JP2022552040A - てんかん発生を予防するおよび/または治療するためのマリマスタットの使用 - Google Patents
てんかん発生を予防するおよび/または治療するためのマリマスタットの使用 Download PDFInfo
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- JP2022552040A JP2022552040A JP2021575914A JP2021575914A JP2022552040A JP 2022552040 A JP2022552040 A JP 2022552040A JP 2021575914 A JP2021575914 A JP 2021575914A JP 2021575914 A JP2021575914 A JP 2021575914A JP 2022552040 A JP2022552040 A JP 2022552040A
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Abstract
Description
てんかん発生は、遷延性で持続する過程であり、その間に、以前は正常であった脳のネットワークが、てんかん発作感受性が増加するように機能的に変化し、従って自発的な再発性のてんかん発作を起こす高まった確率を有する(Pitkanenら、2015)。てんかん発生は、2段階に分けられ:第1は、てんかん状態の発生であり、第2は、それが確立された後のてんかんの進行である。ほとんどの場合、ヒトのてんかん発生は、脳損傷によって始まる(卒中、外傷性脳損傷(TBI)あるいは構造上または代謝上の原因で起こるてんかん重積状態(SE))(Annegersら、1998;Graham Neil S.N.ら、2013;Hesdorfferら、1998)。興味深いことに、てんかん発生率は、脳損傷間で異なり、SEおよび卒中後に最も高い。
血液脳関門破壊、ならびに炎症反応およびシナプス可塑性への寄与を含む、それによりMMPがてんかん発生(epileptogenesis)およびてんかん(epilepsy)に関与し得る、複数のメカニズムがある。てんかんの異なるモデルおよび種類において重要な役割を有する最もよく調べられた蛋白質分解酵素は、MMP-9であると思われる(Vafadariら、2016)。まず、Zhangら(1998;2000)は、痙攣誘発用量のKAを与えたげっ歯類の脳におけるMMP-9(ならびにMMP-2)のレベルの増加を報告した(Zhangら、1998、2000)。次に、KAは、MMP-9のmRNAのみならずMMP-9蛋白質および酵素活性のレベルも上方調節することが示された(Szklarczykら、2002)。重要なことに、これらの応答は、歯状回(つまり、最も広汎なKA投与後可塑性を受ける海馬領域)に限定され、てんかん発生をおそらく支持している。次に、てんかん発生におけるMMP-9の役割が、2つの動物モデル:KA惹起性てんかん重積状態(SE、てんかん発生を惹起することが知られている病態)および痙攣誘発性ペンチレンテトラゾール(PTZ、GABAa受容体拮抗剤)による化学的発火(Wilczynskiら、2008)、で裏付けられた。Wilczynskiら(2008)は、PTZ発火に対する感度がMMP-9ノックアウトマウスでは低下されたが、神経でMMP-9を過剰発現するトランスジェニックラットでは増加されたことを示した。さらに、彼らは、MMP-9欠乏が樹状突起棘のKA惹起性刈り込みを減少させ、かつ苔状線維発芽後の異常シナプス形成を低下させたことを実証した。最後に、彼らはまた、MMP-9が興奮性シナプスに関連し、MMP-9蛋白質のレベルおよび酵素活性の両方がてんかん発作時に顕著に増加することを報告した。その後、てんかん発生におけるMMP-9の推定的役割が、Mizoguchiら(2011)により裏付けられ、彼らは、PTZ発火モデルの損傷海馬における上昇されたMMP-9の活性および発現を示した。
実施例1:インビトロでのMMP-9活性の特異的阻害
