TW201408285A - 免疫耐受誘導劑 - Google Patents
免疫耐受誘導劑 Download PDFInfo
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- TW201408285A TW201408285A TW102124437A TW102124437A TW201408285A TW 201408285 A TW201408285 A TW 201408285A TW 102124437 A TW102124437 A TW 102124437A TW 102124437 A TW102124437 A TW 102124437A TW 201408285 A TW201408285 A TW 201408285A
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- Prior art keywords
- iron
- group
- ala
- immune tolerance
- inducing
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- 239000000411 inducer Substances 0.000 title claims abstract description 23
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Abstract
本發明課題為提供一種免疫耐受誘導劑,其係安全且與先前藥劑作用機構不同之可應用於免疫疾病之治療的控制性樹狀細胞之誘導劑,除此之外的過敏性疾病之預防治療劑或自體免疫疾病之預防治療劑等。本發明之解決方法,係調製免疫耐受誘導劑,其將5-胺乙醯丙酸(ALA)或者其衍生物或其鹽、及鐵化合物作為有效成分。以上述ALA類而言,可適當例示ALA、及同甲酯、乙酯、丙酯、丁酯、戊酯等之各種酯類、以及該等鹽酸鹽、磷酸鹽、硫酸鹽等,以鐵化合物而言,可適當例示檸檬酸亞鐵鈉。
Description
本發明係關於免疫耐受誘導劑,進一步詳言之,係關於一種免疫耐受誘導劑,其包含5-胺乙醯丙酸(ALA)或者其衍生物或該等鹽,適用於控制性樹狀細胞之誘導、過敏性疾病、自體免疫疾病等。本發明之免疫耐受誘導劑,除了控制性樹狀細胞之誘導之外,對造成過敏性疾病、自體免疫疾病等不必要的免疫反應原因的疾病治療或者預防為有用。
免疫耐受係指免疫系統不攻擊可成為抗原之物之狀態。針對自體抗原(autoantigen),通常有不產生免疫反應(immune response)的「自體耐受」,與即使為非自體抗原,也因一定之投與條件所誘導的「獲得耐受」。吾人認為在非自體抗原,有參與因控制性T細胞所致主動態的抑制。免疫耐受所要求之疾病,例如過敏性疾病、自體免疫疾病等,可視為非自體或者使針對自體之免疫學上無反應性崩潰之現象加以捕捉。
樹狀細胞係具有樹狀突起的系統標記陰性MHC級別II陽性之抗原表現(antigen presentation)細胞,自造血幹細胞(hematopoietic stem cell),經過骨髓(myeloid)系或淋巴球系分化經路,分化為未熟樹狀細胞,進一步成為成熟樹狀細胞,但樹狀細胞作為族系(lineage)或成熟階段不同之各種各樣的亞型(subset),廣泛存在於末梢非淋巴組織或淋巴組織。恆定狀態(steady state)(非發炎狀態)未熟樹狀細胞占了大部分,在經由可提供弱抗原刺激與共同刺激(costimulatory)的抗原表現,對首次用於實驗的(naïve)T細胞,誘導細胞系刪除(clonal deletion)或惰性化,同時誘導增強具有免疫抑制能的各種控制性T細胞。因此吾人認為未熟樹狀細胞經由參與該等T細胞功能控制機構之免疫耐受之誘導,而擔任對免疫學的穩態(homeostasis)之維持極重要的作用。一方面,在被微生物、濾過性病毒、異物等外來抗原所侵襲的發炎狀態,捕食(predation)該等的未熟樹狀
細胞,因發炎刺激而分化成成熟樹狀細胞。成熟樹狀細胞作為最強力的抗原表現細胞,賦予抗原刺激與共同刺激於單純T細胞,並分化誘導抗原特異效應T細胞,而誘導免疫反應。又,即使在發炎狀態,作為顯示強力免疫耐受誘導能力的抗原表現細胞,周知有控制性樹狀細胞(亦稱為耐受原性(tolerogenic)樹狀細胞)。
就控制性樹狀細胞,周知有:將人樹狀細胞或其先驅細胞
(precursor cell)在試管內(in vitro)與至少包含IL-10及TGF-β之細胞介素(cytokine)類同時培養,並誘導人免疫控制性樹狀細胞之方法,以該方法所得之人免疫控制性樹狀細胞以及包含該人免疫控制性樹狀細胞之醫藥組成物(參照專利文獻1);或一種製作耐受原性樹狀細胞之方法,其包含將經單離之樹狀細胞,用以感染該樹狀細胞為充分量之呼吸道融合病毒(respiratory syncytial virus),在引起下述細胞表面CD80high、CD86high、CD40high及CD83low之細胞表面表現之條件下予以培養之步驟(參照專利文獻2);或含有控制性樹狀細胞,藉由發炎性細胞介素之過剩分泌所誘導之疾病(敗血症等)之預防或治療劑、IL-10產生促進劑、細胞死亡(apoptosis)抑制劑等(參照專利文獻3)之技術。
周知ALA為廣泛存在於動物、植物或菌類的四吡咯生物合
成途徑之中間體,通常藉由5-胺乙醯丙酸合成酵素,而自琥珀醯基CoA與甘胺酸被生物合成。使用了ALA的光線力學(photodynamics)療法或光動力學(photokinetics)的治療(以下亦稱為「ALA-PDT」)亦被開發出,作為侵入性低且可保持QOL的治療法而受到矚目,且使用了ALA等的腫瘤診斷治療劑等之報告被發表。又,周知ALA作為成人病、癌症、男性不孕之預防改善劑或治療劑為有用(參照例如專利文獻4至6)。
〔專利文獻1〕日本特開2004-298181號公報
〔專利文獻2〕日本特表2011-522837號公報
〔專利文獻3〕日本特開2006-290761號公報
〔專利文獻4〕國際公開WO2010/050179
〔專利文獻5〕日本特開2011-16753號公報
〔專利文獻6〕國際公開WO2009/139156
本發明之課題係提供一種免疫耐受誘導劑,其為安全且與先前藥劑作用機構不同而可應用於免疫疾病之治療的控制性樹狀細胞之誘導劑,除此之外亦為過敏性疾病之預防治療劑或自體免疫疾病之預防治療劑等。
