JP2014511830A - 神経外傷を治療するための方法 - Google Patents
神経外傷を治療するための方法 Download PDFInfo
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Abstract
【選択図】なし
Description
一態様によれば、組成物は、神経外傷、外傷性脳損傷、脳性麻痺及び脊髄損傷の予防又は治療に使用するために、
i)ウリジン及びシチジン、又はそれらの塩、ホスフェート、アシル誘導体若しくはエステルのうちの1種以上と、
ii)ドコサヘキサエン酸(22:6;DHA)、エイコサペンタエン酸(20:5;EPA)及びドコサペンタエン酸(22:5;DPA)又はそれらのエステルのうちの少なくとも1種を含む脂質画分であって、全脂肪酸の重量に基づいて算出して2重量%未満のα−リノレン酸(ALA)を含む脂質画分と、
iii)コリン又はその塩若しくはエステルと
を含む。
EPAを100〜500mg、
DHAを1000〜1500mg、
リン脂質を80〜600mg、
コリンを200〜600mg、
UMP(ウリジン一リン酸)を400〜800mg、
ビタミンE(α−TE)を20〜60mg、
ビタミンCを60〜100mg、
セレンを40〜80μg、
ビタミンB12を1〜5μg、
ビタミンB6を0.5〜2mg、及び
葉酸を200〜600μg
含む。
i)ウリジン及びシチジン、又はそれらの塩、ホスフェート若しくはエステルのうちの1種以上と、
ii)ドコサヘキサエン酸(22:6;DHA)、エイコサペンタエン酸(20:5;EPA)及びドコサペンタエン酸(22:5;DPA)のうちの少なくとも1種を含む脂質画分であって、全脂肪酸の重量に基づいて算出して2重量%未満のα−リノレン酸(ALA)を含む脂質画分と、
iii)コリン又はその塩若しくはエステルと
を含むパーツのキットが提供される。
本発明の一側面において、本発明による組成物は、1種以上の薬学的に許容される担体材料を含む医薬製品として使用し得る。
加齢に伴う記憶機能障害(AAMI)は、正常な老化プロセスの一部として起こる認知低下の最軽度の症状を特徴とする、よく見られる状態である。AAMIの症状は、正常な老化プロセスの結果として、非常にゆっくりと起こる。一方、脊髄損傷(SCI)、神経外傷及び脳性麻痺(CP)は、神経組織が突然に傷害を受け且つその後に神経変性のプロセスが急速に起こる状態である。また、損傷の結果としての機能障害は、即座に出現し、罹患した個体を寿命が終わるまで損なう。さらに、SCI/神経外傷/CPとAAMIとの大きな差異は、AAMIの問題が認知ドメインのみの定義によるのに対し、SCI/神経外傷/CPは種々の問題、例えば、非認知的な運動機能障害の存在を特徴とすることである。損傷後の非認知的な問題とAAMIにおける認知の問題とのこのような差異のため、SCI/神経外傷/CPと関連する非認知的な側面に対する効果を予想することはもちろんのこと、例えばアルツハイマー病(AD)、記憶機能障害などを対象とする先行技術の組成物の、SCI又は神経外傷又はCPへの使用を考えることは、当業者にとって自明ではない。
組成物は、ドコサヘキサエン酸(22:6;DHA)、エイコサペンタエン酸(20:5;EPA)及びドコサペンタエン酸(22:5 ω−3;DPA)からなる群から選択される少なくとも1種のω−3多価不飽和脂肪酸(LC PUFA;炭素原子18個以上の鎖長を有する)、好ましくはDHA及びEPAのうちの少なくとも1種を含む。好ましくは、本組成物は、少なくともDHA、より好ましくはDHA及びEPAを含有する。EPAは、DPA(ω−3)に変換され、脳内におけるDPAのDHAへのその後の変換を増加させる。それ故に、本組成物は好ましくは、相当量のEPAを含有し、したがってインビボでのDHA形成をさらに刺激する。
