WO2002067945A1 - Utilisation de n-acetyl-d-glucosamine dans la fabrication d'un produit pharmaceutique destine au traitement de l'erosion cervicale - Google Patents

Utilisation de n-acetyl-d-glucosamine dans la fabrication d'un produit pharmaceutique destine au traitement de l'erosion cervicale Download PDF

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WO2002067945A1
WO2002067945A1 PCT/CN2002/000118 CN0200118W WO02067945A1 WO 2002067945 A1 WO2002067945 A1 WO 2002067945A1 CN 0200118 W CN0200118 W CN 0200118W WO 02067945 A1 WO02067945 A1 WO 02067945A1
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glucosamine
acetyl
cervical erosion
treating cervical
manufacture
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PCT/CN2002/000118
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English (en)
French (fr)
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Qiwang Xu
Junkang Liu
Zetao Yuan
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Third Military Medical University, Chinese People's Liberation Army, P.R. Of China
Bio-Wave Institute Of Suzhou Hi-Tech New District Corporation, Ltd.
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Application filed by Third Military Medical University, Chinese People's Liberation Army, P.R. Of China, Bio-Wave Institute Of Suzhou Hi-Tech New District Corporation, Ltd. filed Critical Third Military Medical University, Chinese People's Liberation Army, P.R. Of China
Priority to US10/469,268 priority Critical patent/US6992073B2/en
Publication of WO2002067945A1 publication Critical patent/WO2002067945A1/zh

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
    • A61K31/7008—Compounds having an amino group directly attached to a carbon atom of the saccharide radical, e.g. D-galactosamine, ranimustine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P15/00—Drugs for genital or sexual disorders; Contraceptives
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P15/00—Drugs for genital or sexual disorders; Contraceptives
    • A61P15/02—Drugs for genital or sexual disorders; Contraceptives for disorders of the vagina
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics

