JP2018502898A - 神経筋疾患、神経変性疾患、自己免疫疾患、発達疾患および/または代謝疾患の処置のための、脳由来神経栄養因子(bdnf)の誘導された発現 - Google Patents
神経筋疾患、神経変性疾患、自己免疫疾患、発達疾患および/または代謝疾患の処置のための、脳由来神経栄養因子(bdnf)の誘導された発現 Download PDFInfo
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Abstract
Description
神経筋疾患、神経変性疾患、自己免疫疾患、発達疾患および/または代謝疾患の処置のための、脳由来神経栄養因子(BDNF)の誘導された発現
本出願は、2015年1月22日に出願された米国仮出願第62/106,365号への優先権を主張し、その全体は、本明細書において明示的に参考として援用される。
脳由来神経栄養因子(BDNF)は、神経発達において重要な役割を果たすいくつかの内因性タンパク質のうちの1つである。BDNFは、ニューロトロフィンとして、および/またはマイオカインとして神経成長に影響を及ぼす。したがって、BDNFの発現を誘導するための改善された方法が必要とされている。本発明は、DNPを投与することにより、BDNFを発現が増大するように内因的に誘導できるという発見、およびBDNFの発現に有用であり、かつ患者に対して有害ではない、0.001mg/kgから10mg/kg未満の間の用量範囲が存在するという発見に関する。さらに、疾患の宿主を処置するために、BDNFを、血液脳関門を横断させる多くの手法が行われている。例えば、これらの疾患としては、これらに限定されないが、外傷性傷害、脳卒中、ハンチントン病、てんかん、多発性硬化症(MS)、ループス、1型糖尿病および2型糖尿病、若年発症成人型糖尿病(MODY)、重症筋無力症(MG)、関節リウマチ(RA)、グレーブス病、ギラン・バレー症候群(GBS)、メタボリックシンドローム、デュシェンヌ型筋ジストロフィー(DMD)、重度の熱傷、老化、筋萎縮性側索硬化症(ALS)、フリードライヒ失調症、バッテン病、アルツハイマー病、視神経炎、レーベル遺伝性視神経症(LHON)、自閉症、レット症候群、バッテン病、アンジェルマン症候群、リー病、脆弱X症候群、統合失調症、うつ病、パーキンソン病およびミトコンドリア病が挙げられる。処置は、神経筋障害、神経変性障害、自己免疫障害、発達障害および/または代謝障害を逆転させる、遅らせる、または予防するプロセスによって働く。
本発明は、神経筋疾患、神経変性疾患、自己免疫疾患、発達疾患および/または代謝疾患を処置する方法、ならびに、神経筋疾患、神経変性疾患、自己免疫疾患、発達疾患および/または代謝疾患を処置するための、単位用量を含む医薬組成物に関する。具体的には、本発明は、ミトコンドリア脱共役剤(プロトノフォアまたはイオノフォア)2,4−ジニトロフェノール(「DNP」)または二分(bipartite)ジニトロフェノールアイソフォーム(2,3−DNP、2,4−DNP、2,5−DNP、2,6−DNP、3,4−DNP、または3,5−DNP)または、例えばCCCP、FCCP、SF6847、フルフェナム酸、PCP、TTFBなどの、解離可能なプロトンを有するミトコンドリア脱共役剤もしくは弱酸を、それを必要とする患者に、約0.001mg/kg〜5mg/kgの有効用量を使用して投与することにより、ヒトの全身の器官を脳由来ニューロトロフィン因子(「BDNF」)の発現が増大するように内因的に誘導すること、および関連するDNPの医薬組成物およびDNPの単位用量に関する。
一実施形態では、本発明は、外傷性CNS傷害、神経変性疾患、および/または自己免疫疾患、および/または発達障害、および/または代謝疾患を、BDNFを増大させて疾患の進行を和らげるまたは症状の軽減をもたらすために、DNPを体重1kg当たり0.01mg〜体重1kg当たり10mg未満の用量範囲で投与することによって処置する方法を提供する。