WO2007064128A1 - Composition for preventing or treating damages of the mucosa in the gastrointestinal tracts - Google Patents

Composition for preventing or treating damages of the mucosa in the gastrointestinal tracts Download PDF

Info

Publication number
WO2007064128A1
WO2007064128A1 PCT/KR2006/005044 KR2006005044W WO2007064128A1 WO 2007064128 A1 WO2007064128 A1 WO 2007064128A1 KR 2006005044 W KR2006005044 W KR 2006005044W WO 2007064128 A1 WO2007064128 A1 WO 2007064128A1
Authority
WO
WIPO (PCT)
Prior art keywords
revaprazan
pharmaceutically acceptable
preventing
cells
mucosa
Prior art date
Application number
PCT/KR2006/005044
Other languages
French (fr)
Inventor
Ki-Baik Hahm
Dong-Kyu Kim
Mi-Sun Kwak
Sang-Aun Joo
Byoung-Seok Moon
Geun-Seog Song
Original Assignee
Yuhan Corporation
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Yuhan Corporation filed Critical Yuhan Corporation
Priority to BRPI0619081-2A priority Critical patent/BRPI0619081A2/en
Priority to EP06823752A priority patent/EP1954279A4/en
Priority to AU2006321471A priority patent/AU2006321471B2/en
Priority to JP2008543190A priority patent/JP5207974B2/en
Priority to CN200680044428XA priority patent/CN101316594B/en
Priority to CA2631068A priority patent/CA2631068C/en
Publication of WO2007064128A1 publication Critical patent/WO2007064128A1/en
Priority to IL191680A priority patent/IL191680A0/en
Priority to HK09101447.8A priority patent/HK1123507A1/en

Links

Classifications

    • 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
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • 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
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • 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
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A61K31/506—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim not condensed and containing further heterocyclic rings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/04—Drugs for disorders of the alimentary tract or the digestive system for ulcers, gastritis or reflux esophagitis, e.g. antacids, inhibitors of acid secretion, mucosal protectants