Definitions

  • the invention relates to the application of N-acetyl-D-glucosamine in the preparation of a medicine for treating cervical erosion.
  • Cervical erosion is a common gynecological condition. It is caused by superficial defects formed by squamous epithelial necrosis of the cervix and vagina in the process of chronic cervical inflammation, or caused by exudation and secretion of the cervical mucosa. Increased material, cervical mucosal congestion, edema and ulceration, microbial infection, etc. Not only does this condition persist and hardly affect normal life, it also has the potential to develop into cancer.
  • N-acetyl-D-glucosamine is a chemical agent that has been used in the treatment of periodontitis (W09102530A1), microbial infections (W09718790A3), inflammatory bowel disease (W09953929A1), corneal disease ( JP10287570A2), prostate hypertrophy (US05116615), organic gastrointestinal lesions of the lower digestive tract (W093 / 14765), and tissue growth regulators (W0 / 8 702244), beauty (JP59013708A2), shampoo preparations (JP2011505A2), etc. There is currently no application in the preparation of drugs for treating cervical erosion.
  • N-acetyl-D-glucosamine can effectively treat cervical erosion, which is very unexpected, because to cure cervical erosion requires controlling microbial infection, resisting local exudation, eliminating tissue inflammatory edema and pain, and To promote cooperation in various aspects such as tissue repair, doctors must prescribe multiple drugs for patients. It is now found that drugs using N-acetyl-D-glucosamine alone as an active ingredient can cure cervical erosion. Although the antimicrobial infection and tissue growth regulating effects of N-acetyl-D-glucosamine have been disclosed in the prior art, this finding is still surprising. Summary of the Invention
  • the present invention relates to the use of N-acetyl-D-glucosamine and a pharmaceutically acceptable salt thereof in the preparation of a medicament for treating cervical erosion.
  • the invention in another aspect, relates to a method for treating cervical erosion, comprising administering to a patient in need thereof a therapeutically effective amount of N-acetyl-D-glucosamine or a pharmaceutically acceptable salt thereof.
  • N-acetamidine-D-glucosamine is a compound having the following structure: N-acetyl-D-amino It is commercially available or can be prepared according to known methods.
  • patent application W097 / 31121 discloses a method for preparing N-acetyl-D-glucosamine from a chitinase method.
  • Japanese patent application JP63273493 discloses a method for preparing chitin Partial acid hydrolysis to N-acetyl-chitooligosaccharide, and then treated with an enzyme to obtain N-acetyl-D-glucosamine.
  • pharmaceutically acceptable salts of N-acetyl-D-glucosamine mention may be made of those formed with pharmaceutically acceptable acids, such as those formed with inorganic acids, such as hydrochloride, hydrobromide, borate Salts, phosphates, sulfates, hydrogen sulfates, and hydrogen phosphates, as well as those formed with organic acids, such as citrate, stearic acid, ascorbate, methyl sulfate, naphthalene-2-sulfonate, Picrate, fumarate, maleate, malonate, oxalate, succinate, acetate, tartrate, mesylate, tosylate, isethionate, Alpha -ketoglutarate, alpha -glycerol phosphate, and glucose-1-phosphate.
  • pharmaceutically acceptable acids such as those formed with inorganic acids, such as hydrochloride, hydrobromide, borate Salts, phosphates, sulfates, hydrogen sulf
  • the compound of formula (I) or a pharmaceutically acceptable salt thereof is used as a main active ingredient in combination with various pharmaceutically acceptable excipients and / or carriers to prepare external water preparations, emulsions, creams, ointments, and suppositories. Other preparations are used to treat cervical erosion.
  • the amount of active substance is 0.2 to 6% of the total formulation.
  • the daily dose of the drug is 100-2000 mg of N-acetyl-D-glucosamine per person.
  • N-acetyl-D-glucosamine exerts its special effects by regulating cell redistribution at different levels. Macro cell location For the performance of fluctuating growth. N-acetyl-D-glucosamine works normally by regulating the undulating growth of body cells and microbial cells, so that microorganisms cannot colonize locally.
  • micro-ecological efficacy In terms of micro-ecological efficacy, it mainly supports the growth of normal flora, and does not adopt the method of supplementing ecological flora, which avoids the adaptability of the colonizing conditions in the supplementary flora. In terms of promoting skin and mucosal tissue repair, it has a controlling effect on inflammation, injury, infection, and exudation, which is a unique feature of this product. It can be widely used to control symptoms and treat the underlying problem. Best Mode of the Invention
  • test examples are used to demonstrate the wave-promoting properties, low toxicity, antimicrobial colonization activity, and clinical observations of treating cervical erosion by the compound of formula (I) of the present invention.
  • LB medium Improved LB medium (composition: 1% tryptone, 0.5% yeast extract, 1% sodium chloride, 0.1% glucose, 0.002% TTC, PH7. 2_7. 4).
  • the liquid culture results show that the compound of formula (I) can promote the growth of lactic acid bacteria.
  • This experiment uses a biological wave model to study the wave-promoting effect of compounds of formula (I) As a result, it can be seen that the compound of formula (I) can not only make bacterial cells show normal biological wave characteristics, but also make this fluctuation show a more detailed wave mode, indicating that the compound of formula (I) can promote biological fluctuations. This wave-promoting effect can be involved in the repair and redistribution of skin cells.
  • Acute toxicity test including oral, intravenous and maximum dose test
  • the test results show that the acute toxicity test dose of the compound of formula (I) exceeds 2 g / kg, which is 300 times the human injection dose, and there is no acute poisoning reaction.
  • the highest dose has reached lg / kg. After four weeks of testing It was observed that no poisoning reaction occurred.
  • the reproduction test the mice were fed with a regular dose of 7 mg / kg, and after three passages, it was proved that the compound of formula (I) had no effect on the pregnancy, childbirth, breastfeeding, and development of pups in mice. Non-toxic substance.
  • N-acetamidine-D-glucosamine spray was used for trials in the population. As of August 1999, a total of 123 patients were observed. From the trial results, compared with the blank control group (without drugs) and the positive drug (AgN03) control group, statistical analysis shows that the treatment group is significantly different from the positive drug control group and the blank control group in terms of recovery rate and effectiveness. N-acetyl -The therapeutic effect of D-glucosamine spray on cervical erosion is significant 63 ⁇ 4. The statistical results of the effect are as follows:

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Description

N-乙酰- D-氨基葡萄糖在制备治疗 宫颈糜烂药物中的应用 技术领域
本发明涉及 N-乙酰 -D-氨基葡萄糖在制备治疗宫颈糜烂的药物 中的应用。
背景技术
宫颈糜烂（ cervical erosion )是一种妇科常见病症， 由慢性 子宫颈炎症过程中发生的子宫颈阴道部鳞状上皮坏死脱落形成的 表浅缺损或子宫颈管粘膜外翻引起， 表现为渗出及分泌物增多、 宫颈粘膜充血水肿并溃烂、 微生物感染等。 这种病症不仅迁延难 愈， 极大地影响正常生活， 而且有发展为癌症的可能。
目前， 国内外对于宫颈糜烂的治疗， 临床上多采用物理疗法如 电熨、 冷冻、 激光等手段使糜烂组织坏死脱落， 或采用腐蚀药剂 如重铬酸钾、 硝酸银等破坏糜烂組织， 严重者甚至手术切除宫颈 或子宫。 上述疗法给患者带来极大的痛苦， 在去除糜烂組织的同 时也累及大量的正常组织。 目前市售的其他药物制剂， 一般以乙 醇作溶剂， 刺激性强， 溶质本身也产生刺激， 引起疼痛， 并损伤 正常皮肤。 另外， 这些产品在功能上多限于杀菌， 有控制感染的 效果， 但破坏了微生态平衡， 使感染得不到根治。 因此， 本领域 一直需要能有效治疗宫颈糜烂的药物。
本发明人在进行 "生物波"理论的研究过程中， 建立了细菌波 动生长模型。 经过研究认识到这种波动有其内在的调节机制： 某 些化学物质参与生物波动过程的调节， 把病态的周期性慢波转变 成正常的生理性混沌快波， 这类物质称为促波因子。 经分离提纯 和鉴定， 确定有一种因子为 N-乙酰- D-氨基葡萄糖， 其促波作用与 其对细胞的润滑和保护作用有关。 人体的许多生化和生理过程需
- 1 -
确 认 本 要促波因子的参与， 当体内这种促波因子缺乏时则会导致异常状 况。
N-乙酰- D-氨基葡萄糖是一种化学试剂， 二十世纪九十年代以 来陆续被用 于治疗 牙周 炎 （W09102530A1) 、 微生物感染 (W09718790A3) 、 炎 性 肠 病 （W09953929A1) 、 角 膜 疾 病 (JP10287570A2)、 前列腺肥大（US05116615)、 下消化道粘膜器质 性病变（ W093/14765 )等疾病以及组织生长调节剂（ W0/8 702244 )、 美容（JP59013708A2)、 洗发制剂（JP2011505A2)等。 目前尚无在 制备治疗宫颈糜烂药物方面的应用。
本发明现发现 N-乙酰 -D-氨基葡萄糖能有效地治疗宫颈糜烂， 这一发现是非常出人意料的， 因为要治愈宫颈糜烂需要控制微生 物感染、 抗局部渗出、 消除组织炎性水肿和疼痛以及促进组织修 复等多方面配合， 医生必须为患者开出多种药物联合治疗， 而现 发现单独以 N-乙酰- D-氨基葡萄糖为活性成分的药物能够治愈宫 颈糜烂。虽然现有技术中公开过 N-乙酰 -D-氨基葡萄糖的抗微生物 感染和组织生长调节作用， 这一发现仍然是令人惊异的。 发明内容
基于上述发现， 本发明涉及 N-乙酰- D-氨基葡萄糖和其药物可 接受的盐在制备治疗宫颈糜烂的药物中的应用。
另一方面， 本发明涉及一种治疗宫颈糜烂的方法， 包括给予有 此需要的患者治疗有效量的 N-乙酰- D-氨基葡萄糖或其药物可接 受的盐。
N-乙跣 -D-氨基葡萄糖为结构如下的化合物： N -乙酰 -D-氨基
Figure imgf000004_0001
买到或可以按已知方法制 得.例如，专利申请 W097/31121公开了一种从壳多糖酶法制备 N-乙 酰- D-氨基葡萄糖的方法. 日本专利申请 JP63273493公开了一种将 壳多糖部分酸水解为 N-乙酰-壳寡糖，然后用酶处理得到 N-乙酰 -D-氨基葡萄糖的方法.
在 N-乙酰- D-氨基葡萄糖的药物可接受的盐中， 可提及与药物 可接受的酸形成的那些， 例如与无机酸形成的那些， 如盐酸盐、 氢溴酸盐、 硼酸盐、 磷酸盐、 硫酸盐、 硫酸氢盐和磷酸氢盐， 以 及与有机酸形成的那些， 如柠檬酸盐、 笨甲酸盐、 抗坏血酸盐、 甲基硫酸盐、 萘 -2-磺酸盐、 苦味酸盐、 富马酸盐、 马来酸盐、 丙 二酸盐、 草酸盐、 琥珀酸盐、 乙酸盐、 酒石酸盐、 甲磺酸盐、 甲 苯磺酸盐、 羟乙磺酸盐、 α-酮戊二酸盐、 α-甘油磷酸盐和葡萄糖 -1-磷酸盐。