本發明人等,關於對ALA之醫療之應用,已持續各式各樣的研討,而首先發現含有單獨ALA或ALA類與屬鐵離子供給源之檸檬酸亞鐵鈉(SFC)等之鐵化合物的組成物,具有控制性樹狀細胞之誘導作用或過敏性疾病預防治療作用、及自體免疫疾病預防治療作用。
又,首先發現鐵化合物與ALA協同作用,使控制性樹狀細胞之誘導作用、過敏性疾病預防治療作用、及自體免疫疾病預防治療作用增強。在鐵化合物充分存在之情形,或其他途徑攝取鐵化合物之情形,會有以單獨ALA之投與而無問題之情形。在紅肉之攝取量與各國相比為少,日本人礦物質中鐵傾向於不足。因此,在日本人之實施例之一部分係同時添加,但無必要將儲存鐵(storage iron)充分的人作為對象之情形。又,ALA被代謝為卟啉(porphyrin),在光照射下顯示PDT、PDD活性廣為周知,不過在本發明之控制性樹狀細胞之誘導方法、過敏性疾病之預防治療方法或自體免疫疾病之預防治療方法,光非為必要。
本發明人等,進一步關於投與方法或投與量,經一再戮力研討,確立了免疫耐受誘導劑,其係將單獨ALA類、或ALA類與鐵化合物作為有效成分,因而完成本發明。
亦即本發明,係如下述。
〔1〕一種免疫耐受誘導劑,其含有下述式(I)所示之化合物或其鹽,
(式中,R1表示氫原子或醯基;R2表示氫原子、直鏈或者分支狀烷基、環烷基、芳基或芳烷基)。
〔2〕如上述〔1〕記載之免疫耐受誘導劑,其中R1及R2為氫原子。
〔3〕如上述〔1〕或〔2〕記載之免疫耐受誘導劑,其進一步含有鐵化合物。
〔4〕如上述〔3〕記載之免疫耐受誘導劑,其中鐵化合物係選自氯化鐵(ferric chloride)、三氧化二鐵(iron sesquioxide)、硫酸鐵、焦磷酸亞鐵、檸檬酸亞鐵、檸檬酸鐵鈉、檸檬酸亞鐵鈉、檸檬酸鐵銨、焦磷酸鐵、乳酸鐵、葡萄糖酸亞鐵、二伸乙三胺五乙酸鐵鈉、二伸乙三胺五乙酸鐵銨、乙二胺四乙酸鐵鈉、乙二胺四乙酸鐵銨、二羧甲基麩胺酸(glutamic acid)鐵鈉、二羧甲基麩胺酸鐵銨、反丁烯二酸亞鐵、乙酸鐵、草酸鐵、琥珀酸亞鐵、琥珀酸檸檬酸鐵鈉、血質鐵、葡萄聚糖鐵、三伸乙四胺鐵、乳鐵蛋白鐵、運鐵蛋白鐵、葉綠酸鐵鈉、鐵蛋白鐵(ferritin iron)、含糖氧化鐵、及硫化甘胺酸鐵之一種或二種以上之化合物。
〔5〕如上述〔3〕記載之免疫耐受誘導劑,其中鐵化合物為檸檬酸亞鐵鈉。
〔6〕如上述〔1〕至〔5〕中任一項之免疫耐受誘導劑,其適用於控制性樹狀細胞之誘導。
〔7〕如上述〔1〕至〔5〕中任一項之免疫耐受誘導劑,其適用於過敏性疾病。
〔8〕如上述〔7〕記載之免疫耐受誘導劑,其中過敏性疾病為異位性皮膚炎。
〔9〕如上述〔1〕至〔5〕中任一項之免疫耐受誘導劑,其適用於自體免疫疾病。
〔10〕如上述〔9〕記載之免疫耐受誘導劑,其中自體免疫疾病為硬皮症
(scleroderma)。
〔11〕一種免疫耐受之誘導方法,其特徵為投與對象上述〔1〕至〔10〕項中任一項之免疫耐受誘導劑。
〔12〕一種控制性樹狀細胞之誘導方法,其特徵為投與對象上述〔1〕至〔5〕項中任一項之免疫耐受誘導劑。
〔13〕一種誘導控制性樹狀細胞之方法,其特徵為以上述〔1〕至〔5〕項中任一項之免疫耐受誘導劑及GM-CSF,對自骨髓採取之細胞予以試管內處理。
〔14〕一種控制性樹狀細胞,為以上述〔12〕或〔13〕記載之方法所誘導之經單離的控制性樹狀細胞。
〔15〕一種過敏性疾病之預防及/或治療方法,其特徵為投與對象上述〔1〕至〔5〕項中任一項之免疫耐受誘導劑。
〔16〕一種自體免疫疾病之預防及/或治療方法,其特徵為投與對象上述〔1〕至〔5〕項中任一項之免疫耐受誘導劑。
〔17〕一種免疫耐受誘導套組,其包含a)下述式(I)所示之化合物或其鹽;
(式中,R1表示氫原子或醯基;R2表示氫原子、直鏈或者分支狀烷基、環烷基、芳基或芳烷基)
b)鐵化合物;
〔18〕一種免疫耐受之誘導方法,其特徵為同時或分前後投與對象a)下述式(I)所示之化合物或其鹽;
(式中,R1表示氫原子或醯基;R2表示氫原子、直鏈或者分支狀烷基、環烷基、芳基或芳烷基)
b)鐵化合物。
〔19〕一種套組,其用以將包含:a)上述〔1〕至〔5〕項中任一項之免疫耐受誘導劑;及b)GM-CSF之控制性樹狀細胞在試管內誘導。
〔20〕一種過敏性疾病預防治療劑之組合,其包含:a)上述〔1〕至〔5〕項中任一項之免疫耐受誘導劑;b)過敏性疾病治療藥。
〔21〕一種過敏性疾病預防治療劑之組合,其包含a)下述式(I)所示之化合物或其鹽;
(式中,R1表示氫原子或醯基;;R2表示氫原子、直鏈或者分支狀烷基、環烷基、芳基或芳烷基)
b)鐵化合物;及c)過敏性疾病治療藥。
〔22〕一種自體免疫疾病預防治療劑之組合,其包含:a)上述〔1〕至〔5〕項中任一項之免疫耐受誘導劑;及b)自體免疫疾病治療藥。
〔23〕一種自體免疫疾病預防治療劑之組合,其包含:a)下述式(I)所示之化
合物或其鹽;
(式中,R1表示氫原子或醯基;R2表示氫原子、直鏈或者分支狀烷基、環烷基、芳基或芳烷基)b)鐵化合物;及c)自體免疫疾病治療藥。
作為該等發明之其他態樣可例示以下之物。
〔24〕一種控制性樹狀細胞之誘導劑,其含有式(I)所示化合物或其鹽。
〔25〕一種上述〔24〕記載之控制性樹狀細胞之誘導劑,其進一步含有鐵化合物。
〔26〕一種控制性樹狀細胞之誘導方法,其特徵為投與對象上述〔24〕或〔25〕記載之控制性樹狀細胞之誘導劑。
〔27〕一種使用於控制性樹狀細胞之誘導之式(I)所示化合物或其鹽。
〔28〕一種使用於控制性樹狀細胞之誘導之含有式(I)所示化合物或其鹽及鐵化合物之組成物。
〔29〕一種式(I)所示化合物或其鹽之使用,其用以調製控制性樹狀細胞之誘導劑。
〔30〕一種式(I)所示化合物或其鹽及鐵化合物之使用,其用以調製控制性樹狀細胞之誘導劑。
〔31〕一種過敏性疾病之預防及/或治療劑,其含有式(I)所示化合物或其鹽。
〔32〕如上述〔31〕記載之過敏性疾病之預防及/或治療劑,其進一步含有鐵化合物。
〔33〕一種過敏性疾病之預防及/或治療方法,其特徵為投與對象上述〔31〕或〔32〕記載之過敏性疾病之預防及/或治療劑。
〔34〕一種式(I)所示化合物或其鹽,其用於過敏性疾病之預防及/或治療。
〔35〕一種組成物,其含有式(I)所示化合物或其鹽及鐵化合物,用於過敏性疾病之預防及/或治療。
〔36〕一種式(I)所示化合物或其鹽之使用,其用以調製過敏性疾病之預防及/或治療劑。
〔37〕一種式(I)所示化合物或其鹽及鐵化合物之使用,其用以調製過敏性疾病之預防及/或治療劑。