Definitions

  • the present invention relates to a composition for preventing or treating damages of the mucosa in the gastrointestinal tracts, comprising revaprazan or its salt.
  • Revaprazan or its salt binds reversibly to a H 4 TK + exchange site of proton pumps (H " 7K + ATPase) existing in gastric parietal cells to competitively inhibit the secretion of H + into the gastric lumen.
  • Revaprazan or its salt binds to a specific site of the H + ZK + ATPase to block the transport of H + and acid secretion into the gastric lumen, thereby raising intragastric pH.
  • revaprazan or its salt is not affected by gastric acid activation of the drug or gastric acid secretion of the proton pumps. Based on the mechanism of revaprazan or its salt that is different from that of irreversible proton pump inhibitors such as omeprazole, revaprazan or its salt is classified as an Acid Pump Antagonist (APA).
  • APA Acid Pump Antagonist
  • gastrointestinal disorders are caused when offensive factors (e.g., gastric acid) are strengthened or defense factors are weakened.
  • offensive factors e.g., gastric acid
  • proton pump inhibitors e.g., omeprazole
  • acid pump antagonists e.g., revaprazan
  • cy- toprotective agents e.g., sucralfate, rebamipide
  • revaprazan or its salt has a cytoprotective activity in the gastrointestinal tracts, beyond proton pump inhibitory activity.
  • acid pump antagonist i.e., revaprazan or its salt
  • revaprazan or its salt has a cytoprotective activity in the gastrointestinal tracts, beyond proton pump inhibitory activity.
  • Such surprising findings suggest that revaprazan or its salt has not only the effect of inhibiting the secretion of the gastric acid (an offensive factor), but also the gastrointestinal cytoprotective effect of potentiating a defensive factor.
  • the present invention provides a composition for preventing or treating damages of the mucosa in the gastrointestinal tracts, comprising revaprazan or its salt.
  • the present invention provides a composition for preventing or treating damages of the mucosa in the gastrointestinal tracts, comprising revaprazan or its salt and a pharmaceutically acceptable carrier.
  • a method for preventing or treating damage to the gastric mucosa comprising administering to a human in need thereof a pharmaceutical composition comprising an effective amount for preventing or treating damage to gastric mucosa of revaprazan, or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier.
  • a method for preventing or treating drug-induced damage to the gastric mucosa comprising administering to a human in need thereof a pharmaceutical composition comprising an effective amount for preventing or treating drug-induced damage to gastric mucosa of revaprazan, or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier.
  • a method for preventing or treating alcohol-induced damage to the gastric mucosa comprising administering to a human in need thereof a pharmaceutical composition comprising an effective amount for preventing alcohol-induced damage to gastric mucosa of revaprazan, or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier.
  • a method for providing cytoprotection of the gastric mucosa in a human receiving nonsteroidal anti-inflammatory drugs comprising administering to the human prior to or concurrently with NSAIDs a pharmaceutical composition comprising a cy- toprotectively effective amount of revaprazan, or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier.
  • NSAIDs nonsteroidal anti-inflammatory drugs
  • the NSAIDs used in the present invention are not particularly restricted and include all NSAIDs widely used, such as Aspirin, Indomethacin, Diclofenac, Ibuprofen, Naproxen, Piroxicam, Mefenamic Acid, Flufenamic Acid, Floctafenine, Ethenzamide, Sodium salicylate, Diflunisal, Clofezone, Ketophenylbutazone, Phenylbutazone, Alclofenac, Alminoprofen, Ketoprofen, Flurbiprofen, Pranoprofen, Loxoprofen-Na, Tiaramide hydrochloride, Perisoxal citrate, Emorfazone, Acemetacin, Proglumetacin maleate, Bucolome and the like.
  • FTG. 1 shows MTT assay results for the inhibitory effect of revaprazan on cell death due to Helicobacter pylori (H. /ry/o ⁇ )-induced gastrointestinal mucosal damage;
  • FTG. 2 shows MTT assay results for the inhibitory effect of revaprazan on cell death due to ethanol-induced gastrointestinal mucosal damage
  • FTGS. 3 A and 3B are images showing the cytoprotective effect of revaprazan against in vivo gastrointestinal damage
  • FTG. 4 is a Western blot image showing an inhibitory effect of revaprazan on H.
  • FTG. 5 is Electrophoretic Mobility Shift Assay (EMSA) results showing an inhibitory effect of revaprazan on H. /ry/o ⁇ -induced NF-kB activation;
  • FTG. 6 is RT-PCR results showing an effect of revaprazan on the activity of pro- angiogenic growth factors
  • FTG. 7 is a Western blot image showing an effect of revaprazan on the activity of heat-shock proteins
  • FTG. 8 is a comparative image showing the preventive effects for gastric mucosal lesions with the treatment of rebamipide, omeprazole, and revaprazan prior to indomethacin administration;
  • FTG. 9 is a comparative image showing the treatment effect of revaprazan for gastric mucosal lesions after indomethacin administration. Best Mode for Carrying Out the Invention
  • Revaprazan may be prepared according to the methods disclosed in WO96/05177,
  • the salt of revaprazan may be an inorganic acid salt such as hydrochloride, sulfate, phosphate, and nitrate, or an organic acid salt such as tartrate, fumarate, citrate, mesylate, and acetate.
  • Revaprazan hydrochloride is preferred.
  • composition of the present invention may include additives such as lactose or corn starch, lubricants such as magnesium stearate, emulsifiers, suspending agents, stabilizers, and isotonic agents. If necessary, sweetening agents and/or flavoring agents may be added.
  • additives such as lactose or corn starch
  • lubricants such as magnesium stearate, emulsifiers, suspending agents, stabilizers, and isotonic agents. If necessary, sweetening agents and/or flavoring agents may be added.
  • composition of the present invention may be administered orally or par- enterally, including intravenous, intraperitoneal, subcutaneous, rectal and topical routes of administration. Therefore, the composition of the present invention may be formulated into various forms such as tablets, capsules, aqueous solutions or suspensions.
  • carriers such as lactose, corn starch, and lubricating agents, e.g. magnesium stearate, are commonly added.
  • lactose and/or dried corn starch can be used as a diluent.
  • the active ingredient may be combined with emulsifying and/or suspending agents.
  • composition of the present invention may be in the form of an aqueous solution containing pharmaceutically acceptable carriers, e.g., saline, at a pH level of 7.4.
  • pharmaceutically acceptable carriers e.g., saline
  • Revaprazan or its salt can be administered to a patient who needs the prevention or treatment of gastrointestinal mucosal damage in an effective amount ranging from about 50 mg to 400 mg per day, preferably about from 100 mg to 300 mg per day, more preferably about from 150 mg to 250 mg per day, and most preferably about 200 mg per day.
  • the dosage may be changed according to the patient's age, weight, susceptibility, or symptom.
  • the human gastric epithelial (AGS, KCLB 21739) cells were seeded onto 96-well plate at 5 X 10 4 cells/ml and cultured in RPMI 1640 (Gibco BRL, Grand Island, New York, U.S.A.), supplemented with 100 units/mL penicillin, 100 ug/mL streptomycin, and 10 % FBS (Fetal Bovine Serum). Revaprazan and rebamipide, dissolved in sterilized water, were added to AGS cells to reach a final concentration of 50 uM and the cells were incubated at 37 °C for 16 hours.
  • the plate was centrifuged at 24 °C, 3000 rpm for 5 minutes and washed three times with PBS (137 mM NaCl, 2.7 mM KCl, 10 mM Na 2 HPO 4 , and 2 mM KH 2 PO 4 ).
  • PBS 137 mM NaCl, 2.7 mM KCl, 10 mM Na 2 HPO 4 , and 2 mM KH 2 PO 4 .
  • H. pylori ATCC 43504 cultures were resuspended in PBS and cocultured with AGS cells at a final concentration of 5 X 10 CFU/ml. After 48 hours of incubation at 37 °C, the culture was centrifuged at 24 °C, 3000 rpm for 5 minutes to remove the culture medium, i.e., RPMI 1640, and then total viable cell numbers were assessed by MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolim bromide) assay method.
  • MTT 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolim bromide
  • MTT solution prepared by dissolving MTT (Amresco, Ohio, U.S.A.) in PBS (137 mM NaCl, 2.7 mM KCl, 10 mM Na 2 HPO 4 , and 2 mM KH 2 PO 4 ) was added to each well (50 D/well), followed by incubation at 37 °C for 4 hours.
  • DMSO dimethyl sulfoxide
  • HG. 1 The MTT assay results are shown in HG. 1.
  • the 48-hour H. pylori infection caused significant gastric mucosal cytotoxicity.
  • pretreatment of rebamipide and revaprazan was significantly reduced gastric mucosal cytotoxicity by H. pylori infection.
  • Example 2 Measurement of incidence of ethanol-induced cell death (MTT assay-2)
  • 96-well plate at 5 X 10 4 cells/ml and cultured in DMEM-F12 (Gibco BRL, Grand Island, New York, U.S.A.), supplemented with 100 units/mL penicillin, 100 ug/mL streptomycin, and 10 % FBS (Fetal Bovine Serum). Revaprazan and rebamipide, dissolved in sterilized water, were added to RGM-I cells to reach a final concentration of 50 uM and the cells were incubated at 37 °C for 16 hours.
  • DMEM-F12 Gibco BRL, Grand Island, New York, U.S.A.
  • FBS Fetal Bovine Serum
  • the plate was centrifuged at 24 °C, 3000 rpm for 5 minutes and washed three times with PBS (137 mM NaCl, 2.7 mM KCl, 10 mM Na 2 ⁇ PO 4 , and 2 mM KH 2 PO 4 ).
  • ethanol-containing media 200 mM ethanol-containing DMEM-Fl 2, sup- plemented with 100 units/mL penicillin, 100 ug/mL streptomycin, and 10% FBS
  • ethanol-containing media 200 mM ethanol-containing DMEM-Fl 2, sup- plemented with 100 units/mL penicillin, 100 ug/mL streptomycin, and 10% FBS
  • the culture was centrifuged at 24 °C, 3000 rpm for 5 minutes to remove the culture medium and then total viable cell numbers were assessed by MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolim bromide) assay method.
