JP2012525391A - オリタバンシンを用いた細菌感染の治療方法 - Google Patents
オリタバンシンを用いた細菌感染の治療方法 Download PDFInfo
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- JP2012525391A JP2012525391A JP2012508570A JP2012508570A JP2012525391A JP 2012525391 A JP2012525391 A JP 2012525391A JP 2012508570 A JP2012508570 A JP 2012508570A JP 2012508570 A JP2012508570 A JP 2012508570A JP 2012525391 A JP2012525391 A JP 2012525391A
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Abstract
Description
グリコペプチドおよびリポグリコペプチド抗生物質は、細菌の細胞壁および/または細胞膜の統合性に作用する生物学的に作り出されたまたは半合成の抗菌剤の群である(Williamsら, Angewandte Chemie International Edition in English 38: 1172-1193 (1999); Nicolaouら, Angewandte Chemie International Edition in English 38:2097-2152 (1999); Kahneら, Chemical Reviews 105:425-448 (2005); Paceら, Biochemical Pharmacology 71:968-980 (2006))。もっともよく知られるグリコペプチドおよびリポグリコペプチド抗生物質は、バンコマイシン、テイコプラニン、オリタバンシン(米国特許番号第5,840,684号)、ダルババンシン(米国特許第5,750,509号)およびテラバンシン(米国特許第6,635,618号)を含む。最初の2つの薬は、グラム陽性菌に対して効き目の強い活性を有することが臨床的および微生物学的に証明されており、後者の3つの薬は臨床試験中である。オリタバンシン、ダルババンシン、およびテラバンシンは、メチシリン耐性黄色ブドウ球菌、中間および完全なバイコマイシン耐性黄色ブドウ球菌、バンコマイシン耐性腸球菌種、および連鎖球菌種を含むグラム陽性菌に対して強力な活性を有する非常に魅力的な薬理学的プロファイルを有している。
治療
本発明は一般的に対象における細菌感染を治療する方法に向けられる。この方法は、治療上有効な量のグリコペプチド抗生物質を細菌感染をしている対象に投与するステップを含み、グリコペプチド抗生物質はオリタバンシン、その医薬的に許容される塩、水和物、もしくは溶媒和物、またはその混合物であり、有効な量のグリコペプチド抗生物質により、対象において約50%から約95%の範囲でグリコペプチド抗生物質の一部が血清蛋白質に結合する。付加的な局面では、グリコペプチド抗生物質の有効な量により、グリコペプチド抗生物質の血清蛋白質に結合する部分が約80%−約90%、約70%−約90%、または約55%−約65%の範囲となる。
さらに本発明は一般的に、対象における細菌感染を防止する方法に向けられる。この方法は、細菌感染のリスクがある対象に細菌感染を防止するのに十分な量のグリコペプチド抗生物質を投与するステップを含み、グリコペプチド抗生物質はオリタバンシン、その医薬的に許容される塩、水和物、もしくは溶媒和物、またはその混合物であり、細菌感染を防止するのに十分な量により、対象において約50%から約95%の範囲でグリコペプチド抗生物質の一部が血清蛋白質に結合する。付加的な局面では、グリコペプチド抗生物質の量により、グリコペプチド抗生物質の血清蛋白質に結合する部分が約80%−約90%、約70%−約90%、または約55%−約65%の範囲となる。