〔38〕一種自體免疫疾病之預防及/或治療劑,其含有式(I)所示之化合物或其鹽。
〔39〕如上述〔38〕記載之自體免疫疾病之預防及/或治療劑,其進一步含有鐵化合物。
〔40〕一種自體免疫疾病之預防及/或治療方法,其特徵為投與對象上述〔38〕或〔39〕記載之自體免疫疾病之預防及/或治療劑。
〔41〕一種式(I)所示化合物或其鹽,其用於自體免疫疾病之預防及/或治療。
〔42〕一種組成物,其含有式(I)所示化合物或其鹽及鐵化合物,用於自體免疫疾病之預防及/或治療。
〔43〕一種式(I)所示化合物或其鹽之使用,其係用以調製自體免疫疾病之預防及/或治療劑。
〔44〕一種式(I)所示化合物或其鹽及鐵化合物之使用,其係用以調製自體免疫疾病之預防及/或治療劑。
根據本發明之免疫耐受誘導劑,可誘導應用於免疫疾病之治療的控制性樹狀細胞。又,根據本發明之免疫耐受誘導劑,可進行過敏性疾病之預防治療或自體免疫疾病之預防治療。本發明之免疫耐受誘導劑,因與先前免疫抑制劑等作用機構不同,故藉由與既有藥併用則可期待效果更加提高。
第1圖表示樹狀細胞特異的表面標記之表現結果圖。
第2圖表示樹狀細胞特異的免疫相關基因之表現結果圖。
第3圖表示藉由添加ALA至由骨髓採取之細胞而誘導之樹狀細胞(BM-DCALA)所致抑制效應T細胞增殖能力(multiplication capacity)效果之結果圖。
第4圖表示藉由BM-DCALA之控制性T細胞之誘導能力之結果圖。
第5圖表示藉由BM-DCALA之抑制效應T細胞增殖能力效果之結果圖。
第6圖表示藉由BM-DCALA單體之控制性T細胞之誘導能力之結果圖。
第7圖表示針對過敏反應模型(atopic model)小鼠之本發明免疫耐受誘導劑之症狀改善效果圖。
第8圖表示針對過敏反應模型小鼠之本發明免疫耐受誘導劑之症狀改善效果照片。
第9圖表示投與ALA至硬皮症疾病模型小鼠所致對體重及生存期間之影響之圖。
第10圖表示投與ALA所致硬皮症疾病模型小鼠之外觀之照片。
第11圖表示投與ALA所致硬皮症疾病模型小鼠耳之HE染色切片觀察結果圖。
第12圖表示投與ALA所致硬皮症疾病模型小鼠之耳之Masson染色切片之觀察結果圖。
第13圖表示投與ALA所致硬皮症疾病模型小鼠皮膚之HE染色切片之觀察結果圖。
第14圖表示投與ALA所致硬皮症疾病模型小鼠皮膚之Masson染色切片之觀察結果圖。
第15圖表示投與ALA所致硬皮症疾病模型小鼠腎臓皮質周邊之HE染色切片之觀察結果圖。
第16圖表示投與ALA所致硬皮症疾病模型小鼠腎臓皮質周邊之Masson染色切片之觀察結果圖。
第17圖表示ALA所致硬皮症疾病模型小鼠腎臓髓質周邊之HE染色切片之觀察結果圖。
第18圖表示投與ALA所致硬皮症疾病模型小鼠腎臓髓質周邊之Masson染色切片之觀察結果圖。
第19圖表示投與ALA所致硬皮症疾病模型小鼠肝臓之HE染色切片之觀察結果圖。
第20圖表示投與ALA所致硬皮症疾病模型小鼠肝臓之Masson染色切片之觀察結果圖。
第21圖表示投與ALA所致硬皮症疾病模型小鼠肺之HE染色切片之觀察結果圖。
第22圖表示投與ALA所致硬皮症疾病模型小鼠肺之Masson染色切片之觀察結果圖。
第23圖表示投與ALA所致硬皮症疾病模型小鼠皮膚中標記基因之表現結果圖。
第24圖表示投與ALA所致硬皮症疾病模型小鼠脾臟中標記基因之表現結果圖。
第25圖表示投與ALA所致硬皮症疾病模型小鼠腎臓中標記基因之表現結果圖。
在本發明「免疫耐受之誘導」係指針對被ALA類或ALA類及鐵化合物所誘導之特定抗原的免疫反應之抑制狀態,亦即被稱為免疫反應等級之減少、免疫反應發生或進行之延遲、及/或誘導免疫反應所致之減少,以本發明之免疫耐受誘導劑而言,只要是含有上述式(I)所示化合物或其鹽(以下,該等總稱為「ALA類」)作為有效成分之物,則並無特別限定,較佳為除了ALA類,再含有鐵化合物。上述本發明之免疫耐受誘導劑,尤其是藉由將含有ALA類及鐵化合物之免疫耐受誘導劑,投與除了人之外之家畜、家禽類或寵物等之對象,而除了免疫耐受之誘導或控制性樹狀細胞之誘導之外,可進行過敏性疾病之預防及/或治療、或自體免疫疾病之預防及/或治療。此外,在將本發明之免疫耐受誘導劑或免疫耐受誘導套組,適用於控制性樹狀細胞之誘導之情形,稱為「控制性樹狀細胞誘導劑」或「在試管內誘導控制性樹狀細胞之套組」;在適用於過敏性疾病之情形,稱為「過敏性疾病預防及/或治療劑」或「過敏性疾病預防及/或治療套組」;
在適用於自體免疫疾病之情形,稱為「自體免疫疾病預防及/或治療劑」或「自體免疫疾病預防及/或治療套組」。
以本發明之免疫耐受誘導套組而言,只要是作為個別之藥
劑含有ALA類與鐵化合物作為有效成分,且誘導免疫耐受的用途所使用之套組,則無特別限制,若使用此等免疫耐受誘導套組時,可進行除了人之外,在以家畜、家禽類或寵物等對象中之免疫耐受之誘導、或控制性樹狀細胞之誘導或過敏性疾病之預防及/或治療、或自體免疫疾病之預防及/或治療。
在本發明「控制性樹狀細胞」,係指若為與免疫耐受相關的
樹狀細胞之亞型,其中該免疫耐受具有被ALA類或ALA類及鐵化合物所誘導之有抑制可產生組織障礙之T細胞活性作用的控制性T細胞(例如CD4+CD25+Foxp3+控制性T細胞)之誘導能力者,則並無特別限定,亦可為成為治療對象的來自患者之細胞,亦可為來自患者以外之細胞,較佳為來自患者之細胞。本發明之控制性樹狀細胞,例如藉由以免疫耐受誘導劑及GM-CSF,將自骨髓採取之細胞進行試管內處理而可予以誘導、單離。
以將本發明之控制性樹狀細胞用以在試管內誘導之套組而
言,含有上述本發明之免疫耐受誘導劑與GM-CSF,通常附上要旨為用以將控制性樹狀細胞在試管內誘導所使用之附件文書。
以上述過敏性疾病而言,可列舉異位性皮膚炎、過敏性鼻
炎、過敏性結膜炎、支氣管哮喘(bronchial asthma)、花粉症、過敏性胃腸炎、食物過敏、蕁麻疹(hives)等。例如,藉由使用異位性皮膚炎模型小鼠之後述實施例5記載之實驗,而可確認本發明之過敏性疾病預防及/或治療劑對異位性皮膚炎之治療為有效。本發明之過敏性疾病預防及/或治療劑,尤其是含有ALA類及鐵化合物之物通常被使用。
以上述自體免疫疾病而言,可列舉風濕性關節炎(rheumatoid
arthritis)、全身性紅斑狼瘡(systemic lupus erythematosus)、盤狀紅斑狼瘡(discoid lupus erythematosus)、多發性肌炎(polymyositis)、硬皮症(scleroderma)、混合性結締組織病(mixed connective tissue disease)、橋本氏甲狀腺炎(Hashimoto thyroiditis)、原發性黏液水腫(primary myxedema)、甲狀腺中毒症(thyrotoxicosis)、惡性貧血(pernicious anemia)、古巴士德