  • MTT solution prepared by dissolving MTT (Amresco, Ohio, U.S.A.) in PBS (137 mM NaCl, 2.7 mM KCl, 10 mM Na 2 HPO 4 , and 2 mM KH 2 PO 4 ) was added to each well (50 D/well), followed by incubation at 37 °C for 4 hours.
  • DMSO dimethylsulfoxide
  • the rats were fed a sterilized commercial pellet diet (Biogenomics Co., Seoul, Korea), given sterile water ad libitum, and housed in air-conditioned biohazard room with a 12-h light: 12-h dark cycle.
  • the rats were divided into four groups; indomethacin-only treatment group, revaprazan- indomethacin treatment group, ethanol-only treatment group and revaprazan-ethanol treatment group.
  • the rats were food-deprived 24 hours, and then administered with 10 mg/kg revaprazan suspended in 0.5% CMC (carboxymethylcellulose) via oro-gastric tube prior to exposure to either indomethacin (40 mg/kg for 12hrs) or absolute ethanol (6 ml/kg for lhr).
  • CMC carboxymethylcellulose
  • H. pylori infection leads to an increase in phosphorylation of ERK among three major subfamilies of MAPKs.
  • the human gastric epithelial (AGS, KCLB 21739) cells were seeded in culture dishs at 2 X 10 6 cells/lOOmm 2 and cultured in RPMI 1640 (Gibco BRL, Grand Island, New York, U.S.A.), supplemented with 100 units/mL penicillin, 100 ug/mL streptomycin, and 10 % FBS (Fetal Bovine Serum). Revaprazan, dissolved in sterilized water, were added to AGS cells to reach final concentrations of 5 and 25 uM and the cells were incubated at 37 °C for 16 hours.
  • H. pylori ATCC 43504 cultures were re- suspended in PBS and cocultured with AGS cells at a final concentration of 5 X 10 8 CFU/ml.
  • the cells were resuspended in lysis buffer (20 mM Tris-Cl (pH 7.5), 150 mM NaCl, 1 % Triton X-100, 1 mM EDTA, and protease inhibitor cocktail (Roche, Mannheim, Germany)).
  • the suspension was sonicated for approximately 10 seconds, four times using the BIORUPTOR (Cosmo Bio, Koto-ku, Tyoko), and centrifuged at 4 °C, 12000 rpm for 30 minutes.
  • Su- pernatants were used as protein extracts, electrophoresed on 10% SDS-PAGE gels, and transferred to PVDF membranes (Millipore, Massachusetts, U.S.A.) using a semidry transfer system (Hoeffer Pharmacia Biotech, San Francisco, CA, U.S.A.).
  • the PVDF membranes were blocked with blocking buffer (TBST: 10 mM Tris-Cl, pH 8.0, 150 mM NaCl, and 0.1% Tween 20 (Wv)) containing 5% skim milk (Difco, Livonia ML U.S. A.) for one hour at 23 0 C.
  • the PVDF membranes were incubated at 4 °C for 15 hours with 1:1000 dilution (200ng/ml) of primary antibodies for p-ERK or ERK.
  • the PVDF membranes were incubated with 1:2000 dilution (100 ng/ml) of the HRP (horseradish peroxidase)-conjugated secondary antibody (Santa Cruz Biotech, California, U.S.A.) for one hour at 23 °C.
  • the immunocomplex was visualized with an ECL (enhanced chemiluminescence) detection kit (Amersham-Pharmacia Biotec, Buckinghamshire, UK).
  • Example 5 Evaluation of activity of NF-kB transcription factor associated with H. pylon infection (Electrophoretic Mobility Shift Assay, EMSA)
  • NF-kB nuclear factor - kappa B
  • a redox-sensitive transcription factor known to be associated with H. pylori infection was evaluated using EMSA.
  • Rebamipide 50 uM
  • revaprazan 25 uM
  • the human gastric epithelial (AGS, KCLB 21739) cells were seeded in culture dishes at 2 X 10 6 cells/100 mm 2 and cultured in RPMI 1640 (Gibco BRL, Grand Island, New York, U.S.A.), supplemented with 100 units/mL penicillin, 100 ug/mL streptomycin, and 10 % FBS (Fetal Bovine Serum). Revaprazan and rebamipide, dissolved in sterilized water, were added to AGS cells to reach final concentrations of 25 uM and 50 uM, respectively, and the cells were incubated at 37 °C for 16 hours.
  • H.pylori ATCC 43504 cultures were resuspended in PBS and cocultured with AGS cells at a final concentration of 5 X 10 CFU/ml at 37 °C for one hour.
  • the nuclear fractions for EMSA were prepared using the NE-PER Nuclear and the Cytoplasmic Extraction Kit (Pierce, Rockford, IL, U.S.A.).
  • Sequences of double-stranded oligonucleotides used for EMSA of NF-kB were as follows; 5'-AGT TGA GGG GAC TTT CCC AGG C-3', and the oligonucleotides were labeled with a Biotin 3' End DNA Labeling Kit (Pierce, Rockford, IL, U.S.A.).
  • the EMSA was performed with a Light Shift Chemilu- minescent EMSA Kit (Pierce, Rockford, IL, U.S.A.).
  • the rat gastric mucosal (RGM-I, RIKEN cell bank, Japan) cells were seeded in culture dishes at 2 X 10 6 cells/100 mm 2 and cultured in RPMI 1640 (Gibco BRL, Grand Island, New York, U.S. A.), supplemented with 100 units/mL penicillin, 100 ug/ mL streptomycin, and 10% FBS (Fetal Bovine Serum). Revaprazan and rebamipide, dissolved in sterilized water, were added to RGM-I cells to reach final concentrations of 25 uM and 5OuM, respectively, and the cells were cultured at 37 °C for 16 hours.
  • the culture media were removed and the cells were washed three times with PBS (137 mM NaCl, 2.7 mM KCl, 10 mM Na 2 HPO 4 , and 2 mM KH 2 PO 4 ).
  • a solution of sulindac in DMSO was added to the cells to reach a final concentration of 100 uM and the cells were cultured at 37 °C for 8 hours.
  • the cultured cells were collected by centrifugation at 23 °C at 3000 rpm for 3 minutes, and the total RNA was isolated from the cells using the TRIzol reagent (Life technologies, Milan, Italy).
  • the PCR was performed using the Premix Ex Taq kit (Takara, Chiba, Japan) with specific primers as follows; 5'-TGCACCCACGACAGAAGGGGA-S' and 5'-TCACCGCCTTGGCTTGTCACAT-S' (for VEGF);
  • PCR was performed as follows: 35 cycles (VEGF, IL-8, and COX-2) or 28 cycles (GAPDE) of 94 °C for one minute, 60 °C (VEGF), 45 °C (IL-8), 48 °C (COX-2), and 55 °C (GAPDH) for one minute (each), and 72 °C for one minute.
  • VEGF vascular endothelial growth factor
  • IL-8 45 °C
  • COX-2 48 °C
  • GAPDH 55 °C
  • the PCR product was resolved on 1% agarose gels, and stained with 10 mg/ml of an ethidium bromide .
  • the rat gastric mucosal (RGM-I, RIKEN cell bank, Japan) cells were seeded in culture dishes at 2 X 10 6 cells/100 mm 2 and cultured in DMEM-F12 (Gibco BRL, Grand Island, New York, U.S. A.), supplemented with 100 units/mL penicillin, 100 ug/ mL streptomycin, and 10% F ⁇ S (Fetal Bovine Serum).
  • RGM-I cells were pretreated with revaprazan (5, 10, and 25uM) and cultured 37 °C for 16 hours.
  • the culture media were removed and the cells were washed three times with PBS (137 mM NaCl, 2.7 mM KCl, 10 mM Na 2 HPO 4 , and 2 mM KH 2 PO 4 ).
  • a solution of indomethacin in sterilized water was added to the cells to reach a final concentration of 0.5 uM, and the cells were incubated at 37 °C for 16 hours. After incubation, the cells were resuspended in a lysis buffer (20 mM Tris-Cl (pH 7.5), 150 mM NaCl, 1 % Triton X-100, 1 mM EDTA, and protease inhibitor cocktail (Roche, Mannheim, Germany)).
  • the suspension was sonicated for approximately 10 seconds, four times using the BIORUPTOR (Cosmo Bio, Koto-ku, Tokyo), and centrifuged at 4 °C, 12000 rpm for 30 minutes.
  • Su- pernatants were used as protein extracts, the extracted proteins were electrophoresed on 10% SDS-PAGE gels and transferred to PVDF membranes (Millipore, Massachusetts, U.S.A.) using a semidry transfer system (Hoeffer Pharmacia Biotech, San Francisco, CA, U.S.A.).
  • the PVDF membranes were blocked with blocking buffer (TBST: 10 mM Tris-Cl, pH 8.0, 150 mM NaCl, and 0.1% Tween 20 (Wv)) containing 5% skim milk (Difco, Livonia MI, U.S.A.) for one hour at 23 °C.
  • TST blocking buffer
  • skim milk Difco, Livonia MI, U.S.A.
  • the PVDF membranes were incubated at 4 °C for 15 hours with 1:1000 dilution (200 ng/ml) of the primary antibodies for HO-I, HSP27, HSP70 or ⁇ -tubulin (TU-02).
  • the PVDF membranes were incubated with 1:2000 dilution (100 ng/ml) of HRP (horseradish peroxidase)-conjugated secondary antibody (Santa Cruz Biotech, California, U.S.A.) for one hour at 23 °C.
  • HRP horseradish peroxidase
  • the immunocomplex was visualized with an ECL (enhanced chemiluminescence) detection kit (Amersham-Pharmacia Biotec, Buckinghamshire, UK) (see FIG. 7).
  • revaprazan exhibits the cytoprotective effect by stimulating expression of heat-shock proteins.
  • Example 8 Evaluation of the preventive effect of revaprazan on NSAID- induced gastropathy
  • the rats were fed a sterilized commercial pellet diet (Biogenomics Co., Seoul, Korea), given sterile water ad libitum, and housed in air-conditioned biohazard room with a 12-h light: 12-h dark cycle.
  • the rats were food-deprived 24 hours, and then administered with 5, 10 mg/kg revaprazan, 30 mg/kg rebamipide and 5 mg/kg omeprazole suspended in 0.5% CMC (carboxymethylcellulose) via oro-gastric tube prior to exposure to indomethacin (40 mg/kg for 12hrs).
  • Phosphate-buffered saline was perfused into the gastric lumen of the rats to swell the stomachs. Then, the stomachs were opened by an incision along the greater curvature, and the total area of the gastric mucosal lesions was calculated to obtain the average size of the lesions.
  • the rats were fed a sterilized commercial pellet diet (Biogenomics Co., Seoul, Korea), given sterile water ad libitum, and housed in air-conditioned biohazard room with a 12-h light: 12-h dark cycle.
  • the rats were food-deprived 24 hours, and then treated with 1 ml of a solution of indomethacin (40 mg/kg) in 0.5% CMC (carboxymethylcellulose) via oro-gastric tube. 8 hours after the indomethacin treatment, the rats were treated with 1 ml of a solution of revaprazan (5 mg/kg and 10 mg/kg) in 0.5% CMC for one hour, and the degree of gastropathy was determined in the same manner as in Example 8.
  • indomethacin 40 mg/kg
  • CMC carboxymethylcellulose
  • revaprazan or its salt has an excellent preventive or treatment effect for gastrointestinal mucosal damage by potentiating a defensive factor in the gastrointestinal mucosa, simultaneously with acting as an acid pump antagonist.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Medicinal Chemistry (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Epidemiology (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Organic Chemistry (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Chemical & Material Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Plural Heterocyclic Compounds (AREA)