本発明はさらに一般的に、対象における細菌感染の発病予防を提供するための方法に向けられる。この方法は、細菌感染をしている対象に細菌感染の発病予防を達成するのに十分な量のグリコペプチド抗生物質を投与するステップを含み、グリコペプチド抗生物質はオリタバンシン、その医薬的に許容される塩、水和物、もしくは溶媒和物、またはその混合物であり、発病予防を達成するのに十分な量により、対象において約50%から約95%の範囲でグリコペプチド抗生物質の一部が血清蛋白質に結合する。付加的な局面では、グリコペプチド抗生物質の量により、グリコペプチド抗生物質の血清蛋白質に結合する部分が約80%−約90%、約70%−約90%、または約55%−約65%の範囲となる。
本発明は一般的には、対象における細菌感染を治療する方法に向けられる。この方法は、細菌感染をしている対象に治療上有効な量のグリコペプチド抗生物質を投与するステップを含み、グリコペプチド抗生物質はオリタバンシン、その医薬的に許容される塩、水和物、もしくは溶媒和物、またはその混合物であり、有効な量のグリコペプチド抗生物質により、対象においてグリコペプチド抗生物質の一部が選択された範囲内で血清蛋白質に結合する。
・血清アルブミンカラムを用いてHPLCにおける保持時間およびピーク形状の測定
・アルブミンが結合した抗生物質から遊離するよう分離するためのデキストラン被覆チャコールの使用
・赤血球のような生体膜/細胞への遊離した分析物の分離を分析する生物学的平衡透析
・固定化アルブミンまたはその種類への分析物の結合の際にSPRにおける変化を測定する表面プラズモン共鳴
・核磁気共鳴アプローチ
・血清または血清成分が存在しない状態における細菌の指示菌株に対する最小阻害濃度(MIC)に対する、血清または血清成分が存在する状態における細菌の指示菌株に対する最小阻害濃度(MIC)の変動の判定といったような成長ベースのアプローチ
・血清または血清成分が存在しない状態における細菌の指示菌株に対する殺菌動態に対する、血清または血清成分が存在する状態における細菌の指示菌株に対する殺菌動態の測定(速度、阻害曲線の下の領域、固定時間での殺菌の程度)。
%遊離=(濃度緩衝剤チャンバ/濃度血漿チャンバ)×100%
%結合=100%−%遊離
血清成分、典型的には血清アルブミンへの薬剤の結合は一般的に、薬物動態および薬力学的なパラメータの重要な決定要素となるように受け入れられる。毒性、薬物動態、および薬力学の評価の間、非臨床種からヒトへの薬物曝露を解釈するのに血清蛋白質結合の推定は必須である。なぜならば遊離部分が薬剤の活性を決定付けると考えられるからである(Baileyら, Antimicrob. Agents Chemother. 35:1089-1092 (1991); Schmidtら, /. Pharm. Sci. 99(3): 1107-1122 (2009); Schmidtら, Antimicrob Agents Chemother. 52:3994-4000 (2008))。最近の証拠は、「有効部分」の概念をサポートしている。「有効部分」の概念は、ダプトマイシンのような蛋白質結合の高い薬剤の薬力学的な活動への付加的な洞察を提供する(Tsujiら, Determining the active fraction of daptomycin against MRSA by evaluating bactericidal activity in the presence of protein and pharmacodynamic (PD) modeling, abstr Al- 1270/1. Abstr. 49th Intersci. Conf. Antimicrob. Agents Chemother. American Society for Microbiology, Washington, DC (2009))。
算術MIC:黄色ブドウ球菌ATCC29213による培養液微量希釈MIC評価はCLSIガイドライン(Clinical and Laboratory Standards Institute, 2009, CLSI document M7-A7)に基づく。培地は、95%血清:5%CAMHB、および95%血清限外濾過液:5%CAMHBとした。オリタバンシンの算術希釈およびコンパレータを用いて、倍加希釈に対する最小阻害濃度(MIC)の値の精度を増加させた。血清におけるパーセント結合を以下のように計算した。