氏症候群(Good-pasture syndrome)、急速進行性腎小球腎炎(rapidly progressive glomerulonephritis)、重症肌無力症(myasthenia gravis)、尋常性天皰瘡(pemphigus vulgaris)、水皰性類天皰瘡(bullous pemphigoid)、胰島素抗性糖尿病(insulin resistant diabetes)、幼發型糖尿病(juvenile diabetes)、艾迪森病(Addison’s disease)、萎縮性胃炎(atrophic gastritis)、男性不孕症(male sterility)、早發性更年期(climacterium precox)、水晶體因性葡萄膜炎(lesn-induced uveitis)、交換性脈炎、多發性硬化症(multiple sclerosis)、潰瘍性大腸炎(ulcerative colitis)、原發性膽汁鬱積性肝硬化(primary biliary cirrhosis)、慢性活動性肝炎(chronic active hepatitis)、自體免疫性溶血性貧血(autoimmune hemolytic anemia)、陣發性血色素尿症(paroxysmal hemoglobinuria)、陣發性血小板減少性紫斑病(idiopathic thrombocytopenic purpura)、修格蘭氏症候群(Sjögren syndrome)等。例如藉由使用硬皮症模型小鼠之實驗,而可確認本發明之自體免疫疾病預防及/或治療劑對硬皮症之治療為有效。
以本發明之過敏性疾病預防治療劑之組合而言,只要是上
述本發明之過敏性疾病預防及/或治療劑;過敏性疾病治療藥之組合;或ALA類、鐵化合物、及過敏性疾病治療藥之組合,則無限制,藉由投與該等組合,而可預防及/或治療過敏性疾病。以上述過敏性疾病治療藥而言,可列舉車尼賴(tranilast)、延胡索酸可利汀(clemastine fumarate)、塞波海它定鹽酸鹽(cyproheptadine hydrochloride)、苯海拉明(diphenhydramine)、methodiramine、氯咪唑(clemizole)、甲氧基非那明(methoxyphenamine)等之醫藥品。本發明之過敏性疾病預防及/或治療劑或過敏性疾病預防及/或治療套組,因與既有之過敏性疾病治療藥有不同作用機構,故在使用本發明過敏性疾病預防治療劑之組合時,可期待相加的,視情形之有相乘的效果。
以本發明之自體免疫疾病之預防治療劑之組合而言,只要
是上述本發明之自體免疫疾病之預防及/或治療劑、自體免疫疾病治療藥之組合,或ALA類、鐵化合物及自體免疫疾病治療藥之組合,則無限制,藉由投與該等組合,而可預防及/或治療自體免疫疾病。以上述自體免疫疾病治療藥而言,可列舉皮質類固醇(corticosteroid)、環磷醯胺
(cyclophosphamide)、普樂可復(Tacrolimus)、山喜多(mycophenolate mofetil)、抗細胞介素單株抗體(monoclonal antibody)、干擾素β(interferonβ)、共聚物1、洒拉淨(sulfasalazine)、羥氯喹(hydroxychloroquine)、琉氟諾麥(leuflonamide)、培尼皮質酮(prednisone)、TNFα拮抗劑、恩博(etanercept)、因利西司馬(infliximab)等之醫藥品。本發明之自體免疫疾病之預防及/或治療劑或自體免疫疾病之預防及/或治療套組,因與既有之自體免疫疾病治療藥作用機構不同,故若使用本發明之自體免疫疾病之預防治療劑之組合時,可期待相加的,視情形之相乘的效果。
以使用作為本發明免疫耐受誘導劑之有效成分的化合物而言,可例示式(I)所示化合物或其鹽(以下該等總稱為「ALA類」)。亦稱為δ-胺乙醯丙酸之ALA,係式(I)之R1及R2一起為氫原子之情形,且為胺基酸之一種。以ALA衍生物而言,可列舉式(I)之R1為氫原子或醯基、式(I)之R2為氫原子、直鏈或者分支狀烷基、環烷基、芳基或芳烷基之ALA以外之化合物。
上述ALA類之中,可合適地例示式(I)之R1及R2均為氫原子之情形的ALA或其鹽。ALA係亦稱為δ-胺乙醯丙酸的胺基酸之一種。又,以ALA衍生物而言,可例示式(I)之R1為氫原子或醯基,式(I)之R2為氫原子、直鏈或者分支狀烷基、環烷基、芳基或芳烷基之ALA以外之化合物。
以式(I)中之醯基而言,可列舉甲醯基、乙醯基、丙醯基、丁醯基、異丁醯基、戊醯基、異戊醯基、三甲基乙醯、己醯基、辛醯基、苄基羰基等之直鏈或分支狀之碳數1至8之烷醯基或苄基、1-萘甲醯基、2-萘甲醯基基等之碳數7至14之芳醯基(aroyl)。
以式(I)中之烷基而言,可例示甲基、乙基、丙基、異丙基、丁基、異丁基、二級丁基、三級丁基、戊基、異戊基、新戊基、己基、庚基、辛基等之直鏈或分支狀之碳數1至8之烷基。
以式(I)中之環烷基而言,可例示環丙基、環丁基、環戊基、環己基、環庚基、環辛基、環十二基、1-環己烯基等之飽和或可存在一部分不飽和鍵之碳數3至8之環烷基。
以式(I)中之芳基而言,可例示苯基、萘基、蒽基、菲基(phenanthryl)等之碳數6至14之芳基。
以式(I)中芳烷基而言,芳基部分可例示與上述芳基相同,烷基部分可例示與上述烷基相同,具體言之,可列舉苄基、苯乙基、苯基丙基、苯基丁基、二苯甲基、三苯甲基、萘基甲基、萘基乙基等之碳數7至15之芳烷基。
以上述ALA衍生物而言,可例示R1為甲醯基、乙醯基、丙醯基、丁醯基等之化合物,或上述R2為甲基、乙基、丙基、丁基、戊基等之化合物為佳,上述R1與R2之組合,可適當例示甲醯基及甲基、乙醯基及甲基、丙醯基及甲基、丁醯基及甲基、甲醯基及乙基、乙醯基及乙基、丙醯基及乙基、丁醯基及乙基之組合等。