Abstract

Provided is a composition for preventing or treating damages of the mucosa in the gastrointestinal tracts, comprising revaprazan or a salt thereof and a pharmaceutically acceptable carrier. Revaprazan or its salt has an excellent preventive or treatment effect for gastrointestinal mucosal damage by potentiating a defensive factor in the gastrointestinal mucosa, simultaneously with acting as an acid pump antagonist.

Description

Description
COMPOSITION FOR PREVENTING OR TREATING DAMAGES OF THE MUCOSA IN THE GASTROINTESTINAL TRACTS
Technical Field
[1] The present invention relates to a composition for preventing or treating damages of the mucosa in the gastrointestinal tracts, comprising revaprazan or its salt. Background Art
[2] Revaprazan, known by the chemical name,
5,6-dimethyl-2-(4-fluorophenylamino)-4-(l-methyl-l,2,3,4-tetrahydroisoquinolin-2-yl) pyrimidine, is a compound represented by Formula 1 below, and is available as an acid addition salt (e.g., revaprazan hydrochloride) [PCT Publication No. WO96/05177].
[3] <Formula 1>
[4]
Figure imgf000003_0001
[5] Revaprazan or its salt binds reversibly to a H4TK+ exchange site of proton pumps (H "7K+ ATPase) existing in gastric parietal cells to competitively inhibit the secretion of H+ into the gastric lumen. Revaprazan or its salt binds to a specific site of the H+ZK+ ATPase to block the transport of H+ and acid secretion into the gastric lumen, thereby raising intragastric pH. Unlike irreversible proton pump inhibitors such as omeprazole, revaprazan or its salt is not affected by gastric acid activation of the drug or gastric acid secretion of the proton pumps. Based on the mechanism of revaprazan or its salt that is different from that of irreversible proton pump inhibitors such as omeprazole, revaprazan or its salt is classified as an Acid Pump Antagonist (APA).
[6] Meanwhile, gastrointestinal disorders are caused when offensive factors (e.g., gastric acid) are strengthened or defense factors are weakened. Both proton pump inhibitors (e.g., omeprazole) and acid pump antagonists (e.g., revaprazan) are compounds inhibiting the secretion of the offensive factor, i.e., the gastric acid, and cy- toprotective agents (e.g., sucralfate, rebamipide) are compounds potentiating defensive factors.
Disclosure of Invention
Technical Problem
[7] The present inventors have conducted various clinical trials using an acid pump antagonist, i.e., revaprazan or its salt, and have found that revaprazan or its salt has a cytoprotective activity in the gastrointestinal tracts, beyond proton pump inhibitory activity. Such surprising findings suggest that revaprazan or its salt has not only the effect of inhibiting the secretion of the gastric acid (an offensive factor), but also the gastrointestinal cytoprotective effect of potentiating a defensive factor. Technical Solution
[8] Therefore, the present invention provides a composition for preventing or treating damages of the mucosa in the gastrointestinal tracts, comprising revaprazan or its salt.
[9] The present invention provides a composition for preventing or treating damages of the mucosa in the gastrointestinal tracts, comprising revaprazan or its salt and a pharmaceutically acceptable carrier.
[10] In accordance with one aspect of the present invention, there is provided a method for preventing or treating damage to the gastric mucosa comprising administering to a human in need thereof a pharmaceutical composition comprising an effective amount for preventing or treating damage to gastric mucosa of revaprazan, or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier.
[11] In accordance with another aspect of the present invention, there is provided a method for preventing or treating drug-induced damage to the gastric mucosa comprising administering to a human in need thereof a pharmaceutical composition comprising an effective amount for preventing or treating drug-induced damage to gastric mucosa of revaprazan, or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier.
[12] In accordance with still another aspect of the present invention, there is provided a method for preventing or treating alcohol-induced damage to the gastric mucosa comprising administering to a human in need thereof a pharmaceutical composition comprising an effective amount for preventing alcohol-induced damage to gastric mucosa of revaprazan, or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier.
[13] In accordance with still another aspect of the present invention, there is provided a method for providing cytoprotection of the gastric mucosa in a human receiving nonsteroidal anti-inflammatory drugs (NSAIDs), comprising administering to the human prior to or concurrently with NSAIDs a pharmaceutical composition comprising a cy- toprotectively effective amount of revaprazan, or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier. The NSAIDs used in the present invention are not particularly restricted and include all NSAIDs widely used, such as Aspirin, Indomethacin, Diclofenac, Ibuprofen, Naproxen, Piroxicam, Mefenamic Acid, Flufenamic Acid, Floctafenine, Ethenzamide, Sodium salicylate, Diflunisal, Clofezone, Ketophenylbutazone, Phenylbutazone, Alclofenac, Alminoprofen, Ketoprofen, Flurbiprofen, Pranoprofen, Loxoprofen-Na, Tiaramide hydrochloride, Perisoxal citrate, Emorfazone, Acemetacin, Proglumetacin maleate, Bucolome and the like. Brief Description of the Drawings
[14] The above and other features and advantages of the present invention will become more apparent by describing in detail exemplary embodiments thereof with reference to the attached drawings in which:
[15] FTG. 1 shows MTT assay results for the inhibitory effect of revaprazan on cell death due to Helicobacter pylori (H. /ry/oπ)-induced gastrointestinal mucosal damage;
[16] FTG. 2 shows MTT assay results for the inhibitory effect of revaprazan on cell death due to ethanol-induced gastrointestinal mucosal damage;
[17] FTGS. 3 A and 3B are images showing the cytoprotective effect of revaprazan against in vivo gastrointestinal damage;
[18] FTG. 4 is a Western blot image showing an inhibitory effect of revaprazan on H.
/ry/oπ-induced ERK (extracellular signal-regulated kinase) activation;
[19] FTG. 5 is Electrophoretic Mobility Shift Assay (EMSA) results showing an inhibitory effect of revaprazan on H. /ry/oπ-induced NF-kB activation;
[20] FTG. 6 is RT-PCR results showing an effect of revaprazan on the activity of pro- angiogenic growth factors;
[21] FTG. 7 is a Western blot image showing an effect of revaprazan on the activity of heat-shock proteins;
[22] FTG. 8 is a comparative image showing the preventive effects for gastric mucosal lesions with the treatment of rebamipide, omeprazole, and revaprazan prior to indomethacin administration; and
[23] FTG. 9 is a comparative image showing the treatment effect of revaprazan for gastric mucosal lesions after indomethacin administration. Best Mode for Carrying Out the Invention
[24] Revaprazan may be prepared according to the methods disclosed in WO96/05177,
WO97/42186, and/or WO98/18784. The salt of revaprazan may be an inorganic acid salt such as hydrochloride, sulfate, phosphate, and nitrate, or an organic acid salt such as tartrate, fumarate, citrate, mesylate, and acetate. Revaprazan hydrochloride is preferred.
[25] The composition of the present invention may include additives such as lactose or corn starch, lubricants such as magnesium stearate, emulsifiers, suspending agents, stabilizers, and isotonic agents. If necessary, sweetening agents and/or flavoring agents may be added.
[26] The composition of the present invention may be administered orally or par- enterally, including intravenous, intraperitoneal, subcutaneous, rectal and topical routes of administration. Therefore, the composition of the present invention may be formulated into various forms such as tablets, capsules, aqueous solutions or suspensions. In the case of tablets for oral use, carriers such as lactose, corn starch, and lubricating agents, e.g. magnesium stearate, are commonly added. In the case of capsules for oral administration, lactose and/or dried corn starch can be used as a diluent. When an aqueous suspension is required for oral use, the active ingredient may be combined with emulsifying and/or suspending agents. If desired, certain sweetening and/or flavoring agents may be added. For intramuscular, intraperitoneal, subcutaneous and intravenous use, sterile solutions of the active ingredient are usually prepared, and the pH of the solutions should be suitably adjusted and buffered. For intravenous use, the total concentration of solutes should be controlled in order to render the preparation isotonic. The composition of the present invention may be in the form of an aqueous solution containing pharmaceutically acceptable carriers, e.g., saline, at a pH level of 7.4. The solutions may be introduced into a patient's intramuscular blood-stream by local bolus injection.
[27] Revaprazan or its salt can be administered to a patient who needs the prevention or treatment of gastrointestinal mucosal damage in an effective amount ranging from about 50 mg to 400 mg per day, preferably about from 100 mg to 300 mg per day, more preferably about from 150 mg to 250 mg per day, and most preferably about 200 mg per day. Of course, the dosage may be changed according to the patient's age, weight, susceptibility, or symptom. Mode for the Invention
[28] Hereinafter, the present invention will be described more specifically by the following working examples. However, the following working examples are provided only for illustrations and thus the present invention is not limited to or by them.
[29] Example 1: Measurement of incidence oϊ Helicobacter pylori (H. pylori
) -induced cell death (MTT assay- 1 )
[30] In order to determine cytoprotective properties of revaprazan against H. pylori infection, gastric mucosal cells were pretreated with revaprazan and rebamipide prior to H. pylori infection, and the incidence of cell death was measured. Rebamipide, known to have cytoprotective properties, was used as a control drug.
