JP7494186B2 - 下部尿路症状の処置および/または防止のための組成物 - Google Patents
下部尿路症状の処置および/または防止のための組成物 Download PDFInfo
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Description
- 尿道を圧迫するその体積の増加(前立腺肥大)などの前立腺に関連する障害。次いで男性対象は、排尿後尿滴下またはさらに夜間尿漏れの発生に苦しむ;
- 前立腺切除術:これは前立腺の除去である;
- 尿道の腫瘍または尿道の狭窄によって定義され、通常の尿流を塞ぐ尿道狭窄などの健康上の問題
である。
- セカレ・シリアルL.の花粉の水性抽出物;
- ゼア・マイスL.の花粉の水性抽出物;
- ピヌス・シルベストリスL.の花粉の水性抽出物;
- ダクチリス・グロメラタL.の花粉の水性抽出物
の混合物から得られる。
- 重量で抽出物の総重量の45%~90%のセカレ・シリアルL.の花粉の水性抽出物;
- 重量で抽出物の総重量の1%~35%のゼア・マイスL.の花粉の水性抽出物;
- 重量で抽出物の総重量の0.01%~5%のピヌス・シルベストリスL.の花粉の水性抽出物;
- 重量で抽出物の総重量の3%~30%のダクチリス・グロメラタL.の花粉の水性抽出物
の混合物から得られる。
a)花粉の水抽出;
b)花粉および有利にはめしべの水抽出;
c)ステップa)およびb)で得られた抽出物の噴霧乾燥;ならびに
d)c)で得られた植物の花粉およびめしべの前記抽出物の回収
の一連のステップを含むプロセスが挙げられ得る。
a)第1の抽出物を得るための、セカレ・シリアルL.、ゼア・マイスL.、ピヌス・シルベストリスL.およびダクチリス・グロメラタL.の花粉の、45℃未満の温度で少なくとも6時間の水および/または水-アセトン混合物による抽出;
b)第2の抽出物を得るための、ゼア・マイスL.の花粉および有利にはめしべの、45℃未満の温度で少なくとも6時間の水および/または水-アセトン混合物による抽出;
c)a)およびb)で得られた第1および第2の抽出物の混合;
d)c)で得られた混合物の噴霧乾燥;ならびに
e)d)で得られた花粉および有利にはめしべの抽出物の混合物の回収
を含む。
- 組成物の総重量の5~40重量%の水性花粉抽出物;
- 組成物の総重量の20~80重量%のククルビタ属種子の水性抽出物;および
- 組成物の総重量の0.1~10重量%のビタミンEまたはそのエステル
を含む。
- 組成物の総重量の10~30重量%の水性花粉抽出物、例えば、10%、15%、20%、25%、30%;
- 組成物の総重量の30~50重量%のククルビタ属種子の水性抽出物、例えば、30%、35%、40%、45%、50%;および
- 組成物の総重量の1~5重量%のビタミンEまたはそのエステル、例えば、1%、2%、3%、4%、5%
を含む。
- 昼間頻尿症、これは日中の排尿の回数の増加である;
- 夜間頻尿、つまり患者を目覚めさせる排尿の必要。夜間頻尿は、患者が就寝する時点からの夜間排尿の合計に対応するが目覚めの概念を考慮しない「夜間排尿回数」と区別されなければならない。用語「夜間頻尿症」は、夜間排尿の回数の異常な増加を記載することが望まれる状況のためにとっておかれるべきであり、結果として、いくつかの事象によって、または生活の質もしくは不快感に関する起こり得る影響によって定義される病理学的閾値の概念を導入する;
- 尿意切迫感または尿意切迫は、突然の、強制的な、および頻繁な抑えられない尿意である。この用語は、突然の、抵抗できない尿意の発現を指し、これは遅らせることが困難であるか、または不可能である。それは、その残酷さおよび強さが異常な要求である。それは、中程度のまたはさらに少量の尿だけを伴うことが多い。それは、充満した膀胱の感覚から充満した膀胱による尿意の感覚への要求の正常な進行と異なる。正常な生理的要求は、社会的設備および環境的制約を満たすためにある程度の時間延期され得る排尿の前兆である;