将式（I )的化合物或其药物可接受的盐作为主要活性成分，与 多种药学上可接受的赋形剂或 /和载体结合， 制备成外用水剂、 乳 剂、 霜剂、 膏剂、 栓剂等制剂形式， 用于治疗宫颈糜烂。 活性物 质的用量为整个制剂量的 0. 2-6% 。 所述药物的日剂量为每人 100-2000mg N -乙酰 _D-氨基葡萄糖。 虽无意拘于任何理论， 但本发明人认为本发明式（I )化合物治 疗宫颈糜烂的功效是通过调节机体的细胞再分布来实现的。 细胞 再分布指机体组织细胞或微生物细胞的位置不断更替， 胞内生物 大分子的节律性凝-溶状态的更替。 N-乙酰 -D-氨基葡萄糖通过调 节不同层次的细胞再分布发挥其特殊的功效。 宏观细胞位置的更 替表现波动生长特征。 N-乙酰- D-氨基葡萄糖通过调节机体细胞及 微生物细胞波动生长的正常进行， 使微生物不能在局部定植。 在 微生态学功效上， 主要扶持正常菌群生长， 而不采用补充生态菌 群方法， 避免了补充菌群存在着定植条件的适应性问题。 在促进 皮肤粘膜组织修复方面， 其对炎症、 损伤、 感染、 渗出具有控制 效果， 这是本产品独有的特色。 可广泛适用于控制症状， 以及从 根本问题上进行治疗。 本发明的最佳实施方式
以下试验实施例用于证明本发明式 （ I ) 化合物的促波特性、 低毒性、 抗微生物定植活性和治疗宫颈糜烂的临床观察。
一、 式（I )化合物的促波试验
1. 实验材料和方法：
1. 1. 样品： 式（I )化合物纯品。
1. 2. 实验材料：
菌种： 奇异变形杆菌、 乳酸杆菌。
培养基： 改良 LB培养基（组成成份为： 1%胰蛋白胨、 0. 5%酵母 提取物、 1%氯化钠、 0. 1%葡萄糖、 0. 002%TTC、 PH7. 2_7. 4)。
1. 3.实验方法：
在 LB平板中心点种奇异变形杆菌， 37 培养 9小时， 开始出现 不断向外扩展间隔 3小时的同心环， 以此作为对照； 在 LB平板中加 入终浓度为 0. 5%式（I )化合物同法点种奇异变形杆菌， 37Ό培养， 结果不但形成每隔 3小时出现的同心环， 而且与对照相比， 可见在 每条环上有许多细小的波动也表现出来。
液体培养结果表明， 式（I )化合物能促进乳酸杆菌的生长。
2. 实验结果及评价：
本实验采用生物波动模型， 用以研究式（I )化合物的促波作 用， 结果可见式（ I )化合物不仅可以使细菌细胞表现正常的生物 波特征，而且使这种波动表现出更加徵细的波动方式，表明式（ I ) 化合物对生物波动是有促进作用的， 这种促波作用可参与皮肤细 胞的修复和再分布作用。
二、 式（I )化合物的毒理试验包括：
1. 急性毒性试验： 包括口服、 静脉注射和最大极限量给药试 验；
2. Ames试验 ^
3. 小鼠骨髓细胞微核试验；
4. 鼠精子崎性试验
5. 小鼠睾丸染色体畸变试验；
6. 慢性致死试验；
7. 亚慢性毒性（90天喂养）试验；
8. 传统致畸试验；
试验结论表明： 式（ I )化合物急性毒性试验剂量超过 2g/kg, 是人注射剂量的 300倍， 仍未出现急性中毒反应； 在长期毒性试验 中， 最高剂量已达到 lg/kg, 经四周试验观察， 未出现中毒反应； 在生殖试验中，从常规剂量 7mg/kg喂小鼠，经三次传代，证明式（ I ) 化合物对小鼠受孕妊娠、 分娩、 哺乳及仔鼠发育均无影响， 属无 毒物质。
三、 以抗定植作用排除病原微生物的试验
原位细菌定植、 定性、 定量检测试验结果表明， 式（I)化合物 基本无杀菌抑菌作用， 它是通过抗定植的作用使得病原微生物如 白色念珠菌、 阴道嗜血杆菌等不能定植生长， 从而达到抗感染的 目的。
四、 临床试验
采用 2% N-乙跣 -D-氨基葡萄糖喷雾剂试用于人群， 截至一 九九九年八月止， 共观察病人 123例。 从试用结果看， 与空白对照 组（不用药）和阳性药物（ AgN03 )对照组比较， 统计分析表明治 疗组在痊愈率、 有效率方面与阳性药物对照组和空白对照组相差 显著， N-乙酰- D-氨基葡萄糖喷雾剂对宫颈糜烂的治疗效果是显著 6¾, 疗效统计结果如下：
例数 痊愈 有效 治疗组 83 48 15 阳性药物对照组 60 5 8
空白对照组 40 2 6