組成物のα−リノレン酸[ALA]含有量は、低レベルに保持するのが好ましい。α−リノレン酸のインビボ供給が神経外傷において神経を保護することが観察されている(Kingら、J.Neurosci.(26)17:4672〜4680)にもかかわらず、本発明者らは、神経外傷の炎症性のため、高度不飽和脂肪族酸の供給過剰は、過酸化PUFAの作用による損傷組織に対するさらなる傷害のリスクを増加させると考える。AD製品では「通常」ALAレベルが脂肪酸の3重量%超、すなわち、約5重量%であることが示されているが、本発明者らは、ALA濃度を、全脂肪酸の重量に基づいて算出して2.0重量%未満、より好ましくは1.5重量%未満、特に1.0重量%未満のレベルに保持することが好ましいことを発見している。動物研究においては、関連レベルは脂肪酸100g当たり約0.8gであった。しかし、これらの低いALAレベル単独(「対照」)は効果がないようであった。
一態様において、組成物は、炭素原子14個未満の脂肪酸を5重量%未満、好ましくは2重量%未満含有する。
本組成物は、ウリジン、シチジン及び/又はその等価物(塩、ホスフェート、アシル誘導体及び/又はエステルを含む)を含む。ウリジンに関しては、組成物は好ましくは、ウリジン(すなわち、リボシルウラシル)、デオキシウリジン(デオキシリボシルウラシル)、ウリジンホスフェート(UMP、dUMP、UDP、UTP)、核酸塩基ウラシル及びアシル化ウリジン誘導体からなる群から選択される、少なくとも1種のウリジン又はその等価物を含む。一態様において、シチジン、CMP、シチコリン(CDP−コリン)も、適用し得る。好ましくは、本組成物は、ウリジン一リン酸(UMP)、ウリジン二リン酸(UDP)及びウリジン三リン酸(UTP)からなる群から選択されるウリジンホスフェート、並びに/又はシチジンホスフェート(CMP、CDP、CTP、好ましくはCMP)を含む。最も好ましくは、本組成物はUMPを含む。これは、UMPが、身体によって最も効率的に吸収されているためである。好ましくは、本組成物中のウリジンの少なくとも50重量%、より好ましくは少なくとも75重量%、最も好ましくは少なくとも95重量%がUMPによって提供される。投与しなければならない用量は、UMPとして与える。ウラシル供給源の量は、UMP量のモル当量を利用して算出し得る。
本組成物は、コリン、コリン塩及び/又はコリンエステルを含有する。コリン塩は好ましくは、塩化コリン、酒石酸水素コリン又はステアリン酸コリンから選択される。コリンエステルは好ましくは、ホスファチジルコリン及びリゾホスファチジルコリンから選択される。本方法は好ましくは、1日当たり50mg超のコリン、好ましくは1日当たり80〜3000mgのコリン、より好ましくは1日当たり100〜2000mgのコリン、最も好ましくは1日当たり150〜1000mgのコリンを投与するステップを含む。本組成物は好ましくは、液体組成物100ml当たり80mg〜3000mgのコリン、好ましくは100ml当たり100mg〜2000mgのコリン、好ましくは組成物100ml当たり200〜1000mgのコリン、最も好ましくは100ml当たり200mg〜600mgのコリンを含む。前記数値は、コリンに基づき、コリン等価物又は供給源の量は、コリンのモル当量を考慮して算出し得る。
組成物中には少なくとも1種のリン脂質を組み入れることが好ましい。用語「リン脂質」には、コリン画分中に既に入っているPCは含めない。本組成物は好ましくは、少なくとも1種のリン脂質を、100ml当たり0.01〜1グラム、より好ましくは100ml当たり0.05〜0.5グラム、最も好ましくは100ml当たり80〜600mgの量で含む。少なくとも1種のリン脂質は好ましくは、レシチンを用いて提供する。
本組合せは、少なくとも1種のビタミンB群を含む。ビタミンBは、ビタミンB1(チアミン)、ビタミンB2(リボフラビン)、ビタミンB3(ナイアシン又はナイアシンアミド)、ビタミンB5(パントテン酸)、ビタミンB6(ピリドキシン、ピリドキサール、又はピリドキサミン、又はピリドキシン塩酸塩)、ビタミンB7(ビオチン)、ビタミンB9(葉酸又はフォレート)及びビタミンB12(種々のコバラミン)の群から選択される。
ビタミンC又はその機能的等価物は、20〜2000mgの範囲、特定すれば30〜500mgの範囲、より特定すれば75〜150mgの範囲の1日投与量を提供する量で存在する。一態様において、ビタミンC又はその機能的等価物は、組成物100g当たり20〜2000mgの範囲、特定すれば30〜500mgの範囲、より特定すれば75〜150mgの範囲の量で存在する。