ある特定の実施形態では、本発明は、少なくとも以下の疾患:外傷性脳損傷(TBI)、虚血性脳卒中、ハンチントン病(成人発症型ハンチントン病、若年性ハンチントン病)、てんかん(群発発作、不応性発作、非定型欠伸発作、脱力発作、間代性発作、ミオクローヌス発作、強直性発作、強直間代性発作、単純部分発作、複雑部分発作、二次性全般発作、熱性痙攣、非てんかん性発作、笑い・泣き発作(Gelastic and Dacrystic Seizure)、および欠伸発作)、多発性硬化症(MS)(再発寛解型多発性硬化症(RRMS)、二次進行性MS(SPMS)、一次進行性MS(PPMS)、および進行性再発性MS(PRMS))、ループス(全身性エリテマトーデス(SLE)、円板状(皮膚)ループス、薬物誘発性ループス(dil)および新生児ループス)、真性糖尿病(1型糖尿病、2型糖尿病、若年発症成人型糖尿病(MODY:MODY1、MODY2、MODY3、MODY4、MODY5、MODY6、MODY7、MODY8、MODY9、MODY10、MODY11))、統合失調症(妄想型統合失調症、破瓜型統合失調症、緊張型統合失調症、残遺型統合失調症、統合失調感情性障害)、重症筋無力症(MG)(眼筋型重症筋無力症、先天性MGおよび全身性重症筋無力症)、関節リウマチ(RA)、グレーブス病、ギラン・バレー症候群(GBS)、筋ジストロフィー(デュシェンヌ型筋ジストロフィー(DMD)、ベッカー型、筋緊張性、先天性、エメリー・ドレイフス型、顔面肩甲上腕型、肢帯型、遠位型、および眼咽頭型)、重度の熱傷、老化、筋萎縮性側索硬化症(ALS)、運動失調(フリードライヒ失調症、脊髄小脳失調症1(SCA1)、脊髄小脳失調症2(SCA2)、脊髄小脳失調症3(SCA3)、脊髄小脳失調症6(SCA6)、脊髄小脳失調症7(SCA7)、脊髄小脳失調症11(SCA11)、歯状核赤核淡蒼球ルイ体萎縮症(DRPLA)およびグルテン失調症)、バッテン病または神経セロイドリポフスチン沈着症(NCL)(小児性NCL(INCL)、遅発型小児性NCL(LINCL)、若年性NCL(JNCL)または成人型NCL(ANCL))、アルツハイマー病(早期発症型アルツハイマー病、遅発型アルツハイマー病、および家族性アルツハイマー病(FAD))、視神経炎(ON)、レーベル遺伝性視神経症(LHON)、自閉症スペクトラム障害(ASD)(アスペルガー症候群、広汎性発達障害(PDD)、小児期崩壊性障害(CDD)、および自閉症性障害)、レット症候群、アンジェルマン症候群、リー病、プラダー・ウィリー症候群、脆弱X症候群、うつ病(大うつ病、気分変調症、産後うつ病、季節性情動障害、非定型うつ病、精神病性うつ病、双極性障害、月経前不快気分障害、状況因性うつ病(Situational Depression))、パーキンソン病(特発性パーキンソン病、脳血管性パーキンソニズム、レビー小体型認知症、遺伝性パーキンソン病、薬剤性パーキンソン症候群、若年性パーキンソン病および非定型パーキンソニズム)、ミトコンドリア病、発達障害、メタボリックシンドローム(血圧上昇、高血糖レベル、ウエスト周りの過剰な体脂肪および異常なコレステロールレベル)および/または自己免疫障害を、DNPによる処置を用いてBDNF mRNA発現およびタンパク質レベルを誘導して、神経筋および/または神経変性および/または筋消耗を逆転させる、遅らせる、または予防することにより処置する方法を提供する。
使用方法
組成物
単位用量
組成物の共投与
Claims (60)
- 神経筋障害、自己免疫障害、神経変性障害、発達障害または代謝障害を処置する方法であって、
外傷性CNS傷害または神経変性疾患の処置を必要とする患者に、有効用量の2,4−ジニトロフェノール(DNP)またはその薬学的に許容される塩を、前記疾患の症状の寛解を達成するのに十分な長さの期間にわたって投与するステップ
を含み、
BDNFを増加させて疾患の進行を和らげるまたは症状の寛解をもたらすために、前記有効用量の2,4−ジニトロフェノール(DNP)を体重1kg当たり0.001mg〜体重1kg当たり5mgの用量範囲で継続する、方法。 - 前記有効用量が、体重1kg当たり約1.0mg〜体重1kg当たり約5mgの範囲内である、請求項1に記載の方法。
- 前記有効用量が、体重1kg当たり約0.1mg〜体重1kg当たり約1.0mgの範囲内である、請求項1に記載の方法。
- 前記有効用量が、体重1kg当たり0.01mg〜体重1kg当たり約0.1mgの範囲内である、請求項1に記載の方法。
- 前記有効用量が、体重1kg当たり約0.1mg〜体重1kg当たり約0.5mgの範囲内である、請求項1に記載の方法。