第1の非限定的な例において、化合物を、インビトロでMMP-9活性の特異的阻害に関して試験した。海馬ニューロンを、以前に記述されるように(Habasら、2006)出生後0日目(P0)にWistarラット新生仔から調製した。培地は、B27(Invitrogen)ならびに1mMのL-グルタミン、100U/mlのペニシリンおよび0.1mg/mlのストレプトマイシンが補充された神経培地(Neurobasal Medium)から成る。これらの実験のために用いた細胞は、7DIVであった。マリマスタットを、最小有効用量を決定するために異なる濃度;5nM、0.5μM、5μM、40μMおよび100μM、で用いた。マリマスタット添加(培地補充で)後30分に、細胞を、PBSで洗浄し、MMP-9放出に至る神経細胞活動を促すためにグルタミン酸(5μM;培地添加)で処理した。対照培養は、グルタミン酸および阻害剤I(MMP-9活性に対して阻害効果が実証されている阻害剤)の存在下でグルタミン酸で刺激した神経細胞から成った。実験を、4回繰り返した(繰返しとして異なる神経細胞培養物で)。MMP-9活性のレベルを、MMP-9の基質であるネクチン-3の切断により評価した。
マリマスタットは、ネクチン-3のMMP-9依存性切断を阻害する(用いた0.5μM用量からすでに(図1))ことが示された。
インビボでのマリマスタットの阻害効果を示す上の結果に基づいて、本発明者らは、この化合物が血液脳関門を透過するか否か(これは動物におけるその治療用途の前提である)を評価した。本目的のために、マウス(C57B16系統)に、体重1kgあたり9mgのマリマスタットを腹腔内注射した。
マリマスタットは、両方の脳領域(海馬および皮質)ならびに血清中で検出され、これは、マリマスタットが、血液脳関門を透過し、かつ動物試験に利用でき、脳においてMMP-9への阻害効果を発揮することを意味する。
さらなる非限定的実施例で、マリマスタットを、てんかん発生のマウスモデル(海馬内カイニン酸注射)において、インビボで試験した。上の結果に基づき、マリマスタットは血液脳関門を透過し、投与後1時間を超えて脳中に留まることが分かった。これは、マリマスタットの潜在的治療効果を可能にする最適時間である。この段階で、本発明者らは、亜痙攣誘発剤(カイニン酸:これはグルタミン酸受容体の作動物質である)の単回投与後に、MMP-9阻害に対するマリマスタットの効果を評価した。マウスに、KA投与の1時間前に、マリマスタット(9mg/体重kg)を腹腔内注射した。マリマスタットの注射後1時間に、40mMのカイニン酸を、腹腔内投与した。KA注射の結果として、強いてんかん発作が、増加した神経活動のため観察された。
阻害剤投与は、ネクチン-3の酵素的切断(17キロダルトンのネクチン-3断片の光学密度、図2a~2b)のMMP-9依存性過程を特異的に減弱させることが分かった。
てんかん発生マウスモデル(海馬内カイニン酸注射)におけるマリマスタットの治療的使用の機能的分析を、実施した。てんかん発生を、定位的手術中に、海馬CAI領域に直接カイニン酸を投与することにより誘導した。CAIの座標を、Paxinosのマウス脳アトラス(Mouse Brain Atlas)にしたがって選択した。3平面における座標を用いた:
(1)Z軸 - AP(前後) -1.8
(2)X軸 - L (外側) +1.7
(3)Y軸 - DV(背腹) -2.1
(1)30分
(2)6時間
(3)24時間
(1)Z軸 - AP(前後) -2.0
(2)X軸 - L (外側) +1.3
(3)Y軸 - DV(背腹) -1.7
電極埋め込み工程は、以下のプロトコルによった。ステンレス鋼製のビス電極(直径1.6mm、Bilaney Consultants GmbH、Germany)を、頭蓋骨中に設置した(表3;図3)。海馬双極電極を、歯状回中に設置した。2週間連続の(24時間/7日間)ビデオ-EEG(vEEG)追跡を、KA注射直後に開始した。マウスを、PMMAケージに入れ(ケージ当たりマウス1匹)、コミュテーター(SL6C、Plastics One Inc.、USA)を介して記録システムに繋いだ。vEEGを、57-チャンネル増幅器AS40-PLUS(Natus Medical Incorporated、USA)を有するComet EEG PLUSに接続されたツインEEG記録システムを用いて実施し、フィルタリングした(高域フィルターカットオフ、0.3Hz;低域フィルターカットオフ、100Hz)。
(1)KA注射後、最初の24時間(注射した痙攣誘発剤に対する急性応答)
(2)KA注射後、最初の週(注射した痙攣誘発剤に対する急性応答)
(3)KA注射の4週間後(注射した痙攣誘発剤によるてんかん発生~慢性変化)