- 尿失禁は尿の不随意の漏出である。用語尿失禁は、漏れの発生の機序および状況、それらの重症度、それらの回数、任意の要因の存在、それらの社会的、衛生的または生活の質への影響、漏れを回避するためにとられる任意の対策の存在、ならびに最後に患者からの医学的要請の意見に従って特定されなければならない;
- 腹圧性尿失禁(SUI)は、身体活動、咳およびくしゃみ中の尿の不随意の漏出である;
- 切迫性(または急迫性)尿失禁は、尿意切迫感を伴う、またはそれが直前に先行する尿の不随意の漏出である;
- 混合性尿失禁(MUI)は、尿意切迫感と関連する尿の不随意の漏出であり、運動、咳またはくしゃみ中の尿の不随意の漏出も伴う;
- 溢流性失禁は、人がその膀胱を完全に空にできないことに起因する漏れである。これは、頻繁で、しばしば繰り返される尿の漏れをもたらす;
- 遺尿症は不随意の排尿である。用語夜尿症は睡眠中に発生する遺尿症を記載する;
- 持続性失禁は持続性の尿漏れである;
- 膀胱感度:
正常:患者は、切迫する要求を感じるまで徐々に増加する排尿の要求を説明する;
亢進:患者は、非常に早期および持続性の排尿の要求を説明する;
低下:患者は、膀胱体積の増加を感じるが、排尿の要求を感じない;
欠如:患者は一切知覚を感じない。
- 尿勢低下:排尿中の尿の流れの勢いの低下の患者の認識;
- 尿線分割/散乱;
- 尿線途絶:1回または複数回中断する排尿;
- 排尿遅延:排尿開始の遅延;
- 腹圧性排尿:腹部を強く押すと同時に得られる尿の流れ;
- 終末滴下、長引く排尿:滴流で終わる、排尿が徐々におよびゆっくり完了すること。
- 残尿感は、排尿後に膀胱が完全に空になっていないという主観的感覚である;
- 排尿後尿滴下は、排尿直後、ほとんどの場合、男性についてはトイレを出るとき、または女性についてはトイレから立ち上がるときに発生する尿失禁である。
- 膀胱痛、これは恥骨前部または後部において感じられる疼痛を定義するための一般用語である。疼痛は通常、膀胱充満とともに増加し、最終的には排尿後に持続し得る。この用語は「間質性膀胱炎」の用語よりも好まれるべきであり、「間質性膀胱炎」は、一連の診断基準に従ってより正確に定義される病的実態に対応する;
- 尿道痛、これは尿道で感じられ、患者が言及する疼痛である;
- 外陰部痛、これは厳密に外陰部レベルで感じられる疼痛である;
- 膣痛、これは外陰部の区域を超えて膣腔の内部で感じられる疼痛である;
- 陰嚢痛、その記載は索、精巣、精巣上体、またはさらに皮膚におけるより具体的な位置を示唆しない;
- 会陰痛、これは、女性では小陰唇の後交連(vulvar fork)と肛門の間、男性では陰嚢と肛門の間に感じられる疼痛である;
- 骨盤痛、これは、その正確な位置に関してあまり明確に定義されない、より拡散的で、膀胱の蓄尿-排尿サイクルに直接関連しない疼痛である。
- 膀胱痛症候群は、尿路感染または膀胱組織病態の非存在下での、昼間または夜間頻尿症と関連する、膀胱充満中の増加した恥骨上部痛である;
- 尿道痛症候群は、尿路感染または膀胱組織病態の非存在下での、優先的に排尿中に発生する再発性尿道痛である;
- 外陰痛症候群は、排尿サイクルに応じて変わり得るまたは下部尿路機能障害もしくは性障害を示唆する症状と関連し得る、持続的または間欠的外陰痛である;
- 膣痛症候群は、証明された膣感染または任意の他の明らかな膣病態の非存在下での、下部尿路機能障害または性障害を示唆する症状と関連する、持続的または間欠的な膣痛である;
- 陰嚢痛症候群は、精巣上体炎または任意の他の局所病態の非存在下での、下部尿路機能障害または性障害を示唆する症状と関連する、持続的または間欠的な陰嚢痛である;
- 会陰痛症候群は、証明された感染または任意の他の明らかな会陰病態の非存在下での、下部尿路機能障害または性障害を示唆する症状と関連する、持続的または間欠的な会陰痛である;
- 骨盤痛症候群は、証明された感染または任意の他の明らかな病的状態の非存在下での、下部尿路の機能障害、消化器系または性障害を示唆する症状と関連する、持続的または間欠的な骨盤痛である。