- 前記有効用量が、体重1kg当たり約0.5mg〜体重1kg当たり約1.0mgの範囲内である、請求項1に記載の方法。
- 前記有効用量が、体重1kg当たり約1.0mgである、請求項1に記載の方法。
- 前記有効用量を経口的にまたは静脈内に送達する、請求項1から7までのいずれかに記載の方法。
- 前記有効用量を経口的に送達する、請求項1から7までのいずれかに記載の方法。
- 前記有効用量を静脈内に送達する、請求項1から7までのいずれかに記載の方法。
- 前記疾患が、外傷性脳損傷(TBI)、虚血性脳卒中、ハンチントン病、てんかん、多発性硬化症(MS)(再発寛解型多発性硬化症(RRMS)、二次進行性MS(SPMS)、一次進行性MS(PPMS)、および進行性再発性MS(PRMS))、ループス、糖尿病、統合失調症、重症筋無力症(MG)、関節リウマチ(RA)、グレーブス病、ギラン・バレー症候群(GBS)、筋ジストロフィー、重度の熱傷、老化、筋萎縮性側索硬化症(ALS)、運動失調、バッテン病または神経セロイドリポフスチン沈着症(NCL)、アルツハイマー病、視神経炎(ON)、レーベル遺伝性視神経症(LHON)、自閉症スペクトラム障害(ASD)、レット症候群、アンジェルマン症候群、リー病、プラダー・ウィリー症候群、脆弱X症候群、うつ病、パーキンソン病、ミトコンドリア病、発達障害、メタボリックシンドロームおよび/または自己免疫障害からなる群から選択される、請求項1から7までのいずれかに記載の方法。
- 前記疾患が、ハンチントン病である、請求項1から10までのいずれかに記載の方法。
- 前記疾患が、多発性硬化症(MS)(MS)である、請求項1から10までのいずれかに記載の方法。
- 前記疾患が、てんかんである、請求項1から10までのいずれかに記載の方法。
- 前記疾患が、パーキンソン病である、請求項1から10までのいずれかに記載の方法。
- DNPの用量が、多すぎるBDNFの誘導を回避するか、またはBDNFの誘導が少なすぎることにより作用を有しないための手段として、ヒトにおける害を予防するのに有用である、請求項1から10までのいずれかに記載の方法。
- BDNFの発現の増強により、筋消耗または筋機能障害からの保護がもたらされる、請求項1から10までのいずれかに記載の方法。
- 有効用量の2,4−ジニトロフェノール(DNP)を含む、2,4−ジニトロフェノール(DNP)またはその薬学的に許容される塩、溶媒和物、もしくは水和物の医薬組成物であって、前記2,4−ジニトロフェノール(DNP)の有効用量が、体重1kg当たり0.001mg〜体重1kg当たり5mgの範囲内である、医薬組成物。
- 約0.001mg/kg〜約.01mg/kgの範囲内である、請求項18に記載の医薬組成物。
- 約0.01mg/kg〜約.1mg/kgの範囲内である、請求項18に記載の医薬組成物。
- 約0.1mg/kg〜約1mg/kgの範囲内である、請求項18に記載の医薬組成物。
- 約1mg/kg〜約5mg/kgの範囲内である、請求項18に記載の医薬組成物。
- 即時放出形態を含む、請求項18から22までのいずれかに記載の医薬組成物。
- 制御放出形態を含む、請求項18から22までのいずれかに記載の医薬組成物。
- 持続放出形態を含む、請求項18から22までのいずれかに記載の医薬組成物。
- 前記組成物が、BDNF発現を誘導して神経筋および/または神経変性および/または筋消耗を逆転させる、遅らせる、または予防するのに有効な用量である、請求項18から22までのいずれかに記載の医薬組成物。
- 2,4−ジニトロフェノール(DNP)、またはその薬学的に許容される塩、溶媒和物、もしくは水和物の医薬組成物であって、単位用量を含み、前記単位用量が、約.1mg〜約300mgの範囲内である、医薬組成物。
- 前記単位用量が、約0.1mg〜約1mgの範囲内である、請求項27に記載の医薬組成物。
- 前記単位用量が、1mgである、請求項27に記載の医薬組成物。
- 前記単位用量が、約1mg〜約5mgの範囲内である、請求項27に記載の医薬組成物。
- 前記単位用量が、約5mg〜約10mgの範囲内である、請求項27に記載の医薬組成物。
- 前記単位用量が、5mgである、請求項27に記載の医薬組成物。
