JP5765839B2 - 球脊髄性筋萎縮症治療薬 - Google Patents
球脊髄性筋萎縮症治療薬 Download PDFInfo
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- JP5765839B2 JP5765839B2 JP2011544335A JP2011544335A JP5765839B2 JP 5765839 B2 JP5765839 B2 JP 5765839B2 JP 2011544335 A JP2011544335 A JP 2011544335A JP 2011544335 A JP2011544335 A JP 2011544335A JP 5765839 B2 JP5765839 B2 JP 5765839B2
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- muscular atrophy
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- A61K31/403—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with carbocyclic rings, e.g. carbazole
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- A61K31/403—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with carbocyclic rings, e.g. carbazole
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- Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
Description
[1]トリプタン又はその薬理学的に許容される塩を有効成分として含有する、球脊髄性筋萎縮症治療薬。
[2]トリプタンがナラトリプタン、スマトリプタン、ゾルミトリプタン、エレトリプタン又はリザトリプタンである、[1]に記載の球脊髄性筋萎縮症治療薬。
[3]トリプタンがナラトリプタン、スマトリプタン又はリザトリプタンである、[1]に記載の球脊髄性筋萎縮症治療薬。
[4]有効成分がナラトリプタン塩酸塩である、[1]に記載の球脊髄性筋萎縮症治療薬。
[5]長期間に亘って連続的に投与されることを特徴とする、[1]〜[4]のいずれか一項に記載の球脊髄性筋萎縮症治療薬。
[6]球脊髄性筋萎縮症治療薬を製造するための、トリプタン又はその薬理学的に許容される塩の使用。
[7]球脊髄性筋萎縮症の患者に対して、トリプタン又はその薬理学的に許容される塩を治療上有効量投与するステップを含む、球脊髄性筋萎縮症の治療法。
イミグラン(登録商標)錠50(グラクソ・スミスクライン株式会社)、イミグラン(登録商標)点鼻液20(グラクソ・スミスクライン株式会社)、イミグラン(登録商標)注3(グラクソ・スミスクライン株式会社)、ゾーミック(登録商標)錠2.5mg(アストラゼネカ株式会社)、ゾーミック(登録商標)錠RM2.5mg(アストラゼネカ株式会社)、レルパックス(登録商標)錠(ファイザー製薬株式会社)、マクサルト(登録商標)錠 10mg(エーザイ株式会社)、マクサルトRPD(登録商標)錠 10mg(エーザイ株式会社)、アマージ(登録商標)錠2.5mg(グラクソ・スミスクライン株式会社)
細胞レベル及び動物(マウス)レベルでCGRP1がSBMAの病態に関与することが示唆されたことから、SBMAの治療法の確立を目指し、CGRP1を抑制する薬剤を探索した。CGRP1を抑制できる可能性のある薬剤として片頭痛薬のトリプタンを候補とした。ナラトリプタン(ナラトリプタン塩酸塩、グラクソ・スミスクライン社)はトリプタンの中でも血中濃度半減期が長く副作用の少ない薬剤であり脳血液関門を通過しやすいことから、慢性疾患であるSBMAに適応しやすいと考えられた。そこで、まずSBMAモデル細胞における、ナラトリプタンの効果を検討した。
SBMAのモデル細胞(SH-SY5Y mAR97Q stable cell line(神経芽細胞腫SH-SY5YにSBMAの原因タンパクである変異アンドロゲンレセプター(mAR)の遺伝子を導入し安定発現細胞株として作製したもの))を5%FCS、20μMレチノイン酸及び1nM DHTを添加したD-MEM/F-12培地で培養し、2日後に各濃度(0, 100nM, 1μM, 10μM)のナラトリプタン塩酸塩(Toronto Research Chemicals)を添加し、16時間後に細胞を回収した。各細胞のmRNAをRneasy Mini Kit (キアゲン)を用いて抽出し、SuoerScript III(インビトロジェン)を用いてcDNAを調製した後、iCycler (バイオ・ラッド)によるリアルタイムRT-PCRにてCGRP1発現量を比較した。プロトコールは各メーカーのものに従った。結果を図1左に示す。ナラトリプタン塩酸塩はCGRP1の転写を有意に抑制した。