ALA類,在生物體內以式(I)之ALA或其衍生物之狀態作為有效成分作用較佳,因應投與之形態,可投與作為用以提高溶解性之各種鹽、酯、或以生物體內酵素所分解之前藥(先質)。例如,以ALA及其衍生物之鹽而言,可列舉藥理學上容許之酸加成鹽、金屬鹽、銨鹽、有機胺加成鹽等。以酸加成鹽而言,可例示例如鹽酸鹽、氫溴酸鹽、碘化氫酸鹽、磷酸鹽、硝酸鹽、硫酸鹽等各無機酸鹽;甲酸鹽、乙酸鹽、丙酸鹽、甲苯磺酸鹽、琥珀酸鹽、草酸鹽、乳酸鹽、酒石酸鹽、硫乙醇酸鹽、甲烷磺酸鹽、丁酸鹽、戊酸鹽、檸檬酸鹽、反丁烯二酸鹽、順丁烯二酸鹽、蘋果酸鹽等之各有機酸加成鹽。以金屬鹽而言,可例示鋰鹽、鈉鹽、鉀鹽等之各種鹼金屬鹽;鎂、鈣鹽等之各種鹼土類金屬鹽;鋁、鋅等之各種金屬鹽。以銨鹽而言,可例示銨鹽、四甲銨鹽等之烷基銨鹽等。以有機胺鹽而言,可例示三乙胺鹽、哌啶鹽、嗎福林鹽、甲苯胺鹽等之各種鹽。此外,該等鹽在使用時亦可作為溶液使用。
在以上之ALA類中,較為理想者,有ALA、及ALA甲基酯、ALA乙基酯、ALA丙基酯、ALA丁基酯、ALA戊基酯等之各種酯類,以及該等鹽酸鹽、磷酸鹽、硫酸鹽,特佳可例示ALA鹽酸鹽或ALA磷酸鹽。
上述ALA類可藉由化學合成、微生物所致生產、酵素所致生產之任一種周知之方法來製造。又,上述ALA類亦可形成水合物或溶劑
化物,又任一種可單獨使用,或適合組合二種以上使用。
以上述鐵化合物而言,可為有機鹽亦可為無機鹽,以無機
鹽而言,可例示氯化鐵(III)(ferric chloride)、三氧化二鐵(iron sesquioxide)、硫酸鐵、焦磷酸亞鐵;以有機鹽而言,可例示羧酸鹽,例如屬羥羧酸鹽之檸檬酸亞鐵、檸檬酸鐵鈉、檸檬酸亞鐵鈉、檸檬酸鐵銨等之檸檬酸鹽或焦磷酸鐵、乳酸鐵、葡萄糖酸亞鐵、二伸乙三胺五乙酸鐵鈉、二伸乙三胺五乙酸鐵銨、乙二胺四乙酸鐵鈉、乙二胺四乙酸鐵銨、二羧甲基麩胺酸鐵鈉、二羧甲基麩胺酸鐵銨、反丁烯二酸亞鐵、乙酸鐵、草酸鐵、琥珀酸亞鐵、琥珀酸檸檬酸鐵鈉等之有機酸鹽或血質鐵、葡萄聚糖鐵、三伸乙四胺鐵、乳鐵蛋白鐵、運鐵蛋白鐵、葉綠酸鐵鈉、鐵蛋白鐵、含糖氧化鐵、硫化甘胺酸鐵,其中較佳為檸檬酸亞鐵鈉或檸檬酸鐵鈉。
上述鐵化合物可各自單獨使用,亦可混合二種以上使用。
以鐵化合物之投與量而言,若為相對於ALA類之投與量(換算5-ALA),以莫耳比為0.01至100倍則佳,0.05倍至10倍為所望,0.1倍至8倍更理想。
本發明之免疫耐受之誘導方法、控制性樹狀細胞之誘導方
法、過敏性疾病之預防及/或治療方法、以及自體免疫疾病之預防及/或治療方法,較佳為併用投與ALA類及鐵化合物。尤其是在過敏性疾病之預防及/或治療方法,較佳為併用投與ALA類及鐵化合物。在該等情形,作為含有ALA類及鐵化合物之組成物,或者可各自單獨,且同時或分前後投與。在各自單獨投與之情形,較佳為同時投與,在各自單獨且分前後投與之情形,較佳為ALA類及鐵化合物之投與可達成相加的效果,較佳為投與,以可達成相乘的效果。
以本發明之免疫耐受誘導劑、控制性樹狀細胞之誘導劑、
過敏性疾病之預防及/或治療劑、自體免疫疾病之預防及/或治療劑、以及該等套組之各成分之投與經路而言,可列舉包含舌下投與在內之經口投與,或者點鼻投與、吸入投與、包含點滴在內之靜脈內投與、泥罨劑(cataplasm)等之經皮投與、栓劑或經鼻胃管、經鼻腸管、胃瘻管(gastrostomy tube)或者腸瘻管(intestinal fistula)之強制的腸道營養法(enteral nutrition)之投與等之非口服等,較佳為口服。
本發明之免疫耐受誘導劑、控制性樹狀細胞之誘導劑、過
敏性疾病之預防及/或治療劑、自體免疫疾病之預防及/或治療劑、以及該等套組之各成分之劑型而言,雖可因應上述投與經路而適宜決定,不過可列舉溶解於注射劑、點鼻劑、點滴劑、錠劑、膠囊劑、細粒劑、散劑、液劑、糖漿等之水劑、泥罨劑、栓劑等。本發明之免疫耐受誘導劑或免疫耐受誘導套組之各成分,除了醫藥用途之外,亦可以錠劑或膠囊劑之補充劑之形態投與。又尤其是,對嚥下有困難的高齡者或嬰幼兒等,顯示口中快速崩解性之崩解錠之形態,或經鼻胃管(Nasogastric intubation)投與為合適的液劑之形態較佳。。
為了調製本發明之免疫耐受誘導劑、控制性樹狀細胞之誘
導劑、過敏性疾病之預防及/或治療劑、自體免疫疾病之預防及/或治療劑、以及該等之套組,可依照需要,添加藥理學上可容許的載體、成形劑、稀釋劑、添加劑、崩解劑(disintegrator)、結合劑、被覆劑、潤滑劑、表面滑動劑、潤滑劑、風味劑、甜味劑、可溶化劑、溶劑、凝膠化劑、營養劑等,具體言之,可例示水、生理食鹽水、動物性脂肪及油、植物油、乳糖、澱粉、明膠、結晶性纖維素、橡膠、滑石、硬脂酸鎂、羥丙基纖維素、聚烯烴二醇、聚乙烯醇、甘油。此外,在調製本發明之促進移植臓器存活劑(Enhancer of survival of transplanted organ)作為水溶液之情形,為了防止ALA類之分解,必須留意水溶液不再為鹼性,在已成為鹼性之情形,亦可藉由除去氧,而防止分解。
本發明之免疫耐受誘導劑、控制性樹狀細胞之誘導劑、過敏性疾病之預防及/或治療劑、自體免疫疾病之預防及/或治療劑、以及該等之套組,如前述,除了人類以外,亦可在家畜、家禽類或寵物等獸醫領域使用。以此等免疫耐受誘導劑等之投與量、頻率、期間而言,在對象為人類之情形,因年齡、體重、症狀等而不同,而以ALA類之投與量而言,換算ALA莫耳,成人每人為0.1至12mmol/日,較佳為0.2至9mmol/日,更佳為0.3至6mmol/日,進一步較佳為0.35mmol/日至4mmol/日,以投與頻率而言,可例示一日單次至複數次之投與,或藉由點滴等之連續地投與。投與期間亦可以該技術領域之藥理學者或臨床醫師所知之方法來決定。
茲根據實施例更具體說明本發明,但本發明之技術範圍並
非限定於該等例示。
使用ALA及SFC,製作樹狀細胞(DC),使實際上製作的細胞誘導控制性T細胞,且評估自控制性T細胞所分泌的屬發炎抑制性細胞介素的轉型生長因子(transforming growth factor)-β(TGF-β)與以IL-10誘導的控制性DC,是否具有同等功能。
〔藉由添加ALA至由骨髓採取之細胞之樹狀細胞之誘導〕
自A/J(H2-KK)小鼠8週齡採取骨髓,在以溶血處理除去紅血球之後,播種於培養皿。在將RPMI作為基質之培養基(後續記載為RPMI培養基)予以培養,自第二天與細胞介素GM-CSF10ng/ml同時投與ALA鹽酸鹽100μM、SFC50μM,培養3天。將培養基交換新鮮的RPMI培養基(含有GM-CSF10ng/ml、ALA鹽酸鹽100μM、SFC50μM),進一步回收培養3天的細胞。藉由該培養法所得之細胞後續稱為BM-DCALA。