てんかん発生過程誘導後の1ヶ月で、KA注射後1週と同様に、マリマスタットは、単一てんかん発作の持続を阻害した(P=0.02)(図6)。この効果はまた、KA注射後の4週間に海馬内で観察されるてんかん発作の例においても認められる。さらに、マリマスタットは、てんかん発作のスコアおよび回数をわずかに低下させたが、その変化は、有意ではなかった。
参考文献
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Claims (10)
- 脳損傷を罹患した対象においててんかん発生を予防するまたは治療することにおけるマリマスタットまたはその薬学的に許容可能な塩、溶媒和物またはその多形体の使用。
- 脳損傷が、卒中、外傷性脳損傷、あるいは構造的または代謝的原因により惹起された、てんかん重積状態の結果である、請求項1のマリマスタットまたはその薬学的に許容可能な塩の使用。
- マリマスタットまたはその薬学的に許容可能な塩が、経口で、舌下で、頬側で、皮下で、静脈内で、筋肉内でまたは髄腔内で投与される、請求項1または2のマリマスタットまたはその薬学的に許容可能な塩の使用。
- マリマスタットまたはその薬学的に許容可能な塩が、てんかん発生の誘導後に最長6.5日間単回投与量、または1日当たり2回投与される、反復用量でのいずれかで投与される、前記の請求項のいずれか1項に記載のマリマスタットまたはその薬学的に許容可能な塩の使用。
- マリマスタットまたはその薬学的に許容可能な塩が、てんかん発生の誘導後に1~3日の期間において反復用量で投与される、前記の請求項のいずれか1項に記載のマリマスタットまたはその薬学的に許容可能な塩の使用。
- マリマスタットまたはその薬学的に許容可能な塩の単回投与量が、ヒトに利用する場合、200mg~800mgである、前記の請求項のいずれか1項に記載のマリマスタットまたはその薬学的に許容可能な塩の使用。
- マリマスタットまたはその薬学的に許容可能な塩が、てんかん発生の誘導後最初の24時間以内に投与される、前記の請求項のいずれか1項に記載のマリマスタットまたはその薬学的に許容可能な塩の使用。
- マリマスタットまたはその薬学的に許容可能な塩が、てんかん発生の誘導後3時間以内に投与される、前記の請求項のいずれか1項に記載のマリマスタットまたはその薬学的に許容可能な塩の使用。
- マリマスタットまたはその薬学的に許容可能な塩が、てんかん発生の誘導後1時間以内に投与される、前記の請求項のいずれか1項に記載のマリマスタットまたはその薬学的に許容可能な塩の使用。
- マリマスタットまたはその薬学的に許容可能な塩が、てんかん発生の誘導後30分以内に投与される、前記の請求項のいずれか1項に記載のマリマスタットまたはその薬学的に許容可能な塩の使用。
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- 2019-06-17 WO PCT/IB2019/055040 patent/WO2020254853A1/en unknown
Non-Patent Citations (1)
Title |
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MOLECULAR AND CELLULAR PEDIATRICS, vol. 1, no. 6, JPN6023019959, 2014, pages 1 - 6, ISSN: 0005221960 * |
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IL289028A (en) | 2022-07-01 |
CN113993512B (zh) | 2024-03-15 |
JP7507798B2 (ja) | 2024-06-28 |
AU2019451652A1 (en) | 2022-01-27 |
CN113993512A (zh) | 2022-01-28 |
US20220347129A1 (en) | 2022-11-03 |
CA3143675A1 (en) | 2020-12-24 |
WO2020254853A8 (en) | 2022-03-10 |
KR20220024145A (ko) | 2022-03-03 |
WO2020254853A1 (en) | 2020-12-24 |
EP3982945A1 (en) | 2022-04-20 |
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