[31] The human gastric epithelial (AGS, KCLB 21739) cells were seeded onto 96-well plate at 5 X 104 cells/ml and cultured in RPMI 1640 (Gibco BRL, Grand Island, New York, U.S.A.), supplemented with 100 units/mL penicillin, 100 ug/mL streptomycin, and 10 % FBS (Fetal Bovine Serum). Revaprazan and rebamipide, dissolved in sterilized water, were added to AGS cells to reach a final concentration of 50 uM and the cells were incubated at 37 °C for 16 hours. To remove RPMI 1640 media, the plate was centrifuged at 24 °C, 3000 rpm for 5 minutes and washed three times with PBS (137 mM NaCl, 2.7 mM KCl, 10 mM Na 2 HPO 4 , and 2 mM KH 2 PO 4 ). For inoculation,
H. pylori (ATCC 43504) cultures were resuspended in PBS and cocultured with AGS cells at a final concentration of 5 X 10 CFU/ml. After 48 hours of incubation at 37 °C, the culture was centrifuged at 24 °C, 3000 rpm for 5 minutes to remove the culture medium, i.e., RPMI 1640, and then total viable cell numbers were assessed by MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolim bromide) assay method. 1 mg/ml of an MTT solution prepared by dissolving MTT (Amresco, Ohio, U.S.A.) in PBS (137 mM NaCl, 2.7 mM KCl, 10 mM Na2HPO4, and 2 mM KH2PO4) was added to each well (50 D/well), followed by incubation at 37 °C for 4 hours. The supernatant was then removed by centrifugation at 24 °C, 3000 rpm for 5 minutes and the formazan grains formed by the viable cells were dissolved in 99.5% dimethyl sulfoxide (DMSO) (Kanto, Tokyo, Japan) (50 D/well), and the optical intensity was measured at 540 nm using an ELISA reader (TECAN, Maennedorf, Switzerland).
[32] The MTT assay results are shown in HG. 1. Referring to HG. 1 , the 48-hour H. pylori infection caused significant gastric mucosal cytotoxicity. However, pretreatment of rebamipide and revaprazan was significantly reduced gastric mucosal cytotoxicity by H. pylori infection. These results show that revaprazan has cytoprotective effect equal to or greater than rebamipide against H./ry/oπ-induced cytotoxicity.
[33]
[34] Example 2: Measurement of incidence of ethanol-induced cell death (MTT assay-2)
[35] The rat gastric mucosal (RGM-I, RIKEN cell bank, Japan) cells were seeded onto
96-well plate at 5 X 104 cells/ml and cultured in DMEM-F12 (Gibco BRL, Grand Island, New York, U.S.A.), supplemented with 100 units/mL penicillin, 100 ug/mL streptomycin, and 10 % FBS (Fetal Bovine Serum). Revaprazan and rebamipide, dissolved in sterilized water, were added to RGM-I cells to reach a final concentration of 50 uM and the cells were incubated at 37 °C for 16 hours. To remove DMEM-F12 media, the plate was centrifuged at 24 °C, 3000 rpm for 5 minutes and washed three times with PBS (137 mM NaCl, 2.7 mM KCl, 10 mM Na 2 ΗPO 4 , and 2 mM KH 2 PO 4 ).
Then, ethanol-containing media (200 mM ethanol-containing DMEM-Fl 2, sup- plemented with 100 units/mL penicillin, 100 ug/mL streptomycin, and 10% FBS) was added to the cells, and the cells were cultured at 37 °C for 16 hours. After the incubation, the culture was centrifuged at 24 °C, 3000 rpm for 5 minutes to remove the culture medium and then total viable cell numbers were assessed by MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolim bromide) assay method. 1 mg/ml of an MTT solution prepared by dissolving MTT (Amresco, Ohio, U.S.A.) in PBS (137 mM NaCl, 2.7 mM KCl, 10 mM Na 2 HPO 4 , and 2 mM KH 2 PO 4 ) was added to each well (50 D/well), followed by incubation at 37 °C for 4 hours. The supernatant was then removed by centrifugation at 24 °C, 3000 rpm for 5 minutes and the formazan grains formed by the viable cells were dissolved in 99.5% dimethylsulfoxide (DMSO) (Kanto, Tokyo, Japan) (50 D/well), and the optical intensity was measured at 540 nm using an ELISA reader (TECAN, Maennedorf, Switzerland).
[36] The MTT assay results are shown in FIG. 2. Referring to FIG. 2, in the ethanol-only treatment group, significant gastric mucosal cytotoxicity was induced. On the other hand, in the rebamipide/revaprazan-ethanol treatment groups, gastric mucosal cytotoxicity was significantly reduced. These results show that revaprazan has cyto- protective effect equal to or greater than rebamipide.
[37]
[38] Example 3: Evaluation of preventive effect of revaprazan on in vivo gastrointestinal damage
[39] Six-week old specific-pathogen-free (SPF) Sprague-Dawley male rats (Charles
River, Tokyo, Japan) were used for experiments. The rats were fed a sterilized commercial pellet diet (Biogenomics Co., Seoul, Korea), given sterile water ad libitum, and housed in air-conditioned biohazard room with a 12-h light: 12-h dark cycle. The rats were divided into four groups; indomethacin-only treatment group, revaprazan- indomethacin treatment group, ethanol-only treatment group and revaprazan-ethanol treatment group. The rats were food-deprived 24 hours, and then administered with 10 mg/kg revaprazan suspended in 0.5% CMC (carboxymethylcellulose) via oro-gastric tube prior to exposure to either indomethacin (40 mg/kg for 12hrs) or absolute ethanol (6 ml/kg for lhr).
[40] The stomachs of the rats belonging to the groups treated with indomethacin were excised and the degree of gastric mucosal lesions was observed (see FIG. 3A). Referring to FIG. 3 A, in the indomethacin-only treatment group, increased hemorrhagic lesions in gastric mucosa were observed visually. However, in the revaprazan-indomethacin treatment group that had been treated with indomethacin after the revaprazan administration, indomethacin-induced gastric injury was completely inhibited. Also, the stomachs of the rats belonging to the ethanol treatment groups were excised and the degree of gastric mucosal lesions was observed (see FIG. 3B). Referring to FlG. 3B, in the ethanol-only treatment group, remarkably increased hemorrhagic lesions in gastric mucosa were also observed visually. However, in the revaprazan-ethanol treatment group that had been treated with ethanol after the revaprazan administration, ethanol-induced gastric injury was completely inhibited. These results show that pretreatment of revaprazan significantly reduced Non-Steroidal Anti-Inflammatory Drug (NSAID) (e.g., indomethacin)- or ethanol-induced gastric mucosal lesions, thereby achieving excellent cytoprotective effect of the gastrointestinal mucosa.
[41]
[42] Example 4: Evaluation of activity of extracelluar signal-regulated kinase
(ERK) inducing H. pylori -mediated cytotoxicity
[43] H. /ry/oπ-induced cytotoxicity activates MAPK (Mitogen-Activated Protein
Kinase), thereby resulting in apoptosis. Therefore, H. pylori infection leads to an increase in phosphorylation of ERK among three major subfamilies of MAPKs.
[44] The human gastric epithelial (AGS, KCLB 21739) cells were seeded in culture dishs at 2 X 106 cells/lOOmm2 and cultured in RPMI 1640 (Gibco BRL, Grand Island, New York, U.S.A.), supplemented with 100 units/mL penicillin, 100 ug/mL streptomycin, and 10 % FBS (Fetal Bovine Serum). Revaprazan, dissolved in sterilized water, were added to AGS cells to reach final concentrations of 5 and 25 uM and the cells were incubated at 37 °C for 16 hours. RPMI 1640 media was removed and then the cells washed three times with PBS (137 mM NaCl, 2.7 mM KCl, 10 mM Na HPO , and 2 mM KH PO ). For inoculation, H. pylori (ATCC 43504) cultures were re- suspended in PBS and cocultured with AGS cells at a final concentration of 5 X 108 CFU/ml. After 30 minutes of incubation at 37 °C, the cells were resuspended in lysis buffer (20 mM Tris-Cl (pH 7.5), 150 mM NaCl, 1 % Triton X-100, 1 mM EDTA, and protease inhibitor cocktail (Roche, Mannheim, Germany)). The suspension was sonicated for approximately 10 seconds, four times using the BIORUPTOR (Cosmo Bio, Koto-ku, Tyoko), and centrifuged at 4 °C, 12000 rpm for 30 minutes. Su- pernatants were used as protein extracts, electrophoresed on 10% SDS-PAGE gels, and transferred to PVDF membranes (Millipore, Massachusetts, U.S.A.) using a semidry transfer system (Hoeffer Pharmacia Biotech, San Francisco, CA, U.S.A.). In order to prevent non-specific binding between the primary antibodies and the proteins, the PVDF membranes were blocked with blocking buffer (TBST: 10 mM Tris-Cl, pH 8.0, 150 mM NaCl, and 0.1% Tween 20 (Wv)) containing 5% skim milk (Difco, Livonia ML U.S. A.) for one hour at 23 0C. The PVDF membranes were incubated at 4 °C for 15 hours with 1:1000 dilution (200ng/ml) of primary antibodies for p-ERK or ERK. The PVDF membranes were incubated with 1:2000 dilution (100 ng/ml) of the HRP (horseradish peroxidase)-conjugated secondary antibody (Santa Cruz Biotech, California, U.S.A.) for one hour at 23 °C. The immunocomplex was visualized with an ECL (enhanced chemiluminescence) detection kit (Amersham-Pharmacia Biotec, Buckinghamshire, UK).
[45] The Western blot results for the p-ERK of the untreatment group and the revaprazan treatment groups of the H. /ry/oπ-infected cells are shown in FIG. 4. Referring to FIG. 4, revaprazan exhibits a significant, concentration-dependent inhibitory effect on ERK activation.
[46]
[47] Example 5: Evaluation of activity of NF-kB transcription factor associated with H. pylon infection (Electrophoretic Mobility Shift Assay, EMSA)
[48] The DNA binding activity of NF-kB (nuclear factor - kappa B), a redox-sensitive transcription factor known to be associated with H. pylori infection was evaluated using EMSA. Rebamipide (50 uM), known to have cytoprotective properties, was used as a control drug, and revaprazan (25 uM) was used as a test drug.
