JP5826921B2 - 隔離されたバクテリアに関連する疾患の治療方法 - Google Patents
隔離されたバクテリアに関連する疾患の治療方法 Download PDFInfo
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- JP5826921B2 JP5826921B2 JP2014511338A JP2014511338A JP5826921B2 JP 5826921 B2 JP5826921 B2 JP 5826921B2 JP 2014511338 A JP2014511338 A JP 2014511338A JP 2014511338 A JP2014511338 A JP 2014511338A JP 5826921 B2 JP5826921 B2 JP 5826921B2
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- antibiotic
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- clarithromycin
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Description
本願は、2011年5月16日出願の米国仮特許出願第61/486,566号の先願の利益を主張するものであり、この開示は参照として全体に組み込まれるものである。
ある期間にわたって投与することができる。しかしながら、この実施形態の化合物は対象に投与されるが、投与した化合物の量および選択した投与経路は、疾患状態の有効な治療を可能にするために選択されるものである。
この検証モデルとして、24頭の仔ウマ(平均4+/−3日齢)と、非感染の対照として扱う2頭の追加的な仔ウマを使用した。この仔ウマは、獣医学ファーム(Veterinary Science farm)で育てられ、本研究の間雌ウマと共に共存させた。この仔ウマを、生後すぐに、以下の基準、身体検査における正常性、聴診の肺の音の欠如、平熱、および日常的な肺の超音波診断を使用した研究における基準で評価した。この仔ウマは、本研究に登録される前に抗‐ロドコッカスプラズマまたは他の治療を受けなかった。この仔ウマを、BSL2隔離施設中の個々の畜房に雌親と共に移動させた。心拍数、呼吸数、体温、フィブリノーゲン濃度および白血球数のベースライン値を得た。
仔ウマあたり2.2×108のバクテリアの初期用量濃度でR.equiの気管支内の滴下注入で仔ウマを検証し、その後、仔ウマあたり約1.5×105まで低減させた。この菌に、病原性関連プラスミドを含むことが確認された。手短に述べると、バクテリアの培養は、以前に記載される(Jacks, S., Giguere, S., 2010, Veterinary Immunology and Immunopathology 282−286)ように、播種前に一晩アガープレート上にて増殖させるものであり、この開示は参照として本明細書全体に組み込まれる。
この3つの治療グループは、以下の、SLO療法と併用した抗生物質療法(グループA、n=8)、SLO療法(グループB、n=4)単独および標準的な抗生物質療法単独(グループC、n=7)であり、ならびに対照(n=2)は感染せず、かつ治療もしなかった。この抗生物質治療計画は、毎日2回、osを介して得られたクラリスロマイシン(7.5mg/kg)およびリファンピン(5mg/kg)からなる。グループAおよびBのSLOの投与は、1日に2回の皮下注射による0.2mL(2IU)の投与を含んだ。グループAからCの全ての治療を、仔ウマを安楽死させる必要がある点まで症状が進行しない限り、21日間続けた。
7つ肺の部位を病理学組織的に評価し、かつ化膿性肉芽腫炎症および肺胞の壊死の分布、度合いに関して各仔ウマにグレードを付けた。肺炎の点数を、動物全体で、かつ各7つの部位で、個々に作製した。肺組織のサンプルを、細菌学的培養およびRNA分析で得た。末梢血のサンプルをR.equi−特異的IFN−γ産生の評価のために収集した。仔ウマの末梢血単核球(PBMC)は、感染の前の生体外でのR.equiとの刺激作用後、相当量のIFN−γを産生し、かつ感染後の反応におけるグループ間に差異はみられなかった。
