JP2016523262A - 慢性外傷性脳障害iiを予防及び/又は治療する方法 - Google Patents
慢性外傷性脳障害iiを予防及び/又は治療する方法 Download PDFInfo
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Abstract
Description
(式中、R1は、H又はC1〜4アルキルである)の化合物、又はその薬学的に許容される塩、溶媒和物、若しくはプロドラッグを投与するステップを含む、方法を提供する。
現在、多数の臨床研究及び実験的研究が、震盪性損傷後に、過剰リン酸化されたタウの蓄積が存在することを示している。過剰リン酸化されたタウを含有する神経原線維濃縮体の蓄積は、特に、この蓄積を、表面の新皮質層内、詳細には、溝の基底部にて血管周囲かつ優勢に見出すとき、慢性外傷性脳障害の特徴的病理である。ヒト研究(McKeeら、2009、J Neuropath Exp Neurol 68、709〜735)において、例えば、過剰リン酸化されたタウのかかる分布は、繰り返された震盪事故の既往歴を有する対象において容易に明らかである(図1)。この特定の実施例において、過剰リン酸化されたタウの局在性を、繰り返された震盪の既往歴を有するNFLフットボールプレーヤーにおいて示す。溝の基底部にて、最大の蓄積を有する過剰リン酸化されたタウの血管周囲局在性(A)に注意されたい。この病理は、慢性外傷性脳障害に固有である。今日までのこれらの研究において用いた実験動物における溝の非存在が、かかる蓄積が、溝の基底部での局在性のヒトパターンを再現するという証明を不可能にしたが、過剰リン酸化されたタウの類似の蓄積を、動物における実験的震盪後に示した。
本発明者らは、過剰リン酸化されたタウが、震盪性損傷後に血管周囲に蓄積するということを確立し、震盪が、サブスタンスPの血管周囲での放出を生じるかどうかを調査するための震盪動物モデルを用いた。本発明者らは、震盪事故を再現するために震盪のげっ歯類モデルを開発し(Donkinら、2004、7th International Neurotrauma Symposium、75〜78ページ、Medimond Publishers、Bologna、Italy)、かかる事故後にサブスタンスPを放出したかどうかをその後に決定した。震盪事故後の脳血管周囲でのサブスタンスP免疫活性における明確な増大が存在する(図2)。本発明者らは、感覚神経線維の機械的刺激が、サブスタンスPのこの血管周囲での放出に関与したことを提案する。これらの結果は、感覚神経線維の機械的刺激が、サブスタンスP放出を誘導することを示す、非脳組織における従前の研究と一致する(Angら、2011、PLoS One 6、e24535)。
本発明者らは、機械的損傷が、震盪性損傷後にサブスタンスPの放出を生じることを示し、次に、式(I)の化合物が、震盪性損傷後にタウ過剰リン酸化を低減するかどうかを調べた。図2は、震盪性損傷後の式(I”)の化合物のタウリン酸化に対する作用を示す。ラットにおける震盪性損傷が、損傷していない動物(A)と比較して、震盪事故の3日後に広範なタウリン酸化(B)を生じることに注意されたい。損傷誘導の30分後での式(I”)の化合物の投与(1mg/kg、静脈内)は、この3日の時間点でのタウリン酸化のほぼ完全な阻害をもたらす(C)。故に、式(I”)の化合物の投与は、タウ過剰リン酸化を予防し、故に、CTEの発症を予防する。
両方の、サブスタンスPの放出と、過剰リン酸化されたタウの蓄積が、震盪事故後に生じたことを確立し、なぜ、ヒトCTEにおける過剰リン酸化されたタウの蓄積が、脳溝の基底部にて顕著であったかを示すことが残っている。本発明者らは、サブスタンスP放出が、感覚神経線維において機械的受容器の刺激に応答して生じることを、実施例2において示した。現在の開示における1つの高度に革新的なステップは、ヒトを含む、皺脳の動物において、溝が、圧力点を溝の基底部に集中させることにより、大脳皮質を機械的損傷から保護するという認識である。これは、両方の、溝を脳組織内部に取り込み、溝を脳組織内部から排除し、機械的圧力の作用をその後刺激する脳組織モデルにおいて最も説明される(Clootsら、2008、Ann.Biomed.Eng.36、1203〜1215)。溝あり及びなしの脳組織を再現したモデルにおける回転加速である代表的な機械的圧力の作用の刺激を、図5において示す。より高い機械的圧力を黒色として示す。これらの結果は、モデルへの溝の付加が、溝の形態論に関係なく、圧力を溝の基底部に集中させることを明確に示す。この機械的圧力パターンは、CTEにおいて報告し、図1において示した過剰リン酸化されたタウの検死後の局在性と顕著に類似する。
Claims (9)
- 対象における慢性外傷性脳障害又は関連する状態を予防及び/又は治療するための医薬の製造における、式(I)の化合物、又はその薬学的に許容される塩、溶媒和物、若しくはプロドラッグの使用。
- 式(I)の化合物、又はその薬学的に許容される塩、溶媒和物、若しくはプロドラッグを含む、慢性外傷性脳障害又は関連する状態を治療するために用いられる医薬組成物。
- 対象に有効量の式(I)の化合物、又はその薬学的に許容される塩、溶媒和物、若しくはプロドラッグを投与することを含む、対象におけるタウ過剰リン酸化に関連する疾患、状態又は容態の進行を阻害する方法。
- 対象におけるタウ過剰リン酸化に関連する疾患、状態又は容態、例えば、震盪性損傷の進行を阻害するための医薬の製造における式(I)の化合物、又はその薬学的に許容される塩、溶媒和物、若しくはプロドラッグの使用。
- 震盪性損傷を有する対象を治療する方法であって、前記対象に有効量の式(I)の化合物、又はその薬学的に許容される塩、溶媒和物、若しくはプロドラッグを投与するステップを含む、方法。
- 複数の震盪事故に暴露された対象を治療するための方法であって、対象に式(I)の化合物、又はその薬学的に許容される塩、溶媒和物、若しくはプロドラッグを、単一経口用量として、式(I)の化合物、又はその薬学的に許容される塩、溶媒和物、若しくはプロドラッグの血液濃度を治療範囲に、少なくとも3日間維持することができる量で投与するステップを含み、ここで投与ステップは、2度目の震盪事故後、及び必要に応じて、それぞれの更なる震盪事故後に再度行われる、方法。
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JP2021512864A (ja) * | 2018-02-02 | 2021-05-20 | ユーストラリス ファーマシューティカルズ リミテッド (トレーディング アズ プレススラ ニューロ) | 非経口製剤及びその使用 |
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JP2021512864A (ja) * | 2018-02-02 | 2021-05-20 | ユーストラリス ファーマシューティカルズ リミテッド (トレーディング アズ プレススラ ニューロ) | 非経口製剤及びその使用 |
US11801244B2 (en) | 2018-02-02 | 2023-10-31 | Eustralis Pharmaceuticals Limited | Parenteral formulations and uses thereof |
JP7400180B2 (ja) | 2018-02-02 | 2023-12-19 | ユーストラリス ファーマシューティカルズ リミテッド (トレーディング アズ プレススラ ニューロ) | 非経口製剤及びその使用 |
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