AUIC観察:95%血清:5%CAMHBおよび95%血清限外濾過液:5%CAMHBにおいて、最終接種が1×106CFU/mLである黄色ブドウ球菌ATCC29213を用いて時間殺菌の観察を行った。オリタバンシンの試験濃度は2mg/L、1mg/L、および0.5mg/Lとした。時間殺菌培養のアリコートをさまざまな時点で取除き、連続希釈平板培養により細菌を数えた。GraphPad Prismソフトウェアを用いてAUICを計算した。血清におけるパーセント結合を以下のように計算した。
結果
各条件、血清源、および試験薬ごとのMICは、平均変動係数が17%であり、正確であった(表1)。CLSIM7−A8条件(表1の「CAMHB」の欄)(Clinical and Laboratory Standards Institute, 2009, CLSI document M7-A7)の元で求められたMICは、QC範囲(Clinical and Laboratory Standards Institute, 2009, CLSI document M100-S19)内であった。
既知濃度(生理学的に適切な範囲を通常一括する;たとえば0.01μg/mLから100μg/mL)および体積(100μL−500μL)のヒト血清における抗生物質が(Thermo Scientific社の)迅速な平衡透析装置のサンプルチャンバに配置される。当該装置における透析膜のMWCOは、8,000であり、アルブミンおよび大きな血清蛋白質を除外する。次いで、公知の体積(300μL−750μL)のリン酸緩衝生理食塩水のような緩衝剤が緩衝剤コンパートメントに配置される。この単位体は、平衡状態を達成するよう、シールテープで覆われて、37℃で4時間、オービタルシェーカ上で約100rpmまたは上下シェーカ上で20rpmでインキュベートされる。シールは取除かれ、等しい体積(たとえば100μL、100μL)が緩衝剤チャンバおよび血漿チャンバの両方から取除かれ、エッペンドルフチューブへと移され、抗生物質に対する液体クロマトグラフィー/質量分析(LC/MS)分析に以下のように晒される。すなわち、サンプルが10分間、13,000−15,000×gで遠心分離され、その各々のうち50μLが別個の微量遠心機チューブへと移される。合計50μLの血漿が緩衝剤サンプルに加えられ、50μLのPBSが集められた血漿サンプルに加えられる。300μLの沈殿緩衝剤(冷たい90/10のアセトニトリル/水と0.1%のギ酸)が加えられ、蛋白質を沈殿させ、化合物を解離する。サンプルは、激しく攪拌され、氷上で30分間インキュベートされる。上澄みが分析のためにバイアルまたはプレートに移される。適切な内部標準が加えられ、抗生物質がLC/MSにより定量化される。代替的には、上澄みは乾燥され得、抗生物質はLC/MSの前に還元される。内部標準に対するピーク面積からの緩衝剤および血漿チャンバにおける試験化合物の濃度が算出される。血清蛋白質に結合する試験化合物の割合を計算するよう、以下の式が用いられ得る。
%遊離=(濃度緩衝剤チャンバ/濃度血漿チャンバ)×100%
%結合=100%−%遊離
実施例2において上述した平衡透析検査でのように、既知の濃度および体積の分析物が既知の体積の血清(または既知の濃度および体積の精製された血清アルブミン)に加えられ、当該サンプルが限外濾過装置へと移される。簡便な評価プラットフォームは、MWCOが10,000であるとともにサンプル体積が100−300μLの範囲であることを必要とする透析膜を有する96-well Millipore MultiScreen Ultracel-PPB(血漿蛋白質結合)プレートである。限外濾過の後、限外濾過液中の分析物が実施例2において上述したようにLC/MSにより定量化される。
分析物とアルブミンとの混合物(または血清中の分析物)が、溶液において蛋白質が結合した分析物を沈殿させ遊離した分析物を残す態様で、超遠心分離に晒される。この遠心分離工程が完了した後、上澄みが注意深く超遠心分離チューブから取除かれ、分析物が実施例2において上述したようにLC/MSにより定量化される。
Claims (19)
