JP2018507215A - ウィルス感染の処置及び予防において使用する為の新規なキノリン誘導体 - Google Patents
ウィルス感染の処置及び予防において使用する為の新規なキノリン誘導体 Download PDFInfo
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Abstract
Description
(i) 多くのウィルス、例えばレトロウィルス、例えばHIV又はヘルペスウィルス科のDNAウィルス、はウィルス潜伏によって特徴付けられており、それは細胞内で休眠状態になるウィルスの能力であり、従ってウィルスライフサイクルの溶原性部分を定義する、という事実。潜伏は、初期感染後に、完全に根絶すること無しに、ウィルス粒子の増殖が止まるウィルス複製サイクルの段階である。ウィルス潜伏の現象は、宿主内の所謂「リザーバ」の出現に関連しており、それは、一般的に到達しにくく、且つそれはまた、HIVの為の治癒を提供することの困難性の主な理由の一つである;
(ii) 特に長期処置を必要とするウィルス感染についての、薬物耐性株の出現。突然変異株の出現の見込みは特に、レトロウィルス、例えばHIV、にとって重要である。実際、抗HIV薬物に対する耐性は、下記の通り、生物学的レベルで説明されることができる。レトロウィルスとして、HIVは、酵素 逆転写酵素を使用してそのRNAゲノムからDNAを合成し、及び、そのゲノムを再生している間になされた誤りを訂正する為のメカニズムが欠けている。その結果、HIVは、何らかの「生きている」有機体の最高の既知の突然変異率でそのゲノムを複製する。これは、遺伝的変異が自然選択の為の原材料であるので、HIV集団に対して作用する為の自然選択についての理想的な状況を作り出す。
− それらのウィルス量が制御されるか又は減少さえされている;
− CD4+細胞数のそれらのレベルが維持されるか又は回復さえされている;及び/又は、
− ウィルス関連状態、例えばAIDS、に一般的に関連付けられている臨床的徴候が安定化されているか又は消失さえされている。AIDSの臨床的徴候は、感染の段階に応じて変化する。
(i) HIVがレトロウィルスであり、及び、以前に述べた通り、新規な突然変異株の出現がウィルスのこのクラスについて特に重要であるという事実;
(ii) HIVが潜在相に入り、従って現在利用可能な処置によって効率的に標的化されていない「潜在性の」リザーバを形成する為の能力を有するという事実;
(iii) 現在利用可能な処置がまた、時間の経過とともにHIV突然変異株を選択する傾向があり、それは長期的において薬物耐性の出現における主要な役割を有するという事実。
(i) ヌクレオシド類似体とまた呼ばれるヌクレオシド/ヌクレオチド逆転写酵素阻害剤、例えばアバカビル、エムトリシタビン、及びテノホビル;
(ii) 非ヌクレオシド逆転写酵素阻害剤(NNRTIs:non-nucleoside reverse transcriptase inhibitors)、例えばエファビレンツ、エトラビリン、及びネビラピン;
(iii) プロテアーゼ阻害剤(PIs:protease inhibitors)、例えばアタザナビル、ダルナビル、及びリトナビル;
(iv) 侵入阻害剤、例えばエンフビルチド、及びマラビロク;
(v) インテグラーゼ阻害剤、例えばドルテグラビル及びラルテグラビル。
− 所定の期間中にウィルス量を減少させる際の抗HIV剤の作用、しかし上記処置の終了後に該ウィルス量の持続的な低下を必ずしも示さない;及び/又は、
− HIV感染した患者におけるCD4+細胞数のレベルを増加させる際の抗HIV剤の作用。
− 血漿サンプルの1mL当たりのウィルスRNA又はDNAのコピーの数;
− 血漿サンプルの1mL当たりのウィルス粒子の数;及び/又は、
− 血漿サンプル中のウィルス関連タンパク質の活性。
− 血漿サンプルの1mL当たりのHIV RNAのコピーの数;及び/又は、
− 血漿サンプルの1mL当たりのHIV粒子の数;及び/又は、
− 血漿サンプル中のHIV関連タンパク質の活性、それは例えば、該血漿サンプル中の逆転写酵素(RT)活性を決定することを含みうる。
− サンプルの1mL当たりのHIV RNAのコピーの数を決定すること;及び/又は、
− サンプルの1mL当たりのHIV粒子の数を決定すること;及び/又は、
− サンプル中のHIV関連タンパク質の活性を決定すること。