この実験の結果に基づく総合的な所見から、このことが常に統計学的有意性を持つわけではないが、抗生物質計画にSLOを追加することが、いくつかの追加的な利益を提供したことが示された。しかしながら、1つの反応パターンを見る場合、SLO+抗生物質療法グループ(グループA)は、一貫して、抗生物質療法単独グループ(グループC)を含む他のグループと比較してより良い臨床反応を示した。特に興味深いことに、グループAでより低いバクテリア数(p=0.082)が見られた。この全体的なCFU/gの低減は、SLOとの併用療法が、肺うっ血または個々の肉芽腫内への浸透が増大することにより、抗生物質治療の活性を強化してもよいことを示唆する。同様に、グループA(抗生物質+SLO)における仔ウマの肺に堆積したコラーゲンがより少なく、このことにより、影響する気道内のより瘢痕が少なくなることと関連づけることができる可能性がある。同様に、併用治療グループ(グループA)が、顕著に低い肺炎の点数を有するため、この肉眼での病理学的所見が、組み合わせた抗生物質およびSLOの治療の効果を強化することを支持するものである。繰り返しになるが、他の免疫組織学的測定が治療グループ間の差異がないが、多くの場合、全体的にグループA(抗生物質+SLO)がより低い傾向があった。本方法は、いくつかの場合に、抗生物質を受け取るグループおよび抗生物質で治療したグループの間に差異がなかったので、治療の効果を同定するための十分な感受性を有さなかった可能性がある。このことは、検視の前に病変を解決するための十分な時間がないためと考えられた。
前述の実施例は、抗生物質療法単独またはSLO療法単独療法を受けた仔ウマと比較して、検視時に試験した肺組織内のバクテリア数が低いことを示した仔ウマを標準的抗生物質計画(すなわち、リファンピンおよびクラリスロマイシン)およびSLOを含む併用療法で、R.equiで検出した仔ウマを治療したことが説明するものである。この結果は、併用療法中のSLOが、肺うっ血または個々の肉芽腫内への浸透を増大させることにより、抗生物質治療の活性を強化したことを示唆する。したがって、膿瘍に関連したバクテリア感染症の治療を目的とする治療計画においてSLOの包有することが特に考えられる。
Claims (10)
- 哺乳類(人間を除く)の対象において隔離されたバクテリアに関連する、結核および肺炎からなる群から選択される障害を治療する方法であって、ストレプトリジンO(SLO)および抗生物質を含む併用療法を前記対象に投与するステップを含み、前記併用療法で有効量が投与されて前記障害を治療する、方法。
- 前記隔離されたバクテリアが、インフルエンザ菌、髄膜炎菌、肺炎球菌、結核菌、肺炎マイコプラズマ、黄色ブドウ球菌、およびロドコッカス・エクイからなる群から選択される、請求項1に記載の方法。
- 前記SLOを、1日当たり0.0032〜50単位(2単位/0.05ml)の範囲内の用量で投与する、請求項1または2に記載の方法。
- 前記SLOを、1日当たり0.01〜10単位の範囲内の用量で投与する、請求項1または2に記載の方法。
- 前記抗生物質が、リファンピン、シプロフロキサシン(ciprofloxacin)、エノキサシン、ガチフロキサシン、レボフロキサシン、ロメフロキサシン、モキシフロキサシン、ナリジクス酸、ノルフロキサシン、オフロキサシン(ofloxacin)、カプレオマイシン、サイクロセリン、エタンブトール、チオナミド、イソニアジド、ピラジナミド、ストレプトマイシン、クラリスロマイシン(clarithromycin)、リファペンチン(rifapentine)、クロラムフェニコール、メトロニダゾール(metronidazole)、チアンフェニコール、エルタペネム、ドリペネム、シラスタチン、ドキシサイクリン、エリスロマイシン、ナフシリン、オキサシリン、バンコマイシン、ペニシリン、およびそれらの組み合わせからなる群から選択される抗生物質を含む、請求項1から4のいずれか1項に記載の方法。
- 前記対象が肺炎である、請求項1に記載の方法。
- 前記抗生物質が、リファンピンおよびクラリスロマイシンを含む、請求項6に記載の方法。
- 隔離されたバクテリアに関連する、結核および肺炎からなる群から選択される障害を治療するための有効量で、ストレプトリジンO(SLO)および抗生物質を含む、前記障害を治療するための組成物。
- 0.0008〜50単位の範囲の量のSLOを含む、請求項8に記載の組成物。
- 前記抗生物質が、リファンピン、シプロフロキサシン、エノキサシン、ガチフロキサシン、レボフロキサシン、ロメフロキサシン、モキシフロキサシン、ナリジクス酸、ノルフロキサシン、オフロキサシン(ofloxacin)、カプレオマイシン、サイクロセリン、エタンブトール、チオナミド、イソニアジド、ピラジナミド、ストレプトマイシン、クラリスロマイシン(clarithromycin)、リファペンチン(rifapentine)、クロラムフェニコール、メトロニダゾール(Metronidazole)、チアンフェニコール、エルタペネム、ドリペネム、シラスタチン、ドキシサイクリン、エリスロマイシン、ナフシリン、オキサシリン、バンコマイシン、ペニシリンおよびそれらの組み合わせからなる群から選択される抗生物質を含む、請求項8に記載の組成物。
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