- 前記単位用量が、10mgである、請求項27に記載の医薬組成物。
- 前記単位用量が、15mgである、請求項27に記載の医薬組成物。
- 前記単位用量が、20mgである、請求項27に記載の医薬組成物。
- 前記単位用量が、30mgである、請求項27に記載の医薬組成物。
- 前記単位用量が、40mgである、請求項27に記載の医薬組成物。
- 前記単位用量が、50mgである、請求項27に記載の医薬組成物。
- 前記単位用量が、75mgである、請求項27に記載の医薬組成物。
- 前記単位用量が、100mgである、請求項27に記載の医薬組成物。
- 前記単位用量が、150mgである、請求項27に記載の医薬組成物。
- 前記単位用量が、200mgである、請求項27に記載の医薬組成物。
- 前記単位用量が、250mgである、請求項27に記載の医薬組成物。
- 前記単位用量が、300mgである、請求項27に記載の医薬組成物。
- 即時放出形態を含む、請求項27から44までのいずれかに記載の医薬組成物。
- 制御放出形態を含む、請求項27から44までのいずれかに記載の医薬組成物。
- 持続放出形態を含む、請求項27から44までのいずれかに記載の医薬組成物。
- 経口剤形を含む、請求項27から44までのいずれかに記載の医薬組成物。
- 前記経口剤形が錠剤を含む、請求項27から44までのいずれかに記載の医薬組成物。
- 前記経口剤形が、カプセル剤を含む、請求項27から44までのいずれかに記載の医薬組成物。
- 前記経口剤形が、急速溶解性である、請求項27から44までのいずれかに記載の医薬組成物。
- 静脈内に送達される、請求項27から44までのいずれかに記載の医薬組成物。
- 皮下に送達される、請求項27から44までのいずれかに記載の医薬組成物。
- 経皮送達される、請求項27から44までのいずれかに記載の医薬組成物。
- 前記組成物が、BDNF発現を誘導して神経筋および/または神経変性および/または筋消耗を逆転させる、遅らせる、または予防するのに有効な単位用量である、請求項27から44までのいずれかに記載の医薬組成物。
- ハンチントン病に対する処置を含む、請求項27から44までのいずれかに記載の医薬組成物。
- 多発性硬化症(MS)に対する処置を含む、請求項27から44までのいずれかに記載の医薬組成物。
- 外傷性脳損傷(TBI)、虚血性脳卒中、ハンチントン病、てんかん、多発性硬化症(MS)、ループス、糖尿病、統合失調症、重症筋無力症(MG)、関節リウマチ(RA)、グレーブス病、ギラン・バレー症候群(GBS)、筋ジストロフィー、デュシェンヌ型筋ジストロフィー(DMD)、重度の熱傷、筋萎縮性側索硬化症(ALS)、運動失調、バッテン病または神経セロイドリポフスチン沈着症(NCL)、アルツハイマー病、視神経炎(ON)、レーベル遺伝性視神経症(LHON)、自閉症スペクトラム障害(ASD)、レット症候群、アンジェルマン症候群、リー病、プラダー・ウィリー症候群、脆弱X症候群、うつ病、パーキンソン病、ミトコンドリア病、発達障害、メタボリックシンドロームおよび/または自己免疫障害に対する処置を含む、請求項27から44までのいずれかに記載の医薬組成物。
- 神経筋障害、神経変性障害、自己免疫障害、発達障害または代謝障害を処置する方法であって、
有効用量の2,4−ジニトロフェノール(DNP)またはその薬学的に許容される塩を、前記疾患の症状の寛解を達成するのに十分な長さの期間にわたって受けるステップ
を含み、
BDNFを増加させて疾患の進行を和らげるまたは症状の寛解をもたらすために、前記有効用量の2,4−ジニトロフェノール(DNP)を体重1kg当たり0.01mg〜体重1kg当たり5mgの用量範囲で受け続ける、方法。 - 神経筋障害、神経変性障害、自己免疫障害、発達障害または代謝障害を処置する方法であって、
有効用量の2,4−ジニトロフェノール(DNP)またはその薬学的に許容される塩を、前記疾患の症状の寛解を達成するのに十分な長さの期間にわたって投与するための指示を提供するステップ
を含み、
前記有効用量の2,4−ジニトロフェノール(DNP)を体重1kg当たり0.01mg〜体重1kg当たり5mgの用量範囲で受けるよう指示される、方法。
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