− 上記患者が、複製及び/又は感染性が安定化されている又はそれどころか減少されていると考えられていたウィルス株、特にHIV株、で感染されているが、それは処置、例えばART及びHAARTの処置、に対してもはや応答しない;及び/又は、
− 上記患者が、薬物耐性株で感染されている。
− HIVウィルス量の増加;及び/又は、
− CD4+細胞数のレベルの減少;及び/又は、
ここで、HIVウィルス量及び/又はCD4+細胞数のレベルが、好ましくは血漿サンプルにおいて確立されている。
− 上記に開示された通り、従来の処置後に上記患者からの薬物耐性株を選択すること;及び/又は、
− 薬物耐性株で上記患者の初感染をすること。
(i) ヌクレオシド類似体とまた呼ばれるヌクレオシド/ヌクレオチド逆転写酵素阻害剤(NRTIs:nucleoside/nucleotide reverse transcriptase inhibitors)、例えばアバカビル、エムトリシタビン、及びテノホビル;
(ii) 非ヌクレオシド逆転写酵素阻害剤(NNRTIs:non-nucleoside reverse transcriptase inhibitors)、例えばエファビレンツ、エトラビリン、及びネビラピン;
(iii) プロテアーゼ阻害剤(Pis:protease inhibitors),例えばアタザナビル、ダルナビル、及びリトナビル;
(iv) 侵入阻害剤、例えばエンフビルチド、及びマラビロク;
(v) インテグラーゼ阻害剤、例えばドルテグラビル、及びラルテグラビル;並びに、
それらの組み合わせ。
− M41;K65;D67;K70;L74;Y115;M184(M184 V/Iを含む);L210;T215;K219;主なNRTI耐性突然変異として;
− M41;A62;D67;T69;K70;V75;F77;F116;Q151;L210;T215;K219;マルチNTRI耐性突然変異として;
− V90;A98;L100;K101;K103;V106;V108;E138;V179;Y181;Y188;G190;H221;P225;F227;M230;主なNNRTI耐性突然変異として;
− L10;V11;G16;K20;L24;D30;V32;L33;E34;M36;K43;M46;I47;G48;I50;F53;I54;Q58;D60;I62;L63;I64;H69;A71;G73;L74;L76;V77;V82;N83;I84;I85;N88;L89;L90;I93;主なプロテアーゼ阻害剤耐性突然変異として;
− T66;L74;E92;T97;E138;G140,Y143;S147;Q148;N155;主なインテグラーゼ阻害剤耐性突然変異として;
− G36;I37;V38;Q39;Q40;N42;N43;主な侵入阻害剤耐性突然変異として;並びに
それらの組み合わせ。
(i) それを必要とする患者に、式(1)のキノリン誘導体の有効量を投与し、それによって上記患者を処置すること;
(ii) 上記処置を終了すること;
(iii) 任意的に、処置の終了後に、上記患者におけるウィルス量及び/又はCD4+細胞数を測定すること;ここで好ましくは:処置終了後に、
− 低い又は検出できないウィルス量が維持されること;及び/又は、
− CD4+細胞数が安定し又は増加していること;
(iv)任意的に、上記ウィルス量が低くないか又は検出できなくはない場合に及び/又はCD4+細胞数が減少している場合に、それを必要とする患者に、式(1)のキノリン誘導体の有効量を投与すること。
組み換えCBC複合体、例えばCBP20及びCBP80、が、Worch,R.et al.(Specificity of recognition of mRNA 5' cap by human nuclear cap-binding complex. RNA 11、第1355〜1363頁(2005年))において記載されているプロトコルに従って調製される。
組み換えヒトCBCが、化合物1若しくは化合物2又はm(7)GpppG キャップ類似体の漸増濃度の存在下で、キャップされたRNA基体でインキュベートされ、そしてMazza et al. (Large-scale induced fit recognition of an m(7)GpppG cap analogue by the human nuclear cap-binding complex. EMBO J. 第21巻、第5548〜5557頁(2002年)に従って、種々のRNA及びRNA−タンパク質複合体を分離する為に、ネィティブゲル電気泳動によって分析された。