製作作為對照群之自骨髓細胞誘導的BM-DCcon(與成熟樹狀細胞相同,具有引起免疫反應之效應T細胞活性化能力為已知);及自骨髓細胞誘導的BM-DCreg(與控制性樹狀細胞相同,具有抑制免疫反應之控制性T細胞活性化能力之物為已知)。BM-DCcon,係針對藉由以上述相同方法,而播種於培養皿的細胞,與RPMI培養基一起添加GM-CSF(10ng/ml)與IL-4(10ng/ml)5天,予以培養。其後,在相同組成之新鮮的培養基上,添加1μg/ml新的脂多糖(LPS)抗原,進一步培養二天。此外,在理由係為了使樹狀細胞成熟,因成為抗原之物質必須存在,故投與LPS。BM-DCreg藉由與上述相同之方法,針對播種於培養皿之細胞,與RPMI培養基一起,添加GM-CSF(20ng/ml)、IL-10(20ng/ml)、及TGF-β(20mg/ml)7天,加以培養。
〔是否所得之細胞為樹狀細胞之研討〕
前提係研討以上述三種方法所得之BM-DCALA、BM-DCcon、BM-DCreg是否為樹狀細胞。亦即,使用流動細胞儀(flow cytometer),以樹狀細胞標
記CD11b、CD11c之二種加以染色,比較雙方陽性之細胞(亦即樹狀細胞)之數目。結果如第1圖(最左列)所示。其結果,任意之群大多數為CD11b、CD11c雙方陽性,可知被誘導為樹狀細胞。其後,就在此製作的樹狀細胞之功能加以研討。
〔樹狀細胞特異的表面標記之表現〕
藉由添加ALA所誘導之樹狀細胞,是否具有作為成熟樹狀細胞之特徵,或是否具有耐受原性樹狀細胞之特徵,調查樹狀細胞特異的表面標記之表現。亦即,就屬成熟樹狀細胞標記之CD80、CD86、CD40、I-A.I-E(MHC級別II)之表現,使用流動細胞儀予以解析。結果如第1圖(右之4列)所示。其結果如已知,吾人可知BM-DCcon使成熟樹狀細胞標記表現,不過BM-DCreg與此相比,表現降低。相對於此,BM-DCALA,各成熟樹狀細胞標記表現低至與BM-DCreg同程度。亦即,此係教示藉由添加ALA而可製作與BM-DCreg酷似的樹狀細胞。
〔免疫關連基因之表現〕
調查添加ALA所誘導之樹狀細胞,是否進行與成熟樹狀細胞類似的基因表現,或進行與耐受原性樹狀細胞類似的基因表現。亦即調查自BM-DCALA、BM-DCcon、BM-DCreg萃取mRNA,以RT-PCR免疫誘導、免疫抑制相關之基因之表現。結果如第2圖所示。其結果,BM-DCALA屬成熟樹狀細胞標記之CD40之表現低,TGF-β之表現高等,在多數基因表現中,表示與BM-DCreg類似的基因表現之傾向。一方面,在HO-1等之基因,表示與BM-DCcon類似的基因表現。亦即,雖然BM-DCreg與BM-DCALA之性質並無完全一致,不過卻顯示類似。
〔藉由MLR法之BM-DCALA之免疫耐受能力之研討〕
就BM-DCALA與BM-DCreg同樣之T細胞活性化之抑制,亦即就是否可誘導免疫耐受,其係以控制性T細胞之誘導而抑制效應T細胞增殖,而根據MLR(混合型淋巴球反應(Mixed Lymphocyte Reaction))法加以研討。在生物體內,識別成為抗原之異物的成熟樹狀細胞,其抗原表現於T細胞。
識別此的T細胞,進行爆發性增殖。即使在試管內,若將T細胞與成熟DC與抗原一起進行混合培養時,因可觀察到T細胞之增殖,故藉由計測該增殖率,而計測成熟DC之活性則為MLR法。又,周知若混合不同系統之成熟DC與T細胞時,即使無抗原,也可觀察到增殖。
(藉由BM-DCALA之抑制效應T細胞增殖能力效果之研討)
誘導屬成熟樹狀細胞之功能的效應T細胞增殖之能力,是否可根據BM-DCALA之存在來抑制,係以MLR法來研討。自B6系統小鼠之脾臟使用耐綸纖維柱分離T細胞,並以Molecular Probes公司之紫色細胞增殖套組(Violet Cell Proliferation Kit)染色成紫色。其中將2×105cells/well與A/J小鼠之BM-DCcon(使用作為成熟樹狀細胞之替代物)1×104cells/well,同時在MPRI培養基中培養4日。此時,將BM-DCreg或者BM-DCALA添加2×104cells/well。培養後,研討效應T細胞作何等增殖,藉由流動細胞儀,而在T細胞全體(紫色)中,計算效應T細胞(CD4,CD8陽性)佔有何等程度。此外,控制性T細胞雖為CD4陽性,但T細胞全體佔有之比率極微,故可忽略。結果如第3圖所示。其結果,比較為陰性控制之BM-DCcon與T細胞之二種混合培養,藉由添加了BM-DCALA的3種混合培養,而使CD4陽性、CD8陽性T細胞各自之比率降低。亦即BM-DCALA抑制效應T細胞之增殖。此抑制能力,具有效應T細胞增殖抑制能與已知的BM-DCreg同等。
(BM-DCALA所致控制性T細胞之誘導能力之研討)
茲就BM-DCALA是否具有屬耐受原性樹狀細胞之功能的控制性T細胞之誘導能力加以研討。自將FoxP3基因替換成GFP基因之B6系統小鼠,以與實施例4相同之方法,採取T細胞,並予染色,與BM-DCcon混合培養。此時,添加BM-DCreg或者BM-DCALA。研討在T細胞全體(紫色)中,GFP陽性細胞以何等比率存在。結果如第4圖所示。其結果,藉由BM-DCALA之添加,而BM-DCreg同樣T細胞中之GFP陽性細胞之比率增加。亦即此係教示BM-DCALA誘導控制性T細胞。
FoxP3因不存在適於流動細胞儀的抗體,故作為以流動細胞儀確認FoxP3之表現之方法,係使用上述基因植入小鼠(knock-in mouse)。若欲藉由對控制性T細胞之分化信號,使FoxP3表現,則反而使GFP表現。
藉由計算紫色T細胞中GFP陽性細胞之比率,而FoxP3陽性(應成為FoxP3陽性)細胞之比率,亦即可分析(assay)誘導能力(induction potency)。又,如第3圖或第5圖所示之B6系統小鼠亦為GFP基因植入小鼠,不過可確認在屬欲調查的參數之CD4或CD8,則無影響。
(抑制效應T細胞增殖能力效果之研討)
研討將BM-DCALA以單體與T細胞混合培養之情形,BM-DCALA,在抑制效應T細胞增殖能力效果,是否顯示與BM-DCreg相似之行為。與實施例4相同之方法,自B6系統小鼠採取T細胞並予染色,與BM-DCALA混合培養。培養後,藉由流動細胞儀,而在T細胞全體(染成紫色)中,計算效應T細胞佔有何等比率。結果如第5圖所示。其結果,係與和BM-DCcon之二種混合培養時為相同程度之效應T細胞(CD4陽性、CD8陽性)之比率。一方面,BM-DCreg與T細胞之二種混合培養,與BM-DCcon、BM-DCALA之混合培養時不同,效應T細胞之比率低。亦即,在單獨BM-DCALA,並無抑制效應T細胞增殖能力效果,還是具有促進增殖的成熟樹狀細胞狀的作用。藉此係教示BM-DCALA並非與BM-DCreg完全相同的細胞。