SBMAのモデル細胞(SH-SY5Y mAR97Q stable cell line)を10%FCS添加D-MEM/F-12培地を用いて24ウエルプレートに播種した。翌日、5%FCS、20μMレチノイン酸及び1nM DHTを添加したD-MEM/F-12培地に交換し、各濃度(0, 100nM, 1μM, 10μM)のナラトリプタン塩酸塩(Toronto Research Chemicals)を添加した(0日目)。翌日(1日目)に培地と薬剤の交換を行い、2日目にWST-1を各ウエルに50μl滴下混合し、4時間37℃下で培養した後、反応液を96ウエルプレートに移し、PowerScan HT(大日本製薬)にて吸光度測定した。プロトコールはメーカーのものに従った。結果を図1右に示す。ナラトリプタン塩酸塩は細胞生存率を有意に改善した。
SBMAモデルマウス(ヒト変異ARのトランスジェニックマウス:AR-97Q)(WO2004/016083、Katsuno,M., et al.(2002). Testosterone Reduction Prevents Phenotypic Expression in a Transgenic Mouse Model of Spinal and Bulbar Muscular Atrophy. Neuron, 35, 843-854)に対するナラトリプタンの効果を検討した。ナラトリプタン塩酸塩(Toronto Research Chemical)を所定の濃度(0μM(コントロール), 1.8μM, 18μM)に水で溶解し、生後5週よりSBMAマウス(雄)に任意に飲水させた。生後5週より毎週、以下の各項目を測定した。
(a)体重
(b)運動機能(Rotorod): Economex rotarod (Colombus Instruments)を用いて回転(16/分)するロッド上に各マウスを3分間乗せ落下するまでの時間を測定した。
(c)生存率(Survival rate): 各群のマウスの生存率をKaplan-Meierを用いてデータ解析した。
(d)握力(Grip): 斉藤式マウス用握力測定装置(MUROMACHI)を用いて測定した。
SBMAモデルマウス(ヒト変異ARのトランスジェニックマウス:AR-97Q)とCGRP1ノックアウトマウス(CGRP KO)とを交配し、CGRP1をノックアウトしたSBMAモデルマウスAR-97Q(+/-)/CGRP(-/-) (雄)を作製した(図4)。CGRP1ノックアウトマウスは東京大学代謝生理化学教室の栗原裕基教授より譲渡を受けた。作製したAR-97Q(+/-)/CGRP(-/-) (雄)とSBMAモデルマウスAR-97Q(+/-)/CGRP(+/+)について生後5週より毎週、以下の各項目を測定した。
(a)体重
(b)運動機能(Rotorod): Economex rotarod (Colombus Instruments)を用いて回転(16/分)するロッド上に各マウスを3分間乗せ落下するまでの時間を測定した。
(c)生存率(Survival rate): 各群のマウスの生存率をKaplan-Meierを用いてデータ解析した。
(d)握力(Grip): 斉藤式マウス用握力測定装置(MUROMACHI)を用いて測定した。
ナラトリプタン以外のトリプタンもSBMAに対して薬効を示すか否かを調べた。スマトリプタン(Toronto Research Chemical)及び安息香酸リザトリプタン(Toronto Research Chemical)を評価対象とした。SBMAのモデル細胞(SH-SY5Y mAR97Q stable cell line)をOpti-MEM(インビトロジェン)培地を用いて24ウエルプレートに播種した。翌日、20μMレチノイン酸及び1nM DHTを添加したOpti-MEM(インビトロジェン)培地に交換した。この培地交換から4日後に各濃度(0, 1μM, 10μM, 100μM)で各トリプタンを添加した(各n=6)。投与24時間後にLDHアッセイを行った。いずれのトリプタンもSBMAモデル細胞に対する治療効果を示した(図6)。即ち、SBMAに対する治療効果はトリプタン系薬剤に共通する特性であることが明らかとなった。尚、ナラトリプタンは低濃度で高い効果を示し、特に有効であるといえる。