[49] The human gastric epithelial (AGS, KCLB 21739) cells were seeded in culture dishes at 2 X 106 cells/100 mm2 and cultured in RPMI 1640 (Gibco BRL, Grand Island, New York, U.S.A.), supplemented with 100 units/mL penicillin, 100 ug/mL streptomycin, and 10 % FBS (Fetal Bovine Serum). Revaprazan and rebamipide, dissolved in sterilized water, were added to AGS cells to reach final concentrations of 25 uM and 50 uM, respectively, and the cells were incubated at 37 °C for 16 hours. The culture media were removed and the cells were twice washed with PBS (137 mM NaCl, 2.7 mM KCl, 10 mM Na ΗPO , and 2 mM KH PO ). For inoculation, H.pylori (ATCC 43504) cultures were resuspended in PBS and cocultured with AGS cells at a final concentration of 5 X 10 CFU/ml at 37 °C for one hour. The nuclear fractions for EMSA were prepared using the NE-PER Nuclear and the Cytoplasmic Extraction Kit (Pierce, Rockford, IL, U.S.A.). Sequences of double-stranded oligonucleotides used for EMSA of NF-kB were as follows; 5'-AGT TGA GGG GAC TTT CCC AGG C-3', and the oligonucleotides were labeled with a Biotin 3' End DNA Labeling Kit (Pierce, Rockford, IL, U.S.A.). The EMSA was performed with a Light Shift Chemilu- minescent EMSA Kit (Pierce, Rockford, IL, U.S.A.).
[50] The evaluation results for the DNA binding activity of the NF-kB using EMSA are shown in FIG. 5. These results indicated that NF-kB activity was significantly inhibited by revaprazan pretreatment, thereby achieving cytoprotective effect equal to or greater than rebamipide.
[51]
[52] Example 6: Measurement of expression levels of proteins participating in cyto- protection (RT-PCR)
[53] In order to evaluate cytoprotective effect of revaprazan, 100 uM of sulindac belonging to NSAIDs was added to the rat cells, and the expression levels of pro- angiogenic growth factors, VEGF (Vascular Endothelial Growth Factor), interlukin-8 (IL-8), and COX-2 (cyclooxygenase-2) were measured. Rebamipide (50 uM), known to have cytoprotective properties, was used as a control drug and revaprazan (25 uM) was used as a test drug.
[54] The rat gastric mucosal (RGM-I, RIKEN cell bank, Japan) cells were seeded in culture dishes at 2 X 106 cells/100 mm2 and cultured in RPMI 1640 (Gibco BRL, Grand Island, New York, U.S. A.), supplemented with 100 units/mL penicillin, 100 ug/ mL streptomycin, and 10% FBS (Fetal Bovine Serum). Revaprazan and rebamipide, dissolved in sterilized water, were added to RGM-I cells to reach final concentrations of 25 uM and 5OuM, respectively, and the cells were cultured at 37 °C for 16 hours. The culture media were removed and the cells were washed three times with PBS (137 mM NaCl, 2.7 mM KCl, 10 mM Na 2 HPO 4 , and 2 mM KH 2 PO 4 ). A solution of sulindac in DMSO was added to the cells to reach a final concentration of 100 uM and the cells were cultured at 37 °C for 8 hours. The cultured cells were collected by centrifugation at 23 °C at 3000 rpm for 3 minutes, and the total RNA was isolated from the cells using the TRIzol reagent (Life technologies, Milan, Italy). Sterilized RNase-free water was added to 2 Dof the total RNA and 1 D of 10 pmol/oligo dT to obtain reaction solutions with a volume of 34 D. The reaction solutions were incubated at 65 °C for 5 minutes, and 10 D of a 5 X reverse-transcription buffer, 5 D of 10 mM dNTPs, and 1 D of M-MLV reverse transcriptase were added thereto. The resultant solutions were incubated at 37 °C for one hour to obtain cDNA (Promega, Madison, WI), and the cDNA were amplified by PCR. The PCR was performed using the Premix Ex Taq kit (Takara, Chiba, Japan) with specific primers as follows; 5'-TGCACCCACGACAGAAGGGGA-S' and 5'-TCACCGCCTTGGCTTGTCACAT-S' (for VEGF);
5'-GAAGATAGATTGCCCGA-S' and 5'-CATAGCCTCTCACACATTTC-S' (for IL- 8); 5'-ATCTGTGTGGGTACAAATTTG-S' and 5'-GTCTCTCATCTGCAATAATGTG-S' (for COX-2); 5'-TGAAGGTCGGTGTCAACGGATTTGTC-S' and
5'-CATGTAGGCCATGAGGTCCACCAC-S' (for GAPDH). As described above, GAPDH was used as positive control. The PCR was performed as follows: 35 cycles (VEGF, IL-8, and COX-2) or 28 cycles (GAPDE) of 94 °C for one minute, 60 °C (VEGF), 45 °C (IL-8), 48 °C (COX-2), and 55 °C (GAPDH) for one minute (each), and 72 °C for one minute. The PCR product was resolved on 1% agarose gels, and stained with 10 mg/ml of an ethidium bromide .
[55] The expression levels of IL-8, VEGF, and COX-2 in the rebamipide-sulindac treatment group and the revaprazan-sulindac treatment group are shown in FTG. 6. Referring to FlG. 6, the expression levels of IL-8, VEGF, and COX-2 in the revaprazan-sulindac treatment group were much higher than those in the rebamipide- sulindac treatment group. It is known that one of mechanisms contributing to NSAID- induced gastric mucosal damage is associated with a reduction in VEGF, IL-8, and COX-2 causing gastric mucosal regeneration and ischemia. In this regard, the results of FlG. 6 showing the increased expression levels of IL-8, VEGF, and COX-2 in the revaprazan-sulindac treatment group reveal that revaprazan has a good cytoprotective effect for the gastrointestinal mucosa.
[56]
[57] Example 7: Evaluation of activities of heat-shock proteins (Western blotting)
[58] To measure expression of heat-shock proteins, HO-I, HSP27, HSP70, cells were pretreated with concentrations of 5, 10, and 25 uM revaprazan, and then treated with indomethacin (a NSAID, 0.5 uM).
[59] The rat gastric mucosal (RGM-I, RIKEN cell bank, Japan) cells were seeded in culture dishes at 2 X 106 cells/100 mm2 and cultured in DMEM-F12 (Gibco BRL, Grand Island, New York, U.S. A.), supplemented with 100 units/mL penicillin, 100 ug/ mL streptomycin, and 10% FΗS (Fetal Bovine Serum). RGM-I cells were pretreated with revaprazan (5, 10, and 25uM) and cultured 37 °C for 16 hours. The culture media were removed and the cells were washed three times with PBS (137 mM NaCl, 2.7 mM KCl, 10 mM Na 2 HPO 4 , and 2 mM KH 2 PO 4 ). A solution of indomethacin in sterilized water was added to the cells to reach a final concentration of 0.5 uM, and the cells were incubated at 37 °C for 16 hours. After incubation, the cells were resuspended in a lysis buffer (20 mM Tris-Cl (pH 7.5), 150 mM NaCl, 1 % Triton X-100, 1 mM EDTA, and protease inhibitor cocktail (Roche, Mannheim, Germany)). The suspension was sonicated for approximately 10 seconds, four times using the BIORUPTOR (Cosmo Bio, Koto-ku, Tokyo), and centrifuged at 4 °C, 12000 rpm for 30 minutes. Su- pernatants were used as protein extracts, the extracted proteins were electrophoresed on 10% SDS-PAGE gels and transferred to PVDF membranes (Millipore, Massachusetts, U.S.A.) using a semidry transfer system (Hoeffer Pharmacia Biotech, San Francisco, CA, U.S.A.). In order to prevent non-specific binding between the primary antibodies and the proteins, the PVDF membranes were blocked with blocking buffer (TBST: 10 mM Tris-Cl, pH 8.0, 150 mM NaCl, and 0.1% Tween 20 (Wv)) containing 5% skim milk (Difco, Livonia MI, U.S.A.) for one hour at 23 °C. The PVDF membranes were incubated at 4 °C for 15 hours with 1:1000 dilution (200 ng/ml) of the primary antibodies for HO-I, HSP27, HSP70 or α-tubulin (TU-02). The PVDF membranes were incubated with 1:2000 dilution (100 ng/ml) of HRP (horseradish peroxidase)-conjugated secondary antibody (Santa Cruz Biotech, California, U.S.A.) for one hour at 23 °C. The immunocomplex was visualized with an ECL (enhanced chemiluminescence) detection kit (Amersham-Pharmacia Biotec, Buckinghamshire, UK) (see FIG. 7).
[60] It can be seen from FIG. 7 that revaprazan exhibits the cytoprotective effect by stimulating expression of heat-shock proteins.
[61]
[62] Example 8: Evaluation of the preventive effect of revaprazan on NSAID- induced gastropathy
[63] Six-week old specific-pathogen-free (SPF) Sprague Dawley male rats (Charles
River, Tokyo, Japan) were used for experiments. The rats were fed a sterilized commercial pellet diet (Biogenomics Co., Seoul, Korea), given sterile water ad libitum, and housed in air-conditioned biohazard room with a 12-h light: 12-h dark cycle. The rats were food-deprived 24 hours, and then administered with 5, 10 mg/kg revaprazan, 30 mg/kg rebamipide and 5 mg/kg omeprazole suspended in 0.5% CMC (carboxymethylcellulose) via oro-gastric tube prior to exposure to indomethacin (40 mg/kg for 12hrs). Phosphate-buffered saline was perfused into the gastric lumen of the rats to swell the stomachs. Then, the stomachs were opened by an incision along the greater curvature, and the total area of the gastric mucosal lesions was calculated to obtain the average size of the lesions.
[64] Comparative results of the preventive effects for gastric mucosal lesions in the control group and the test groups are shown in FIG. 8. Referring to FIG. 8, hemorrhagic lesions are observed in the control group, the omeprazole pretreatment group, and the rebamipide pretreatment group, whereas little hemorrhagic lesions are observed in the revaprazan pretreatment group. These results show that revaprazan has an excellent preventive effect on gastric mucosal lesions.
[65]
[66] Example 9: Evaluation of the treatment effect of revaprazan on NSAID- induced gastropathy
[67] Six-week old specific-pathogen-free (SPF) Sprague Dawley male rats (Charles
River, Tokyo, Japan) were used for experiments. The rats were fed a sterilized commercial pellet diet (Biogenomics Co., Seoul, Korea), given sterile water ad libitum, and housed in air-conditioned biohazard room with a 12-h light: 12-h dark cycle. The rats were food-deprived 24 hours, and then treated with 1 ml of a solution of indomethacin (40 mg/kg) in 0.5% CMC (carboxymethylcellulose) via oro-gastric tube. 8 hours after the indomethacin treatment, the rats were treated with 1 ml of a solution of revaprazan (5 mg/kg and 10 mg/kg) in 0.5% CMC for one hour, and the degree of gastropathy was determined in the same manner as in Example 8.
[68] Comparative results of the treatment effects for gastric mucosal lesions in the in- domethacin-only treatment group and the indomethacin-revaprazan treatment groups are shown in FlG. 9. Referring to FlG. 9, in the indomethacin-revaprazan treatment groups, gastric mucosal hemorrhagic lesions were remarkably improved and the number of erosions and ulcers was also reduced. These results show that revaprazan has an excellent treatment effect for gastric mucosal lesions. Industrial Applicability
[69] As described above, revaprazan or its salt has an excellent preventive or treatment effect for gastrointestinal mucosal damage by potentiating a defensive factor in the gastrointestinal mucosa, simultaneously with acting as an acid pump antagonist.