- 対象における細菌感染を治療する方法であって、治療上有効な量のグリコペプチド抗生物質を細菌感染をしている対象に投与するステップを含み、前記グリコペプチド抗生物質はオリタバンシン、その医薬的に許容される塩、水和物、もしくは溶媒和物、またはその混合物であり、前記有効な量のグリコペプチド抗生物質により、前記対象において約50%から約95%の範囲で前記グリコペプチド抗生物質の一部が血清蛋白質に結合する、方法。
- 対象における細菌感染を防止する方法であって、細菌感染のリスクがある対象に細菌感染を防止するのに十分な量のグリコペプチド抗生物質を投与するステップを含み、前記グリコペプチド抗生物質はオリタバンシン、その医薬的に許容される塩、水和物、もしくは溶媒和物、またはその混合物であり、細菌感染を防止するのに十分な前記量により、前記対象において約50%から約95%の範囲で前記グリコペプチド抗生物質の一部が血清蛋白質に結合する、方法。
- 対象における細菌感染の発病予防を提供するための方法であって、細菌感染をしている対象に細菌感染の発病予防を達成するのに十分な量のグリコペプチド抗生物質を投与するステップを含み、前記グリコペプチド抗生物質はオリタバンシン、その医薬的に許容される塩、水和物、もしくは溶媒和物、またはその混合物であり、前記発病予防を達成するのに十分な量により、前記対象において約50%から約95%の範囲でグリコペプチド抗生物質の一部が血清蛋白質に結合する、方法。
- 前記グリコペプチド抗生物質の血清蛋白質に結合する部分は約55%から約65%の範囲である、請求項1−3のいずれか1項に記載の方法。
- 前記グリコペプチド抗生物質の血清蛋白質に結合する部分は約80%から約90%の範囲である、請求項1−3のいずれか1項に記載の方法。
- 前記グリコペプチド抗生物質の血清蛋白質に結合する部分は約70%から約90%の範囲である、請求項1−3のいずれか1項に記載の方法。
- 前記グリコペプチド抗生物質の血清蛋白質に結合する部分は、前記グリコペプチド抗生物質の投与の完了の約30分後に判定される、請求項1−3のいずれか1項に記載の方法。
- 前記グリコペプチド抗生物質の血清蛋白質に結合する部分は、前記グリコペプチド抗生物質の投与の完了の約24時間後に判定される、請求項1−3のいずれか1項に記載の方法。
- 対象における細菌感染を治療する方法であって、治療上有効な量のグリコペプチド抗生物質を細菌感染をしている対象に投与するステップを含み、前記グリコペプチド抗生物質はオリタバンシン、その医薬的に許容される塩、水和物、もしくは溶媒和物、またはその混合物であり、前記有効な量のグリコペプチド抗生物質により、前記対象において、前記グリコペプチド抗生物質の投与の完了の約30分から約24時間後の平均から約50%から約95%の範囲でグリコペプチド抗生物質の平均的な部分が血清蛋白質に結合する、方法。
- 対象における細菌感染を防止する方法であって、細菌感染のリスクがある対象に細菌感染を防止するのに十分な量のグリコペプチド抗生物質を投与するステップを含み、前記グリコペプチド抗生物質はオリタバンシン、その医薬的に許容される塩、水和物、もしくは溶媒和物、またはその混合物であり、細菌感染を防止するのに十分な前記量により、前記対象において前記グリコペプチド抗生物質の投与の完了の約30分から約24時間後の平均から約50%から約95%の範囲でグリコペプチド抗生物質の平均的な部分が血清蛋白質に結合する、方法。
- 対象における細菌感染の発病予防を提供するための方法であって、細菌感染をしている対象に細菌感染の発病予防を達成するのに十分な量のグリコペプチド抗生物質に投与するステップを含み、前記グリコペプチド抗生物質はオリタバンシン、その医薬的に許容される塩、水和物、もしくは溶媒和物、またはその混合物であり、前記発病予防を達成するのに十分な量により、前記対象において、前記グリコペプチド抗生物質の投与の完了の約30分から約24時間後の平均から約50%から約95%の範囲でグリコペプチド抗生物質の平均的な部分が血清蛋白質に結合する、方法。
- 前記グリコペプチド抗生物質の血清蛋白質に結合する部分は約55%から約65%の範囲である、請求項9−11のいずれか1項に記載の方法。
- 前記グリコペプチド抗生物質の血清蛋白質に結合する部分は約80%から約90%の範囲である、請求項9−11のいずれか1項に記載の方法。