本組成物は好ましくは、セレンを含有する。セレンの抗酸化活性は、脳領域の傷害を予防及び/又は阻害するので有利である。好ましくは、本方法は、セレンを液体製品100ml当たり0.01及び5mg、より好ましくは液体製品100ml当たり0.02及び0.1mg含む組成物の投与を提供する。1日当たりに投与されるセレンの量は、好ましくは0.01mg超、より好ましくは0.01〜5mgである。
組成物はタンパク性材料をさらに含んでいてもよいが、このような構成要素は、優れたSCI修復を達成するのに必要とは考えられない。実際に、それ故に、低体積の組成物中に活性物質を濃縮することが可能である。タンパク質画分が含まれるとしたら、タンパク質画分は、無傷のタンパク質、無傷のタンパク質の加水分解及び合成によって得ることができるペプチド、80重量%超のアミノ酸を含むペプチドの誘導体を含む。ヌクレオシド材料及びコリンからの窒素は、タンパク質としては計算しないものとする。
本発明による方法においては、SCI及び神経外傷などに対して有益な効果を達成するのにマンガン及びモリブデンのレベルの増大は必要ないことが判明した。
EPA 100〜500mg、好ましくは約300mg、
DHA 1000〜1500mg、好ましくは約1200mg、
リン脂質80〜600mg、好ましくは約106mg、
コリン200〜600mg、好ましくは約400mg、
UMP(ウリジン一リン酸)400〜800mg、好ましくは約625mg、
ビタミンE(α−TE)20〜60mg、好ましくは約40mg、
ビタミンC 60〜100mg、好ましくは約80mg、
セレン40〜80μg、好ましくは約60μg、
ビタミンB12 1〜5μg、好ましくは約3μg、
ビタミンB6 0.5〜2mg、好ましくは約1mg、及び
葉酸200〜600μg、好ましくは約400μg。
1.例1:製品の好ましい範囲
エネルギー 125kcal
タンパク質 3.8g
炭水化物 16.5g
脂肪 4.9g
EPA 300mg
DHA 1200mg
リン脂質 106mg
コリン 400mg
UMP(ウリジン一リン酸) 625mg
ビタミンE(α−TE) 40mg
ビタミンC 80mg
セレン 60μg
ビタミンB12 3μg
ビタミンB6 1mg
葉酸 400μg
ナトリウム 125mg
カリウム 187.5mg
塩化物 156.3mg
カルシウム 100mg
リン 87.5mg
マグネシウム 25.0mg
鉄 2mg
亜鉛 1.5mg
ヨウ素 16.3μg
マンガン 0.41mg
銅 225μg
モリブデン 12.5μg
クロム 8.4μg
ビタミンA 200μg
チアミン(B1) 0.19mg
リボフラビン(B2) 0.20mg
ナイアシン(B3) NE2.25mg
パントテン酸(B5) 0.66mg
ビタミンD 0.88μg
ビオチン 5.0μg
ビタミンK 6.6μg
略語:EPA、エイコサペンタエン酸;DHA、ドコサヘキサエン酸;TE、トコフェロール等価物;NE、ナイアシン等価物。
脳性麻痺との診断を受けた若齢乳児(young infant)において、製品を試験した。この製品は、本発明による活性構成要素を含んでいた。この製品は、乳児が通常のミルクとは別個に摂取し得る液体処方を調製するのに使用することもできるし、通常のベビーフード又はベビーミルクへの添加物として又はそれらの強化物として使用することもできる。この実験においては、後者の投与方法を選択した。少量の強化物(1.3g)を乾燥ベビーミルク粉末の標準的なアリコート(製品取扱説明書に従って約13〜15g)に加えて、そのまま授乳できる最終的な標準ベビーミルクを得た。
この計画には、雌の成体Sprague−Dawleyラット(約250g)を用いた。全ての動物の脊髄に、静的圧迫モデルを用いて胸髄レベル(thoracic level)T12(T12)において損傷を与えた(Nystromら、1988年;Huangら、2007年)。反射性排尿が確立されるまで、手動膀胱圧出を1日2回行った。2組の動物を研究した:一部は損傷の5週間後に屠殺し、他は損傷の7週間後に屠殺した。それらのデータは、統計的な差異がなかったので統合した。
群I:対照食餌(n=8)
群II:UMP食餌(n=9)
群III:UMP+DHA食餌(n=9)
群IV:DHA食餌(n=9)