Claims

Claims
[1] A composition for preventing or treating damages of the mucosa in the gastrointestinal tracts, comprising revaprazan or a salt thereof and a pharmaceutically acceptable carrier.
[2] The composition of claim 1, wherein the salt of revaprazan is revaprazan hydrochloride.
[3] A method for preventing or treating damage to the gastric mucosa comprising administering to a human in need thereof a pharmaceutical composition comprising an effective amount for preventing or treating damage to gastric mucosa of revaprazan, or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier.
[4] A method for preventing or treating drug-induced damage to the gastric mucosa comprising administering to a human in need thereof a pharmaceutical composition comprising an effective amount for preventing or treating drug- induced damage to gastric mucosa of revaprazan, or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier.
[5] A method for preventing or treating alcohol-induced damage to the gastric mucosa comprising administering to a human in need thereof a pharmaceutical composition comprising an effective amount for preventing alcohol-induced damage to gastric mucosa of revaprazan, or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier.
[6] A method for providing cytoprotection of the gastric mucosa in a human receiving non-steroidal anti-inflammatory drugs (NSAIDs), comprising administering to the human prior to or concurrently with NSAIDs a pharmaceutical composition comprising a cytoprotectively effective amount of revaprazan, or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier.
[7] The method according to any one of claims 3 to 6, wherein the pharmaceutically acceptable salt is revaprazan hydrochloride.
[8] The method according to any one of claims 3 to 6, wherein the effective amount is about 100 mg to 300 mg per day.
[9] The method according to any one of claims 3 to 6, wherein the effective amount is about 150 mg to 250 mg per day.
[10] The method according to any one of claims 3 to 6, wherein the effective amount is about 200 mg per day.
PCT/KR2006/005044 2005-12-01 2006-11-28 Composition for preventing or treating damages of the mucosa in the gastrointestinal tracts WO2007064128A1 (en)

Priority Applications (8)

Application Number Priority Date Filing Date Title
BRPI0619081-2A BRPI0619081A2 (en) 2005-12-01 2006-11-28 composition for prevention or treatment of mucosal damage in the gastrointestinal tract and use
EP06823752A EP1954279A4 (en) 2005-12-01 2006-11-28 Composition for preventing or treating damages of the mucosa in the gastrointestinal tracts
AU2006321471A AU2006321471B2 (en) 2005-12-01 2006-11-28 Composition for preventing or treating damages of the mucosa in the gastrointestinal tracts
JP2008543190A JP5207974B2 (en) 2005-12-01 2006-11-28 Composition for prevention or treatment of gastrointestinal mucosal damage
CN200680044428XA CN101316594B (en) 2005-12-01 2006-11-28 Composition for preventing or treating damages of the mucosa in the gastrointestinal tracts
CA2631068A CA2631068C (en) 2005-12-01 2006-11-28 Composition for preventing or treating damages of the mucosa in the gastrointestinal tracts
IL191680A IL191680A0 (en) 2005-12-01 2008-05-25 Pharmaceutical compositions containing revaprazen or a salt thereof
HK09101447.8A HK1123507A1 (en) 2005-12-01 2009-02-16 Composition for preventing or treating damages of the mucosa in the gastrointestinal tracts

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
KR20050116567 2005-12-01
KR10-2005-0116567 2005-12-01

Publications (1)

Publication Number Publication Date
WO2007064128A1 true WO2007064128A1 (en) 2007-06-07

Family

ID=38092428

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/KR2006/005044 WO2007064128A1 (en) 2005-12-01 2006-11-28 Composition for preventing or treating damages of the mucosa in the gastrointestinal tracts

Country Status (15)

Country Link
US (1) US7776873B2 (en)
EP (1) EP1954279A4 (en)
JP (1) JP5207974B2 (en)
KR (1) KR100805660B1 (en)
CN (2) CN102309490A (en)
AU (1) AU2006321471B2 (en)
BR (1) BRPI0619081A2 (en)
CA (1) CA2631068C (en)
CR (1) CR10018A (en)
EC (1) ECSP088545A (en)
HK (1) HK1123507A1 (en)
IL (1) IL191680A0 (en)
MY (1) MY145406A (en)
WO (1) WO2007064128A1 (en)
ZA (1) ZA200805747B (en)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2008078922A1 (en) * 2006-12-22 2008-07-03 Yuhan Corporation Revaprazan-containing solid dispersion and process for the preparation thereof
WO2011004882A1 (en) 2009-07-09 2011-01-13 ラクオリア創薬株式会社 Acid pump antagonist for treatment of diseases associated with abnormal gastrointestinal movement
WO2012108631A2 (en) * 2011-02-11 2012-08-16 Yuhan Corporation Pharmaceutical compositions comprising revaprazan-containing nanoparticles and processes for the preparation thereof
WO2012161448A1 (en) * 2011-05-20 2012-11-29 Yuhan Corporation Pharmaceutical composition for oral administration in form of suspension comprising revaprazan or its salt
US10835541B2 (en) 2015-07-30 2020-11-17 Takeda Pharmaceutical Company Limited Tablet