(藉由BM-DCALA單體之控制性T細胞之誘導能力之研討)
研討BM-DCALA以單體與T細胞混合培養之情形,BM-DCALA是否在控制性T細胞之誘導中顯示與BM-DCreg相似之行為。藉由與實施例4相同之方法,自將FoxP3基因取代以GFP基因之B6系統小鼠,進行T細胞之採取、染色,並與BM-DCALA經混合培養。研討培養後,在T細胞全體(染成紫色)中,GFP陽性細胞以何等比率存在。結果如第6圖所示。其結果,因BM-DCALA之添加,而使BM-DCreg同樣T細胞中之GFP陽性細胞之比率增加。亦即,此係教示BM-DCALA,即使單獨也可誘導控制性T細胞。
由以上實施例1至4所示結果,在試管內,使用ALA與SFC而誘導的BMDC之細胞表面分子表現或T細胞增殖之抑制、Treg之增加功能等,可獲得與使用TGF-β及IL-10而誘導的控制性DC相同的結果。
〔過敏反應模型小鼠之製作〕
小鼠使用10週齡之雄NC/Nga系統。使用2,4,6-三硝基氯苯(TNCB)作為過敏原,引起了過敏症狀。第0天將胸部、腹部、背部剃毛,將溶解
於乙醇:丙酮(4:1)的2%之TNCB、及4%之十二基硫酸鈉(SDS)滴下150μl(胸部50μl、腹部50μl、背部50μl)。投與SDS因而破壞來自皮膚所致過敏原之障壁。其後,在第4,11,18天,在無SDS下,僅滴下1%之TNCB。
〔免疫耐受誘導劑之投與〕
ALA+SFC係每日以探針使之口服。此時,濃度為ALA鹽酸鹽(100mg/kg)+SFC(115mg/kg),或者ALA鹽酸鹽(10mg/kg)+SFC(11.5mg/kg)之二條件。
〔ALA+SFC之症狀改善效果〕
作為過敏症狀之評價系統,係使用皮膚炎計分與耳郭厚度。前者係藉由視認(visual recognition)之皮膚炎症狀之判定。在將背部與兩耳皮膚之損傷,以紅斑(erythema)/出血、浮腫(edema)、摩擦受傷導致皮膚發炎(chafe)/表皮之剝落、結痂(scab)/乾燥之四項基準計分之後,計算各症狀分數之合算值。等級分為0(無症狀)、1(穩定)、2(中等程度)、3(嚴重)。在第11、18、25天進行計分。結果如第7圖(左)所示。就後者,將已屠宰的小鼠兩耳浸漬於10%之中性福馬林24小時,予以固定。其後將組織予以石蠟固定,以厚度4μm予以切片。切片以H&E溶液染色,以顯微鏡觀察,計測厚度。在此亦同樣在第11、18、25天進行計分。結果如第7圖(右)所示。又,在第18天中各投與群之小鼠之照片以第8圖表示。
如第7圖及第8圖可知,滅菌水投與群、ALA(100mg/kg)
+SFC(115mg/kg)投與群、ALA(10mg/kg)+SFC(11.5mg/kg)投與群中之皮膚炎在第11、18、25天加以計分,結果可觀察到ALA(100mg/kg)+SFC(115mg/kg)投與群、及ALA(10mg/kg)+SFC(11.5mg/kg)投與群,相較於滅菌水投與群有顯著地改善。同樣地計測耳郭之厚度,結果可觀察到ALA(100mg/kg)+SFC(115mg/kg)投與群、及ALA(10mg/kg)+SFC(11.5mg/kg)投與群,與滅菌水投與群比較有顯著地改善。
〔硬皮症疾病模型之製作〕
使用作為予體之B10.D2雌性(7-8週齡)野生型小鼠,作為受體之Rag-2/Balb/c雌性(7-8週齡)免疫缺陷小鼠。藉由自予體小鼠將脾臟細胞各群5×107個、或各4×107個注射(移植)至受體,來製作硬皮症疾病模型
小鼠。因受體為免疫缺陷,故並不產生受體側所致排斥反應,自予體所移植之脾臟細胞並不被受體側之免疫系所除去,而針對自予體所移植的脾臟細胞中所含淋巴球,因受體本身為異物,故來自予體之淋巴球攻擊受體全身。因呈現該反應之全身性發炎、組織纖維症(fibrosis)、廣泛的全身性硬化症等之症狀,與人之硬皮症(硬皮症)酷似,故可使用作為硬皮症疾病模型。
〔免疫耐受誘導劑之投與〕
自剛進行予體之脾臟細胞移植後經過9週,每日一次投與ALA鹽酸鹽100mg/kg+SFC157mg/kg(以下以「ALA」表述),並使用探針投與。
〔藉由投與ALA之對體重及生存期間之影響〕
研討硬皮症發病所致體重減少是否因ALA而緩和,或又是否使生存期間延長。其結果,如第9圖所示,藉由投與ALA,而可觀察到體重減少之抑制傾向。又,可觀察到藉由投與ALA,而至第9週為止之成活率傾向於增高。接著,又在各群中代表性的外觀如第10圖所示。可觀察到藉由投與ALA,而使脫毛緩和。此外,對照組(control)並無移植來自予體小鼠之脾臟細胞,且為Rag-2/Balb/c雌性(7-8週齡)免疫缺陷小鼠之數據。由以上可知,藉由投與ALA,可觀察到硬皮症之症狀緩和效果。
〔藉由投與ALA對組織之影響(組織染色)〕
屬硬皮症症狀之纖維化或免疫細胞之累積(發炎)是否因投與ALA而緩和,可以上述來自模型小鼠之組織染色予以確認。為了觀察因發炎所致耳、皮膚、腎臓、肝臓、肺之樣態,而製作各臓器之切片,進行用以確認T細胞之累積的HE染色、及染色具有膠原之結締組織之Masson染色。在細胞移植前之首次用於實驗(Naive)、非投與ALA第6週、投與ALA第6週之三條件,以×40、×100、×200、×400之4種倍率觀察HE染色切片及Masson染色切片,確認因投與ALA,而使症狀緩和。
〔耳〕
HE染色切片之觀察結果如第11圖所示。其結果,在HE染色切片,無法觀察到因投與ALA所見之大的差異(中段與下段之比較)。同樣地,
Masson染色切片之觀察結果如第12圖所示。其結果,ALA投與群之膠原積蓄(以經濃厚染色部分之密度表示)與非投與群比較,則已被抑制(中段與下段之比較)。
〔皮膚〕
皮膚之纖維化係硬皮症之最具代表性的症狀之一。HE染色切片之觀察結果如第13圖所示。其結果,在HE染色切片並無觀察到因投與ALA所見之大的差異(中段與下段之比較)。同樣地,Masson染色切片之觀察結果如第14圖所示。其結果,ALA投與群之膠原積蓄與非投與群比較,則已被抑制(中段與下段之比較)。
〔腎臓皮質周邊〕
HE染色切片之觀察結果如第15圖所示。其結果,在HE染色切片並無觀察到因ALA投與所見之大的差異(中段與下段之比較)。同樣地,Masson染色切片之觀察結果如第16圖所示。其結果,ALA投與群之膠原積蓄與非投與群比較,則已被抑制(中段與下段之比較)。
〔腎臓髓質周邊〕
