の分泌に特徴付けられる病状を治療する方法もまた提供される。高レベルのIL-8の分泌に特徴付けられる病状には、以下のものが含まれる:術後の心肺バイパスのリスク、心肺停止、炎症性大腸炎、アテローム性動脈硬化症、非好酸球性喘息、喘息、非特異性気道過敏症、慢性閉塞性肺疾患、院内肺炎、外傷性脳損傷、脳卒中、脳における再潅流傷害、内毒素血症により誘発される急性呼吸窮迫症候群、糖尿病、増殖性糖尿病網膜症、移植組織不適合(腎移植組織不適合、肺移植組織不適合、膵臓移植組織不適合、腸移植組織不適合、心臓移植組織不適合、膀胱移植組織不適合、多臓器移植組織不適合を含む)、アルツハイマー病、パーキンソン病、HIV-1感染、AIDS、HIV-1関連痴呆、ウィルス感染症、アデノウィルスによる感染、ヒトライノウィルスによる感染、インフルエンザウィルスによる感染、ヘルペスウィルスによる感染、がん、シクロオキシゲナーゼ耐性熱、乾癬、関節リウマチ、シェーグレン症候群、ベーチェット症候群、乾癬性関節炎、糸球体腎炎、熱傷(例えば、日焼けによる熱傷)、急性膵炎、気道熱傷、酸による肺損傷、再膨張性の肺水腫(REPE)。
また、本願発明による強心配糖体を、注射による投与または気道への噴霧による投与を目的として製剤化することも可能である。
代替として、この強心配糖体を点鼻薬または鼻腔用スプレーとして製剤化することも可能である。
本願発明による強心配糖体を、座薬として、または経皮投与用に製剤化することもまた可能である。例えば、軟膏、または局所塗布用溶液、あるいは経皮的または超経皮的に制御しまたは自発的放出をおこなうパッチとして製剤化することが可能である。また、この強心配糖体を、点耳薬、点眼薬、うがい薬として製剤化することも可能である。
また、この強心配糖体を、中枢神経系内のインプラントとして製剤化することも可能である。
強心配糖体および医薬的に許容可能な担体を含む化合物、ならびに、このような化合物を用いて治療する方法もまた、本願発明により提供されるものである。
上記により、説明の目的で本発明の特定の態様を本明細書中に記載したものの、本発明の精神と範囲を逸脱することなく様々な改良を行なうことができるであろうということを理解されたい。
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Claims (12)
- 高レベルのIL-8を分泌する細胞からのIL-8の分泌を抑制または低減する方法であって、強心配糖体を含有する化合物に該細胞を接触させることを含む方法。
- 該細胞がCF肺上皮細胞である、請求項1に記載の方法。
- 該強心配糖体がオレアンドリン、ジギトキシン、ジゴキシン、ウアバイン、ジゴキシゲニン、ジギトキシゲニン、およびアセチル−ストロパンチジン(acetyl-stropanthidin)からなる群より選択されるものである、請求項1に記載の方法。
- 該強心配糖体がオレアンドリンである、請求項1に記載の方法。
- 該強心配糖体がジギトキシンである、請求項1に記載の方法。
- 該強心配糖体がジゴキシンである、請求項1に記載の方法。
- 高レベルのIL-8に特徴付けられる病状を治療する方法であって、本疾患を患う哺乳動物に有効量の強心配糖体を含有する化合物を投与することを含む方法。
- 該哺乳動物がヒトである、請求項7に記載の方法。
- 該高レベルのIL-8が、心肺バイパス術、心肺停止、炎症性大腸炎、肺疾患および肺の不調、外傷性脳損傷、脳卒中、移植組織不適合、アルツハイマー病、パーキンソン病、HIV、ウィルス感染症、および発熱からなる群より選択される状態に起因するものである、請求項8に記載の方法。
- 該高レベルのIL-8が、シクロオキシゲナーゼ阻害薬抵抗性の発熱に起因するものである、請求項9に記載の方法。
- 嚢胞性線維症を患うヒトにおける高レベルのIL-8に特徴付けられる病状を治療する方法であって、強心配糖体を含有する化合物の有効量をヒトに投与することを含む方法。
- 該化合物が医薬的に許容できる担体をさらに含有するものである、請求項11に記載の方法。
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JP2013516491A (ja) * | 2010-01-11 | 2013-05-13 | フェニックス・バイオテクノロジー・インコーポレイテッド | 強心配糖体で神経学的状態を治療する方法 |
JP2020505466A (ja) * | 2017-01-31 | 2020-02-20 | メディツィーニシェ ホーホシューレ ハノーファー(エムハーハー) | 天然化合物および線維症 |
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US20100120704A1 (en) | 2010-05-13 |
EP1513403A4 (en) | 2006-08-30 |
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CA2487732C (en) | 2013-10-15 |
US8569248B2 (en) | 2013-10-29 |
AU2003240818B2 (en) | 2006-05-04 |
US20140187505A1 (en) | 2014-07-03 |
JP2010070575A (ja) | 2010-04-02 |
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US20060234955A1 (en) | 2006-10-19 |
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