- 「臨床過活動膀胱症候群」または「尿意切迫-頻尿症症候群」は、通常頻尿症または夜間頻尿と関連する、尿失禁を伴うまたは伴わない尿意切迫感の発生によって定義される。この症候群は、尿力学検査によって立証された排尿筋過活動を示唆するが、それは下部尿路の機能障害の他の種類に起因することもあるため特異的ではない。さらに、用語「過活動膀胱の臨床症候群」は、尿路感染も明らかな局所器質病態(腫瘍など)もないことを仮定する;
- 膀胱下閉塞を示唆する「排尿障害症候群」は、尿路感染または明らかな局所病態の非存在下で、主に排尿関連障害を有する男性において使用されるべきである。女性において、排尿障害症候群は、膀胱下閉塞よりも過活動膀胱を示唆するはずである。
錠剤(表1)
カプセル(表2)
ソフトカプセル(表3)
カプセル(表4)
LUTS、より具体的には尿失禁に苦しんでいる18~75歳(平均年齢60.35)の年齢の160人の患者に研究を行った。
- 120~200mgのP2花粉の水性抽出物および5~10mgのEA5花粉の油性抽出物(=GRAMINEX(登録商標))、100~300mgのカボチャ種子の水性抽出物ならびに16~30mgのD-アルファ-酢酸トコフェリルを含む組成物A;
- 120~200mgのP2花粉の水性抽出物および5~10mgのEA5花粉の油性抽出物(=GRAMINEX(登録商標))を含む組成物B;または
- プラセボ(微結晶性セルロース、イソマルト、ステアリン酸マグネシウム、二酸化ケイ素、およびコーティング剤(Aqua Polish D Grey 089.45MS)を含む錠剤)
の同じ条件下での投与と比較した。
a~c。2つずつの比較。同じ群内で、異なる小文字は、各時点の間の統計的に有意な差異を示す(ボンフェローニ補正)。
A~B。2つずつの比較。同じ所与の時点について、異なる大文字は群間の統計的に有意な差異を示す(ボンフェローニ補正)。
この研究の目的は、切迫性(または急迫性)尿失禁または混合性尿失禁を示す過活動膀胱(OAB)の症状と診断された女性における本発明に従う組成物の反応を確認することである。
2つの群の間の人口統計的特徴および失禁に関して、最初に差異はなかった。
この研究の目的は、腹圧性失禁と診断された女性における、本発明に従う組成物の反応を確認することである。
図14に示されている通り、ICIQ-UI SFにより、プラセボ群と比較して、本発明に従う組成物「PSCEP」を用いて処置した群において顕著な改善が3カ月後に観察された(p=0.048)。
この研究では、切迫性(または急迫性)尿失禁または混合性尿失禁を示す過活動膀胱(OAB)の症状の診断を有する26人の女性を、本発明に従う(実施例1に従う)組成物を用いて処置した(n=26)。
一晩当たり0または1回の排尿(/一晩);
2回の排尿/一晩;
3~4回の排尿/一晩;
5~6回の排尿/一晩;または
6回より多い排尿/一晩
図17に示されている通り、本発明に従う(実施例1に従う)組成物は、切迫性(または急迫性)尿失禁または混合性尿失禁を有する患者の夜間排尿回数を顕著に減らす:
本発明に従う組成物を用いると、研究の開始(組み入れ)時に、一晩当たり6回を超える排尿を有した患者のパーセンテージは、90日間の処置後になくなり、したがって、6回より多い排尿/一晩のこのカテゴリーに依然として見出される患者はいない;
一晩当たり3~4回の排尿を有した患者のパーセンテージは50%減少している;
一晩当たり2回の排尿を有した患者のパーセンテージは55%減少している;
結果として、次いで本発明者らは、一晩当たり0~1回の排尿を示した患者の群において、3.3倍の患者を見出している。
アセチルコリン(Ach)は、シグナルを他の細胞、すなわちニューロン、筋細胞および腺細胞に送るために、神経細胞によって放出される神経伝達物質である。アセチルコリンは、これらの細胞の表面上の受容体に結合し、それらを活性化することによってその効果を発揮する。アセチルコリン受容体の2つの主なクラス、ニコチン性およびムスカリン性があり、これらは異なる組織で見出される。膀胱では、アセチルコリンの作用は、排尿筋の平滑筋に位置するムスカリン受容体の存在に依存する。M1、M2、M3、M4およびM5と呼ばれる5種類のムスカリン受容体のうちM2およびM3は膀胱に存在する。M2は数が優勢であり、M3は主として、アセチルコリンに対する直接的な収縮反応のメディエーターである。健康な膀胱が収縮するためには、アセチルコリンが、コリン作動性神経から放出され、排尿筋中のM3受容体を活性化し、放出の緩和を伴うと排尿が生じる。