- 前記グリコペプチド抗生物質の血清蛋白質に結合する部分は約70%から約90%の範囲である、請求項9−11のいずれか1項に記載の方法。
- 前記グリコペプチド抗生物質の血清蛋白質に結合する平均的な部分は、9つの測定値の平均値を計算することにより求められ、前記9つの測定値は、
(i)前記グリコペプチド抗生物質の投与の完了の約30分後におけるグリコペプチド抗生物質の血清蛋白質に結合する部分の第1の測定値と、
(ii)前記グリコペプチド抗生物質の投与の完了の約1.5時間後におけるグリコペプチド抗生物質の血清蛋白質に結合する部分の第2の測定値と、
(iii)前記グリコペプチド抗生物質の投与の完了の約2.5時間後におけるグリコペプチド抗生物質の血清蛋白質に結合する部分の第3の測定値と、
(iv)前記グリコペプチド抗生物質の投与の完了の約3.5時間後におけるグリコペプチド抗生物質の血清蛋白質に結合する部分の第4の測定値と、
(v)前記グリコペプチド抗生物質の投与の完了の約4.5時間後におけるグリコペプチド抗生物質の血清蛋白質に結合する部分の第5の測定値と、
(vi)前記グリコペプチド抗生物質の投与の完了の約5.5時間後におけるグリコペプチド抗生物質の血清蛋白質に結合する部分の第6の測定値と、
(vii)前記グリコペプチド抗生物質の投与の完了の約6.5時間後におけるグリコペプチド抗生物質の血清蛋白質に結合する部分の第7の測定値と、
(viii)前記グリコペプチド抗生物質の投与の完了の約12時間後におけるグリコペプチド抗生物質の血清蛋白質に結合する部分の第8の測定値と、
(ix)前記グリコペプチド抗生物質の投与の完了の約24時間後におけるグリコペプチド抗生物質の血清蛋白質に結合する部分の第9の測定値とを含む、請求項9−11のいずれか1項に記載の方法。 - グリコペプチド抗生物質の血清蛋白質に結合する前記部分は、平衡透析、超遠心分離、および限外濾過からなる群から選択される手段により判定される、請求項1−15のいずれか1項に記載の方法。
- 前記細菌感染は複雑性皮膚および皮膚組織感染症(cSSSI)である、請求項1−16のいずれか1項に記載の方法。
- 前記グリコペプチド抗生物質は前記グリコペプチド抗生物質および医薬的に許容される担体または希釈剤を含有する医薬組成物の形態にある、請求項1−17のいずれか1項に記載の方法。
- 前記投与は静脈内投与または経口投与による、請求項1−18のいずれか1項に記載の方法。
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JP2016181289A (ja) * | 2010-07-20 | 2016-10-13 | シャープ株式会社 | コンテンツ再生装置、および、コンテンツ再生装置の制御方法 |
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BRPI1014767A2 (pt) | 2016-04-19 |
EP2424559B1 (en) | 2024-04-03 |
CA2760159C (en) | 2021-01-12 |
CA2760159A1 (en) | 2010-11-11 |
WO2010129233A9 (en) | 2011-02-03 |
US9682061B2 (en) | 2017-06-20 |
AU2010245097A9 (en) | 2015-08-13 |
EP2424559A1 (en) | 2012-03-07 |
WO2010129233A2 (en) | 2010-11-11 |
PT2424559T (pt) | 2024-04-30 |
US20120035097A1 (en) | 2012-02-09 |
AU2010245097B2 (en) | 2015-08-13 |
EP2424559A4 (en) | 2012-10-03 |
AU2010245097A1 (en) | 2011-11-10 |
CN102573882A (zh) | 2012-07-11 |
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