CGRP1の作用部位を調べるため、細胞生存率アッセイ及びLDHアッセイを行った。細胞生存率アッセイでは、運動ニューロンのモデル細胞であるヒト神経芽細胞腫のSH-SY5YにCGRP1(ぺプチド研究所)を投与した。培地はD-MEM/F12 (Dulbecco’s Modified Eagle Medium : Nutrient Mixture F-12, GIBCO)に10%ウシ血清(FCS), ペニシリンーストレプトマイシン(各20U/ml, 20μg/ml, GIBCO)を添加したものを用いた。24ウエルプレートに細胞を播種し、37℃細胞培養インキュベータに静置した。2日後、D-MEM/F12(5%ウシ血清含有)の培地にレチノイン酸(20μM)を添加することで分化を誘導するとともにアンドロゲン(DHT, 1nM)を同時添加した(0日目)。培地は2日目に交換し、4日目に各濃度(0, 10, 100, 1000nM)のCGRP1をD-MEM/F12、20μMレチノイン酸、1nM DHTの無血清培地下に投与した。投与2時間後にWST-1(Roche Applied Science)を各ウエルに50μl滴下混合し37℃細胞培養インキュベータに静置した。4時間後に反応液を96ウエルプレートに移し、PowerScan HT(大日本製薬)にて吸光度測定した。各プロトコールはメーカーのものに従った。
SBMAモデルマウス脊髄におけるGFAPの発現を調べた。まず、CGRP1コントロールSBMAモデルマウス(97Q CGRP(+/+))、CGRP1ノックアウトSBMAモデルマウス(97Q CGRP(-/-))、及びSBMAコントロールマウス(24Q)の各脊髄(胸髄、15週)のパラフィンブロックよりプレパラート切片を作成した。一次抗体は抗GFAP抗体(Cell Signaling Technology, #3670 (1:1000))を使用し、免疫染色はEnVision+ Kit(Dako)を用いた。プロトコールはメーカーのものに従った。免疫染色された胸髄水平断で中心管を一角とする前角側4分の1部分のGFAP陽性領域を画像解析ソフトWinROOF(三谷商事)により半定量し、コントロールと比較した。
ナラトリプタンを投与した場合のGFAPの発現変化を調べた。ナラトリプタンを投与したSBMAモデルマウス(97Qナラトリプタン)及び投与しないSBMAモデルマウス(97Qコントロール)、並びにSBMAコントロールマウス(24Qコントロール)について、脊髄(胸髄、15週)のパラフィンブロックよりプレパラート切片を作成した。その他の方法は6.の実験と同様である。
CGRP1がどのようなメカニズムを介して神経変性を惹起するかを解析した。SBMAモデル細胞に対し、6.の実験と同様の方法で4日目に各濃度(0, 0.01, 0.1μM)のJNK阻害薬SP-600125(Calbiochem)を投与した。24時間後に各ウエルの培養液を96ウエルのプレートに移し、ロシュの細胞障害性検出キットPLUS(LDH)を用い、PowerScan HT(大日本製薬)にて吸光度測定した。各プロトコールはメーカーのものに従った。
SBMAモデルマウスの病態へのJNK経路の関与について更に検討した。SBMAモデルマウス(97Q)、コントロールマウス(24Q)、CGRP1コントロールSBMAモデルマウス(97Q CGRP(+/+))、CGRP1ノックアウトSBMAモデルマウス(97Q CGRP(-/-))、ナラトリプタンを投与しないSBMAモデルマウス(97Qコントロール)、及びナラトリプタンを投与したSBMAモデルマウス(97Qナラトリプタン)について、脊髄(胸髄、15週)のパラフィンブロックよりプレパラート切片を作成した。一次抗体は抗p-c-Jun抗体(Cell Signaling Technology, #2361 (1:1000))を使用し、免疫染色はEnVision+ Kit(Dako)を用いた。プロトコールはメーカーのものに従った。免疫染色された胸髄水平断で中心管を一角とする前角側4分の1部分のp-c-Jun陽性領域を画像解析ソフトWinROOF(三谷商事)により半定量し、コントロールと比較した。
以上の実験の結果、「トリプタン系薬剤はSBMAに対して治療効果を示し、中でもナラトリプタンの効果は高いこと」及び「SBMAに対する治療戦略としてトリプタン系薬剤の長期間に亘る連続的投与が有効であること」が明らかとなった。トリプタン系薬剤は偏頭痛の治療薬として認可・臨床応用されている薬剤であり、その適用法として「長期間に亘る連続的な投与」は想定されていない。上記知見は、従来の適用とは全く異なることはもとより従来の使用実績からは到底予想できない、トリプタン系薬剤の新たな用途を提供する。
本明細書の中で明示した論文、公開特許公報、及び特許公報などの内容は、その全ての内容を援用によって引用することとする。
Claims (5)
- ナラトリプタン、スマトリプタン若しくはリザトリプタン、又はその薬理学的に許容される塩を有効成分として含有する、球脊髄性筋萎縮症治療薬。
- ナラトリプタン塩酸塩を有効成分として含有する、球脊髄性筋萎縮症治療薬。
- 長期間に亘って連続的に投与されることを特徴とする、請求項1又は2に記載の球脊髄性筋萎縮症治療薬。
- 球脊髄性筋萎縮症治療薬を製造するための、ナラトリプタン、スマトリプタン若しくはリザトリプタン、又はその薬理学的に許容される塩の使用。
- 球脊髄性筋萎縮症治療薬を製造するための、ナラトリプタン塩酸塩の使用。
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