本発明に従う(実施例1に従う)組成物、独立して試験した活性成分のそれぞれ、および参照アンタゴニストの用量-反応曲線を正規化した。IC50データは、以下の表に示され、図18に示されている。
Claims (8)
- 組成物の総重量の5~40重量%の、マツ科およびイネ科に属する植物混合物から得られる水性花粉抽出物を含有する花粉抽出物、ここで、前記水性花粉抽出物が、
重量で、前記抽出物の総重量の45%~90%のセカレ・シリアルL.の花粉の水性抽出物、
重量で、前記抽出物の総重量の1%~35%のゼア・マイスL.の花粉の水性抽出物、
重量で、前記抽出物の総重量の0.01%~5%のピヌス・シルベストリスL.の花粉の水性抽出物、
重量で、前記抽出物の総重量の3%~30%のダクチリス・グロメラタL.の花粉の水性抽出物
の混合物から得られ;
組成物の総重量の20~80重量%の、ククルビタ属に属する植物種子の水性抽出物、ここで、前記抽出物の総重量の10重量%未満の含有率で脂肪酸を含有し;
組成物の総重量の0.1~10重量%のビタミンEまたはそのエステル;ならびに
重量で抽出物の総重量の0.1%~10%のゼア・マイスL.のめしべの水性抽出物
を含んでなる、女性における蓄尿、排尿および/または排尿後相と関連する下部尿路症状(LUTS)の処置および/または防止における使用のための組成物であって、前記女性における蓄尿、排尿および/または排尿後相と関連する下部尿路症状(LUTS)が尿失禁である、組成物。 - ククルビタ属種子の前記水性抽出物が、前記抽出物の総重量の5~8重量%の含有率で脂肪酸を含有することを特徴とする、請求項1に記載の使用のための組成物。
- ゼア・マイスL.のめしべの水性抽出物、マンガン、ベチュラ・アルバ、ケラスス・アビウム、エクイセトゥム・アルウェンセ、パセオルス・ウルガリス、アキレア・ミレフォリウム、アグロピロン・レペンス、ガリウム・ベラム、ラヴァンドラ・オフィキナリス、メンタ・ピペリタ、ウルティカ・ディオイカの抽出物から選択される活性剤をさらに含むことを特徴とする、請求項1または2に記載の使用のための組成物。
- 経口投与に適した形態であることを特徴とする、請求項1~3のいずれか1項に記載の使用のための組成物。
- 錠剤、カプセル、ソフトカプセル、ソフトゲル、半固体、固体、液体または粉末の形態で製剤化されることを特徴とする、請求項4に記載の使用のための組成物。
- 腹圧性尿失禁、切迫性(または急迫性)尿失禁および混合性尿失禁の処置における使用のための、請求項1~5のいずれか1項に記載の組成物。
- 目覚めを誘導する夜間排尿回数の減少における使用のための、請求項6に記載の組成物。
- 組成物の総重量の10~30重量%の水性花粉抽出物、
組成物の総重量の30~50重量%のククルビタ属種子の水性抽出物、および
組成物の総重量の1~5重量%のビタミンEまたはそのエステル
を含むことを特徴とする、請求項1に記載の組成物。
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FR1900478 | 2019-01-18 | ||
FR1900478A FR3091819B1 (fr) | 2019-01-18 | 2019-01-18 | Composition pour le traitement et/ou la prevention des symptomes du bas appareil urinaire |
PCT/EP2020/050671 WO2020148224A1 (fr) | 2019-01-18 | 2020-01-13 | Composition pour le traitement et/ou la prevention des symptomes du bas appareil urinaire |