HE染色切片之觀察結果如第17圖所示。其結果,在HE染色切片並無觀察到投與ALA所見之大的差異(中段與下段之比較)。同樣地,Masson染色切片之觀察結果如第18圖所示。其結果,ALA投與群之膠原積蓄與非投與群比較則被抑制(中段與下段之比較)。
〔肝臓〕
HE染色切片之觀察結果如第19圖所示。其結果,在HE染色切片,於ALA非投與群可觀察到細胞之累積,不過在ALA投與群則無觀察到(中段與下段之比較)。同樣地Masson染色切片之觀察結果如第20圖所示。其結果,並無觀察到投與ALA所見之大的差異(中段與下段之比較)。
〔肺〕
HE染色切片之觀察結果如第21圖所示。其結果,在HE染色切片並無觀察到因投與ALA所見之大的差異(中段與下段之比較)。同樣地Masson染色切片之觀察結果如第22圖所示。其結果,並無觀察到投與ALA所見之大的差異(中段與下段之比較)。
〔藉由投與ALA對組織之影響(基因表現)〕
屬硬皮症症狀的纖維化或發炎是否因投與ALA而被抑制,可藉由上述來自模型小鼠之組織中各種標記基因之表現,各在投與ALA3週後、6週後、及9週後檢測,而加以確認。自皮膚、腎臓、脾臟組織,使用以RNeasy迷你套組萃取的mRNA,調查因RT-PCR而與發炎、纖維化等相關之基因表現。以對照而言,係使用Balb/c雄(7-8週齡)小鼠。
調查作為上述標記基因,HO-1(被認為係屬抗氧化蛋白質,且誘導regDC)基因、TGF-β(發炎抑制性細胞介素)基因、IFN-γ(發炎促進、抑制之兩種意義的細胞介素)基因、膠原-1(纖維化標記)基因、α-SMA(纖維化標記)基因、IL-6(發炎性細胞介素)基因、雄骨橋蛋白(osteopontin)(OPN)(發炎性細胞介素)基因、IL-21(已知在自體免疫疾病中多量產生)基因、TNF-α(發炎性細胞介素)基因、IL-10(發炎抑制性細胞介素)基因、及FoxP3(控制性T細胞標記)之表現。
〔皮膚〕
皮膚之纖維化係硬皮症之最具代表性症狀之一。在皮膚中結果如第23圖所示。在皮膚,係教示藉由投與ALA,而可觀察到屬纖維化標記之膠原-1(第23圖之右最上)、α-SMA(自第23圖之右上第三個)之顯著降低,此係教示投與ALA,使屬硬皮症症狀之纖維化緩和。
〔脾臟〕
在脾臟中之結果如第24圖所示。在脾臟,可觀察到藉由投與ALA,而屬控制性T細胞標記之FoxP3(自第24圖之右上第3個)、屬產生控制性T細胞之發炎抑制性細胞介素的IL-10之上升傾向(第24圖之右之最下),此係教示ALA所致控制性T細胞之活性化。
〔腎臓〕
腎臓中結果如第25圖所示。吾人考慮在腎臓誘導免疫耐受,可觀察到被血紅素所誘導之HO-1上升(第25圖之左最上)、屬纖維化標記之膠原-1之降低傾向(自第25圖之右上第二個)、屬發炎性細胞介素之IL-6減少傾向、雄骨橋蛋白(OPN)之減少(自第25圖上方第三個),此係教示ALA抑制發炎,預防纖維化。
本發明之控制性樹狀細胞之誘導劑、過敏性疾病預防及/或治療劑、自體免疫疾病預防及/或治療劑等之免疫耐受誘導劑,在醫藥、醫療之領域可有利地使用。
Claims (23)
- 一種免疫耐受誘導劑,其含有下述式(I)所示之化合物或其鹽,
- 如請求項1之免疫耐受誘導劑,其中R1及R2為氫原子。
- 如請求項1或2之免疫耐受誘導劑,更含有鐵化合物。
- 如請求項3之免疫耐受誘導劑,其中鐵化合物係選自氯化鐵、三氧化二鐵、硫酸鐵、焦磷酸亞鐵、檸檬酸亞鐵、檸檬酸鐵鈉、檸檬酸亞鐵鈉、檸檬酸鐵銨、焦磷酸鐵、乳酸鐵、葡萄糖酸亞鐵、二伸乙三胺五乙酸鐵鈉、二伸乙三胺五乙酸鐵銨、乙二胺四乙酸鐵鈉、乙二胺四乙酸鐵銨、二羧甲基麩胺酸鐵鈉、二羧甲基麩胺酸鐵銨、反丁烯二酸亞鐵、乙酸鐵、草酸鐵、琥珀酸亞鐵、琥珀酸檸檬酸鐵鈉、血質鐵、葡萄聚糖鐵、三伸乙四胺鐵、乳鐵蛋白鐵、運鐵蛋白鐵、葉綠酸鐵鈉、鐵蛋白鐵、含糖氧化鐵、及硫化甘胺酸鐵之一種或二種以上之化合物。
- 如請求項3之免疫耐受誘導劑,其中鐵化合物為檸檬酸亞鐵鈉。
- 如請求項1至5中任一項之免疫耐受誘導劑,其適用於控制性樹狀細胞之誘導。
- 如請求項1至5中任一項之免疫耐受誘導劑,其適用於過敏性疾病。
- 如請求項7之免疫耐受誘導劑,其中過敏性疾病為異位性皮膚炎。
- 如請求項1至5中任一項之免疫耐受誘導劑,其適用於自體免疫疾病。
- 如請求項9之免疫耐受誘導劑,其中自體免疫疾病為硬皮症。
- 一種免疫耐受之誘導方法,其特徵為投與對象如請求項1至10中任一 項之免疫耐受誘導劑。
- 一種控制性樹狀細胞之誘導方法,其特徵為投與對象如請求項1至5中任一項之免疫耐受誘導劑。
- 一種誘導控制性樹狀細胞之方法,其特徵為以如請求項1至5中任一項之免疫耐受誘導劑及GM-CSF,對自骨髓採取之細胞予以試管內處理。
- 一種控制性樹狀細胞,係以如請求項12或13之方法所誘導之經單離的控制性樹狀細胞。
- 一種過敏性疾病之預防及/或治療方法,其特徵為投與對象如請求項1至5中任一項之免疫耐受誘導劑。
- 一種自體免疫疾病之預防及/或治療方法,其特徵為投與對象如請求項1至5中任一項之免疫耐受誘導劑。
- 一種免疫耐受誘導套組,其包含:a)下述式(I)所示之化合物或其鹽,
- 一種免疫耐受之誘導方法,其特徵為同時或分前後投與對象a)下述式(I)所示之化合物或其鹽,
- 一種套組,其用以將包含:a)如請求項1至5中任一項之免疫耐受誘導劑;及b)GM-CSF之控制性樹狀細胞在試管內誘導。
- 一種過敏性疾病預防治療劑之組合,其包含:a)如請求項1至5中任一項之免疫耐受誘導劑;及b)過敏性疾病治療藥。
- 一種過敏性疾病預防治療劑之組合,其包含:a)下述式(I)所示之化合物或其鹽,
- 一種自體免疫疾病預防治療劑之組合,其包含:a)如請求項1至5中任一項之免疫耐受誘導劑;及b)自體免疫疾病治療藥。
- 一種自體免疫疾病預防治療劑之組合,其包含:a)下述式(I)所示之化合物或其鹽,
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EP2873417A1 (en) | 2015-05-20 |
HK1204285A1 (zh) | 2015-11-13 |
PL2873417T3 (pl) | 2019-09-30 |
CN104411306A (zh) | 2015-03-11 |
JP5904518B2 (ja) | 2016-04-13 |
EP2873417B1 (en) | 2019-03-06 |
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