CBC複合体の制限タンパク分解が、Mazza et al. (Large-scale induced fit recognition of an m(7)GpppG cap analogue by the human nuclear cap-binding complex. EMBO J. 第21巻、第5548〜5557頁(2002年))に記載されたプロトコルに従って確立されている。
CBC複合体のマススペクトロメトリー分析が、Schirle et al.(Mass spectrometry-based proteomics in preclinical drug discovery.Chem Biol.,第19巻:第72〜84頁(2012年))に記載されたプロトコルに従って確立されている。
光で活性化可能な部分を有し且つ精製された組み換え体CBP20及びCBP80(CBC)上で化合物2との競合を有する化合物2誘導体を使用して、我々は、化合物2それ自体がUV照射後にCBP20とCBP80との間の投与量依存共有結合架橋を誘発することができること、そしてこの複合体がSDS-PAGEによって分離されることを発見した。同じ結果が、グルクロン酸抱合された化合物1、ヒト肝細胞を使用して代謝物として生成される化合物2のより可溶性な誘導体で得られた。
HIV陰性の個体からの軟膜が、スイスのチューリッヒにある地方献血センター(http://www.blutspendezurich.ch/)及びCentre de transfusion sanguine Montpellierから入手された。ヒト末梢血単核細胞(PBMCs:Human peripheral blood mononuclear cells)が、Ficoll(Axis-Shield PoC AS)勾配遠心分離によって分離された。次に、細胞が、活性化の為に、10%ウシ胎児血清(FCS:fetal calf serum)(Thermo Fischer Ref SV30160.03)、1000U/mLのIL2(Peprotech Ref 200-02)、及び5μg/mLのPHA(Roche Ref 1249738)で補充されたRPMI Glutamax培地(Life Technologies Ref 61870-010)において、1x106細胞/mLの密度まで、37°C、5% CO2で培養された。3日後、細胞がプールされ、そして感染の為に、10%ウシ胎仔血清(FCS)、1000U/mLのIL-2で補充されたRPMI Glutamax培地において、1x106細胞/mLの密度まで再懸濁された。HIV-1感染は、4時間、細胞1mL当たり10μgのAda-M R5 HIV株で行われた。次に、細胞が遠心分離され、そして、最終0.05% DMSO濃度に従って、希釈されたDMSO可溶化薬物(Sigma Ref D4818)で補充された培地において1x106細胞/mLの密度まで再懸濁された。細胞が、3日目に部分培地交換で、6日間処理された。細胞培養上清HIV p24滴定が、製造者の指示に従ってIngen Innotestキット(Ingen Ref 80564)を用いたELISAにより実行された。
図2は、結果を示す。下の右にあるグラフは、他の3つのグラフの結果を集める。「Cpd (1)」は、式(1)の化合物物を意味する。
本明細書は、健康な男性対象における単回経口漸増用量からなる化合物(2)を用いたヒト初回投与試験において得られた薬物動態学的(PK)結果を詳述する。4つの投与量レベルが調べられた(50、100、150、及び200mg)。
・ 1日目 投与前、投与後0.33、0.66、1.00、1.50、2.00、2.50、3.00、4.00、6.00、8.00、10.00、及び12.00時間;
・ 2日目 投与後24.00及び36.00時間;
・ 3日目 投与後48.00時間;
・ 10日目 投与後240時間;
・ 24日目 投与後576時間;
・ 45日目 投与後1080時間。
血漿濃度が、PKデータ生成の為のPKソフトウェアを通じて処理された。PKパラメータは、パーソナルコンピュータ上で稼働するPhoenix(登録商標)WinNonlin(登録商標)(Pharsight Corporation)を使用して、ノンコンパートメント解析(NCA:non-compartmental analysis)によって計算された。
・ 薬物動態学者に提供された検証された全ての血漿濃度がPK分析の為に使用された。