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JP2012046459A (ja) | 2010-08-28 | 2012-03-08 | Asama Chemical Co Ltd | 泌尿器系疾患予防治療用組成物及びその製造方法 |
WO2018041790A1 (fr) | 2016-08-31 | 2018-03-08 | Sérélys Pharma S.A.M. | Composition comprenant des extraits de pollens et/ou de pistils, procede de preparation et utilisations associees |
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FR3070263B1 (fr) * | 2017-08-28 | 2020-07-24 | Serelys Pharma S A M | Composition pour son utilisation dans le traitement et/ou la prevention de l’infertilite |
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JP2012046459A (ja) | 2010-08-28 | 2012-03-08 | Asama Chemical Co Ltd | 泌尿器系疾患予防治療用組成物及びその製造方法 |
WO2018041790A1 (fr) | 2016-08-31 | 2018-03-08 | Sérélys Pharma S.A.M. | Composition comprenant des extraits de pollens et/ou de pistils, procede de preparation et utilisations associees |
Non-Patent Citations (2)
Title |
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Menopause Rev.,2018年,17(2),pp. 77-85 |
日本食品科学工学会誌,2011年,Vol. 58, No.9,pp. 454-459 |
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Publication number | Publication date |
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CN113316456B (zh) | 2024-05-14 |
BR112021013006A2 (pt) | 2021-09-14 |
EP3911347A1 (fr) | 2021-11-24 |
DK3911347T3 (da) | 2023-11-13 |
WO2020148224A1 (fr) | 2020-07-23 |
CA3123859A1 (fr) | 2020-07-23 |
CN113316456A (zh) | 2021-08-27 |
ES2966149T3 (es) | 2024-04-18 |
PT3911347T (pt) | 2023-12-11 |
JP2022522997A (ja) | 2022-04-21 |
BR112021013006A8 (pt) | 2023-04-11 |
MX2021008602A (es) | 2021-09-21 |
FR3091819A1 (fr) | 2020-07-24 |
EP3911347B1 (fr) | 2023-10-04 |
PL3911347T3 (pl) | 2024-02-05 |
US20230149498A1 (en) | 2023-05-18 |
AU2020209886A1 (en) | 2021-08-26 |
FR3091819B1 (fr) | 2021-04-23 |
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