Claims

权 利 要 求
1. N-乙酰 -D-氨基葡萄糖和其药物可接受的盐在制备治疗宫 颈糜烂的药物中的应用。
2. 权利要求 1的应用，其中所述药物为外用水剂、乳剂、霜剂、 膏剂、 栓剂形式的制剂。
3. 权利要求 1或 2的应用， 其中所述药物的日剂量为 100-2000mg N-乙酰 -D-氨基葡萄糖。
PCT/CN2002/000118 2001-02-28 2002-02-28 Utilisation de n-acetyl-d-glucosamine dans la fabrication d'un produit pharmaceutique destine au traitement de l'erosion cervicale WO2002067945A1 (fr)

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CN1232257C (zh) 2003-03-27 2005-12-21 中国人民解放军第三军医大学 N－乙酰氨基葡萄糖在制备治疗和控制物理化学因素致非特异性炎症的药物中的应用
AU2003261624A1 (en) * 2003-09-05 2005-03-29 Shenyang Sunbellcom Bio-Pharmaceutical Co., Ltd. A red nocardia cell wall skeleton preparation process and its therapeutic use on treating cervical erosion
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US20100152304A1 (en) * 2008-12-17 2010-06-17 Geng Funeng Pharmaceutical composition comprising periplaneta americana or its ethanol extract and a method of using the same for treating inflammations
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