・ 前回の投与に関連した実際の血液サンプリング時点が使用された。
・ 時間ゼロと定量限界(LOQ:limit of quantification)以上の最初の濃度との間の遅延時間の時点で、LOQ未満の濃度がゼロ(0)に設定された。LOQ以上の2つの濃度間の定量限界未満(BLOQ:below limit of quantification)濃度が、欠落データと見なされた。後続(Trailing)濃度BLOQが計算に用いられた。
・ 投与前濃度が欠落している場合、期待される結果がBLOQであると仮定してそれは任意的にゼロに設定された。
化合物(2)の単回経口投与後、投与量に関わらず、化合物(1)血漿濃度が親薬物のそれらよりも著しく高いので、化合物(2)の化合物(1)への生体内変換は速く且つ主要な薬物代謝物として現れる。第1の定量可能な化合物(1)濃度は一般的に、投与後40分で(24人の被験者中、20人)で、1例の場合(被験者No.306について投与後20分)早く、及び3例の場合(被験者No.102,No.106,及びNo.406について投与後1時間)遅く、観察される。
Claims (7)
- 医薬品として使用する為の、請求項1に記載のキノリン誘導体又はその医薬的に許容される塩の一つ。
- ウィルス又はレトロウィルスの感染、特にAIDS又はAIDS関連状態又はヒト免疫不全ウィルス(HIV)、の処置又は予防において使用する為の、請求項1に記載のキノリン誘導体又はその医薬的に許容される塩の一つ。
- 請求項1に記載のキノリン誘導体又はその医薬的に許容される塩の一つと、少なくとも一つの医薬的に許容される添加剤とを含む医薬組成物。
- 請求項1に記載のキノリン誘導体又はその医薬的に許容される塩の一つを含む医薬品。
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EP3669873A1 (en) | 2018-12-20 | 2020-06-24 | Abivax | Quinoline derivatives for use ine the traeatment of inflammation diseases |
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AU2016223687A1 (en) | 2017-08-31 |
PT3262037T (pt) | 2020-04-09 |
EP3262037A1 (en) | 2018-01-03 |
JP6797126B2 (ja) | 2020-12-09 |
DK3262037T3 (da) | 2020-05-04 |
RU2723013C2 (ru) | 2020-06-08 |
BR112017017500B1 (pt) | 2023-04-04 |
US10329317B2 (en) | 2019-06-25 |
SI3262037T1 (sl) | 2020-09-30 |
PL3262037T3 (pl) | 2020-10-19 |
CN107531681A (zh) | 2018-01-02 |
EP3059236A1 (en) | 2016-08-24 |
AU2016223687B2 (en) | 2020-03-19 |
KR20170129698A (ko) | 2017-11-27 |
ZA201705633B (en) | 2018-12-19 |
HRP20200649T1 (hr) | 2020-10-16 |
KR102583506B1 (ko) | 2023-09-26 |
CU20170109A7 (es) | 2018-02-08 |
MX2017010506A (es) | 2017-11-13 |
RU2017128643A3 (ja) | 2019-04-15 |
EP3262037B1 (en) | 2020-02-12 |
BR112017017500A2 (pt) | 2018-04-17 |
CA2975577A1 (en) | 2016-09-01 |
CA2975577C (en) | 2020-04-07 |
HUE048577T2 (hu) | 2020-07-28 |
RS60369B1 (sr) | 2020-07-31 |
CN107531681B (zh) | 2020-11-24 |
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