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN105998688A (en) * 2016-06-22 2016-10-12 郑亮 Restraining method for gastric mucosal damage
KR20180107341A (en) * 2017-03-16 2018-10-02 차의과학대학교 산학협력단 Composition for the treatment and prevention of Leaky Gut Syndrome comprising Potassium-Competitive Acid Blocker as active component

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1996005177A1 (en) * 1994-08-13 1996-02-22 Yuhan Corporation Novel pyrimidine derivatives and processes for the preparation thereof
WO1997042186A1 (en) 1996-05-04 1997-11-13 Yuhan Corporation Process for preparation of pyrimidine derivatives
WO1998018784A1 (en) 1996-10-29 1998-05-07 Yuhan Corporation Process for preparation of pyrimidine derivatives
US20050249811A1 (en) * 2001-06-01 2005-11-10 Pozen Inc. Pharmaceutical compositions for the coordinated delivery of NSAIDs

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
NZ235877A (en) * 1989-11-02 1992-09-25 Mcneil Ppc Inc Composition comprising acetaminophen or nsaid and an h 1 or h 2 receptor blocker and/or proton pump inhibitor for treating overindulgence
CN1088706C (en) * 1996-10-25 2002-08-07 卫福有限公司 Novel heterocyclic amide compound and medical use thereof
GB0110338D0 (en) * 2001-04-27 2001-06-20 Sb Pharmco Inc Novel processes

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1996005177A1 (en) * 1994-08-13 1996-02-22 Yuhan Corporation Novel pyrimidine derivatives and processes for the preparation thereof
WO1997042186A1 (en) 1996-05-04 1997-11-13 Yuhan Corporation Process for preparation of pyrimidine derivatives
WO1998018784A1 (en) 1996-10-29 1998-05-07 Yuhan Corporation Process for preparation of pyrimidine derivatives
US20050249811A1 (en) * 2001-06-01 2005-11-10 Pozen Inc. Pharmaceutical compositions for the coordinated delivery of NSAIDs

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See also references of EP1954279A4

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2008078922A1 (en) * 2006-12-22 2008-07-03 Yuhan Corporation Revaprazan-containing solid dispersion and process for the preparation thereof
US8663658B2 (en) 2006-12-22 2014-03-04 Yuhan Corporation Revaprazan-containing solid dispersion and process for the preparation thereof
WO2011004882A1 (en) 2009-07-09 2011-01-13 ラクオリア創薬株式会社 Acid pump antagonist for treatment of diseases associated with abnormal gastrointestinal movement
WO2012108631A2 (en) * 2011-02-11 2012-08-16 Yuhan Corporation Pharmaceutical compositions comprising revaprazan-containing nanoparticles and processes for the preparation thereof
WO2012108631A3 (en) * 2011-02-11 2012-10-26 Yuhan Corporation Pharmaceutical compositions comprising revaprazan-containing nanoparticles and processes for the preparation thereof
KR101730865B1 (en) 2011-02-11 2017-04-27 주식회사유한양행 Pharmaceutical compositions comprising revaprazan-containing nanoparticles and processes for the preparation thereof
WO2012161448A1 (en) * 2011-05-20 2012-11-29 Yuhan Corporation Pharmaceutical composition for oral administration in form of suspension comprising revaprazan or its salt
US10835541B2 (en) 2015-07-30 2020-11-17 Takeda Pharmaceutical Company Limited Tablet

Also Published As

Publication number Publication date
KR100805660B1 (en) 2008-02-21
CN101316594B (en) 2012-07-25
HK1123507A1 (en) 2009-06-19
ECSP088545A (en) 2008-08-29
JP5207974B2 (en) 2013-06-12
JP2009517462A (en) 2009-04-30
ZA200805747B (en) 2009-11-25
AU2006321471A1 (en) 2007-06-07
BRPI0619081A2 (en) 2011-09-20
US20070129391A1 (en) 2007-06-07
CR10018A (en) 2008-09-02
MY145406A (en) 2012-02-15
EP1954279A4 (en) 2009-06-03
CA2631068A1 (en) 2007-06-07
IL191680A0 (en) 2009-08-03
KR20070057663A (en) 2007-06-07
US7776873B2 (en) 2010-08-17
CN101316594A (en) 2008-12-03
CA2631068C (en) 2011-01-11
CN102309490A (en) 2012-01-11
AU2006321471B2 (en) 2010-07-29
EP1954279A1 (en) 2008-08-13

Similar Documents

Publication Publication Date Title
CA2631068C (en) Composition for preventing or treating damages of the mucosa in the gastrointestinal tracts
US8507555B2 (en) Non-toxic anti-cancer drug combining ascorbate, magnesium and a naphthoquinone
HU230982B1 (en) Pharmaceutical compositions containing an alpha-adrenergic antagonist and darifenacin useful for treatment of lower urinary tract symptoms
RU2640180C2 (en) Method for adjuvant therapy of cancer
Isacoff et al. Phase II clinical trial with high-dose methotrexate therapy and citrovorum factor rescue
JP2009532479A (en) Simultaneous administration of adenosine A1 receptor antagonist and anticonvulsant
US20070293518A1 (en) Prolonged improvement of renal function comprising infrequent administration of an aa1ra
WO2017006254A1 (en) Drug combination comprising an angiotensin ii receptor antagonist, a neutral endopeptidase inhibitor and a mineralcorticoid receptor antagonist
JP4841433B2 (en) Therapeutic treatment
AU2004216133B2 (en) Adenosine A1 receptor antagonist for the treatment of cardiac and renal diseases
US20090215791A1 (en) New therapeutic use of 4-(2-fluorophenyl)-6-methyl-2-(1-piperazinyl)thieno[2,3-d]pyrimidine
JP2012505925A (en) Therapeutic compositions and methods for treating chronic kidney disease associated with metabolic imbalance
US6462021B1 (en) Use of low molecular weight thrombin inhibitor
TW201242597A (en) A synergistic pharmaceutical combination for the treatment of pancreatic cancer
US20040092563A1 (en) Angiotensin II antagonists
KR101351682B1 (en) Compositions for treatment of systemic mastocytosis
CN110831597A (en) Treatment of hepatocellular carcinoma
US20240285583A1 (en) Pharmaceutical composition comprising 1-(3-cyano-1-isopropyl-indol-5-yl)pyrazole-4-carboxylic acid
Juan et al. A6702 Dose-and time-effect relationship and mechanisms of proliferation of rat vascular smooth muscle cells stimulated by high sodium
KR20060061399A (en) Novel association consisting of an anti-atherothrombotic agent and of a platelet antiaggregating agent
IL120271A (en) Pharmaceutical composition comprising a sorbitol dehydrogenase inhibitor for reducing tissue damage associated with ischemia
Warnock et al. Hypertension
Seedat Current concepts in the treatment of hypertension
Alivernini et al. NSAIDs in rheumatoid arthritis today
Graham Clinical aspects of the protective effects of prostaglandins on non-steroidal anti-inflammatory drug-associated mucosal injury

Legal Events

Date Code Title Description
WWE Wipo information: entry into national phase

Ref document number: 200680044428.X

Country of ref document: CN

121 Ep: the epo has been informed by wipo that ep was designated in this application
WWE Wipo information: entry into national phase

Ref document number: 2006823752

Country of ref document: EP

WWE Wipo information: entry into national phase

Ref document number: 191680

Country of ref document: IL

WWE Wipo information: entry into national phase

Ref document number: 2008543190

Country of ref document: JP

Ref document number: 2631068

Country of ref document: CA

Ref document number: CR2008-010018

Country of ref document: CR

WWE Wipo information: entry into national phase

Ref document number: MX/a/2008/006794

Country of ref document: MX

WWE Wipo information: entry into national phase

Ref document number: 12008501272

Country of ref document: PH

WWE Wipo information: entry into national phase

Ref document number: 2008060908

Country of ref document: EG

NENP Non-entry into the national phase

Ref country code: DE

WWE Wipo information: entry into national phase

Ref document number: 08056424

Country of ref document: CO

WWE Wipo information: entry into national phase

Ref document number: 2006321471

Country of ref document: AU

WWE Wipo information: entry into national phase

Ref document number: 5306/DELNP/2008

Country of ref document: IN

ENP Entry into the national phase

Ref document number: 2006321471

Country of ref document: AU

Date of ref document: 20061128

Kind code of ref document: A

ENP Entry into the national phase

Ref document number: PI0619081

Country of ref document: BR

Kind code of ref document: A2

Effective date: 20080602