詳細な説明を、表1に示す。
我々の研究の第2部においては、動物に以下の処置を施した:
群V:対照食餌(n=8)
群VI:「本発明の食餌」(n=8)
詳細な概要を、第1部の食餌と共に、表1に示す。
− 「本発明の食餌」を餌とした動物は、対照と比較して、ロコモーションの明らかな改善を示した;
− 「本発明の食餌」を餌とした動物は、損傷の9週間後においては、対照群と比較して有意に増加したニューロン生存、及び有意に減少したマクロファージ動員を示した。
Claims (15)
- 神経外傷、外傷性脳損傷、脳性麻痺及び脊髄損傷の予防又は治療に使用するための、
i)ウリジン及びシチジン、又はそれらの塩、ホスフェート、アシル誘導体若しくはエステルのうちの1種以上と、
ii)ドコサヘキサエン酸(22:6;DHA)、エイコサペンタエン酸(20:5;EPA)及びドコサペンタエン酸(22:5;DPA)又はそれらのエステルのうちの少なくとも1種を含む脂質画分であって、全脂肪酸の重量に基づいて算出して2重量%未満のα−リノレン酸(ALA)を含む脂質画分と、
iii)コリン又はその塩若しくはエステルと
を含む組成物。 - 前記脂質画分が中鎖脂肪酸(MCT)を含み、(MCT C6:0+C7:0+C8:0の合計)対(C9:0とC10:0の合計)が2:1未満である、請求項1に記載の組成物。
- 前記脂質画分が、総脂肪酸に基づき2重量%未満の、炭素原子14個未満の脂肪酸を含む、請求項1又は2に記載の組成物。
- 組成物100ml当たり合計25mg未満のシステイン及びタウリンをさらに含む、先行する請求項の何れか一項に記載の組成物。
- リノール酸(LA)が、15g/100g(脂肪酸)未満の量で存在する、先行する請求項の何れか一項に記載の組成物。
- ビタミンB6、ビタミンB12及びビタミンB9又はそれらの等価物の群から選択される少なくとも1種のビタミンBをさらに含み、好ましくはビタミンB6、B9及びB12を含む、先行する請求項の何れか一項に記載の組成物。
- 前記脂質画分が、1日当たり9〜300mg/100kJのDHA+EPA+DPA、好ましくはDHA+EPAを含む、先行する請求項の何れか一項に記載の組成物。
- ウリジン、シチジン又はそれらの塩、ホスフェート、若しくはエステルのうち1種以上を、ウリジン及びシチジンとして算出して1.5〜130mg/100kJ含む、先行する請求項の何れか一項に記載の組成物。
- コリン又はその塩若しくはエステルを、コリンとして算出して1〜300mg/100kJ含む、先行する請求項の何れか一項に記載の組成物。
- ビタミンC又はその等価物、ビタミンE又はその等価物及びセレンからなる群から選択される1種以上をさらに含む、先行する請求項の何れか一項に記載の組成物。
- 少なくとも1種のリン脂質をさらに含む、先行する請求項の何れか一項に記載の組成物。
- 医薬が栄養製品として提供される、先行する請求項の何れか一項に記載の組成物。
- 医薬が医薬製品として提供される、先行する請求項の何れか一項に記載の組成物。
- 液体100ml当たり、
EPAを100〜500mg、
DHAを1000〜1500mg、
リン脂質を80〜600mg、
コリンを200〜600mg、
UMP(ウリジン一リン酸)を400〜800mg、
ビタミンE(α−TE)を20〜60mg、
ビタミンCを60〜100mg、
セレンを40〜80μg、
ビタミンB12を1〜5μg、
ビタミンB6を0.5〜2mg、及び
葉酸を200〜600μg
含む、先行する請求項の何れか一項に記載の水性液体組成物。 - 神経外傷、外傷性脳損傷、脳性麻痺及び脊髄損傷の予防又は治療に使用するための、
i)ウリジン及びシチジン、又はそれらの塩、ホスフェート若しくはエステルのうちの1種以上と、
ii)ドコサヘキサエン酸(22:6;DHA)、エイコサペンタエン酸(20:5;EPA)及びドコサペンタエン酸(22:5;DPA)のうちの少なくとも1種を含む脂質画分であって、全脂肪酸の重量に基づいて算出して2重量%未満のα−リノレン酸(ALA)を含む脂質画分と、
iii)コリン又はその塩若しくはエステルと
を含むパーツのキット。
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